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Cheung YF, Chow PC, So EKF, Chan KW. Circulating transforming growth factor-β and aortic dilation in repaired hearts: abridged secondary publication. Hong Kong Med J 2022; 28 Suppl 3:12-16. [PMID: 35701223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023] Open
Affiliation(s)
- Y F Cheung
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong
| | - P C Chow
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong
| | - E K F So
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong
| | - K W Chan
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong
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Yoneda J, Huang W, Feng M, Yang CH, Chan KW, Tanttu T, Gilbert W, Leon RCC, Hudson FE, Itoh KM, Morello A, Bartlett SD, Laucht A, Saraiva A, Dzurak AS. Coherent spin qubit transport in silicon. Nat Commun 2021; 12:4114. [PMID: 34226564 PMCID: PMC8257656 DOI: 10.1038/s41467-021-24371-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 05/23/2021] [Indexed: 11/09/2022] Open
Abstract
A fault-tolerant quantum processor may be configured using stationary qubits interacting only with their nearest neighbours, but at the cost of significant overheads in physical qubits per logical qubit. Such overheads could be reduced by coherently transporting qubits across the chip, allowing connectivity beyond immediate neighbours. Here we demonstrate high-fidelity coherent transport of an electron spin qubit between quantum dots in isotopically-enriched silicon. We observe qubit precession in the inter-site tunnelling regime and assess the impact of qubit transport using Ramsey interferometry and quantum state tomography techniques. We report a polarization transfer fidelity of 99.97% and an average coherent transfer fidelity of 99.4%. Our results provide key elements for high-fidelity, on-chip quantum information distribution, as long envisaged, reinforcing the scaling prospects of silicon-based spin qubits.
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Affiliation(s)
- J Yoneda
- School of Electrical Engineering and Telecommunications, The University of New South Wales, Sydney, NSW, Australia. .,Tokyo Tech Academy for Super Smart Society, Tokyo Institute of Technology, Tokyo, Japan.
| | - W Huang
- School of Electrical Engineering and Telecommunications, The University of New South Wales, Sydney, NSW, Australia.,Solid State Physics Laboratory, ETH Zurich, Zurich, Switzerland
| | - M Feng
- School of Electrical Engineering and Telecommunications, The University of New South Wales, Sydney, NSW, Australia
| | - C H Yang
- School of Electrical Engineering and Telecommunications, The University of New South Wales, Sydney, NSW, Australia
| | - K W Chan
- School of Electrical Engineering and Telecommunications, The University of New South Wales, Sydney, NSW, Australia
| | - T Tanttu
- School of Electrical Engineering and Telecommunications, The University of New South Wales, Sydney, NSW, Australia
| | - W Gilbert
- School of Electrical Engineering and Telecommunications, The University of New South Wales, Sydney, NSW, Australia
| | - R C C Leon
- School of Electrical Engineering and Telecommunications, The University of New South Wales, Sydney, NSW, Australia
| | - F E Hudson
- School of Electrical Engineering and Telecommunications, The University of New South Wales, Sydney, NSW, Australia
| | - K M Itoh
- School of Fundamental Science and Technology, Keio University, Yokohama, Japan
| | - A Morello
- School of Electrical Engineering and Telecommunications, The University of New South Wales, Sydney, NSW, Australia
| | - S D Bartlett
- Centre for Engineered Quantum Systems, School of Physics, University of Sydney, Sydney, NSW, Australia
| | - A Laucht
- School of Electrical Engineering and Telecommunications, The University of New South Wales, Sydney, NSW, Australia
| | - A Saraiva
- School of Electrical Engineering and Telecommunications, The University of New South Wales, Sydney, NSW, Australia
| | - A S Dzurak
- School of Electrical Engineering and Telecommunications, The University of New South Wales, Sydney, NSW, Australia.
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Leung HT, Woo YC, Fong CHY, Tan KCB, Lau EYF, Chan KW, Leung JYY. A clinical prediction score using age at diagnosis and saline infusion test parameters can predict aldosterone-producing adenoma from idiopathic adrenal hyperplasia. J Endocrinol Invest 2020; 43:347-355. [PMID: 31529391 DOI: 10.1007/s40618-019-01114-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 09/07/2019] [Indexed: 12/21/2022]
Abstract
PURPOSE Accurate subtyping of the primary aldosteronism into aldosterone-producing adenoma (APA) and idiopathic adrenal hyperplasia (IAH) is important to direct for specific treatment modalities. The objective of the study was to compare the clinical and biochemical parameters of APA and IAH patients to derive a Clinical Prediction Score reliably predicting APA from IAH. METHODS This was a retrospective multi-centre study recruiting 38 APA patients and 42 IAH patients from four major hospitals in Hong Kong using database from Surgical Outcomes Monitoring and Improvement Programme and Clinical Data Analysis and Reporting System. Their clinical and biochemical parameters were evaluated. RESULTS Patients in APA group were younger than IAH group (mean age 48.6 ± 9.2 vs. 57.1 ± 7.3 years old, p < 0.001), had more suppressed renin before saline infusion in saline infusion test (SIT) (median 0.19 [IQR 0.15-0.37] vs. 0.39 [IQR 0.19-0.69] ng/mL/h, p = 0.01), and higher aldosterone level after saline infusion in SIT (median 674 [IQR 498-1000] vs. 327 [IQR 242-483] pmol/L, p < 0.001). A clinical prediction score using three parameters was devised, comprising age at diagnosis < 50 years, PRA before saline infusion in SIT ≤ 0.26 ng/mL/h, and aldosterone level after saline infusion in SIT ≥ 424 pmol/L. A score of 2 would predict APA with a sensitivity of 84.2% and specificity of 88.1%, and a score of 3 would predict APA with a sensitivity of 31.6% and specificity of 100%. CONCLUSIONS Clinical Prediction Score based on the combination of age at diagnosis, PRA, and aldosterone level in the saline infusion tests could reliably predict APA from IAH.
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Affiliation(s)
- H T Leung
- Department of Medicine and Geriatrics, Ruttonjee Hospital, Wan Chai, Hong Kong.
| | - Y C Woo
- Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - C H Y Fong
- Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - K C B Tan
- Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - E Y F Lau
- Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong
| | - K W Chan
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Lai Chi Kok, Hong Kong
| | - J Y Y Leung
- Department of Medicine and Geriatrics, Ruttonjee Hospital, Wan Chai, Hong Kong
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4
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Leon RCC, Yang CH, Hwang JCC, Lemyre JC, Tanttu T, Huang W, Chan KW, Tan KY, Hudson FE, Itoh KM, Morello A, Laucht A, Pioro-Ladrière M, Saraiva A, Dzurak AS. Coherent spin control of s-, p-, d- and f-electrons in a silicon quantum dot. Nat Commun 2020; 11:797. [PMID: 32047151 PMCID: PMC7012832 DOI: 10.1038/s41467-019-14053-w] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [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: 06/10/2019] [Accepted: 12/11/2019] [Indexed: 11/09/2022] Open
Abstract
Once the periodic properties of elements were unveiled, chemical behaviour could be understood in terms of the valence of atoms. Ideally, this rationale would extend to quantum dots, and quantum computation could be performed by merely controlling the outer-shell electrons of dot-based qubits. Imperfections in semiconductor materials disrupt this analogy, so real devices seldom display a systematic many-electron arrangement. We demonstrate here an electrostatically confined quantum dot that reveals a well defined shell structure. We observe four shells (31 electrons) with multiplicities given by spin and valley degrees of freedom. Various fillings containing a single valence electron-namely 1, 5, 13 and 25 electrons-are found to be potential qubits. An integrated micromagnet allows us to perform electrically-driven spin resonance (EDSR), leading to faster Rabi rotations and higher fidelity single qubit gates at higher shell states. We investigate the impact of orbital excitations on single qubits as a function of the dot deformation and exploit it for faster qubit control.
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Affiliation(s)
- R C C Leon
- Centre for Quantum Computation and Communication Technology, School of Electrical Engineering and Telecommunications, The University of New South Wales, Sydney, NSW, 2052, Australia.
| | - C H Yang
- Centre for Quantum Computation and Communication Technology, School of Electrical Engineering and Telecommunications, The University of New South Wales, Sydney, NSW, 2052, Australia
| | - J C C Hwang
- Centre for Quantum Computation and Communication Technology, School of Electrical Engineering and Telecommunications, The University of New South Wales, Sydney, NSW, 2052, Australia
- Research and Prototype Foundry, The University of Sydney, Sydney, NSW, 2006, Australia
| | - J Camirand Lemyre
- Institut Quantique et Département de Physique, Université de Sherbrooke, Sherbrooke, Québec, J1K 2R1, Canada
| | - T Tanttu
- Centre for Quantum Computation and Communication Technology, School of Electrical Engineering and Telecommunications, The University of New South Wales, Sydney, NSW, 2052, Australia
| | - W Huang
- Centre for Quantum Computation and Communication Technology, School of Electrical Engineering and Telecommunications, The University of New South Wales, Sydney, NSW, 2052, Australia
| | - K W Chan
- Centre for Quantum Computation and Communication Technology, School of Electrical Engineering and Telecommunications, The University of New South Wales, Sydney, NSW, 2052, Australia
| | - K Y Tan
- QCD Labs COMP Centre of Excellence, Department of Applied Physics, Aalto University, 00076, Aalto, Finland
| | - F E Hudson
- Centre for Quantum Computation and Communication Technology, School of Electrical Engineering and Telecommunications, The University of New South Wales, Sydney, NSW, 2052, Australia
| | - K M Itoh
- School of Fundamental Science and Technology, Keio University, 3-14-1 Hiyoshi, Kohokuku, Yokohama, 223-8522, Japan
| | - A Morello
- Centre for Quantum Computation and Communication Technology, School of Electrical Engineering and Telecommunications, The University of New South Wales, Sydney, NSW, 2052, Australia
| | - A Laucht
- Centre for Quantum Computation and Communication Technology, School of Electrical Engineering and Telecommunications, The University of New South Wales, Sydney, NSW, 2052, Australia
| | - M Pioro-Ladrière
- Institut Quantique et Département de Physique, Université de Sherbrooke, Sherbrooke, Québec, J1K 2R1, Canada
- Quantum Information Science Program, Canadian Institute for Advanced Research, Toronto, ON, M5G 1Z8, Canada
| | - A Saraiva
- Centre for Quantum Computation and Communication Technology, School of Electrical Engineering and Telecommunications, The University of New South Wales, Sydney, NSW, 2052, Australia.
| | - A S Dzurak
- Centre for Quantum Computation and Communication Technology, School of Electrical Engineering and Telecommunications, The University of New South Wales, Sydney, NSW, 2052, Australia.
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5
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Zhao R, Tanttu T, Tan KY, Hensen B, Chan KW, Hwang JCC, Leon RCC, Yang CH, Gilbert W, Hudson FE, Itoh KM, Kiselev AA, Ladd TD, Morello A, Laucht A, Dzurak AS. Single-spin qubits in isotopically enriched silicon at low magnetic field. Nat Commun 2019; 10:5500. [PMID: 31796728 PMCID: PMC6890755 DOI: 10.1038/s41467-019-13416-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [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: 03/28/2019] [Accepted: 11/06/2019] [Indexed: 11/09/2022] Open
Abstract
Single-electron spin qubits employ magnetic fields on the order of 1 Tesla or above to enable quantum state readout via spin-dependent-tunnelling. This requires demanding microwave engineering for coherent spin resonance control, which limits the prospects for large scale multi-qubit systems. Alternatively, singlet-triplet readout enables high-fidelity spin-state measurements in much lower magnetic fields, without the need for reservoirs. Here, we demonstrate low-field operation of metal-oxide-silicon quantum dot qubits by combining coherent single-spin control with high-fidelity, single-shot, Pauli-spin-blockade-based ST readout. We discover that the qubits decohere faster at low magnetic fields with [Formula: see text] μs and [Formula: see text] μs at 150 mT. Their coherence is limited by spin flips of residual 29Si nuclei in the isotopically enriched 28Si host material, which occur more frequently at lower fields. Our finding indicates that new trade-offs will be required to ensure the frequency stabilization of spin qubits, and highlights the importance of isotopic enrichment of device substrates for the realization of a scalable silicon-based quantum processor.
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Affiliation(s)
- R Zhao
- Centre for Quantum Computation and Communication Technology, School of Electrical Engineering and Telecommunications, University of New South Wales, Sydney, NSW, 2052, Australia.
- National Institute of Standards and Technology, 325 Broadway, Boulder, CO, 80305, USA.
| | - T Tanttu
- Centre for Quantum Computation and Communication Technology, School of Electrical Engineering and Telecommunications, University of New South Wales, Sydney, NSW, 2052, Australia
| | - K Y Tan
- QCD Labs, QTF Centre of Excellence, Department of Applied Physics, Aalto University, 00076, Aalto, Finland
- IQM Finland Oy, Vaisalantie 6 C, 02130, Espoo, Finland
| | - B Hensen
- Centre for Quantum Computation and Communication Technology, School of Electrical Engineering and Telecommunications, University of New South Wales, Sydney, NSW, 2052, Australia
| | - K W Chan
- Centre for Quantum Computation and Communication Technology, School of Electrical Engineering and Telecommunications, University of New South Wales, Sydney, NSW, 2052, Australia
| | - J C C Hwang
- Centre for Quantum Computation and Communication Technology, School of Electrical Engineering and Telecommunications, University of New South Wales, Sydney, NSW, 2052, Australia
- Research and Prototype Foundry, The University of Sydney, Sydney, NSW, 2006, Australia
| | - R C C Leon
- Centre for Quantum Computation and Communication Technology, School of Electrical Engineering and Telecommunications, University of New South Wales, Sydney, NSW, 2052, Australia
| | - C H Yang
- Centre for Quantum Computation and Communication Technology, School of Electrical Engineering and Telecommunications, University of New South Wales, Sydney, NSW, 2052, Australia
| | - W Gilbert
- Centre for Quantum Computation and Communication Technology, School of Electrical Engineering and Telecommunications, University of New South Wales, Sydney, NSW, 2052, Australia
| | - F E Hudson
- Centre for Quantum Computation and Communication Technology, School of Electrical Engineering and Telecommunications, University of New South Wales, Sydney, NSW, 2052, Australia
| | - K M Itoh
- School of Fundamental Science and Technology, Keio University, 3-14-1 Hiyoshi, Kohoku-ku, Yokohama, 223-8522, Japan
| | - A A Kiselev
- HRL Laboratories, LLC, 3011 Malibu Canyon Road, Malibu, CA, 90265, USA
| | - T D Ladd
- HRL Laboratories, LLC, 3011 Malibu Canyon Road, Malibu, CA, 90265, USA
| | - A Morello
- Centre for Quantum Computation and Communication Technology, School of Electrical Engineering and Telecommunications, University of New South Wales, Sydney, NSW, 2052, Australia
| | - A Laucht
- Centre for Quantum Computation and Communication Technology, School of Electrical Engineering and Telecommunications, University of New South Wales, Sydney, NSW, 2052, Australia
| | - A S Dzurak
- Centre for Quantum Computation and Communication Technology, School of Electrical Engineering and Telecommunications, University of New South Wales, Sydney, NSW, 2052, Australia.
