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Lucijanic M, Krecak I, Galusic D, Holik H, Perisa V, Moric Peric M, Zekanovic I, Budimir J, Lekovic D, Kusec R. Triple a score (AAA: age, absolute neutrophil count and absolute lymphocyte count) and its prognostic utility in patients with overt fibrotic and prefibrotic myelofibrosis. Ann Hematol 2024; 103:2157-2159. [PMID: 38652241 DOI: 10.1007/s00277-024-05751-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 04/06/2024] [Indexed: 04/25/2024]
Affiliation(s)
- Marko Lucijanic
- Hematology Department, University Hospital Dubrava, Av. Gojka Suska 6, Zagreb, 10000, Croatia.
- University of Zagreb School of Medicine, Zagreb, Croatia.
| | - Ivan Krecak
- Department of Internal Medicine, General Hospital of Sibenik-Knin county, Sibenik, Croatia
- University of Rijeka School of Medicine, Rijeka, Croatia
- Sibenik University of Applied Science, Sibenik, Croatia
| | - Davor Galusic
- Department of Hematology, University Hospital of Split, Split, Croatia
- University of Split School of Medicine, Split, Croatia
| | - Hrvoje Holik
- Department of Internal Medicine, Dr. Josip Bencevic General Hospital, Slavonski Brod, Croatia
- University of Osijek Faculty of Medicine, Osijek, Croatia
| | - Vlatka Perisa
- University of Osijek Faculty of Medicine, Osijek, Croatia
- Department of Hematology, Osijek University Hospital, Osijek, Croatia
| | | | - Ivan Zekanovic
- Department of Internal Medicine, General Hospital Zadar, Zadar, Croatia
| | - Josipa Budimir
- Department of Internal Medicine, General Hospital of Sibenik-Knin county, Sibenik, Croatia
| | - Danijela Lekovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Clinic of Hematology, University Clinical Center of Serbia, Belgrade, Serbia
| | - Rajko Kusec
- Hematology Department, University Hospital Dubrava, Av. Gojka Suska 6, Zagreb, 10000, Croatia
- University of Zagreb School of Medicine, Zagreb, Croatia
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Lucijanic M, Krecak I, Soric E, Sabljic A, Galusic D, Holik H, Perisa V, Moric Peric M, Zekanovic I, Budimir J, Kusec R. Evaluation of Absolute Neutrophil, Lymphocyte and Platelet Count and Their Ratios as Predictors of Thrombotic Risk in Patients with Prefibrotic and Overt Myelofibrosis. Life (Basel) 2024; 14:523. [PMID: 38672793 PMCID: PMC11051164 DOI: 10.3390/life14040523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 04/09/2024] [Accepted: 04/16/2024] [Indexed: 04/28/2024] Open
Abstract
AIM To investigate the prognostic contribution of absolute neutrophil (ANC), lymphocyte (ALC), platelet count and their ratios, neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR), to thrombotic risk in patients with prefibrotic and overt fibrotic myelofibrosis (MF). METHODS We retrospectively analyzed a cohort of 256 patients with prefibrotic (85 patients) and overt fibrotic MF (171 patients) treated in six Croatian hematological centers. RESULTS Prefibrotic compared to overt fibrotic MF patients presented with significantly higher ALC, platelet count and PLR, and experienced longer time to thrombosis (TTT). Among prefibrotic patients, ANC > 8.33 × 109/L (HR 13.08, p = 0.036), ALC > 2.58 × 109/L (HR 20.63, p = 0.049) and platelet count > 752 × 109/L (HR 10.5, p = 0.043) remained independently associated with shorter TTT. Among overt fibrotic patients, ANC > 8.8 × 109/L (HR 4.49, p = 0.004), ALC ≤ 1.43 × 109/L (HR 4.15, p = 0.003), platelet count ≤ 385 × 109/L (HR 4.68, p = 0.004) and chronic kidney disease (HR 9.07, p < 0.001) remained independently associated with shorter TTT. CONCLUSIONS Prognostic properties of ANC, ALC and platelet count are mutually independent and exceed those of NLR and PLR regarding thrombotic risk stratification. ALC and platelet count associate in opposite directions with thrombotic risk in prefibrotic and overt fibrotic MF patients.
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Affiliation(s)
- Marko Lucijanic
- Hematology Department, University Hospital Dubrava, Av. Gojka Suska 6, 10000 Zagreb, Croatia
- School of Medicine, University of Zagreb, Ul. Salata 3, 10000 Zagreb, Croatia
| | - Ivan Krecak
- Department of Internal Medicine, General Hospital Sibenik, Ul. Stjepana Radica 83, 22000 Sibenik, Croatia
- School of Medicine, University of Rijeka, Ul. Brace Branchetta 20/1, 51000 Rijeka, Croatia
- Sibenik University of Applied Science, Trg Andrije Hebranga 11, 22000 Sibenik, Croatia
| | - Ena Soric
- Hematology Department, University Hospital Dubrava, Av. Gojka Suska 6, 10000 Zagreb, Croatia
| | - Anica Sabljic
- Hematology Department, University Hospital Dubrava, Av. Gojka Suska 6, 10000 Zagreb, Croatia
| | - Davor Galusic
- Department of Hematology, University Hospital of Split, Soltanska ul. 1, 21000 Split, Croatia
- School of Medicine, University of Split, Soltanska ul. 2, 21000 Split, Croatia
| | - Hrvoje Holik
- Department of Internal Medicine, “Dr. Josip Bencevic” General Hospital, Ul. Andrije Stampara, 35000 Slavonski Brod, Croatia
- Faculty of Medicine, University of Osijek, Ul. Josipa Huttlera 4, 31000 Osijek, Croatia
| | - Vlatka Perisa
- Faculty of Medicine, University of Osijek, Ul. Josipa Huttlera 4, 31000 Osijek, Croatia
- Department of Hematology, Osijek University Hospital, Ul. Josipa Huttlera 4, 31000 Osijek, Croatia
| | - Martina Moric Peric
- Department of Internal Medicine, General Hospital Zadar, Ul. Boze Pericica 5, 23000 Zadar, Croatia
| | - Ivan Zekanovic
- Department of Internal Medicine, General Hospital Zadar, Ul. Boze Pericica 5, 23000 Zadar, Croatia
| | - Josipa Budimir
- Department of Internal Medicine, General Hospital Sibenik, Ul. Stjepana Radica 83, 22000 Sibenik, Croatia
| | - Rajko Kusec
- Hematology Department, University Hospital Dubrava, Av. Gojka Suska 6, 10000 Zagreb, Croatia
- School of Medicine, University of Zagreb, Ul. Salata 3, 10000 Zagreb, Croatia
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Lucijanic M, Krecak I, Soric E, Sabljic A, Vasilj T, Cicic D, Vrkljan Vuk A, Kremer Z, Dilber I, Glasnovic A, Jaksic O, Kusec R. Secondary polycythemia in acutely ill COVID-19 patients is associated with higher mortality but not markedly higher thrombotic risk. Scand J Clin Lab Invest 2024; 84:84-90. [PMID: 38414267 DOI: 10.1080/00365513.2024.2321589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 02/18/2024] [Indexed: 02/29/2024]
Abstract
Secondary polycythemia is commonly observed among patients with chronic pulmonary diseases. However, its significance in the context of Coronavirus disease 2019 (COVID-19) is unknown. We retrospectively evaluated a total of 5872 hospitalized COVID-19 patients with mostly severe and critical symptoms, and without prior or subsequently diagnosed myeloproliferative neoplasm. Patients were stratified based on admission hemoglobin into four subgroups: anemia (hemoglobin <120 g/L for females and 130 g/L for males), normal hemoglobin, mild (hemoglobin 160-165 g/L for females and 165-185 g/L for males) and severe polycythemia (hemoglobin >165 g/L for females and >185 g/L for males). Among 5872 patients, a total of 158 (2.7%) had mild and 25 (0.4%) severe polycythemia. Polycythemia was significantly associated with higher respiratory and functional impairment, reduced plasma volume, higher serum osmolarity and comorbidity burden specific to the degree of polycythemia. Patients presenting with mild (odds ratio (OR) = 1.63, p = .003) and severe polycythemia (OR = 4.98, p < .001) had increased risk of death in comparison to patients with normal hemoglobin, whereas no significant associations with venous thromboembolism, arterial thrombosis nor major bleeding were observed. Anemia was associated with higher risk of death (OR = 1.42, p < .001), venous thromboembolism (OR = 1.34, p < .006) and major bleeding (OR = 2.27, p < .001) in comparison to normal hemoglobin. Associations of polycythemia and anemia with mortality diminished, and anemia with venous thromboembolism and major bleeding persisted, after multivariate adjustments for age, sex, comorbidities, COVID-19 severity and functional status. Secondary polycythemia in hospitalized COVID-19 patients without prior of subsequently diagnosed myeloproliferative neoplasm is rare and is associated with high mortality, increasing with degree of polycythemia, but not markedly higher thrombotic risk.
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Affiliation(s)
- Marko Lucijanic
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Ivan Krecak
- Internal Medicine Department, General Hospital Sibenik-Knin County, Sibenik, Croatia
- Faculty of Medicine, University of Rijeka, Rijeka, Croatia
- University of Applied Sciences, Sibenik, Croatia
| | - Ena Soric
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia
| | - Anica Sabljic
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia
| | - Tamara Vasilj
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia
| | - David Cicic
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia
| | | | | | - Ivo Dilber
- Internal Medicine Department, General hospital Zadar, Zadar, Croatia
| | | | - Ozren Jaksic
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Rajko Kusec
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
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Lucijanic M, Sabljic A, Vlasac Glasnovic J, Soric E, Jonjic Z, Kusec R. Heavily pretreated patient with nodal marginal zone lymphoma successfully treated with mosunetuzumab. Ann Hematol 2024; 103:1015-1016. [PMID: 38006570 DOI: 10.1007/s00277-023-05565-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 11/22/2023] [Indexed: 11/27/2023]
Affiliation(s)
- Marko Lucijanic
- Hematology Department, University hospital Dubrava, Av. Gojka Suska 6, 10000, Zagreb, Croatia.
- Internal Medicine Department, School of Medicine University of Zagreb, Salata 3, 10000, Zagreb, Croatia.
| | - Anica Sabljic
- Hematology Department, University hospital Dubrava, Av. Gojka Suska 6, 10000, Zagreb, Croatia
| | - Josipa Vlasac Glasnovic
- Hematology Department, University hospital Dubrava, Av. Gojka Suska 6, 10000, Zagreb, Croatia
| | - Ena Soric
- Hematology Department, University hospital Dubrava, Av. Gojka Suska 6, 10000, Zagreb, Croatia
| | - Zeljko Jonjic
- Hematology Department, University hospital Dubrava, Av. Gojka Suska 6, 10000, Zagreb, Croatia
| | - Rajko Kusec
- Hematology Department, University hospital Dubrava, Av. Gojka Suska 6, 10000, Zagreb, Croatia
- Internal Medicine Department, School of Medicine University of Zagreb, Salata 3, 10000, Zagreb, Croatia
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Lucijanic M, Tomasovic-Loncaric C, Stoos-Veic T, De Both T, Jalsenjak B, Kusec R. Myeloid sarcoma of the urinary bladder as the presenting feature of secondary acute myeloid leukemia, successfully treated with venetoclax and azacitidine. Ann Hematol 2024; 103:671-672. [PMID: 37946030 DOI: 10.1007/s00277-023-05529-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 10/27/2023] [Indexed: 11/12/2023]
MESH Headings
- Humans
- Sarcoma, Myeloid/complications
- Sarcoma, Myeloid/diagnosis
- Sarcoma, Myeloid/drug therapy
- Urinary Bladder
- Azacitidine/therapeutic use
- Leukemia, Myeloid, Acute/complications
- Leukemia, Myeloid, Acute/diagnosis
- Leukemia, Myeloid, Acute/drug therapy
- Bridged Bicyclo Compounds, Heterocyclic/therapeutic use
- Neoplasms, Second Primary/diagnosis
- Neoplasms, Second Primary/drug therapy
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Sulfonamides
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Affiliation(s)
- Marko Lucijanic
- Hematology Department, University Hospital Dubrava, Av. Gojka Suska 6, 10000, Zagreb, Croatia.
- School of Medicine, University of Zagreb, Zagreb, Croatia.
| | - Cedna Tomasovic-Loncaric
- Pathology and Cytology Department, University Hospital Dubrava, Zagreb, Croatia
- Catholic University of Croatia, Zagreb, Croatia
| | - Tajana Stoos-Veic
- Pathology and Cytology Department, University Hospital Dubrava, Zagreb, Croatia
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Tomislav De Both
- Urology Department, University Hospital Dubrava, Zagreb, Croatia
| | - Barbara Jalsenjak
- Hematology Department, University Hospital Dubrava, Av. Gojka Suska 6, 10000, Zagreb, Croatia
| | - Rajko Kusec
- Hematology Department, University Hospital Dubrava, Av. Gojka Suska 6, 10000, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
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Lucijanic M, Krecak I, Soric E, Sabljic A, Galusic D, Holik H, Perisa V, Peric MM, Zekanovic I, Kusec R. Higher estimated plasma volume status is associated with increased thrombotic risk and impaired survival in patients with primary myelofibrosis. Biochem Med (Zagreb) 2023; 33:020901. [PMID: 37143717 PMCID: PMC10152616 DOI: 10.11613/bm.2023.020901] [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: 10/05/2022] [Accepted: 02/02/2023] [Indexed: 05/06/2023] Open
Abstract
Introduction Blood plasma represents a large reservoir of cytokines and other mediators of inflammation. Higher estimated plasma volume status (ePVS) has been shown to correlate with increased thrombotic risk in polycythemia vera patients, but its clinical and prognostic associations in patients with myelofibrosis are unknown which we aim to evaluate in this study. Materials and methods We retrospectively analysed a multicentric cohort of 238 patients with primary (PMF) and secondary myelofibrosis (SMF). Estimated plasma volume status was calculated using the Strauss-derived Duarte formula. Overall survival (OS) and time to thrombosis (TTT) considering both arterial and venous thromboses were primary endpoints of interest. Results Median ePVS was 5.8 dL/g and it did not significantly differ between PMF and SMF patients. Patients with more advanced disease features, more pronounced inflammation and higher comorbidity burden had higher ePVS. Higher ePVS (> 5.6 dL/g) was associated with shorter OS in PMF (unadjusted hazard ratio, HR = 2.8, 95% confidence interval, CI (1.79-4.41), P < 0.001) and SMF (unadjusted HR = 2.55, 95% CI (1.1-5.71), P =0.025) and with shorter TTT in PMF (> 7 dL/g, unadjusted HR = 4.1, 95% CI (1.44-11.59), P = 0.009) patients. Associations with OS diminished in multivariate analyses after adjustments for the dynamic-international-prognostic-scoring-system (DIPSS) and myelofibrosis-secondary-to-PV-and ET-prognostic-model (MYSEC-PM), respectively. Association with TTT remained significant independently of JAK2 mutation, white blood cell count and chronic kidney disease. Conclusions Myelofibrosis patients with more advanced disease features and more pronounced inflammation have higher ePVS, indicative of expanded plasma volume. Higher ePVS is associated with impaired survival in PMF and SMF and higher thrombotic risk in PMF patients.
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Affiliation(s)
- Marko Lucijanic
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia
- University of Zagreb School of Medicine, Zagreb, Croatia
- Corresponding author:
| | - Ivan Krecak
- Department of Internal Medicine, General Hospital Sibenik, Sibenik, Croatia
- University of Rijeka School of Medicine, Rijeka, Croatia
| | - Ena Soric
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia
| | - Anica Sabljic
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia
| | - Davor Galusic
- Department of Hematology, University Hospital Center Split, Split, Croatia
- University of Split School of Medicine, Split, Croatia
| | - Hrvoje Holik
- Department of Internal Medicine, “Dr. Josip Bencevic” General Hospital, Slavonski Brod, Croatia
- University of Osijek Faculty of Medicine, Osijek, Croatia
| | - Vlatka Perisa
- University of Osijek Faculty of Medicine, Osijek, Croatia
- Department of Hematology, Osijek University Hospital, Osijek, Croatia
| | | | - Ivan Zekanovic
- Department of Internal Medicine, General Hospital Zadar, Zadar, Croatia
| | - Rajko Kusec
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia
- University of Zagreb School of Medicine, Zagreb, Croatia
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Lucijanic M, Veic P, Aric I, Tupek KM, Soric E, Sabljic A, Vlasac Glasnovic J, Stoos-Veic T, Krecak I, Kusec R. Higher JAK2 V617F mutant allele burden in patients with chronic myeloproliferative neoplasms is associated with a higher prevalence of chronic kidney disease and unfavorable dynamics of kidney function over time. Ann Hematol 2023:10.1007/s00277-023-05305-3. [PMID: 37269389 DOI: 10.1007/s00277-023-05305-3] [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: 03/12/2023] [Accepted: 05/27/2023] [Indexed: 06/05/2023]
Affiliation(s)
- Marko Lucijanic
- Hematology Department, University Hospital Dubrava, Av. Gojka Suska 6, 10000, Zagreb, Croatia.
