: Background and objectives: Patients with follicular lymphoma (FL) in advanced stages are currently deemed incurable with standard treatments. However, FL is considered to be eradicable in the ...small group of patients presenting with localized disease. The objective of this study was to analyze the clinical features and the outcome of a series of patients with FL in early stages with a long follow‐up.Patients and methods: A total of 48 patients (25m/23f; median age: 50 yr) diagnosed consecutively with FL in Ann Arbor stage I (25 cases) or II (23) at a single institution with a median follow‐up of 9.5 yr were included in the study. Main biological and clinical characteristics at diagnosis, including Follicular Lymphoma International Prognostic Index (FLIPI) were analyzed; treatment and response were assessed and analyzed for prognosis.Results: The histologic subtypes were: FL type I, 20 cases (42%); type II, 24 (50%); type III, three (6%); and unclassifiable, one (2%). Distribution according to FLIPI was: low risk (36 cases) and intermediate risk (five cases). Treatment mainly consisted of combination chemotherapy (CHOP in 34 cases) plus involved‐field radiotherapy in 26 cases. Forty patients (89%) achieved a complete response (CR), three (7%) a partial response, and two (4%) were non‐responders; the remaining three patients did not receive therapy. No initial variable predicted CR achievement. About 57% of the patients in CR eventually relapsed with a relapse risk of 46% at 10 yr. Intermediate‐risk FLIPI predicted failure‐free survival. Histologic transformation was observed in six patients with a 10‐yr risk of transformation of 13%. Twelve patients died during follow‐up, in two cases as a result of unrelated causes. Overall survival (OS) at 10 yr was 79%. The FLIPI was the sole variable predicting OS.Conclusions: Although the majority of patients with localized FL achieve CR, the risk of relapse is high. The FLIPI is of prognostic value in these patients.
Objective
To compare the efficacy and safety of CD34+ selected ex vivo T‐cell depletion (TCD) vs post‐transplant cyclophosphamide, sirolimus, and mycophenolate mofetil (PTCy‐Sir‐MMF) as graft‐vs‐host ...disease (GVHD) prophylaxis.
Methods
We retrospectively included patients who underwent allogeneic hematopoietic stem cell transplantation (allo‐HSCT) with either TCD (n = 38) or PTCy‐Sir‐MMF (n = 91).
Results
Cumulative incidence of neutrophil and platelet recovery was 92% vs 99% (P = .06) and 89% vs 97% (P = .3) in TCD and PTCy‐Sir‐MMF, respectively. Cumulative incidences of aGHVD grade II‐IV, III‐IV, and moderate to severe cGVHD were 11% vs 19% (P = .2), 3% vs 2% (P = .9), and 3% vs 36% (P < .001) in TCD and PTCy‐Sir‐MMF, respectively. The 2‐year non‐relapse mortality, relapse, disease‐free and overall survival were 25% vs 8% (P = .01), 20% vs 16% (P = .2), 55% vs 76% (P = .004), 57% vs 83% (P = .004) for TCD and PTCy‐Sir‐MMF, respectively. Cumulative incidence of cytomegalovirus and Epstein‐Barr infection requiring therapy was 76% vs 40% (P < .001) and 32% vs 0% (P < .001) in TCD and PTCy‐Sir‐MMF, respectively. PTCy‐Sir‐MMF platform showed faster T‐cell reconstitution.
Conclusions
PTCy‐Sir‐MMF provides better survival outcomes but is associated with higher risk of cGVHD compared to TCD.
Thrombotic microangiopathy (TMA) is an important complication associated with several diseases that are rare and life-threatening. TMA is common to thrombotic thrombocytopenic purpura (TTP) and ...hemolytic uremic syndrome (HUS). TTP is defined by a severe deficiency of ADAMTS13, and early treatment is associated with good prognosis. The diagnosis of HUS can be difficult due to the potential multiple etiologies, and the best treatment option in most cases is not well-established yet. The implementation of a multidisciplinary team (MDT) could decrease the time to diagnosis and treatment for HUS and may improve the outcomes of these patients.
To determine the impact of MDT on morbidity and mortality death or chronic renal replacement therapy (CRRT) requirements, incidence and response time (RT) defined as the period between hospital admission and the first day of direct therapy administration, length of stay at an intensive care unit (ICU-LOS) and total hospitalization (T-LOS) were also assessed.
