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Aleshina OA, Zakurdaeva K, Vasileva AN, Dubov SK, Dubov VS, Vorobyev VI, Butaev LS, Sukhareva AM, Gavrilova LV, Toropova IY, Popova MO, Siniaev AA, Kulagin AD, Kaplanov KD, Petrenko AA, Ochirova OI, Karpova A, Chelysheva EY, Turkina AG, Gurianova MA, Al-Radi LS, Gilyazitdinova EA, Egorova EK, Chabaeva YA, Kulikov SM, Sveshnikova YV, Kunst MA, Shuvaev V, Rakhmani AF, Panteleeva OL, Grishunina ME, Samoylova OS, Vorontsova E, Baryshnikova DV, Parovichnikova EN. Clinical Outcomes in Patients With COVID-19 and Hematologic Disease. Clin Lymphoma Myeloma Leuk 2023:S2152-2650(23)00128-3. [PMID: 37236904 PMCID: PMC10102503 DOI: 10.1016/j.clml.2023.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/30/2023] [Accepted: 04/07/2023] [Indexed: 05/28/2023]
Abstract
BACKGROUND Patients with hematologic diseases are at higher risk of the SARS-CoV-2 infection and more severe clinical outcomes of the coronavirus disease. CHRONOS19 is an observational prospective cohort study with the aim to determine the short and longer-term clinical outcomes, risk factors for disease severity and mortality, and rates of postinfectious immunity in patients with malignant and nonmalignant hematologic diseases and COVID-19. PATIENTS AND METHODS Overall, 666 patients were enrolled in the study, of which 626 were included in the final data analysis. The primary endpoint was 30-days all-cause mortality. Secondary endpoints included COVID-19 complications, rates of ICU admission and mechanical ventilation, outcomes of a hematologic disease in SARS-CoV-2 infected patients, overall survival, and risk factors for disease severity and mortality. Data from 15 centers were collected at 30, 90, and 180 days after COVID-19 was diagnosed and were managed using a web-based e-data capture platform. All evaluations were performed in the pre-omicron period of COVID-19 pandemic. RESULTS Thirty-days all-cause mortality was 18.9%. The predominant cause of death (in 80% of cases) were COVID-19 complications. At 180 days, the majority (70%) of additional deaths were due to hematologic disease progression. At a median follow-up of 5.7 [0.03-19.04] months, 6-months overall survival was 72% [95% CI: 0.69-0.76]. One-third of patients had severe SARS-CoV-2 disease. The rate of ICU admission was 22% with 77% of these patients requiring mechanical ventilation, with poor survival rate. A univariate analysis revealed that older age (≥ 60 years), male sex, malignant hematologic disease, myelotoxic agranulocytosis, transfusion dependence, refractory disease or relapse, diabetes among comorbidities, any complications, especially ARDS alone or in combination with CRS, admission to an ICU, and mechanical ventilation were associated with higher risks of mortality. Treatment of the hematologic disease was changed, postponed, or canceled in 63% of patients. At a longer follow-up (90 and 180 days), the status of the hematologic disease changed in 7.5% of patients. CONCLUSION Patients with hematologic disease and COVID-19 have high mortality rates, predominantly due to COVID-19 complications. At a longer-term follow-up, no significant impact of COVID-19 on the course of a hematologic disease was revealed.
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Affiliation(s)
- Olga A Aleshina
- National Medical Research Center for Hematology, Moscow, Russia.
