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Espinoza-Gutarra MR, Ailawadhi S. Bridging the gap: how do we enroll more racial-ethnic minority patients in hematological drug trials? Expert Rev Hematol 2023; 16:905-910. [PMID: 37870168 DOI: 10.1080/17474086.2023.2273851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 10/18/2023] [Indexed: 10/24/2023]
Affiliation(s)
- Manuel R Espinoza-Gutarra
- Assistant Professor, Division of Hematology-Oncology, University of Alabama at Birmingham, Birmingham, AL
| | - Sikander Ailawadhi
- Professor of Medicine, Division of Hematology-Oncology, Mayo Clinic, Jacksonville, FL
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Mendonça PDS, Pinheiro RF, Magalhães SMM. Myelodysplastic Syndrome Over Time: A Comparative Analysis of Overall Outcome. Mayo Clin Proc 2019; 94:2593-2594. [PMID: 31806111 DOI: 10.1016/j.mayocp.2019.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 10/04/2019] [Accepted: 10/08/2019] [Indexed: 11/26/2022]
Affiliation(s)
- Priscila da Silva Mendonça
- Postgraduate Program in Medical Science, Cancer Cytogenomic Laboratory, Federal University of Ceará, Ceará, Fortaleza, Brazil; University Hospital Walter Cantidio, Brazilian Company of Hospital Services (EBSERH), Fortaleza, Ceará, Brazil
| | - Ronald Feitosa Pinheiro
- Postgraduate Program in Medical Science, Federal University of Ceará, Fortaleza, Ceará, Brazil; Cancer Cytogenomic Laboratory, Federal University of Ceará, Fortaleza, Ceará, Brazil; University Hospital Walter Cantidio, Brazilian Company of Hospital Services (EBSERH), Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Silvia Maria Meira Magalhães
- Postgraduate Program in Medical Science, Federal University of Ceará, Fortaleza, Ceará, Brazil; Cancer Cytogenomic Laboratory, Federal University of Ceará, Fortaleza, Ceará, Brazil; University Hospital Walter Cantidio, Brazilian Company of Hospital Services (EBSERH), Federal University of Ceará, Fortaleza, Ceará, Brazil
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de Matos AG, Ribeiro Junior HL, de Paula Borges D, Okubo BM, de Sousa JC, Barbosa MC, de Castro MF, Gonçalves RP, Pinheiro RF, Magalhães SMM. Interleukin-8 and nuclear factor kappa B are increased and positively correlated in myelodysplastic syndrome. Med Oncol 2017; 34:168. [PMID: 28856536 DOI: 10.1007/s12032-017-1023-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 08/09/2017] [Indexed: 11/27/2022]
Abstract
The pathogenesis of myelodysplastic syndromes (MDS) is complex and depends on the interaction between aberrant hematopoietic cells and their microenvironment, probably including aberrations in cytokines and their signaling pathways. To evaluate interleukin-8 (IL-8) plasma levels and nuclear factor kappa B (NF-kB) in patients with MDS and to test possible correlation between IL-8 and NF-Kb, a total of 45 individuals were analyzed: 25 consecutive adult de novo MDS patients and 20 sex and age-matched healthy elderly volunteers. IL-8 analysis was performed by ELISA and activity of NF-kB by chemiluminescent assay. MDS patients showed higher level of IL-8 when compared to controls (p = 0.006). Patients aged 75 and above showed even higher levels (p = 0.035). NF-kB activity was significantly elevated in MDS patients when compared to controls (p < 0.0001) and higher in patients older than 75 years (p = 0.047). NF-kB activity was associated with higher serum ferritin (p = 0.042) and higher percentage of blasts (p = 0.028). A significant positive correlation between IL-8 and NF-kB was demonstrated (r = 0.480; p = 0.015). Many pathways involved in pathophysiology of MDS have been recently described, suggesting that an inflammatory process may act as a pathogenic driver. In this study, significantly elevated levels of IL-8 and NF-kB were demonstrated in MDS patients, with positive association of NF-kB with some markers of poor prognosis. A positive correlation between IL-8 and NF-kB suggests they cooperate as part of a complex networking of immune and inflammatory factors involved in MDS.
