1
|
Harada GK, Mar N, Rezazadeh A, Nourbaksh M, Houshyar R, Daneshvar M, Gin GE, Uchio EM, Sehgal V, Kuo JV, Seyedin SN. Development of a Screening Nomogram for Regional Lymph Node Metastasis Development in Muscle Invasive Bladder Cancer after Multiagent Systemic Therapy. Int J Radiat Oncol Biol Phys 2023; 117:e390. [PMID: 37785312 DOI: 10.1016/j.ijrobp.2023.06.2514] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) A reliable method of identifying clinically node negative bladder cancer patients at greater risk of developing lymph node metastasis and may require intensified therapy is needed. The purpose of this study was to create a nomogram to quantify the risk for regional lymphatic involvement in non-metastatic muscle invasive bladder cancer. MATERIALS/METHODS Usingthe National Cancer Database, patients with clinical T2-4N0M0 urothelial carcinoma of the bladder between the years of 2004 - 2020 were selected. All patients completed multiagent chemotherapy followed by surgery for pathologic nodal staging to determine presence or absence of nodal disease. No neoadjuvant radiation therapy was allowed and patients with history of prior malignancies were excluded. Following a 70:30 training to testing data split, baseline variables were assessed using univariate logistic regression. Variables were selected for inclusion in the multivariate logistic regression model using a combination of previously reported findings in the literature and/or if found to have a p-value < 0.05 on univariate analysis. A nomogram was constructed using this final model with assessment using calibration plots and the area under the receiver operating characteristics curve (AUC), respectively. An empiric cut point was chosen at 95% sensitivity to identify patients at "high" and "low" risk for pathologic nodal disease with overall assessment in both cohorts using chi-square. RESULTS A total of 6194patients were identified for study with a median age of 65 years (IQR = 58 - 71 years). Most patients were male (68.0%) with T2 disease (81.2%). The final multivariate model included age at time of diagnosis (OR = 0.99; 95% CI = 0.99 - 1.00; p = 0.172), time from diagnosis to initiation of chemotherapy (OR = 1.00; 95% CI = 1.00 - 1.01; p = 0.005), papillary histology (OR = 0.85; 95% CI = 0.72 - 1.01; p = 0.068), and clinical T stage (Table 1). Model calibration demonstrated excellent goodness-of-fit with good discrimination (AUC = 0.644). Within the training data, high risk patients were seen to have a twofold increase in pathologic nodal disease (N = 835/3924, 21.2%) when compared to those identified as low risk (N = 38/347, 9.9%) (p < 0.001). Validation within the testing data set demonstrated similar results with pathologic node rates of 22.8% and 7.8% for high- and low-risk patients, respectively (AUC = 0.645, p < 0.001). CONCLUSION This study demonstrates a clinically applicable risk stratification tool for identifying patients at risk for developing lymphadenopathy in T2-4 bladder cancer and may help guide future research in selecting patients eligible for escalation of therapy. Future studies should aim to externally validate this tool within prospective cohorts, and seek to determine if this nomogram may provide further prognostic utility.
Collapse
Affiliation(s)
- G K Harada
- Department of Radiation Oncology, University of California - Irvine, Orange, CA
| | - N Mar
- Division of Hematology/Oncology, Department of Medicine, UC Irvine School Of Medicine, Orange, CA
| | - A Rezazadeh
- Division of Hematology/Oncology, Department of Medicine, UC Irvine School Of Medicine, Orange, CA
| | | | | | - M Daneshvar
- Department of Urology, UC Irvine School of Medicine, Orange, CA
| | - G E Gin
- Department of Urology, UC Irvine School of Medicine, Orange, CA
| | - E M Uchio
- Department of Urology, UC Irvine School of Medicine, Orange, CA
| | - V Sehgal
- University of California, Irvine, Irvine, CA
| | - J V Kuo
- Department of Radiation Oncology, University of California - Irvine, Orange, CA
| | - S N Seyedin
- Department of Radiation Oncology, University of Iowa Hospitals and Clinics, Iowa City, IA
| |
Collapse
|
2
|
Harada GK, Mar N, Rezazadeh A, Nourbaksh M, Houshyar R, Daneshvar M, Gin GE, Uchio EM, Sehgal V, Kuo JV, Seyedin SN. Prognostication of Overall Survival in Muscle Invasive Bladder Cancer: An Application of a Lymph Node Metastasis Nomogram. Int J Radiat Oncol Biol Phys 2023; 117:S112-S113. [PMID: 37784295 DOI: 10.1016/j.ijrobp.2023.06.441] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The purpose of this study was to determine if a previously developed nomogram predictive of developing pathologic lymph node metastasis after multiagent chemotherapy for clinical node-negative muscle invasive bladder cancer may also prognosticate overall survival (OS) in patients treated with definitive chemoradiotherapy (CRT). MATERIALS/METHODS Using the National Cancer Database, we identified all patients with cN0 muscle invasive urothelial carcinoma of the bladder treated with definitive CRT from 2004 to 2020. Patient probability of occult nodal disease was assessed using a previous nomogram developed from those treated with multiagent chemotherapy alone followed by pathologic nodal assessment. Following a 70:30 training and testing data split, variables were assessed for association with OS using the log-rank test, with those with p < 0.05 deemed eligible for inclusion within a multivariate Cox proportional hazards model. Patients were then stratified as high-, medium-, or low-risk for death using the hazard function's prognostic index. The proportional hazards assumption was checked using Schoenfeld residuals and discrimination assessed using dynamic area under the receiver operating characteristics curves (AUC). Validation was assessed within the testing and a retrospectively collected institutional cohort of 15 patients treated from 2014 - 2020 with CRT. RESULTS A total of 1047 patients were identified for this study with median age of 78 years (IQR = 70-83 years) and follow-up of 31.3 months (IQR = 16.0 - 56.6 months). Cox analysis revealed patient age (HR = 1.03; 95% CI = 1.02 - 1.04; p < 0.001), Charlson-Deyo Score, and predicted probability of developing future lymphadenopathy (HR = 4.47; 95% CI = 1.83 - 10.93; p = 0.001) were significantly associated with OS. Median OS for those identified as high, medium, and low risk for death on Cox analysis was 34.2 months (IQR = 21.3 - 40.6 months), 38.9 months (IQR = 31.4 - 47.2 months), and 77.8 months (IQR = 56.1 - 100.3 months), respectively (AUC range = 0.615 - 0.870) (p < 0.001). Similar discrimination was seen within the testing cohort as well with significant differences between median OS across each group (AUC range = 0.580 - 0.726) (p < 0.001). Notably, among patients within the institutional cohort, only one patient stratified as high (N = 1/2; 50.0%) or medium risk (N = 0/5; 0.0%) remained alive at time of final follow-up, whereas 88.9% (N = 7/8) of low-risk patients survived (p = 0.051). Similarly, significant differences in OS were again seen between risk groups, with a median OS of 51.3 months and 19.9 months for high- and medium-risk patients, respectively, while median OS for low-risk patients was not reached (p = 0.006). CONCLUSION This study demonstrates the prognostic utility of a previously reported nomogram in predictions of OS. Investigation is warranted to explore how radiation and chemotherapy may offset worse OS in those at high risk for occult nodal disease progression.
Collapse
Affiliation(s)
- G K Harada
- Department of Radiation Oncology, University of California - Irvine, Orange, CA
| | - N Mar
- Division of Hematology/Oncology, Department of Medicine, UC Irvine School Of Medicine, Orange, CA
| | - A Rezazadeh
- Division of Hematology/Oncology, Department of Medicine, UC Irvine School Of Medicine, Orange, CA
| | | | | | - M Daneshvar
- Department of Urology, UC Irvine School of Medicine, Orange, CA
| | - G E Gin
- Department of Urology, UC Irvine School of Medicine, Orange, CA
| | - E M Uchio
- Department of Urology, UC Irvine School of Medicine, Orange, CA
| | - V Sehgal
- University of California, Irvine, Irvine, CA
| | - J V Kuo
- Department of Radiation Oncology, University of California - Irvine, Orange, CA
| | - S N Seyedin
- Department of Radiation Oncology, University of Iowa Hospitals and Clinics, Iowa City, IA
| |
Collapse
|
3
|
Rogers S, Baumert B, Blanck O, Böhmer D, Boström J, Engenhart-Cabillic R, Ermis E, Exner S, Guckenberger M, Habermehl D, Hemmatazad H, Henke G, Lohaus F, Lux S, Mai S, Minasch D, Rezazadeh A, Steffal C, Temming S, Wittig A, Zweifel C, Riesterer O, Combs SE. Correction to: Stereotactic radiosurgery and radiotherapy for resected brain metastases: current pattern of care in the Radiosurgery and Stereotactic Radiotherapy Working Group of the German Association for Radiation Oncology (DEGRO). Strahlenther Onkol 2023; 199:113-114. [PMID: 36374315 DOI: 10.1007/s00066-022-02021-1] [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: 11/16/2022]
Affiliation(s)
- S Rogers
- Radio-Onkologie-Zentrum KSA-KSB, Kantonsspital Aarau, 5001, Aarau, Switzerland.
