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Ma S, La J, Swinnerton KN, Guffey D, Bandyo R, De Las Pozas G, Hanzelka K, Xiao X, Rojas-Hernandez CM, Amos CI, Chitalia V, Ravid K, Merriman KW, Flowers CR, Fillmore N, Li A. Thrombosis risk prediction in lymphoma patients: A multi-institutional, retrospective model development and validation study. Am J Hematol 2024. [PMID: 38654461 DOI: 10.1002/ajh.27335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 02/05/2024] [Accepted: 03/23/2024] [Indexed: 04/26/2024]
Abstract
Venous thromboembolism (VTE) poses a significant risk to cancer patients receiving systemic therapy. The generalizability of pan-cancer models to lymphomas is limited. Currently, there are no reliable risk prediction models for thrombosis in patients with lymphoma. Our objective was to create a risk assessment model (RAM) specifically for lymphomas. We performed a retrospective cohort study to develop Fine and Gray sub-distribution hazard model for VTE and pulmonary embolism (PE)/ lower extremity deep vein thrombosis (LE-DVT) respectively in adult lymphoma patients from the Veterans Affairs national healthcare system (VA). External validations were performed at the Harris Health System (HHS) and the MD Anderson Cancer Center (MDACC). Time-dependent c-statistic and calibration curves were used to assess discrimination and fit. There were 10,313 (VA), 854 (HHS), and 1858 (MDACC) patients in the derivation and validation cohorts with diverse baseline. At 6 months, the VTE incidence was 5.8% (VA), 8.2% (HHS), and 8.8% (MDACC), respectively. The corresponding estimates for PE/LE-DVT were 3.9% (VA), 4.5% (HHS), and 3.7% (MDACC), respectively. The variables in the final RAM included lymphoma histology, body mass index, therapy type, recent hospitalization, history of VTE, history of paralysis/immobilization, and time to treatment initiation. The RAM had c-statistics of 0.68 in the derivation and 0.69 and 0.72 in the two external validation cohorts. The two models achieved a clear differentiation in risk stratification in each cohort. Our findings suggest that easy-to-implement, clinical-based model could be used to predict personalized VTE risk for lymphoma patients.
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Affiliation(s)
- Shengling Ma
- Section of Hematology-Oncology, Baylor College of Medicine, Houston, Texas, USA
| | - Jennifer La
- Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, Massachusetts, USA
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Kaitlin N Swinnerton
- Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, Massachusetts, USA
| | - Danielle Guffey
- Institute for Clinical & Translational Research, Baylor College of Medicine, Houston, Texas, USA
| | | | - Giordana De Las Pozas
- Department of Cancer Registry, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Katy Hanzelka
- Division of Pharmacy, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Xiangjun Xiao
- Institute for Clinical & Translational Research, Baylor College of Medicine, Houston, Texas, USA
| | | | - Christopher I Amos
- Institute for Clinical & Translational Research, Baylor College of Medicine, Houston, Texas, USA
- Section of Epidemiology and Population Science, Baylor College of Medicine, Houston, Texas, USA
| | - Vipul Chitalia
- Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, Massachusetts, USA
- Department of Medicine and Whitaker Cardiovascular Institute, Boston University Chobanian and Advedisian School of Medicine, Boston, Massachusetts, USA
- Institute of Medical Engineering and Sciences, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Katya Ravid
- Department of Medicine and Whitaker Cardiovascular Institute, Boston University Chobanian and Advedisian School of Medicine, Boston, Massachusetts, USA
| | - Kelly W Merriman
- Department of Cancer Registry, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Christopher R Flowers
- Department of Lymphoma-Myeloma, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Nathanael Fillmore
- Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, Massachusetts, USA
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Ang Li
- Section of Hematology-Oncology, Baylor College of Medicine, Houston, Texas, USA
