1
|
Triantafilo N, Sarmiento M, Campbell J, Rojas P, García MJ, Sandoval V, Bertín P, Ocqueteau M, Risueño MC, Rodríguez I, Galleguillos M. [Acute myeloid leukemia. Analysis of 114 patients]. Rev Med Chil 2022; 150:643-649. [PMID: 37906765 DOI: 10.4067/s0034-98872022000500643] [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: 09/07/2021] [Accepted: 12/21/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND Acute myeloid leukemia (AML) is the most common leukemia in adults. AIM To Describe our population of patients with AML and report the outcomes of our treatments. MATERIAL AND METHODS Review of electronic clinical records of 114 patients with AML with a median age of 57 years (59% men). RESULTS Seventeen percent of patients were classified as low risk, 38% as intermediate risk and 33% as high risk. Seventy-six percent of patients were treated with intensive chemotherapy. Five years overall survival according to cytogenetic risk was 59, 41, and 12% in low, intermediate, and high-risk patients, respectively. The outcomes were better in patients under 60 years. The median survival of patients treated with intensive chemotherapy aged less than 60 years and 60 years and above was 3.4 and 1 year, respectively. CONCLUSIONS Our results are comparable to those reported in developed countries. Improving the survival of patients 60 years and older is our main challenge.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Pablo Bertín
- Hematología, Red de Salud UCChristus, Santiago, Chile
| | | | | | - Isabel Rodríguez
- Laboratorio de Hematología, Red de Salud UC-Christus, Santiago, Chile
| | | |
Collapse
|
2
|
Cabrera D, Rao I, Raasch F, Solis N, Pizarro M, Freire M, Sáenz De Urturi D, Ramírez CA, Triantafilo N, León J, Riquelme A, Barrera F, Baudrand R, Aspichueta P, Arrese M, Arab JP. Mineralocorticoid receptor modulation by dietary sodium influences NAFLD development in mice. Ann Hepatol 2022; 24:100357. [PMID: 33940220 DOI: 10.1016/j.aohep.2021.100357] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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: 01/19/2021] [Revised: 03/02/2021] [Accepted: 03/02/2021] [Indexed: 02/04/2023]
Abstract
INTRODUCTION AND OBJECTIVES Nonalcoholic-fatty-liver disease (NAFLD) is considered the hepatic manifestation of metabolic syndrome (MetS). Mineralocorticoid receptor (MR) activation is associated with increased risk of MetS but few studies have assessed the role of liver MR on NAFLD. We aimed to evaluate the effect of MR modulation by sodium intake in liver injury in experimental models of NAFLD. MATERIALS AND METHODS C57BL/6J mice were fed either a high-fat-diet (HFD) or a choline/methionine deficient (MCD) diet with different sodium concentrations. Hepatic concentration of lipid species, serum aldosterone levels, expression of MR, proinflammatory and profibrotic markers and liver histology were assessed. RESULTS Mice fed with High-Na+/HFD showed a lower MR expression in liver (p = 0.01) and less steatosis on histology (p = 0.04). Consistently, animals from this group exhibited lower levels of serum aldosterone (p = 0.028) and lower hepatic triglyceride content (p = 0.008). This associated to a reduced expression of lipogenic genes, significant changes in lipid subspecies, lower HOMA-IR (p < 0.05), and lower expression of pro-inflammatory and profibrotic markers compared to those mice fed a Low-Na+/HFD. Additionally, mice fed a High-Na+/HFD showed higher expression of salt-inducible kinase (SIK)-1 and lower expression of serum-and-glucocorticoid-inducible kinase (SGK)-1. Similar results were observed with the MCD diet model. CONCLUSION We identified in two experimental models of NAFLD that High-Na+ diet content is associated to lower serum aldosterone levels and hepatic MR downregulation, associated to decreased steatosis and reduced de novo hepatic lipogenesis, proinflammatory and profibrotic markers. Decreased activation of hepatic MR seems to generate beneficial downstream inhibition of lipogenesis in experimental NAFLD.
Collapse
Affiliation(s)
- Daniel Cabrera
- Departamento de Gastroenterologia, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile; Facultad de Ciencias Médicas, Universidad Bernardo O Higgins, Santiago, Chile
| | - Isabel Rao
- Departamento de Gastroenterologia, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Fabiola Raasch
- Departamento de Gastroenterologia, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Nancy Solis
- Departamento de Gastroenterologia, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Margarita Pizarro
- Departamento de Gastroenterologia, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Mariela Freire
- Departamento de Gastroenterologia, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | | | | | - Nicolás Triantafilo
- Departamento de Hematologia, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Jonathan León
- Departamento de Gastroenterologia, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Arnoldo Riquelme
- Departamento de Gastroenterologia, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile; Departamento de Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Francisco Barrera
- Departamento de Gastroenterologia, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Rene Baudrand
- Departamento de Endocrinologia, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Patricia Aspichueta
- Department of Physiology, University of the Basque Country UPV/EHU, Leioa, Spain; Biocruces Health Research Institute, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Spain
| | - Marco Arrese
- Departamento de Gastroenterologia, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile; Centro de Envejecimiento y Regeneracion (CARE), Departamento de Biologia Celular y Molecular, Facultad de Ciencias Biologicas Pontificia Universidad Catolica de Chile, Santiago, Chile.