| | - B Baumert
- Kantonsspital Graubünden, 7000, Chur, Switzerland
| | - O Blanck
- Campus Kiel, Universitätsklinikum Schleswig-Holstein, 24105, Kiel, Germany
| | - D Böhmer
- Campus Benjamin Franklin, Charite University Medicine, 12203, Berlin, Germany
| | - J Boström
- Gamma Knife Zentrum, 44892, Bochum, Germany
| | | | - E Ermis
- Bern University Hospital (Inselspital), 3010, Bern, Switzerland
| | - S Exner
- Strahlenzentrum Hamburg, 22419, Hamburg, Germany
| | | | | | - H Hemmatazad
- Bern University Hospital (Inselspital), 3010, Bern, Switzerland
| | - G Henke
- Kantonsspital St. Gallen, 9000, St Gallen, Switzerland
| | - F Lohaus
- University Hospital Dresden, 01307, Dresden, Germany
| | - S Lux
- Radprax Strahlentherapie, 42697, Solingen, Germany
| | - S Mai
- Universitätsmedizin Mannheim, 68167, Mannheim, Germany
| | - D Minasch
- University Hospital Innsbruck, 6020, Innsbruck, Austria
| | - A Rezazadeh
- University Hospital of Cologne, 50937, Cologne, Germany
| | - C Steffal
- KFJ/SMZ-Süd Vienna, Klinik Favoriten, 1100, Vienna, Austria
| | - S Temming
- Robert Janker Klinik, 53129, Bonn, Germany
| | - A Wittig
- University Hospital Jena, 07743, Jena, Germany
| | - C Zweifel
- Kantonsspital Graubünden, 7000, Chur, Switzerland
| | - O Riesterer
- Radio-Onkologie-Zentrum KSA-KSB, Kantonsspital Aarau, 5001, Aarau, Switzerland
| | - S E Combs
- Kinik an der Isaar, Technisches Universität München, Munich, Germany
| |
Collapse
|
4
|
Fischer JC, Balz V, Jazmati D, Bölke E, Freise NF, Keitel V, Feldt T, Jensen BEO, Bode J, Lüdde T, Häussinger D, Adams O, Schneider EM, Enczmann J, Rox JM, Hermsen D, Schulze-Bosse K, Kindgen-Milles D, Knoefel WT, van Griensven M, Haussmann J, Tamaskovics B, Plettenberg C, Scheckenbach K, Corradini S, Pedoto A, Maas K, Schmidt L, Grebe O, Esposito I, Ehrhardt A, Peiper M, Buhren BA, Calles C, Stöhr A, Gerber PA, Lichtenberg A, Schelzig H, Flaig Y, Rezazadeh A, Budach W, Matuschek C. Prognostic markers for the clinical course in the blood of patients with SARS-CoV-2 infection. Eur J Med Res 2022; 27:255. [PMID: 36411478 PMCID: PMC9676819 DOI: 10.1186/s40001-022-00864-z] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 10/20/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The presentation of peptides and the subsequent immune response depend on the MHC characteristics and influence the specificity of the immune response. Several studies have found an association between HLA variants and differential COVID-19 outcomes and have shown that HLA genotypes are associated with differential immune responses against SARS-CoV-2, particularly in severely ill patients. Information, whether HLA haplotypes are associated with the severity or length of the disease in moderately diseased individuals is absent. METHODS Next-generation sequencing-based HLA typing was performed in 303 female and 231 male non-hospitalized North Rhine Westphalian patients infected with SARS-CoV2 during the first and second wave. For HLA-Class I, we obtained results from 528 patients, and for HLA-Class II from 531. In those patients, who became ill between March 2020 and January 2021, the 22 most common HLA-Class I (HLA-A, -B, -C) or HLA-Class II (HLA -DRB1/3/4, -DQA1, -DQB1) haplotypes were determined. The identified HLA haplotypes as well as the presence of a CCR5Δ32 mutation and number of O and A blood group alleles were associated to disease severity and duration of the disease. RESULTS The influence of the HLA haplotypes on disease severity and duration was more pronounced than the influence of age, sex, or ABO blood group. These associations were sex dependent. The presence of mutated CCR5 resulted in a longer recovery period in males. CONCLUSION The existence of certain HLA haplotypes is associated with more severe disease.
Collapse
Affiliation(s)
- Johannes C. Fischer
- grid.14778.3d0000 0000 8922 7789Institute for Transplant Diagnostics and Cell Therapeutics, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Vera Balz
- grid.14778.3d0000 0000 8922 7789Institute for Transplant Diagnostics and Cell Therapeutics, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Danny Jazmati
- grid.14778.3d0000 0000 8922 7789Department of Radiation Oncology, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Edwin Bölke
- grid.14778.3d0000 0000 8922 7789Department of Radiation Oncology, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Noemi F. Freise
- grid.14778.3d0000 0000 8922 7789Department of Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Verena Keitel
- grid.14778.3d0000 0000 8922 7789Department of Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Torsten Feldt
- grid.14778.3d0000 0000 8922 7789Department of Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Björn-Erik Ole Jensen
- grid.14778.3d0000 0000 8922 7789Department of Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Johannes Bode
- grid.14778.3d0000 0000 8922 7789Department of Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Tom Lüdde
- grid.14778.3d0000 0000 8922 7789Institute for Virology, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Dieter Häussinger
- grid.14778.3d0000 0000 8922 7789Department of Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Ortwin Adams
- grid.14778.3d0000 0000 8922 7789Institute for Virology, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - E. Marion Schneider
- grid.410712.10000 0004 0473 882XDivision of Experimental Anesthesiology, University Hospital Ulm, Ulm, Germany
| | - Jürgen Enczmann
- grid.14778.3d0000 0000 8922 7789Institute for Transplant Diagnostics and Cell Therapeutics, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Jutta M. Rox
- grid.14778.3d0000 0000 8922 7789Institute for Transplant Diagnostics and Cell Therapeutics, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Derik Hermsen
- grid.14778.3d0000 0000 8922 7789Central Institute for Laboratory Diagnostics and Clinical Chemistry, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Karin Schulze-Bosse
- grid.14778.3d0000 0000 8922 7789Central Institute for Laboratory Diagnostics and Clinical Chemistry, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Detlef Kindgen-Milles
- grid.14778.3d0000 0000 8922 7789Department of Anesthesiology, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Wolfram Trudo Knoefel
- grid.14778.3d0000 0000 8922 7789Department of Surgery and Interdisciplinary Surgical Intensive Care Unit, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Martijn van Griensven
- grid.5012.60000 0001 0481 6099Department cBITE, MERLN Institute for Technology-Inspired Regenerative Medicine, Maastricht University, Maastricht, The Netherlands
| | - Jan Haussmann
- grid.14778.3d0000 0000 8922 7789Department of Radiation Oncology, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Balint Tamaskovics
- grid.14778.3d0000 0000 8922 7789Department of Radiation Oncology, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Christian Plettenberg
- grid.14778.3d0000 0000 8922 7789Department of Ear, Nose and Throat Disease, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Kathrin Scheckenbach
- grid.14778.3d0000 0000 8922 7789Department of Ear, Nose and Throat Disease, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Stefanie Corradini
- grid.5252.00000 0004 1936 973XDepartment of Radiation Oncology, LMU University of Munich, Munich, Germany
| | - Alessia Pedoto
- grid.51462.340000 0001 2171 9952Department of Anesthesiology, Memorial Sloan Kettering Cancer Center, New York, NY USA
| | - Kitti Maas
- grid.14778.3d0000 0000 8922 7789Department of Radiation Oncology, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Livia Schmidt
- grid.14778.3d0000 0000 8922 7789Department of Radiation Oncology, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Olaf Grebe
- Department of Cardiology and Rhythmology, Petrus Hospital, Wuppertal, Germany
| | - Irene Esposito
- grid.14778.3d0000 0000 8922 7789Institute of Pathology, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Anja Ehrhardt
- grid.412581.b0000 0000 9024 6397Institute of Virology, University of Witten/Herdecke, Witten, Germany
| | - Matthias Peiper
- grid.14778.3d0000 0000 8922 7789Medical Faculty, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Bettina Alexandra Buhren
- grid.14778.3d0000 0000 8922 7789Department of Radiation Oncology, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Christian Calles
- grid.14778.3d0000 0000 8922 7789Coordination Center for Clinical Studies, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Andreas Stöhr
- grid.14778.3d0000 0000 8922 7789Coordination Center for Clinical Studies, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Peter Arne Gerber
- grid.14778.3d0000 0000 8922 7789Department of Radiation Oncology, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Artur Lichtenberg
- grid.14778.3d0000 0000 8922 7789Department of Cardiac Surgery, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Hubert Schelzig
- grid.14778.3d0000 0000 8922 7789Department of Vascular Surgery, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Yechan Flaig
- grid.14778.3d0000 0000 8922 7789Department of Radiation Oncology, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Amir Rezazadeh
- grid.14778.3d0000 0000 8922 7789Department of Radiation Oncology, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Wilfried Budach
- grid.14778.3d0000 0000 8922 7789Department of Radiation Oncology, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Christiane Matuschek
- grid.14778.3d0000 0000 8922 7789Department of Radiation Oncology, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| |
Collapse
|
5
|
Rogers S, Baumert B, Blanck O, Böhmer D, Boström J, Engenhart-Cabillic R, Ermis E, Exner S, Guckenberger M, Habermehl D, Hemmatazad H, Henke G, Lohaus F, Lux S, Mai S, Minasch D, Rezazadeh A, Steffal C, Temming S, Wittig A, Zweifel C, Riesterer O, Combs S. Stereotactic radiosurgery and radiotherapy for resected brain metastases: current pattern of care in the Radiosurgery and Stereotactic Radiotherapy Working Group of the German Association for Radiation Oncology (DEGRO). Strahlenther Onkol 2022; 198:919-925. [PMID: 36006436 DOI: 10.1007/s00066-022-01991-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 03/24/2022] [Accepted: 07/17/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE Preoperative stereotactic radiosurgery (SRS) of brain metastases may achieve similar local control and better leptomeningeal control rates than postoperative fractionated stereotactic radiotherapy (FSRT) in patients treated with elective metastasectomy. To plan a multicentre trial of preoperative SRS compared with postoperative FSRT, a survey of experts was conducted to determine current practice. METHODS A survey with 15 questions was distributed to the DEGRO Radiosurgery and Stereotactic Radiotherapy Working Group. Participants were asked under what circumstances they offered SRS, FSRT, partial and/or whole brain radiotherapy before or after resection of a brain metastasis, as well as the feasibility of preoperative stereotactic radiosurgery and neurosurgical resection within 6 days. RESULTS Of 25 participants from 24 centres, 22 completed 100% of the questions. 24 respondents were radiation oncologists and 1 was a neurosurgeon. All 24 centres have one or more dedicated radiosurgery platform and all offer postoperative FSRT. Preoperative SRS is offered by 4/24 (16.7%) centres, and 9/24 (37.5%) sometimes recommend single-fraction postoperative SRS. Partial brain irradiation is offered by 8/24 (33.3%) centres and 12/24 (50%) occasionally recommend whole-brain irradiation. Two centres are participating in clinical trials of preoperative SRS. SRS techniques and fractionation varied between centres. CONCLUSION All responding centres currently offer postoperative FSRT after brain metastasectomy. Approximately one third offer single-fraction postoperative SRS and four already perform preoperative SRS. With regard to potential co-investigators, 18 were identified for the PREOP‑2 multicentre trial, which will randomise between preoperative SRS and postoperative FSRT.