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Ackley S, Calmasini C, Bouteloup V, Hill-Jarrett TG, Swinnerton KN, Chêne G, Dufouil C, Glymour MM. Contribution of Global Amyloid-PET Imaging for Predicting Future Cognition in the MEMENTO Cohort. Neurology 2024; 102:e208054. [PMID: 38412412 DOI: 10.1212/wnl.0000000000208054] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 10/16/2023] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Global amyloid-PET is associated with cognition and cognitive decline, but most research on this association does not account for past cognitive information. We assessed the prognostic benefit of amyloid-PET measures for future cognition when prior cognitive assessments are available, evaluating the added value of amyloid measures beyond information on multiple past cognitive assessments. METHODS The French MEMENTO cohort (a cohort of outpatients from French research memory centers to improve knowledge on Alzheimer disease and related disorders) includes older outpatients with incipient cognitive changes, but no dementia diagnosis at inclusion. Global amyloid burden was assessed using positron emission tomography (amyloid-PET) for a subset of participants; semiannual cognitive testing was subsequently performed. We predicted mini-mental state examination (MMSE) scores using demographic characteristics (age, sex, marital status, and education) alone or in combination with information on prior cognitive measures. The added value of amyloid burden as a predictor in these models was evaluated with percent reduction of the mean squared error (MSE). All models were conducted separately for evaluating the added value of dichotomous amyloid positivity status compared with a continuous amyloid-standardized uptake-value ratio. RESULTS Our analytic sample comprised 510 individuals who underwent amyloid-PET scans with at least 4 MMSE assessments. The mean age at the PET scan was 71.6 (standard deviation 7.4) years; 60.7% were female. The median follow-up was 4.6 years (interquartile range: 0.9 years). Adding amyloid burden when adjusting for only demographic characteristics reduced the MSE of predictions by 5.08% (95% CI 0.97%-10.86%) and 12.64% (95% CI 3.35%-25.28%) for binary and continuous amyloid, respectively. If the model included 1 past MMSE measure, the MSE improvement was 3.51% (95% CI 1.01%-7.28%) when adding binary amyloid and 8.83% (95% CI 2.63%-16.37%) when adding continuous amyloid. Improvements in model fit were smaller with the addition of amyloid burden when more than 1 past cognitive assessment was included. For all models incorporating past cognitive assessments, differences in predictions amounted to a fraction of 1 MMSE point on average. DISCUSSION In a clinical setting, global amyloid burden did not appreciably improve cognitive predictions when past cognitive assessments were available. TRIAL REGISTRATION INFORMATION ClinicalTrials.gov Identifier: NCT02164643.
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Affiliation(s)
- Sarah Ackley
- From the Department of Epidemiology (S.A., M.M.G.), Boston University, MA; Department of Epidemiology and Biostatistics (C.C., K.N.S.), University of California, San Francisco; University Bordeaux (V.B., G.C., C.D.), Inserm, UMR 1219; Pole de sante publique Centre Hospitalier Universitaire (CHU) de Bordeaux (V.B., G.C., C.D.), France; and Memory & Aging Center (T.G.H.-J.), University of California, San Francisco
| | - Camilla Calmasini
- From the Department of Epidemiology (S.A., M.M.G.), Boston University, MA; Department of Epidemiology and Biostatistics (C.C., K.N.S.), University of California, San Francisco; University Bordeaux (V.B., G.C., C.D.), Inserm, UMR 1219; Pole de sante publique Centre Hospitalier Universitaire (CHU) de Bordeaux (V.B., G.C., C.D.), France; and Memory & Aging Center (T.G.H.-J.), University of California, San Francisco
| | - Vincent Bouteloup
- From the Department of Epidemiology (S.A., M.M.G.), Boston University, MA; Department of Epidemiology and Biostatistics (C.C., K.N.S.), University of California, San Francisco; University Bordeaux (V.B., G.C., C.D.), Inserm, UMR 1219; Pole de sante publique Centre Hospitalier Universitaire (CHU) de Bordeaux (V.B., G.C., C.D.), France; and Memory & Aging Center (T.G.H.-J.), University of California, San Francisco
| | - Tanisha G Hill-Jarrett
