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Stabellini N, Tomlinson B, Cullen J, Shanahan J, Waite K, Montero AJ, Barnholtz-Sloan JS, Hamerschlak N. Sex differences in adults with acute myeloid leukemia and the impact of sex on overall survival. Cancer Med 2022; 12:6711-6721. [PMID: 36419242 PMCID: PMC10067038 DOI: 10.1002/cam4.5461] [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: 09/08/2022] [Revised: 10/17/2022] [Accepted: 11/11/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND There is a male predominance of acute myeloid leukemia (AML) incidence, but survival data are conflicting. The objective of this study is to carry out a comprehensive analysis of sex differences in AML, and to investigate the impact of sex disparities in survival. METHODS The cohort included patients ≥18 years diagnosed with AML (2010-2022). Demographics, treatment patterns, treatment adverse events, and survival were analyzed. The population was described and compared by sex, and sex-based risks and associations were obtained via Cox proportional-hazards regression. RESULTS In total, 1020 AML patients were analyzed (57.4% males), with lower risk of death for females (aHR = 0.41, 95% CI 0.26-0.66). Among females, BMT (aHR = 0.51, 95% CI 0.27-0.97), hospitalization record (aHR = 0.65, 95%CI 0.45-0.93), and higher appointment completion rates (aHR = 0.98, 95% CI 0.98-0.98) were associated with lower risk of death. Overall, and similarly in males, higher age at diagnosis (aHR = 1.03, 95% CI 1.02-1.04) and a TP53 mutation (aHR = 2.24, 95% CI 1.69-2.97) were associated with higher risk of death. CONCLUSION Sex differences exist in both AML incidence and overall survival. Treatment and health care factors should be addressed by caregivers and public policies developed to reduce mortality rates and mitigate existing sex differences.
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Affiliation(s)
- Nickolas Stabellini
- Graduate Education Office, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.,Department of Hematology-Oncology, University Hospitals Seidman Cancer Center, Cleveland, Ohio, USA.,Faculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, Brazil.,Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Benjamin Tomlinson
- Department of Hematology-Oncology, University Hospitals Seidman Cancer Center, Cleveland, Ohio, USA
| | - Jennifer Cullen
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.,Case Comprehensive Cancer Center, Cleveland, Ohio, USA
| | - John Shanahan
- Cancer Informatics, Seidman Cancer Center at University Hospitals of Cleveland, Cleveland, Ohio, USA
| | - Kristin Waite
- Division of Cancer Epidemiology and Genetics (DCEG), Trans-Divisional Research Program (TDRP), National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Alberto J Montero
- Department of Hematology-Oncology, University Hospitals Seidman Cancer Center, Cleveland, Ohio, USA
| | - Jill S Barnholtz-Sloan
- Division of Cancer Epidemiology and Genetics (DCEG), Trans-Divisional Research Program (TDRP), National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA.,Center for Biomedical Informatics and Information Technology (CBIIT), National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Nelson Hamerschlak
- Oncohematology Department, Hospital Israelita Albert Einstein, São Paulo, Brazil
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da Fonseca LG, Fuster-Anglada C, Carrera C, Millán C, Samper E, Sapena V, Díaz-González Á, Sanduzzi-Zamparelli M, Leal C, Forner A, Bruix J, Reig M, Boix L, Díaz A. Mutational profile of skin lesions in hepatocellular carcinoma patients under tyrosine kinase inhibition: a repercussion of a wide-spectrum activity. Oncotarget 2021; 12:440-449. [PMID: 33747359 PMCID: PMC7939531 DOI: 10.18632/oncotarget.27891] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 02/01/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND/AIM Dermatological adverse events (DAE) in hepatocellular carcinoma (HCC) patients treated with sorafenib predicts better outcome. Some turn into skin lesions (SL) requiring pathology examination. We describe incidence, characteristics and molecular profile of SL in HCC patients treated with sorafenib. MATERIALS AND METHODS SL were prospectively collected in 311 HCC patients who started sorafenib. SL from sorafenib cohort were compared to those from a control patient group selected to match SL type and demographics. HRAS, KRAS and BRAF mutations were analyzed by CAST-PCR, mutated p53 and MAPK pathway activation by immunohistochemistry and immune infiltration by hematoxylin-eosin staining. RESULTS Eighty-eight out of 311 patients developed DAE and 7.4% SL required histological assessment. Most frequent lesions were keratoacanthomas (n = 4), squamous-cell carcinomas (SCC)(n = 5), basal-cell carcinomas (BCC)(n = 3) and seborrheic keratosis (n = 5). HRAS and KRAS mutations were detected in 4 SL, while no mutations showed in control SL. Nuclear pERK immunostaining was identified in 33.3% of cases versus 5.3% of controls. Most SL (90%) from patients with DAE were proliferative with intense immune infiltration (73%). CONCLUSIONS The onset of SL and their molecular profile did not impact negatively on patient's prognosis, but intense proliferation of SL may reflect compensatory activation of MAPK pathway and warrants their close monitoring.