We compared a pre-MDT implementation period (from January/2008 to May/2016) versus post-MDT period (from May/2016 to December/2016). The screening TMA diagnosis was made according the following criteria: hemolytic anemia, thrombocytopenia and acute renal damage and without ADAMTS13 deficiency. An online chat was implemented to provide instant medical information.
Twenty-eight patients were included. The incidence changed from 2.3 cases/pre-MDT: (all cases: n = 18) to 10 cases/year post-MDT (all cases: n = 10). Two patients died in pre-MDT and post- MDT (11% versus 20%, P = 0.60). From pre-MDT, the number of patients who required CRRT by post-MDT decreased from 7 (39%) to 0, P = 0.03. Similarly, RT, ICU-LOS and T-LOS median(p25-p75) decreased from 10 (2-12) days to 0.5 (0-1.5) days, P = 0.04, from 16 (9-30) days to 10 (4-13) days, P = 0.01 and from 33 (22-53) days to 16 (12-32) days, P < 0.01, respectively.
MDT implementation was associated with a greater number of patients who meet TMA criteria. A decrease in the RT and T-LOS periods were observed and associated with better outcomes in these patients.
In the mammalian telencephalon, part of the progenitor cells transition from multipolar to bipolar morphology as they invade the mantle zone. This associates with changing patterns of radial ...migration. However, the molecules implicated in these morphology transitions are not well known. In the present work, we analyzed the function of FoxP2 protein in this process during telencephalic development in vertebrates. We analyzed the expression of FoxP2 protein and its relation with cell morphology and migratory patterns in mouse and chicken developing striatum. We observed FoxP2 protein expressed in a gradient from the subventricular zone to the mantle layer in mice embryos. In the FoxP2 low domain cells showed multipolar migration. In the striatal mantle layer where FoxP2 protein expression is higher, cells showed locomoting migration and bipolar morphology. In contrast, FoxP2 showed a high and homogenous expression pattern in chicken striatum, thus bipolar morphology predominated. Elevation of FoxP2 in the striatal subventricular zone by in utero electroporation promoted bipolar morphology and impaired multipolar radial migration. In mouse cerebral cortex we obtained similar results. FoxP2 promotes transition from multipolar to bipolar morphology by means of gradiental expression in mouse striatum and cortex. Together these results indicate a role of FoxP2 differential expression in cell morphology control of the vertebrate telencephalon.
The SARS-CoV-2 pandemic has had a great impact on the physical and psychological health of the population. The aim of our study was to assess child and adolescent mental health in a cohort throughout ...the 2020-2021 school year.
We conducted a longitudinal prospective study in a cohort of children aged 5 to 14 years in Catalonia, Spain, from September 2020 to July 2021. Participants were randomly selected and followed up by their primary care paediatricians. The risk of mental health problems was assessed with the Strengths and Difficulties Questionnaire (SDQ), completed by one of the legal guardians of the child. In addition, we obtained information on the sociodemographic and health characteristics of the participants and their nuclear families. We collected the data by means of an online survey through the REDCap platform at the beginning of the academic year and at the end of each term (4 time points).
At the beginning of the school year, 9.8% of participants were cases of probable psychopathology compared to 6.2% at the end of the year. The perceived level of worry of the children for their own health and the health of their families was associated with the presence of psychopathology, especially at the beginning of the year, while the perception of a good family atmosphere was consistently associated with a decreased risk. No variable related to COVID-19 was associated with abnormal results in the SDQ.
During the 2020-2021 school year, the percentage of children with probable psychopathology decreased from 9.8% to 6.2%.
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La pandemia por SARS-CoV-2 ha tenido un alto impacto en la salud física y psicológica de la población. Nuestro objetivo fue evaluar la salud mental infanto-juvenil de una cohorte ...poblacional a lo largo del curso 2020-2021.
Estudio longitudinal y prospectivo de una cohorte de niños escolarizados entre 5 y 14años en Cataluña entre septiembre de 2020 y julio de 2021. Los participantes fueron seleccionados de forma aleatoria y seguidos por el pediatra de referencia en la atención primaria. La evaluación del riesgo de psicopatología fue realizada a través del Strengths and Difficulties Questionnaire (SDQ), contestada por un tutor legal del niño. Fueron recogidas también variables sociodemográficas y de salud del individuo y su núcleo de convivencia. Los datos fueron recogidos mediante una encuesta on-line a través de la plataforma RedCap al inicio del curso y al final de cada trimestre (4cortes).