Collapse
Affiliation(s)
- S Rogers
- Radio-Onkologie-Zentrum KSA-KSB, Kantonsspital Aarau, 5001, Aarau, Switzerland.
| | - B Baumert
- Kantonsspital Graubünden, 7000, Chur, Switzerland
| | - O Blanck
- Universitätsklinikum Schleswig-Holstein, Campus Kiel, 24105, Kiel, Germany
| | - D Böhmer
- Charite University Medicine, Campus Benjamin Franklin, 12203, Berlin, Germany
| | - J Boström
- Gamma Knife Zentrum, 44892, Bochum, Germany
| | | | - E Ermis
- Bern University Hospital (Inselspital), 3010, Bern, Switzerland
| | - S Exner
- Strahlenzentrum Hamburg, 22419, Hamburg, Germany
| | | | | | - H Hemmatazad
- Bern University Hospital (Inselspital), 3010, Bern, Switzerland
| | - G Henke
- Kantonsspital St. Gallen, 9000, St Gallen, Switzerland
| | - F Lohaus
- University Hospital Dresden, 01307, Dresden, Germany
| | - S Lux
- Radprax Strahlentherapie, 42697, Solingen, Germany
| | - S Mai
- Universitätsmedizin Mannheim, 68167, Mannheim, Germany
| | - D Minasch
- University Hospital Innsbruck, 6020, Innsbruck, Austria
| | - A Rezazadeh
- University Hospital of Cologne, 50937, Cologne, Germany
| | - C Steffal
- KFJ/SMZ-Süd Vienna; Klinik Favoriten, 1100, Vienna, Austria
| | - S Temming
- Robert Janker Klinik, 53129, Bonn, Germany
| | - A Wittig
- University Hospital Jena, 07743, Jena, Germany
| | - C Zweifel
- Kantonsspital Graubünden, 7000, Chur, Switzerland
| | - O Riesterer
- Radio-Onkologie-Zentrum KSA-KSB, Kantonsspital Aarau, 5001, Aarau, Switzerland
| | - S Combs
- Kinik an der Isaar, Technisches Universität München, Munich, Germany
| |
Collapse
|
6
|
Freise NF, Kivel M, Grebe O, Meyer C, Wafaisade B, Peiper M, Zeus T, Schmidt J, Neuwahl J, Jazmati D, Luedde T, Bölke E, Feldt T, Jensen BEO, Bode J, Keitel V, Haussmann J, Tamaskovics B, Budach W, Fischer JC, Knoefel WT, Schneider M, Gerber PA, Pedoto A, Häussinger D, van Griensven M, Rezazadeh A, Flaig Y, Kirchner J, Antoch G, Schelzig H, Matuschek C. Acute cardiac side effects after COVID-19 mRNA vaccination: a case series. Eur J Med Res 2022; 27:80. [PMID: 35655235 PMCID: PMC9160507 DOI: 10.1186/s40001-022-00695-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [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: 02/15/2022] [Accepted: 04/27/2022] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Vaccination against SARS-CoV-2 has been the main tool to contain the pandemic. The rush development of the 3 vaccines and their expedited approval have led to inoculation of millions of patients around the world, leading to a containment of the disease. Despite continuous viral mutations and the identification of weaker variants, the severity of the infections has been mild, with many patients being either asymptomatic or recovering at home. Currently the focus has shifted from the host of organ damage related to the infection to potential side effects of the vaccine. Myocarditis has been reported as one of the potential side effects from the mRNA vaccine, affecting young healthy individuals. Up to September 30, 2021, 1.243 cases of myocarditis after vaccination with BNT162b2 Comirnaty© were registered in young adults by the Paul-Ehrlich-Institute in Germany alone. The exact pathophysiology and the risk factors for myocarditis following vaccination remain unclear. We present a case series of eight patients with cardiac symptom shortly after SARS-CoV-2 mRNA vaccination (BNT162b6, Biontech, Comirnaty© or mRNA-1237 Moderna, Spikevax©). PATIENTS AND METHODS Eight patients between 13 and 56 years of age, vaccinated with either BNT162b2 or mRNA-1273 mRNA vaccine between January and August 2021 developed cardiac side effects shortly after either their first or second dose of the vaccine. Clinical data were retrieved from the clinical information system and analyzed. To support diagnosis of myocarditis or pericarditis, cardiac magnetic resonance imaging (MRI) was performed shortly after the onset of symptoms, with further investigations in severe cases. Symptoms were defined as dyspnea, chest pain and cardiac arrhythmia as determined by electrocardiography. RESULTS Eight patients (5 males and 3 females) developed cardiac symptoms compatible with myocarditis, according to the CDC criteria, shortly after SARS-CoV-2 mRNA vaccination. Three patients (2 males, 1 female) required hospitalization due to severe chest pain and elevated troponin levels. All patients recovered fully within 7 days from the symptom onset. CONCLUSIONS Our data suggest that cardiac adverse events such as myocarditis or pericarditis shortly after SARS-CoV-2 mRNA vaccination are rare but possible and occur particularly in male patients.
Collapse
Affiliation(s)
- Noemi F Freise
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Milena Kivel
- Department of Pediatric, University Hospital Düsseldorf, Medical Faculty, Heinrich-Heine-University, 40225, Düsseldorf, Germany
| | - Olaf Grebe
- Department of Cardiology and Rhythmology, Petrus Hospital, Wuppertal, Germany
| | - Christian Meyer
- Department for Cardiology, Rhythmology, Angiology and Intensive Care Medicine, cNEP Research Consortium, EVK Düsseldorf, Düsseldorf, Germany
| | - Bahram Wafaisade
- Department for Cardiology, Rhythmology, Angiology and Intensive Care Medicine, cNEP Research Consortium, EVK Düsseldorf, Düsseldorf, Germany
| | - Matthias Peiper
- Department for Cardiology, Rhythmology, Angiology and Intensive Care Medicine, cNEP Research Consortium, EVK Düsseldorf, Düsseldorf, Germany
| | - Tobias Zeus
- Medical Faculty, Department of Cardiology, University Hospital of Düsseldorf, Düsseldorf, Germany
| | - Jan Schmidt
- Medical Faculty, Department of Cardiology, University Hospital of Düsseldorf, Düsseldorf, Germany
| | - Judith Neuwahl
- Department of Radiation Oncology, University Hospital, Medical Faculty, Heinrich Heine University, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Danny Jazmati
- Department of Radiation Oncology, University Hospital, Medical Faculty, Heinrich Heine University, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Tom Luedde
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Edwin Bölke
- Department of Radiation Oncology, University Hospital, Medical Faculty, Heinrich Heine University, Moorenstr. 5, 40225, Düsseldorf, Germany.