| | - Juan P Arab
- Departamento de Gastroenterologia, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile; Centro de Envejecimiento y Regeneracion (CARE), Departamento de Biologia Celular y Molecular, Facultad de Ciencias Biologicas Pontificia Universidad Catolica de Chile, Santiago, Chile.
| |
Collapse
|
3
|
Sarmiento M, Rojas P, Triantafilo N, Campbell J, García MJ, Ocqueteau M, Sandoval V, Rojas A, Gazmuri JT, Guerrero G, Vergara M, Bertin P, Ramírez P, Jara V, Gutiérrez C, Soto K, Arellano S, Pizarro I, Lorca C. [Age does not affect the outcome of allogeneic hematopoietic precursor transplantation for acute myeloid leukemia]. Rev Med Chil 2021; 149:22-29. [PMID: 34106132 DOI: 10.4067/s0034-98872021000100022] [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] [Received: 10/23/2020] [Accepted: 11/23/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND In our country, transplantation centers differ in the age limit for allogeneic hematopoietic transplantation (ALOHT). In our program, transplants with age- adjusted conditioning are performed in patients until 70 years old. Currently more than 60% of ALOHT reported to the Center for International Bone Marrow Transplantation Research (CIBMTR) are performed in patients older than 40 years. AIM To report our experience with ALOHT in acute myelogenous leukemia (AML), analyzing patient age at transplantation in different periods and transplant results in different age groups. MATERIAL AND METHODS A retrospective analysis of the database of adult hematopoietic transplants in AML patients was performed. Demographic data, disease characteristics, transplant data, survival and relapse times, and mortality were collected. RESULTS In our program, 1030 transplants were performed in adults and 119 ALOHT were performed in AML patients, between 1990 and 2020. The median age of patients in all periods was 41 years, (range 16-69). The median age was 33 and 45 years, in the periods 1990-2000 and 2000-2020 respectively (p < 0.01). Seventy-eight patients received myeloablative conditioning (median age 44 years) and 41 reduced intensity conditioning (median age 53 years). Five-year overall survival was 44.6% (confidence intervals (CI) 41-48). Non relapse mortality of all periods was 19% (CI 17 - 40%) and relapse rate was 17 % (CI 16-22). No difference in five years overall survival among patients younger than 40, 41 to 50 and over 51 years was observed. CONCLUSIONS Overall Survival, non-relapse mortality and relapse rate were similar in younger and older patients in our program and similar to those previously reported in other centers.
Collapse
Affiliation(s)
- Mauricio Sarmiento
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Patricio Rojas
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Nicolás Triantafilo
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - James Campbell
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - María José García
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Mauricio Ocqueteau
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Vicente Sandoval
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Andrés Rojas
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - José Tomás Gazmuri
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Gonzalo Guerrero
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Maximiliano Vergara
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Pablo Bertin
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Pablo Ramírez
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Verónica Jara
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Catherine Gutiérrez
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Katherine Soto
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Silvana Arellano
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Isabel Pizarro
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Carla Lorca
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| |
Collapse
|
4
|
Salinas Laval J, Triantafilo N, Zúñiga P. Asociación entre enfermedad de von Willebrand y angiodisplasia: ¿casualidad o causalidad? Rev Med Chil 2020; 148:1475-1480. [DOI: 10.4067/s0034-98872020001001475] [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] [Received: 08/26/2019] [Accepted: 03/20/2020] [Indexed: 11/17/2022]
|
5
|
Abstract
Cabergoline and bromocriptine are among the most commonly used drugs to treat prolactinoma. Cabergoline is a long-acting dopamine receptor agonist which might offer advantages over bromocriptine. However, it is not clear if this translates into clinical benefits. Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified two systematic reviews including 12 studies addressing the question of this article, including five randomized controlled trials. We combined the evidence using meta-analysis and generated a summary of findings following the GRADE approach. We concluded cabergoline is more effective than bromocriptine in resolution of amenorrhea/oligomenorrhea and galactorrhea, it probably increases pregnancy rate, and it is associated to less adverse effects. It is not clear whether cabergoline is also more effective with respect to tumor growth because the certainty of the evidence is very low.
Collapse
Affiliation(s)
- Nicolás Triantafilo
- Departamento de Medicina Interna, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Proyecto Epistemonikos, Santiago, Chile. Address: Facultad de Medicina, Pontificia Universidad Católica de Chile, Lira 63, Santiago Centro, Chile.
| | - Victoria Castro-Gutiérrez
- Proyecto Epistemonikos, Santiago, Chile; Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Gabriel Rada
- Departamento de Medicina Interna, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Proyecto Epistemonikos, Santiago, Chile; Programa de Salud Basada en Evidencia, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; GRADE working group; The Cochrane Collaboration
| |
Collapse
|