- Internal Medicine Department, School of Medicine, University of Zagreb, Salata 3, 10000, Zagreb, Croatia.
| | - Petra Veic
- Internal Medicine Department, School of Medicine, University of Zagreb, Salata 3, 10000, Zagreb, Croatia
| | - Ivona Aric
- Clinical Department of Laboratory Diagnostics, University Hospital Dubrava, Zagreb, Croatia
| | - Katarina Marija Tupek
- Clinical Department of Laboratory Diagnostics, University Hospital Dubrava, Zagreb, Croatia
| | - Ena Soric
- Hematology Department, University Hospital Dubrava, Av. Gojka Suska 6, 10000, Zagreb, Croatia
| | - Anica Sabljic
- Hematology Department, University Hospital Dubrava, Av. Gojka Suska 6, 10000, Zagreb, Croatia
| | - Josipa Vlasac Glasnovic
- Hematology Department, University Hospital Dubrava, Av. Gojka Suska 6, 10000, Zagreb, Croatia
| | - Tajana Stoos-Veic
- Pathology and Cytology Department, University Hospital Dubrava, Zagreb, Croatia
| | - Ivan Krecak
- Department of Internal Medicine, General Hospital of Sibenik-Knin County, Sibenik, Croatia
- Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Rajko Kusec
- Hematology Department, University Hospital Dubrava, Av. Gojka Suska 6, 10000, Zagreb, Croatia
- Internal Medicine Department, School of Medicine, University of Zagreb, Salata 3, 10000, Zagreb, Croatia
- Clinical Department of Laboratory Diagnostics, University Hospital Dubrava, Zagreb, Croatia
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Lucijanic M, Krecak I, Soric E, Galusic D, Holik H, Perisa V, Moric Peric M, Zekanovic I, Kusec R. Palpable spleen size is differently prognostic in primary and secondary myelofibrosis. Leuk Lymphoma 2023; 64:893-896. [PMID: 36799562 DOI: 10.1080/10428194.2023.2179360] [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: 02/18/2023]
Affiliation(s)
- Marko Lucijanic
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia.,University of Zagreb School of Medicine, Zagreb, Croatia
| | - Ivan Krecak
- Department of Internal Medicine, General Hospital Sibenik, Sibenik, Croatia.,University of Rijeka School of Medicine, Rijeka
| | - Ena Soric
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia
| | - Davor Galusic
- Department of Hematology, University Hospital of Split, Split, Croatia.,University of Split School of Medicine, Split, Croatia
| | - Hrvoje Holik
- Department of Internal Medicine, "Dr. Josip Bencevic" General Hospital, Ul. Andrije Stampara, Slavonski Brod, Croatia.,University of Osijek Faculty of Medicine, Osijek, Croatia
| | - Vlatka Perisa
- University of Osijek Faculty of Medicine, Osijek, Croatia.,Department of Hematology, Osijek University Hospital, Osijek, Croatia
| | | | - Ivan Zekanovic
- Department of Internal Medicine, General Hospital Zadar, Zadar, Croatia
| | - Rajko Kusec
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia.,University of Zagreb School of Medicine, Zagreb, Croatia
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Sabljic A, Sedinic Lacko M, Kusec R, Pejsa V, Lucijanic M. No Evident Prognostic Benefit of Statin Use in Diffuse Large B-Cell Lymphoma Patients with Unfavorable Disease Features Treated with R-DA-EPOCH. Pharmacology 2022; 107:623-627. [PMID: 36228590 DOI: 10.1159/000526625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 08/10/2022] [Indexed: 11/19/2022]
Abstract
Recent reports indicate that patients with aggressive non-Hodgkin lymphomas might benefit if concomitantly receiving statins with rituximab, cyclophosphamide, hydroxydaunorubicin, vincristine (Oncovin) and prednisone immunochemotherapy. We retrospectively analyzed a cohort of 130 newly diagnosed diffuse large B-cell lymphomas with unfavorable clinical features treated with first-line rituximab, dose-adjusted etoposide, prednisone, vincristine [Oncovin], cyclophosphamide, hydroxydaunorubicin (R-DA-EPOCH) immunochemotherapy in period 2005-2019. A total of 17/130 (13.1%) patients received statins concomitantly with immunochemotherapy, mostly atorvastatin and in intermediate statin dose intensity. Besides tendency to be associated with older age (p = 0.070), there were no other significant associations of statins use with neither sex, disease stage, R-IPI, or other unfavorable disease features (p > 0.05 for all analyses). Also, no significant differences were present considering feasibility (number of cycles with dose escalation/reduction), toxicity (number of cycles with anemia, thrombocytopenia, neutropenia, febrile neutropenia, and septic complications) nor efficacy (response rates) of R-DA-EPOCH regimen (p > 0.05 for all analyses). Also, statin use had no significant association with neither OS (p = 0.480) nor PFS (p = 0.891). Lack of associations of statin use with relevant clinical outcomes was further corroborated by multivariate analyses.
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Affiliation(s)
- Anica Sabljic
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia
| | | | - Rajko Kusec
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia.,University of Zagreb School of Medicine, Zagreb, Croatia
| | - Vlatko Pejsa
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia.,University of Zagreb School of Medicine, Zagreb, Croatia
| | - Marko Lucijanic
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia.,University of Zagreb School of Medicine, Zagreb, Croatia
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Lucijanic M, Krecak I, Soric E, Sabljic A, Galusic D, Holik H, Perisa V, Peric MM, Zekanovic I, Kusec R. MPN-541 Estimated Plasma Volume Status in Patients With Primary Myelofibrosis and Associated Thrombotic and Mortality Risks. Clin Lymphoma Myeloma Leuk 2022; 22 Suppl 2:S341-S342. [PMID: 36164017 DOI: 10.1016/s2152-2650(22)01467-7] [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] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
CONTEXT Blood plasma experiences substantial changes in both volume and composition in patients with chronic myeloproliferative neoplasms (MPN) and represents a large reservoir of cytokines and other mediators of inflammation. Higher estimated plasma volume status (ePVS) has recently been shown to correlate with increased thrombotic risk in polycythemia vera patients. OBJECTIVE To estimate clinical and prognostic associations of ePVS in patients with myelofibrosis. DESIGN Retrospective cohort study. SETTING 6 hematology centers. PATIENTS 238 myelofibrosis patients, 168 with PMF, 34 with post-PV SMF and 36 with post-ET SMF. INTERVENTIONS ePVS was calculated using the Strauss derived Duarte formula: (100-hematocrit (%)/hemoglobin (g/dL) and expressed as dl/g. MAIN OUTCOME MEASURES Overall survival (OS) and time to thrombosis (TTT). RESULTS Median ePVS was 5.8 dl/g and it did not significantly differ between PMF and SMF patients. Among other associations, higher ePVS was significantly associated with higher degree of bone-marrow fibrosis, absence of JAK2-mutation, lower white blood cells (WBC), platelets and hemoglobin, presence of circulatory blasts, higher C-reactive protein, higher lactate dehydrogenase, lower albumin and higher Charlson comorbidity index in an overall cohort, as well as with more pronounced splenomegaly and higher Dynamic International Prognostic Scoring System (DIPSS) risk in primary myelofibrosis (PMF) and higher Mysec-PM risk in secondary myelofibrosis (SMF) patients (P<0.05 for all analyses). Higher ePVS (>5.6 dl/g) was associated with shorter overall-survival (OS) in PMF (HR=2.8, P<0.001) and SMF (HR=2.55, P=0.025) and with shorter time-to-thrombosis in PMF (>7 dl/g, HR=4.1, P=0.009) patients. Associations with overall survival diminished in multivariate analyses after adjustments for DIPSS and Mysec-PM, respectively. Association with TTT remained significant independently of JAK2, WBC and chronic kidney disease. CONCLUSIONS Myelofibrosis patients with more advanced disease features and more pronounced inflammation have higher ePVS, indicative of expanded plasma volume. Higher ePVS is associated with impaired survival in PMF and SMF and higher thrombotic risk in PMF patients.
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Affiliation(s)
| | | | - Ena Soric
- University hospital Dubrava, Zagreb, Croatia
| | | | | | - Hrvoje Holik
- General hospital Slavonski brod, Slavonski Brod, Croatia
| | | | | | | | - Rajko Kusec
- University hospital Dubrava, Zagreb, Croatia
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Barbui T, Carobbio A, Ghirardi A, Iurlo A, Sobas MA, Elli EM, Rumi E, De Stefano V, Lunghi F, Marchetti M, Daffini R, Gasior Kabat M, Cuevas B, Fox ML, Andrade‐Campos MM, Palandri F, Guglielmelli P, Benevolo G, Harrison C, Foncillas M, Bonifacio M, Alvarez‐Larran A, Kiladjian J, Bolaños Calderón E, Patriarca A, Quiroz Cervantes K, Griesshammer M, Garcia‐Gutierrez V, Marin Sanchez A, Magro Mazo E, Carli G, Hernandez‐Boluda JC, Osorio S, Carreno‐Tarragona G, Sagues Serrano M, Kusec R, Navas Elorza B, Angona A, Xicoy Cirici B, Lopez Abadia E, Koschmieder S, Cattaneo D, Bucelli C, Cichocka E, de Nałęcz AK, Cavalca F, Borsani O, Betti S, Bellini M, Curto‐Garcia N, Rambaldi A, Vannucchi AM. Determinants of early triage for hospitalization in myeloproliferative neoplasm (MPN) patients with COVID-19. Am J Hematol 2022; 97:E470-E473. [PMID: 36111658 PMCID: PMC9538387 DOI: 10.1002/ajh.26732] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 09/08/2022] [Accepted: 09/13/2022] [Indexed: 01/31/2023]
Affiliation(s)
- Tiziano Barbui
- FROM Research FoundationPapa Giovanni XXIII HospitalBergamoItaly
| | | | - Arianna Ghirardi
- FROM Research FoundationPapa Giovanni XXIII HospitalBergamoItaly
| | - Alessandra Iurlo
- Hematology DivisionFoundation IRCCS Ca' Granda Ospedale Maggiore PoliclinicoMilanItaly
| | - Marta Anna Sobas
- Department of Hematology, Blood Neoplasms and Bone Marrow TransplantationWroclaw Medical UniversityWrocławPoland
| | - Elena Maria Elli
- Hematology Division and Bone Marrow Transplant Unit, San Gerardo HospitalASST MonzaMonzaItaly
| | - Elisa Rumi
- Department of molecular medicineUniversity of PaviaPaviaItaly
| | - Valerio De Stefano
- Diagnostic Imaging, Oncological Radiotherapy, and Hematology DepartmentFondazione Universitaria Policlinico A. Gemelli ‐ IRCCS ‐ Catholic University of Sacred Heart of RomeRomeItaly
| | - Francesca Lunghi
- Hematology and BMT UnitUniversity Vita‐Salute San Raffaele, San Raffaele Scientific InstituteMilanItaly
| | - Monia Marchetti
- Division of HematologyAOU SS. Antonio e Biagio e C. ArrigoAlessandriaItaly
| | - Rosa Daffini
- Division of HematologyASST‐Spedali CiviliBresciaItaly
| | | | - Beatriz Cuevas
- Division of HematologyHospital Universitario de BurgosBurgosSpain
| | - Maria Laura Fox
- Department of Hematology, Vall d'Hebron Institute of Oncology (VHIO)Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital CampusBarcelonaSpain
| | | | - Francesca Palandri
- Institute of HematologyIRCCS Azienda Ospedaliero‐Universitaria di BolognaBolognaItaly
| | - Paola Guglielmelli
- Center Research and Innovation of Myeloproliferative Neoplasms (CRIMM), Department of Experimental and Clinical Medicine, Azienda Ospedaliera Universitaria CareggiUniversity of FlorenceFlorenceItaly
| | - Giulia Benevolo
- Hematology UnitAOU Città della Salute e della ScienzaTurinItaly
| | - Claire Harrison
- Department of HaematologyGuy's and St. Thomas' NHS Foundation TrustLondonUK
| | | | | | | | | | | | - Andrea Patriarca
- Division of Hematology, Department of Translational MedicineAOU Maggiore della CaritàNovaraItaly
| | | | - Martin Griesshammer
- University Clinic for Hematology, Oncology, Hemostaseology and Palliative CareJohannes Wesling Medical CenterMindenGermany
| | | | | | - Elena Magro Mazo
- Division of HematologyHospital Universitario Principe de AsturiasAlcalà de Henares (Madrid)Spain
| | | | | | | | | | - Miguel Sagues Serrano
- Division of HematologyICO L'Hospitalet‐Hospital Moises BroggiSant Joan Despì (Barcelona)Spain
| | - Rajko Kusec
- Department of haematology, Clinic of internal medicineUniversity Hospital Dubrava‐School of Medicine University of ZagrebZagrebCroatia
| | | | - Anna Angona
- Division of HematologyICO Girona Hospital Josep TruetaGironaSpain
| | - Blanca Xicoy Cirici
- Division of HematologyICO Hospital Germans Trias i PujolBadalona (Barcelona)Spain
| | - Emma Lopez Abadia
- Division of HematologyHospital General de ElcheElche (Alicante)Spain
| | - Steffen Koschmieder
- Department of Hematology, Oncology, Hemostaseology, and Stem Cell Transplantation, Faculty of MedicineRWTH Aachen UniversityAachenGermany
| | - Daniele Cattaneo
- Hematology DivisionFoundation IRCCS Ca' Granda Ospedale Maggiore PoliclinicoMilanItaly,Department of Oncology and HematologyUniversità degli Studi di MilanoMilanItaly
| | - Cristina Bucelli
- Hematology DivisionFoundation IRCCS Ca' Granda Ospedale Maggiore PoliclinicoMilanItaly
| | - Edyta Cichocka
- Department of Hematology and Bone Marrow TransplantationNicolaus Copernicus HospitalTorunPoland
| | | | - Fabrizio Cavalca
- Hematology Division and Bone Marrow Transplant Unit, San Gerardo HospitalASST MonzaMonzaItaly
| | - Oscar Borsani
- Department of molecular medicineUniversity of PaviaPaviaItaly
| | - Silvia Betti
- Diagnostic Imaging, Oncological Radiotherapy, and Hematology DepartmentFondazione Universitaria Policlinico A. Gemelli ‐ IRCCS ‐ Catholic University of Sacred Heart of RomeRomeItaly
| | - Marta Bellini
- Hematology and Bone Marrow Transplant UnitASST Papa Giovanni XXIIIBergamoItaly
| | | | - Alessandro Rambaldi
- Department of Oncology and HematologyUniversità degli Studi di MilanoMilanItaly,Hematology and Bone Marrow Transplant UnitASST Papa Giovanni XXIIIBergamoItaly
| | - Alessandro Maria Vannucchi
- Center Research and Innovation of Myeloproliferative Neoplasms (CRIMM), Department of Experimental and Clinical Medicine, Azienda Ospedaliera Universitaria CareggiUniversity of FlorenceFlorenceItaly
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Geissler K, Jäger E, Barna A, Gurbisz M, Marschon R, Graf T, Nösslinger T, Pfeilstöcker M, Machherndl-Spandl S, Stauder R, Zebisch A, Sill H, Öhler L, Kusec R, Hoermann G, Valent P. Multistep pathogenesis of chronic myelomonocytic leukemia in patients. Eur J Haematol 2022; 109:50-57. [PMID: 35299281 PMCID: PMC9310570 DOI: 10.1111/ejh.13768] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 03/09/2022] [Accepted: 03/10/2022] [Indexed: 01/01/2023]
Abstract
Background A multistep pathogenesis of myeloid leukemia including mutations in epigenetic, spliceosome, and signaling genes has been recently demonstrated in a preclinical model but is poorly validated in patients. Methods Clinical, phenotypic, and biologic features were compared between three distinct molecularly defined CMML cohorts including TET2 monomutated patients (T, n = 10), TET2/SRSF2 bimutated patients (TS, n = 19), and patients who had NRAS mutations in addition to TET2/SRSF2 comutations (TSN, n = 14). Results Median survival was 90, 45, and 9 months, respectively (p = .001). Whereas no patient in the T and TS group transformed into acute myeloid leukemia (AML), 6/14 patients in the TSN group had AML at study entry or transformed during follow‐up. Leukocyte counts, blast cell counts, and LDH levels were significantly higher in TSN vs. TS and T, respectively, whereas hemoglobin and platelet values were not significantly different. Increased growth factor‐independent myeloid colony formation was restricted to TSN but not found in T and TS, respectively. The proportion of patients showing in vitro myelomonocytic skewing in T, TS, and TSN was 0%, 56%, and 100%, respectively (p = .010). Conclusion Our results demonstrate that the model of multistep pathogenesis in CMML can be recapitulated in patients regarding clinical, phenotypic, and biologic features.