| | - Torsten Feldt
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Björn Erik Ole Jensen
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Johannes Bode
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Verena Keitel
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany.,Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Magdeburg, Medical Faculty of Otto Von Guericke University Magdeburg, Leipziger Str. 44, 39104, Magdeburg, Germany
| | - Jan Haussmann
- Department of Radiation Oncology, University Hospital, Medical Faculty, Heinrich Heine University, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Balint Tamaskovics
- Department of Radiation Oncology, University Hospital, Medical Faculty, Heinrich Heine University, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Wilfried Budach
- Department of Radiation Oncology, University Hospital, Medical Faculty, Heinrich Heine University, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Johannes C Fischer
- Institute for Transplant Diagnostics and Cell Therapeutics, Heinrich Heine University, Düsseldorf, Germany
| | - Wolfram Trudo Knoefel
- Medical Faculty, Department of Surgery and Interdisciplinary Surgical Intensive Care Unit, Heinrich Heine University, Düsseldorf, Germany
| | - Marion Schneider
- Division of Experimental Anesthesiology, University Hospital Ulm, Ulm, Germany
| | - Peter Arne Gerber
- Medical Faculty, Heinrich-Heine-University, 40225, Düsseldorf, Germany
| | - Alessia Pedoto
- Department of Anesthesiology, Memorial Sloan Kettering Cancer Center, NY, USA
| | - Dieter Häussinger
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Martijn van Griensven
- Department cBITE, Maastricht University, MERLN Institute for Technology-Inspired Regenerative Medicine, Maastricht, The Netherlands
| | - Amir Rezazadeh
- Department of Radiation Oncology, University Hospital, Medical Faculty, Heinrich Heine University, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Yechan Flaig
- Department of Radiation Oncology, University Hospital, Medical Faculty, Heinrich Heine University, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Julian Kirchner
- Medical Faculty, Department of Diagnostic and Interventional Radiology, University Hospital of Düsseldorf, Dusseldorf, Germany
| | - Gerald Antoch
- Medical Faculty, Department of Diagnostic and Interventional Radiology, University Hospital of Düsseldorf, Dusseldorf, Germany
| | - Hubert Schelzig
- Medical Faculty, Department of Vascular Surgery, University Hospital Heinrich Heine University, Düsseldorf, Germany
| | - Christiane Matuschek
- Department of Radiation Oncology, University Hospital, Medical Faculty, Heinrich Heine University, Moorenstr. 5, 40225, Düsseldorf, Germany
| |
Collapse
|
7
|
Rezazadeh A, Soleimanjahi H, Soudi S, Habibian A. Comparison of the Effect of Adipose Mesenchymal Stem Cells-Derived Secretome with and without Reovirus in CT26 Cells. Arch Razi Inst 2022; 77:615-622. [PMID: 36284984 PMCID: PMC9548274 DOI: 10.22092/ari.2021.353845.1615] [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] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 05/23/2021] [Indexed: 01/24/2023]
Abstract
Colorectal cancer is the fourth leading cause of cancer-related deaths that has significantly increased over the past three decades. New therapeutic approaches, such as oncolytic viruses, have become very imperative recently to destroy cancer cells. The use of mesenchymal stem cells (MSCs) secretome that is produced in response to variant conditions involves different paracrine molecules secretion that has therapeutic potential in several chronic diseases. Mesenchymal stem cells and their derivatives are employed as regenerative medicine; nevertheless, there is ambiguity in the function of these cells in the control of malignancy. This study aimed to examine the apoptotic effect of secretomes derived from MSCs affected by encompassing oncolytic reoviruses. Mesenchymal stem cells were cultured after separation from abdominal adipose tissue of BALB/c mice. After three passages, the cells were infected by reovirus at the multiplicity of infection of 1 plaque-forming unit per cell. Uninfected and infected secretomes with reovirus were collected separately. The colorectal cancer CT26 cells were confronted with uninfected secretome, infected secretions, reovirus as a positive control, and Dulbecco's Modified Eagle Medium/High Glucose as negative control separately. Finally, apoptosis and necrosis were evaluated by flow cytometry. The infected secretome with reovirus was capable to induce apoptosis more than the uninfected secretome in CT26. However, the supernatant of reovirus infected cells was more capable to induce cell death, in comparison to the infected secretome. Infected MSCs with oncolytic reovirus produced a type of condition media that enhanced apoptosis induction and could have a therapeutic effect on cancer cells. Nonetheless, tumoral cells confronted with the oncolytic reovirus showed more capability in inducing apoptosis in CT26 cells. As a result, the use of oncolytic virus and infected secretome are more effective than uninfected secretome in inducing apoptosis.
Collapse
Affiliation(s)
- A Rezazadeh
- Department of Virology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - H Soleimanjahi
- Department of Virology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - S Soudi
- Department of Immunology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - A Habibian
- Department of Virology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| |
Collapse
|
8
|
Djiepmo F, Tamaskovics B, Bölke E, Peiper M, Haussmann J, Neuwahl J, Jazmati D, Maas K, Schmidt L, Gelzhäuser R, Schleich C, Corradini S, Orth K, van Griensven M, Rezazadeh A, Karimi K, Budach W, Matuschek C. Low-dose radiation treatment for painful plantar enthesophyte: a highly effective therapy with little side effects. Eur J Med Res 2022; 27:28. [PMID: 35197107 PMCID: PMC8867737 DOI: 10.1186/s40001-022-00642-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 01/13/2022] [Indexed: 12/02/2022] Open
Abstract
AIM Plantar enthesophyte is a common degenerative disorder. Surgical and medical treatment options are associated with either poor outcome or high percentage of relapse. Observations have indicated a beneficial effect of radiation therapy. We therefore wanted to evaluate pain reduction using orthovolt or cobalt-based radiation treatment for painful plantar enthesophyte and determine long-term response as well as prognostic parameters in this condition. METHODS We identified a total of 102 consecutive patients treated for a total of 117 symptomatic heel spurs. 59 patients were treated with cobalt radiation, 31 patients with orthovolt therapy and 12 patients with both radiation systems. Primary outcome measure was pain reduction being scored using the modified Rowe Score prior therapy, at the end of each treatment series as well as after 6 weeks. Secondary outcome measure was long-term outcome, evaluated in patients with a follow-up period of longer than 3 years. RESULTS Before radiation therapy, 61 patients (60.4%) had a score of 0, significant strong pain. At the time of completion of radiation treatment, 3 patients (2.7%) were pain-free (score of 30), whereas 8 patients (7.9%) had still severe pain (score 0). 6 weeks after radiation therapy, 33 patients (32.7%) were pain-free and 8 patients (7.9%) had severe pain (score 0), while at the time data of collection, 74 patients (73%) were free of pain and 1 patient (1%) had strong pain (score 0). Duration of pain before the start of radiation treatment was a significant prognostic factor (p = 0.012) for response to treatment. CONCLUSION Radiotherapy of painful plantar enthesophyte is a highly effective therapy with little side effects providing long-term therapeutic response. The only significant prognostic parameter for response to treatment is the duration of pre-radiation therapy pain. Early integration of radiation therapy in the treatment seems to result in superior pain reduction.
Collapse
Affiliation(s)
- Freddy Djiepmo
- Department of Radiation Oncology, Heinrich Heine University, Dusseldorf, Germany
| | - Bálint Tamaskovics
- Department of Radiation Oncology, Heinrich Heine University, Dusseldorf, Germany
| | - Edwin Bölke
- Department of Radiation Oncology, Heinrich Heine University, Dusseldorf, Germany
- Klinik Für Strahlentherapie Und Radiologische Onkologie, Heinrich-Heine-Universität, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Matthias Peiper
- Medical Faculty, Heinrich-Heine-University, Dusseldorf, Germany
| | - Jan Haussmann
- Department of Radiation Oncology, Heinrich Heine University, Dusseldorf, Germany
| | - Judith Neuwahl
- Department of Radiation Oncology, Heinrich Heine University, Dusseldorf, Germany
| | - Danny Jazmati
- Department of Radiation Oncology, Heinrich Heine University, Dusseldorf, Germany
| | - Kitti Maas
- Department of Radiation Oncology, Heinrich Heine University, Dusseldorf, Germany
| | - Livia Schmidt
- Department of Radiation Oncology, Heinrich Heine University, Dusseldorf, Germany
| | - Roman Gelzhäuser
- Institute of Mathematical Statistics and Probability Theory, Heinrich-Heine-University, Dusseldorf, Germany
| | - Christoph Schleich
- Radiology Dusseldorf/Viersen, Ernst-Schneider-Platz 1, Dusseldorf, Germany
| | - Stefanie Corradini
- Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany
| | - Klaus Orth
- University of Hannover, Hannover, Germany
| | - Martijn van Griensven
- Department cBITE, MERLN Institute for Technology-Inspired Regenerative Medicine, Maastricht University, Maastricht, The Netherlands
| | - Amir Rezazadeh
- Department of Radiation Oncology, Heinrich Heine University, Dusseldorf, Germany
| | - Kimia Karimi
- Department of Radiation Oncology, Heinrich Heine University, Dusseldorf, Germany
| | - Wilfried Budach
- Department of Radiation Oncology, Heinrich Heine University, Dusseldorf, Germany
| | - Christiane Matuschek
- Department of Radiation Oncology, Heinrich Heine University, Dusseldorf, Germany
| |
Collapse
|
9
|
Mohebbi N, Rezazadeh A. Clinical Pharmacists: Practitioners Who Are Essential Members to Enhance Pharmaceutical Care During Covid-19 Pandemic. jpc 2021. [DOI: 10.18502/jpc.v9i3.7367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The article's abstract is not available.