| | | | | | | | | | | | - Lev S Butaev
- S.P. Botkin City Clinical Hospital, Moscow, Russia
| | | | | | | | - Marina O Popova
- R.M. Gorbacheva Research Institute, Pavlov University, Saint-Petersburg, Russia
| | - Aleksandr A Siniaev
- R.M. Gorbacheva Research Institute, Pavlov University, Saint-Petersburg, Russia
| | - Aleksandr D Kulagin
- R.M. Gorbacheva Research Institute, Pavlov University, Saint-Petersburg, Russia
| | | | | | | | - Alina Karpova
- N.A. Semashko Republican Clinical Hospital, Ulan-Ude, Russia
| | | | - Anna G Turkina
- National Medical Research Center for Hematology, Moscow, Russia
| | | | | | | | - Elena K Egorova
- National Medical Research Center for Hematology, Moscow, Russia
| | | | | | | | | | - Vasily Shuvaev
- Research Institute of Hematology and Transfusiology, Saint-Petersburg, Russia
| | | | | | | | - Olga S Samoylova
- N.A. Semashko Regional Clinical Hospital, Nizhniy Novgorod, Russia
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Khvastunova AN, Al-Radi LS, Fedyanina OS, Kuznetsova SA. Simultaneous finding of chronic lymphocytic leukemia and residual hairy cell leukemia using a lymphocyte-binding anti-CD antibody microarray. Clin Case Rep 2018; 6:753-755. [PMID: 29636954 PMCID: PMC5889256 DOI: 10.1002/ccr3.1416] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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: 07/28/2017] [Revised: 12/04/2017] [Accepted: 12/05/2017] [Indexed: 11/06/2022] Open
Abstract
The morphologic diagnosis of hairy cell leukemia coexisting with another lymphoproliferative disorder is hindered by the small size of hairy cell population. It can be simplified by presorting peripheral blood mononuclear cell using an anti-CD antibody microarray on transparent support (including anti-CD11c, CD25, CD103, and CD123) before their morphology analysis.
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Affiliation(s)
- Alina N Khvastunova
- Dmitry Rogachev National Research Centre of Pediatric Hematology Oncology and Immunology, Russian Ministry of Health 1 Samory Mashela st. Moscow 117997 Russia.,Centre for Theoretical Problems of Physicochemical Pharmacology RAS4 Kosygina st.Moscow 119991 Russia
| | - Liubov S Al-Radi
- Research Center for Hematology Russian Ministry of Health 4 Novy Zykovsky proezd Moscow 125167 Russia
| | - Olga S Fedyanina
- Dmitry Rogachev National Research Centre of Pediatric Hematology Oncology and Immunology, Russian Ministry of Health 1 Samory Mashela st. Moscow 117997 Russia.,Centre for Theoretical Problems of Physicochemical Pharmacology RAS4 Kosygina st.Moscow 119991 Russia
| | - Sofya A Kuznetsova
- Dmitry Rogachev National Research Centre of Pediatric Hematology Oncology and Immunology, Russian Ministry of Health 1 Samory Mashela st. Moscow 117997 Russia.,Centre for Theoretical Problems of Physicochemical Pharmacology RAS4 Kosygina st.Moscow 119991 Russia
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Al-Radi LS, Moiseeva TN, Smirnova SY, Shmakov RG. [Hairy cell leukemia and pregnancy]. TERAPEVT ARKH 2017; 89:99-104. [PMID: 28766548 DOI: 10.17116/terarkh201789799-104] [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] [Indexed: 11/17/2022]
Abstract
The paper presents experience in following up and treating hairy cell leukemia (HCL) during pregnancy. The combination of HCL and pregnancy was observed in 5 patients. The patients' median age was 35 years (range, 28-42 years). The diagnosis of HCL was based on a conventional examination protocol: clinical blood analysis with the morphological assessment of lymphocytes, a myelogram and trepanobiopsy, immunophenotypic analysis of lymphocytes or bone marrow (in all the patients), cytochemical determination of tartrate-resistant acid phosphatase in 3 patients, and identification of BRAFV600E mutation in 3 patients. Three pregnant women were treated for HCL in the postpartum period. In one patient with HCL, pregnancy was seen in remission after treatment with cladribine. In one patient with HCL detected at 11 weeks' gestation, interferon-α therapy during the second trimester of pregnancy was performed for increased cytopenia, which was followed by cladribine therapy after delivery. Pregnancy and delivery were uncomplicated in all the patients; 3 patients had vaginal delivery and 2 patients underwent cesarean section. All infants were healthy, with no developmental abnormalities during a follow-up period of 6-140 months (median 30 months). All the patients with HCL are currently in remission: 4 patients in first remission at a follow-up of 10 to 48 months (median 15 months) and one patient in second remission at a follow-up of 88 months. Possible observational tactics is possible when HCL is detected during pregnancy. Treatment of HCL during pregnancy is necessary in cases of deep or progressive cytopenia and/or splenomegaly. The use of interferon-α or splenectomy is preferable.