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Affiliation(s)
- Klaus Geissler
- Medical School, Sigmund Freud University, Vienna, Austria.,Department of Internal Medicine V with Hematology, Oncology and Palliative Medicine, Hospital Hietzing, Vienna, Austria
| | - Eva Jäger
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Agnes Barna
- Blood Transfusion Service, Blood Transfusion Service for Upper Austria, Austrian Red Cross, Linz, Austria
| | - Michael Gurbisz
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Renate Marschon
- Laboratory for Molecular and Genetic Diagnostics, Ordensklinikum Linz, Linz, Austria
| | - Temeida Graf
- Department of Internal Medicine V with Hematology, Oncology and Palliative Medicine, Hospital Hietzing, Vienna, Austria
| | - Thomas Nösslinger
- Department of Internal Medicine III, Hanusch Hospital, Vienna, Austria
| | | | - Sigrid Machherndl-Spandl
- Department of Internal Medicine I with Hematology with Stem Cell Transplantation, Hemostaseology and Medical Oncology, Ordensklinikum Linz Barmherzige Schwestern - Elisabethinen, Linz, Austria
| | - Reinhard Stauder
- Internal Medicine V with Hematology and Oncology, Medical University of Innsbruck, Innsbruck, Austria
| | - Armin Zebisch
- Department of Internal Medicine, Division of Hematology, Medical University of Graz, Graz, Austria.,Otto-Loewi Research Center for Vascular Biology, Immunology and Inflammation, Division of Pharmacology, Medical University of Graz, Graz, Austria
| | - Heinz Sill
- Department of Internal Medicine, Division of Hematology, Medical University of Graz, Graz, Austria
| | - Leopold Öhler
- Department of Internal Medicine/Oncology, St. Josef Hospital, Vienna, Austria
| | - Rajko Kusec
- School of Medicine, University of Zagreb, University Hospital Dubrava, Zagreb, Croatia
| | | | - Peter Valent
- Ludwig Boltzmann Institute for Hematology and Oncology (LBI HO), Medical University of Vienna, Vienna, Austria.,Department of Internal Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, Vienna, Austria
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13
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Lucijanic M, Soric E, Lacko MS, Sabljic A, Krecak I, Bistrovic P, Jordan A, Manola S, Jaksic O, Lucijanic T, Derek L, Kusec R. Gradual increase in RDW is similarly prognostic for in-hospital mortality in both anemic and non-anemic COVID-19 patients. J Med Virol 2022; 94:3509-3511. [PMID: 35419812 PMCID: PMC9088494 DOI: 10.1002/jmv.27785] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 04/07/2022] [Accepted: 04/11/2022] [Indexed: 01/09/2023]
Affiliation(s)
- Marko Lucijanic
- Hematology department, University hospital Dubrava, Zagreb, Croatia.,University of Zagreb School of medicine, Zagreb, Croatia
| | - Ena Soric
- Hematology department, University hospital Dubrava, Zagreb, Croatia
| | | | - Anica Sabljic
- Hematology department, University hospital Dubrava, Zagreb, Croatia
| | - Ivan Krecak
- Internal medicine department, General hospital Sibenik, Sibenik, Croatia
| | - Petra Bistrovic
- Cardiology department, University hospital Dubrava, Zagreb, Croatia
| | - Ana Jordan
- Cardiology department, University hospital Dubrava, Zagreb, Croatia
| | - Sime Manola
- University of Zagreb School of medicine, Zagreb, Croatia.,Cardiology department, University hospital Dubrava, Zagreb, Croatia
| | - Ozren Jaksic
- Hematology department, University hospital Dubrava, Zagreb, Croatia.,University of Zagreb School of medicine, Zagreb, Croatia
| | - Tomo Lucijanic
- Endocrinology department, University hospital Dubrava, Zagreb, Croatia
| | - Lovorka Derek
- Laboratory department, University hospital Dubrava, Zagreb, Croatia
| | - Rajko Kusec
- Hematology department, University hospital Dubrava, Zagreb, Croatia.,University of Zagreb School of medicine, Zagreb, Croatia
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14
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Lucijanic M, Krecak I, Kusec R. Renal disease associated with chronic myeloproliferative neoplasms. Expert Rev Hematol 2022; 15:93-96. [DOI: 10.1080/17474086.2022.2039117] [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: 11/04/2022]
Affiliation(s)
- Marko Lucijanic
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia
- University of Zagreb School of Medicine, Zagreb, Croatia
| | - Ivan Krecak
- Department of Internal Medicine, General Hospital of Šibenik-Knin County, Šibenik, Croatia
| | - Rajko Kusec
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia
- University of Zagreb School of Medicine, Zagreb, Croatia
- Division of Molecular Diagnosis and Genetics, Clinical Department of Laboratory Diagnostics, University Hospital Dubrava, Zagreb, Croatia
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15
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Lucijanic M, Huzjan Korunic R, Sedinic M, Kovacevic S, Atic A, Pejsa V, Kusec R. Baseline and progressive adipopenia in newly diagnosed patients with diffuse large B-cell lymphoma with unfavorable features are associated with worse clinical outcomes. Leuk Lymphoma 2022; 63:1556-1565. [PMID: 35105266 DOI: 10.1080/10428194.2022.2034160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
We retrospectively analyzed perirenal and subcutaneous fat thickness and their dynamics from baseline to end-of-treatment computerized-tomography scans in a cohort of 118 newly diagnosed diffuse large B-cell lymphoma (DLBCL) patients with unfavorable features treated with R-DA-EPOCH regimen. Higher revised-international-prognostic-index (R-IPI) score was significantly associated with higher baseline perirenal and lower subcutaneous fat thickness. Up to 51% patients experienced perirenal and 40% subcutaneous fat-tissue loss during immunochemotherapy period. R-DA-EPOCH feasibility, toxicity and obtained response to therapy did not significantly differ regarding baseline perirenal and subcutaneous fat measurements whereas higher number of febrile-neutropenia cycles was associated with more pronounced subcutaneous fat loss. In multivariate-analyses subcutaneous fat loss of ≥6% (hazard-ratio (HR) =4.58, p < 0.001) and achieving response to therapy (HR = 0.03, p < 0.001) predicted overall-survival, and baseline subcutaneous fat thickness ≤24 mm (HR = 3.14, p = 0.023), baseline minimal perirenal fat thickness ≤8 mm (HR = 2.44, p = 0.042) and achieving response to therapy (HR = 0.04, p < 0.001) predicted progression-free-survival independently of each other.
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Affiliation(s)
- Marko Lucijanic
- Department of Hematology, University Hospital Dubrava, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Renata Huzjan Korunic
- School of Medicine, University of Zagreb, Zagreb, Croatia.,Department of Diagnostic and Interventional Radiology, Dubrava University Hospital, Zagreb, Croatia
| | - Martina Sedinic
- Department of Hematology, University Hospital Dubrava, Zagreb, Croatia
| | - Stjepan Kovacevic
- Department of Internal Medicine, General Hospital Slavonski Brod, Slavonski Brod, Croatia
| | - Armin Atic
- Department of Emergency Medicine, University Hospital Dubrava, Zagreb, Croatia
| | - Vlatko Pejsa
- Department of Hematology, University Hospital Dubrava, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Rajko Kusec
- Department of Hematology, University Hospital Dubrava, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
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16
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Lucijanic M, Krecak I, Verstovsek S, Soric E, Galusic D, Holik H, Perisa V, Peric MM, Zekanovic I, Kusec R. Higher red blood cell distribution width predicts thrombosis risk in primary and secondary myelofibrosis. Ann Hematol 2021; 101:1355-1357. [PMID: 34825960 DOI: 10.1007/s00277-021-04724-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 11/07/2021] [Indexed: 10/19/2022]
Affiliation(s)
- Marko Lucijanic
- Hematology Department, University Hospital Dubrava, Av. Gojka Suska 6, 10000, Zagreb, Croatia. .,University of Zagreb School of Medicine, Ul. Salata 3, 10000, Zagreb, Croatia.
| | - Ivan Krecak
- Department of Internal Medicine, General Hospital Sibenik, Ul. Stjepana Radica 83, 22000, Sibenik, Croatia
| | - Srdan Verstovsek
- Department of Leukemia, University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Ena Soric
- Hematology Department, University Hospital Dubrava, Av. Gojka Suska 6, 10000, Zagreb, Croatia
| | - Davor Galusic
- Department of Hematology, University Hospital of Split, Soltanska ul. 1, 21000, Split, Croatia.,School of Medicine, University of Split, Soltanska ul. 2, 21000, Split, Croatia
| | - Hrvoje Holik
- Department of Internal Medicine, Josip Bencevic" General Hospital, Ul. Andrije Štampara, "Dr, 35000, Slavonski Brod, Croatia.,Faculty of Medicine, University of Osijek, Ul. Josipa Huttlera 4, 31000, Osijek, Croatia
| | - Vlatka Perisa
- Faculty of Medicine, University of Osijek, Ul. Josipa Huttlera 4, 31000, Osijek, Croatia.,Department of Hematology, Osijek University Hospital, Ul. Josipa Huttlera 4, 31000, Osijek, Croatia
| | - Martina Moric Peric
- Department of Internal Medicine, General Hospital Zadar, Ul. Boze Pericica 5, 23000, Zadar, Croatia
| | - Ivan Zekanovic
- Department of Internal Medicine, General Hospital Zadar, Ul. Boze Pericica 5, 23000, Zadar, Croatia
| | - Rajko Kusec
- Hematology Department, University Hospital Dubrava, Av. Gojka Suska 6, 10000, Zagreb, Croatia.,University of Zagreb School of Medicine, Ul. Salata 3, 10000, Zagreb, Croatia
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17
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Lucijanic M, Piskac Zivkovic N, Ivic M, Sedinic M, Brkljacic B, Mutvar A, Atic A, Rudan D, Barsic B, Luksic I, Kusec R, Ivanac G. Asymptomatic deep vein thromboses in prolonged hospitalized COVID-19 patients. Wien Klin Wochenschr 2021; 133:1281-1288. [PMID: 34821975 PMCID: PMC8614081 DOI: 10.1007/s00508-021-01973-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 10/18/2021] [Indexed: 12/13/2022]
Abstract
High incidence of venous thromboembolic (VTE) events in coronavirus disease 2019 (COVID-19) patients has been reported despite pharmacologic thromboprophylaxis. We performed prospective bilateral lower extremity ultrasound evaluation of prolonged hospitalized COVID-19 ward patients from our institution without clinical suspicion of deep vein thrombosis (DVT). A total of 102 patient were included in the study. All patients were receiving pharmacologic thromboprophylaxis, the majority in intermediate or therapeutic doses. Asymptomatic DVT was detected in 26/102 (25.5%) patients: 22 had distal and four had proximal DVT, six had bilateral leg involvement. Pulmonary embolism was highly prevalent (17/70, 24.3%) but similarly grouped among patients with and without asymptomatic DVT. In total 37.2% of patients included in the study were recognized as having VTE. Asymptomatic DVT events were more common in intensive care unit (ICU) survivors (60% in postmechanically ventilated ICU survivors, 21.2% in ward patients, 22% in high-flow oxygen treated patients; P = 0.031), in patients with higher modified International Medical Prevention Registry on Venous Thromboembolism (IMPROVE) VTE risk-score (median 3 vs. 2 points with and without DVT; P = 0.021) and higher body temperature on admission (median 38.7 °C vs. 37.7 °C with and without DVT; P = 0.001). No clear associations with Padua VTE risk score, demographic and other clinical characteristics, intensity of thromboprophylaxis, severity of other COVID-19 symptoms, degree of systemic inflammation or D‑dimers on admission were found (P > 0.05 for all analyses). Systematic ultrasound assessment in prolonged hospitalized severe COVID-19 patients prior to hospital discharge is needed, especially in ICU survivors, to timely recognize and appropriately treat patients with asymptomatic DVT.
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Affiliation(s)
- Marko Lucijanic
- Hematology Department, Dubrava University Hospital, Av. Gojka Suska 6, 10000, Zagreb, Croatia.
- Primary respiratory and intensive care center, Dubrava University Hospital, Zagreb, Croatia.
- School of Medicine, University of Zagreb, Zagreb, Croatia.
| | - Nevenka Piskac Zivkovic
- School of Medicine, University of Zagreb, Zagreb, Croatia
- Pulmology Department, Dubrava University Hospital, Zagreb, Croatia
| | - Marija Ivic
- Hematology Department, Dubrava University Hospital, Av. Gojka Suska 6, 10000, Zagreb, Croatia
- Primary respiratory and intensive care center, Dubrava University Hospital, Zagreb, Croatia
| | - Martina Sedinic
- Hematology Department, Dubrava University Hospital, Av. Gojka Suska 6, 10000, Zagreb, Croatia
- Primary respiratory and intensive care center, Dubrava University Hospital, Zagreb, Croatia
| | - Boris Brkljacic
- School of Medicine, University of Zagreb, Zagreb, Croatia
- Department of Diagnostic and Interventional Radiology, Dubrava University Hospital, Zagreb, Croatia
| | - Andrea Mutvar
- Primary respiratory and intensive care center, Dubrava University Hospital, Zagreb, Croatia
- Department of Nuclear Medicine, Dubrava University Hospital, Zagreb, Croatia
| | - Armin Atic
- Primary respiratory and intensive care center, Dubrava University Hospital, Zagreb, Croatia
| | - Diana Rudan
- Primary respiratory and intensive care center, Dubrava University Hospital, Zagreb, Croatia
- Cardiology Department, Dubrava University Hospital, Zagreb, Croatia
- University North, University Centre Varazdin, Varazdin, Croatia
- Catholic University of Croatia, Zagreb, Croatia
| | - Bruno Barsic
- Primary respiratory and intensive care center, Dubrava University Hospital, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Ivica Luksic
- Primary respiratory and intensive care center, Dubrava University Hospital, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
- Department of Maxillofacial Surgery, Dubrava University Hospital, Zagreb, Croatia
| | - Rajko Kusec
- Hematology Department, Dubrava University Hospital, Av. Gojka Suska 6, 10000, Zagreb, Croatia
- Primary respiratory and intensive care center, Dubrava University Hospital, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Gordana Ivanac
- School of Medicine, University of Zagreb, Zagreb, Croatia
- Department of Diagnostic and Interventional Radiology, Dubrava University Hospital, Zagreb, Croatia
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18
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Lucijanic M, Huzjan Korunic R, Sedinic M, Kusec R, Pejsa V. More Pronounced Muscle Loss During Immunochemotherapy is Associated with Worse Clinical Outcomes in Newly Diagnosed Patients with Diffuse Large B-Cell Lymphoma with Unfavorable Features. Ther Clin Risk Manag 2021; 17:1037-1044. [PMID: 34594106 PMCID: PMC8478493 DOI: 10.2147/tcrm.s323749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 08/13/2021] [Indexed: 11/25/2022] Open
Abstract
Introduction Cancer-induced cachexia is associated with poor prognosis in patients with non-Hodgkin lymphoma, but it is unknown how and to what extent curable lymphoma treatments affect the musculoskeletal system. Patients and Methods We retrospectively analyzed 104 newly diagnosed diffuse large B-cell lymphoma (DLBCL) patients with unfavorable disease features treated with the R-DA-EPOCH regimen. Psoas muscle area (PMA) measured at L3 vertebra level was compared between staging (pre-therapy) and revision (end of treatment) computerized tomography (CT) scans. Results Small but significant decline in PMA was observed during the immunochemotherapy period (average loss 5%; P=0.016) with 57.7% of patients experiencing muscle loss. Higher body surface area (OR=17.98 for each m2; P=0.034), number of cycles with dose reduction (OR=2.86 for each cycle; P=0.039) and worse response to therapy (OR=3.09 for each response category; P=0.052) were recognized as independent contributors to the PMA loss in multivariate analysis. One quarter of patients had more pronounced PMA loss (≥21%), which was associated with significantly worse overall and progression-free survival. Both ≥21% PMA loss and non-achieving response to therapy remained independently associated with inferior OS (PMA loss HR=2.98; P=0.016 and achieving response HR=0.04; P<0.001) and PFS (PMA loss HR=3.16; P=0.005 and achieving response HR=0.08; P=0.001) in multivariate analyses. Discussion Muscle loss occurs in approximately half of newly diagnosed DLBCL patients with unfavorable disease features during R-DA-EPOCH immunochemotherapy. If pronounced, this is associated with worse clinical outcomes irrespectively of achieved response to therapy. Muscle loss seems to be mostly affected by the efficacy and tolerability of the regimen.
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Affiliation(s)
- Marko Lucijanic
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia.,University of Zagreb School of Medicine, Zagreb, Croatia
| | - Renata Huzjan Korunic
- University of Zagreb School of Medicine, Zagreb, Croatia.,Radiology Department, University Hospital Dubrava, Zagreb, Croatia
| | - Martina Sedinic
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia
| | - Rajko Kusec
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia.,University of Zagreb School of Medicine, Zagreb, Croatia
| | - Vlatko Pejsa
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia.,University of Zagreb School of Medicine, Zagreb, Croatia
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19
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Machherndl-Spandl S, Jäger E, Barna A, Gurbisz M, Marschon R, Graf T, Graf E, Geissler C, Hoermann G, Nösslinger T, Pfeilstöcker M, Bettelheim P, Zach O, Weltermann A, Heibl S, Thaler J, Zebisch A, Sill H, Stauder R, Webersinke G, Kusec R, Ulsperger E, Schneeweiss B, Öhler L, Germing U, Valent P, Tüchler H, Geissler K. Impact of age on the cumulative risk of transformation in patients with chronic myelomonocytic leukaemia. Eur J Haematol 2021; 107:265-274. [PMID: 33998054 PMCID: PMC8480146 DOI: 10.1111/ejh.13647] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 03/02/2021] [Revised: 05/02/2021] [Accepted: 05/04/2021] [Indexed: 12/19/2022]
Abstract
In older patients with chronic myelomonocytic leukaemia (CMML) and limited life expectancy due to age and or comorbidities, it is particularly important to consider the risk of transformation for individualised treatment decisions. There is limited information on potential differences between younger and older CMML patients regarding the cumulative risk of transformation as well as haematological, molecular and biologic characteristics. We analysed data from the Austrian Biodatabase for CMML (ABCMML) to compare these parameters in 518 CMML patients. Categorisation of patients into 3 age-related groups: <60 years, 60-79 years and ≥80 years, showed a significantly lower risk of transformation at higher age by competing risk analysis, with a 4-year risk of 39%, 23% and 13%, respectively (P < .0001). The lower probability of transformation was associated with a lower percentage of blast cells in the peripheral blood (PB) of older patients. Furthermore, we provide a simple score based on age, PB blasts and platelet counts that allowed us to define subgroups of CMML patients with a different cumulative transformation risk, including a low-risk group with a transformation risk of only 5%. Our findings may facilitate reasonable treatment decisions in elderly patients with CMML.
