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Mizumaki H, Ishiyama K, Aoki J, Mori J, Mizuno S, Doki N, Fukuda T, Uchida N, Onizuka M, Tanaka M, Katayama Y, Ozawa Y, Ikegame K, Takada S, Kawakita T, Aotsuka N, Atsuta Y, Yanada M. Outcomes after allogeneic hematopoietic stem cell transplantation in acute myeloid leukemia patients with der(1;7)(q10;p10). EJHAEM 2022; 4:251-257. [PMID: 36819182 PMCID: PMC9928652 DOI: 10.1002/jha2.609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 10/20/2022] [Indexed: 11/09/2022]
Abstract
The prognosis of acute myeloid leukemia (AML) patients with der(1;7)(q10;p10) who underwent allogeneic hematopoietic stem cell transplantation (allo-SCT) is unclear due to its rarity. We retrospectively analyzed 151 AML patients with der(1;7)(q10;p10) and compared the findings with those of 853 AML patients with monosomy 7 or chromosome 7q deletion (-7/del(7q)) using Japanese nationwide registry data. The der(1;7)(q10;p10) group showed significantly better transplant outcomes than the -7/del(7q) group. In the multivariate analysis of the der(1;7)(q10;p10) group, additional chromosomal abnormalities and a poor performance status significantly influenced the survival. In conclusion, allo-SCT is a feasible treatment option for AML patients with der(1;7)(q10;p10).
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Affiliation(s)
- Hiroki Mizumaki
- Department of HematologyKanazawa University HospitalKanazawaJapan
| | - Ken Ishiyama
- Department of HematologyKanazawa University HospitalKanazawaJapan
| | - Jun Aoki
- Department of Hematopoietic Stem Cell TransplantationNational Cancer Center HospitalTokyoJapan
| | - Jinichi Mori
- Department of HematologyJyoban Hospital of Tokiwa FoundationFukushimaJapan
| | - Shohei Mizuno
- Division of HematologyDepartment of Internal MedicineAichi Medical UniversityNagakuteJapan
| | - Noriko Doki
- Hematology DivisionTokyo Metropolitan Cancer and Infectious Diseases CenterKomagome HospitalTokyoJapan
| | - Takahiro Fukuda
- Department of Hematopoietic Stem Cell TransplantationNational Cancer Center HospitalTokyoJapan
| | - Naoyuki Uchida
- Department of HematologyFederation of National Public Service Personnel Mutual Aid Associations Toranomon HospitalTokyoJapan
| | - Masahito Onizuka
- Department of Hematology and OncologyTokai University School of MedicineIseharaJapan
| | | | - Yuta Katayama
- Department of HematologyHiroshima Red Cross Hospital and Atomic‐bomb Survivors HospitalHiroshimaJapan
| | - Yukiyasu Ozawa
- Department of HematologyJapanese Red Cross Aichi Medical Center Nagoya Daiichi HospitalNagoyaJapan
| | - Kazuhiro Ikegame
- Department of HematologyHyogo Medical University HospitalHyogoJapan
| | - Satoru Takada
- Leukemia Research CenterSaiseikai Maebashi HospitalMaebashiJapan
| | - Toshiro Kawakita
- Department of HematologyNational Hospital Organization Kumamoto Medical CenterKumamotoJapan
| | - Nobuyuki Aotsuka
- Division of Hematology‐OncologyJapanese Red Cross Society Narita HospitalNaritaJapan
| | - Yoshiko Atsuta
- Japanese Data Center for Hematopoietic Cell TransplantationNagoyaJapan,Department of Registry Science for Transplant and Cellular TherapyAichi Medical University School of MedicineNagakuteJapan
| | - Masamitsu Yanada
- Department of Hematology and Cell TherapyAichi Cancer CenterNagoyaJapan
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2
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França IGDF, Melo MMLD, Teixeira MSC, Cordeiro JVA, Borges DDP, Oliveira RTGD, Furtado SR, Magalhães SMM, Pinheiro RF. Role of conventional cytogenetics in sequential karyotype analysis of myelodysplastic syndrome: a patient with der(1;7)(q10;p10). Hematol Transfus Cell Ther 2019; 41:91-94. [PMID: 30793111 PMCID: PMC6371229 DOI: 10.1016/j.htct.2018.05.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 05/23/2018] [Indexed: 12/02/2022] Open