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6
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Masucci L, Torres S, Eisen A, Trudeau M, Tyono I, Saunders H, Chan KW, Isaranuwatchai W. Cost-utility analysis of 21-gene assay for node-positive early breast cancer. ACTA ACUST UNITED AC 2019; 26:307-318. [PMID: 31708649 DOI: 10.3747/co.26.4769] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Background For women with lymph node (ln)-positive, estrogen receptor-positive, and her2 (human epidermal growth factor receptor 2)-negative breast cancer (bca), current guidelines recommend treatment with both hormonal therapy and chemotherapy. The 21-gene Recurrence Score (rs) assay might be helpful in selecting patients with bca who can be spared chemotherapy when they have 1-3 positive lns and a lower risk of recurrence. In the present study, we performed a cost-utility analysis comparing use of the 21-gene rs assay with current practice from the perspective of a Canadian health care payer. Methods A Markov model was developed to determine costs and quality-adjusted life-years (qalys) over a patient's lifetime. Patient outcomes in both study groups were examined based on published clinical trials. Costs were derived primarily from published Canadian sources. Costs and outcomes were discounted at 1.5% annually, and costs are reported in 2016 Canadian dollars. A probabilistic analysis was used, and the model parameters were varied in a sensitivity analysis. Results The results indicate that use of the 21-gene rs assay was less costly ($432 less) and more effective (0.22 qalys) than current practice. The probabilistic analysis revealed that 70% of the 10,000 simulated incremental cost-effectiveness ratios were in the southeast quadrant. The results were sensitive to the probability of a low rs and to the probability of receiving chemotherapy in the low-risk rs category and in current practice. Conclusions Use of the 21-gene rs assay could be a cost-effective strategy for Ontario patients with estrogen receptor-positive, her2-negative early bca and 1-3 positive lns.
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Affiliation(s)
- L Masucci
- Centre for Excellence in Economic Analysis Research, St. Michael's Hospital, University of Toronto, Toronto, ON
| | - S Torres
- Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON
| | - A Eisen
- Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON.,Cancer Care Ontario, University of Toronto, Toronto, ON
| | - M Trudeau
- Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON.,Cancer Care Ontario, University of Toronto, Toronto, ON
| | - I Tyono
- Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON
| | - H Saunders
- Centre for Excellence in Economic Analysis Research, St. Michael's Hospital, University of Toronto, Toronto, ON
| | - K W Chan
- Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON.,Cancer Care Ontario, University of Toronto, Toronto, ON.,Canadian Centre for Applied Research in Cancer Control, University of Toronto, Toronto, ON
| | - W Isaranuwatchai
- Centre for Excellence in Economic Analysis Research, St. Michael's Hospital, University of Toronto, Toronto, ON.,Canadian Centre for Applied Research in Cancer Control, University of Toronto, Toronto, ON.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON
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7
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Chan W, Chow DLY, Lau HY, Chan KW, Tung SY, Wong CS. Fungal Infection Mimicking Nasopharyngeal Carcinoma Recurrence: a Case Report. Hong Kong Journal of Radiology 2019. [DOI: 10.12809/hkjr1916999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- W Chan
- Department of Clinical Oncology, Tuen Mun Hospital, Tuen Mun, Hong Kong
| | - DLY Chow
- Department of Radiology, Tuen Mun Hospital, Tuen Mun, Hong Kong
| | - HY Lau
- Department of Radiology, Tuen Mun Hospital, Tuen Mun, Hong Kong
| | - KW Chan
- Department of Pathology, The University of Hong Kong, Pokfulam, Hong Kong
| | - SY Tung
- Department of Clinical Oncology, Tuen Mun Hospital, Tuen Mun, Hong Kong
| | - CS Wong
- Department of Clinical Oncology, Tuen Mun Hospital, Tuen Mun, Hong Kong
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8
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Tan K, Chow WS, Leung J, Ho A, Ozaki R, Kam G, Li J, Choi CH, Tsang MW, Chan N, Lee KK, Chan KW. Clinical considerations when adding a sodium-glucose co-transporter-2 inhibitor to insulin therapy in patients with diabetes mellitus. Hong Kong Med J 2019; 25:312-319. [PMID: 31416990 DOI: 10.12809/hkmj197802] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- K Tan
- Department of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - W S Chow
- Department of Medicine, Queen Mary Hospital, Pokfulam, Hong Kong
| | - J Leung
- Department of Integrated Medical Service, Ruttonjee and Tang Shiu Kin Hospitals, Hong Kong
| | - A Ho
- Department of Medicine and Geriatrics, Tuen Mun Hospital, Tuen Mun, Hong Kong
| | - R Ozaki
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - G Kam
- Department of Medicine and Geriatrics, United Christian Hospital, Kwun Tong, Hong Kong
| | - J Li
- Department of Medicine, Yan Chai Hospital, Tsuen Wan, Hong Kong
| | - C H Choi
- Department of Medicine, Queen Elizabeth Hospital, Jordan, Hong Kong
| | - M W Tsang
- Specialist in Endocrinology, Private Practice
| | - N Chan
- Specialist in Endocrinology, Private Practice
| | - K K Lee
- Department of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - K W Chan
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Laichikok, Hong Kong
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9
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Chang WC, Lee HC, Chan SI, Chiu SY, Lee HM, Chan KW, Wong MC, Chan KL, Yeung WS, Choy LW, Chong SY, Siu MW, Lo TL, Yan WC, Ng MK, Poon LT, Pang PF, Lam WC, Wong YC, Chung WS, Mo YM, Lui SY, Hui LM, Chen EYH. Negative symptom dimensions differentially impact on functioning in individuals at-risk for psychosis. Schizophr Res 2018; 202:310-315. [PMID: 29935882 DOI: 10.1016/j.schres.2018.06.041] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 04/20/2018] [Accepted: 06/14/2018] [Indexed: 12/24/2022]
Affiliation(s)
- W C Chang
- Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, Hong Kong; State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong.
| | - H C Lee
- Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - S I Chan
- Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - S Y Chiu
- Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - H M Lee
- Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - K W Chan
- Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, Hong Kong; State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong
| | - M C Wong
- Department of Psychiatry, Queen Mary Hospital, Hong Kong
| | - K L Chan
- Department of Psychiatry, Queen Mary Hospital, Hong Kong
| | - W S Yeung
- Department of Psychiatry, Pamela Youde Nethersole Eastern Hospital, Hong Kong
| | - L W Choy
- Department of Psychiatry, Pamela Youde Nethersole Eastern Hospital, Hong Kong
| | - S Y Chong
- Department of Psychiatry, Kwai Chung Hospital, Hong Kong
| | - M W Siu
- Department of Psychiatry, Kwai Chung Hospital, Hong Kong
| | - T L Lo
- Department of Psychiatry, Kwai Chung Hospital, Hong Kong
| | - W C Yan
- Department of Psychiatry, Kowloon Hospital, Hong Kong
| | - M K Ng
- Department of Psychiatry, Kowloon Hospital, Hong Kong
| | - L T Poon
- Department of Psychiatry, United Christian Hospital, Hong Kong
| | - P F Pang
- Department of Psychiatry, United Christian Hospital, Hong Kong
| | - W C Lam
- Department of Psychiatry, United Christian Hospital, Hong Kong
| | - Y C Wong
- Department of Psychiatry, Tai Po Hospital, Hong Kong
| | - W S Chung
- Department of Psychiatry, Tai Po Hospital, Hong Kong
| | - Y M Mo
- Department of Psychiatry, Alice Ho Miu Ling Nethersole Hospital, Hong Kong
| | - S Y Lui
- Department of Psychiatry, Castle Peak Hospital, Hong Kong
| | - L M Hui
- Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - E Y H Chen
- Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, Hong Kong; State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong
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10
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Bhatt ST, Bednarski JJ, Berg J, Trinkaus K, Murray L, Hayashi R, Schulz G, Hente M, Grimley M, Chan KW, Kamani N, Jacobsohn D, Nieder M, Hale G, Yu L, Adams R, Dalal J, Pulsipher MA, Haut P, Chaudhury S, Davis J, Jaroscak J, Andreansky M, Willert J, Shenoy S. Immune Reconstitution and Infection Patterns after Early Alemtuzumab and Reduced Intensity Transplantation for Nonmalignant Disorders in Pediatric Patients. Biol Blood Marrow Transplant 2018; 25:556-561. [PMID: 30321596 DOI: 10.1016/j.bbmt.2018.10.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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: 08/01/2018] [Accepted: 10/08/2018] [Indexed: 11/16/2022]
Abstract
Hematopoietic stem cell transplantation (HSCT) is a therapeutic option for many nonmalignant disorders (NMD) and is curative or prevents disease progression. Reduced-intensity conditioning (RIC) in HSCT for NMD may reduce regimen-related acute toxicities and late complications. Myeloablation is often replaced by immune suppression in RIC regimens to support donor engraftment. The pace of immune reconstitution after immune suppression by RIC regimens is influenced by agents used, donor source, and graft-versus-host disease prophylaxis/treatment. In a multicenter trial (NCT 00920972) of HSCT for NMD, a RIC regimen consisting of alemtuzumab, fludarabine, and melphalan was substituted for myeloablation. Alemtuzumab was administered early (days -21 to -19) to mitigate major lymphodepletion of the incoming graft and the risk of graft rejection. Immune reconstitution and infectious complications were prospectively monitored for 1-year post-HSCT. Seventy-one patients met inclusion criteria for this report and received marrow or peripheral blood stem cell transplants. Immune reconstitution and infections are reported for related donor (RD) and unrelated donor (URD) transplants at 3 time-points (100days, 6 months, and 1 year post-HSCT). Natural killer cell recovery was rapid, and numbers normalized in both cohorts by day +100. Mean CD3, CD4, and CD8 T-lymphocyte numbers normalized by 6 months after RD HSCT and by 1 year in the URD group. CD4 and CD8 T-lymphocyte counts were significantly higher in patients who received RD HSCT at 6 months and at 1 year, respectively, post-HSCT compared with patients who received URD HSCT. The pace of CD19 B-cell recovery was markedly different between RD and URD cohorts. Mean B-cell numbers were normal by day 100 after RD HSCT but took 1 year post-HSCT to normalize in the URD cohort. Despite these differences in immune reconstitution, the timing and nature of infections did not differ between the groups, presumably because of comparable T-lymphocyte recovery. Immune reconstitution occurred at a faster pace than in prior reports using RIC with T-cell depletion. The incidence of infections was similar for both cohorts and occurred most frequently in the first 100days post-HSCT. Viral and fungal infections occurred at a lower incidence in this cohort, with "early" alemtuzumab compared with regimens administering serotherapy in the peritransplantation period. Patients were susceptible to bacterial infections primarily in the first 100days irrespective of donor source and had no increase in mortality from the same. The overall mortality rate from infections was 1.4% at 1 year. Close monitoring and prophylaxis against bacterial infections in the first 100days post-HSCT is necessary but is followed by robust immune reconstitution, especially in the T-cell compartment.
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Affiliation(s)
- Sima T Bhatt
- Washington University and Saint Louis Children's Hospital, St. Louis, Missouri
| | - Jeffrey J Bednarski
- Washington University and Saint Louis Children's Hospital, St. Louis, Missouri
| | - Julia Berg
- Washington University and Saint Louis Children's Hospital, St. Louis, Missouri
| | - Kathryn Trinkaus
- Siteman Cancer Center Biostatistics Shared Resource, St. Louis, Missouri
| | - Lisa Murray
- Washington University and Saint Louis Children's Hospital, St. Louis, Missouri
| | - Robert Hayashi
- Washington University and Saint Louis Children's Hospital, St. Louis, Missouri
| | - Ginny Schulz
- Washington University and Saint Louis Children's Hospital, St. Louis, Missouri
| | - Monica Hente
- Washington University and Saint Louis Children's Hospital, St. Louis, Missouri
| | | | - Ka Wah Chan
- Methodist Children's Hospital, San Antonio, Texas
| | - Naynesh Kamani
- Children's National Medical Center, Washington, District of Columbia
| | - David Jacobsohn
- Children's National Medical Center, Washington, District of Columbia
| | - Michael Nieder
- Johns Hopkins All Children's Hospital, St. Petersburg, Florida
| | - Gregory Hale
- Johns Hopkins All Children's Hospital, St. Petersburg, Florida
| | - Lolie Yu
- Louisiana State University, New Orleans, Louisiana
| | | | | | - Michael A Pulsipher
- Children's Center for Cancer and Blood Diseases, Children's Hospital Los Angeles, USC Keck School of Medicine, Los Angeles, California
| | - Paul Haut
- Riley Children's Hospital, Indianapolis, Indiana
| | | | - Jeffrey Davis
- Children's and Women's Health Centre of British Columbia, Vancouver, British Columbia, Canada
| | - Jennifer Jaroscak
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | | | | | - Shalini Shenoy
- Washington University and Saint Louis Children's Hospital, St. Louis, Missouri.