Al inicio del curso escolar el 9,8% de los alumnos fueron casos probables de psicopatología, frente al 6,2% de final de curso. La percepción del nivel de preocupación de los niños por su salud y la de su familia se relacionó con presentar psicopatología, especialmente al inicio del curso, mientras que la percepción de un buen ambiente familiar se relacionó en todo momento con menor riesgo. Ninguna variable relacionada con la COVID-19 se asoció con resultado alterado del SDQ.
A lo largo del curso escolar 2020-2021 el porcentaje de niños con probabilidad de presentar psicopatología mejoró, y pasó del 9,8% al 6,2%.
The SARS-CoV-2 pandemic has had a great impact on the physical and psychological health of the population. The aim of our study was to assess child and adolescent mental health in a cohort throughout the 2020-2021 school year.
We conducted a longitudinal prospective study in a cohort of children aged 5 to 14 years in Catalonia, Spain, from September 2020 to July 2021. Participants were randomly selected and followed up by their primary care paediatricians. The risk of mental health problems was assessed with the Strengths and Difficulties Questionnaire (SDQ), completed by one of the legal guardians of the child. In addition, we obtained information on the sociodemographic and health characteristics of the participants and their nuclear families. We collected the data by means of an online survey through the REDCap platform at the beginning of the academic year and at the end of each term (4 time points).
At the beginning of the school year, 9.8% of participants were cases of probable psychopathology compared to 6.2% at the end of the year. The perceived level of worry of the children for their own health and the health of their families was associated with the presence of psychopathology, especially at the beginning of the year, while the perception of a good family atmosphere was consistently associated with a decreased risk. No variable related to COVID-19 was associated with abnormal results in the SDQ.
During the 2020-2021 school year, the percentage of children with probable psychopathology decreased from 9.8% to 6.2%.
Display omitted
The SARS-CoV-2 pandemic has had a great impact on the physical and psychological health of the population. The aim of this study was to evaluate child and adolescent mental health in ...a population cohort along the 2020–2021 school year.
This was a prospective longitudinal study of a cohort of children from 5–14 years of age in Catalonia, Spain, performed from September 2020 to July 2021. The participants were randomly selected and accompanied by their primary care paediatrician. Evaluation of risk of psychopathology was performed using the Strengths and Difficulties Questionnaire (SDQ) carried out by one of the legal guardians of the child. We also collected sociodemographic and health variables of the participants and their nuclear family. Data were collected by an online survey through the RedCap platform at the beginning of the academic year and at the end of each trimester (4 cuts).
At the beginning of the school year, 9.8% of the patients were probable cases of psychopathology compared to 6.2% at the end of the year. The perception of the level of preoccupation of the children for their health and that of their family was related to presenting psychopathology, especially at the beginning of the year, with the perception of a good family atmosphere being always related to lower risk. No variable related to COVID-19 was associated with an altered SDQ result.
Along the 2020–2021 school year, the percentage of children with a probability of presenting psychopathology decreased from 9.8% to 6.2%.
La pandemia por SARS-CoV-2 ha tenido un alto impacto en la salud física y psicológica de la población. Nuestro objetivo fue evaluar la salud mental infanto-juvenil de una cohorte poblacional a lo largo del curso 2020-21.
estudio longitudinal y prospectivo de una cohorte de niños escolarizados entre 5 y 14 años en Cataluña entre septiembre 2020 y julio 2021. Los participantes fueron seleccionados de forma aleatoria y seguidos por el pediatra de referencia en la atención primaria. La evaluación del riesgo de psicopatología fue realizada a través del cuestionario Strengths and Difficulties Questionnaire (SDQ) contestada por un tutor legal del niño. Fueron recogidas también variables sociodemográficas y de salud del individuo y su núcleo de convivencia. Los datos fueron recogidos mediante una encuesta on line a través de la plataforma RedCap al inicio del curso y al final de cada trimestre (4 cortes).
Al inicio del curso escolar el 9,8% de los pacientes fueron casos probables de psicopatología, frente al 6,2% de final de curso. La percepción del nivel de preocupación de los niños por su salud y la de su familia se relacionó con presentar psicopatología, especialmente al inicio del curso, mientras que la percepción de un buen ambiente familiar se relacionó en todo momento con menor riesgo. Ninguna variable relacionada con el COVID-19 se asoció con resultado alterado del SDQ.
A lo largo del curso escolar 2020-2021 el porcentaje de niños con probabilidad de presentar psicopatología mejoró y pasó del 9,8% al 6,2%.