- From the Department of Epidemiology (S.A., M.M.G.), Boston University, MA; Department of Epidemiology and Biostatistics (C.C., K.N.S.), University of California, San Francisco; University Bordeaux (V.B., G.C., C.D.), Inserm, UMR 1219; Pole de sante publique Centre Hospitalier Universitaire (CHU) de Bordeaux (V.B., G.C., C.D.), France; and Memory & Aging Center (T.G.H.-J.), University of California, San Francisco
| | - Kaitlin N Swinnerton
- From the Department of Epidemiology (S.A., M.M.G.), Boston University, MA; Department of Epidemiology and Biostatistics (C.C., K.N.S.), University of California, San Francisco; University Bordeaux (V.B., G.C., C.D.), Inserm, UMR 1219; Pole de sante publique Centre Hospitalier Universitaire (CHU) de Bordeaux (V.B., G.C., C.D.), France; and Memory & Aging Center (T.G.H.-J.), University of California, San Francisco
| | - Geneviève Chêne
- From the Department of Epidemiology (S.A., M.M.G.), Boston University, MA; Department of Epidemiology and Biostatistics (C.C., K.N.S.), University of California, San Francisco; University Bordeaux (V.B., G.C., C.D.), Inserm, UMR 1219; Pole de sante publique Centre Hospitalier Universitaire (CHU) de Bordeaux (V.B., G.C., C.D.), France; and Memory & Aging Center (T.G.H.-J.), University of California, San Francisco
| | - Carole Dufouil
- From the Department of Epidemiology (S.A., M.M.G.), Boston University, MA; Department of Epidemiology and Biostatistics (C.C., K.N.S.), University of California, San Francisco; University Bordeaux (V.B., G.C., C.D.), Inserm, UMR 1219; Pole de sante publique Centre Hospitalier Universitaire (CHU) de Bordeaux (V.B., G.C., C.D.), France; and Memory & Aging Center (T.G.H.-J.), University of California, San Francisco
| | - M M Glymour
- From the Department of Epidemiology (S.A., M.M.G.), Boston University, MA; Department of Epidemiology and Biostatistics (C.C., K.N.S.), University of California, San Francisco; University Bordeaux (V.B., G.C., C.D.), Inserm, UMR 1219; Pole de sante publique Centre Hospitalier Universitaire (CHU) de Bordeaux (V.B., G.C., C.D.), France; and Memory & Aging Center (T.G.H.-J.), University of California, San Francisco
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Bihn JR, Cioffi G, Waite KA, Kruchko C, Neff C, Price M, Ostrom QT, Swinnerton KN, Elbers DC, Mooney MA, Rachlin J, Stein TD, Brophy MT, Do NV, Ferguson RE, Priemer DS, Perl DP, Hickman RA, Nabors B, Rusiecki J, Barnholtz-Sloan JS, Fillmore NR. Brain tumors in United States military veterans. Neuro Oncol 2024; 26:387-396. [PMID: 37738677 PMCID: PMC10836768 DOI: 10.1093/neuonc/noad182] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Indexed: 09/24/2023] Open
Abstract
BACKGROUND Comprehensive analysis of brain tumor incidence and survival in the Veteran population has been lacking. METHODS Veteran data were obtained from the Veterans Health Administration (VHA) Medical Centers via VHA Corporate Data Warehouse. Brain tumor statistics on the overall US population were generated from the Central Brain Tumor Registry of the US data. Cases were individuals (≥18 years) with a primary brain tumor, diagnosed between 2004 and 2018. The average annual age-adjusted incidence rates (AAIR) and 95% confidence intervals were estimated per 100 000 population and Kaplan-Meier survival curves evaluated overall survival outcomes among Veterans. RESULTS The Veteran population was primarily white (78%), male (93%), and between 60 and 64 years old (18%). Individuals with a primary brain tumor in the general US population were mainly female (59%) and between 18 and 49 years old (28%). The overall AAIR of primary brain tumors from 2004 to 2018 within the Veterans Affairs cancer registry was 11.6. Nonmalignant tumors were more common than malignant tumors (AAIR:7.19 vs 4.42). The most diagnosed tumors in Veterans were nonmalignant pituitary tumors (AAIR:2.96), nonmalignant meningioma (AAIR:2.62), and glioblastoma (AAIR:1.96). In the Veteran population, survival outcomes became worse with age and were lowest among individuals diagnosed with glioblastoma. CONCLUSIONS Differences between Veteran and US populations can be broadly attributed to demographic composition differences of these groups. Prior to this, there have been no reports on national-level incidence rates and survival outcomes for Veterans. These data provide vital information that can drive efforts to understand disease burden and improve outcomes for individuals with primary brain tumors.