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Affiliation(s)
- Sigrid Machherndl-Spandl
- Department of Internal Medicine I with Hematology, Stem Cell Transplantation, Hemostasis and Medical Oncology, Ordensklinikum Elisabethinen Hospital, Linz, Austria
| | - Eva Jäger
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Agnes Barna
- Blood Transfusion Service, Blood Transfusion Service for Upper Austria, Austrian Red Cross, Linz, Austria
| | - Michael Gurbisz
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Renate Marschon
- Laboratory for molecular and genetic diagnostics, Ordensklinikum Linz, Linz, Austria
| | - Temeida Graf
- Department of Internal Medicine V with Hematology, Oncology and Palliative Medicine, Hospital Hietzing, Vienna, Austria
| | - Elmir Graf
- Department of Internal Medicine V with Hematology, Oncology and Palliative Medicine, Hospital Hietzing, Vienna, Austria
| | | | - Gregor Hoermann
- MLL Munich Leukemia Laboratory, Munich, Germany.,Ludwig Boltzmann Institute for Hematology and Oncology (LBI HO), Medical University of Vienna, Vienna, Austria
| | - Thomas Nösslinger
- Department of Internal Medicine III, Hanusch Hospital, Vienna, Austria
| | | | - Peter Bettelheim
- Department of Internal Medicine I with Hematology, Stem Cell Transplantation, Hemostasis and Medical Oncology, Ordensklinikum Elisabethinen Hospital, Linz, Austria
| | - Otto Zach
- Laboratory for molecular and genetic diagnostics, Ordensklinikum Linz, Linz, Austria
| | - Ansgar Weltermann
- Department of Internal Medicine I with Hematology, Stem Cell Transplantation, Hemostasis and Medical Oncology, Ordensklinikum Elisabethinen Hospital, Linz, Austria
| | - Sonja Heibl
- Department of Internal Medicine IV, Hospital Wels-Grieskirchen, Wels, Austria
| | - Josef Thaler
- Department of Internal Medicine IV, Hospital Wels-Grieskirchen, Wels, Austria
| | - Armin Zebisch
- Division of Hematology, Medical University of Graz, Graz, Austria.,Otto-Loewi Research Centre for Vascular Biology, Immunology and Inflammation, Division of Pharmacology, Medical University of Graz, Graz, Austria
| | - Heinz Sill
- Division of Hematology, Medical University of Graz, Graz, Austria
| | - Reinhard Stauder
- Internal Medicine V with Hematology and Oncology, Medical University of Innsbruck, Innsbruck, Austria
| | - Gerald Webersinke
- Laboratory for molecular and genetic diagnostics, Ordensklinikum Linz, Linz, Austria
| | - Rajko Kusec
- Internal Medicine V with Hematology and Oncology, Medical University of Innsbruck, Innsbruck, Austria.,School of Medicine, University Hospital Dubrava, University of Zagreb, Zagreb, Croatia
| | - Ernst Ulsperger
- Department of Internal Medicine, Hospital Horn, Horn, Austria
| | - Bruno Schneeweiss
- Department of Internal Medicine, Hospital Kirchdorf, Kirchdorf, Austria
| | - Leopold Öhler
- Department of Internal Medicine/Oncology, St. Josef Hospital, Vienna, Austria
| | - Ulrich Germing
- Department of Hematology, Oncology, and Clinical Immunology, Heinrich-Heine-University, Düsseldorf, Germany
| | - Peter Valent
- Ludwig Boltzmann Institute for Hematology and Oncology (LBI HO), Medical University of Vienna, Vienna, Austria.,Division of Hematology and Hemostaseology, Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria
| | - Heinz Tüchler
- Department of Internal Medicine III, Hanusch Hospital, Vienna, Austria
| | - Klaus Geissler
- Department of Internal Medicine V with Hematology, Oncology and Palliative Medicine, Hospital Hietzing, Vienna, Austria.,Sigmund Freud University, Vienna, Austria
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20
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Lucijanic M, Huzjan Korunic R, Ivic M, Fazlic Dzankic A, Kusec R, Pejsa V. Perirenal and subcutaneous fat differently affect outcomes in newly diagnosed classical Hodgkin lymphoma patients. Hematol Oncol 2021; 39:575-579. [PMID: 33991435 DOI: 10.1002/hon.2887] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 05/05/2021] [Indexed: 11/10/2022]
Affiliation(s)
- Marko Lucijanic
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia.,University of Zagreb, School of Medicine, Zagreb, Croatia
| | - Renata Huzjan Korunic
- University of Zagreb, School of Medicine, Zagreb, Croatia.,Department of Diagnostic and Interventional Radiology, Dubrava University Hospital, Zagreb, Croatia
| | - Marija Ivic
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia
| | | | - Rajko Kusec
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia.,University of Zagreb, School of Medicine, Zagreb, Croatia
| | - Vlatko Pejsa
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia.,University of Zagreb, School of Medicine, Zagreb, Croatia
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21
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Pandzic Jaksic V, Grizelj D, Livun A, Ajduk M, Boscic D, Vlasic A, Marusic M, Gizdic B, Kusec R, Jaksic O. Inflammatory Gene Expression in Neck Perivascular and Subcutaneous Adipose Tissue in Men With Carotid Stenosis. Angiology 2021; 73:234-243. [PMID: 33906471 DOI: 10.1177/00033197211012539] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The inflammatory phenotype of neck adipose tissue (NAT) might reflect its involvement in the pathogenesis of carotid atherosclerosis. We investigated inflammatory gene expression in the subcutaneous and the perivascular (pericarotid) adipose tissue from patients with carotid stenosis (CS) undergoing endarterectomy and a control group of patients without significant carotid atherosclerosis undergoing thyroid surgery. Only male patients were included (n = 13 in each study group). Clinical and biochemical data along with serum leptin, adiponectin, and monocyte chemoattractant protein 1 (MCP-1) were collected. Adipose tissue samples were obtained from both the subcutaneous and pericarotid compartments. Real-time polymerase chain reaction was used to measure gene expression of macrophage markers and adipokines. The CS group had higher subcutaneous and pericarotid visfatin gene expression and higher pericarotid expression of MCP-1 and CD68 genes. The ratio between pericarotid CD206 and CD68 gene expression was similar between study groups. Adiponectin gene expression in both NAT compartments did not differ between groups, but it was negatively associated with body weight. These observations suggest that NAT, and especially the pericarotid compartment, express enhanced inflammatory properties in patients with CS, but the proportion of anti-inflammatory macrophages in advanced atherosclerosis seems to be maintained.
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Affiliation(s)
- Vlatka Pandzic Jaksic
- Department of Endocrinology, Diabetes and Clinical Pharmacology, Dubrava Clinical Hospital, Zagreb, Croatia
| | - Danijela Grizelj
- Department of Cardiology, Dubrava Clinical Hospital, Zagreb, Croatia
| | - Ana Livun
- Department of Laboratory Diagnostics, Dubrava Clinical Hospital, Zagreb, Croatia
| | - Marko Ajduk
- Department of Vascular Surgery, Dubrava Clinical Hospital, Zagreb, Croatia
| | - Drago Boscic
- Department of Otorhinolaryngology, Dubrava Clinical Hospital, Zagreb, Croatia
| | - Ana Vlasic
- Department of Otorhinolaryngology, Dubrava Clinical Hospital, Zagreb, Croatia
| | - Maruska Marusic
- Department of Laboratory Diagnostics, Dubrava Clinical Hospital, Zagreb, Croatia
| | - Branimir Gizdic
- Department of Laboratory Diagnostics, Dubrava Clinical Hospital, Zagreb, Croatia
| | - Rajko Kusec
- Department of Laboratory Diagnostics, Dubrava Clinical Hospital, Zagreb, Croatia.,Department of Hematology, Dubrava Clinical Hospital, Zagreb, Croatia
| | - Ozren Jaksic
- Department of Hematology, Dubrava Clinical Hospital, Zagreb, Croatia
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22
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Lucijanic M, Krecak I, Galusic D, Sedinic M, Holik H, Perisa V, Moric Peric M, Zekanovic I, Stoos-Veic T, Pejsa V, Kusec R. Higher serum uric acid is associated with higher risks of thrombosis and death in patients with primary myelofibrosis. Wien Klin Wochenschr 2021; 134:97-103. [PMID: 33464403 DOI: 10.1007/s00508-020-01802-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Accepted: 12/21/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Serum uric acid (SUA) can promote inflammation and is associated with increased cardiovascular morbidity. Primary (PMF) and secondary myelofibrosis (SMF) are myeloproliferative neoplasms characterized by high cellular turnover and substantial risk of thrombosis and death. METHODS We have retrospectively investigated SUA in 173 patients with myelofibrosis (125 PMF; 48 SMF) and 30 controls. RESULTS The PMF patients had significantly higher SUA in comparison to SMF and controls. In both PMF and SMF higher SUA was significantly associated with arterial hypertension and decreased renal function. Among PMF patients, higher SUA was significantly associated with older age, larger spleen, higher white blood cell counts, higher lactate dehydrogenase, lower immunoglobulin G levels, allopurinol use and non-smoking. Among SMF patients, higher SUA was associated with male sex (P < 0.05 for all analyses). In PMF higher SUA was univariately associated with inferior survival (> 427 μmol/L hazard ratio (HR) = 2.22; P = 0.006) and shorter time to thrombosis (> 444 μmol/L HR = 5.05; P = 0.006), which could be shown separately for arterial (> 380 μmol/L; HR = 4.9; P = 0.013) and venous thromboses (> 530 μmol/L; HR = 17.9; P < 0.001). In multivariate analyses, SUA remained significantly associated with inferior survival independent of the Dynamic International Prognostic Staging System and with shorter time to thrombosis independent of age in PMF patients; however, the prognostic significance of SUA was diminished after including serum creatinine in the models. SUA was not prognostic in SMF patients. CONCLUSION The PMF patients present with higher SUA levels, which are associated with features of more advanced disease and higher risks of arterial and venous thrombosis and death.
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Affiliation(s)
- Marko Lucijanic
- Hematology Department, University Hospital Dubrava, Av. Gojka Suska 6, 10000, Zagreb, Croatia.
- School of Medicine, University of Zagreb, Ul. Salata 3, 10000, Zagreb, Croatia.
| | - Ivan Krecak
- Hematology Department, General Hospital Sibenik, Ul. Stjepana Radića 83, 22000, Sibenik, Croatia
| | - Davor Galusic
- Department of Hematology, University Hospital of Split, Soltanska ul. 1, 21000, Split, Croatia
| | - Martina Sedinic
- Hematology Department, University Hospital Dubrava, Av. Gojka Suska 6, 10000, Zagreb, Croatia
| | - Hrvoje Holik
- Department of Internal Medicine, "Dr. Josip Bencevic" General Hospital, Ul. Andrije Štampara, 35000, Slavonski Brod, Croatia
| | - Vlatka Perisa
- Department of Hematology, Osijek University Hospital, Ul. Josipa Huttlera 4, 31000, Osijek, Croatia
- Faculty of Medicine, University of Osijek, Ul. Josipa Huttlera 4, 31000, Osijek, Croatia
| | - Martina Moric Peric
- Department of Internal Medicine, General Hospital Zadar, Ul. Boze Pericica 5, 23000, Zadar, Croatia
| | - Ivan Zekanovic
- Department of Internal Medicine, General Hospital Zadar, Ul. Boze Pericica 5, 23000, Zadar, Croatia
| | - Tajana Stoos-Veic
- School of Medicine, University of Zagreb, Ul. Salata 3, 10000, Zagreb, Croatia
- Department of Clinical Cytology and Cytometry, University Hospital Dubrava, Av. Gojka Suska 6, 10000, Zagreb, Croatia
| | - Vlatko Pejsa
- Hematology Department, University Hospital Dubrava, Av. Gojka Suska 6, 10000, Zagreb, Croatia
- School of Medicine, University of Zagreb, Ul. Salata 3, 10000, Zagreb, Croatia
| | - Rajko Kusec
- Hematology Department, University Hospital Dubrava, Av. Gojka Suska 6, 10000, Zagreb, Croatia
- School of Medicine, University of Zagreb, Ul. Salata 3, 10000, Zagreb, Croatia
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23
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Lucijanic M, Galusic D, Krecak I, Sedinic M, Holik H, Perisa V, Moric Peric M, Zekanovic I, Stoos-Veic T, Kusec R. Reduced renal function strongly affects survival and thrombosis in patients with myelofibrosis. Ann Hematol 2020; 99:2779-2785. [PMID: 32862283 DOI: 10.1007/s00277-020-04239-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 07/09/2020] [Accepted: 08/26/2020] [Indexed: 01/01/2023]
Abstract
We retrospectively investigated a cohort of 176 myelofibrosis patients (128 primary-PMF; 48 secondary-SMF) from five hematology centers. The presence of chronic kidney disease (CKD) was determined in addition to other clinical characteristics. CKD was present in 26.1% of MF patients and was significantly associated with older age (P < 0.001), higher WBC (P = 0.015), and its subsets (neutrophil, monocyte, and basophil counts), higher platelets (P = 0.001), lower albumin (P = 0.018), higher serum uric acid (P = 0.001), higher LDH (P = 0.022), and the presence of CV risk factors (P = 0.011). There was no significant association with driver mutations, degree of bone marrow fibrosis, PMF/SMF, or DIPSS risk categories (P > 0.05 for all analyses). The presence of CKD was significantly associated with shorter time to arterial (HR = 3.49; P = 0.041) and venous thrombosis (HR = 7.08; P = 0.030) as well as with shorter overall survival (HR 2.08; P = 0.009). In multivariate analyses, CKD (HR = 1.8; P = 0.014) was associated with shorter survival independently of the DIPSS (HR = 2.7; P < 0.001); its effect being more pronounced in lower (HR = 3.56; P = 0.036) than higher DIPSS categories (HR = 2.07; P = 0.023). MF patients with CKD should be candidates for active management aimed at the improvement of renal function. Prospective studies defining the optimal therapeutic approach are highly needed.
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Affiliation(s)
- Marko Lucijanic
- Hematology Department, University Hospital Dubrava, Av. Gojka Suska 6, 10000, Zagreb, Croatia.
| | - Davor Galusic
- Department of Hematology, University Hospital of Split, Soltanska ul. 1, 21000, Split, Croatia
| | - Ivan Krecak
- Hematology Department, General Hospital Sibenik, Ul. Stjepana Radića 83, 22000, Sibenik, Croatia
| | - Martina Sedinic
- Hematology Department, University Hospital Dubrava, Av. Gojka Suska 6, 10000, Zagreb, Croatia
| | - Hrvoje Holik
- Department of Internal Medicine, "Dr. Josip Bencevic" General Hospital, Ul. Andrije Štampara, 35000, Slavonski Brod, Croatia
| | - Vlatka Perisa
- Department of Hematology, Osijek University Hospital, Ul. Josipa Huttlera 4, 31000, Osijek, Croatia.,Faculty of Medicine, University of Osijek, Ul. Josipa Huttlera 4, 31000, Osijek, Croatia
| | - Martina Moric Peric
- Department of Internal Medicine, General Hospital Zadar, Ul. Boze Pericica 5, 23000, Zadar, Croatia
| | - Ivan Zekanovic
- Department of Internal Medicine, General Hospital Zadar, Ul. Boze Pericica 5, 23000, Zadar, Croatia
| | - Tajana Stoos-Veic
- Department of Clinical Cytology and Cytometry, University Hospital Dubrava, Av. Gojka Suska 6, 10000, Zagreb, Croatia.,School of Medicine, University of Zagreb, Ul. Salata 3, 10000, Zagreb, Croatia
| | - Rajko Kusec
- Hematology Department, University Hospital Dubrava, Av. Gojka Suska 6, 10000, Zagreb, Croatia.,School of Medicine, University of Zagreb, Ul. Salata 3, 10000, Zagreb, Croatia
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24
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Lucijanic M, Galusic D, Krecak I, Sedinic M, Soric E, Holik H, Perisa V, Moric Peric M, Zekanovic I, Stoos-Veic T, Kusec R. C reactive protein to albumin ratio as prognostic marker in primary and secondary myelofibrosis. Leuk Lymphoma 2020; 61:2969-2974. [PMID: 32654566 DOI: 10.1080/10428194.2020.1789627] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
We retrospectively investigated C reactive protein to albumin ratio (CAR) in a cohort of 142 patients with myelofibrosis [101 primary (PMF); 41 secondary (SMF)] and compared it to hematological and clinical parameters. Among other associations, higher CAR was significantly associated with higher grade of bone marrow fibrosis, lower frequency of Calreticulin (CALR) mutations, presence of constitutional symptoms, massive splenomegaly, transfusion dependency, blast phase disease, lower hemoglobin, lower platelets, higher ferritin and higher lactate dehydrogenase (LDH) (p < .05 for all analyses). Higher CAR was able to predict inferior survival in PMF independently of DIPSS [hazard ratio (HR)=2.17; p = .015 for high CAR and HR = 2.05; p < .001 for DIPSS] and in SMF independently of Mysec-PM (HR = 6.48; p = .022 for high CAR and HR = 2.63; p = .013 for Mysec-PM) demonstrating its good prognostic potential. CAR seems to be an independent and prognostically relevant parameter, both in PMF and SMF, and might aid in timely recognition of most vulnerable patients.