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11
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Huang D, Cheng YY, Wong YT, Yung SY, Tam CC, Chan KW, Lam CC, Yiu KH, Hai JJ, Lau CP, Chan WY, Chiang CE, Tse HF, Chan PH, Siu CW. P5554TIMI risk score for secondary prevention of recurrent cardiovascular events in a real world cohort of post acute ST-elevation myocardial infarction patients. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- D Huang
- The University of Hong Kong, Queen Mary Hospital, Cardiology Division, Department of Medicine, Hong Kong, Hong Kong SAR People's Republic of China
| | - Y Y Cheng
- The University of Hong Kong, Queen Mary Hospital, Cardiology Division, Department of Medicine, Hong Kong, Hong Kong SAR People's Republic of China
| | - Y T Wong
- The University of Hong Kong, Queen Mary Hospital, Cardiology Division, Department of Medicine, Hong Kong, Hong Kong SAR People's Republic of China
| | - S Y Yung
- The University of Hong Kong, Queen Mary Hospital, Cardiology Division, Department of Medicine, Hong Kong, Hong Kong SAR People's Republic of China
| | - C C Tam
- The University of Hong Kong, Queen Mary Hospital, Cardiology Division, Department of Medicine, Hong Kong, Hong Kong SAR People's Republic of China
| | - K W Chan
- The University of Hong Kong, Queen Mary Hospital, Cardiology Division, Department of Medicine, Hong Kong, Hong Kong SAR People's Republic of China
| | - C C Lam
- The University of Hong Kong, Queen Mary Hospital, Cardiology Division, Department of Medicine, Hong Kong, Hong Kong SAR People's Republic of China
| | - K H Yiu
- The University of Hong Kong, Queen Mary Hospital, Cardiology Division, Department of Medicine, Hong Kong, Hong Kong SAR People's Republic of China
| | - J J Hai
- The University of Hong Kong, Queen Mary Hospital, Cardiology Division, Department of Medicine, Hong Kong, Hong Kong SAR People's Republic of China
| | - C P Lau
- The University of Hong Kong, Queen Mary Hospital, Cardiology Division, Department of Medicine, Hong Kong, Hong Kong SAR People's Republic of China
| | - W Y Chan
- The University of Hong Kong, Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Hong Kong, Hong Kong SAR People's Republic of China
| | - C E Chiang
- National Yang Ming University, Taipei Veterans General Hospital, Division of Cardiology, Taipei, Taiwan ROC
| | - H F Tse
- The University of Hong Kong, Queen Mary Hospital, Cardiology Division, Department of Medicine, Hong Kong, Hong Kong SAR People's Republic of China
| | - P H Chan
- The University of Hong Kong, Queen Mary Hospital, Cardiology Division, Department of Medicine, Hong Kong, Hong Kong SAR People's Republic of China
| | - C W Siu
- The University of Hong Kong, Queen Mary Hospital, Cardiology Division, Department of Medicine, Hong Kong, Hong Kong SAR People's Republic of China
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12
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Huang D, Cheng YY, Wong YT, Yung SY, Tam CC, Chan KW, Lam CC, Yiu KH, Hai JJ, Lau CP, Chan WY, Chiang CE, Tse HF, Chan PH, Siu CW. P1727TIMI risk score for secondary prevention of recurrent cardiovascular events in a real world cohort of post acute non-ST-elevation myocardial infarction patients. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- D Huang
- The University of Hong Kong, Queen Mary Hospital, Cardiology Division, Department of Medicine, Hong Kong, Hong Kong SAR People's Republic of China
| | - Y Y Cheng
- The University of Hong Kong, Queen Mary Hospital, Cardiology Division, Department of Medicine, Hong Kong, Hong Kong SAR People's Republic of China
| | - Y T Wong
- The University of Hong Kong, Queen Mary Hospital, Cardiology Division, Department of Medicine, Hong Kong, Hong Kong SAR People's Republic of China
| | - S Y Yung
- The University of Hong Kong, Queen Mary Hospital, Cardiology Division, Department of Medicine, Hong Kong, Hong Kong SAR People's Republic of China
| | - C C Tam
- The University of Hong Kong, Queen Mary Hospital, Cardiology Division, Department of Medicine, Hong Kong, Hong Kong SAR People's Republic of China
| | - K W Chan
- The University of Hong Kong, Queen Mary Hospital, Cardiology Division, Department of Medicine, Hong Kong, Hong Kong SAR People's Republic of China
| | - C C Lam
- The University of Hong Kong, Queen Mary Hospital, Cardiology Division, Department of Medicine, Hong Kong, Hong Kong SAR People's Republic of China
| | - K H Yiu
- The University of Hong Kong, Queen Mary Hospital, Cardiology Division, Department of Medicine, Hong Kong, Hong Kong SAR People's Republic of China
| | - J J Hai
- The University of Hong Kong, Queen Mary Hospital, Cardiology Division, Department of Medicine, Hong Kong, Hong Kong SAR People's Republic of China
| | - C P Lau
- The University of Hong Kong, Queen Mary Hospital, Cardiology Division, Department of Medicine, Hong Kong, Hong Kong SAR People's Republic of China
| | - W Y Chan
- The University of Hong Kong, Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Hong Kong, Hong Kong SAR People's Republic of China
| | - C E Chiang
- National Yang Ming University, Taipei Veterans General Hospital, Division of Cardiology, Taipei, Taiwan ROC
| | - H F Tse
- The University of Hong Kong, Queen Mary Hospital, Cardiology Division, Department of Medicine, Hong Kong, Hong Kong SAR People's Republic of China
| | - P H Chan
- The University of Hong Kong, Queen Mary Hospital, Cardiology Division, Department of Medicine, Hong Kong, Hong Kong SAR People's Republic of China
| | - C W Siu
- The University of Hong Kong, Queen Mary Hospital, Cardiology Division, Department of Medicine, Hong Kong, Hong Kong SAR People's Republic of China
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13
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Chan DCW, Lui CY, Yuen KT, Kwok CH, Chan KW, Cheng ACK. Secondary Adrenal Insufficiency: A Cross-sectional Study of Nasopharyngeal Carcinoma Patients after Treatment with Intensity-modulated Radiotherapy. Hong Kong J Radiol 2018. [DOI: 10.12809/hkjr1816827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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14
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Tang JC, Chan KW, Law SY. Evaluation of a novel clinicopathological marker JK-1 for human oesophageal carcinoma. Hong Kong Med J 2018; 24 Suppl 3:41-44. [PMID: 29937447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023] Open
Affiliation(s)
- J Co Tang
- Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University
| | - K W Chan
- Department of Pathology, The University of Hong Kong
| | - S Yk Law
- Department of Surgery, The University of Hong Kong
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15
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Eckrich MJ, Madden L, Taylor C, Matheny C, Frausto-Garcia E, Chan KW, Quigg TC. Reduced-Intensity Allogeneic Stem Cell Transplant for Sickle Cell Disease in Pediatrics: A Single Institution Experience. Biol Blood Marrow Transplant 2018. [DOI: 10.1016/j.bbmt.2017.12.521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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16
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Li B, Xu WW, Han L, Chan KT, Tsao SW, Lee NPY, Law S, Xu LY, Li EM, Chan KW, Qin YR, Guan XY, He QY, Cheung ALM. MicroRNA-377 suppresses initiation and progression of esophageal cancer by inhibiting CD133 and VEGF. Oncogene 2017; 36:3986-4000. [PMID: 28288140 PMCID: PMC5511242 DOI: 10.1038/onc.2017.29] [Citation(s) in RCA: 101] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 12/29/2016] [Accepted: 01/11/2017] [Indexed: 02/05/2023]
Abstract
Esophageal cancer is one of the most lethal cancers worldwide with poor survival and limited therapeutic options. The discovery of microRNAs created a new milestone in cancer research. miR-377 is located in chromosome region 14q32, which is frequently deleted in esophageal squamous cell carcinoma (ESCC), but the biological functions, clinical significance and therapeutic implication of miR-377 in ESCC are largely unknown. In this study, we found that miR-377 expression was significantly downregulated in tumor tissue and serum of patients with ESCC. Both tumor tissue and serum miR-377 expression levels were positively correlated with patient survival. Higher serum miR-377 expression was inversely associated with pathologic tumor stage, distant metastasis, residual tumor status and chemoradiotherapy resistance. The roles of miR-377 in suppressing tumor initiation and progression, and the underlying molecular mechanisms were investigated. Results of in vitro and in vivo experiments showed that miR-377 overexpression inhibited the initiation, growth and angiogenesis of ESCC tumors as well as metastatic colonization of ESCC cells, whereas silencing of miR-377 had opposite effects. Mechanistically, miR-377 regulated CD133 and VEGF by directly binding to their 3' untranslated region. Moreover, systemic delivery of formulated miR-377 mimic not only suppressed tumor growth in nude mice but also blocked tumor angiogenesis and metastasis of ESCC cells to the lungs without overt toxicity to mice. Collectively, our study established that miR-377 plays a functional and significant role in suppressing tumor initiation and progression, and may represent a promising non-invasive diagnostic and prognostic biomarker and therapeutic strategy for patients with ESCC.
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MESH Headings
- AC133 Antigen/genetics
- Adult
- Aged
- Aged, 80 and over
- Animals
- Carcinoma, Squamous Cell/diagnosis
- Carcinoma, Squamous Cell/genetics
- Carcinoma, Squamous Cell/mortality
- Carcinoma, Squamous Cell/pathology
- Case-Control Studies
- Cell Line, Tumor
- Cell Transformation, Neoplastic/genetics
- Disease Progression
- Down-Regulation/genetics
- Esophageal Neoplasms/diagnosis
- Esophageal Neoplasms/genetics
- Esophageal Neoplasms/mortality
- Esophageal Neoplasms/pathology
- Esophageal Squamous Cell Carcinoma
- Female
- Gene Expression Regulation, Neoplastic
- HEK293 Cells
- Humans
- Male
- Mice
- Mice, Inbred BALB C
- Mice, Inbred NOD
- Mice, Nude
- Mice, SCID
- MicroRNAs/physiology
- Middle Aged
- Vascular Endothelial Growth Factor A/genetics
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Affiliation(s)
- B Li
- School of Biomedical Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, China
- The University of Hong Kong-Shenzhen Institute of Research and Innovation (HKU-SIRI), Shenzhen, China
- Centre for Cancer Research, The University of Hong Kong, Pokfulam, China
| | - W W Xu
- School of Biomedical Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, China
- The University of Hong Kong-Shenzhen Institute of Research and Innovation (HKU-SIRI), Shenzhen, China
| | - L Han
- School of Biomedical Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, China
- The University of Hong Kong-Shenzhen Institute of Research and Innovation (HKU-SIRI), Shenzhen, China
| | - K T Chan
- Department of Surgery, The University of Hong Kong, Pokfulam, China
| | - S W Tsao
- School of Biomedical Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, China
- Centre for Cancer Research, The University of Hong Kong, Pokfulam, China
| | - N P Y Lee
- Centre for Cancer Research, The University of Hong Kong, Pokfulam, China
- Department of Surgery, The University of Hong Kong, Pokfulam, China
| | - S Law
- Centre for Cancer Research, The University of Hong Kong, Pokfulam, China
- Department of Surgery, The University of Hong Kong, Pokfulam, China
| | - L Y Xu
- The Key Laboratory of Molecular Biology for High Cancer Incidence Coastal Chaoshan Area, Shantou University Medical College, Shantou, China
| | - E M Li
- The Key Laboratory of Molecular Biology for High Cancer Incidence Coastal Chaoshan Area, Shantou University Medical College, Shantou, China
| | - K W Chan
- The University of Hong Kong-Shenzhen Institute of Research and Innovation (HKU-SIRI), Shenzhen, China
- Centre for Cancer Research, The University of Hong Kong, Pokfulam, China
- Department of Pathology, The University of Hong Kong, Pokfulam, China
| | - Y R Qin
- Department of Clinical Oncology, First Affiliated Hospital, Zhengzhou University, Zhengzhou, China
| | - X Y Guan
- Centre for Cancer Research, The University of Hong Kong, Pokfulam, China
- Department of Clinical oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, China
| | - Q Y He
- College of Life Science and Technology, Jinan University, 601 West Huangpu Blvd., Guangzhou, China
| | - A L M Cheung
- School of Biomedical Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, China
- The University of Hong Kong-Shenzhen Institute of Research and Innovation (HKU-SIRI), Shenzhen, China
- Centre for Cancer Research, The University of Hong Kong, Pokfulam, China
- School of Biomedical Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong, SAR, China. E-mail:
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17
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Eapen M, Kurtzberg J, Zhang MJ, Hattersely G, Fei M, Mendizabal A, Chan KW, De Oliveira S, Schultz KR, Wall D, Horowitz MM, Wagner JE. Umbilical Cord Blood Transplantation in Children with Acute Leukemia: Impact of Conditioning on Transplantation Outcomes. Biol Blood Marrow Transplant 2017; 23:1714-1721. [PMID: 28684372 DOI: 10.1016/j.bbmt.2017.06.023] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 06/27/2017] [Indexed: 11/15/2022]
Abstract
The Blood and Marrow Transplant Clinical Trials Network (BMT CTN 0501) randomized children with hematologic malignancies to transplantation with 1 or 2 cord blood units (UCB) between 2006 and 2012. While the trial concluded that survival was similar regardless of number of units infused, survival was better than previously reported. This prompted a comparison of survival of trial versus nontrial patients to determine the generalizability of trial results and whether survival was better because of the trial treatment regimen. During the trial period, 396 recipients of a single UCB unit met trial eligibility but were not enrolled. Trial patients (n = 100) received total body irradiation (TBI) 1320 cGy, cyclophosphamide 120 mg/kg, and fludarabine 75 mg/m2 (TCF). Nontrial patients either received the same regimen (n = 62; nontrial TCF) or alternative regimens (n = 334; nontrial regimens). Five-year survival between trial and nontrial patients conditioned with TCF was similar (70% versus 62%). However, 5-year survival was significantly lower with nontrial TBI-containing (47%; hazard ratio [HR], 1.97; P = .001) and chemotherapy-only regimens (49%; HR, 1.87; P = .007). The results of BMT CTN 0501 appear generalizable to the population of trial-eligible patients. The survival difference between the trial-specified regimen and other regimens indicate the importance of conditioning regimen for UCB transplantation.