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Affiliation(s)
- John R Bihn
- VA Boston Healthcare System, Boston, Massachusetts, USA
| | - Gino Cioffi
- Trans Divisional Research Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
- Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA
| | - Kristin A Waite
- Trans Divisional Research Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
- Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA
| | - Carol Kruchko
- Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA
| | - Corey Neff
- Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA
- Department of Neurosurgery, Duke University School of Medicine, Durham, North Carolina, USA
| | - Mackenzie Price
- Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA
- Department of Neurosurgery, Duke University School of Medicine, Durham, North Carolina, USA
| | - Quinn T Ostrom
- Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA
- Department of Neurosurgery, Duke University School of Medicine, Durham, North Carolina, USA
- The Preston Robert Tisch Brain Tumor Center, Duke University School of Medicine, Durham, North Carolina, USA
| | | | - Danne C Elbers
- VA Boston Healthcare System, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Michael A Mooney
- VA Boston Healthcare System, Boston, Massachusetts, USA
- Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Jacob Rachlin
- VA Boston Healthcare System, Boston, Massachusetts, USA
| | - Thor D Stein
- VA Boston Healthcare System, Boston, Massachusetts, USA
- Boston University, Chobanian and Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Mary T Brophy
- VA Boston Healthcare System, Boston, Massachusetts, USA
- Boston University, Chobanian and Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Nhan V Do
- VA Boston Healthcare System, Boston, Massachusetts, USA
- Boston University, Chobanian and Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Ryan E Ferguson
- VA Boston Healthcare System, Boston, Massachusetts, USA
- Boston University, Chobanian and Avedisian School of Medicine, Boston, Massachusetts, USA
| | - David S Priemer
- Department of Pathology, Uniformed Services University School of Medicine, Bethesda, Maryland, USA
- Henry M. Jackson Foundation for The Advancement of Military Medicine, Bethesda, Maryland, USA
| | - Daniel P Perl
- Department of Pathology, Uniformed Services University School of Medicine, Bethesda, Maryland, USA
| | - Richard A Hickman
- Henry M. Jackson Foundation for The Advancement of Military Medicine, Bethesda, Maryland, USA
- Human Oncology and Pathogenesis Program, Sloan Kettering Institute, New York, New York, USA
- Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of Health Sciences, Bethesda, Maryland, USA
| | - Burt Nabors
- Department of Neurology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Jennifer Rusiecki
- Department of Preventive Medicine and Biostatistics, Uniformed Services University School of Medicine, Bethesda, Maryland, USA
| | - Jill S Barnholtz-Sloan
- Trans Divisional Research Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
- Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA
- Center for Biomedical Informatics and Information Technology, National Cancer Institute, Bethesda, Maryland, USA
| | - Nathanael R Fillmore
- VA Boston Healthcare System, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
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Do NV, Elbers DC, Fillmore NR, Ajjarapu S, Bergstrom SJ, Bihn J, Corrigan JK, Dhond R, Dipietro S, Dolgin A, Feldman TC, Goryachev SD, Huhmann LB, La J, Marcantonio PA, McGrath KM, Miller SJ, Nguyen VQ, Schneeloch GR, Sung FC, Swinnerton KN, Tarren AH, Tosi HM, Valley D, Vo AD, Yildirim C, Zheng C, Zwolinski R, Sarosy GA, Loose D, Shannon C, Brophy MT. Matching Patients to Accelerate Clinical Trials (MPACT): Enabling Technology for Oncology Clinical Trial Workflow. Stud Health Technol Inform 2024; 310:1086-1090. [PMID: 38269982 DOI: 10.3233/shti231132] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
Clinical trial enrollment is impeded by the significant time burden placed on research coordinators screening eligible patients. With 50,000 new cancer cases every year, the Veterans Health Administration (VHA) has made increased access for Veterans to high-quality clinical trials a priority. To aid in this effort, we worked with research coordinators to build the MPACT (Matching Patients to Accelerate Clinical Trials) platform with a goal of improving efficiency in the screening process. MPACT supports both a trial prescreening workflow and a screening workflow, employing Natural Language Processing and Data Science methods to produce reliable phenotypes of trial eligibility criteria. MPACT also has a functionality to track a patient's eligibility status over time. Qualitative feedback has been promising with users reporting a reduction in time spent on identifying eligible patients.
