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Muñoz-Langa J, Jimenez-Fonseca P, Carmona-Bayonas A, de Castro EM, Pérez-Segura P, Cánovas MS, Gomez D, Moran LO, de Tejada MBG, Seguí E, López GB, Adrián SG, Campos MC, Olmos VP, Portero BO, Moyano MS, Crespo JAS, Sánchez LT, Rebollo MA, Rivas PO, Altozano JP, Lescure ÁR, Muñoz-Martín A. Rationale, design and methodology of TESEO study: a registry of thrombosis and neoplasia of SEOM (Spanish Society of Medical Oncology). Clin Transl Oncol 2020; 23:799-811. [PMID: 32789772 DOI: 10.1007/s12094-020-02472-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 08/03/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND RATIONALE Thromboembolic complications are a serious, preventable and common event in cancer patients that contributes to increasing morbidity and mortality. Despite increasing knowledge on cancer-associated thrombosis (CAT), there are still several aspects of diagnosis, clinical management, treatment and prognosis with uncertainties that are under-represented in randomized clinical trials. For this reason, the Spanish Society of Medical Oncology (SEOM) launched in June 2018 a registry of CAT. METHODS/DESIGN TESEO is an ongoing prospective, non-interventional, multicentric study in consecutive cancer patients with newly diagnosed of thromboembolic event (TEE). Eligibility criteria include being > 18 years with a histologically confirmed diagnosis of cancer and a symptomatic or incidental TEE confirmed with an imaging technique in the previous month or any time after the cancer diagnosis and signing of informed consent. The study consists of two types of integrated but independent prospective registries. Regular CAT sub-registry includes information on patient's cancer´s characteristics, anticoagulant treatment provided and outcome data. Special CAT sub-registry includes variables related to special situations of CAT that comprise patients with severe kidney failure, thrombocytopenia, high risk of bleeding related to the cancer or with coexistence of bleeding and patients who receive new treatments such a targeted therapy, antiangiogenics agents and immunotherapy. The registry considers the status of the cancer and the time to assess how the prognosis is changed based on when the thrombus occurs. Some outcomes such as rethrombosis, major bleeding, tumor progression and survival will be valued in various time intervals including 1, 3, 6 and 12 months after the even in the first year; and then every 6 months until the patient's death. RESULTS After 18 months and with 35 centers and researchers, the registry has 1128 patients. CONCLUSION TESEO registry will provide clinical real-world evidence for prevention, treatment and complications of CAT in different scenarios that are under-represented in randomized clinical trials.
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Affiliation(s)
- J Muñoz-Langa
- Medical Oncology Department, Hospital Clínico Universitario de Valencia, Avinguda Blasco Ibáñez nº 17, Valencia, 46010, Spain.
| | - P Jimenez-Fonseca
- Medical Oncology Department, Hospital Universitario Central de Asturias, ISPA, Oviedo, Spain
| | - A Carmona-Bayonas
- Hematology and Medical Oncology Department, Hospital Universitario Morales Meseguer, University of Murcia, IMIB, Murcia, Spain
| | - E M de Castro
- Medical Oncology Department, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain
| | - P Pérez-Segura
- Medical Oncology Department, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - M S Cánovas
- Hematology and Medical Oncology Department, Hospital Universitario Morales Meseguer, University of Murcia, IMIB, Murcia, Spain
| | - D Gomez
- Medical Oncology Department, Hospital Universitario Central de Asturias, ISPA, Oviedo, Spain
| | - L O Moran
- Medical Oncology Department, Hospital Universitario Gregorio Marañón, Madrid, Spain
| | - M B G de Tejada
- Medical Oncology Department, Hospital Universitario Val d´Hebron, Barcelona, Spain
| | - E Seguí
- Medical Oncology Department, Hospital Universitario Santa Creu i Sant Pau, Barcelona, Spain
| | - G B López