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3
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Clinical impact of the loss of chromosome 7q on outcomes of patients with myelodysplastic syndromes treated with allogeneic hematopoietic stem cell transplantation. Bone Marrow Transplant 2019; 54:1471-1481. [PMID: 30718803 DOI: 10.1038/s41409-019-0469-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Revised: 01/21/2019] [Accepted: 01/22/2019] [Indexed: 12/16/2022]
Abstract
We conducted a nationwide retrospective study to evaluate the prognostic influence of +1, der(1;7)(q10;p10) [hereafter der(1;7)] and -7/del(7q) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) for de novo myelodysplastic syndromes (MDS). In this database, 69 MDS patients with der(1;7), 75 with -7/del(7q), and 511 with normal karyotype (NK) underwent allo-HSCT at advanced disease status. The 3-year overall survival (OS) and cumulative incidence of relapse (CIR) were 50.4 and 19.4% for those with der(1;7), 36.2 and 38.4% for -7/del(7q), and 51.1 and 20.7% for NK, respectively. In the multivariate analysis, the presence of -7/del(7q) correlated with a significantly shorter OS (HR [95% CI], 1.38 [1.00-1.89]; P = 0.048) and higher CIR (HR, 2.11 [1.36-3.28]; P = 0.001) than those with NK. There were 23 patients with der(1;7), 29 with -7/del(7q), and 347 with NK who underwent allo-HSCT at early disease status. The 3-year OS and CIR were as follows: 47.3 and 9.5% for the der(1;7) group, 70.5 and 13.8% for -7/del(7q), and 70.9 and 5.6% for NK, respectively. No significant differences were observed in OS and CIR among three groups. The impact of the loss of chromosome 7q on OS and CIR may differ based on its type and disease status after allo-HSCT for MDS.
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4
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Rare cytogenetic abnormalities in myelodysplastic syndromes. Mediterr J Hematol Infect Dis 2015; 7:e2015034. [PMID: 25960862 PMCID: PMC4418404 DOI: 10.4084/mjhid.2015.034] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Accepted: 04/20/2015] [Indexed: 02/03/2023] Open
Abstract
The karyotype represents one of the main cornerstones for the International Prognostic Scoring System (IPSS) and the revised IPSS-R (IPSS-R) that are most widely used for prognostication in patients with myelodysplastic syndromes (MDS). The most frequent cytogenetic abnormalities in MDS, i.e. del(5q), -7/del(7q), +8, complex karyotypes, or -Y have been extensively explored for their prognostic impact. The IPSS-R also considers some less frequent abnormalities such as del(11q), isochromosome 17, +19, or 3q abnormalities. However, more than 600 different cytogenetic categories had been identified in a previous MDS study. This review aims to focus interest on selected rare cytogenetic abnormalities in patients with MDS. Examples are numerical gains of the chromosomes 11 (indicating rapid progression), of chromosome 14 or 14q (prognostically intermediate to favorable), -X (in females, with an intermediate prognosis), or numerical abnormalities of chromosome 21. Structural abnormalities are also considered, e.g. del(13q) that is associated with bone marrow failure syndromes and favorable response to immunosuppressive therapy. These and other rare cytogenetic abnormalities should be integrated into existing prognostication systems such as the IPSS-R. However, due to the very low number of cases, this is clearly dependent on international collaboration. Hopefully, this article will help to inaugurate this process.