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Affiliation(s)
- Nhan V Do
- VA Boston Healthcare System, Boston MA, USA
- Boston University School of Medicine, Boston MA, USA
| | - Danne C Elbers
- VA Boston Healthcare System, Boston MA, USA
- Harvard Medical School, Boston MA, USA
| | - Nathanael R Fillmore
- VA Boston Healthcare System, Boston MA, USA
- Harvard Medical School, Boston MA, USA
| | | | | | - John Bihn
- VA Boston Healthcare System, Boston MA, USA
| | | | - Rupali Dhond
- VA Boston Healthcare System, Boston MA, USA
- Boston University School of Medicine, Boston MA, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Mary T Brophy
- VA Boston Healthcare System, Boston MA, USA
- Boston University School of Medicine, Boston MA, USA
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Martens KL, Li A, La J, May SB, Swinnerton KN, Tosi H, Elbers DC, Do NV, Brophy MT, Gaziano JM, Lotfollahzadeh S, Chitalia V, Ravid K, Fillmore NR. Epidemiology of Cancer-Associated Venous Thromboembolism in Patients With Solid and Hematologic Neoplasms in the Veterans Affairs Health Care System. JAMA Netw Open 2023; 6:e2317945. [PMID: 37306999 PMCID: PMC10261992 DOI: 10.1001/jamanetworkopen.2023.17945] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 04/16/2023] [Indexed: 06/13/2023] Open
Abstract
Importance Identifying changes in epidemiologic patterns of the incidence and risk of cancer-associated thrombosis (CAT), particularly with evolving cancer-directed therapy, is essential for risk stratification. Objective To assess the incidence of CAT over time and to determine pertinent patient-specific, cancer-specific, and treatment-specific factors associated with its risk. Design, Setting, and Participants This longitudinal, retrospective cohort study was conducted from 2006 to 2021. Duration of follow-up was from the date of diagnosis until first venous thromboembolism (VTE) event, death, loss of follow-up (defined as a 90-day gap without clinical encounters), or administrative censoring on April 1, 2022. The study took place within the US Department of Veterans Affairs national health care system. Patients with newly diagnosed invasive solid tumors and hematologic neoplasms were included in the study. Data were analyzed from December 2022 to February 2023. Exposure Newly diagnosed invasive solid tumors and hematologic neoplasms. Main Outcomes Incidence of VTE was assessed using a combination of International Classification of Diseases, Ninth Revision, Clinical Modification and International Statistical Classification of Diseases, Tenth Revision, Clinical Modification and natural language processing confirmed outcomes. Cumulative incidence competing risk functions were used to estimate incidence of CAT. Multivariable Cox regression models were built to assess the association of baseline variables with CAT. Pertinent patient variables included demographics, region, rurality, area deprivation index, National Cancer Institute comorbidity index, cancer type, staging, first-line systemic treatment within 3 months (time-varying covariate), and other factors that could be associated with the risk of VTE. Results A total of 434 203 patients (420 244 men [96.8%]; median [IQR] age, 67 [62-74] years; 7414 Asian or Pacific Islander patients [1.7%]; 20 193 Hispanic patients [4.7%]; 89 371 non-Hispanic Black patients [20.6%]; 313 157 non-Hispanic White patients [72.1%]) met the inclusion criteria. Overall incidence of CAT at 12 months was 4.5%, with yearly trends ranging stably from 4.2% to 4.7%. The risk of VTE was associated with cancer type and stage. In addition to confirming well-known risk distribution among patients with solid tumors, a higher risk of VTE was observed among patients with aggressive lymphoid neoplasms compared with patients with indolent lymphoid or myeloid hematologic neoplasms. Compared with no treatment, patients receiving first-line chemotherapy (hazard ratio [HR], 1.44; 95% CI, 1.40-1.49) and immune checkpoint inhibitors (HR, 1.49; 95% CI, 1.22-1.82) had a higher adjusted relative risk than patients receiving targeted therapy (HR, 1.21; 95% CI, 1.13-1.30) or endocrine therapy (HR, 1.20; 95% CI, 1.12-1.28). Finally, adjusted VTE risk was significantly higher among Non-Hispanic Black patients (HR, 1.23; 95% CI, 1.19-1.27) and significantly lower in Asian or Pacific Islander patients (HR, 0.84; 95% CI, 0.76-0.93) compared with Non-Hispanic White patients. Conclusions and Relevance In this cohort study of patients with cancer, a high incidence of VTE was observed, with yearly trends that remained stable over the 16-year study period. Both novel and known factors associated with the risk of CAT were identified, providing valuable and applicable insights in this current treatment landscape.