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Affiliation(s)
- Mary Eapen
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin.
| | - Joanne Kurtzberg
- Department of Pediatrics, Duke University, Durham, North Carolina
| | - Mei-Jie Zhang
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Gareth Hattersely
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Mingwei Fei
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | | | - Ka Wah Chan
- Hematology/Oncology, Texas Transplant Institute, San Antonio, Texas
| | - Satiro De Oliveira
- Department of Pediatrics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Kirk R Schultz
- Hematology/Oncology, B.C. Children's Hospital, British Columbia, Canada
| | - Donna Wall
- Hematology/Oncology, The Hospital for Sick Children, Toronto, Canada
| | - Mary M Horowitz
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - John E Wagner
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota
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18
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Bitan M, Ahn KW, Millard HR, Pulsipher MA, Abdel-Azim H, Auletta JJ, Brown V, Chan KW, Diaz MA, Dietz A, Vincent MG, Guilcher G, Hale GA, Hayashi RJ, Keating A, Mehta P, Myers K, Page K, Prestidge T, Shah NN, Smith AR, Woolfrey A, Thiel E, Davies SM, Eapen M. Personalized Prognostic Risk Score for Long-Term Survival for Children with Acute Leukemia after Allogeneic Transplantation. Biol Blood Marrow Transplant 2017; 23:1523-1530. [PMID: 28527984 DOI: 10.1016/j.bbmt.2017.05.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 04/18/2017] [Accepted: 05/10/2017] [Indexed: 10/19/2022]
Abstract
We studied leukemia-free (LFS) and overall survival (OS) in children with acute myeloid (AML, n = 790) and acute lymphoblastic leukemia (ALL, n = 1096) who underwent transplantation between 2000 and 2010 and who survived for at least 1 year in remission after related or unrelated donor transplantation. Analysis of patient-, disease-, and transplantation characteristics and acute and chronic graft-versus-host disease (GVHD) was performed to identify factors with adverse effects on LFS and OS. These data were used to develop risk scores for survival. We did not identify any prognostic factors beyond 4 years after transplantation for AML and beyond 3 years for ALL. Risk score for survival for AML includes age, disease status at transplantation, cytogenetic risk group, and chronic GVHD. For ALL, the risk score includes age at transplantation and chronic GVHD. The 10-year probabilities of OS for AML with good (score 0, 1, or 2), intermediate (score 3), and poor risk (score 4, 5, 6, or 7) were 94%, 87%, and 68%, respectively. The 10-year probabilities of OS for ALL were 89% and 80% for good (score 0 or 1) and poor risk (score 2), respectively. Identifying children at risk for late mortality with early intervention may mitigate some excess late mortality.
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Affiliation(s)
- Menachem Bitan
- Department of Pediatric Hematology/Oncology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Kwang Woo Ahn
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Biostatistics, Institute for Health and Society, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Heather R Millard
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Michael A Pulsipher
- Division of Hematology, Oncology, and Blood and Marrow Transplantation, Children's Hospital Los Angeles, USC Keck School of Medicine, Los Angeles, California
| | - Hisham Abdel-Azim
- Division of Hematology, Oncology, and Blood and Marrow Transplantation, Children's Hospital Los Angeles, USC Keck School of Medicine, Los Angeles, California
| | - Jeffery J Auletta
- Host Defense Program, Divisions of Hematology/Oncology/Bone Marrow Transplant and Infectious Diseases, Nationwide Children's Hospital, Columbus, Ohio
| | - Valerie Brown
- Division of Pediatric Oncology/Hematology, Department of Pediatrics, Penn State Hershey Children's Hospital and College of Medicine, Hershey, Pennsylvania
| | - Ka Wah Chan
- Department of Pediatrics, Texas Transplant Institute, San Antonio, Texas
| | - Miguel Angel Diaz
- Department of Hematology/Oncology, Hospital Infantil Universitario Nino Jesus, Madrid, Spain
| | - Andrew Dietz
- Division of Hematology, Oncology, and Blood and Marrow Transplantation, Children's Hospital Los Angeles, USC Keck School of Medicine, Los Angeles, California
| | | | - Gregory Guilcher
- Section of Paediatric Oncology and Blood and Marrow Transplant, Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Gregory A Hale
- Department of Hematology/Oncology, Johns Hopkins All Children's Hospital, St. Petersburg, Florida
| | - Robert J Hayashi
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Amy Keating
- University of Colorado-Children's Hospital, Aurora, Colorado
| | - Parinda Mehta
- Division of Bone Marrow Transplant and Immune Deficiency, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Kasiani Myers
- Division of Bone Marrow Transplant and Immune Deficiency, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Kristin Page
- Division of Pediatric Blood and Marrow Transplantation, Duke University Medical Center, Durham, North Carolina
| | - Tim Prestidge
- Blood and Cancer Centre, Starship Children's Hospital, Auckland, New Zealand
| | - Nirali N Shah
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland
| | - Angela R Smith
- University of Minnesota Blood and Marrow Transplant Program, Minneapolis, Minnesota
| | - Ann Woolfrey
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Elizabeth Thiel
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Stella M Davies
- Division of Bone Marrow Transplant and Immune Deficiency, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Mary Eapen
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin.
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19
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Khandelwal P, Millard HR, Thiel E, Abdel-Azim H, Abraham AA, Auletta JJ, Boulad F, Brown VI, Camitta BM, Chan KW, Chaudhury S, Cowan MJ, Angel-Diaz M, Gadalla SM, Gale RP, Hale G, Kasow KA, Keating AK, Kitko CL, MacMillan ML, Olsson RF, Page KM, Seber A, Smith AR, Warwick AB, Wirk B, Mehta PA. Hematopoietic Stem Cell Transplantation Activity in Pediatric Cancer between 2008 and 2014 in the United States: A Center for International Blood and Marrow Transplant Research Report. Biol Blood Marrow Transplant 2017; 23:1342-1349. [PMID: 28450183 DOI: 10.1016/j.bbmt.2017.04.018] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [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: 02/06/2017] [Accepted: 04/19/2017] [Indexed: 12/26/2022]
Abstract
This Center for International Blood and Marrow Transplant Research report describes the use of hematopoietic stem cell transplantation (HSCT) in pediatric patients with cancer, 4408 undergoing allogeneic (allo) and3076 undergoing autologous (auto) HSCT in the United States between 2008 and 2014. In both settings, there was a greater proportion of boys (n = 4327; 57%), children < 10 years of age (n = 4412; 59%), whites (n = 5787; 77%), and children with a performance score ≥ 90% at HSCT (n = 6187; 83%). Leukemia was the most common indication for an allo-transplant (n = 4170; 94%), and among these, acute lymphoblastic leukemia in second complete remission (n = 829; 20%) and acute myeloid leukemia in first complete remission (n = 800; 19%) werethe most common. The most frequently used donor relation, stem cell sources, and HLA match were unrelated donor (n = 2933; 67%), bone marrow (n = 2378; 54%), and matched at 8/8 HLA antigens (n = 1098; 37%) respectively. Most allo-transplants used myeloablative conditioning (n = 4070; 92%) and calcineurin inhibitors and methotrexate (n = 2245; 51%) for acute graft-versus-host disease prophylaxis. Neuroblastoma was the most common primary neoplasm for an auto-transplant (n = 1338; 44%). Tandem auto-transplants for neuroblastoma declined after 2012 (40% in 2011, 25% in 2012, and 8% in 2014), whereas tandem auto-transplants increased for brain tumors (57% in 2008 and 77% in 2014). Allo-transplants from relatives other than HLA-identical siblings doubled between 2008 and 2014 (3% in 2008 and 6% in 2014). These trends will be monitored in future reports of transplant practices in the United States.
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Affiliation(s)
- Pooja Khandelwal
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Heather R Millard
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Elizabeth Thiel
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin.
| | - Hisham Abdel-Azim
- Division of Hematology, Oncology and Blood & Marrow Transplantation, Children's Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, California
| | - Allistair A Abraham
- Division of Blood and Marrow Transplantation, Center for Cancer and Blood Disorders, Children's National Medical Center, Washington, DC
| | - Jeffery J Auletta
- Host Defense Program, Divisions of Hematology/Oncology/Bone Marrow Transplant and Infectious Diseases, Nationwide Children's Hospital, Columbus, Ohio
| | - Farid Boulad
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Valerie I Brown
- Division of Pediatric Oncology/Hematology, Department of Pediatrics, Penn State Hershey Children's Hospital, College of Medicine, Hershey, Pennsylvania
| | - Bruce M Camitta
- Midwest Center for Cancer and Blood Disorders, Medical College of Wisconsin and Children's Hospital of Wisconsin, Milwaukee, Wisconsin
| | - Ka Wah Chan
- Department of Pediatrics, Texas Transplant Institute, San Antonio, Texas
| | - Sonali Chaudhury
- Division of Pediatric Hematology, Oncology and Stem Cell Transplant, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Morton J Cowan
- Pediatric Allergy Immunology and Blood and Marrow Transplant Division, UCSF Benioff Children's Hospital, San Francisco, California
| | - Miguel Angel-Diaz
- Department of Hematology/Oncology, Hospital Infantil Universitario Nino Jesus, Madrid, Spain
| | - Shahinaz M Gadalla
- Division of Cancer Epidemiology & Genetics, NIH-NCI Clinical Genetics Branch, Rockville, Maryland
| | - Robert Peter Gale
- Hematology Research Centre, Division of Experimental Medicine, Department of Medicine, Imperial College London, London, United Kingdom
| | - Gregory Hale
- Department of Hematology/Oncology, Johns Hopkins All Children's Hospital, St. Petersburg, Florida
| | - Kimberly A Kasow
- Division of Hematology-Oncology, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Amy K Keating
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado
| | - Carrie L Kitko
- Pediatric Hematology/Oncology Division, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Margaret L MacMillan
- University of Minnesota, Blood and Marrow Transplant Program, Minneapolis, Minnesota
| | - Richard F Olsson
- Division of Therapeutic Immunology, Department of Laboratory Medicine, Karolinska Institute, Stockholm, Sweden; Centre for Clinical Research Sormland, Uppsala University, Uppsala, Sweden
| | - Kristin M Page
- Division of Pediatric Blood and Marrow Transplantation, Duke University Medical Center, Durham, North Carolina
| | - Adriana Seber
- Internal Medicine, University of Sao Paulo School of Medicine, Sau Paulo, Brazil
| | - Angela R Smith
- University of Minnesota, Blood and Marrow Transplant Program, Minneapolis, Minnesota
| | - Anne B Warwick
- Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Baldeep Wirk
- Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, Washington
| | - Parinda A Mehta
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
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20
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Fung TM, Wong WC, Chan KW, Fung KS. Virilisation in a menopausal woman with a previous kidney transplant. Hong Kong Med J 2016; 22:623.e3-4. [PMID: 27920403 DOI: 10.12809/hkmj164901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- T M Fung
- Department of Obstetrics and Gynaecology, Princess Margaret Hospital, Laichikok, Hong Kong
| | - W C Wong
- Department of Clinical Pathology, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong
| | - K W Chan
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Laichikok, Hong Kong
| | - K S Fung
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Laichikok, Hong Kong
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21
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Madden LM, Hayashi RJ, Chan KW, Pulsipher MA, Douglas D, Hale GA, Chaudhury S, Haut P, Kasow KA, Gilman AL, Murray LM, Shenoy S. Response to: "Technology and Long-Term Health-Related Quality-of-Life Outcomes in Children with Nonmalignant Disorders after Reduced-Intensity Conditioning and Stem Cell Transplantation". Biol Blood Marrow Transplant 2016; 22:1734. [PMID: 27343717 DOI: 10.1016/j.bbmt.2016.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Accepted: 06/16/2016] [Indexed: 10/21/2022]
Affiliation(s)
- Lisa M Madden
- Washington University School of Medicine, St. Louis, Missouri
| | | | - Ka Wah Chan
- Methodist Children's Hospital of South Texas, San Antonio, Texas
| | - Michael A Pulsipher
- Children's Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, California
| | | | | | | | - Paul Haut
- Riley Hospital for Children, Indianapolis, Indiana
| | | | | | - Lisa M Murray
- Washington University School of Medicine, St. Louis, Missouri
| | - Shalini Shenoy
- Washington University School of Medicine, St. Louis, Missouri.
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22
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Shenoy S, Ngwube A, Walters MC, Abraham A, Chaudhury S, Soni S, Pulsipher MA, Chan KW, Nieder ML, Parikh S, Haight AE, Kasow KA, Hale GA, Connelly JA, Andreansky M, Godder K, Delgado DC, Neufeld E, Kwiatkowski JL, Thompson AA. Unrelated Donor Marrow (BMT) or Cord Blood Transplantation (UCBT) for Thalassemia Major after Reduced Intensity Conditioning (URTH Trial Extension). Biol Blood Marrow Transplant 2016. [DOI: 10.1016/j.bbmt.2015.11.854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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23
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Kenny NJ, Chan KW, Nong W, Qu Z, Maeso I, Yip HY, Chan TF, Kwan HS, Holland PWH, Chu KH, Hui JHL. Ancestral whole-genome duplication in the marine chelicerate horseshoe crabs. Heredity (Edinb) 2016; 116:190-9. [PMID: 26419336 PMCID: PMC4806888 DOI: 10.1038/hdy.2015.89] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2015] [Revised: 08/17/2015] [Accepted: 08/18/2015] [Indexed: 01/03/2023] Open
Abstract
Whole-genome duplication (WGD) results in new genomic resources that can be exploited by evolution for rewiring genetic regulatory networks in organisms. In metazoans, WGD occurred before the last common ancestor of vertebrates, and has been postulated as a major evolutionary force that contributed to their speciation and diversification of morphological structures. Here, we have sequenced genomes from three of the four extant species of horseshoe crabs-Carcinoscorpius rotundicauda, Limulus polyphemus and Tachypleus tridentatus. Phylogenetic and sequence analyses of their Hox and other homeobox genes, which encode crucial transcription factors and have been used as indicators of WGD in animals, strongly suggests that WGD happened before the last common ancestor of these marine chelicerates >135 million years ago. Signatures of subfunctionalisation of paralogues of Hox genes are revealed in the appendages of two species of horseshoe crabs. Further, residual homeobox pseudogenes are observed in the three lineages. The existence of WGD in the horseshoe crabs, noted for relative morphological stasis over geological time, suggests that genomic diversity need not always be reflected phenotypically, in contrast to the suggested situation in vertebrates. This study provides evidence of ancient WGD in the ecdysozoan lineage, and reveals new opportunities for studying genomic and regulatory evolution after WGD in the Metazoa.