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Affiliation(s)
- Leonardo G da Fonseca
- Barcelona Clinic Liver Cancer (BCLC) Group, Liver Unit, Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Barcelona, Spain.,Authors collaborated equally as first author
| | - Carla Fuster-Anglada
- Barcelona Clinic Liver Cancer (BCLC) Group, Department of Pathology, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain.,Authors collaborated equally as first author
| | - Cristina Carrera
- Melanoma Unit, Dermatology Department, Hospital Clínic de Barcelona, Universitat de Barcelona, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Barcelona, Spain
| | - Cristina Millán
- Barcelona Clinic Liver Cancer (BCLC) Group, Liver Unit, Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Barcelona, Spain
| | - Esther Samper
- Barcelona Clinic Liver Cancer (BCLC) Group, Liver Unit, Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Barcelona, Spain
| | - Victor Sapena
- Barcelona Clinic Liver Cancer (BCLC) Group, Liver Unit, Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Barcelona, Spain
| | - Álvaro Díaz-González
- Barcelona Clinic Liver Cancer (BCLC) Group, Liver Unit, Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Barcelona, Spain
| | - Marco Sanduzzi-Zamparelli
- Barcelona Clinic Liver Cancer (BCLC) Group, Liver Unit, Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Barcelona, Spain
| | - Cassia Leal
- Barcelona Clinic Liver Cancer (BCLC) Group, Liver Unit, Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Barcelona, Spain
| | - Alejandro Forner
- Barcelona Clinic Liver Cancer (BCLC) Group, Liver Unit, Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Barcelona, Spain
| | - Jordi Bruix
- Barcelona Clinic Liver Cancer (BCLC) Group, Liver Unit, Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Barcelona, Spain
| | - Maria Reig
- Barcelona Clinic Liver Cancer (BCLC) Group, Liver Unit, Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Barcelona, Spain
| | - Loreto Boix
- Barcelona Clinic Liver Cancer (BCLC) Group, Liver Unit, Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Barcelona, Spain.,Authors collaborated equally as senior author
| | - Alba Díaz
- Barcelona Clinic Liver Cancer (BCLC) Group, Department of Pathology, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain.,Authors collaborated equally as senior author
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Raphael MJ, Lougheed MD, Wei X, Karim S, Robinson AG, Bedard PL, Booth CM. A population-based study of pulmonary monitoring and toxicity for patients with testicular cancer treated with bleomycin. Curr Oncol 2020; 27:291-298. [PMID: 33380860 PMCID: PMC7755436 DOI: 10.3747/co.27.6389] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 11/15/2022] Open
Abstract
Background Bleomycin is commonly used to treat advanced testicular cancer and can be associated with severe pulmonary toxicity. The primary objective of the present study was to describe the use of pulmonary function tests (pfts) and chest imaging before, during, and after treatment with bleomycin. Methods To identify all incident cases of testicular cancer treated with bleomycin-based chemotherapy in the Canadian province of Ontario during 2005-2010, the Ontario Cancer Registry was linked with chemotherapy treatment records. Health administrative databases were used to describe use of pfts, chest imaging, and physician visits for respiratory complaints. Results Of 394 patients treated with orchiectomy and chemotherapy who received at least 1 dose of bleomycin, 93% had complete chemotherapy records available. In the 4 weeks before, during, and within 2 years after finishing bleomycin-based chemotherapy, pfts were performed in 17%, 17%, and 29% of patients respectively. Chest imaging was performed in 68%, 62%, and 98% of patients in the same time periods. In the 2 years after bleomycin-based chemotherapy, 23% of treated patients had a physician visit for respiratory symptoms. That rate was substantially higher for men with greater exposure to bleomycin: 40% (24 of 60) for 10-12 doses bleomycin compared with 21% (53 of 250) for 7-9 doses and with 14% (8 of 58) for 1-6 doses (p = 0.002). Conclusions Quality improvement initiatives are needed to increase baseline rates of chest imaging within 4 weeks of starting chemotherapy for testicular cancer; to understand why such a high proportion of men have chest imaging during bleomycin-based chemotherapy; and to mitigate the excess pulmonary toxicity seen with increasing exposure to bleomycin.