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Affiliation(s)
- Kylee L Martens
- Division of Hematology & Medical Oncology, Oregon Health & Science University, Portland
| | - Ang Li
- Section of Hematology-Oncology, Baylor College of Medicine, Houston, Texas
| | - Jennifer La
- Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston
- Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Sarah B May
- Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston
- Institute for Clinical & Translational Research, Baylor College of Medicine, Houston, Texas
| | - Kaitlin N Swinnerton
- Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston
| | - Hannah Tosi
- Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston
| | - Danne C Elbers
- Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston
- Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Nhan V Do
- Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston
- Boston University School of Medicine, Boston, Massachusetts
| | - Mary T Brophy
- Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston
- Boston University School of Medicine, Boston, Massachusetts
| | - J Michael Gaziano
- Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston
- Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | | | - Vipul Chitalia
- Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston
- Boston University School of Medicine, Boston, Massachusetts
| | - Katya Ravid
- Boston University School of Medicine, Boston, Massachusetts
| | - Nathanael R Fillmore
- Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston
- Department of Medicine, Harvard Medical School, Boston, Massachusetts
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Buto P, Swinnerton KN, La Joie R, Zimmerman SC, Glymour MM, Ackley SF, Brenowitz WD. Genetic Risk Score for Alzheimer’s Disease Predicts Brain Volume Differences in Mid‐ and Late‐life in UK Biobank Participants. Alzheimers Dement 2022. [DOI: 10.1002/alz.066409] [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: 12/24/2022]
Affiliation(s)
| | | | - Renaud La Joie
- Memory and Aging Center, UCSF Weill Institute for Neurosciences, University of California, San Francisco San Francisco CA USA
| | | | | | - Sarah F Ackley
- University of California, San Francisco San Francisco CA USA
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7
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Ackley SF, Calmasini C, Swinnerton KN, Bouteloup V, Chêne G, Dufouil C, Glymour MM. The Added Value of Global Amyloid Burden in Predicting Cognition in the MEMENTO Cohort. Alzheimers Dement 2022. [DOI: 10.1002/alz.063459] [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: 12/24/2022]
Affiliation(s)
- Sarah F Ackley
- University of California, San Francisco San Francisco CA USA
| | | | | | - Vincent Bouteloup
- Bordeaux University Hospital Bordeaux France
- Centre Inserm U1219, Institut de Santé Publique, d’Epidémiologie et de Développement (ISPED), Bordeaux School of Public Health, Université de Bordeaux Bordeaux France
| | - Geneviève Chêne
- Univ. Bordeaux, INSERM, BPH, U1219 Bordeaux France
- Pole de sante publique Centre Hospitalier Universitaire (CHU) de Bordeaux Bordeaux France
| | - Carole Dufouil
- Univ. Bordeaux, INSERM, BPH, U1219 Bordeaux France
- Pole de sante publique Centre Hospitalier Universitaire (CHU) de Bordeaux Bordeaux France
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8
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Calmasini C, Swinnerton KN, Zimmerman SC, Peterson RL, George KM, Gilsanz P, Hayes-Larson E, Mayeda ER, Mungas DM, Whitmer RA, Glymour MM. Association of Social Integration with Cognitive Status in a Multi-Ethnic Cohort: Results From the Kaiser Healthy Aging and Diverse Life Experiences Study. J Geriatr Psychiatry Neurol 2022; 35:789-799. [PMID: 35077251 PMCID: PMC10020945 DOI: 10.1177/08919887211070259] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
We evaluated overall and race-specific relationships between social integration and cognition in older adults. Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE) cohort participants included 1343 Asian, Black, Latino, or non-Latino White Kaiser Permanente Northern California members. We estimated the effect of social integration on verbal episodic memory, semantic memory, and executive function derived from the Spanish and English Neuropsychological Assessment (SENAS) Scales. Social integration scores included marital status; volunteer activity; and contact with children, relatives, friends, and confidants. We estimated covariate-adjusted linear mixed-effects models for baseline and 17-month follow-up cognition. Social integration was associated with higher baseline cognitive scores (average β = 0.066 (95% confidence interval: 0.040, 0.092)) overall and in each racial/ethnic group. The association did not vary by race/ethnicity. Social integration was not associated with the estimated rate of cognitive change. In this cohort, more social integration was similarly associated with better late-life cognition across racial/ethnic groups.
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Affiliation(s)
- Camilla Calmasini
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Kaitlin N. Swinnerton
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Scott C. Zimmerman
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Rachel L. Peterson
- Department of Public Health Sciences, University of California Davis, Davis, CA, USA
- Department of Neurology, University of California Davis Health, Sacramento, CA, USA
| | - Kristen M. George
- Department of Public Health Sciences, University of California Davis, Davis, CA, USA
- Department of Neurology, University of California Davis Health, Sacramento, CA, USA
| | - Paola Gilsanz
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Eleanor Hayes-Larson
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Elizabeth Rose Mayeda
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Dan M. Mungas
- Department of Neurology, University of California Davis Health, Sacramento, CA, USA
| | - Rachel A. Whitmer
- Department of Public Health Sciences, University of California Davis, Davis, CA, USA
| | - M. Maria Glymour
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
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9
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Calmasini C, Swinnerton KN, Zimmerman SC, Peterson RL, George KM, Gilsanz P, Hayes‐Larson E, Mungas DM, Whitmer RA, Glymour MM. Association of social integration with cognitive status: results from the Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE) study. Alzheimers Dement 2021. [DOI: 10.1002/alz.053202] [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: 11/11/2022]