Collapse
|
10
|
Fischer JC, Schmidt AG, Bölke E, Uhrberg M, Keitel V, Feldt T, Jensen B, Häussinger D, Adams O, Schneider EM, Balz V, Enczmann J, Rox J, Hermsen D, Schulze-Bosse K, Kindgen-Milles D, Knoefel WT, van Griensven M, Haussmann J, Tamaskovics B, Plettenberg C, Scheckenbach K, Corradini S, Pedoto A, Maas K, Schmidt L, Grebe O, Esposito I, Ehrhardt A, Peiper M, Buhren BA, Calles C, Stöhr A, Lichtenberg A, Freise NF, Lutterbeck M, Rezazadeh A, Budach W, Matuschek C. Association of HLA genotypes, AB0 blood type and chemokine receptor 5 mutant CD195 with the clinical course of COVID-19. Eur J Med Res 2021; 26:107. [PMID: 34530915 PMCID: PMC8444184 DOI: 10.1186/s40001-021-00560-4] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 07/23/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND COVID-19, the pandemic disease caused by infection with SARS-CoV-2, may take highly variable clinical courses, ranging from symptom-free and pauci-symptomatic to fatal disease. The goal of the current study was to assess the association of COVID-19 clinical courses controlled by patients' adaptive immune responses without progression to severe disease with patients' Human Leukocyte Antigen (HLA) genetics, AB0 blood group antigens, and the presence or absence of near-loss-of-function delta 32 deletion mutant of the C-C chemokine receptor type 5 (CCR5). PATIENT AND METHODS An exploratory observational study including 157 adult COVID-19 convalescent patients was performed with a median follow-up of 250 days. The impact of different HLA genotypes, AB0 blood group antigens, and the CCR5 mutant CD195 were investigated for their role in the clinical course of COVID-19. In addition, this study addressed levels of severity and morbidity of COVID-19. The association of the immunogenetic background parameters were further related to patients' humoral antiviral immune response patterns by longitudinal observation. RESULTS Univariate HLA analyses identified putatively protective HLA alleles (HLA class II DRB1*01:01 and HLA class I B*35:01, with a trend for DRB1*03:01). They were associated with reduced durations of disease instead decreased (rather than increased) total anti-S IgG levels. They had a higher virus neutralizing capacity compared to non-carriers. Conversely, analyses also identified HLA alleles (HLA class II DQB1*03:02 und HLA class I B*15:01) not associated with such benefit in the patient cohort of this study. Hierarchical testing by Cox regression analyses confirmed the significance of the protective effect of the HLA alleles identified (when assessed in composite) in terms of disease duration, whereas AB0 blood group antigen heterozygosity was found to be significantly associated with disease severity (rather than duration) in our cohort. A suggestive association of a heterozygous CCR5 delta 32 mutation status with prolonged disease duration was implied by univariate analyses but could not be confirmed by hierarchical multivariate testing. CONCLUSION The current study shows that the presence of HLA class II DRB1*01:01 and HLA class I B*35:01 is of even stronger association with reduced disease duration in mild and moderate COVID-19 than age or any other potential risk factor assessed. Prospective studies in larger patient populations also including novel SARS-CoV-2 variants will be required to assess the impact of HLA genetics on the capacity of mounting protective vaccination responses in the future.
Collapse
Affiliation(s)
- Johannes C Fischer
- Institute for Transplantation Diagnostics and Cell Therapeutics, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University, 40225, Dusseldorf, Germany
| | - Albrecht G Schmidt
- Department of Radiation Oncology, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Dusseldorf, Germany
| | - Edwin Bölke
- Department of Radiation Oncology, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Dusseldorf, Germany.
| | - Markus Uhrberg
- Institute for Transplantation Diagnostics and Cell Therapeutics, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University, 40225, Dusseldorf, Germany
| | - Verena Keitel
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Dusseldorf, Germany
| | - Torsten Feldt
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Dusseldorf, Germany
| | - Björn Jensen
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Dusseldorf, Germany
| | - Dieter Häussinger
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Dusseldorf, Germany
| | - Ortwin Adams
- Institute for Virology, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University Dusseldorf, Universitaetsstr. 1, 40225, Dusseldorf, Germany
| | - E Marion Schneider
- Division of Experimental Anesthesiology, University Hospital Ulm, Ulm, Germany
| | - Vera Balz
- Institute for Transplantation Diagnostics and Cell Therapeutics, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University, 40225, Dusseldorf, Germany
| | - Jürgen Enczmann
- Institute for Transplantation Diagnostics and Cell Therapeutics, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University, 40225, Dusseldorf, Germany
| | - Jutta Rox
- Institute for Transplantation Diagnostics and Cell Therapeutics, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University, 40225, Dusseldorf, Germany
| | - Derik Hermsen
- Central Institute for Laboratory Diagnostics and Clinical Chemistry, Medical Faculty Heinrich-Heine University, Dusseldorf, Germany
| | - Karin Schulze-Bosse
- Central Institute for Laboratory Diagnostics and Clinical Chemistry, Medical Faculty Heinrich-Heine University, Dusseldorf, Germany
| | - Detlef Kindgen-Milles
- Medical Faculty, Department of Anesthesiology, Heinrich Heine University, Dusseldorf, Germany
| | - Wolfram Trudo Knoefel
- Medical Faculty, Department of Surgery and Interdisciplinary Surgical Intensive Care Unit, Heinrich Heine University, Dusseldorf, Germany
| | - Martijn van Griensven
- Department cBITE, Maastricht University, MERLN Institute for Technology-Inspired Regenerative Medicine, Maastricht, the Netherlands
| | - Jan Haussmann
- Department of Radiation Oncology, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Dusseldorf, Germany
| | - Balint Tamaskovics
- Department of Radiation Oncology, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Dusseldorf, Germany
| | - Christian Plettenberg
- Medical Faculty, Department of Ear, Nose and Throat Disease, Heinrich Heine University, Dusseldorf, Germany
| | - Kathrin Scheckenbach
- Medical Faculty, Department of Ear, Nose and Throat Disease, Heinrich Heine University, Dusseldorf, Germany
| | - Stefanie Corradini
- Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany
| | - Alessia Pedoto
- Department of Anesthesiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Kitti Maas
- Department of Radiation Oncology, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Dusseldorf, Germany
| | - Livia Schmidt
- Department of Radiation Oncology, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Dusseldorf, Germany
| | - Olaf Grebe
- Department of Cardiology and Rhythmology, Petrus Hospital, Wuppertal, Germany
| | - Irene Esposito
- Institute of Pathology, University of Dusseldorf, Dusseldorf, Germany
| | - Anja Ehrhardt
- Institute of Virology, University of Witten/Herdecke, Witten, Germany
| | - Matthias Peiper
- Medical Faculty, University of Dusseldorf, Dusseldorf, Germany
| | - Bettina Alexandra Buhren
- Department of Radiation Oncology, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Dusseldorf, Germany
| | - Christian Calles
- Medical Faculty, Coordination Center for Clinical Studies, University of Dusseldorf, Dusseldorf, Germany
| | - Andreas Stöhr
- Medical Faculty, Coordination Center for Clinical Studies, University of Dusseldorf, Dusseldorf, Germany
| | - Artur Lichtenberg
- Department of Cardiac Surgery, Medical Faculty, University of Dusseldorf, Dusseldorf, Germany
| | - Noemi F Freise
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Dusseldorf, Germany
| | - Matthias Lutterbeck
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Dusseldorf, Germany
| | - Amir Rezazadeh
- Department of Radiation Oncology, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Dusseldorf, Germany
| | - Wilfried Budach
- Department of Radiation Oncology, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Dusseldorf, Germany
| | - Christiane Matuschek
- Department of Radiation Oncology, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Dusseldorf, Germany
| |
Collapse
|
11
|
Fischer JC, Schmidt AG, Bölke E, Keitel V, Feldt T, Jensen B, Freise NF, Häussinger D, Schneider EM, Hermsen D, Kindgen-Milles D, Knoefel WT, Haussmann J, Tamaskovics B, Plettenberg C, Scheckenbach K, Corradini S, Rox J, Balz V, Maas K, Schmidt L, Grebe O, Ehrhardt A, Gerber PA, Peiper M, Buhren BA, Lichtenberg A, Rezazadeh A, Budach W, Matuschek C. Correction to: Informed consent and informed intervention: SARS‑CoV‑2 vaccinations not just call for disclosure of newly emerging safety data but also for hypothesis generation and testing. Eur J Med Res 2021; 26:104. [PMID: 34517930 PMCID: PMC8436013 DOI: 10.1186/s40001-021-00574-y] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Johannes C Fischer
- Institute for Transplantation Diagnostics and Cell Therapeutics, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University, 40225, Düsseldorf, Germany
| | - Albrecht G Schmidt
- Department of Radiation Oncology, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Edwin Bölke
- Department of Radiation Oncology, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany.