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Affiliation(s)
- N J Kenny
- Simon F.S. Li Marine Science Laboratory,
School of Life Sciences, Center of Soybean Research, State Key Laboratory of
Agrobiotechnology, The Chinese University of Hong Kong, Shatin,
Hong Kong
| | - K W Chan
- Simon F.S. Li Marine Science Laboratory,
School of Life Sciences, Center of Soybean Research, State Key Laboratory of
Agrobiotechnology, The Chinese University of Hong Kong, Shatin,
Hong Kong
| | - W Nong
- Simon F.S. Li Marine Science Laboratory,
School of Life Sciences, Center of Soybean Research, State Key Laboratory of
Agrobiotechnology, The Chinese University of Hong Kong, Shatin,
Hong Kong
| | - Z Qu
- Simon F.S. Li Marine Science Laboratory,
School of Life Sciences, Center of Soybean Research, State Key Laboratory of
Agrobiotechnology, The Chinese University of Hong Kong, Shatin,
Hong Kong
| | - I Maeso
- Centro Andaluz de Biología del
Desarrollo (CABD), Consejo Superior de Investigaciones
Científicas/Universidad Pablo de Olavide, Sevilla,
Spain
| | - H Y Yip
- Simon F.S. Li Marine Science Laboratory,
School of Life Sciences, Center of Soybean Research, State Key Laboratory of
Agrobiotechnology, The Chinese University of Hong Kong, Shatin,
Hong Kong
| | - T F Chan
- School of Life Sciences, Center of
Soybean Research, State Key Laboratory of Agrobiotechnology, The Chinese
University of Hong Kong, Shatin, Hong Kong
| | - H S Kwan
- School of Life Sciences, The Chinese
University of Hong Kong, Shatin, Hong Kong
| | - P W H Holland
- Department of Zoology, University of
Oxford, Oxford, UK
| | - K H Chu
- Simon F.S. Li Marine Science Laboratory,
School of Life Sciences, The Chinese University of Hong Kong,
Shatin, Hong Kong
| | - J H L Hui
- Simon F.S. Li Marine Science Laboratory,
School of Life Sciences, Center of Soybean Research, State Key Laboratory of
Agrobiotechnology, The Chinese University of Hong Kong, Shatin,
Hong Kong
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24
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Chung KF, Yeung WF, Zhang SP, Zhang ZJ, Wong MT, Lee WK, Chan KW. Acupuncture for persistent insomnia associated with major depressive disorder: a randomised controlled trial. Hong Kong Med J 2016; 22 Suppl 2:S9-S14. [PMID: 26908336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Affiliation(s)
- K F Chung
- Department of Psychiatry, University of Hong Kong
| | - W F Yeung
- School of Chinese Medicine, University of Hong Kong
| | - S P Zhang
- School of Chinese Medicine, Hong Kong Baptist University
| | - Z J Zhang
- School of Chinese Medicine, University of Hong Kong
| | - M T Wong
- Department of Psychiatry, Kowloon Hospital
| | - W K Lee
- Department of Psychiatry, Kwai Chung Hospital
| | - K W Chan
- Department of Psychiatry, United Christian Hospital
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25
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Ponce DM, Eapen M, Sparapani R, O'Brien TA, Chan KW, Chen J, Craddock J, Schultz KR, Wagner JE, Perales MA, Barker JN. In Vivo T Cell Depletion with Myeloablative Regimens on Outcomes after Cord Blood Transplantation for Acute Lymphoblastic Leukemia in Children. Biol Blood Marrow Transplant 2015; 21:2173-2179. [PMID: 26327630 PMCID: PMC4639413 DOI: 10.1016/j.bbmt.2015.08.022] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 08/17/2015] [Indexed: 11/20/2022]
Abstract
The inclusion of antithymocyte globulin (ATG) in cord blood transplantation is controversial. We evaluated outcomes according to ATG inclusion in 297 children and adolescents with acute lymphoblastic leukemia (ALL) who received myeloablative total body irradiation-based conditioning and either single-unit (74%) or double-unit (26%) grafts. Ninety-two patients (31%) received ATG and 205 (69%) did not. ATG recipients were more likely to be cytomegalovirus seronegative. The incidences of day 100 grades II to IV acute graft-versus-host disease (GVHD; 30% versus 54%, P = .0002) and chronic GVHD (22% versus 43%, P = .0008) were lower with ATG compared with non-ATG regimens. However, day 100 grades III to IV acute GVHD was comparable (11% versus 17%, P = .15). The 3-year incidences of transplant-related mortality (16% versus 17%, P = .98), relapse (17% versus 27%, P = .12), and leukemia-free survival (66% versus 55%, P = .23) in ATG and non-ATG recipients were similar. There were no differences in viral reactivation between treatment groups (60% versus 58%, P = .83). Therefore, the data suggest that incorporation of ATG with myeloablative conditioning regimens may be useful in reducing the risk of acute and chronic GVHD without any deleterious effect on transplant-related mortality, relapse, or leukemia-free survival in children and adolescents with ALL.
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Affiliation(s)
- Doris M Ponce
- Adult Bone Marrow Transplantation Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Mary Eapen
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin.
| | - Rodney Sparapani
- Divison of Biostatistics, Institute for Health and Society, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Tracey A O'Brien
- Blood & Marrow Transplant Program, Kids Cancer Centre, Sydney Children's Hospital, Sydney, Australia
| | - Ka Wah Chan
- Department of Pediatrics, Texas Transplant Institute, San Antonio, Texas
| | - Junfang Chen
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - John Craddock
- Center for Cancer and Blood Disorders, Children's Hospital Colorado, Aurora, Colorado
| | - Kirk R Schultz
- Department of Pediatric Hematology, Oncology and Bone Marrow Transplant, British Columbia's Children's Hospital, The University of British Columbia, Vancouver, British Columbia, Canada
| | - John E Wagner
- Division of Blood and Marrow Transplantation, Department of Pediatrics, University of Minnesota Medical Center, Minneapolis, Minnesota
| | - Miguel-Angel Perales
- Adult Bone Marrow Transplantation Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Juliet N Barker
- Adult Bone Marrow Transplantation Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Medicine, Weill Cornell Medical College, New York, New York
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26
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King AA, Kamani N, Bunin N, Sahdev I, Brochstein J, Hayashi RJ, Grimley M, Abraham A, Dioguardi J, Wah Chan K, Douglas D, Adams R, Andreansky M, Anderson E, Gilman A, Chaudhury S, Yu L, Dalal J, Hale G, Cuvelier G, Jain A, Krajewski J, Gillio A, Kasow KA, Delgado D, Hanson E, Murray L, Shenoy S. Successful matched sibling donor marrow transplantation following reduced intensity conditioning in children with hemoglobinopathies. Am J Hematol 2015; 90:1093-8. [PMID: 26348869 DOI: 10.1002/ajh.24183] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 09/04/2015] [Indexed: 01/04/2023]
Abstract
Fifty-two children with symptomatic sickle cell disease sickle cell disease (SCD) (N = 43) or transfusion-dependent thalassemia (N = 9) received matched sibling donor marrow (46), marrow and cord product (5), or cord blood (1) allografts following reduced intensity conditioning (RIC) with alemtuzumab, fludarabine, and melphalan between March 2003 and May 2014*. The Kaplan-Meier probabilities of overall and event-free survival at a median of 3.42 (range, 0.75-11.83) years were 94.2% and 92.3% for the group, 93% and 90.7% for SCD, and 100% and 100% for thalassemia, respectively. Treatment-related mortality (all related to graft versus host disease, GVHD) was noted in three (5.7%) recipients, all 17-18 years of age. Acute and chronic GVHD was noted in 23% and 13%, respectively, with 81% of recipients off immunosuppression by 1 year. Graft rejection was limited to the single umbilical cord blood recipient who had prompt autologous hematopoietic recovery. Fourteen (27%) had mixed chimerism at 1 year and beyond; all had discontinued immunosuppression between 4 and 12 months from transplant with no subsequent consequence on GVHD or rejection. Infectious complications included predominantly bacteremia (48% were staphylococcus) and CMV reactivation (43%) necessitating preemptive therapy. Lymphocyte recovery beyond 6 months was associated with subsidence of infectious complications. All patients who engrafted were transfusion independent; no strokes or pulmonary complications of SCD were noted, and pain symptoms subsided within 6 months posttransplant. These findings support using RIC for patients with hemoglobinopathy undergoing matched sibling marrow transplantation (*www.Clinical Trials.gov: NCT00920972, NCT01050855, NCT02435901).
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Affiliation(s)
- Allison A. King
- Department of Pediatric; Washington University School of Medicine; St. Louis Missouri
| | - Naynesh Kamani
- Department of Pediatrics; Children's National Medical Center; Washington District of Columbia
| | - Nancy Bunin
- Department of Pediatrics; Children's Hospital of Philadelphia; Philadelphia Pennsylvania
| | - Indira Sahdev
- Department of Pediatrics; Cohen Children's Medical Center of New York; New Hyde Park New York
| | - Joel Brochstein
- Department of Pediatrics; Cohen Children's Medical Center of New York; New Hyde Park New York
| | - Robert J. Hayashi
- Department of Pediatric; Washington University School of Medicine; St. Louis Missouri
| | - Michael Grimley
- Department of Pediatrics; Cincinnati Children's Hospital; Cincinnati Ohio
| | - Allistair Abraham
- Department of Pediatrics; Children's National Medical Center; Washington District of Columbia
| | - Jacqueline Dioguardi
- Department of Pediatrics; Children's National Medical Center; Washington District of Columbia
| | - Ka Wah Chan
- Department of Pediatrics; Methodist Children's Hospital of South Texas; San Antonio Texas
| | - Dorothea Douglas
- Department of Pediatrics; Phoenix Children's Hospital; Phoenix Arizona
| | - Roberta Adams
- Department of Pediatrics; Phoenix Children's Hospital; Phoenix Arizona
| | - Martin Andreansky
- Department of Pediatrics; University of Miami Health System; Miami Florida
| | | | - Andrew Gilman
- Department of Pediatrics; Levine Children's Hospital; Charlotte North Carolina
| | - Sonali Chaudhury
- Department of Pediatrics; Lurie Children's Hospital; Chicago Illinois
| | - Lolie Yu
- Department of Pediatrics; Louisiana State University Medical Center; New Orleans Louisiana
| | - Jignesh Dalal
- Department of Pediatrics; Children's Mercy Hospitals and Clinics; Kansas City Missouri
| | - Gregory Hale
- Department of Pediatrics; All Children's Hospital; St. Petersburg Florida
| | - Geoff Cuvelier
- Department of Pediatrics; CancerCare Manitoba; CAN Manitoba, Canada
| | - Akshat Jain
- Department of Pediatrics; Cohen Children's Medical Center of New York; New Hyde Park New York
| | - Jennifer Krajewski
- Department of Pediatrics; Joseph M. Sanzari Children's Hospital; Hackensack New Jersey
| | - Alfred Gillio
- Department of Pediatrics; Joseph M. Sanzari Children's Hospital; Hackensack New Jersey
| | - Kimberly A. Kasow
- Department of Pediatrics; University of Chapel Hill, Chapel Hill; North Carolina
| | - David Delgado
- Department of Pediatrics; Riley Hospital for Children; Indianapolis Indiana
| | - Eric Hanson
- Department of Pediatric; Washington University School of Medicine; St. Louis Missouri
| | - Lisa Murray
- Department of Pediatric; Washington University School of Medicine; St. Louis Missouri
| | - Shalini Shenoy
- Department of Pediatric; Washington University School of Medicine; St. Louis Missouri
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27
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Tung KY, Cheng KS, Lee WK, Kwong PK, Chan KW, Law ACB, Lo WTL. Psychiatric Morbidity in Chinese Adults with Type 1 Diabetes in Hong Kong. East Asian Arch Psychiatry 2015; 25:128-136. [PMID: 26429840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVES To determine the prevalence of psychiatric morbidity and identify the correlates, as well as to evaluate the effectiveness of the Hospital Anxiety and Depression Scale and the 12-item General Health Questionnaire to screen for psychiatric morbidity in Chinese adults with type 1 diabetes. METHODS Subjects were recruited from a local public diabetes specialist outpatient clinic from August 2013 to January 2014. Demographic and clinical factors were recorded. Psychiatric diagnosis was established using the Chinese-bilingual version of the Structured Clinical Interview for the DSM-IV Axis I disorders. Scores for the Hospital Anxiety and Depression Scale and the 12-item General Health Questionnaire were compared with the psychiatric diagnosis. RESULTS Of the 136 patients, the point prevalence of overall psychiatric, depressive, and anxiety disorders was 39.7%, 23.5%, and 25.7%, respectively. Family history of mental illness, smoking status, history of mental illness, presence of social problems, perceived absence of confidant, presence of neuropathy and hyperlipidaemia, as well as higher level of glycosylated haemoglobin were found to be the associated factors. CONCLUSION Psychiatric disorders were common in Chinese adults with type 1 diabetes. Finding out associated factors and using the Hospital Anxiety and Depression Scale and the 12-item General Health Questionnaire as a screening tool helped to identify patients in a diabetes clinic with psychiatric disorders.