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Affiliation(s)
- Marko Lucijanic
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia
| | - Davor Galusic
- Department of Hematology, University Hospital of Split, Split, Croatia
| | - Ivan Krecak
- Hematology Department, General Hospital Sibenik, Sibenik, Croatia
| | - Martina Sedinic
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia
| | - Ena Soric
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia
| | - Hrvoje Holik
- Department of Internal Medicine, "Dr. Josip Bencevic" General Hospital, Ul. Andrije Štampara, Slavonski Brod, Croatia
| | - Vlatka Perisa
- Department of Hematology, Osijek University Hospital, Osijek, Croatia.,Faculty of Medicine, University of Osijek, Osijek, Croatia
| | | | - Ivan Zekanovic
- Department of Internal Medicine, General Hospital Zadar, Zadar, Croatia
| | - Tajana Stoos-Veic
- Department of Clinical Cytology and Cytometry, University Hospital Dubrava, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Rajko Kusec
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
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25
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Geissler K, Jäger E, Barna A, Gurbisz M, Graf T, Graf E, Nösslinger T, Pfeilstöcker M, Tüchler H, Sliwa T, Keil F, Geissler C, Heibl S, Thaler J, Machherndl-Spandl S, Zach O, Weltermann A, Bettelheim P, Stauder R, Zebisch A, Sill H, Schwarzinger I, Schneeweiss B, Öhler L, Ulsperger E, Kusec R, Germing U, Sperr WR, Knöbl P, Jäger U, Hörmann G, Valent P. Correlation of RAS-Pathway Mutations and Spontaneous Myeloid Colony Growth with Progression and Transformation in Chronic Myelomonocytic Leukemia-A Retrospective Analysis in 337 Patients. Int J Mol Sci 2020; 21:ijms21083025. [PMID: 32344757 PMCID: PMC7215883 DOI: 10.3390/ijms21083025] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 04/05/2020] [Revised: 04/19/2020] [Accepted: 04/22/2020] [Indexed: 01/07/2023] Open
Abstract
Although the RAS-pathway has been implicated as an important driver in the pathogenesis of chronic myelomonocytic leukemia (CMML) a comprehensive study including molecular and functional analyses in patients with progression and transformation has not been performed. A close correlation between RASopathy gene mutations and spontaneous in vitro myeloid colony (CFU-GM) growth in CMML has been described. Molecular and/or functional analyses were performed in three cohorts of 337 CMML patients: in patients without (A, n = 236) and with (B, n = 61) progression/transformation during follow-up, and in patients already transformed at the time of sampling (C, n = 40 + 26 who were before in B). The frequencies of RAS-pathway mutations (variant allele frequency ≥ 20%) in cohorts A, B, and C were 30%, 47%, and 71% (p < 0.0001), and of high colony growth (≥20/105 peripheral blood mononuclear cells) 31%, 44%, and 80% (p < 0.0001), respectively. Increases in allele burden of RAS-pathway mutations and in numbers of spontaneously formed CFU-GM before and after transformation could be shown in individual patients. Finally, the presence of mutations in RASopathy genes as well as the presence of high colony growth prior to transformation was significantly associated with an increased risk of acute myeloid leukemia (AML) development. Together, RAS-pathway mutations in CMML correlate with an augmented autonomous expansion of neoplastic precursor cells and indicate an increased risk of AML development which may be relevant for targeted treatment strategies.
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MESH Headings
- Cell Transformation, Neoplastic/genetics
- Cell Transformation, Neoplastic/metabolism
- Cytogenetic Analysis
- Disease Progression
- Gene Expression Regulation, Leukemic
- Humans
- Leukemia, Myelomonocytic, Chronic/genetics
- Leukemia, Myelomonocytic, Chronic/metabolism
- Leukemia, Myelomonocytic, Chronic/mortality
- Leukemia, Myelomonocytic, Chronic/pathology
- Mutation
- Neoplasm Staging
- Neoplastic Stem Cells/metabolism
- Prognosis
- Retrospective Studies
- Signal Transduction
- ras Proteins/genetics
- ras Proteins/metabolism
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Affiliation(s)
- Klaus Geissler
- Medical School, Sigmund Freud University, 1020 Vienna, Austria
- Department of Internal Medicine V with Hematology, Oncology and Palliative Medicine, Hospital Hietzing, 1130 Vienna, Austria; (T.G.); (E.G.)
- Correspondence: ; Tel.: +43-01-80110-3122; Fax: +43-01-80110-2671
| | - Eva Jäger
- Department of Laboratory Medicine, Medical University of Vienna, 1090 Vienna, Austria; (E.J.); (M.G.); (I.S.)
| | - Agnes Barna
- Blood Transfusion Service, Blood Transfusion Service for Upper Austria, Austrian Red Cross, 4020 Linz, Austria;
| | - Michael Gurbisz
- Department of Laboratory Medicine, Medical University of Vienna, 1090 Vienna, Austria; (E.J.); (M.G.); (I.S.)
| | - Temeida Graf
- Department of Internal Medicine V with Hematology, Oncology and Palliative Medicine, Hospital Hietzing, 1130 Vienna, Austria; (T.G.); (E.G.)
| | - Elmir Graf
- Department of Internal Medicine V with Hematology, Oncology and Palliative Medicine, Hospital Hietzing, 1130 Vienna, Austria; (T.G.); (E.G.)
| | - Thomas Nösslinger
- Department of Internal Medicine III, Hanusch Hospital, 1140 Vienna, Austria; (T.N.); (M.P.); (H.T.); (T.S.); (F.K.)
| | - Michael Pfeilstöcker
- Department of Internal Medicine III, Hanusch Hospital, 1140 Vienna, Austria; (T.N.); (M.P.); (H.T.); (T.S.); (F.K.)
| | - Heinz Tüchler
- Department of Internal Medicine III, Hanusch Hospital, 1140 Vienna, Austria; (T.N.); (M.P.); (H.T.); (T.S.); (F.K.)
| | - Thamer Sliwa
- Department of Internal Medicine III, Hanusch Hospital, 1140 Vienna, Austria; (T.N.); (M.P.); (H.T.); (T.S.); (F.K.)
| | - Felix Keil
- Department of Internal Medicine III, Hanusch Hospital, 1140 Vienna, Austria; (T.N.); (M.P.); (H.T.); (T.S.); (F.K.)
| | - Christoph Geissler
- Department of Laboratory Medicine, Hospital Hietzing, 1130 Vienna, Austria;
| | - Sonja Heibl
- Department of Internal Medicine IV, Hospital Wels-Grieskirchen, 4600 Wels, Austria; (S.H.); (J.T.)
| | - Josef Thaler
- Department of Internal Medicine IV, Hospital Wels-Grieskirchen, 4600 Wels, Austria; (S.H.); (J.T.)
| | - Sigrid Machherndl-Spandl
- Department of Internal Medicine I with Hematology with Stem Cell Transplantation, Hemostaseology and Medical Oncology, Ordensklinikum Linz Barmherzige Schwestern - Elisabethinen, 4020 Linz, Austria; (S.M.-S.); (O.Z.); (A.W.); (P.B.)
| | - Otto Zach
- Department of Internal Medicine I with Hematology with Stem Cell Transplantation, Hemostaseology and Medical Oncology, Ordensklinikum Linz Barmherzige Schwestern - Elisabethinen, 4020 Linz, Austria; (S.M.-S.); (O.Z.); (A.W.); (P.B.)
| | - Ansgar Weltermann
- Department of Internal Medicine I with Hematology with Stem Cell Transplantation, Hemostaseology and Medical Oncology, Ordensklinikum Linz Barmherzige Schwestern - Elisabethinen, 4020 Linz, Austria; (S.M.-S.); (O.Z.); (A.W.); (P.B.)
| | - Peter Bettelheim
- Department of Internal Medicine I with Hematology with Stem Cell Transplantation, Hemostaseology and Medical Oncology, Ordensklinikum Linz Barmherzige Schwestern - Elisabethinen, 4020 Linz, Austria; (S.M.-S.); (O.Z.); (A.W.); (P.B.)
| | - Reinhard Stauder
- Internal Medicine V with Hematology and Oncology, Medical University of Innsbruck, 6020 Innsbruck, Austria;
| | - Armin Zebisch
- Department of Internal Medicine, Division of Hematology, Medical University of Graz, 8036 Graz, Austria; (A.Z.); (H.S.)
- Otto-Loewi-Research Center for Vascular Biology, Immunology and Inflammation, Division of Pharmacology, Medical University of Graz, 8036 Graz, Austria
| | - Heinz Sill
- Department of Internal Medicine, Division of Hematology, Medical University of Graz, 8036 Graz, Austria; (A.Z.); (H.S.)
| | - Ilse Schwarzinger
- Department of Laboratory Medicine, Medical University of Vienna, 1090 Vienna, Austria; (E.J.); (M.G.); (I.S.)
| | - Bruno Schneeweiss
- Department of Internal Medicine, Hospital Kirchdorf, 4560 Kirchdorf, Austria;
| | - Leopold Öhler
- Department of Internal Medicine/Oncology, St. Josef Hospital, 1130 Vienna, Austria;
| | - Ernst Ulsperger
- Department of Internal Medicine, Hospital Horn, 3580 Horn, Austria;
| | - Rajko Kusec
- School of Medicine, University of Zagreb, University Hospital Dubrava, 10000 Zagreb, Croatia;
| | - Ulrich Germing
- Department of Hematology, Oncology, and Clinical Immunology, Heinrich-Heine-University, 40225 Düsseldorf, Germany;
| | - Wolfgang R. Sperr
- Department of Internal Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, 1090 Vienna, Austria; (W.R.S.); (P.K.); (U.J.); (P.V.)
| | - Paul Knöbl
- Department of Internal Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, 1090 Vienna, Austria; (W.R.S.); (P.K.); (U.J.); (P.V.)
| | - Ulrich Jäger
- Department of Internal Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, 1090 Vienna, Austria; (W.R.S.); (P.K.); (U.J.); (P.V.)
| | - Gregor Hörmann
- Central Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Innsbruck, 6020 Innsbruck, Austria;
| | - Peter Valent
- Department of Internal Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, 1090 Vienna, Austria; (W.R.S.); (P.K.); (U.J.); (P.V.)
- Ludwig Boltzmann Institute for Hematology and Oncology (LBI HO), Medical University of Vienna, 1090 Vienna, Austria
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26
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Galusic D, Lucijanic M, Livun A, Radman M, Blaslov V, Vicelic Cutura L, Petric M, Miljak A, Lucijanic J, Drmic Hofman I, Kusec R. Higher AURKA and PLK1 expression are associated with inferior overall survival in patients with myelofibrosis. Blood Cells Mol Dis 2020; 81:102396. [PMID: 31837568 DOI: 10.1016/j.bcmd.2019.102396] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 12/02/2019] [Accepted: 12/02/2019] [Indexed: 01/28/2023]
Abstract
Aurora-kinase-A (AURKA), BORA and Polo-like-kinase-1 (PLK1) are regulating cell-cycle control and promotion of mitosis entry. AURKA contributes to Janus-kinase-2 (JAK2) activation and increased AURKA protein levels were reported in CD34+ and CD41+ cells of myeloproliferative neoplasm patients, leading to aneuploidy and aberrant megakaryopoiesis. We aimed to investigate AURKA, BORA and PLK1 mRNA expression in unfractionated bone-marrow aspirates of 43 patients with myelofibrosis (28 primary-/PMF, 15 secondary-myelofibrosis/SMF) and 12 controls and to assess their clinical correlations. AURKA expression did not significantly differ between myelofibrosis and controls (P = 0.466). Higher AURKA expression was significantly associated with higher absolute monocyte-count (P = 0.024) and shorter overall survival (HR = 3.77; P = 0.012). Patients with both PMF and SMF had lower BORA expression than controls (P = 0.009). Higher BORA expression was significantly associated with absence of constitutional symptoms (P = 0.049), absence of circulatory blasts (P = 0.047), higher monocyte- (P = 0.040) and higher eosinophil-counts (P = 0.016) and had neutral effect on survival (P > 0.05). PLK1 expression did not significantly differ between myelofibrosis and controls (P = 0.103). Higher PLK1 expression was significantly associated with higher white-blood-cell-count (P = 0.042) and inferior overall survival (HR = 5.87; P = 0.003). In conclusion, AURKA, BORA and PLK1 are involved in pathogenesis of myelofibrosis and may affect survival. Future studies investigating these interesting associations are warranted.
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Affiliation(s)
- Davor Galusic
- Department of Hematology, University Hospital of Split, Soltanska 1, 21000 Split, Croatia
| | - Marko Lucijanic
- Hematology Department, University Hospital Dubrava, Av. Gojka Suska 6, 10000 Zagreb, Croatia
| | - Ana Livun
- Clinical Institute of Laboratory Diagnosis, Division of Molecular Diagnosis and Genetics, University Hospital Dubrava, Av. Gojka Suska 6, 10000 Zagreb, Croatia
| | - Maja Radman
- Department of Endocrinology, University Hospital of Split, Soltanska 1, 21000 Split, Croatia; School of Medicine, University of Split, Soltanska 2, 21000 Split, Croatia
| | - Viktor Blaslov
- Department of Hematology, University Hospital of Split, Soltanska 1, 21000 Split, Croatia
| | - Lucana Vicelic Cutura
- Department of Hematology, University Hospital of Split, Soltanska 1, 21000 Split, Croatia
| | - Marija Petric
- Department of Hematology, University Hospital of Split, Soltanska 1, 21000 Split, Croatia
| | - Antonija Miljak
- Department of Hematology, University Hospital of Split, Soltanska 1, 21000 Split, Croatia
| | - Jelena Lucijanic
- Health Care Center Zagreb-West, Prilaz Baruna Filipovića 11, 10000 Zagreb, Croatia
| | - Irena Drmic Hofman
- School of Medicine, University of Split, Soltanska 2, 21000 Split, Croatia; Department of Pathology, Forensic Medicine and Cytology, University Hospital of Split, Spinciceva 1, 21000 Split, Croatia
| | - Rajko Kusec
- Hematology Department, University Hospital Dubrava, Av. Gojka Suska 6, 10000 Zagreb, Croatia; Clinical Institute of Laboratory Diagnosis, Division of Molecular Diagnosis and Genetics, University Hospital Dubrava, Av. Gojka Suska 6, 10000 Zagreb, Croatia; School of Medicine, University of Zagreb, Salata 3, Zagreb, Croatia.
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27
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Lucijanic M, Livun A, Tupek KM, Stoos-Veic T, Pejsa V, Jonjic Z, Dzankic AF, Ivic M, Kusec R. Neutral effect of Glioma-associated oncogene-1 expression on survival in myelofibrosis. Wien Klin Wochenschr 2019; 132:464-466. [PMID: 31712882 DOI: 10.1007/s00508-019-01572-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 08/13/2019] [Revised: 10/17/2019] [Accepted: 10/18/2019] [Indexed: 11/30/2022]
Abstract
This study retrospectively analyzed glioma-associated oncogene 1 (GLI‑1) mRNA expression in unfractionated bone marrow aspirates of 32 patients with myelofibrosis and 16 controls. It was found that GLI‑1 expression did not significantly differ between primary, secondary myelofibrosis and controls (median difference in threshold cycles ∆CT 7.2, 7.3 and 6.9, respectively; P = 0.864), as well as that survival curves of myelofibrosis patients with higher/lower GLI‑1 expression showed multiple overlaps and overall comparable course (P = 0.651). The results suggest that general upregulation of GLI‑1 does not seem to be a feature of the disease and are in line with modest biological and clinical effects observed with inhibitors of Hedgehog signaling pathway in patients with myelofibrosis.