| | - Verena Keitel
- Department of Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Torsten Feldt
- Department of Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Björn Jensen
- Department of Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Noemi F Freise
- Department of Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Dieter Häussinger
- Department of Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - E Marion Schneider
- Division of Experimental Anesthesiology, University Hospital Ulm, Ulm, Germany
| | - Derik Hermsen
- Central Institute for Laboratory Diagnostics and Clinical Chemistry, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - Detlef Kindgen-Milles
- Department of Anesthesiology, Medical Faculty, Heinrich Heine University, Dusseldorf, Germany
| | - Wolfram Trudo Knoefel
- Department of Surgery and Interdisciplinary Surgical Intensive Care Unit, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany.,Medicine, Department cBITE, Maastricht, The Netherlands
| | - Jan Haussmann
- Department of Radiation Oncology, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Balint Tamaskovics
- Department of Radiation Oncology, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Christian Plettenberg
- Department of Otolaryngology-Head and Neck Surgery, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Kathrin Scheckenbach
- Department of Otolaryngology-Head and Neck Surgery, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Stefanie Corradini
- Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany
| | - Jutta Rox
- Institute for Transplantation Diagnostics and Cell Therapeutics, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University, 40225, Düsseldorf, Germany
| | - Vera Balz
- Institute for Transplantation Diagnostics and Cell Therapeutics, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University, 40225, Düsseldorf, Germany
| | - Kitti Maas
- Department of Radiation Oncology, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Livia Schmidt
- Department of Radiation Oncology, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Olaf Grebe
- Department of Cardiology and Rhythmology, Petrus Hospital, Wuppertal, Germany
| | - Anja Ehrhardt
- Institute of Virology, University of Witten/Herdecke, Witten, Germany
| | | | - Matthias Peiper
- Department of Cardiac Surgery, Medical Faculty, University of Dusseldorf, Düsseldorf, Germany
| | - Bettina Alexandra Buhren
- Department of Radiation Oncology, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Artur Lichtenberg
- Department of Cardiac Surgery, Medical Faculty, University of Dusseldorf, Düsseldorf, Germany
| | - Amir Rezazadeh
- Department of Radiation Oncology, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Wilfried Budach
- Department of Radiation Oncology, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Christiane Matuschek
- Department of Radiation Oncology, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| |
Collapse
|
12
|
Hoff NP, Freise NF, Schmidt AG, Firouzi-Memarpuri P, Reifenberger J, Luedde T, Bölke E, Meller S, Homey B, Feldt T, Jensen BEO, Keitel V, Schmidt L, Maas K, Haussmann J, Tamaskovics B, Budach W, Fischer JC, Buhren BA, Knoefel WT, Schneider M, Gerber PA, Pedoto A, Häussinger D, Grebe O, van Griensven M, Braun SA, Salzmann S, Rezazadeh A, Matuschek C. Delayed skin reaction after mRNA-1273 vaccine against SARS-CoV-2: a rare clinical reaction. Eur J Med Res 2021; 26:98. [PMID: 34433495 PMCID: PMC8386154 DOI: 10.1186/s40001-021-00557-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 05/08/2021] [Accepted: 07/20/2021] [Indexed: 02/07/2023] Open
Abstract
Background The coronavirus disease 2019 (COVID‐19) is associated with a wide clinical spectrum of skin manifestations, including urticarial, vesicular, vasculitic and chilblain‐like lesions. Recently, delayed skin reactions have been reported in 1% individuals following mRNA vaccination against SARS-CoV-2. The exact pathophysiology and the risk factors still remain unclear. Patients and methods 6821 employees and patients were vaccinated at our institutions between February and June 2021. Every patient received two doses of the mRNA-1273 vaccine in our hospitals, and reported back in case of any side effects which were collected in our hospital managed database. Results Eleven of 6821 vaccinated patients (0.16%) developed delayed skin reactions after either the first or second dose of the mRNA-1273 vaccine against SARS-CoV-2. Eight of 11 patients (73%) developed a rash after the first dose, while in 3/11 (27%), the rash occurred after the second dose. More females (9/11) were affected. Four of 11 patients required antihistamines, with two needing additional topical steroids. All the cutaneous manifestations resolved within 14 days. None of the skin reactions after the first dose of the vaccine prevented the administration of the second dose. There were no long-term cutaneous sequelae in any of the affected individuals. Conclusion Our data suggests that skin reactions after the use of mRNA-1273 vaccine against SARS-CoV-2 are possible, but rare. Further studies need to be done to understand the pathophysiology of these lesions.
Collapse
Affiliation(s)
- Norman-Philipp Hoff
- Department of Dermatology, University Hospital Düsseldorf, Medical Faculty, Heinrich-Heine-University, 40225, Düsseldorf, Germany
| | - Noemi F Freise
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Albrecht G Schmidt
- Department of Radiation Oncology, University Hospital Medical Faculty, Heinrich-Heine-University, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Parnian Firouzi-Memarpuri
- Department of Dermatology, University Hospital Düsseldorf, Medical Faculty, Heinrich-Heine-University, 40225, Düsseldorf, Germany
| | - Julia Reifenberger
- Department of Dermatology, University Hospital Düsseldorf, Medical Faculty, Heinrich-Heine-University, 40225, Düsseldorf, Germany
| | - Tom Luedde
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Edwin Bölke
- Department of Radiation Oncology, University Hospital Medical Faculty, Heinrich-Heine-University, Moorenstr. 5, 40225, Düsseldorf, Germany.
| | - Stephan Meller
- Department of Dermatology, University Hospital Düsseldorf, Medical Faculty, Heinrich-Heine-University, 40225, Düsseldorf, Germany
| | - Bernhard Homey
- Department of Dermatology, University Hospital Düsseldorf, Medical Faculty, Heinrich-Heine-University, 40225, Düsseldorf, Germany
| | - Torsten Feldt
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Björn Erik Ole Jensen
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Verena Keitel
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Livia Schmidt
- Department of Radiation Oncology, University Hospital Medical Faculty, Heinrich-Heine-University, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Kitti Maas
- Department of Radiation Oncology, University Hospital Medical Faculty, Heinrich-Heine-University, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Jan Haussmann
- Department of Radiation Oncology, University Hospital Medical Faculty, Heinrich-Heine-University, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Balint Tamaskovics
- Department of Radiation Oncology, University Hospital Medical Faculty, Heinrich-Heine-University, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Wilfried Budach
- Department of Radiation Oncology, University Hospital Medical Faculty, Heinrich-Heine-University, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Johannes C Fischer
- Institute for Transplant Diagnostics and Cell Therapeutics, Heinrich Heine University, Düsseldorf, Germany
| | | | - Wolfram Trudo Knoefel
- Department of Surgery and Interdisciplinary Surgical Intensive Care Unit Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Marion Schneider
- Division of Experimental Anesthesiology, University Hospital Ulm, Ulm, Germany
| | - Peter Arne Gerber
- Medical Faculty, Heinrich-Heine-University, 40225, Düsseldorf, Germany
| | - Alessia Pedoto
- Department of Anesthesiology, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Dieter Häussinger
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Olaf Grebe
- Department of Cardiology and Rhythmology, Petrus Hospital, Wuppertal, Germany
| | - Martijn van Griensven
- Department cBITE, MERLN Institute for Technology-Inspired Regenerative Medicine, Maastricht University, Maastricht, The Netherlands
| | - Stephan A Braun
- Department of Dermatology, University Hospital Düsseldorf, Medical Faculty, Heinrich-Heine-University, 40225, Düsseldorf, Germany.,Department of Dermatology, University Hospital Münster, Münster, Germany
| | - Stefan Salzmann
- Department of Dermatology, University Hospital Münster, Münster, Germany
| | - Amir Rezazadeh
- Department of Radiation Oncology, University Hospital Medical Faculty, Heinrich-Heine-University, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Christiane Matuschek
- Department of Radiation Oncology, University Hospital Medical Faculty, Heinrich-Heine-University, Moorenstr. 5, 40225, Düsseldorf, Germany
| |
Collapse
|
13
|
Fischer JC, Schmidt AG, Bölke E, Keitel V, Feldt T, Jensen B, Freise NF, Häussinger D, Schneider EM, Hermsen D, Kindgen-Milles D, Knoefel WT, Haussmann J, Tamaskovics B, Plettenberg C, Scheckenbach K, Corradini S, Rox J, Balz V, Maas K, Schmidt L, Grebe O, Erhardt A, Gerber PA, Peiper M, Buhren BA, Lichtenberg A, Rezazadeh A, Budach W, Matuschek C. Informed consent and informed intervention: SARS-CoV-2 vaccinations not just call for disclosure of newly emerging safety data but also for hypothesis generation and testing. Eur J Med Res 2021; 26:87. [PMID: 34362461 PMCID: PMC8343366 DOI: 10.1186/s40001-021-00558-y] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 07/09/2021] [Indexed: 12/21/2022] Open
Abstract
Background COVID-19 infection is a major threat to patients and health care providers around the world. One solution is the vaccination against SARS-CoV-2. Methods We performed a comprehensive query of the latest publications on the prevention of viral infections including the recent vaccination program and its side effects. Results The situation is evolving rapidly and there is no reasonable alternative to population-scale vaccination programs as currently enrolled. Conclusion Therefore, regulatory authorities should consider supplementing their conventional mandate of post-approval pharmacovigilance, which is based on the collection, assessment, and regulatory response to emerging safety findings.
Collapse
Affiliation(s)
- Johannes C Fischer
- Institute for Transplantation Diagnostics and Cell Therapeutics, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University, 40225, Düsseldorf, Germany
| | - Albrecht G Schmidt
- Department of Radiation Oncology, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Edwin Bölke
- Department of Radiation Oncology, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany.
| | - Verena Keitel
- Department of Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Torsten Feldt
- Department of Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Björn Jensen
- Department of Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Noemi F Freise
- Department of Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Dieter Häussinger
- Department of Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - E Marion Schneider
- Division of Experimental Anesthesiology, University Hospital Ulm, Ulm, Germany
| | - Derik Hermsen
- Central Institute for Laboratory Diagnostics and Clinical Chemistry, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - Detlef Kindgen-Milles
- Department of Anesthesiology, Medical Faculty, Heinrich Heine University, Dusseldorf, Germany
| | - Wolfram Trudo Knoefel
- Department of Surgery and Interdisciplinary Surgical Intensive Care Unit, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany.,Medicine, Department cBITE, Maastricht, The Netherlands
| | - Jan Haussmann
- Department of Radiation Oncology, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Balint Tamaskovics
- Department of Radiation Oncology, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Christian Plettenberg
- Department of Otolaryngology-Head and Neck Surgery, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Kathrin Scheckenbach
- Department of Otolaryngology-Head and Neck Surgery, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Stefanie Corradini
- Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany
| | - Jutta Rox
- Institute for Transplantation Diagnostics and Cell Therapeutics, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University, 40225, Düsseldorf, Germany
| | - Vera Balz
- Institute for Transplantation Diagnostics and Cell Therapeutics, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University, 40225, Düsseldorf, Germany
| | - Kitti Maas
- Department of Radiation Oncology, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Livia Schmidt
- Department of Radiation Oncology, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Olaf Grebe
- Department of Cardiology and Rhythmology, Petrus Hospital, Wuppertal, Germany
| | - Anja Erhardt
- Institute of Virology, University of Witten/Herdecke, Witten, Germany
| | | | - Matthias Peiper
- Department of Cardiac Surgery, Medical Faculty, University of Dusseldorf, Düsseldorf, Germany
| | - Bettina Alexandra Buhren
- Department of Radiation Oncology, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Artur Lichtenberg
- Department of Cardiac Surgery, Medical Faculty, University of Dusseldorf, Düsseldorf, Germany
| | - Amir Rezazadeh
- Department of Radiation Oncology, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Wilfried Budach
- Department of Radiation Oncology, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Christiane Matuschek
- Department of Radiation Oncology, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| |
Collapse
|
14
|
Rezazadeh A, Hajimiri SH, Kebriaeezadeh A, Gholami K, Hashemian F, Khoshnevisan A, Mohebbi N. Clinical and economic impact of comprehensive medication management implementation by clinical pharmacists in an intensive care unit: a cost–benefit analysis. Journal of Pharmaceutical Health Services Research 2021. [DOI: 10.1093/jphsr/rmab026] [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: 11/12/2022]
Abstract
Abstract
Objectives
Critically ill patients are at risk of drug-related problems (DRPs) and healthcare-related cost. Clinical pharmacists are specifically trained in pharmacotherapy evaluation; they can identify and prevent DRPs. We aim to evaluate clinical and economic impact of clinical pharmacist by cost–benefit analysis in intensive care unit.