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Affiliation(s)
- L S Al-Radi
- National Research Center for Hematology, Ministry of Health of Russia, Moscow, Russia
| | - T N Moiseeva
- National Research Center for Hematology, Ministry of Health of Russia, Moscow, Russia
| | - S Yu Smirnova
- National Research Center for Hematology, Ministry of Health of Russia, Moscow, Russia
| | - R G Shmakov
- Acad. V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia, Moscow, Russia
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Al-Radi LS, Moiseeva TN, Julhakyan HL, Ntanishyan KI, Kovrigina AM, Glebova SM, Lugovskaya SA, Dvirnyk VN, Khvastunova AN, Yakutik IA, Savchenko VG. [Experience in investigating splenic red pulp lymphoma]. TERAPEVT ARKH 2016; 88:53-60. [PMID: 27070164 DOI: 10.17116/terarkh201688453-60] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM To generalize hematologists' experience of the diagnosis and differential diagnosis of splenic red pulp lymphoma (SRPL). MATERIAL AND METHODS Eighty-seven splenic biopsy specimens taken from patients with different B-cell lymphoproliferative diseases were examined in the Hematology Research Center in 2013-2014. The diagnosis of SRPL was based on the morphological, immunohistochemical, immunophenotypic, and molecular examinations of the splenic biopsy specimens, blood and bone marrow (BM) tests in 4 (4.6%) cases. RESULTS There was significant splenomegaly in all SRPL cases, lymphocytosis in 56 to 94% (leukocytes, 55 and 75·109/l in 2 cases), circulation of hairy lymphocytes with the phenotypes CD20+ (markedly), CD11c+/±, CD103+/± (weakly), LAIR-1+, CD25-, CD5-, CD10-, and CD23-, which did not contain tartate-resistant acid phosphatase, without BRAFV600E mutation, BM with insignificant lymphoid infiltration of CD20+, CD25-, Annexin 1-, and Cyclin D1-. The weight of the spleen averaged 3900 g (1450-9500 g); its tissue exhibited lymphoid infiltration of the red pulp with the phenotypes CD20+, DBA.44+, CD25-, Annexin1-, Cyclin D1-, CD103-, CD123-, CD27-, focal СD11c±, and TRAP±. Four patients (2 after splenectomy (SE) and 2 after SE and chemotherapy with cladribine and rituximab) are being followed up in remission. CONCLUSION SRPL is a rare disease that should be presumed to be in significant splenomegaly and lymphocytosis with hairy lymphocytes, which have only some markers for classical hairy cell leukemia (HCL), in minor BM lesion. SE is the standard for diagnosis and treatment. The differential diagnosis of SRPL with HCL has clear criteria and that with HCL-v is undetected.
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Affiliation(s)
- L S Al-Radi
- National Research Center for Hematology, Ministry of Health of Russia, Moscow, Russia
| | - T N Moiseeva
- National Research Center for Hematology, Ministry of Health of Russia, Moscow, Russia
| | - H L Julhakyan
- National Research Center for Hematology, Ministry of Health of Russia, Moscow, Russia
| | - K I Ntanishyan
- National Research Center for Hematology, Ministry of Health of Russia, Moscow, Russia
| | - A M Kovrigina
- National Research Center for Hematology, Ministry of Health of Russia, Moscow, Russia
| | - S M Glebova
- National Research Center for Hematology, Ministry of Health of Russia, Moscow, Russia
| | - S A Lugovskaya
- Russian Medical Academy of Postgraduate Education, Ministry of Health of Russia, Moscow, Russia
| | - V N Dvirnyk
- National Research Center for Hematology, Ministry of Health of Russia, Moscow, Russia
| | - A N Khvastunova
- Dmitry Rogachev Federal Research-and-Clinical Center for Pediatric Hematology, Oncology, and Immunology, Moscow, Russia
| | - I A Yakutik
- National Research Center for Hematology, Ministry of Health of Russia, Moscow, Russia
| | - V G Savchenko
- National Research Center for Hematology, Ministry of Health of Russia, Moscow, Russia