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Affiliation(s)
- Anacélia Gomes de Matos
- Cancer Cytogenomic Laboratory, Federal University of Ceará, Fortaleza, Brazil
- Post-graduate Program in Medical Science, Federal University of Ceará, Fortaleza, Brazil
- Center for Research and Drug Development (NPDM), Federal University of Ceará, R. Coronel Nunes de Melo, 1000 - 2° andar, Rodolfo Teófilo, Fortaleza, CE, CEP 60430-275, Brazil
| | - Howard Lopes Ribeiro Junior
- Cancer Cytogenomic Laboratory, Federal University of Ceará, Fortaleza, Brazil
- Post-graduate Program in Medical Science, Federal University of Ceará, Fortaleza, Brazil
- Center for Research and Drug Development (NPDM), Federal University of Ceará, R. Coronel Nunes de Melo, 1000 - 2° andar, Rodolfo Teófilo, Fortaleza, CE, CEP 60430-275, Brazil
| | - Daniela de Paula Borges
- Cancer Cytogenomic Laboratory, Federal University of Ceará, Fortaleza, Brazil
- Post-graduate Program in Medical Science, Federal University of Ceará, Fortaleza, Brazil
- Center for Research and Drug Development (NPDM), Federal University of Ceará, R. Coronel Nunes de Melo, 1000 - 2° andar, Rodolfo Teófilo, Fortaleza, CE, CEP 60430-275, Brazil
| | - Bruno Memória Okubo
- Cancer Cytogenomic Laboratory, Federal University of Ceará, Fortaleza, Brazil
- Post-graduate Program in Medical Science, Federal University of Ceará, Fortaleza, Brazil
| | - Juliana Cordeiro de Sousa
- Cancer Cytogenomic Laboratory, Federal University of Ceará, Fortaleza, Brazil
- Post-graduate Program in Medical Science, Federal University of Ceará, Fortaleza, Brazil
| | | | | | | | - Ronald Feitosa Pinheiro
- Cancer Cytogenomic Laboratory, Federal University of Ceará, Fortaleza, Brazil.
- Post-graduate Program in Medical Science, Federal University of Ceará, Fortaleza, Brazil.
- Department of Clinical Medicine, Federal University of Ceará, Fortaleza, Brazil.
- Center for Research and Drug Development (NPDM), Federal University of Ceará, R. Coronel Nunes de Melo, 1000 - 2° andar, Rodolfo Teófilo, Fortaleza, CE, CEP 60430-275, Brazil.
| | - Silvia Maria Meira Magalhães
- Cancer Cytogenomic Laboratory, Federal University of Ceará, Fortaleza, Brazil
- Post-graduate Program in Medical Science, Federal University of Ceará, Fortaleza, Brazil
- Department of Clinical Medicine, Federal University of Ceará, Fortaleza, Brazil
- Center for Research and Drug Development (NPDM), Federal University of Ceará, R. Coronel Nunes de Melo, 1000 - 2° andar, Rodolfo Teófilo, Fortaleza, CE, CEP 60430-275, Brazil
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Chaubey R, Sazawal S, Mahapatra M, Chhikara S, Saxena R. Does Indian Myelodysplastic Syndrome Have a Biology Different from That in the West ? Asian Pac J Cancer Prev 2016; 17:2341-2. [PMID: 27221942 DOI: 10.7314/apjcp.2016.17.4.2341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
abstract.