Methods
This was a prospective, interventional study from healthcare provider perspective which conducted over 6 months in a neurosurgery intensive care unit (ICU) of a university hospital on 162 patients. A clinical pharmacist was dedicated to implement comprehensive medication management. All pharmacotherapy problems were categorized and economic impact of clinical pharmacist’s interventions including cost–benefit ratio and net benefit in the ICU was assessed.
Key findings
A total of 1524 interventions were done. The top five pharmacotherapy-related problems were defined as, drug selection (33.3%), dose adjustment (17.32%), fluid and electrolyte management (12.99%), drug discontinuation (12.07%) and therapeutic drug monitoring (6.75%). The minimum and maximum benefit–cost ratio was 8.4:1 to 12.7:1 and net benefit was $169,205 to $266,633, respectively over the 6-month period.
Conclusions
The participation of a clinical pharmacist in a multidisciplinary ICU team by implementation of comprehensive medication management may reduce healthcare expenditures and improve drug safety.
Collapse
Affiliation(s)
- Amir Rezazadeh
- Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
- Research Center for Rational Use of Drugs, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Hossein Hajimiri
- Department of Pharmacoeconomics and Pharmaceutical Administration, School of Pharmacy, Tehran University of Medical sciences, Tehran, Iran
- Pharmaceutical Management and Economics Research Center, Tehran University of Medical sciences, Tehran, Iran
| | - Abbas Kebriaeezadeh
- Department of Pharmacoeconomics and Pharmaceutical Administration, School of Pharmacy, Tehran University of Medical sciences, Tehran, Iran
- Pharmaceutical Management and Economics Research Center, Tehran University of Medical sciences, Tehran, Iran
| | - Kheirollah Gholami
- Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
- Research Center for Rational Use of Drugs, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Hashemian
- Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran Medical sciences, Islamic Azad University, Tehran, Iran
| | - Alireza Khoshnevisan
- Department of neurosurgery, Shariati hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Niayesh Mohebbi
- Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
- Research Center for Rational Use of Drugs, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
15
|
Telmadarrehei T, Tang JD, Raji O, Rezazadeh A, Narayanan L, Shmulsky R, Jeremic D. A Study of the Gut Bacterial Community of Reticulitermes virginicus Exposed to Chitosan Treatment. Insects 2020; 11:E681. [PMID: 33049915 PMCID: PMC7601259 DOI: 10.3390/insects11100681] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 09/28/2020] [Accepted: 10/05/2020] [Indexed: 01/04/2023]
Abstract
A thorough understanding of microbial communities in the gut of lower termites is needed to develop target-specific and environmentally benign wood protection systems. In this study, the bacterial community from Reticulitermes virginicus was examined by Illumina sequencing of 16S ribosomal RNA (rRNA) spanning the V3 and V4 regions. Prior to library preparation, the termites were subjected to five treatments over an 18-day period: three groups were fed on wood treated with 0.5% chitosan, 25% acetic acid, or water, the fourth group was taken directly from the original collection log, and the fifth group was starved. Metagenomic sequences were analyzed using QIIME 2 to understand the treatments' effects on the dynamics of the gut bacteria. Four dominant phyla were detected: Bacteroidetes (34.4% of reads), Firmicutes (20.6%), Elusimicrobia (15.7%), and Proteobacteria (12.9%). A significant effect of chitosan treatment was observed in two phyla; Firmicutes abundance was significantly lower with chitosan treatment when compared to other groups, while Actinobacteria was lower in unexposed and starved termites. The results suggest that chitosan treatment not only affects the structure of the microbial community in the gut, but other treatments such as starving also cause shifts in termite gut communities.
Collapse
Affiliation(s)
- Telmah Telmadarrehei
- Department of Sustainable Bioproducts, Mississippi State University, 201 Locksley Way, Starkville, MS 39759, USA; (O.R.); (L.N.); (R.S.); (D.J.)
| | - Juliet D. Tang
- Forest Products Laboratory, USDA Forest Service, 201 Lincoln Green, Starkville, MS 39759, USA;
| | - Olanrewaju Raji
- Department of Sustainable Bioproducts, Mississippi State University, 201 Locksley Way, Starkville, MS 39759, USA; (O.R.); (L.N.); (R.S.); (D.J.)
- Department of Chemical Engineering and Applied Science, University of Toronto, 200 College Street, Toronto, ON M5S 3E5, Canada
| | - Amir Rezazadeh
- Institute of Food and Agriculture Science, University of Florida, 8400 Picos Road, Ste. 101, Fort Pierce, FL 34945, USA;
| | - Lakshmi Narayanan
- Department of Sustainable Bioproducts, Mississippi State University, 201 Locksley Way, Starkville, MS 39759, USA; (O.R.); (L.N.); (R.S.); (D.J.)
| | - Rubin Shmulsky
- Department of Sustainable Bioproducts, Mississippi State University, 201 Locksley Way, Starkville, MS 39759, USA; (O.R.); (L.N.); (R.S.); (D.J.)
| | - Dragica Jeremic
- Department of Sustainable Bioproducts, Mississippi State University, 201 Locksley Way, Starkville, MS 39759, USA; (O.R.); (L.N.); (R.S.); (D.J.)
| |
Collapse
|
16
|
Rezazadeh A, Mohebbi N. [Main challenges of electrolyte imbalance in older patients with COVID-19 and risk of QT prolongation]. Rev Esp Cardiol 2020; 74:199. [PMID: 33519022 PMCID: PMC7833788 DOI: 10.1016/j.recesp.2020.07.030] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Amir Rezazadeh
- Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Teherán, Irán.,Research Center for Rational Use of Drugs, Tehran University of Medical Sciences, Teherán, Irán
| | - Niayesh Mohebbi
- Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Teherán, Irán.,Research Center for Rational Use of Drugs, Tehran University of Medical Sciences, Teherán, Irán
| |
Collapse
|
17
|
Loriot Y, Balar A, Petrylak D, Tagawa S, Rezazadeh A, Fléchon A, Jain R, Agarwal N, Bupathi M, Barthélémy P, Beuzeboc P, Palmbos P, Kyriakopoulos C, Pouessel D, Sternberg C, Hong Q, Goswami T, Itri L, Grivas P. LBA24 TROPHY-U-01 cohort 1 final results: A phase II study of sacituzumab govitecan (SG) in metastatic urothelial cancer (mUC) that has progressed after platinum (PLT) and checkpoint inhibitors (CPI). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.2253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
|
18
|
Siefker-Radtke A, Loriot Y, Necchi A, Huddart R, Burgess E, Rezazadeh A, O'Hagan A, De Porre P, Avadhani A, Monga M, Cherkas Y, Moy C, Santiago-Walker A. 751P Analysis of circulating tumor DNA (ctDNA) from the phase II BLC2001 trial of erdafitinib in locally advanced or metastatic urothelial carcinoma (mUC) to identify markers of intrinsic resistance to fibroblast growth factor receptor (FGFR)-targeted therapy. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
19
|
Necchi A, Siefker-Radtke A, Loriot Y, Park S, Garcia-Donas J, Huddart R, Burgess E, Fleming M, Rezazadeh A, Mellado B, Varlamov S, Joshi M, Duran I, Zakharia Y, Fu M, Santiago-Walker A, O'Hagan A, Monga M, Tagawa S. 750P Erdafitinib (ERDA) in patients (pts) with locally advanced or metastatic urothelial carcinoma (mUC): Subgroup analyses of long-term efficacy outcomes of a pivotal phase II trial (BLC2001). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
20
|
Rezazadeh A, Mohebbi N. Main challenges of electrolyte imbalance in older patients with COVID-19 and risk of QT prolongation. ACTA ACUST UNITED AC 2020; 74:199. [PMID: 32855095 PMCID: PMC7402101 DOI: 10.1016/j.rec.2020.07.012] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 07/29/2020] [Indexed: 11/22/2022]
Affiliation(s)
- Amir Rezazadeh
- Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran; Research Center for Rational Use of Drugs, Tehran University of Medical Sciences, Tehran, Iran
| | - Niayesh Mohebbi
- Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran; Research Center for Rational Use of Drugs, Tehran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
21
|
Rezazadeh A, Taghizadeh-Ghehi M. Comment on "Retrospective study of hypersensitivity reactions to chemotherapeutic agents in a thoracic oncology service". J Clin Pharm Ther 2018; 44:335-336. [PMID: 30450760 DOI: 10.1111/jcpt.12779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2018] [Revised: 08/28/2018] [Accepted: 10/25/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Amir Rezazadeh
- Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Taghizadeh-Ghehi
- Research Center for Rational Use of Drugs, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
22
|
Saad F, Chi K, Shore N, Graff J, Posadas E, Freeman S, Tryon J, Trudel G, de Jong J, Meltzer J, Zhao X, Tran N, Rezazadeh A. Interim results of a phase Ib study of niraparib plus androgen receptor-targeted therapy in men with metastatic castration-resistant prostate cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy284.043] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
23
|
Rezazadeh A, Ghasemnezh A, Barani M, Telmadarre T. Effect of Salinity on Phenolic Composition and Antioxidant Activity of Artichoke (Cynara scolymus L.) Leaves. ACTA ACUST UNITED AC 2012. [DOI: 10.3923/rjmp.2012.245.252] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
24
|
Rahbari S, Nabian S, Azizi HR, Rezazadeh A, Mokhber-Dezfouli MR. Detection of IgG Antibodies toCryptosporidium parvumUsingEimeria tenellaandCryptosporidium parvumAntigens. Journal of Applied Animal Research 2011. [DOI: 10.1080/09712119.2005.9706810] [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] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- S. Rahbari
- a Department of Parasitology Faculty of Veterinary Medicine , University of Tehran , Tehran , Iran
| | - S. Nabian
- a Department of Parasitology Faculty of Veterinary Medicine , University of Tehran , Tehran , Iran
| | - H. R. Azizi
- b Department of Parasitology Faculty of Veterinary Medicine , University of Shahre-kord , Iran
| | - A. Rezazadeh
- a Department of Parasitology Faculty of Veterinary Medicine , University of Tehran , Tehran , Iran
| | - M. R. Mokhber-Dezfouli
- a Department of Parasitology Faculty of Veterinary Medicine , University of Tehran , Tehran , Iran
| |
Collapse
|
25
|
Snyder LA, Honea N, Coons SW, Eschbacher J, Smith KA, Spetzler RF, Sanai N, Groves MD, DeGroot J, Tremont I, Forman A, Kang S, Pei BL, Julie W, Schultz D, Yuan Y, Guha N, Hwu WJ, Papadopoulos N, Camphausen K, Yung WA, Ryken T, Johnston SK, Graham C, Grimm S, Colman H, Raizer J, Chamberlain MC, Mrugala MM, Adair JE, Beard BC, Silbergeld DL, Rockhill JK, Kiem HP, Lee EQ, Batchelor TT, Lassman AB, Schiff DS, Kaley TJ, Wong ET, Mikkelsen T, Purow BW, Drappatz J, Norden AD, Beroukhim R, Weiss S, Alexander BM, Sceppa C, Gerard M, Hallisey SD, Bochacki CA, Smith KH, Muzikansky AM, Wen PY, Peereboom DM, Mikkelson T, Sloan AE, Rich JN, Supko JG, Ye X, Brewer C, Lamborn K, Prados M, Grossman SA, Zhu JJ, Recht LD, Colman H, Kesari S, Kim LJ, Balch AH, Pope CC, Brulotte M, Beelen AP, Chamberlain MC, Wong ET, Ram Z, Gutin PH, Stupp R, Marsh J, McDonald K, Wheeler H, Teo C, Martin L, Palmer L, Rodriguez M, Buckland M, Koh ES, Back M, Robinson B, Joseph D, Nowak AK, Saito R, Sonoda Y, Yamashita Y, Kanamori M, Kumabe T, Tominaga T, Rodon J, Tawbi HA, Thomas AL, Amakye DD, Granvil C, Shou Y, Dey J, Buonamici S, Dienstmann R, Mita AC, Dummer R, Hutterer M, Martha N, Sabine E, Thaddaus G, Florian S, Christine M, Stefan O, Richard G, Martin M, Johanna B, Jochen T, Ullrich H, Wolfgang W, Peter V, Gunther S, Field KM, Cher L, Wheeler H, Hovey E, Nowak AK, Simes J, Sawkins K, France T, Brown C, Nicholas MK, Chmura S, Paleologos N, Krouwer H, Malkin M, Junck L, Vick NA, Lukas RV, Jaeckle KA, Anderson SK, Kosel M, Sarkaria J, Brown P, Flynn PJ, Buckner JC, Galanis E, Batchelor T, Grossman S, Brem S, Lesser G, Voloschin A, Nabors LB, Mikkelsen T, Desideri S, Supko J, Peereboom D, Westphal M, Pietsch T, Bach F, Heese O, Vredenburgh JJ, Desjardins A, Reardon DA, Peters KB, Kirkpatrick JP, Herndon JE, Coan AD, Bailey L, Janney D, Lu C, Friedman HS, Desjardins A, Reardon DA, Peters KB, Herndon JE, Gururangan S, Norfleet J, Friedman HS, Vredenburgh JJ, Lassman AB, Kaley TJ, DeAngelis LM, Hormigo A, Mellinghoff IK, Otap DD, Seger J, Doyle LA, Ludwig E, Lacouture ME, Panageas KS, Rezazadeh A, LaRocca RV, Vitaz TW, Villanueva WG, Hodes J, Haysley L, Pertschuk D, Cloughesy TF, Chang SM, Aghi MK, Vogelbaum MA, Liau LM, Shafa B, Jolly DJ, Ibanez CE, Perez OD, Robbins JM, Gruber HE, Maher EA, Stewart C, Hatanpaa K, Raisanen J, Mashimo T, Yang XL, Muralidhara C, Madden C, Ramachandran A, Mickey B, Bachoo R. ONGOING CLINICAL TRIALS. Neuro Oncol 2011; 13:iii85-iii91. [PMCID: PMC3199166 DOI: 10.1093/neuonc/nor154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2023] Open
|
26
|
Rezazadeh A, Sedighizadeh M, Karimi M. Proton Exchange Membrane Fuel Cell Control Using a Predictive Control Based on Neural Network. ACTA ACUST UNITED AC 2010. [DOI: 10.7763/ijcee.2010.v2.117] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
|
27
|
Rezazadeh A, Desai PC, Laber DA, Ghim S, Schaefer G, Jenson AB, Kloecker GH. Detection of HPV in different subtypes of non-small cell lung cancer (NSCLC). J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.22098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
28
|
Rezazadeh A, Herzig G, Herzig R. Rituximab, gemcitabine, vinorelbine, and methylprednisone (R-GVM), a hematopoietic cell (HC) mobilizing and salvage regimen for malignant lymphoma (ML). J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.17537] [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: 11/20/2022] Open
Abstract
17537 Background: The prognosis of pts with recurrent ML remains poor. High-dose therapy (HDT) with HC rescue can cure a proportion of such pts. HC mobilization can be adversely affected by number and duration of prior treatments, interval from diagnosis to HC collection, prior radiotherapy and marrow involvement. There remains a need for more effective and less toxic salvage regimens, capable of mobilizing HCs. Methods: The mobilizing potential of R-GVM salvage regimen with hematopoietic growth factor (HGF) support (G- and GM-CSF) was evaluated in 6 pts with relapsed (n=5) or primary refractory (n=1) ML. Pts received R-GVM salvage therapy [rituximab (375 mg/m2, day 1), gemcitabine (1 g/m2, day 1, 8), vinorelbine (30 mg/m2, day 1, 8) and methylprednisone (1 g/m2, day 1, 8)] with HGF administration and subsequent HC collection. The HGF support was started on day 9 and was continued through apheresis which started when the CD34+ cell count ≥ 20/μl (median day of R-GVM cycle: 15, range 14–19). Pts had daily apheresis with continued HGF support until at least 5 x 106 CD34+ cells/kg were collected. The hematologic and non-hematologic toxicity were tolerable in all pts; no pt required hospitalization. Results: 6 pts (age range 20–45 years) with Hodgkin (n =3) and non- Hodgkin lymphoma (n =3) were evaluated in this study. Pts had received 1–3 previous treatment regimens. The median number of R-GVM courses given before HC collection was 2.5 (range 1–5). Effective HC mobilization (≥5x106 CD34+ cells/kg) was obtained in all ps. A single apheresis resulted in satisfactory HC collection in 4 pts (range 8.2–17.7 x 106 CD34+ cells/kg); 2 pts required 3 aphereses to collect an adequate number of cells (6.7 and 7.4 x 106 CD34+ cells/kg). One pt was heavily pretreated and had failed two previous attempts of HC mobilization (one with HGF alone and one with cyclophosphamide and HGF); the other pt was HIV+ treated with HAART and had prior marrow involvement. As a salvage regimen, one pt had progressive disease, 1 had stable disease, 1 had a partial response, and 3 had a complete response before proceeding with HDT with HC rescue. Conclusions: R-GVM regimen is feasible, tolerable and effective in mobilizing HPC in patients with relapsed and refractory lymphoma. No significant financial relationships to disclose.
Collapse
Affiliation(s)
| | - G. Herzig
- James Graham Brown Cancer Ctr, Louisville, KY
| | - R. Herzig
- James Graham Brown Cancer Ctr, Louisville, KY
| |
Collapse
|
29
|
Abstract
In 200 consecutive routine diagnostic laparoscopies, 31 cases (15.5%) of endometriosis were found. Of these 200 cases, 131 patients (65.5%) were referred for laparoscopy because of infertility. In 22 (71.0%) out of 31 patients with endometriosis infertility was the indication for laparoscopy. In the remainder of the patients laparoscopy was performed because of other indications. Half of the patients with endometriosis showed moderate or severe degrees of the disease. Seventy-one percent of the patients were below the age of 29. According to our findings, the presumption that endometriosis is a rare disease in Iran is considered to be erroneous.
Collapse
|