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Affiliation(s)
- K Y Tung
- Kwai Chung Hospital, Hong Kong SAR, China
| | - K S Cheng
- Kwai Chung Hospital, Hong Kong SAR, China
| | - W K Lee
- Kwai Chung Hospital, Hong Kong SAR, China
| | - P K Kwong
- Kwai Chung Hospital, Hong Kong SAR, China
| | - K W Chan
- Medical and Geriatrics Department, Princess Margaret Hospital, Hong Kong SAR, China
| | - A C B Law
- Medical and Geriatrics Department, Princess Margaret Hospital, Hong Kong SAR, China
| | - W T L Lo
- Kwai Chung Hospital, Hong Kong SAR, China
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28
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Burke MJ, Verneris MR, Le Rademacher J, He W, Abdel-Azim H, Abraham AA, Auletta JJ, Ayas M, Brown VI, Cairo MS, Chan KW, Diaz Perez MA, Dvorak CC, Egeler RM, Eldjerou L, Frangoul H, Guilcher GMT, Hayashi RJ, Ibrahim A, Kasow KA, Leung WH, Olsson RF, Pulsipher MA, Shah N, Shah NN, Thiel E, Talano JA, Kitko CL. Transplant Outcomes for Children with T Cell Acute Lymphoblastic Leukemia in Second Remission: A Report from the Center for International Blood and Marrow Transplant Research. Biol Blood Marrow Transplant 2015; 21:2154-2159. [PMID: 26327632 DOI: 10.1016/j.bbmt.2015.08.023] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [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: 07/06/2015] [Accepted: 08/20/2015] [Indexed: 10/23/2022]
Abstract
Survival for children with relapsed T cell acute lymphoblastic leukemia (T-ALL) is poor when treated with chemotherapy alone, and outcomes after allogeneic hematopoietic cell transplantation (HCT) is not well described. Two hundred twenty-nine children with T-ALL in second complete remission (CR2) received an HCT after myeloablative conditioning between 2000 and 2011 and were reported to the Center for International Blood and Marrow Transplant Research. Median age was 10 years (range, 2 to 18). Donor source was umbilical cord blood (26%), matched sibling bone marrow (38%), or unrelated bone marrow/peripheral blood (36%). Acute (grades II to IV) and chronic graft-versus-host disease occurred in, respectively, 35% (95% confidence interval [CI], 27% to 45%) and 26% (95% CI, 20% to 33%) of patients. Transplant-related mortality at day 100 and 3-year relapse rates were 13% (95% CI, 9% to 18%) and 30% (95% CI, 24% to 37%), respectively. Three-year overall survival and disease-free survival rates were 48% (95% CI, 41% to 55%) and 46% (95% CI, 39% to 52%), respectively. In multivariate analysis, patients with bone marrow relapse, with or without concurrent extramedullary relapse before HCT, were most likely to relapse (hazard ratio, 3.94; P = .005) as compared with isolated extramedullary disease. In conclusion, HCT for pediatric T-ALL in CR2 demonstrates reasonable and durable outcomes, and consideration for HCT is warranted.
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Affiliation(s)
- Michael J Burke
- Division of Hematology/Oncology/Blood and Marrow Transplant, Department of Pediatrics, Medical College of Wisconsin and Children's Hospital of Wisconsin, Milwaukee, WI.
| | | | - Jennifer Le Rademacher
- CIBMTR(®) (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI; Division of Biostatistics, Institute for Health and Society, Medical College of Wisconsin, Milwaukee, WI
| | - Wensheng He
- CIBMTR(®) (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI
| | - Hisham Abdel-Azim
- Division of Hematology, Oncology and Blood & Marrow Transplantation, Children's Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, CA
| | - Allistair A Abraham
- Division of Blood and Marrow Transplantation, Center for Cancer and Blood Disorders, Children's National Medical Center, Washington, DC
| | - Jeffery J Auletta
- Divisions of Hematology/Oncology, Bone Marrow Transplantation and Infectious Diseases, Nationwide Children's Hospital, Columbus, OH
| | - Mouhab Ayas
- Department of Pediatric Hematology Oncology, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Valerie I Brown
- Division of Pediatric Oncology/Hematology, Department of Pediatrics, Penn State Hershey Children's Hospital and College of Medicine, Hershey, PA
| | - Mitchell S Cairo
- Department of Pediatrics, New York Medical College, Valhalla, NY
| | - Ka Wah Chan
- Department of Pediatrics, Texas Transplant Institute, San Antonio, TX
| | - Miguel A Diaz Perez
- Department of Hematology/Oncology, Hospital Infantil Universitario Nino Jesus, Madrid, Spain
| | - Christopher C Dvorak
- Department of Pediatrics, University of California San Francisco Medical Center, San Francisco, CA
| | - R Maarten Egeler
- Department of Hematology/Oncology, Hospital for Sick Children, Toronto, ON, Canada
| | - Lamis Eldjerou
- Department of Pediatrics, University of Florida, Gainsville, FL
| | - Haydar Frangoul
- Division of Hematology-Oncology, Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN
| | - Gregory M T Guilcher
- Section of Paediatric Oncology and Blood and Marrow Transplant, Alberta Children's Hospital, Calgary, AB, Canada
| | - Robert J Hayashi
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Washington University School of Medicine in St. Louis, St. Louis, MO
| | - Ahmed Ibrahim
- Department of Hematology/Oncology, Makassed General Hospital, Beiruit, Lebanon
| | - Kimberly A Kasow
- Division of Hematology-Oncology, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Wing H Leung
- Division of Bone Marrow Transplantation, St. Jude Children's Research Hospital, Memphis, TN
| | - Richard F Olsson
- Division of Therapeutic Immunology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Clinical Research Sörmland, Uppsala University, Uppsala, Sweden
| | - Michael A Pulsipher
- Division of Hematology, Oncology and Blood & Marrow Transplantation, Children's Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, CA
| | - Niketa Shah
- Division of Hematology/Oncology, Department of Pediatrics, Mayo Clinic Arizona and Phoenix Children's Hospital, Phoenix, AZ
| | - Nirali N Shah
- Pediatric Oncology Branch, Center for Cancer Research (CCR), National Cancer Institute (NIH), Bethesda, MD
| | - Elizabeth Thiel
- CIBMTR(®) (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI
| | - Julie-An Talano
- Division of Hematology/Oncology/Blood and Marrow Transplant, Department of Pediatrics, Medical College of Wisconsin and Children's Hospital of Wisconsin, Milwaukee, WI
| | - Carrie L Kitko
- Stem Cell Transplant Program, Department of Pediatrics, Vanderbilt University, Nashville, TN
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29
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Pai SY, Logan BR, Griffith LM, Buckley RH, Parrott RE, Dvorak CC, Kapoor N, Hanson IC, Filipovich AH, Jyonouchi S, Sullivan KE, Small TN, Burroughs L, Skoda-Smith S, Haight AE, Grizzle A, Pulsipher MA, Chan KW, Fuleihan RL, Haddad E, Loechelt B, Aquino VM, Gillio A, Davis J, Knutsen A, Smith AR, Moore TB, Schroeder ML, Goldman FD, Connelly JA, Porteus MH, Xiang Q, Shearer WT, Fleisher TA, Kohn DB, Puck JM, Notarangelo LD, Cowan MJ, O'Reilly RJ. Transplantation outcomes for severe combined immunodeficiency, 2000-2009. N Engl J Med 2014; 371:434-46. [PMID: 25075835 PMCID: PMC4183064 DOI: 10.1056/nejmoa1401177] [Citation(s) in RCA: 465] [Impact Index Per Article: 46.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND The Primary Immune Deficiency Treatment Consortium was formed to analyze the results of hematopoietic-cell transplantation in children with severe combined immunodeficiency (SCID) and other primary immunodeficiencies. Factors associated with a good transplantation outcome need to be identified in order to design safer and more effective curative therapy, particularly for children with SCID diagnosed at birth. METHODS We collected data retrospectively from 240 infants with SCID who had received transplants at 25 centers during a 10-year period (2000 through 2009). RESULTS Survival at 5 years, freedom from immunoglobulin substitution, and CD3+ T-cell and IgA recovery were more likely among recipients of grafts from matched sibling donors than among recipients of grafts from alternative donors. However, the survival rate was high regardless of donor type among infants who received transplants at 3.5 months of age or younger (94%) and among older infants without prior infection (90%) or with infection that had resolved (82%). Among actively infected infants without a matched sibling donor, survival was best among recipients of haploidentical T-cell-depleted transplants in the absence of any pretransplantation conditioning. Among survivors, reduced-intensity or myeloablative pretransplantation conditioning was associated with an increased likelihood of a CD3+ T-cell count of more than 1000 per cubic millimeter, freedom from immunoglobulin substitution, and IgA recovery but did not significantly affect CD4+ T-cell recovery or recovery of phytohemagglutinin-induced T-cell proliferation. The genetic subtype of SCID affected the quality of CD3+ T-cell recovery but not survival. CONCLUSIONS Transplants from donors other than matched siblings were associated with excellent survival among infants with SCID identified before the onset of infection. All available graft sources are expected to lead to excellent survival among asymptomatic infants. (Funded by the National Institute of Allergy and Infectious Diseases and others.).
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Affiliation(s)
- Sung-Yun Pai
- The authors' affiliations are listed in the Appendix
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Houben CH, Tsui SY, Mou JW, Chan KW, Tam YH, Lee KH. Reconstructive surgery for females with congenital adrenal hyperplasia due to 21-hydroxylase deficiency: a review from the Prince of Wales Hospital. Hong Kong Med J 2014; 20:481-5. [PMID: 25045882 DOI: 10.12809/hkmj144227] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To present the results of feminising genitoplasty done in female patients with congenital adrenal hyperplasia due to 21-hydroxylase deficiency. DESIGN Case series. SETTING A tertiary referral centre in Hong Kong. PATIENTS Female patients with congenital adrenal hyperplasia undergoing corrective surgery for virilisation between 1993 and 2012. MAIN OUTCOME MEASURES The operative result was judged with a scoring system (1-3) for four areas: appearance of clitoris, labia and vagina, plus requirement for revision surgery. RESULTS A total of 23 female patients with congenital adrenal hyperplasia with a median age of 17.5 (range, 1.5-33.8) years were identified. Of these individuals, 17 presented in the neonatal period and early infancy, of which four had an additional salt-losing crisis. Six patients-including four migrants from mainland China-were late presenters at a median age of 2 (range, 0.5-14) years. Twenty-two patients had corrective surgery at a median age of 2 (range, 1-14) years. Clitoral reduction was performed in all, and further surgery in 21 patients. The additional surgery was flap vaginoplasty in 10 patients, a modified Passerini procedure in six, and a labial reconstruction in five; one patient with prominent clitoris was for observation only. Minor revision surgery (eg mucosal trimming) was required in three patients; a revision vaginoplasty was done in one individual. Of the 23 patients, 18 (78%) with a median age of 20 (range, 9.3-33.8) years participated in the outcome evaluation: a 'good' outcome (4 points) was seen in 12 patients and a 'satisfactory' (5-9 points) result in five patients. CONCLUSIONS Nearly three quarters of our cohort (n=17) presented with classic virilising form of 21-hydroxylase deficiency. Only four (25%) patients experienced a salt-losing crisis. Female gender assignment at birth was maintained for all individuals in this group. 'Good' and 'satisfactory' outcomes of surgery were reported in nearly all participants.
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Affiliation(s)
- C H Houben
- Division of Paediatric Surgery and Paediatric Urology, Department of Surgery, Prince of Wales Hospital, Shatin, Hong Kong
| | - S Y Tsui
- Division of Paediatric Surgery and Paediatric Urology, Department of Surgery, Prince of Wales Hospital, Shatin, Hong Kong
| | - J W Mou
- Division of Paediatric Surgery and Paediatric Urology, Department of Surgery, Prince of Wales Hospital, Shatin, Hong Kong
| | - K W Chan
- Division of Paediatric Surgery and Paediatric Urology, Department of Surgery, Prince of Wales Hospital, Shatin, Hong Kong
| | - Y H Tam
- Division of Paediatric Surgery and Paediatric Urology, Department of Surgery, Prince of Wales Hospital, Shatin, Hong Kong
| | - K H Lee
- Division of Paediatric Surgery and Paediatric Urology, Department of Surgery, Prince of Wales Hospital, Shatin, Hong Kong
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Chan KW, Donnelly KJ. Does K-wire position in tension band wiring of olecranon fractures affect its complications and removal of metal rate? J Orthop 2014; 12:111-7. [PMID: 25972703 DOI: 10.1016/j.jor.2014.04.018] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Accepted: 04/15/2014] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Despite the recognised complications of migration of wires and soft tissue irritation, tension band wiring (TBW) remains the gold standard for fixation of displaced, minimally comminuted olecranon fractures. There is much variation in placement of the K-wires with current AO guidance stating that each wire should be drilled through the anterior cortex and then backed up by 1 cm. The aim of this study was to examine the effect of K-wire position (intramedullary vs. transcortical) on stability of the construct and significant local complications. METHODS All patients who underwent TBW for an isolated olecranon fracture in our trauma unit between 1/1/2009 and 31/12/2011 were included in this retrospective study. Mean follow-up was 14 months (range 5-29 months). Data was gathered from medical records and radiographs. The outcome measured was removal of metal due to complications such as wound problems or proximal migration of wires as standard practice within out trauma unit. RESULTS Sixty-three patients met the inclusion criteria. Forty-seven had an intramedullary compared with 16 with transcortical configuration (ratio 3:1). Nine patients (19%) with intramedullary K-wires required removal of metalwork - seven due to prominent metalwork and two with wound infection. Four patients (25%) with transcortical K-wires required removal of metalwork - three due to prominent metalwork and one with failure of metalwork. There was no significant statistical difference between transcortical and intramedullary K-wire placement with regards to complication rates following tension band wiring of an isolated olecranon fracture requiring removal of metal (Chi squared test with Yates' correction p = 0.89). CONCLUSION We concluded that we found no difference in complications or metalwork removal rate in the placement of K-wire in tension band wiring for isolated olecranon fracture. We recognise our study was limited by small numbers and is based on the experience of one trauma unit.
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Affiliation(s)
- K W Chan
- Altnagelvin Area Hospital, Glenshane Road, Londonderry BT47 6SB, United Kingdom
| | - K J Donnelly
- Altnagelvin Area Hospital, Glenshane Road, Londonderry BT47 6SB, United Kingdom
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Hitzler JK, He W, Doyle J, Cairo M, Camitta BM, Chan KW, Perez MAD, Fraser C, Gross TG, Horan JT, Kennedy-Nasser AA, Kitko C, Kurtzberg J, Lehmann L, O’Brien T, Pulsipher MA, Smith FO, Zhang MJ, Eapen M, Carpenter PA. Outcome of transplantation for acute lymphoblastic leukemia in children with Down syndrome. Pediatr Blood Cancer 2014; 61:1126-8. [PMID: 24391118 PMCID: PMC4080799 DOI: 10.1002/pbc.24918] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Accepted: 12/06/2013] [Indexed: 11/06/2022]
Abstract
We report on 27 patients with Down syndrome (DS) and acute lymphoblastic leukemia (ALL) who received allogeneic hematopoietic cell transplantation (HCT) between 2000 and 2009. Seventy-eight percent of patients received myeloablative conditioning and 52% underwent transplantation in second remission. Disease-free survival (DFS) was 24% at a median of 3 years. Post-transplant leukemic relapse was more frequent than expected for children with DS-ALL (54%) than for non-DS ALL. These data suggest leukemic relapse rather than transplant toxicity is the most important cause of treatment failure. Advancements in leukemia control are especially needed for improvement in HCT outcomes for DS-ALL.