Affiliation(s)
| | | | | | | | | | - Paola Gilsanz
- Kaiser Permanente Division of Research Oakland CA USA
| | | | - Dan M Mungas
- University of California, Davis School of Medicine Sacramento CA USA
| | | | - M Maria Glymour
- University of California, San Francisco San Francisco CA USA
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10
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Ciampa CJ, Parent JH, Lapoint MR, Swinnerton KN, Taylor MM, Tennant VR, Whitman AJ, Jagust WJ, Berry AS. Elevated Dopamine Synthesis as a Mechanism of Cognitive Resilience in Aging. Cereb Cortex 2021; 32:2762-2772. [PMID: 34718454 DOI: 10.1093/cercor/bhab379] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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: 06/14/2021] [Revised: 09/20/2021] [Accepted: 09/21/2021] [Indexed: 12/27/2022] Open
Abstract
Aging is associated with declines in multiple components of the dopamine system including loss of dopamine-producing neurons, atrophy of the dopamine system's cortical targets, and reductions in the density of dopamine receptors. Countering these patterns, dopamine synthesis appears to be stable or elevated in older age. We tested the hypothesis that elevation in dopamine synthesis in aging reflects a compensatory response to neuronal loss rather than a nonspecific monotonic shift in older age. We measured individual differences in striatal dopamine synthesis capacity in cognitively normal older adults using [18F]Fluoro-l-m-tyrosine positron emission tomography cross-sectionally and tested relationships with longitudinal reductions in cortical thickness and working memory decline beginning up to 13 years earlier. Consistent with a compensation account, older adults with the highest dopamine synthesis capacity were those with greatest atrophy in posterior parietal cortex. Elevated dopamine synthesis capacity was not associated with successful maintenance of working memory performance overall, but had a moderating effect such that higher levels of dopamine synthesis capacity reduced the impact of atrophy on cognitive decline. Together, these findings support a model by which upregulation of dopamine synthesis represents a mechanism of cognitive resilience in aging.
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Affiliation(s)
- Claire J Ciampa
- Department of Psychology, Brandeis University, Waltham, MA 02453, USA
| | - Jourdan H Parent
- Department of Psychology, Brandeis University, Waltham, MA 02453, USA
| | - Molly R Lapoint
- Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Kaitlin N Swinnerton
- Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Morgan M Taylor
- Department of Psychology, Brandeis University, Waltham, MA 02453, USA
| | - Victoria R Tennant
- Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA 94720, USA
| | - A J Whitman
- Molecular Biophysics and Integrated Bioimaging, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
| | - William J Jagust
- Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA 94720, USA.,Molecular Biophysics and Integrated Bioimaging, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
| | - Anne S Berry
- Department of Psychology, Brandeis University, Waltham, MA 02453, USA
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11
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Berry AS, Harrison TM, Whitman A, Swinnerton KN, Tennant VR, Fenton LE, Hsu M, Jagust WJ. P2-423: THE INFLUENCE OF DOPAMINE SYNTHESIS CAPACITY ON REWARD LEARNING AND INCIDENTAL ENCODING IN AGING. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.2830] [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: 10/25/2022]
Affiliation(s)
- Anne S. Berry
- E O Lawrence Berkeley National Laboratory; Berkeley CA USA
| | | | - A.J.S. Whitman
- E O Lawrence Berkeley National Laboratory; Berkeley CA USA
| | | | | | | | - Ming Hsu
- Haas School of Business; Berkeley CA USA
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12
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Lockhart SN, Schöll M, Baker SL, Ayakta N, Swinnerton KN, Bell RK, Mellinger TJ, Shah VD, O'Neil JP, Janabi M, Jagust WJ. Amyloid and tau PET demonstrate region-specific associations in normal older people. Neuroimage 2017; 150:191-199. [PMID: 28232190 PMCID: PMC5391247 DOI: 10.1016/j.neuroimage.2017.02.051] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [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: 08/12/2016] [Revised: 01/27/2017] [Accepted: 02/19/2017] [Indexed: 01/22/2023] Open
Abstract
β-amyloid (Aβ) and tau pathology become increasingly prevalent with age, however, the spatial relationship between the two pathologies remains unknown. We examined local (same region) and non-local (different region) associations between these 2 aggregated proteins in 46 normal older adults using [18F]AV-1451 (for tau) and [11C]PiB (for Aβ) positron emission tomography (PET) and 1.5T magnetic resonance imaging (MRI) images. While local voxelwise analyses showed associations between PiB and AV-1451 tracer largely in the temporal lobes, k-means clustering revealed that some of these associations were driven by regions with low tracer retention. We followed this up with a whole-brain region-by-region (local and non-local) partial correlational analysis. We calculated each participant's mean AV-1451 and PiB uptake values within 87 regions of interest (ROI). Pairwise ROI analysis demonstrated many positive PiB-AV-1451 associations. Importantly, strong positive partial correlations (controlling for age, sex, and global gray matter fraction, p<.01) were identified between PiB in multiple regions of association cortex and AV-1451 in temporal cortical ROIs. There were also less frequent and weaker positive associations of regional PiB with frontoparietal AV-1451 uptake. Particularly in temporal lobe ROIs, AV-1451 uptake was strongly predicted by PiB across multiple ROI locations. These data indicate that Aβ and tau pathology show significant local and non-local regional associations among cognitively normal elderly, with increased PiB uptake throughout the cortex correlating with increased temporal lobe AV-1451 uptake. The spatial relationship between Aβ and tau accumulation does not appear to be specific to Aβ location, suggesting a regional vulnerability of temporal brain regions to tau accumulation regardless of where Aβ accumulates.