Abstract
BACKGROUND: In early-stage triple negative breast cancer (TNBC), the addition of carboplatin (CBDCA) to neoadjuvant chemotherapy (CT) increases pathologic complete response (pCR) and ...relapsed-free survival. However, it is unclear whether CBDCA improves overall survival (OS). In addition, the prognostic and/or predictive role of pathogenic germline variants (PGV) in BRCA1/2 genes and other cancer risk in this setting is not fully understood. Here, we assessed the efficacy of (neo)adjuvant CBDCA and the prognostic and predictive role of a panel of 14 genes in patients (pts) with eTNBC.
METHODS: This is a retrospective study on 117 pts diagnosed with early-stage TNBC between 2000-2021 at Hospital Clinic of Barcelona. Eighty-one pts (69%) were candidates for PGV testing. Overall, 14 genes (PGV) (BRCA1, BRCA2, PALB2, BRIP1, CHEK2, TP53, ATM, RAD51C, RAD51D, BARD1, MLH1, MSH2, MSH6 and PMS2) were assessed using the TruSight hereditary cancer panel (Illumina MySeq platform) according to local guidelines. Univariable and multivariable logistic regression and Cox regression analyses were performed to identify clinical and molecular predictors of pCR and relapse-free survival (RFS), respectively. Chi-squared or Fisher’s exact tests were used to assess characteristics’ distribution as appropriate.
RESULTS: Of 117 pts, 83 (71%) received CT in the neoadjuvant setting and 28 (24%) in the adjuvant setting. CBDCA was added to standard CT in 68 pts (82%) in the neoadjuvant cohort and 7 pts (6%) in the adjuvant cohort. Among pts with germline testing, 32/81 (39%) harbored PGV. BRCA1 was the most frequently mutated gene (18/32, 56%), followed by BRCA2 (5/32, 16%), PALB2 (4/32, 13%), BRIP1 (2/32, 6%), CHEK2, TP53 and PMS2 (3/32, 6%). Percentages of pts receiving CBDCA were similar between patients with and without PGV (14/16,87% and wild type (53/67,79%)(p=0.120). In the neoadjuvant cohort (n=83), CBDCA was the only variable significantly associated with pCR at both univariate (pCR rates of 58.5% with CBCDA and 14.3% without CBCDA; odds ratio OR=8.2 95% CIs 2.0-55.7, p=0.008) and remained statistically significant after adjusting for PGV, tumor size and nodal status (OR=6.9 95% CIs 1.4-53.0, p=0.028). pCR rates according to PGV are reported in Table 1. In terms of RFS, addition of CBDCA to neoadjuvant therapy (hazard ratio HR=0.2 0.1-0.45, p< 0.001), PGV (HR=0.2 0.05-0.9, p=0.048), pCR (HR=0.2 0.1-0.6, p=0.004) and nodal status (HR=5.1 1.7-15.2, p< 0.003) were significantly associated with RFS in univariate analyses. In a multivariable model, CBDCA remained an independent predictor of improved RFS along with pCR. When the neoadjuvant and adjuvant cohort were pooled together (n=117), platinum-based CT remained significantly associated with better RFS (HR=0.2 0.14-0.86, p=0.021) regardless of time of administration (i.e., neoadjuvant or adjuvant). With a median follow-up of 5 years, CBCDA use was not found associated with OS (HR=0.7 0.3-1.8, p= 0.560).
CONCLUSIONS: The addition of CBDCA to standard CT was significantly associated with pCR and RFS but not OS, consistent with the phase III data. The benefit in terms of RFS was independent of the presence and the type of pathogenic germline alterations.
Table 1. pCR rates according to PGV
Citation Format: Adela Rodríguez Hernández, Benedetta Conte, Laia Fernández, Fara Brasó-Maristany, Belén Pastor, Miriam Potrony, Lorena Moreno, Elia Grau, Joan Antón Puig-Butillé, Aurora Sánchez, Blanca González-Farré, Esther Sanfeliu, Olga Martínez-Sáez, Claudette Falato, Maria Vidal, Nuria Chic, Tomás Pascual, Francesco Schettini, Montserrat Muñoz, Francesc Balaguer, Aleix Prat, Barbara Adamo. Efficacy of platinum-based chemotherapy and germline mutational status in early-stage triple-negative breast cancer: a unicenter retrospective analysis with long-term follow-up abstract. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P6-01-09.
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