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Affiliation(s)
- Rekha Chaubey
- Department of Hematology, All India Institute of Medical Sciences, New Delhi E-mail : drrekhacgupta@ gmail.com
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Belli CB, Pinheiro RF, Bestach Y, Larripa IB, da Silva Tanizawa RS, Alfonso G, Gonzalez J, Rosenhain M, Watman N, Cavalcante de Andrade Silva M, Negri Aranguren P, García Rivello H, Magalhaes SM, Valladares X, Undurraga MS, Velloso ER. Myelodysplastic syndromes in South America: a multinational study of 1080 patients. Am J Hematol 2015; 90:851-8. [PMID: 26104573 DOI: 10.1002/ajh.24097] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 06/18/2015] [Accepted: 06/19/2015] [Indexed: 01/23/2023]
Abstract
There are previously reported data describing differences between Asian and European patients with Myelodysplastic Syndromes (MDS), few direct comparisons based on cancer registration characteristics or using cohorts to validate scoring systems. This is the first study from South-America, which attempts to describe demographic, clinical features, and outcome of MDS patients. We retrospectively analyzed 1,080 patients with de novo MDS from Argentina (635), Brazil (345), and Chile (100). Chilean patients were younger (P = 0.001) with female preponderance (P = 0.071). Brazilian series showed a higher predominance of RARS subtype regarding FAB and WHO classifications (P < 0.001). Hemoglobin levels were significantly lower in Brazilian and Chilean series (P < 0.001), and Chilean series also showed a lower platelet count (P = 0.028), with no differences concerning the neutrophil count, % BM blast, and the distribution of cytogenetic risk groups (P > 0.05). Chilean series depicted a lower overall survival (OS; 35 months vs. 56 months-Argentine; 55 months-Brazil, P = 0.030), which was consistent with a higher predominance of the high-risk group according both to the IPSS and IPSS-R (P = 0.046 and P < 0.001). The IPSS-R system and its variables showed a good reproducibility to predict clinical outcome for the whole South-American population. Epidemiological and clinical characteristics, distribution among prognostic subgroups, the OS, and the access to disease modifying therapies were more similar between Argentinean and Brazilian compared with Chilean MDS series. This will need further analysis in a larger group of patients. Descriptive and comparative studies are necessary to establish epidemiological features useful for public health attitudes to generate suitable therapeutic schemes.
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Affiliation(s)
- Carolina B. Belli
- Instituto de Medicina Experimental (IMEX-CONICET)/Academia Nacional de Medicina; Laboratorio de Genética Hematológica; Buenos Aires Argentina
- On behalf of the Grupo de Estudio de SMD, Sociedad Argentina de Hematología; Buenos Aires Argentina
| | | | - Yesica Bestach
- Instituto de Medicina Experimental (IMEX-CONICET)/Academia Nacional de Medicina; Laboratorio de Genética Hematológica; Buenos Aires Argentina
| | - Irene B. Larripa
- Instituto de Medicina Experimental (IMEX-CONICET)/Academia Nacional de Medicina; Laboratorio de Genética Hematológica; Buenos Aires Argentina
| | | | - Graciela Alfonso
- Servicio de Hematología; Hospital General de Agudos “A. J. Posadas”; El Palomar Argentina
- On behalf of the Grupo de Estudio de SMD, Sociedad Argentina de Hematología; Buenos Aires Argentina
| | - Jacqueline Gonzalez
- Servicio de Hematología, Hospital General de Agudos “C Durand,”; Buenos Aires Argentina
- On behalf of the Grupo de Estudio de SMD, Sociedad Argentina de Hematología; Buenos Aires Argentina
| | - Mariana Rosenhain
- Servicio de Hematología; Hospital General de Agudos “Tornú,”; Buenos Aires Argentina
- On behalf of the Grupo de Estudio de SMD, Sociedad Argentina de Hematología; Buenos Aires Argentina
| | - Nora Watman
- Servicio de Hematología; Hospital General de Agudos “Ramos Mejía,”; Buenos Aires Argentina
| | | | | | - Hernán García Rivello
- Servicio de Patología; Hospital Italiano de, Buenos Aires; Argentina
- On behalf of the Grupo de Estudio de SMD, Sociedad Argentina de Hematología; Buenos Aires Argentina
| | | | | | | | - Elvira R.P. Velloso
- Hematology and Transfusion Medicine; Hospital Das Clinicas, University of Sao Paulo; Brazil