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Affiliation(s)
- M J Raphael
- Division of Medical Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Department of Medicine, University of Toronto, Toronto, ON
- Department of Oncology, Queen's University, Kingston, ON
| | - M D Lougheed
- Department of Public Health Sciences, Queen's University, Kingston, ON
- Division of Respirology, Department of Medicine, Queen's University, Kingston, ON
- ices, Toronto, ON
| | - X Wei
- Division of Medical Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Department of Medicine, University of Toronto, Toronto, ON
- ices, Toronto, ON
| | - S Karim
- Department of Oncology, Tom Baker Cancer Centre, University of Calgary, Calgary, AB
| | - A G Robinson
- Division of Medical Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Department of Medicine, University of Toronto, Toronto, ON
- Department of Oncology, Queen's University, Kingston, ON
| | - P L Bedard
- Division of Medical Oncology and Hematology, Department of Medicine, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON
| | - C M Booth
- Division of Medical Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Department of Medicine, University of Toronto, Toronto, ON
- Department of Oncology, Queen's University, Kingston, ON
- Department of Public Health Sciences, Queen's University, Kingston, ON
- ices, Toronto, ON
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Abstract
Recombinant human growth hormone (rhGH) has been available since 1985. Before 1985 growth hormone (GH) was extracted from cadaveric pituitary glands, but this was stopped in most countries that year, following the recognition that it could transmit Creutzfeldt-Jacob disease. The primary goal of rhGH treatment in GHD patients is to normalize height during childhood and adolescence and attain an adult height within the normal range and within the target height range (genetic potential). Genome-wide association studies have been used increasingly to study the genetic influence on height. There is a wide response to rhGH therapy, likely due to compliance issues, severity of GH deficiency and patient's sensitivity to rhGH. While some pediatric endocrinologists will use a fixed dose of rhGH, most will use an auxology-based dosing approach. This will involve starting at the lower end of the dose range and then titrating upwards based on the patient's response to therapy with measurement of IGF-1 concentrations to ensure that the patient is not over treated or undertreated. Although treatment of children with GHD with rhGH has generally been safe, careful follow-up by a pediatric endocrinologist in partnership with the pediatrician or primary care physician is recommended. The aim of this paper is to review the strategies and recommendations for treatment of GHD in children and patients in the transition to adult care.
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Affiliation(s)
- Erick Richmond
- Pediatric Endocrinology, National Children's Hospital, San José, CR, USA
| | - Alan D Rogol
- Pediatric Endocrinology, University of Virginia, Charlottesville, VA, USA.
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Bæksted C, Nissen A, Pappot H, Bidstrup PE, Mitchell SA, Basch E, Dalton SO, Johansen C. Danish Translation and Linguistic Validation of the U.S. National Cancer Institute's Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE). J Pain Symptom Manage 2016; 52:292-7. [PMID: 27090851 DOI: 10.1016/j.jpainsymman.2016.02.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [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: 12/18/2015] [Revised: 01/20/2016] [Accepted: 02/05/2016] [Indexed: 10/21/2022]
Abstract
CONTEXT The Common Terminology Criteria for Adverse Events (CTCAE) is the basis for standardized clinician-based grading and reporting of adverse events in cancer clinical trials. The U.S. National Cancer Institute has developed the Patient-Reported Outcomes version of the CTCAE (PRO-CTCAE) to incorporate patient self-reporting of symptomatic adverse events. OBJECTIVES The aim of the study was to translate and linguistically validate a Danish language version of PRO-CTCAE. METHODS The U.S. English language PRO-CTCAE was translated into Danish using forward and backward procedures with reconciliation. The linguistic validity of the PRO-CTCAE Danish was examined in two successive rounds of semistructured cognitive interviews in a sample of 56 patients equally distributed by gender and cancer type (prostate, head and neck, lung, breast, gynecological, gastrointestinal, and hematological cancer), and who were currently undergoing cancer treatment. RESULTS In the first round of linguistic validation (n = 42), the phrasing of five symptomatic toxicities was adjusted, and the refined phrasing was retested in a second round of interviews (n = 14). Agreement about phrasing that was both culturally acceptable and semantically comprehensible was achieved in the second round. Statements from participants describing the meaning of the PRO-CTCAE symptomatic toxicities support conceptual equivalence to the U.S. English language version. CONCLUSION Availability of the NCI PRO-CTCAE in languages beyond English will support international congruence in self-reporting of side effects of cancer treatment. A rigorous methodology was used to develop the Danish language version of PRO-CTCAE. Results provide preliminary support for the use of PRO-CTCAE in cancer clinical trials that include Danish speakers.
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Affiliation(s)
- Christina Bæksted
- Unit for Documentation & Quality, Danish Cancer Society, Copenhagen, Denmark; Department of Oncology, The Finsen Centre, Rigshospitalet, Copenhagen, Denmark.
| | - Aase Nissen
- Unit for Documentation & Quality, Danish Cancer Society, Copenhagen, Denmark
| | - Helle Pappot
- Department of Oncology, The Finsen Centre, Rigshospitalet, Copenhagen, Denmark
| | | | - Sandra A Mitchell
- Outcomes Research Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland, USA
| | - Ethan Basch
- Cancer Outcomes Research Program, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | | | - Christoffer Johansen
- Unit of Survivorship, Danish Cancer Society, Copenhagen, Denmark; Department of Oncology, The Finsen Centre, Rigshospitalet, Copenhagen, Denmark
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