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Affiliation(s)
- Johann K. Hitzler
- The Hospital for Sick Children, University of Toronto, Toronto ON, Canada
| | - Wensheng He
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - John Doyle
- The Hospital for Sick Children, University of Toronto, Toronto ON, Canada
| | | | - Bruce M. Camitta
- Midwest Center for Cancer and Blood Disorders, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Ka Wah Chan
- Texas Transplant Institute, San Antonio, TX, USA
| | | | | | | | - John T. Horan
- Children’s Healthcare of Atlanta at Egleston, Atlanta, GA, USA
| | | | | | | | | | | | | | | | - Mei-Jie Zhang
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Mary Eapen
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
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Dai Y, Wilson G, Huang B, Peng M, Teng G, Zhang D, Zhang R, Ebert MPA, Chen J, Wong BCY, Chan KW, George J, Qiao L. Silencing of Jagged1 inhibits cell growth and invasion in colorectal cancer. Cell Death Dis 2014; 5:e1170. [PMID: 24722295 PMCID: PMC5424114 DOI: 10.1038/cddis.2014.137] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2014] [Revised: 02/18/2014] [Accepted: 02/26/2014] [Indexed: 01/09/2023]
Abstract
Dysregulated Notch signaling has a critical role in the tumorigenesis. Jagged1, a Notch ligand, is overexpressed in various human cancers. Recent studies revealed the involvement of Jagged1 in colorectal cancer (CRC) development. These basic studies provide a promising potential for inhibition of the Notch pathway for the treatment of CRC. Herein, we aimed to investigate the consequences of targeting Jagged1 using shRNA on CRC both in vitro and in vivo to test their potential to inhibit this key element for CRC treatment. We found that downregulation of Jagged1 with lentiviral Jagged1-shRNA resulted in decreased colon cancer cell viability in vitro, most likely mediated through reduced cell proliferation. Importantly, Jagged1 knockdown induced G0/G1 phase cell cycle arrest, with reduced Cyclin D1, Cyclin E and c-Myc expression. Silencing of Jagged1 reduced the migration and invasive capacity of the colon cancer cells in vitro. Furthermore, colon cancer cells with knockdown of Jagged1 had much slower growth rate than control cells in a xenograft mouse model in vivo, with a marked downregulation of cell proliferation markers (PCNA, Ki-67, and c-Myc) and metastasis markers (MMP-2 and MMP-9). These findings rationalize a mechanistic approach to CRC treatment based on Jagged1-targeted therapeutic development.
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Affiliation(s)
- Y Dai
- Department of Gastroenterology, Peking University First Hospital, Beijing, China
| | - G Wilson
- Storr Liver Unit, Westmead Millennium Institute, Department of Medicine and Western Clinical School, The University of Sydney, Westmead, NSW, Australia
| | - B Huang
- Research Center of Basic Medical Sciences and Department of Immunology, Key Laboratory of Immune Microenvironment and Diseases of Educational Ministry of China, Tianjin Medical University, Tianjin, China
| | - M Peng
- Research Center of Basic Medical Sciences and Department of Immunology, Key Laboratory of Immune Microenvironment and Diseases of Educational Ministry of China, Tianjin Medical University, Tianjin, China
| | - G Teng
- Department of Gastroenterology, Peking University First Hospital, Beijing, China
| | - D Zhang
- Research Center of Basic Medical Sciences and Department of Immunology, Key Laboratory of Immune Microenvironment and Diseases of Educational Ministry of China, Tianjin Medical University, Tianjin, China
| | - R Zhang
- Research Center of Basic Medical Sciences and Department of Immunology, Key Laboratory of Immune Microenvironment and Diseases of Educational Ministry of China, Tianjin Medical University, Tianjin, China
| | - M P A Ebert
- Department of Medicine II, Klinikum Rechts der Isar, Technical University, Munich, Germany
| | - J Chen
- School of Biomedical Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - B C Y Wong
- Departments of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - K W Chan
- Departments of Pathology, The University of Hong Kong, Pokfulam, Hong Kong
| | - J George
- Storr Liver Unit, Westmead Millennium Institute, Department of Medicine and Western Clinical School, The University of Sydney, Westmead, NSW, Australia
| | - L Qiao
- Storr Liver Unit, Westmead Millennium Institute, Department of Medicine and Western Clinical School, The University of Sydney, Westmead, NSW, Australia
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Quigg TC, McDonald L, Luke J, Chan KW, Jude VH, Sanders R. Allogeneic Hematopoietic Stem Cell Transplantation (HSCT) Outcomes for Juvenile Myelomonocytic Leukemia (JMML), a 15-Year Single Center Experience. Biol Blood Marrow Transplant 2014. [DOI: 10.1016/j.bbmt.2013.12.293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Abstract
An acquired ileal atresia is a rare occurrence. A 3-week-old neonate is presented, who developed postnatally a type 2 ileal atresia and an ileal stenosis within a pre-existing internal hernia secondary to an adhesion band. The literature reports a total of eight cases (4 females) with acquired ileal atresia in babies ranging in age from 3 weeks to 2 years (median 4 months). Mechanical forces (eg, adhesion band, intussusception and volvulus) onto the intestine are most frequently (75%) implicated as the primary event. The distal ileum is most often affected and a type 3A atresia is identified in six of eight (75%) cases.
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Affiliation(s)
- C H Houben
- Department of Surgery, Prince of Wales Hospital, Hong Kong, Hong Kong
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Kurtzberg J, Prockop S, Teira P, Bittencourt H, Lewis V, Chan KW, Horn B, Yu L, Talano JA, Nemecek E, Mills CR, Chaudhury S. Allogeneic human mesenchymal stem cell therapy (remestemcel-L, Prochymal) as a rescue agent for severe refractory acute graft-versus-host disease in pediatric patients. Biol Blood Marrow Transplant 2013; 20:229-35. [PMID: 24216185 DOI: 10.1016/j.bbmt.2013.11.001] [Citation(s) in RCA: 158] [Impact Index Per Article: 14.4] [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: 08/13/2013] [Accepted: 11/01/2013] [Indexed: 12/31/2022]
Abstract
Severe steroid-refractory acute graft-versus-host disease (aGVHD) is related to significant mortality and morbidity after allogeneic stem cell transplantation. Early clinical trials of therapy with human mesenchymal stem cells (hMSCs) in pediatric patients with severe aGVHD resistant to multiple immunosuppressive agents showed promising results. In this study, we evaluated the risk/benefit profile of remestemcel-L (Prochymal), a third-party, off-the-shelf source of hMSCs, as a rescue agent for treatment-resistant aGVHD in pediatric patients. Children with grade B-D aGVHD failing steroids and, in most cases, other immunosuppressive agents were eligible for enrollment. Patients received 8 biweekly i.v. infusions of 2 × 10(6) hMSCs/kg for 4 weeks, with an additional 4 weekly infusions after day +28 for patients who achieved either a partial or mixed response. The enrolled patients compose a very challenging population with severe disease that was nonresponsive to the standard of care, with 88% of the patients experiencing severe aGVHD (grade C or D). Seventy-five patients (median age, 8 yr; 58.7% male; and 61.3% Caucasian) were treated in this study. Sixty-four patients (85.3%) had received an unrelated hematopoietic stem cell graft, and 28 patients (37.3%) had received a cord blood graft. At baseline, the distribution of aGVHD grades B, C, and D was 12.0%, 28.0%, and 60.0%, respectively. The median duration of aGVHD before enrollment was 30 d (range, 2 to 1639 d), and patients failed a median of 3 immunosuppressive agents. Organ involvement at baseline was 86.7% gastrointestinal, 54.7% skin, and 36.0% liver. Thirty-six patients (48.0%) had 2 organs involved, and 11 patients (14.7%) had all 3 organs involved. When stratified by aGVHD grade at baseline, the rate of overall response (complete and partial response) at day +28 was 66.7% for aGVHD grade B, 76.2% for grade C, and 53.3% for grade D. Overall response for individual organs at day +28 was 58.5% for the gastrointestinal system, 75.6% for skin, and 44.4% for liver. Collectively, overall response at day +28 for patients treated for severe refractory aGVHD was 61.3%, and this response was correlated with statistically significant improved survival at day +100 after hMSC infusion. Patients who responded to therapy by day +28 had a higher Kaplan-Meier estimated probability of 100-d survival compared with patients who did not respond (78.1% versus 31.0%; P < .001). Prochymal infusions were generally well tolerated, with no evidence of ectopic tissue formation.
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Affiliation(s)
- Joanne Kurtzberg
- Pediatric Blood and Bone Marrow Transplant Program, Duke University Medical Center, Durham, North Carolina
| | - Susan Prockop
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Pierre Teira
- Hematology-Oncology Division, Charles Bruneau Cancer Center, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Quebec, Canada
| | - Henrique Bittencourt
- Hematology-Oncology Division, Charles Bruneau Cancer Center, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Quebec, Canada
| | - Victor Lewis
- Pediatric Oncology, Blood and Marrow Transplantation, Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Ka Wah Chan
- Pediatric Blood and Marrow Transplant Program, Texas Transplant Institute, Methodist Children's Hospital of South Texas, San Antonio, Texas
| | - Biljana Horn
- Blood and Marrow Transplant Program, Benioff Children's Hospital, University of California, San Francisco, California
| | - Lolie Yu
- Bone Marrow Transplant Program, Children's Hospital, Louisiana State University Health Science Center, New Orleans, Louisiana
| | - Julie-An Talano
- Department of Pediatric Hematology Oncology, Children's Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Eneida Nemecek
- Pediatric BMT Program, Oregon Health & Science University, Portland, Oregon
| | | | - Sonali Chaudhury
- Division of Pediatric Hematology, Oncology, Stem Cell Transplantation, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
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Chang MH, Tsai FH, Chou SJ, Wang JH, Lo DY, Zheng ZZ, Chan KW, Lai JM. Positive influence of L-carnitine on the different muscle fibres types of racing pigeons. J Anim Physiol Anim Nutr (Berl) 2013; 98:739-46. [PMID: 24164218 DOI: 10.1111/jpn.12135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 01/23/2013] [Accepted: 09/16/2013] [Indexed: 11/29/2022]
Abstract
Succinate dehydrogenase (SDH), Ca(2+) ATPase, Lactate dehydrogenase (LDH), are involved in energy metabolism. These enzymes can be used as indicators of the energy capacity of aerobic cells. The study investigated the effects of L-carnitine supplementation on M. pectoralis superficialis, M. pectoralis profundus, M. extensor carpi radialis muscle and M. flexor carpi ulnaris. Twenty-eight racing pigeons hatched at the same time were divided randomly into three groups. Eight pigeons, which were used as the control group, were sacrificed at 92-day old. The remaining twenty pigeons continued training until they reached 157-day old, with half the pigeons getting 25 mg/head/day of L-carnitine, while the other half given the same amount of water. The pigeons were assessed by histochemical methods and reverse transcription polymerase chain reaction (RT-PCR). To assess influence of L-carnitine on muscle fibre composition and the performance of three genes' mRNA, this study applied SDH localization, SDH, Ca(2+) ATPase and LDH mRNA expression to examine the results after oral administration of L-carnitine in vivo in racing pigeons. The results showed that L-carnitine significantly elevated the amount of white muscle fibre type IIa (p < 0.05). The mRNA expression quantities of SDH and LDH gene was higher via RT-PCR method. However, the expression of Ca(2+) ATPase remains similar. In conclusion, appropriate oral administration of L-carnitine of 25 mg/pigeon/day will result in an improvement of muscles related to flying.
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Affiliation(s)
- M H Chang
- Department of Veterinary Medicine, College of Agriculture, National Chiayi University, Chiayi City, Taiwan, China
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Houben CH, Wong HY, Mou WC, Chan KW, Tam YH, Lee KH. Hitching the gallbladder in laparoscopic-assisted cholecysto-cholangiography: a simple technique. Pediatr Surg Int 2013; 29:953-5. [PMID: 23857561 DOI: 10.1007/s00383-013-3347-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/08/2013] [Indexed: 10/26/2022]
Abstract
Neonatal cholestatic disorder in the late neonatal period requires often cholangiography to differentiate between biliary atresia and other causes of prolonged neonatal jaundice. A simplified method of a laparoscopic-assisted cholecysto-cholangiography is presented. Retrospective chart review was conducted of all patients who from May 2002 to April 2012 underwent a laparoscopic-assisted cholecysto-cholangiography with routine fixation of the fundus of the gallbladder to the lateral aspect of the abdominal wall. A total of 18 infants (8 boys) aged 41-104 (median 64) days underwent laparoscopic-assisted cholecysto-cholangiography for prolonged jaundice. The technique identified ten cases of a patent bile duct system and eight biliary atresias. (Thirty-two cases of suspected biliary atresia were confirmed by laparoscopy alone.) Two cases required suturing of a bile leak at the puncture site. Hitching the gallbladder to the lateral abdominal wall is a simple method allowing an optimal radiographic assessment of the extra- and intra-hepatic bile duct anatomy.
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Affiliation(s)
- C H Houben
- Division of Paediatric Surgery and Paediatric Urology, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.
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Abstract
OBJECTIVE. To investigate the prevalence of pre-cancerous uterine cervix lesions as detected in Papanicolaou (Pap) smears from female sex workers in Hong Kong. DESIGN. Retrospective analysis of laboratory records. SETTING. Private anatomical pathology laboratory, Hong Kong. PATIENTS. Female sex workers undergoing Pap smear examinations at two non-governmental organisations between 2006 and 2012. MAIN OUTCOME MEASURES. Detection of pre-cancerous uterine cervical conditions and their management. RESULTS. A total of 2697 satisfactory Pap smears from female sex workers were performed during the study period from 2006 to 2012. In these subjects, the point prevalence of low-grade squamous intraepithelial lesion and atypical squamous cells of unknown significance was 10.12% (compared with 3.92% for the general population during the same period), whereas that of high-grade squamous intraepithelial lesions and atypical squamous cells of unknown significance with or without high-grade intraepithelial lesions was 2.22% (compared with 0.54% in the general population). For both categories of lesions, the higher prevalence among female sex workers than in the general population was statistically significant. Most patients who had abnormal Pap smears received proper referrals and follow-up management according to recommended guidelines. CONCLUSIONS. Female sex workers in Hong Kong as a group had a significantly higher prevalence of abnormal Pap smears than the general population. Non-governmental organisations providing free-of-charge screening services to these women helped early detection and proper follow-up for those who had abnormal Pap smears, whilst also increasing their awareness of women's health issues.