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Moiseeva TN, Al-Radi LS, Kovrigina AM, Goryacheva SR, Julakyan UL, Margolin OV, Skidan NI, Tseytlina MA, Kravchenko SK. [Nodular lymphocyte-predominant Hodgkin's lymphoma: Principles of diagnosis and treatment]. TERAPEVT ARKH 2016; 87:78-83. [PMID: 26821421 DOI: 10.17116/terarkh2015871178-83] [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] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM To describe the clinical and morphological features of the rare Hodgkin's lymphoma (HL) subtype--nodular lymphocyte-predominant HL (NLPHL). SUBJECTS AND METHODS Forty-two patients were diagnosed with NLPHL in 2010 to 2014. The male to female ratio was 2.2:1; the median age was 37 years (range 17-68 years). NLPHL was diagnosed on the basis of the histological and immunohistochemical examinations of tumor biopsy specimens; disease stages were determined by standard HL studies. RESULTS Before NLPHL was detected, 23 (55%) patients were diagnosed as having HL in 13 cases, follicular lymphoma in 2, lymphofollicular hyperplasia in 3, angioimmunoblastic lymphoma in 1, diffuse large B-cell lymphoma in 3, and B-cell lymphoma (non-HL) in 1. Long-term (3-21-year; median 8 years) persistent lymphadenopathy was observed in 16 (38%) patients. Seventeen (40.5%) patients had early (I-II) stages of the disease and 25 (59.5%) had advanced stages. B symptoms were noted in 24% of cases. There was involvement of extranodal sites (salivary gland, tonsil) in 2 patients, spleen in 14 (33%), bone marrow in 8, and bulky disease in 2. Cycles of ABVD ± rituximab ± radiotherapy (RT) were used in early-stage NLPHL; those of R-BEACOPP-14 ± RT were performed in the advanced stages of the disease or its transformation to diffuse large B-cell lymphoma with excessive T cells. CONCLUSION When patients have a history of long-term asymptomatic lymphadenopathy, it is necessary to rule out NLPHL, for which purpose an immunohistochemical examination of a biopsy specimen and its reexamination in a laboratory having experience in diagnosing NLPHL must necessarily be done. Lower RT doses and rituximab incorporated into the cycle of treatment are indicated to reduce its toxicity and to preserve therapeutic efficiency.
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Affiliation(s)
- T N Moiseeva
- Hematology Research Center, Ministry of Health of Russia, Moscow, Russia
| | - L S Al-Radi
- Hematology Research Center, Ministry of Health of Russia, Moscow, Russia
| | - A M Kovrigina
- Hematology Research Center, Ministry of Health of Russia, Moscow, Russia
| | - S R Goryacheva
- Hematology Research Center, Ministry of Health of Russia, Moscow, Russia
| | - U L Julakyan
- Hematology Research Center, Ministry of Health of Russia, Moscow, Russia
| | - O V Margolin
- Hematology Research Center, Ministry of Health of Russia, Moscow, Russia
| | - N I Skidan
- Hematology Research Center, Ministry of Health of Russia, Moscow, Russia
| | - M A Tseytlina
- Hematology Research Center, Ministry of Health of Russia, Moscow, Russia
| | - S K Kravchenko
- Hematology Research Center, Ministry of Health of Russia, Moscow, Russia
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Al-Radi LS, Moiseeva TN, Polyanskaya TY, Kovrigina AM, Kostina IE, Khvastunova AN, Yakutik IA, Lugovskaya SA. [Isolated sacral injury in hairy cell leukemia: A case report and analysis of literature data]. TERAPEVT ARKH 2015; 87:94-96. [PMID: 26390731 DOI: 10.17116/terarkh201587794-96] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Hairy cell leukemia (HCL), a chronic B-cell lymphoproliferative disease with special villous morphology and immunophenotypic markers of lymphoid cells, is characterized by the involvement of bone marrow and spleen. The paper describes a case of a 29-year-old female patient without abnormal clinical blood tests and myelograms, with normal spleen sizes, in whom the only manifestation of HCL was massive scrotal injury with a soft tissue component in the small pelvic cavity.