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5
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Westman MK, Pedersen-Bjergaard J, Andersen MT, Andersen MK. IDH1 and IDH2 mutations in therapy-related myelodysplastic syndrome and acute myeloid leukemia are associated with a normal karyotype and with der(1;7)(q10;p10). Leukemia 2012. [PMID: 23192014 DOI: 10.1038/leu.2012.347] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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6
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Slovak ML, O'Donnell M, Smith DD, Gaal K. Does MDS with der(1;7)(q10;p10) constitute a distinct risk group? A retrospective single institutional analysis of clinical/pathologic features compared to -7/del(7q) MDS. ACTA ACUST UNITED AC 2009; 193:78-85. [PMID: 19665067 DOI: 10.1016/j.cancergencyto.2009.04.013] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2009] [Accepted: 04/07/2009] [Indexed: 10/20/2022]
Abstract
The der(1;7)(q10;p10) aberration is observed in about 1-3% of the myelodysplastic syndromes (MDS) and less commonly in acute myeloid leukemia (AML) and the myeloproliferative disorders. This unbalanced translocation is considered a "variant" of the del(7q)/-7 subgroup and has been assigned a poor risk karyotype score in the MDS International Prognostic Scoring System (IPSS). Recent reports suggest der(1;7) MDS should be considered a discrete MDS subgroup with an intermediate, not poor, karyotype score. At the City of Hope, we compared the clinical-pathologic features of 12 der(1;7) MDS patients to 51 MDS patients with del(7q) (n=10) or -7 (n=41), selected for a similar frequency of secondary aberrations. The der(1;7) patients showed older age at diagnosis, lower platelet counts, less trilineage dysplasia, and lower blast counts. The der(1;7) patients did not differ from del(7q)/-7 patients in subtypes of MDS by World Health Organization, French-American-British classifications, or bone marrow cellularity. Neither the proportion of therapy-related MDS nor the transformation to AML differed significantly among the three subgroups. Five-year survival rates for der(1;7), del(7q), and -7 (44.4, 32.0, and 23.6%, respectively) did not differ significantly (P=0.94). While der(1;7) MDS is associated with some clinically distinctive features, reassignment of risk category based on these data would be premature.
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Affiliation(s)
- Marilyn L Slovak
- Cytogenetics Laboratory, City of Hope, 1500 E. Duarte Road, Duarte, CA 91010, USA.
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7
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MESH Headings
- Adult
- Child
- Chromosome Aberrations
- Chromosome Banding
- Chromosomes, Human/ultrastructure
- Forecasting
- Humans
- In Situ Hybridization, Fluorescence
- Leukemia, Myeloid, Acute/classification
- Leukemia, Myeloid, Acute/genetics
- Leukemia, Myeloid, Acute/mortality
- Leukemia, Myeloid, Acute/pathology
- Neoplasm Proteins/physiology
- Prognosis
- Translocation, Genetic
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Affiliation(s)
- Nallasivam Palanisamy
- Department of Pathology, Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI, USA.
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8
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Acute erythroleukemia with der(1;7)(q10;p10) as a sole acquired abnormality after treatment with azathioprine. ACTA ACUST UNITED AC 2008; 186:58-60. [DOI: 10.1016/j.cancergencyto.2008.06.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2008] [Revised: 05/27/2008] [Accepted: 06/09/2008] [Indexed: 11/20/2022]
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9
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Ooyashiki K. [Diagnosis and treatment of myelodysplastic syndrome]. NIHON NAIKA GAKKAI ZASSHI. THE JOURNAL OF THE JAPANESE SOCIETY OF INTERNAL MEDICINE 2008; 97:627-632. [PMID: 22675769 DOI: 10.2169/naika.97.627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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10
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Kokalj Vokac N, Zagorac A, Erjavec Skerget A, Roskar Z, Podgornik H, Cernelc P. Der(1;16)(q10;p10) in acute myeloid leukemia: the first female case described. Acta Haematol 2008; 119:54-6. [PMID: 18268405 DOI: 10.1159/000115965] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2007] [Accepted: 11/13/2007] [Indexed: 11/19/2022]
MESH Headings
- Aged
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Chromosome Aberrations
- Chromosomes, Human, Pair 1
- Chromosomes, Human, Pair 16
- Female
- Humans
- Karyotyping
- Leukemia, Myeloid, Acute/diagnosis
- Leukemia, Myeloid, Acute/drug therapy
- Leukemia, Myeloid, Acute/genetics
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Affiliation(s)
- Nadja Kokalj Vokac
- Laboratory of Medical Genetics, University Medical Centre Maribor, Maribor, Slovenia.
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11
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Park TS, Song J, Lee KA, Lee SG, Yoon S, Kim JS, Lyu CJ, Choi JR. A der(1;15)(q10;q10) is a rare nonrandom whole-arm translocation in patients with acute lymphoblastic leukemia. ACTA ACUST UNITED AC 2008; 179:132-5. [PMID: 18036400 DOI: 10.1016/j.cancergencyto.2007.08.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2007] [Accepted: 08/08/2007] [Indexed: 02/07/2023]
Abstract
A rare karyotypic event, der(1;15)(q10;q10), which involves the whole long arms of chromosomes 1 and 15, has been reported in patients with various conditions, including acute myelogenous leukemia, myelodysplastic syndrome, polycythemia vera, and multiple myeloma. Only 27 cases of unbalanced der(1;15)(q10;q10) have been documented in the literature as single or complexed chromosomal abnormalities in hematological malignancies. Here, we describe two cases of acute lymphoblastic leukemia with der(1;15)(q10;q10), and review the previous reports. Although more case studies are needed, we suggest that der(1;15)(q10;q10) should be considered a nonrandom chromosomal abnormality in hematological malignancies including both lymphoid and myeloid neoplasms.
