Anemia is a frequent manifestation of myelofibrosis (MF) and there is an unmet need for effective treatments in anemic MF patients. The REALISE phase 2 study (NCT02966353) evaluated the efficacy and ...safety of a novel ruxolitinib dosing strategy with a reduced starting dose with delayed up-titration in anemic MF patients. Fifty-one patients with primary MF (66.7%), post-essential thrombocythemia MF (21.6%), or post-polycythemia vera MF (11.8%) with palpable splenomegaly and hemoglobin <10 g/dl were included. Median age was 67 (45-88) years, 41.2% were female, and 18% were transfusion-dependent. Patients received 10 mg ruxolitinib b.i.d. for the first 12 weeks, then up-titrations of up to 25 mg b.i.d. were permitted, based on efficacy and platelet counts. Overall, 70% of patients achieved a ≥50% reduction in palpable spleen length at any time during the study. The most frequent adverse events leading to dose interruption/adjustment were thrombocytopenia (17.6%) and anemia (11.8%). Patients who had a dose increase had greater spleen size and higher white blood cell counts at baseline. Median hemoglobin levels remained stable and transfusion requirements did not increase compared with baseline. These results reinforce the notion that it is unnecessary to delay or withhold ruxolitinib because of co-existent or treatment-emergent anemia.
Tyrosine kinase inhibitor therapy revolutionized chronic myeloid leukemia treatment and showed how targeted therapy and molecular monitoring could be used to substantially improve survival outcomes. ...We used chronic myeloid leukemia as a model to understand a critical question: why do some patients have an excellent response to therapy, while others have a poor response? We studied gene expression in whole blood samples from 112 patients from a large phase III randomized trial (clinicaltrials gov. Identifier: NCT00471497), dichotomizing cases into good responders (BCR::ABL1 ≤10% on the International Scale by 3 and 6 months and ≤0.1% by 12 months) and poor responders (failure to meet these criteria). Predictive models based on gene expression demonstrated the best performance (area under the curve =0.76, standard deviation =0.07). All of the top 20 pathways overexpressed in good responders involved immune regulation, a finding validated in an independent data set. This study emphasizes the importance of pretreatment adaptive immune response in treatment efficacy and suggests biological pathways that can be targeted to improve response.
Philadelphia chromosome‐negative (Ph−) myeloproliferative neoplasms (MPNs) are a heterogeneous group of clonal disorders of the bone marrow, and are associated with a high disease burden, reduced ...quality of life (QOL), and shortened survival. This multinational, multicenter, non‐interventional registry “MERGE” was initiated with an objective to collect data on the epidemiological indices of classical Ph‐MPNs, existing treatment patterns, and impact of MPNs on health‐related QOL in various countries/regions in Asia, including the Middle East, Turkey, and Algeria. Of the 884 eligible patients with MPNs, 169 had myelofibrosis (MF), 301 had polycythemia vera (PV), 373 had essential thrombocythemia (ET), and 41 had unclassified MPNs. The median age was 58 years (range, 47‐66 years), and 50% of patients were males. The prevalence and incidence of MPNs were estimated to be 57‐81 and 12‐15 per 100 000 hospital patients per year over the last 4 years, respectively, in these countries. Total symptom score (mean standard deviation; SD) at baseline was highest in patients with MF (23.5 17.47) compared with patients with ET (14.6 14.26) and PV (16.6 14.84). Patients with ET had a lower mean (SD) number of inpatient visits (0.9 0.77 days), and patients with MF had more outpatient visits (5.2 3.17 days) on an average, compared with the entire MPN group. The study showed that patients with MPNs have a severe disease burden and reduced QOL. A discordance between physician and patient perception of symptom assessment was observed in this study (International clinical trials registry ID: CTRI/2014/05/004598).
This MERGE registry study provides epidemiological data on the distribution of MPNs and their diagnosis, management, and treatment patterns in developing emerging countries in Asia, including the Middle East, Turkey, and Algeria. The study showed that patients with MPNs have a severe disease burden and reduced quality of life. A discordance between physician and patient perception of symptom assessment was observed in this study.
Securing IoT Devices using Blockchain Concept Sadek, Islam M. Momtaz A.; Ilyas, Muhammed
2021 International Conference on Engineering and Emerging Technologies (ICEET),
2021-Oct.-27
Conference Proceeding
The internet of things (IoT) implementation leads to an extended attack surface that requires continuous mitigation of security. Mission-critical situations (e.g., Smart Grid, Intelligent ...Transportation Systems, video surveillance, e-health) to business-oriented applications are all examples of IoT applications (e.g., banking, logistics, insurance, and contract law). IoT has made human existence considerably easier and more efficient. Because IoT devices are less expensive to build due to the use of various software, sensors, and the use of Artificial Intelligence, they violate several security regulations. That's why, in the IoT systems; extensive security support is required, particularly for mission-critical applications, but also for downstream commercial applications. There have been a variety of security strategies and approaches suggested and/or used. Blockchain is an amazing concept that manages a distributed ecosystem without the need for a third party. Researchers discovered that it has the ability to solve IoT software-related security problems. The biggest obstacle is combining blockchain with resource-constrained IoT computers. An experimental setup to incorporate blockchain on a smart laboratory IoT -based was completed, and then tested against Wireshark sniffing attacks, the system was more vulnerable to cyber-crimes attacks as we found out that when we employed blockchain technology as the communication medium of IoT devices, the no. of bytes needed for packet transmission was more than the bytes needed without applying Blockchain with about 959 bytes on average.
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