- Medical Oncology Department, Hospital Universitario Insular de Gran Canaria, Tenerife, Spain
| | - S G Adrián
- Medical Oncology Department, Hospital Universitario de Móstoles, Madrid, Spain
| | - M C Campos
- Medical Oncology Department, Hospital Universitario Lucus Augusti, Lugo, Spain
| | - V P Olmos
- Medical Oncology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - B O Portero
- Medical Oncology Department, Hospital Universitario Infanta Leonor, Madrid, Spain
| | - M S Moyano
- Medical Oncology Department, Hospital Universitario de Jerez de la Frontera, Cádiz, Spain
| | - J A S Crespo
- Medical Oncology Department, Hospital Virgen de la Luz, Cuenca, Spain
| | - L T Sánchez
- Medical Oncology Department, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - M A Rebollo
- Medical Oncology Department, Institut Català D'Oncologia (ICO), L'Hospitalet, Barcelona, Spain
| | - P O Rivas
- Medical Oncology Department, Hospital Central de la Defensa Gomez Ulla, Madrid, Spain
| | - J P Altozano
- Medical Oncology Department, Hospital Virgen de los Lirios, Alcoy, Alicante, Spain
| | - Á R Lescure
- Medical Oncology Department, Hospital General Universitario de Elche, Elche, Spain
| | - A Muñoz-Martín
- Medical Oncology Department, Hospital Universitario Gregorio Marañón, Madrid, Spain
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Carmona-Bayonas A, Jimenez-Fonseca P, de Castro EM, Mata E, Biosca M, Custodio A, Espinosa J, Vázquez EG, Henao F, Ayala de la Peña F. SEOM clinical practice guideline: management and prevention of febrile neutropenia in adults with solid tumors (2018). Clin Transl Oncol 2018; 21:75-86. [PMID: 30470991 PMCID: PMC6339667 DOI: 10.1007/s12094-018-1983-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 11/08/2018] [Indexed: 01/15/2023]
Abstract
Febrile neutropenia (FN) is a common dose-limiting toxicity of chemotherapy, with a profound impact on the evolution of patients with cancer, due to the potential development of serious complications, mortality, delays, and decrease in treatment intensity. This article seeks to present an updated clinical guideline, with recommendations regarding the diagnosis, prevention, and treatment of febrile neutropenia in adults with solid tumors. The aspects covered include how to properly approach the risk of microbial resistances, epidemiological aspects, considerations about the initial empirical approach adapted to the risk, special situations, and prevention of complications. A decision-making algorithm is included for use in the emergency department based on a new, validated tool, the Clinical Index of Stable Febrile Neutropenia, which can be used in patients with solid tumors who appear stable in the initial phase of neutropenic infections, and can help detect those at high risk for complications in whom early discharge must be avoided.
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Affiliation(s)
- A Carmona-Bayonas
- Hematology and Medical Oncology Department, Hospital Universitario Morales Meseguer, IMIB, Avenida Marqués de los Vélez, 30008, Murcia, Spain
| | - P Jimenez-Fonseca
- Medical Oncology Department, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - E M de Castro
- Medical Oncology Department, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - E Mata
- Medical Oncology Department, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - M Biosca
- Medical Oncology Department, Hospital Vall D'Hebron, Barcelona, Spain
| | - A Custodio
- Medical Oncology Department, Hospital Universitario La Paz, Madrid, Spain.,CIBERONC (CB16/12/00398), Madrid, Spain
| | - J Espinosa
- Medical Oncology Department, Hospital General de Ciudad Real, Ciudad Real, Spain
| | - E G Vázquez
- Infectious Disease Department, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain.,Departamento de Medicina, Facultad de Medicina, Universidad de Murcia, Murcia, Spain
| | - F Henao
- Medical Oncology Department, Complejo Hospitalario Regional Virgen Macarena, Seville, Spain
| | - F Ayala de la Peña
- Hematology and Medical Oncology Department, Hospital Universitario Morales Meseguer, IMIB, Avenida Marqués de los Vélez, 30008, Murcia, Spain.