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Affiliation(s)
- Tae Sung Park
- Department of Laboratory Medicine, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, Seoul 120-752, Korea
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12
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Sait SNJ, Claydon MA, Conroy JM, Nowak NJ, Barcos M, Baer MR. Translocation (4;11)(p12;q23) with rearrangement of FRYL and MLL in therapy-related acute myeloid leukemia. ACTA ACUST UNITED AC 2007; 177:143-6. [PMID: 17854671 DOI: 10.1016/j.cancergencyto.2007.05.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2007] [Revised: 05/21/2007] [Accepted: 05/29/2007] [Indexed: 11/20/2022]
Abstract
Reciprocal chromosomal translocations involving the MLL gene at chromosome region 11q23 are recurring cytogenetic abnormalities in both de novo and therapy-related acute myeloid leukemia (AML) and in acute lymphoblastic leukemia. We report a t(4;11)(p12;q23) with rearrangement of MLL and FRYL (also known as AF4p12), a human homolog to the furry gene of Drosophila, in an adult patient with therapy-related AML after fludarabine and rituximab therapy for small lymphocytic lymphoma and radiation therapy for breast carcinoma. To our knowledge, t(4;11)(p12;q23) has been reported in two previous patients, and MLL and FRYL rearrangement was demonstrated in one of them. Both of the previous patients had therapy-related leukemias after exposure to topoisomerase II inhibitors, whereas our patient had received cytotoxic therapy that did not include a topoisomerase II inhibitor. Thus, t(4;11)(p12;q23) with MLL and FRYL involvement represents a new recurring 11q23 translocation, to date seen only in therapy-related acute leukemias.
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MESH Headings
- Acute Disease
- Antibodies, Monoclonal/administration & dosage
- Antibodies, Monoclonal, Murine-Derived
- Antineoplastic Combined Chemotherapy Protocols/adverse effects
- Chromosomes, Human, Pair 11/genetics
- Chromosomes, Human, Pair 4/genetics
- DNA-Binding Proteins/genetics
- Female
- Gene Rearrangement
- Histone-Lysine N-Methyltransferase
- Humans
- In Situ Hybridization, Fluorescence
- Karyotyping
- Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy
- Leukemia, Myeloid/chemically induced
- Leukemia, Myeloid/genetics
- Middle Aged
- Myeloid-Lymphoid Leukemia Protein/genetics
- Nuclear Proteins/genetics
- Rituximab
- Transcriptional Elongation Factors
- Translocation, Genetic
- Vidarabine/administration & dosage
- Vidarabine/analogs & derivatives
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Affiliation(s)
- Sheila N J Sait
- Clinical Cytogenetics Laboratory, DNA Microarray and Genomics Facility, Departments of Pathology and Medicine, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263, USA.
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13
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Sanada M, Uike N, Ohyashiki K, Ozawa K, Lili W, Hangaishi A, Kanda Y, Chiba S, Kurokawa M, Omine M, Mitani K, Ogawa S. Unbalanced translocation der(1;7)(q10;p10) defines a unique clinicopathological subgroup of myeloid neoplasms. Leukemia 2007; 21:992-7. [PMID: 17315020 DOI: 10.1038/sj.leu.2404619] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The unbalanced translocation, der(1;7)(q10;p10), is one of the characteristic cytogenetic abnormalities found in myelodysplastic syndromes (MDS) and other myeloid neoplasms. Although described frequently with very poor clinical outcome and possible relationship with monosomy 7 or 7q- (-7/7q-), this recurrent cytogenetic abnormality has not been explored fully. Here we analyzed retrospectively 77 cases with der(1;7)(q10;p10) in terms of their clinical and cytogenetic features, comparing with other 46 adult -7/7q- cases without der(1;7)(q10;p10). In contrast with other -7/7q- cases, where the abnormality tends to be found in one or more partial karyotypes, der(1;7)(q10;p10) represents the abnormality common to all the abnormal clones and usually appears as a sole chromosomal abnormality during the entire clinical courses, or if not, is accompanied only by a limited number and variety of additional abnormalities, mostly trisomy 8 and/or loss of 20q. der(1;7)(q10;p10)-positive MDS cases showed lower blast counts (P<0.0001) and higher hemoglobin concentrations (P<0.0075) at diagnosis and slower progression to acute myeloid leukemia (P=0.0043) than other -7/7q- cases. der(1;7)(q10;p10) cases showed significantly better clinical outcome than other -7/7q cases (P<0.0001). In conclusion, der(1;7)(q10;p10) defines a discrete entity among myeloid neoplasms, showing unique clinical and cytogenetic characteristics.