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Affiliation(s)
- Marko Lucijanic
- Hematology Department, University Hospital Dubrava, Av. Gojka Suska 6, 10000, Zagreb, Croatia.
| | - Ana Livun
- Division of Molecular Diagnosis and Genetics, Clinical Department of Laboratory Diagnostics, University Hospital Dubrava, Zagreb, Croatia
| | - Katarina Marija Tupek
- Division of Molecular Diagnosis and Genetics, Clinical Department of Laboratory Diagnostics, University Hospital Dubrava, Zagreb, Croatia
| | - Tajana Stoos-Veic
- Department of Clinical Cytology and Cytometry, University Hospital Dubrava, Zagreb, Croatia.,Faculty of Medicine, University of Osijek, Osijek, Croatia
| | - Vlatko Pejsa
- Hematology Department, University Hospital Dubrava, Av. Gojka Suska 6, 10000, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Zeljko Jonjic
- Hematology Department, University Hospital Dubrava, Av. Gojka Suska 6, 10000, Zagreb, Croatia
| | | | - Marija Ivic
- Hematology Department, University Hospital Dubrava, Av. Gojka Suska 6, 10000, Zagreb, Croatia
| | - Rajko Kusec
- Hematology Department, University Hospital Dubrava, Av. Gojka Suska 6, 10000, Zagreb, Croatia.,Division of Molecular Diagnosis and Genetics, Clinical Department of Laboratory Diagnostics, University Hospital Dubrava, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
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28
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Lucijanic M, Kusec R. Could haemochromatosis ( HFE) gene mutations affect response to iron chelation in myelodysplastic syndrome? Br J Haematol 2019; 186:640-641. [DOI: 10.1111/bjh.15943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Marko Lucijanic
- Haematology Department University Hospital Dubrava Zagreb Croatia
| | - Rajko Kusec
- Haematology Department University Hospital Dubrava Zagreb Croatia
- School of Medicine University of Zagreb Zagreb Croatia
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29
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Geissler K, Jäger E, Barna A, Gurbisz M, Marschon R, Graf T, Graf E, Borjan B, Jilch R, Geissler C, Hoermann G, Esterbauer H, Schwarzinger I, Nösslinger T, Pfeilstöcker M, Tüchler H, Reisner R, Sliwa T, Keil F, Bettelheim P, Machherndl-Spandl S, Doleschal B, Zach O, Weltermann A, Heibl S, Thaler J, Zebisch A, Sill H, Stauder R, Webersinke G, Petzer A, Kusec R, Ulsperger E, Schneeweiss B, Berger J, Öhler L, Germing U, Sperr WR, Knöbl P, Jäger U, Valent P. The Austrian biodatabase for chronic myelomonocytic leukemia (ABCMML) : A representative and useful real-life data source for further biomedical research. Wien Klin Wochenschr 2019; 131:410-418. [PMID: 31321531 PMCID: PMC6748886 DOI: 10.1007/s00508-019-1526-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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: 04/04/2019] [Revised: 06/11/2019] [Accepted: 06/18/2019] [Indexed: 12/22/2022]
Abstract
In the Austrian biodatabase for chronic myelomonocytic leukemia (ABCMML) clinicolaboratory real-life data have been captured from 606 CMML patients from 14 different hospitals over the last 30 years. It is the only large biodatabase worldwide in which functional methods such as semisolid in vitro cultures complement modern molecular methods such as next generation sequencing. This provides the possibility to comprehensively study the biology of CMML. The aim of this study was to compare patient characteristics with published CMML cohorts and to validate established prognostic parameters in order to examine if this real-life database can serve as a representative and useful data source for further research. After exclusion of patients in transformation characteristics of 531 patients were compared with published CMML cohorts. Median values for age, leukocytes, hemoglobin, platelets, lactate dehydrogenase (LDH) and circulating blasts were within the ranges of reported CMML series. Established prognostic parameters including leukocytes, hemoglobin, blasts and adverse cytogenetics were able to discriminate patients with different outcome. Myeloproliferative (MP) as compared to myelodysplastic (MD)-CMML patients had higher values for circulating blasts, LDH, RAS-pathway mutations and for spontaneous myelomonocytic colony growth in vitro as well as more often splenomegaly. This study demonstrates that the patient cohort of the ABCMML shares clinicolaboratory characteristics with reported CMML cohorts from other countries and confirms phenotypic and genotypic differences between MP-CMML and MD-CMML. Therefore, results obtained from molecular and biological analyses using material from the national cohort will also be applicable to other CMML series and thus may have a more general significance.
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Affiliation(s)
- Klaus Geissler
- Sigmund Freud University, Vienna, Austria. .,Department of Internal Medicine V with Hematology, Oncology and Palliative Medicine, Hospital Hietzing, Wolkersbergenstraße 1, 1130, Vienna, Austria.
| | - Eva Jäger
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Agnes Barna
- Blood Transfusion Service, Blood Transfusion Service for Upper Austria, Austrian Red Cross, Linz, Austria
| | - Michael Gurbisz
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Renate Marschon
- Department of Internal Medicine I with Hematology with Stem Cell Transplantation, Hemostaseology and Medical Oncology, Ordensklinikum Linz Barmherzige Schwestern - Elisabethinen, Linz, Austria
| | - Temeida Graf
- Department of Internal Medicine V with Hematology, Oncology and Palliative Medicine, Hospital Hietzing, Wolkersbergenstraße 1, 1130, Vienna, Austria
| | - Elmir Graf
- Department of Internal Medicine V with Hematology, Oncology and Palliative Medicine, Hospital Hietzing, Wolkersbergenstraße 1, 1130, Vienna, Austria
| | - Bojana Borjan
- Internal Medicine V with Hematology and Oncology, Medical University of Innsbruck, Innsbruck, Austria
| | - Ruth Jilch
- Department of Laboratory Medicine, Hospital Hietzing, Vienna, Austria
| | | | - Gregor Hoermann
- Central Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Innsbruck, Innsbruck, Austria
| | - Harald Esterbauer
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Ilse Schwarzinger
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Thomas Nösslinger
- Department of Internal Medicine III, Hanusch Hospital, Vienna, Austria
| | | | - Heinz Tüchler
- Department of Internal Medicine III, Hanusch Hospital, Vienna, Austria
| | - Regina Reisner
- Department of Internal Medicine III, Hanusch Hospital, Vienna, Austria
| | - Thamer Sliwa
- Department of Internal Medicine III, Hanusch Hospital, Vienna, Austria
| | - Felix Keil
- Department of Internal Medicine III, Hanusch Hospital, Vienna, Austria
| | - Peter Bettelheim
- Department of Internal Medicine I with Hematology with Stem Cell Transplantation, Hemostaseology and Medical Oncology, Ordensklinikum Linz Barmherzige Schwestern - Elisabethinen, Linz, Austria
| | - Sigrid Machherndl-Spandl
- Department of Internal Medicine I with Hematology with Stem Cell Transplantation, Hemostaseology and Medical Oncology, Ordensklinikum Linz Barmherzige Schwestern - Elisabethinen, Linz, Austria
| | - Bernhard Doleschal
- Department of Internal Medicine I with Hematology with Stem Cell Transplantation, Hemostaseology and Medical Oncology, Ordensklinikum Linz Barmherzige Schwestern - Elisabethinen, Linz, Austria
| | - Otto Zach
- Department of Internal Medicine I with Hematology with Stem Cell Transplantation, Hemostaseology and Medical Oncology, Ordensklinikum Linz Barmherzige Schwestern - Elisabethinen, Linz, Austria
| | - Ansgar Weltermann
- Department of Internal Medicine I with Hematology with Stem Cell Transplantation, Hemostaseology and Medical Oncology, Ordensklinikum Linz Barmherzige Schwestern - Elisabethinen, Linz, Austria
| | - Sonja Heibl
- Department of Internal Medicine IV, Hospital Wels-Grieskirchen, Wels, Austria
| | - Josef Thaler
- Department of Internal Medicine IV, Hospital Wels-Grieskirchen, Wels, Austria
| | - Armin Zebisch
- Department of Internal Medicine, Division of Hematology, Medical University of Graz, Graz, Austria
| | - Heinz Sill
- Department of Internal Medicine, Division of Hematology, Medical University of Graz, Graz, Austria
| | - Reinhard Stauder
- Internal Medicine V with Hematology and Oncology, Medical University of Innsbruck, Innsbruck, Austria
| | - Gerald Webersinke
- Department of Internal Medicine I with Hematology with Stem Cell Transplantation, Hemostaseology and Medical Oncology, Ordensklinikum Linz Barmherzige Schwestern - Elisabethinen, Linz, Austria
| | - Andreas Petzer
- Department of Internal Medicine I with Hematology with Stem Cell Transplantation, Hemostaseology and Medical Oncology, Ordensklinikum Linz Barmherzige Schwestern - Elisabethinen, Linz, Austria
| | - Rajko Kusec
- School of Medicine, University of Zagreb, University Hospital Dubrava, Zagreb, Croatia
| | - Ernst Ulsperger
- Department of Internal Medicine, Hospital Horn, Horn, Austria
| | - Bruno Schneeweiss
- Department of Internal Medicine, Hospital Kirchdorf, Kirchdorf, Austria
| | - Jörg Berger
- Department of Internal Medicine, Hospital Schwarzach, Schwarzach, Austria
| | - Leopold Öhler
- Department of Internal Medicine/Oncology, St. Josef Hospital, Vienna, Austria
| | - Ulrich Germing
- Department of Hematology, Oncology, and Clinical Immunology, Heinrich-Heine-University, Düsseldorf, Germany
| | - Wolfgang R Sperr
- Department of Internal Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, Vienna, Austria.,Ludwig Boltzmann Institute for Hematology and Oncology (LBI HO), Medical University of Vienna, Vienna, Austria
| | - Paul Knöbl
- Department of Internal Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, Vienna, Austria
| | - Ulrich Jäger
- Department of Internal Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, Vienna, Austria.,Ludwig Boltzmann Institute for Hematology and Oncology (LBI HO), Medical University of Vienna, Vienna, Austria
| | - Peter Valent
- Department of Internal Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, Vienna, Austria.,Ludwig Boltzmann Institute for Hematology and Oncology (LBI HO), Medical University of Vienna, Vienna, Austria
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30
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Asp J, Skov V, Bellosillo B, Kristensen T, Lippert E, Dicker F, Schwarz J, Wojtaszewska M, Palmqvist L, Akiki S, Aggerholm A, Tolstrup Andersen M, Girodon F, Kjær L, Oppliger Leibundgut E, Pancrazzi A, Vorland M, Andrikovics H, Kralovics R, Cassinat B, Coucelo M, Eftimov A, Haslam K, Kusec R, Link-Lenczowska D, Lodé L, Matiakowska K, Naguib D, Navaglia F, Novotny GW, Percy MJ, Sudarikov A, Hermouet S, Pallisgaard N. International external quality assurance of JAK2 V617F quantification. Ann Hematol 2019; 98:1111-1118. [PMID: 30535576 PMCID: PMC6469832 DOI: 10.1007/s00277-018-3570-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 11/11/2018] [Accepted: 11/26/2018] [Indexed: 01/30/2023]
Abstract
External quality assurance (EQA) programs are vital to ensure high quality and standardized results in molecular diagnostics. It is important that EQA for quantitative analysis takes into account the variation in methodology. Results cannot be expected to be more accurate than limits of the technology used, and it is essential to recognize factors causing substantial outlier results. The present study aimed to identify parameters of specific importance for JAK2 V617F quantification by quantitative PCR, using different starting materials, assays, and technical platforms. Sixteen samples were issued to participating laboratories in two EQA rounds. In the first round, 19 laboratories from 11 European countries analyzing JAK2 V617F as part of their routine diagnostics returned results from in-house assays. In the second round, 25 laboratories from 17 countries participated. Despite variations in starting material, assay set-up and instrumentation the laboratories were generally well aligned in the EQA program. However, EQA based on a single technology appears to be a valuable tool to achieve standardization of the quantification of JAK2 V617F allelic burden.
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Affiliation(s)
- Julia Asp
- Department of Clinical Chemistry and Transfusion Medicine, Institute of Biomedicine, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Vibe Skov
- Department of Hematology, Zealand University Hospital, Roskilde, Denmark
| | | | - Thomas Kristensen
- Department of Pathology, Odense University Hospital, Odense, Denmark
| | | | | | - Jiri Schwarz
- Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | - Marzena Wojtaszewska
- Department of Hematology and Bone Marrow Transplantation, Poznan University of Medical Sciences, Poznan, Poland
| | - Lars Palmqvist
- Department of Clinical Chemistry and Transfusion Medicine, Institute of Biomedicine, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Susanna Akiki
- Department of Laboratory Medicine and Pathology, Qatar Rehabilitation Institute (QRI), Hamad Bin Khalifa Medical City (HBKM), Doha, Qatar
| | | | | | | | - Lasse Kjær
- Department of Hematology, Zealand University Hospital, Roskilde, Denmark
| | | | - Alessandro Pancrazzi
- Centro di Ricerca e Innovazione per le Malattie Mieloproliferative (CRIMM), Florence, Italy
| | | | | | - Robert Kralovics
- CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria, and Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria
| | - Bruno Cassinat
- Service de Biologie Cellulaire, AP-HP, Hopital Saint-Louis, Paris, France
| | - Margarida Coucelo
- Clinical Hematology Unit, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Aleksandar Eftimov
- Center for Biomolecular Pharmaceutical Analyses, Faculty of Pharmacy, UKiM, Skopje, Republic of Macedonia
| | | | - Rajko Kusec
- Dubrava University Hospital and Zagreb School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Dorota Link-Lenczowska
- Molecular Diagnostics Laboratory, Hematology Diagnostics Department, Jagiellonian University Hospital, Krakow, Poland
| | - Laurence Lodé
- Hématologie Biologique, CHRU de Montpellier, Montpellier, France
| | | | | | - Filippo Navaglia
- Department of Laboratory Medicine, University - Hospital of Padova, Padova, Italy
| | - Guy Wayne Novotny
- Department of Hematology and Department of Pathology, Molecular Unit, Herlev Hospital, University of Copenhagen, Herlev Ringvej 75, DK-2730, Herlev, Denmark
| | | | | | - Sylvie Hermouet
- Laboratory of Hematology, University Hospital (CHU) Nantes, Nantes, France
- CRCINA, Inserm UMR892 / CNRS UMR6299, Centre de Recherche en Cancérologie et Immunologie Nantes-Angers, Université de Nantes, Nantes, France
| | - Niels Pallisgaard
- Department of Hematology, Zealand University Hospital, Roskilde, Denmark
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31
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Hatalova A, Schwarz J, Gotic M, Penka M, Hrubisko M, Kusec R, Egyed M, Griesshammer M, Podolak-Dawidziak M, Hellmann A, Klymenko S, Niculescu-Mizil E, Petrides PE, Grosicki S, Sever M, Cantoni N, Thiele J, Wolf D, Gisslinger H. Recommendations for the diagnosis and treatment of patients with polycythaemia vera. Eur J Haematol 2018; 101:654-664. [PMID: 30058088 DOI: 10.1111/ejh.13156] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 06/28/2018] [Accepted: 06/28/2018] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To present the Central European Myeloproliferative Neoplasm Organisation (CEMPO) treatment recommendations for polycythaemia vera (PV). METHODS During meetings held from 2015 through 2017, CEMPO discussed PV and its treatment and recent data. RESULTS PV is associated with increased risks of thrombosis/thrombo-haemorrhagic complications, fibrotic progression and leukaemic transformation. Presence of Janus kinase (JAK)-2 gene mutations is a diagnostic marker and standard diagnostic criterion. World Health Organization 2016 diagnostic criteria for PV, focusing on haemoglobin levels and bone marrow morphology, are mandatory. PV therapy aims at managing long-term risks of vascular complications and progression towards transformation to acute myeloid leukaemia and myelodysplastic syndrome. Risk stratification for thrombotic complications guides therapeutic decisions. Low-risk patients are treated first line with low-dose aspirin and phlebotomy. Cytoreduction is considered for low-risk (phlebotomy intolerance, severe/progressive symptoms, cardiovascular risk factors) and high-risk patients. Hydroxyurea is suspected of leukaemogenic potential. IFN-α has demonstrated efficacy in many clinical trials; its pegylated form is best tolerated, enabling less frequent administration than standard interferon. Ropeginterferon alfa-2b has been shown to be more efficacious than hydroxyurea. JAK1/JAK2 inhibitor ruxolitinib is approved for hydroxyurea resistant/intolerant patients. CONCLUSIONS Greater understanding of PV is serving as a platform for new therapy development and treatment response predictors.