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Carmona-Bayonas A, Jiménez-Fonseca P, Virizuela J, Antonio M, Font C, Biosca M, Ramchandani A, Martinez-Garcia J, Hernando J, Espinosa J, de Castro EM, Ghanem I, Beato C, Blasco A, Garrido M, Mondéjar R, Arcusa MÁ, Aragón I, Manzano A, Sevillano E, Castañón E, Ayala F. Performance of the clinical index of stable febrile neutropenia (CISNE) in different types of infections and tumors. Clin Transl Oncol 2016; 19:386-395. [PMID: 27525978 DOI: 10.1007/s12094-016-1540-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 08/02/2016] [Indexed: 11/28/2022]
Abstract
PURPOSE The clinical index of stable febrile neutropenia (CISNE) can contribute to patient safety without increasing the complexity of decision-making. However, febrile neutropenia (FN) is a diverse syndrome. The aim of this analysis is to assess the performance of CISNE according to the type of tumor and infection and to characterize these patients. METHODS We prospectively recruited 1383 FN episodes in situations of apparent clinical stability. Bonferroni-adjusted z tests of proportions were used to assess the association between the infections suspected at the time of onset and the type of tumor with the risk of serious complications and mortality. The performance of CISNE was appraised in each category using the Breslow-Day test for homogeneity of odds ratios and Forest Plots. RESULTS 171 patients had a serious complication (12.3 %, 95 % confidence interval 10.7-14.2 %). The most common initial assumptive diagnoses were: fever without focus (34.5 %), upper respiratory infection (14.9 %), enteritis (12.7 %), stomatitis (11.8 %), and acute bronchitis (10.7 %). Lung and breast were the most common tumors, accounting for approximately 56 % of the series. The distribution of complications, mortality, and bacteremia varies for each of these categories. However, Breslow-Day tests indicate homogeneity of the odds ratio of the dichotomized CISNE score to predict complications in all infection and tumor subtypes. CONCLUSION Despite FN's clinical and microbiological heterogeneity, the CISNE score was seen to be consistent and robust in spite of these variations. Hence, it appears to be a safe tool in seemingly stable FN.
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Affiliation(s)
- A Carmona-Bayonas
- Hematology and Medical Oncology Department, Hospital Universitario Morales Meseguer, Calle Marqués de los Vélez s/n, 30008, Murcia, Spain.
| | | | - J Virizuela
- Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - M Antonio
- ICO Duran i Reynals, Barcelona, Spain
| | - C Font
- Hospital Universitario Clínic, Barcelona, Spain
| | - M Biosca
- Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - A Ramchandani
- Hospital Universitario Insular de Gran Canaria, Las Palmas, Spain
| | | | - J Hernando
- Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - J Espinosa
- Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
| | - E M de Castro
- Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - I Ghanem
- Hospital Universitario La Paz, Madrid, Spain
| | - C Beato
- Hospital Nisa Sevilla Aljarafe, Hospital Universitario Clínico San Carlos, Sevilla, Spain
| | - A Blasco
- Hospital General Universitario de Valencia, Valencia, Spain
| | - M Garrido
- Universidad Católica Pontificia de Chile, Santiago de Chile, Chile
| | - R Mondéjar
- Hospital Universitario de la Princesa, Madrid, Spain
| | - M Á Arcusa
- Consorci Sanitari de Terrassa, Barcelona, Spain
| | - I Aragón
- Hospital Juan Ramón Jiménez, Huelva, Spain
| | - A Manzano
- Hospital Clínico Universitario San Carlos, Madrid, Spain
| | - E Sevillano
- Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | - E Castañón
- Clínica Universidad de Navarra, Pamplona, Spain
| | - F Ayala
- Hospital Universitario Morales Messeguer, Murcia, Spain
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de Castro EM, Silva IN, Perpétuo FO. [Russel's syndrome. Report of a case with development of precocious puberty]. Arq Neuropsiquiatr 1987; 45:72-80. [PMID: 3606439 DOI: 10.1590/s0004-282x1987000100010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The Russel's syndrome is characterized by emaciation and hyperactivity in children and is caused by hypothalamic expansive process. This report presents the typical signs of the syndrome associated with growth hormone secretion disorders and precocious puberty pattern appearing at the age of four. The pathogenesis of the disorder is discussed and related to the hypothalamus-pituitary axis dysfunction caused by the tumor growth.
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