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MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Chromosome Aberrations
- Chromosomes, Human, Pair 1
- Chromosomes, Human, Pair 7
- Female
- Hematopoietic Stem Cell Transplantation
- Humans
- Leukemia, Myeloid, Acute/genetics
- Leukemia, Myeloid, Acute/pathology
- Male
- Middle Aged
- Myelodysplastic Syndromes/genetics
- Myelodysplastic Syndromes/pathology
- Myeloproliferative Disorders/genetics
- Myeloproliferative Disorders/pathology
- Retrospective Studies
- Translocation, Genetic
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Affiliation(s)
- M Sanada
- Department of Regeneration Medicine for Hematopoiesis, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
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14
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Odish OFF, Gotoh A, Liu YC, Shoji N, Kimura Y, Kodama A, Ohyashiki K. Recurrent unbalanced whole-arm t(1;10)(q10;p10) in myelodysplastic syndrome: a case report and literature review. ACTA ACUST UNITED AC 2007; 172:165-7. [PMID: 17213027 DOI: 10.1016/j.cancergencyto.2006.09.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2006] [Revised: 09/18/2006] [Accepted: 09/27/2006] [Indexed: 11/24/2022]
Abstract
We report a patient with myelodysplastic syndrome (refractory anemia) showing the karyotype 46,XY,+1,der(1;10)(q10;p10), resulting in trisomy 1q and monosomy 10q abnormality. This finding suggests that either trisomy of 1q or centromeric connection between chromosomes 1 and 10, rather than the absence of 10q, might be essential toward neoplastic transformation.
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Affiliation(s)
- Omar Ferkad Faraj Odish
- The First Department of Internal Medicine (Hematology/Oncology Division), Tokyo Medical University, 6-7-1 Nishi-shinjuku, Shinjuku-ku, Tokyo 160-0023, Japan
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15
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Liu YC, Ito Y, Hsiao HH, Sashida G, Kodama A, Ohyashiki JH, Ohyashiki K. Risk factor analysis in myelodysplastic syndrome patients with del(20q): prognosis revisited. ACTA ACUST UNITED AC 2006; 171:9-16. [PMID: 17074585 DOI: 10.1016/j.cancergencyto.2006.06.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2006] [Revised: 06/06/2006] [Accepted: 06/08/2006] [Indexed: 11/20/2022]
Abstract
The deletion of the long arm of chromosome 20, or del(20q), is a common cytogenetic abnormality in various myeloid disorders and is known to be a favorable prognostic factor in myelodysplastic syndromes (MDS) when it is the sole change. However, del(20q) occurs with one or more cytogenetic changes when it is associated with disease progression. Here, we analyzed 33 patients with MDS and del(20q) to ascertain the risk factors in MDS. We categorized del(20q) into two groups: one with the del(20q) clone (> or =50% marrow metaphases), corresponding to genomic integrity, and the other with a late appearance of a minor del(20q) clone (<50% metaphases) with additional cytogenetic changes, representing genomic instability. Of the MDS patients with del(20q) at initial presentation, the negative factors in predicting prognosis on survival are (i) INT-2/High risk according to the International Prognostic Scoring System, (ii) any additional cytogenetic changes, or (iii) minor del(20q) clone. The late appearance of del(20q) at any phase is linked to a significantly unfavorable prognosis, thus indicating the clinical and biological heterogeneity of del(20q) in MDS.
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Affiliation(s)
- Yi-Chang Liu
- First Department of Internal Medicine, Hematology/Oncology Division, Tokyo Medical University, 6-7-1 Nishi-Shinjuku, Tokyo, Japan
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16
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Current Awareness in Hematological Oncology. Hematol Oncol 2006. [DOI: 10.1002/hon.754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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