A Risk Stratification System in Myeloma Patients with Autologous Stem Cell Transplantation

Recurrent pregnancy loss: risk factors and predictive modeling approaches

PURPOSE

This review aims to identify and analyze the risk factors associated with recurrent pregnancy loss (RPL) and to evaluate the effectiveness of various predictive models in estimating the risk of RPL. The review also explores recent advancements in machine learning algorithms that can enhance the accuracy of these predictive models. The ultimate goal is to provide a comprehensive understanding of how these tools can aid in the personalized management of women experiencing RPL.

MATERIALS AND METHODS

The review synthesizes current literature on RPL, focusing on various risk factors such as chromosomal abnormalities, autoimmune conditions, hormonal imbalances, and structural uterine anomalies. It also analyzes different predictive models for RPL risk assessment, including genetic screening tools, risk scoring systems that integrate multiple clinical parameters, and machine learning algorithms capable of processing complex datasets. The effectiveness and limitations of these models are critically evaluated to provide insights into their clinical application.

RESULTS

Key risk factors for RPL were identified, including chromosomal abnormalities (e.g. translocations and aneuploidies), autoimmune conditions (e.g. antiphospholipid syndrome), hormonal imbalances (e.g. thyroid dysfunction and luteal phase defects), and structural uterine anomalies (e.g. septate or fibroid-affected uteri). Predictive models such as genetic screening tools and risk scoring systems were shown to be effective in estimating RPL risk. Recent advancements in machine learning algorithms demonstrate potential for enhancing predictive accuracy by analyzing complex datasets, which may lead to improved personalized management strategies.

CONCLUSIONS

The integration of risk factors and predictive modeling offers a promising approach to improving outcomes for women affected by RPL. A comprehensive understanding of these factors and models can aid clinicians and researchers in refining risk assessment and developing targeted interventions. The review underscores the need for further research into specific pathways involved in RPL and the potential of novel treatments aimed at mitigating risk.

Effect of tandem autologous stem cell transplantation on survival in pediatric patients with high-risk solid tumors in South China

BACKGROUND

Despite advances in treatment, the prognosis for patients with high-risk pediatric solid tumors remains dismal. Tandem autologous stem cell transplantation (ASCT) offers promise for improving outcomes in these patients. This study aimed to examine the efficacy and prognostic factors of tandem ASCT in pediatric patients with high-risk solid tumors.

AIM

To determine the survival outcomes and prognostic factors in pediatric patients with high-risk solid tumors undergoing tandem ASCT.

METHODS

A total of 40 pediatric patients with high-risk solid tumors treated from March 2015 to August 2022 were included in this retrospective study. The diagnoses of the patients included neuroblastoma, germ cell tumors, atypical teratoid/rhabdoid tumor, medulloblastoma, and pineoblastoma. After induction chemotherapy, all patients received tandem ASCT and were allocated into two groups (group A and group B) based on high-dose chemotherapy regimens. Prognostic relevance was evaluated by examining patient characteristics, such as sex, age, lactate dehydrogenase levels, primary site, the number of metastatic sites, and bone marrow involvement.

RESULTS

The median follow-up duration since the first ASCT was 24 months (range: 1-91 months), with 5-year overall survival (OS) and event-free survival (EFS) rates of 73% and 70%, respectively, for the entire cohort. The 3-year OS rates were 67% for group A and 87% for group B (P = 0.29), with corresponding 3-year EFS rates of 67% and 79% (P = 0.57). Among neuroblastoma patients, the 5-year OS and EFS were 69% and 63% (P = 0.23). Univariable analysis revealed a notable association of age ≥ 36 months and elevated lactate dehydrogenase level at diagnosis with poorer OS. Despite acute adverse effects, all patients demonstrated good tolerance to the treatment, with no occurrences of transplant-related mortality.

CONCLUSION

Tandem ASCT demonstrates promising survival outcomes for patients with high-risk solid tumors, particularly neuroblastoma, with manageable toxicity and no transplant-related mortality.