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Affiliation(s)
- Samuel N Lockhart
- Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, CA 94720, USA.
| | - Michael Schöll
- Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, CA 94720, USA; MedTech West and the Department of Psychiatry and Neurochemistry, University of Gothenburg, 413 45 Gothenburg, Sweden.
| | - Suzanne L Baker
- Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, CA 94720, USA; Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA.
| | - Nagehan Ayakta
- Department of Neurology, Memory and Aging Center, University of California San Francisco, San Francisco, CA 94158, USA.
| | - Kaitlin N Swinnerton
- Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, CA 94720, USA; Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA.
| | - Rachel K Bell
- Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, CA 94720, USA.
| | - Taylor J Mellinger
- Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, CA 94720, USA; Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA.
| | - Vyoma D Shah
- Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, CA 94720, USA; Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA.
| | - James P O'Neil
- Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA.
| | - Mustafa Janabi
- Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA.
| | - William J Jagust
- Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, CA 94720, USA; Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA.
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13
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Lockhart SN, Schöll M, Mellinger TJ, Swinnerton KN, Bell RK, O'Neil JP, Janabi M, Baker SL, Jagust WJ. O4‐01‐05: Examining Amyloid and Tau Inter‐Regional Pet Association Patterns in Cognitively Normal Older Adults. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.06.610] [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: 10/20/2022]
Affiliation(s)
| | - Michael Schöll
- University of California BerkeleyBerkeleyCA USA
- University of GothenburgGothenburgSweden
| | - Taylor J. Mellinger
- University of California BerkeleyBerkeleyCA USA
- Lawrence Berkeley National LaboratoryBerkeleyCA USA
| | - Kaitlin N. Swinnerton
- University of California BerkeleyBerkeleyCA USA
- Lawrence Berkeley National LaboratoryBerkeleyCA USA
| | | | | | | | - Suzanne L. Baker
- University of California BerkeleyBerkeleyCA USA
- Lawrence Berkeley National LaboratoryBerkeleyCA USA
| | - William J. Jagust
- University of California BerkeleyBerkeleyCA USA
- Lawrence Berkeley National LaboratoryBerkeleyCA USA
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Mellinger TJ, Swinnerton KN, Bell RK, Landau SM, Jagust WJ. P3‐270: Current Cognitive Engagement is Associated with Reduced Glucose Hypometabolism in Cognitively Normal Elderly. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.06.1933] [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: 11/29/2022]
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Mellinger TJ, Swinnerton KN, Bell RK, Landau SM, Jagust WJ. IC‐P‐155: Current Cognitive Engagement is Associated With Reduced Glucose Hypometabolism in Cognitively Normal Elderly. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.06.186] [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: 11/27/2022]
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16
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Lockhart SN, Schöll M, Mellinger TJ, Swinnerton KN, Bell RK, O'Neil JP, Janabi M, Baker SL, Jagust WJ. IC‐P‐193: Examining Amyloid and TAU Inter‐Regional PET Association Patterns in Cognitively Normal Older Adults. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.06.224] [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: 10/20/2022]
Affiliation(s)
| | - Michael Schöll
- University of California BerkeleyBerkeleyCA USA
- University of GothenburgGothenburgSweden
| | - Taylor J. Mellinger
- University of California BerkeleyBerkeleyCA USA
- Lawrence Berkeley National LaboratoryBerkeleyCA USA
| | - Kaitlin N. Swinnerton
- University of California BerkeleyBerkeleyCA USA
- Lawrence Berkeley National LaboratoryBerkeleyCA USA
| | | | | | | | - Suzanne L. Baker
- University of California BerkeleyBerkeleyCA USA
- Lawrence Berkeley National LaboratoryBerkeleyCA USA
| | - William J. Jagust
- University of California BerkeleyBerkeleyCA USA
- Lawrence Berkeley National LaboratoryBerkeleyCA USA
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