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Affiliation(s)
- Antónia Hatalova
- Clinic of Hematology and Blood Transfusion, University Hospital, Faculty of Medicine, Medical School Comenius University, Slovak Medical University, Bratislava, Slovakia
| | - Jiri Schwarz
- Clinical Section, Institute of Hematology and Blood Transfusion, Institute of Clinical and Experimental Hematology, Charles University, Prague, Czechia
| | - Mirjana Gotic
- Clinic for Hematology Clinical Center of Serbia, Medical Faculty University of Belgrade, Belgrade, Serbia
| | - Miroslav Penka
- Department of Clinical Hematology, Masaryk University Hospital, Brno, Czechia
| | - Mikulas Hrubisko
- Clinic of Hematology and Blood Transfusion, University Hospital, Faculty of Medicine, Medical School Comenius University, Slovak Medical University, Bratislava, Slovakia
| | - Rajko Kusec
- Department of Hematology, Dubrava University Hospital, University of Zagreb, Medical School, Zagreb, Croatia
| | - Miklós Egyed
- Department of Hematology, Somogy County Mór Kaposi General Hospital, Kaposvár, Hungary
| | - Martin Griesshammer
- Department of Hematology, Oncology and Palliative Medicine, Johannes Wesling Academic Medical Center, Minden, Germany
- University Clinic for Hematology, Oncology and Palliative Medicine, Johannes Wesling Medical Center Minden, University of Bochum, Bochum, Germany
| | - Maria Podolak-Dawidziak
- Department of Hematology, Blood Neoplasms and Bone Marrow Transplantation, Wróclaw Medical University, Wróclaw, Poland
| | - Andrzej Hellmann
- Department of Hematology and Transplantology, Medical University Hospital, Gdaňsk, Poland
| | - Sergiy Klymenko
- Department of Medical Genetics, State Institution National Research Center for Radiation Medicine of National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine
| | | | - Petro E Petrides
- Hematology Oncology Center Munich, Ludwig-Maximilian's University, Munich, Germany
| | - Sebastian Grosicki
- Department of Cancer Prevention, Public School of Health, Silesian Medical University, Katowice, Poland
| | - Matjaz Sever
- Department of Hematology, University Clinical Center, Ljubljana, Slovenia
| | - Nathan Cantoni
- Division of Hematology, University Clinic of Medicine, Kantonsspital Aarau, Switzerland
| | - Jürgen Thiele
- Institute of Pathology, University of Cologne, Cologne, Germany
| | - Dominik Wolf
- Department of Internal Medicine V, Hematology & Oncology, Innsbruck Medical University, Innsbruck, Austria
- Medical Clinic 3, Oncology, Hematology and Rheumatology, University Hospital of Bonn, Bonn, Germany
| | - Heinz Gisslinger
- Division of Hematology and Blood Coagulation, Department of Internal Medicine I, Medical University of Vienna Hospital, Vienna, Austria
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32
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Lucijanic M, Cicic D, Stoos-Veic T, Pejsa V, Rahelic D, Lucijanic T, Vasilj T, Ivic M, Sedinic M, Kusec R. Combining information on C reactive protein and serum albumin into the Glasgow Prognostic Score strongly discriminates survival of myelofibrosis patients. Blood Cells Mol Dis 2018; 72:14-16. [PMID: 29891442 DOI: 10.1016/j.bcmd.2018.06.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Accepted: 06/05/2018] [Indexed: 10/14/2022]
Affiliation(s)
- Marko Lucijanic
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia.
| | - David Cicic
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia
| | - Tajana Stoos-Veic
- Department of Clinical Cytology and Cytometry, University Hospital Dubrava, Zagreb, Croatia; University of Osijek, Faculty of Medicine, Osijek, Croatia
| | - Vlatko Pejsa
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia; University of Zagreb, School of Medicine, Zagreb, Croatia
| | - Dario Rahelic
- University of Zagreb, School of Medicine, Zagreb, Croatia; Endocrinology, Diabetes and Metabolic Disorders Department, University Hospital Dubrava, Zagreb, Croatia
| | - Tomo Lucijanic
- Endocrinology, Diabetes and Metabolic Disorders Department, University Hospital Dubrava, Zagreb, Croatia
| | - Tamara Vasilj
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia
| | - Marija Ivic
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia
| | - Martina Sedinic
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia
| | - Rajko Kusec
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia; University of Zagreb, School of Medicine, Zagreb, Croatia; Division of Molecular Diagnosis and Genetics, Clinical Department of Laboratory Diagnostics, University Hospital Dubrava, Zagreb, Croatia
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Lucijanic M, Cicic D, Stoos-Veic T, Pejsa V, Lucijanic J, Fazlic Dzankic A, Vlasac Glasnovic J, Soric E, Skelin M, Kusec R. Elevated Neutrophil-to-Lymphocyte-ratio and Platelet-to-Lymphocyte Ratio in Myelofibrosis: Inflammatory Biomarkers or Representatives of Myeloproliferation Itself? Anticancer Res 2018; 38:3157-3163. [PMID: 29715157 DOI: 10.21873/anticanres.12579] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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: 02/28/2018] [Revised: 03/19/2018] [Accepted: 03/20/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM We aimed to investigate clinical associations of inflammatory biomarkers neutrophil-to-lymphocyte-ratio (NLR) and platelet-to-lymphocyte-ratio (PLR) in patients with myelofibrosis, myeloproliferative neoplasm with inflammatory background. PATIENTS AND METHODS We retrospectively analyzed a cohort of 102 myelofibrosis patients. NLR and PLR were assessed in addition to other disease-specific parameters. RESULTS NLR and PLR were significantly higher in myelofibrosis than in healthy controls. Higher NLR was significantly associated with Janus-kinase-2 (JAK2)-mutation, wild-type-Calreticulin (CALR), older age and parameters reflecting increased proliferative potential of disease (higher leukocytes, higher hemoglobin, larger spleen-size), whereas there was no significant association with C-reactive-protein (CRP). Higher PLR was significantly associated with absence of blast-phase-disease, absence of constitutional-symptoms, lower percentage-of-circulatory-blasts, smaller spleen-size and lower CRP. In the Cox-regression-model, higher-NLR (HR=2.76; p=0.004), lower-PLR (HR=1.99; p=0.042) and Dynamic-International-Prognostic-System (DIPSS) (HR=3.26; p<0.001) predicted inferior survival independently of each other. CONCLUSION In the context of myelofibrosis, elevated NLR and PLR are more likely to represent myeloproliferation itself and not necessary the extent of inflammation.
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Affiliation(s)
- Marko Lucijanic
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia
| | - David Cicic
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia
| | - Tajana Stoos-Veic
- Department of Clinical Cytology and Cytometry, University Hospital Dubrava, Zagreb, Croatia.,Faculty of Medicine, University of Osijek, Osijek, Croatia
| | - Vlatko Pejsa
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | | | - Amina Fazlic Dzankic
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia.,Hematology Department, General Hospital Sisak, Sisak, Croatia
| | | | - Ena Soric
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia
| | - Marko Skelin
- Pharmacy Department, General Hospital Sibenik, Sibenik, Croatia
| | - Rajko Kusec
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia.,Divison of Molecular Diagnosis and Genetics, Clinical Department of Laboratory Diagnostics, University Hospital Dubrava, Zagreb, Croatia
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Pandzic Jaksic V, Grizelj D, Livun A, Boscic D, Ajduk M, Kusec R, Jaksic O. Neck adipose tissue - tying ties in metabolic disorders. Horm Mol Biol Clin Investig 2018; 33:/j/hmbci.ahead-of-print/hmbci-2017-0075/hmbci-2017-0075.xml. [PMID: 29425108 DOI: 10.1515/hmbci-2017-0075] [Citation(s) in RCA: 12] [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: 10/30/2017] [Accepted: 01/08/2018] [Indexed: 01/18/2023]
Abstract
Upper body adipose tissue accumulation has been associated with clustering of metabolic disorders and increased cardiovascular risk. Neck circumference (NC) indicated that subcutaneous adipose tissue (SAT) in that region is an independent pathogenic depot that might account for the additional risk missed by visceral adipose tissue (VAT). Neck adipose tissue (NAT) is not only one more ectopic depot but has several particular features that might modulate its metabolic role. Besides a controversial impact on obstructive apnea syndrome, neck fat encompasses carotid arteries as an important perivascular adipose tissue (PVAT) depot. With dysfunctional changes in obesity, physiologic vascular regulation is lost and inflammatory signals accelerate atherogenesis. Unexpected was the discovery of brown and beige adipocytes in the neck of human adults. When stimulated, brown adipose tissue (BAT) dissipates energy through thermogenesis and it is associated with other favorable metabolic effects. Moreover, the neck is the region where the browning mechanism was disclosed. With this unique plastic nature, NAT revealed multiple ties, challenging dynamics and potential new therapeutic targets that might have significant implications on metabolic outcomes and vascular risk.
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Affiliation(s)
- Vlatka Pandzic Jaksic
- Department of Endocrinology, Dubrava University Hospital, Av. G. Šuška 6, 10000 Zagreb, Croatia
| | - Danijela Grizelj
- Department of Cardiology, Dubrava University Hospital, 10000 Zagreb, Croatia
| | - Ana Livun
- Department of Molecular Biology, Dubrava University Hospital, 10000 Zagreb, Croatia
| | - Drago Boscic
- Department of Otorhinolaryngology, Dubrava University Hospital, 10000 Zagreb, Croatia
| | - Marko Ajduk
- Department of Vascular Surgery, Dubrava University Hospital, 10000 Zagreb, Croatia
| | - Rajko Kusec
- Department of Molecular Biology, Dubrava University Hospital, 10000 Zagreb, Croatia
| | - Ozren Jaksic
- Department of Hematology, Dubrava University Hospital, 10000 Zagreb, Croatia
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Lucijanic M, Prka Z, Pejsa V, Stoos-Veic T, Lucijanic J, Kusec R. Prognostic implications of low transferrin saturation in patients with primary myelofibrosis. Leuk Res 2018; 66:89-95. [PMID: 29407589 DOI: 10.1016/j.leukres.2018.01.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 01/15/2018] [Accepted: 01/22/2018] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Transferrin saturation (TSAT) 20% or less is considered to represent functional iron deficiency in the context of malignant disease, phenomenon mediated through inflammatory changes of iron homeostasis. We aimed to investigate clinical and prognostic significance of low TSAT in patients with primary (PMF) and secondary myelofibrosis (SMF), malignant diseases characterized by strong inflammatory milieu. METHODS We retrospectively analyzed 87 patients with myelofibrosis and compared TSAT with disease specific parameters. RESULTS One-third of patients had TSAT ≤20%. Lower TSAT was significantly associated with Janus-kinase-2 (JAK2) mutation (P = 0.007), transfusion independency (P = 0.003), higher platelets (P = 0.004), lower mean-corpuscular-volume (P < 0.001), lower ferritin (P < 0.001), higher absolute-neutrophil-count (P = 0.027), lower absolute-lymphocyte-count (P = 0.041) and lower albumin (P = 0.018). PMF patients presenting with low TSAT (≤20%) experienced significantly shorter overall-survival (OS) (HR = 2.43; P = 0.017), whereas TSAT did not affect OS of SMF patients (HR = 1.48; P = 0.623). Low TSAT remained significantly associated with inferior OS in PMF in a series of multivariate Cox regression models comparing its properties to anemia, transfusion dependency, ferritin and Dynamic-International-Prognostic-System (DIPSS). CONCLUSIONS Low TSAT has detrimental effect on survival of PMF patients. This effect is independent of anemia and of ferritin levels that seem to be better at representing iron overload in PMF patients.
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Affiliation(s)
- Marko Lucijanic
- Hematology Department, University Hospital Dubrava, Av. Gojka Suska 6, 10000 Zagreb, Croatia.
| | - Zeljko Prka
- School of Medicine, University of Zagreb, Salata 3, 10000 Zagreb, Croatia
| | - Vlatko Pejsa
- Hematology Department, University Hospital Dubrava, Av. Gojka Suska 6, 10000 Zagreb, Croatia; School of Medicine, University of Zagreb, Salata 3, 10000 Zagreb, Croatia
| | - Tajana Stoos-Veic
- Department of Clinical Cytology and Cytometry, University Hospital Dubrava, Av. Gojka Suska 6, 10000 Zagreb, Croatia; Faculty of Medicine, University of Osijek, Ul. Josipa Huttlera 4, 31000 Osijek, Croatia
| | - Jelena Lucijanic
- Health Care Center Zagreb-West, Prilaz baruna Filipovica 11, 10000 Zagreb, Croatia
| | - Rajko Kusec
- Hematology Department, University Hospital Dubrava, Av. Gojka Suska 6, 10000 Zagreb, Croatia; School of Medicine, University of Zagreb, Salata 3, 10000 Zagreb, Croatia; Divison of Molecular Diagnosis and Genetics, Clinical Department of Laboratory Diagnostics, University Hospital Dubrava, Av. Gojka Suska 6, 10000 Zagreb, Croatia
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Lucijanic M, Mitrovic Z, Cicic D, Prka Z, Pejsa V, Livun A, Stoos-Veic T, Romic Z, Zivkovic M, Lucijanic I, Fabris Z, Kusec R. Increased mean platelet volume (MPV) is an independent predictor of inferior survival in patients with primary and secondary myelofibrosis. Int J Hematol 2017; 107:166-172. [PMID: 29022201 DOI: 10.1007/s12185-017-2348-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 09/27/2017] [Accepted: 10/02/2017] [Indexed: 11/28/2022]
Abstract
Neoplastic megakaryopoiesis is a dominant feature of Philadelphia-chromosome-negative myeloproliferative neoplasms (Ph- MPNs), and elevated mean-platelet-volume (MPV) is a common finding in these diseases. The clinical and prognostic significances of MPV in patients with primary (PMF) and secondary myelofibrosis (SMF) have not been reported. We retrospectively analyzed 87 patients with myelofibrosis (66 with PMF, 21 with SMF) treated at our institution. MPV was recorded in addition to other hematological and clinical parameters. MPV was elevated in both PMF and SMF patients in comparison to controls, whereas there was no statistically significant difference between PMF and SMF. Elevated MPV was associated with lower platelets (P = 0.016), higher white blood cells (P = 0.015), higher percentage of circulatory blasts (P = 0.009), higher lactate dehydrogenase (P = 0.011), larger spleen size (P = 0.014) and higher Dynamic International Prognostic score category (P = 0.027), while there was no statistically significant association with driver mutations or degree of bone marrow fibrosis. Higher MPV was univariately associated with inferior overall survival in the whole cohort (HR = 3.82, P = 0.006), PMF (HR = 4.35, P = 0.007) and SMF patients (HR = 7.22, P = 0.034). These associations remained significant in multivariate analyses adjusted for DIPSS. Higher MPV is associated with more aggressive disease features and exhibits powerful independent prognostic properties in both PMF and SMF settings.
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Affiliation(s)
- Marko Lucijanic
- Hematology Department, University Hospital Dubrava, Av. Gojka Suska 6, 10000, Zagreb, Croatia.
| | - Zdravko Mitrovic
- Hematology Department, University Hospital Dubrava, Av. Gojka Suska 6, 10000, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - David Cicic
- Hematology Department, University Hospital Dubrava, Av. Gojka Suska 6, 10000, Zagreb, Croatia
| | - Zeljko Prka
- Hematology Department, University Hospital Dubrava, Av. Gojka Suska 6, 10000, Zagreb, Croatia
| | - Vlatko Pejsa
- Hematology Department, University Hospital Dubrava, Av. Gojka Suska 6, 10000, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Ana Livun
- Division of Molecular Diagnosis and Genetics, Clinical Department of Laboratory Diagnostics, University Hospital Dubrava, Zagreb, Croatia
| | - Tajana Stoos-Veic
- Department of Clinical Cytology and Cytometry, University Hospital Dubrava, Zagreb, Croatia.,Faculty of Medicine, University of Osijek, Osijek, Croatia
| | - Zeljko Romic
- Clinical Department of Laboratory Diagnostics, University Hospital Dubrava, Zagreb, Croatia
| | - Marcela Zivkovic
- Clinical Department of Laboratory Diagnostics, University Hospital Dubrava, Zagreb, Croatia
| | - Iva Lucijanic
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Zrinka Fabris
- Radiology Department, General Hospital Dubrovnik, Dubrovnik, Croatia
| | - Rajko Kusec
- Hematology Department, University Hospital Dubrava, Av. Gojka Suska 6, 10000, Zagreb, Croatia.,Division of Molecular Diagnosis and Genetics, Clinical Department of Laboratory Diagnostics, University Hospital Dubrava, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
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Lucijanic M, Livun A, Stoos-Veic T, Pejsa V, Jaksic O, Cicic D, Lucijanic J, Romic Z, Orehovec B, Aralica G, Miletic M, Kusec R. High absolute basophil count is a powerful independent predictor of inferior overall survival in patients with primary myelofibrosis. Hematology 2017; 23:201-207. [PMID: 28906207 DOI: 10.1080/10245332.2017.1376843] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Marko Lucijanic
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia
| | - Ana Livun
- Divison of Molecular Diagnosis and Genetics, Clinical Department of Laboratory Diagnostics, University Hospital Dubrava, Zagreb, Croatia
| | - Tajana Stoos-Veic
- Department of Clinical Cytology and Cytometry, University Hospital Dubrava, Zagreb, Croatia
- Faculty of Medicine, University of Osijek, Osijek, Croatia
| | - Vlatko Pejsa
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Ozren Jaksic
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - David Cicic
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia
| | | | - Zeljko Romic
- Clinical Department of Laboratory Diagnostics, University Hospital Dubrava, Zagreb, Croatia
| | - Biserka Orehovec
- Clinical Department of Laboratory Diagnostics, University Hospital Dubrava, Zagreb, Croatia
| | - Gorana Aralica
- School of Medicine, University of Zagreb, Zagreb, Croatia
- Pathology Department, University Hospital Dubrava, Zagreb, Croatia
| | - Marko Miletic
- Radiology Department, General Hospital Dubrovnik, Dubrovnik, Croatia
| | - Rajko Kusec
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia
- Divison of Molecular Diagnosis and Genetics, Clinical Department of Laboratory Diagnostics, University Hospital Dubrava, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
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Zivko M, Galesic K, Kusec R, Laganovic M, Jelakovic B. SP029ARTERIAL STIFFNESS IN PATIENTS WITH END STAGE RENAL DISEASE-ASSOCIATION WITH THE ANGIOTENSIN CONVERTING ENZYME (ACE) GENE POLYMORPHISM. Nephrol Dial Transplant 2017. [DOI: 10.1093/ndt/gfx138.sp029] [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: 11/14/2022] Open
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Lucijanic M, Livun A, Tupek KM, Stoos-Veic T, Aralica G, Gecek I, Pejsa V, Kusec R. Heat shock protein 27 (HSP27/HSPB1) expression is increased in patients with primary and secondary myelofibrosis and may be affecting their survival. Leuk Lymphoma 2017; 58:2497-2500. [PMID: 28278711 DOI: 10.1080/10428194.2017.1296146] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Marko Lucijanic
- a Department of Hematology , University Hospital Dubrava , Zagreb , Croatia
| | - Ana Livun
- b Clinical Institute of Laboratory Diagnosis, Division of Molecular Diagnosis and Genetics , University Hospital Dubrava , Zagreb , Croatia
| | - Katarina Marija Tupek
- b Clinical Institute of Laboratory Diagnosis, Division of Molecular Diagnosis and Genetics , University Hospital Dubrava , Zagreb , Croatia
| | - Tajana Stoos-Veic
- c Department of Clinical Cytology and Cytometry , University Hospital Dubrava , Zagreb , Croatia.,d School of Medicine , University of Osijek , Osijek , Croatia
| | - Gorana Aralica
- e Department of Pathology , University Hospital Dubrava , Zagreb , Croatia.,f School of Medicine , University of Zagreb , Zagreb , Croatia
| | - Iva Gecek
- e Department of Pathology , University Hospital Dubrava , Zagreb , Croatia
| | - Vlatko Pejsa
- a Department of Hematology , University Hospital Dubrava , Zagreb , Croatia.,f School of Medicine , University of Zagreb , Zagreb , Croatia
| | - Rajko Kusec
- a Department of Hematology , University Hospital Dubrava , Zagreb , Croatia.,b Clinical Institute of Laboratory Diagnosis, Division of Molecular Diagnosis and Genetics , University Hospital Dubrava , Zagreb , Croatia.,f School of Medicine , University of Zagreb , Zagreb , Croatia
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Lucijanic M, Pejsa V, Jaksic O, Mitrovic Z, Tomasovic-Loncaric C, Stoos-Veic T, Prka Z, Pirsic M, Haris V, Vasilj T, Kusec R. The Degree of Anisocytosis Predicts Survival in Patients with Primary Myelofibrosis. Acta Haematol 2016; 136:98-100. [PMID: 27189016 DOI: 10.1159/000445247] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Accepted: 03/06/2016] [Indexed: 11/19/2022]
Affiliation(s)
- Marko Lucijanic
- Department of Hematology, University Hospital Dubrava, Zagreb, Croatia
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Livun A, Newberry KJ, Manshouri T, Kusec R, Verstovsek S. Genes Involved in Maintaining the Bone Marrow Stroma Are Dysregulated in Patients with Myelofibrosis: Lenalidomide Treatment Up-regulates SOCS3. Anticancer Res 2015; 35:5219-5223. [PMID: 26408680 PMCID: PMC4913273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
AIM The purpose of the present study was to determine whether genes involved in the organization of the hematopoietic niche were dysregulated in patients with primary myelofibrosis (MF) treated with lenalidomide. MATERIALS AND METHODS We used reverse-transcription quantitative polymerase chain reaction to study the expression of a set of genes involved in the organization of the hematopoietic niche in peripheral blood and bone marrow (BM) mononuclear cell (MNC) samples from 32 patients with primary MF who participated in a phase II trial of lenalidomide plus prednisone. RESULTS At baseline (before treatment) cyclo-oxygenase 2 (COX2) was significantly up-regulated, while chemokine (C-X-C motif) receptor 4 (CXCR4), paired box 5 (PAX5) C-terminus, and hypoxia inducible factor 1A (HIF1A) were significantly down-regulated in BM MNCs from patients with primary MF compared to BM MNCs from healthy individuals. After 9 months of treatment, the expression of suppressor of cytokine signaling 3 (SOCS3) was significantly increased. CONCLUSION Patients with primary MF showed aberrant expression of several genes involved in maintaining BM homeostasis and our findings suggest that treatment with lenalidomide plus prednisone up-regulates SOCS3.