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Affiliation(s)
- L S Al-Radi
- Hematology Research Center, Ministry of Health of Russia, Moscow, Russia
| | - T N Moiseeva
- Hematology Research Center, Ministry of Health of Russia, Moscow, Russia
| | - T Yu Polyanskaya
- Hematology Research Center, Ministry of Health of Russia, Moscow, Russia
| | - A M Kovrigina
- Hematology Research Center, Ministry of Health of Russia, Moscow, Russia
| | - I E Kostina
- Hematology Research Center, Ministry of Health of Russia, Moscow, Russia
| | - A N Khvastunova
- D. Rogachev Federal Research Clinical Center of Pediatric Hematology, Oncology, and Immunology, Ministry of Health of Russia, Moscow, Russia
| | - I A Yakutik
- Hematology Research Center, Ministry of Health of Russia, Moscow, Russia
| | - S A Lugovskaya
- Russian Medical Academy of Postgraduate Education, Ministry of Health of Russia, Moscow, Russia
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Moiseeva TN, Al-Radi LS, Sharkunov NN, Chernova NG, Klyasova GA, Gracheva AN, Baryakh EA, Maryin DS, Shitareva IV, Julakyan UL, Kostina IE, Sinitsina MN, Galstyan GM, Kravchenko SK. [Pneumocystis pneumonia in patients with Hodgkin lymphoma]. TERAPEVT ARKH 2014; 86:60-65. [PMID: 25715489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
AIM To assess the results of diagnosing and treating Pneumocystis pneumonia (PP) in patients with Hodgkin lymphoma (HL) over 15 years. SUBJECTS AND METHODS In 1999 to 2013, PP occurred in 22 (3%) of 741 HL patients receiving programmed polychemotherapy (PCT). The male/female ratio was 1:1.1; median age was 32 (18-65) years. Advanced stages (IIB-IV) of the disease were seen in 82% of the patients. The diagnosis of PP was established when Pneumocystis (more than 5 cysts in the specimen) was detected in the lavage fluid by indirect immunofluorescence assay. RESULTS PP developed after 4 or more cycles of PCT. Along with Pneumocystis, all the cases were found to have additional pathogens: herpes virus in 72% and bacteria and fungi in 33%. All the patients received combined antimicrobial therapy using high doses of intravenous trimethoprim-sulfamethoxazole. Ten (45%) patients required mechanical ventilation (MV). The total mortality in PP was 32% (7 patients died); moreover, none of the patients without MV died whereas the mortality among those who had MV was 70% (7 of the 10 patients died). High death rates (80%) were noted among the patients with recurrent and resistant HL. CONCLUSION PP should be prevented with trimethoprim-sulfamethoxazole in patients with LH during PCT. If respiratory failure and X-ray signs of interstitial pneumonia appear, there is a need for fibrobronchoscopy with bronchoalveolar lavage and comprehensive microbiological testing of lavage fluid.
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Al-Radi LS, Moiseeva TN, Chernova NG, Sharkunov NN, Margolin OV, Shitareva IV, Baryakh EA, Klyasova GA, Roshchina LS, Kostina IE, Kravchenko SK, Pivnik AV, Vorobiov AI. [Tuberculosis in patients with lymphoproliferative diseases]. TERAPEVT ARKH 2014; 86:42-49. [PMID: 25715486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
AIM To study the clinical manifestations, diagnosis, and treatment of lymphoproliferative diseases (LPD) concurrent with tuberculosis. SUBJECTS AND METHODS In 1990 to 2013, the Hematology Research Center, Ministry of Health of Russia, followed up 4422 patients with LPD. Lymphomas and leukemias were diagnosed using the universally protocols. Tuberculosis was verified by the results of a comprehensive examination involving the histological study of biopsy specimens. RESULTS Tuberculosis was identified in 85 (2%) patients with LPD. According to the nosological entity, the tuberculosis detection rates were 3% (40/1350) in Hodgkin lymphoma (HL), 1.2% (20/1627) in aggressive lymphomas, 1.4% (16/1136) in mature cell lymphomas and chronic lymphocytic leukemia, and 2.9% (9/309) in hairy cell leukemia. In accordance with its site, pulmonary tuberculosis was 73%; extrapulmonary tuberculosis, 14%; generalized tuberculosis, 12%. In pulmonary tuberculosis, its disseminated and focal involvements were found in 71 and 18% of cases, respectively. Tuberculosis was detected in 43% of the patients with HL in remission; it occurred only in other hemoblastoses in its active phase. When tuberculosis and LPD were simultaneously found, both diseases were concurrently treated. If the chemotherapy of LPD was effective, tuberculosis was cured in all the patients. CONCLUSION Patients with LPD are a group at increased risk for tuberculosis. The diagnosis of recurrent LPD must be histologically proven. When tuberculosis and LPD are simultaneously found, both diseases should be concurrently treated.
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Stepina VN, Seniuta NB, Pavlish OA, Iakovleva LS, Pivnik AV, Al-Radi LS, Osmanov EA, Gurova EP, Miasnikova IN, Kologrivova ZA. [HTLV-I-associated hemoblastoses in different regions of the USSR]. Vopr Virusol 1991; 36:159-62. [PMID: 1882526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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