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Ribeiro HL, de Oliveira RTG, Maia ARS, Pires Ferreira Filho LI, de Sousa JC, Heredia FF, Magalhães SMM, Pinheiro RF. Polymorphisms of DNA repair genes are related to the pathogenesis of myelodysplastic syndrome. Hematol Oncol 2014; 33:220-8. [DOI: 10.1002/hon.2175] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Revised: 07/08/2014] [Accepted: 09/09/2014] [Indexed: 12/22/2022]
Affiliation(s)
- Howard Lopes Ribeiro
- Post-Graduate Program in Medical Science; Federal University of Ceara; Fortaleza Ceara Brazil
- Cancer Cytogenomic Laboratory; Federal University of Ceara; Fortaleza Ceara Brazil
| | | | - Allan Rodrigo Soares Maia
- Post-Graduate Program in Medical Science; Federal University of Ceara; Fortaleza Ceara Brazil
- Cancer Cytogenomic Laboratory; Federal University of Ceara; Fortaleza Ceara Brazil
| | - Luiz Ivando Pires Ferreira Filho
- Post-Graduate Program in Medical Science; Federal University of Ceara; Fortaleza Ceara Brazil
- Cancer Cytogenomic Laboratory; Federal University of Ceara; Fortaleza Ceara Brazil
| | - Juliana Cordeiro de Sousa
- Post-Graduate Program in Medical Science; Federal University of Ceara; Fortaleza Ceara Brazil
- Cancer Cytogenomic Laboratory; Federal University of Ceara; Fortaleza Ceara Brazil
| | | | - Silvia Maria Meira Magalhães
- Post-Graduate Program in Medical Science; Federal University of Ceara; Fortaleza Ceara Brazil
- Cancer Cytogenomic Laboratory; Federal University of Ceara; Fortaleza Ceara Brazil
| | - Ronald Feitosa Pinheiro
- Post-Graduate Program in Medical Science; Federal University of Ceara; Fortaleza Ceara Brazil
- Post-Graduate Program of Pathology; Federal University of Ceara; Fortaleza Ceara Brazil
- Cancer Cytogenomic Laboratory; Federal University of Ceara; Fortaleza Ceara Brazil
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Sridharan A, Jain R, Bachhuber MA, Yu Y, Ramesh K, Gundabolu K, Friedman EW, Verma AK. Epidemiologic study of myelodysplastic syndromes in a multiethnic, inner city cohort. Exp Hematol Oncol 2014; 3:22. [PMID: 25170429 PMCID: PMC4147386 DOI: 10.1186/2162-3619-3-22] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Accepted: 08/04/2014] [Indexed: 12/04/2022] Open
Abstract
Little is known about the epidemiology of MDS in minority populations. The IPSS and newly released IPSS-R are important clinical tools in prognostication of patients with MDS. Therefore, we conducted a retrospective epidemiological analysis of MDS in an ethnically diverse cohort of patients. Demographics, disease characteristics, and survival were determined in 161 patients seen at Montefiore Medical Center from 1997 to 2011. We observed that Hispanics presented at a younger age than blacks and whites (68 vs. 73.7 vs. 75.6 years); this difference was significant (p = 0.01). A trend towards greater prevalence of thrombocytopenia in Hispanics was observed, but this was not significant (p = 0.08). No other differences between the groups were observed. Overall median survival after diagnosis was the highest among Hispanics (8.6 years) followed by blacks (6.2 years) and Caucasians (3.7). Adjusted hazard ratios however did not show significant differences in risk of death between the groups. The IPSS-R showed slightly better discrimination when compared to the IPSS in this cohort (Somers Dxy 0.39 vs. 0.35, respectively) but observed survival more was more closely approximated by IPSS than by IPSS-R. Our study highlights the possibility of ethnic differences in the presentation of MDS and raises questions regarding which prognostic system is more predictive in this population.
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Affiliation(s)
- Ashwin Sridharan
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Rishi Jain
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Marcus A Bachhuber
- Philadelphia Veterans Affairs Medical Center, Philadelphia, PA, USA ; Robert Wood Johnson Foundation Clinical Scholars Program, Univeristy of Pennsylvania, Philadelphia, PA, USA ; Leonard Davis Insititute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA
| | - Yiting Yu
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, 302B Chanin, 1300 Morris Park Ave, Bronx, NY 10461, USA
| | - Kh Ramesh
- Department of Pathology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Krishna Gundabolu
- Department of Hematology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Ellen W Friedman
- Department of Hematology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Amit K Verma
- Division of Oncology, Albert Einstein College of Medicine, Bronx, NY, USA
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