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Affiliation(s)
- K M Leung
- Diagnostix Pathology Laboratories Ltd., Canossa Hospital, 1 Old Peak Road, Hong Kong.
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Hitzler JK, He W, Doyle J, Cairo M, Camitta BM, Chan KW, Diaz Perez MA, Fraser C, Gross TG, Horan JT, Kennedy-Nasser AA, Kitko C, Kurtzberg J, Lehmann L, O'Brien T, Pulsipher MA, Smith FO, Zhang MJ, Eapen M, Carpenter PA. Outcome of transplantation for acute myelogenous leukemia in children with Down syndrome. Biol Blood Marrow Transplant 2013; 19:893-7. [PMID: 23467128 DOI: 10.1016/j.bbmt.2013.02.017] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Accepted: 02/22/2013] [Indexed: 11/26/2022]
Abstract
Data on outcomes of allogeneic transplantation in children with Down syndrome and acute myelogenous leukemia (DS-AML) are scarce and conflicting. Early reports stress treatment-related mortality as the main barrier; a recent case series points to posttransplantation relapse. We reviewed outcome data for 28 patients with DS-AML reported to the Center for International Blood and Marrow Transplant Research between 2000 and 2009 and performed a first matched-pair analysis of 21 patients with DS-AML and 80 non-DS AML controls. The median age at transplantation for DS-AML was 3 years, and almost half of the cohort was in second remission. The 3-year probability of overall survival was only 19%. In multivariate analysis, adjusting for interval from diagnosis to transplantation, risks of relapse (hazard ratio [HR], 2.84; P < .001; 62% versus 37%) and transplant-related mortality (HR, 2.52; P = .04; 24% versus 15%) were significantly higher for DS-AML compared to non-DS AML. Overall mortality risk (HR, 2.86; P < .001; 21% versus 52%) was significantly higher for DS-AML. Both transplant-related mortality and relapse contribute to higher mortality. Excess mortality in DS-AML patients can only effectively be addressed through an international multicenter effort to pilot strategies aimed at lowering both transplant-related mortality and relapse risks.
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Affiliation(s)
- Johann K Hitzler
- The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
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McDonald L, Luke J, Fletcher T, Sanders R, Jude VH, Chan KW. Development of a Pediatric HSCT Multi-Disciplinary Survivor Clinic. Biol Blood Marrow Transplant 2013. [DOI: 10.1016/j.bbmt.2012.11.252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Chan GSW, Lam MF, Kwan L, Fung SH, Chan SC, Chan KW. Clinicopathological study of renal biopsies after liver transplantation. Hong Kong Med J 2013; 19:27-32. [PMID: 23378351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
OBJECTIVE To perform a clinicopathological study of patients having renal biopsies after liver transplantation. DESIGN Case series. SETTING; Queen Mary Hospital, Hong Kong. PATIENTS All post-liver transplantation patients who had a renal biopsy in the period from January 2000 to December 2010. RESULTS Eleven renal biopsies were retrieved for review from 10 patients with liver transplantation. The male-to-female ratio was 9:1 (age range, 47-63 years). The median liver transplant-to-renal biopsy interval was 1590 (range, 102-3699) days. The predominant histological changes were interstitial fibrosis and tubular atrophy. Diabetic nephropathy (n=6) and immunoglobulin A nephropathy (n=4) were the commonest glomerulopathies. Only one patient had chronic calcineurin inhibitor nephrotoxicity. With a mean follow-up of 53 months, three patients died 2 to 53 months post-renal biopsy. All surviving patients had chronic renal impairment. Five patients developed end-stage renal failure and four had significant persistent proteinuria. CONCLUSION Renal pathology was variable after liver transplantation; most biopsies showed complex renal lesions, whilst calcineurin inhibitor nephrotoxicity was rare. The recognition of kidney histology attributable to metabolic derangements after liver transplantation is potentially important in the interpretation of renal biopsy specimens and patient management. The renal outlook of this group of patients is guarded.
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Affiliation(s)
- Gavin S W Chan
- Department of Pathology, Queen Mary Hospital, The University of Hong Kong, Hong Kong.
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Bednarski JJ, Le C, Murray L, Hayashi R, Yu L, Dalal J, Kamani N, Jacobsohn DA, Pulsipher MA, Petrovic A, Chan KW, Grimley M, Haut P, Adams R, Douglas D, Chaudhury S, Gilman A, Jaroscak J, Andreansky M, Schultz KR, Willert JR, Shenoy S. Immune Reconstitution Following Reduced Intensity Stem Cell Transplantation for Non-Malignant Disorders in Children. Biol Blood Marrow Transplant 2013. [DOI: 10.1016/j.bbmt.2012.11.218] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Ang EY, Soh JY, Liew WK, Chan KW, Thoon KC, Chong CY, Lau YL, Lee BW. Reliability of acute illness dihydrorhodamine-123 testing for chronic granulomatous disease. Clin Lab 2013; 59:203-206. [PMID: 23505928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Dihydrorhodamine (DHR) flow cytometric analysis is used to evaluate granulocyte oxidative bursts and is the test of choice for the diagnosis of chronic granulomatous disease (CGD). We present the clinical and DHR test profiles of five subjects assessed during and after acute illness. METHODS This was a retrospective report of the findings of five out of a total of one hundred and seventeen patients, whose blood was sent to the laboratory for dihydrorhodamine-123 flow cytometry testing between January 2005 and December 2010. Using whole blood technique and stimulation using phorbol myristate acetate, the results of DHR were expressed as stimulation index and coefficient of variation of histograms of stimulated cells and compared with healthy controls. DHR tests were repeated when the patients had recovered and were clinically well. RESULTS These five patients showed abnormal DHR test results during their acute illness, with a stimulation index (SI) lower (p = 0.009) and coefficient of variation (CV) higher (p = 0.009) than controls. The DHR profiles repeated when patients had recovered showed normalization of tests with no significant difference for SI (p = 0.602) and CV (p = 0.917) compared to controls. Wilcoxon Signed Rank tests showed a significant improvement in SI (p = 0.043) and CV (p = 0.043) upon recovery. On follow up, all five patients were well, with no further severe or atypical infections. CONCLUSIONS DHR may be transiently abnormal during acute illness, and may therefore not be reliable when assessed during an acute illness. If these subjects had CGD, it would be of a hypomorphic variant that has not previously been described.
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Affiliation(s)
- E Y Ang
- University Children's Medical Institute, National University Health Systems, Singapore
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Luke JL, McDonald L, Jude V, Chan KW, Cuellar NG. Clinical practice implications of immunizations after pediatric bone marrow transplant: a literature review. J Pediatr Oncol Nurs 2012; 30:7-17. [PMID: 23160793 DOI: 10.1177/1043454212462069] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The number of pediatric bone marrow transplants is increasing for malignant and nonmalignant diseases. The number of survivors is also increasing, and their long-term health and protection from infection is increasingly important. To prevent infections, it is standard practice to re-immunize pediatric patients after bone marrow transplant (BMT) using the Centers for Disease Control and Prevention immunization guidelines; however, surveys in the United States and other parts of the world indicate that many BMT patients do not receive all the recommended immunizations. A literature review was conducted to identify research based on evidence for immunization following BMT and to recognize barriers to the process. Also, the immunization clinical guidelines from 2000 and 2011 for patients following BMT were compared and an updated clinical protocol and immunization schedule was developed to reflect the current evidence, encourage a change in practice, and discourage fragmented care.
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Affiliation(s)
- Julie L Luke
- Methodist Children's Hospital, San Antonio, TX 78229, USA.
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Lockhart S, McDonald L, Rytting M, Chan KW. Clonal cytogenetic abnormalities after tyrosine kinase inhibitor therapy in Ph+ ALL resolution after decitabine therapy. Pediatr Blood Cancer 2012; 59:573-5. [PMID: 21910215 DOI: 10.1002/pbc.23318] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2011] [Accepted: 07/27/2011] [Indexed: 11/08/2022]
Abstract
Mixed chimerism and presence of minimal residual disease after stem cell transplantation (SCT) usually predict leukemia recurrence. In Philadelphia chromosome positive (Ph+) leukemia tyrosine kinase inhibitors can restore remission. These agents can induce clonal cytogenetic abnormalities in the Philadelphia negative cell population (CCA/Ph-), which may rarely progress to acute myeloid leukemia. A child with Ph+ acute lymphoblastic leukemia showed mixed donor chimerism and persistent bcr-abl transcripts after a matched sibling SCT. There was no response to tyrosine kinase inhibitor (TKI) therapy, but she has remained hematologically normal for more than 5 years. CCA/Ph- was detected but resolved with hypomethylating therapy.
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Affiliation(s)
- Sharon Lockhart
- Department of Hematology Oncology, Dell Children's Medical Center of Central Texas, Austin, Texas, USA
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Chan KW, Chu WH, Law IC. Giant urethral diverticulum calculus presenting as scrotal abscess. Hong Kong Med J 2012; 18:66-67. [PMID: 22302916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
We report herein a patient with a urethral calculus associated with urethral diverticulum. A 39-year-old man presented with scrotal swelling and acute retention of urine. Computed tomography of the pelvis and cystoscopy demonstrated a giant calculus in the proximal penile urethra. Emergency in-situ lithotripsy was performed. Complete stone clearance was achieved and a large urethral diverticulum was encountered. The rare occurrence of urethral diverticulum and associated stone disease were discussed.
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Affiliation(s)
- K W Chan
- Department of Surgery, Kwong Wah Hospital, Yaumatei, Hong Kong.
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Ciurea SO, Saliba RM, Hamerschlak N, Karduss Aurueta AJ, Bassett R, Fernandez-Vina M, Petropoulos D, Worth LL, Chan KW, Couriel DR, Rondon G, Sharma M, Qazilbash M, Jones RB, Kebriaei P, McMannis J, Hosing CM, Nieto Y, Champlin RE, Shpall EJ, de Lima M. Fludarabine, melphalan, thiotepa and anti-thymocyte globulin conditioning for unrelated cord blood transplant. Leuk Lymphoma 2012; 53:901-6. [PMID: 21988645 DOI: 10.3109/10428194.2011.631159] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Unrelated cord blood transplant (CBT) is an alternative treatment option for patients who lack a matched donor. However, the optimal type and intensity of the preparative regimen remains unclear. We evaluated the toxicity and outcomes of a conditioning regimen consisting of melphalan 140 mg/m(2) (day - 8), thiotepa 10 mg/kg (day - 7), fludarabine 160 mg/m(2) over 4 days (days - 6 to - 3) and rabbit antithymocyte globulin (ATG) 1.25 mg/kg (day - 4) and 1.75 mg/kg (day - 3) (FMT). Forty-seven patients with advanced hematologic malignancies with a median age of 23 years (30 adults and 17 children) were treated. Sixty percent of patients were in remission at transplant. Ninety-one percent of the patients engrafted neutrophils after a median of 22 days, and all but one of the patients achieving donor engraftment had hematopoietic recovery with 100% cord blood-derived cells. Grade 3 gastrointestinal toxicity was the major non-hematopoietic toxicity, occurring in 32% of patients. Cumulative incidence of day-100 grade II-IV acute graft-versus-host disease (aGVHD) and chronic graft-versus-host disease (cGVHD) was 53% and 34%, respectively, and non-relapse mortality at day 100 and 2 years was 11% and 40%. Two-year disease-free and overall survival rates were 31% and 44%, respectively. These results suggest that FMT is a feasible conditioning regimen for patients undergoing CBT.
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Affiliation(s)
- Stefan O Ciurea
- Department of Stem Cell Transplant and Cellular Therapy, Hospital Israelita Albert Einstein, Sao Paulo, Brazil
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Wong JSW, Cheung YS, Chan KW, Chong CCN, Lee KF, Wong J, Lai PBS. Single-incision laparoscopic cholecystectomy: from four wounds to one. Hong Kong Med J 2011; 17:465-468. [PMID: 22147316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
OBJECTIVE To review the initial results and surgical outcomes of single-incision laparoscopic cholecystectomy. DESIGN Prospective case series. SETTING A university teaching hospital and a regional hospital in Hong Kong. PATIENTS All patients undergoing single-incision laparoscopic cholecystectomy from August 2009 to March 2011. RESULTS Fifty patients underwent single-incision laparoscopic cholecystectomy during the study period. The indications for surgery included symptomatic gallstones (n=43) and gallbladder polyps (n=7). The mean operating time was 78 (standard deviation, 24) minutes. Forty-five of the patients successfully underwent single-incision laparoscopic cholecystectomy, giving a success rate of 90%. In the remaining five patients, additional working ports were constructed to obtain better exposure and dissection around Calot's triangle. On comparing the results of the initial 25 cases to the subsequent 25 cases, in the latter group the operating time was significantly shorter (86 vs 71 minutes; P=0.02), and the success rate was higher (80% vs 100%; P=0.05). During the median follow-up period of 6.8 months, four patients had complications, which included: postoperative urinary retention (n=2), one each with a haematoma and an incisional hernia. No patient endured bile duct injury, postoperative bile leakage, or haemorrhage in our series. CONCLUSION Single-incision laparoscopic cholecystectomy is feasible and safe for treatment of uncomplicated gallbladder diseases. There was a reduction in the operating time and increase in success rate with accumulation of experience. Nevertheless, surgeons should be cautious about the potential risks of this new technique.
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Affiliation(s)
- Jeff S W Wong
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
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Ko GTC, Yeung CY, Leung WYS, Chan KW, Chung CH, Fung LM, Ip TP, Kum G, Lau KP, Lau IT, Li JKY, Siu SC, Tsang MW, Yeung VTF, Tong PCY, So WY, Chan JCN. Cost implication of team-based structured versus usual care for type 2 diabetic patients with chronic renal disease. Hong Kong Med J 2011; 17 Suppl 6:9-12. [PMID: 22147352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Affiliation(s)
- G T C Ko
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
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