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Affiliation(s)
- Ana Livun
- Division of Molecular Diagnostics and Genetics, Department of Laboratory Diagnosis, Dubrava University Hospital, Zagreb, Croatia
| | - Kate J Newberry
- Department of Leukemia, The University of MD Anderson Cancer Center, Houston, TX, U.S.A
| | - Taghi Manshouri
- Department of Leukemia, The University of MD Anderson Cancer Center, Houston, TX, U.S.A
| | - Rajko Kusec
- University of Zagreb, School of Medicine, Zagreb, Croatia
| | - Srdan Verstovsek
- Department of Leukemia, The University of MD Anderson Cancer Center, Houston, TX, U.S.A.
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Lucijanic M, Lasan-Trcic R, Kusec R, Pejsa V, Stoos-Veic T, Jaksic O. Loss of response to azacitidine is associated with deletion 12p13 in a patient with myelodysplastic syndrome with unique translocation t(13;17)(q12;q25) after prior breast cancer and acute promyelocytic leukemia. Ann Hematol 2015; 94:1617-9. [PMID: 26088813 DOI: 10.1007/s00277-015-2428-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Accepted: 06/09/2015] [Indexed: 11/26/2022]
MESH Headings
- Antimetabolites, Antineoplastic/administration & dosage
- Antimetabolites, Antineoplastic/adverse effects
- Azacitidine/administration & dosage
- Azacitidine/adverse effects
- Breast Neoplasms/drug therapy
- Breast Neoplasms/genetics
- Breast Neoplasms/pathology
- Chromosome Deletion
- Chromosomes, Human, Pair 12/genetics
- Chromosomes, Human, Pair 13/genetics
- Drug Resistance, Neoplasm/drug effects
- Drug Resistance, Neoplasm/genetics
- Female
- Humans
- Leukemia, Promyelocytic, Acute/chemically induced
- Leukemia, Promyelocytic, Acute/drug therapy
- Leukemia, Promyelocytic, Acute/genetics
- Leukemia, Promyelocytic, Acute/pathology
- Middle Aged
- Myelodysplastic Syndromes/chemically induced
- Myelodysplastic Syndromes/genetics
- Myelodysplastic Syndromes/pathology
- Neoplasms, Second Primary/drug therapy
- Neoplasms, Second Primary/genetics
- Neoplasms, Second Primary/pathology
- Translocation, Genetic
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Affiliation(s)
- Marko Lucijanic
- Department of Hematology, University Hospital Dubrava, Avenija Gojka Suska 6, 10000, Zagreb, Croatia
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Tadic M, Stoos-Veic T, Kusec R. Endoscopic ultrasound guided fine needle aspiration and useful ancillary methods. World J Gastroenterol 2014; 20:14292-14300. [PMID: 25339816 PMCID: PMC4202358 DOI: 10.3748/wjg.v20.i39.14292] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Revised: 03/22/2014] [Accepted: 07/11/2014] [Indexed: 02/06/2023] Open
Abstract
The role of endoscopic ultrasound (EUS) in evaluating pancreatic pathology has been well documented from the beginning of its clinical use. High spatial resolution and the close proximity to the evaluated organs within the mediastinum and abdominal cavity allow detection of small focal lesions and precise tissue acquisition from suspected lesions within the reach of this method. Fine needle aspiration (FNA) is considered of additional value to EUS and is performed to obtain tissue diagnosis. Tissue acquisition from suspected lesions for cytological or histological analysis allows, not only the differentiation between malignant and non-malignant lesions, but, in most cases, also the accurate distinction between the various types of malignant lesions. It is well documented that the best results are achieved only if an adequate sample is obtained for further analysis, if the material is processed in an appropriate way, and if adequate ancillary methods are performed. This is a multi-step process and could be quite a challenge in some cases. In this article, we discuss the technical aspects of tissue acquisition by EUS-guided-FNA (EUS-FNA), as well as the role of an on-site cytopathologist, various means of specimen processing, and the selection of the appropriate ancillary method for providing an accurate tissue diagnosis and maximizing the yield of this method. The main goal of this review is to alert endosonographers, not only to the different possibilities of tissue acquisition, namely EUS-FNA, but also to bring to their attention the importance of proper sample processing in the evaluation of various lesions in the gastrointestinal tract and other accessible organs. All aspects of tissue acquisition (needles, suction, use of stylet, complications, etc.) have been well discussed lately. Adequate tissue samples enable comprehensive diagnoses, which answer the main clinical questions, thus enabling targeted therapy.
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Mitrović Z, Komljenović I, Jaksic O, Prka Z, Crnek SS, Stojsavljević RA, Pirsic M, Haris V, Kusec R, Dautovic D, Pejsa V. [The use of peripherally inserted central catheter (PICC) in patients with hematological malignancies--a single center experience]. Lijec Vjesn 2014; 136:136-140. [PMID: 25154182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
UNLABELLED AIM. In this study we presented our experience with peripherally inserted central venous catheter (PICC) in patients with hematological malignancies. METHODS In the period from 2009 to 2012, a total of 105 PICCs were inserted in 90 patients. Patients with Non-Hodgkin lymphoma treated with DA-EPOCH comprised almost 40% of the cohort. RESULTS The total PICC in-dwell time was 14781 days with a median of 129 days (range 8-570 days). Malposition of the PICC occurred in 12 patients (11.4%) with a successful reposition or re-insertion. In 39 patients (37%) PICC was removed before the end of treatment due to suspected or proven infection (30 patients, 29%; 2.03 per 1000 PICC days), thrombosis associated with PICC in four patients (3.8%), occlusion of the PICC (two patients), misplaced catheter (two patients), and suspected thromboembolism in a single patient. CONCLUSION PICC is a safe and convenient long-term venous access in patients with hematological malignancies.
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Zivko M, Kusec R, Galesić K. Impact of angiotensin-converting enzyme gene polymorphism on proteinuria and arterial hypertension. Coll Antropol 2013; 37:765-770. [PMID: 24308214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Proteinuria is the hallmark of renal disease. In essential hypertension the onset of de novo proteinuria is associated with faster rate of progression of disease. Some authors have suggested that the DD genotype of the angiotensin-converting enzyme (ACE) gene would be an adverse renal prognosis factor. It may also have different effects on the reduction of proteinuria by ACE inhibitors in patients with proteinuria. Observations on the association between the ACE gene polymorphism and hypertension have been inconsistent, which might be due to ethnic and geographical variations. In this study was to investigated the relationship between ACE gene polymorphism and antiproteinuric effect of ACE inhibitors (ramipril) and to evaluate the possible association between I/D polymorphism and hypertension. We recruited 66 hypertensive patients (male 42, female 24) with overt proteinuria (urinary protein excretion over 500 mg/day). Patients were classified into three groups in accordance with ACE genotypes (17 DD; 35 ID; 14 II). They were treated with ramipril and prospectively followed up for one year. Various clinical parameters including age, body mass index (BMI), 24-h urine protein, creatinine, creatinine clearance (Ccr), systolic and diastolic blood pressure (SBP and DBP), mean arterial pressure (MAP) were measured in the pre- and post-treatment periods. The ACE gene insertion/deletion(I/D) polymorphisms in intron 16 were determined by PCR. Results showed that there were no significant differences in the clinical parameters such as age, gender, serum creatinine, Ccr, SBP, DBP, MAP, and daily urinary excretion of protein among three groups (P > 0.05). ID genotype patients were found to have lower BMI (p = 0.031). ACE inhibition significantly reduced proteinuria in all genotype groups (p < 0.05). The percentage reductions of 24-h urinary excretion of protein were significantly different between the genotype groups (p = 0.042) and for DD genotype were significantly greater than in ID (79.2 +/- 28.9% vs 49.2 +/- 64.8%, P = 0.015). The slope of SBP was the main factor related to the slope of the percentage reduction of proteinuria, however, a significant negative correlation coefficient between these parameters was found (rs = -0.382, p = 0.002). We failed to find significant difference in outcomes of treatments with ACE inhibitor between male and female according the I/D polymorphism of the ACE gene. D allele in the ACE genotype could be a useful genetic marker with important clinical, therapeutic and prognostic implications in recognizing patients with proteinuria that are at greater risk of renal damage.
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Affiliation(s)
- Marijana Zivko
- General Hospital Virovitica, Department of Internal Medicine, Virovitica, Croatia.
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Tomić NG, Marusić S, Bozikov V, Kusec R, Bacić-Vrca V, Tadić M. The relationship between methylenetetrahydrofolate reductase C677T gene polymorphism and diabetic nephropathy in Croatian type 2 diabetic patients. Coll Antropol 2013; 37:789-793. [PMID: 24308218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Methylenetetrahydrofolate reductase (MTHFR) polymorphism has been shown to be associated with the development of diabetic nephropathy in many ethnic groups. In this study, we examined the correlation between MTHFR C677T polymorphism and microalbuminuria in patients with diabetes mellitus type 2 in Croatian patients. 85 patients with diabetes mellitus type 2 were recruited. Patients were classified into two groups--with and without diabetic nephropathy according to urinary albumin excretion rate in urine collected during 24 hours. The C677T genotype was determined by real-time PCR analysis. The genotype frequencies were CC 36.5%, CT 42.3% and TT 21.2% in diabetic patients without nephropathy versus CC 39.4%, CT 45.4% and TT 15.2% in those with nephropathy. There was no statistically significant difference in allele distribution between patients with nephropathy and those without (p = 0.788). Our study did not show a correlation between mutations in the MTHFR gene and diabetic nephropathy in Croatian patients. Diabetic nephropathy is influenced by multiple risk factors which can modify the importance of MTHFR polymorphism in its development.
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Affiliation(s)
- Nives Gojo Tomić
- University of Zagreb, University Hospital Dubrava, Department of Clinical Pharmacology, Zagreb, Croatia.
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Abstract
CD30+ T-cell lymphoproliferative disorders (LD) comprise two main groups of diseases: CD30+ LD of the skin and systemic anaplastic large cell lymphoma (ALCL). The main feature of these disorders is the expression of CD30. We present a patient with an unusual clinical presentation of CD30+ lymphoproliferative disease in a 54-year old Caucasian male who presented with generalized lymphadenopathy and pronounced skin hyperpigmentation. In the lymph nodes and skin, CD30+ lymphoproliferation (ALCL) was diagnosed. The Prussian blue staining identified that the pigment responsible for the skin color was hemosiderin. Chemotherapy was started but the patient's condition progressively worsened and he died a week after the first cycle. The complete color transformation of the entire skin due to hemosiderin accumulation is, to the best of our knowledge, the first reported observation in a CD30+ lymphoproliferation/ALCL patient. We speculate that hemosiderin-loaded macrophages resulted from the paraneoplastic process by some still unknown mechanism.
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Affiliation(s)
- Zeljko Prka
- Department of Internal Medicine, University Hospital Dubrava, Zagreb, Croatia.
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Znaor A, Virag M, Znaor T, Manojlović S, Kusec R. Lifestyle habits and the risk of head and neck cancer in Zagreb region. Coll Antropol 2011; 35:1125-1128. [PMID: 22397248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
In 2002, International Agency for Research on Cancer launched a multicentric case-control study of head and neck cancer in 15 centres in 11 European countries, Croatia included. The Alcohol-related Cancers and Genetic Susceptibility in Europe (ARCAGE) study database with approximately 2500 case-control pairs is currently the largest head and neck cancer patients database in Europe. The aim of the present study was to estimate the risk of smoking and alcohol consumption in head and neck cancer patients from Zagreb region recruited in scope of the ARCAGE study. The cases (45 males, 9 females) and the controls (37 males, 9 females) were recruited from University Hospital Dubrava and Merkur University Hospital. A blood sample and a lifestyle questionnaire were collected from all study subjects. Data were analysed by logistic regression analysis. The distribution of cases was: 43 oral, 9 pharyngeal and 2 laryngeal cancer cases. Ever-smokers had a 4-fold higher cancer risk (adjusted OR 4.3 (CI 1.20-15.4)) compared to never-smokers. The adjusted odds ratio for alcohol consumption more than once a week was 4.1 (CI 1.5-11.2). The results are in keeping with previously published data from other countries.
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Affiliation(s)
- Ariana Znaor
- Croatian National Institute of Public Health, Zagreb, Croatia.
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Labar B, Kusec R, Jaksić B, Skare-Librenjak L, Nacinović-Duletić A, Petricević-Sincić J, Carzavec D, Coha B, Gverić-Krecak V, Corović E, Lang N, Lojen-Nemet Z, Babok-Flegarić R. [Diagnosis and therapy for patients with essential thrombocythemia. Guidelines of Croatian Cooperative Group for hematologic disorders--KROHEM]. Lijec Vjesn 2010; 132:333-339. [PMID: 21294321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Essential thrombocythemia (ET) is a clonal myeloproliferative neoplasm. Croatian Cooperative Group for hematologic disorders, KROHEM proposes the diagnostic and treatment guidelines for ET. Diagnosis of ET is based on the criteria and classification of World Health Organization (WHO). The level of treatment recommendation is based on the UpToDate (web based medical community database) criteria. For ET diagnosis it is mandatory to show sustained increased number of platelets with typical histomorphological changes of megakaryopoiesis in bone marrow. Secondary thrombocytosis and other chronic myeloproliferative neoplasms have to be excluded. Therapy is based on risk factors for ET. The risk factors are number of platelets, patient's age, and the risk levels for thrombosis and bleeding. Patients with low risk (age < 60 years and platelets < 1000 x 10(9)/L) arw not candidates for therapy. In younger group of patients with platelets between 1000 and 1500 x 10(9)/L or more than 1500 x 10(9)/L treatment with anagrelide or hydroxyurea is recommended respectively. In high risk patients hydroxyurea is the first line treatment. Anagrelide is indicated in these patients in the absence of treatment response. Alpha-interferon is recommended for pregnant women with ET and high platelet counts.
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Affiliation(s)
- Boris Labar
- Klinika za unutrasnje bolesti, Medicinski fakultet Sveucilista u Zagrebu, KBC Zagreb.
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Marijanovic I, Marusic Vrsalovic M, Caput Mihalic K, Matic I, Antunovic M, Kusec R, Nagy B. 561 Renin-angiotensin system expression in myeloproliferative diseases. EJC Suppl 2010. [DOI: 10.1016/s1359-6349(10)71362-8] [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
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