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[PMID]:29267674
[Au] Autor:Rodrigues CT; Duarte MAH; Guimarães BM; Vivan RR; Bernardineli N
[Ad] Endereço:Universidade de São Paulo - USP, Bauru School of Dentistry, Department of Dentistry, Endodontics and Dental Materials, Bauru, SP, Brazil.
[Ti] Título:Comparison of two methods of irrigant agitation in the removal of residual filling material in retreatment.
[So] Source:Braz Oral Res;31:e113, 2017 Dec 18.
[Is] ISSN:1807-3107
[Cp] País de publicação:Brazil
[La] Idioma:eng
[Ab] Resumo:The aim of this study was to compare the efficacy of passive ultrasonic irrigation and EasyClean for removing residual filling material in retreatment. Twenty-two maxillary lateral incisors with apical curvature were instrumented with ProTaper files and filled with Endofill using the lateral compactation technique. Removal of filling material was performed with Reciproc, Mtwo and ProDesign Logic 50/.01 files. The teeth were inserted in a silicone mould, which was placed in a metal muffle, and split to visualize the residual filling material. The samples were divided into two groups (n = 11) according to the irrigation protocol: Passive ultrasonic irrigation (PUI group) with 3 activations of 20 seconds and EasyClean (Easy Equipamentos Odontológicos, Belo Horizonte, Brazil) (EC group) used in continuous rotation with 3 activations of 20 seconds, both using NaOCl and EDTA. Environmental scanning electron microscopic images of the apical, middle, and cervical thirds were taken before and after the irrigant activation. The Kappa test was used to determine interexaminer agreement. Statistical analysis was performed using Kruskal-Wallis, Mann-Whitney, and Wilcoxon tests (p < 0.05). PUI and EC improved the removal of remnant filling material in all root canal thirds (p < 0.05). PUI and EC presented similar performance in the final step of retreatment (p > 0.05). No significant difference was observed in the removal of filling material in the apical, middle, and cervical thirds in both groups (p > 0.05). EasyClean in continuous rotary motion is useful in retreatment and was shown to be as effective as ultrasonic activation in the removal of remnant filling material.
[Mh] Termos MeSH primário: Materiais Restauradores do Canal Radicular
Irrigantes do Canal Radicular/química
Tratamento do Canal Radicular/instrumentação
Terapia por Ultrassom/instrumentação
[Mh] Termos MeSH secundário: Seres Humanos
Teste de Materiais
Microscopia Eletrônica de Varredura
Valores de Referência
Reprodutibilidade dos Testes
Retratamento/instrumentação
Irrigantes do Canal Radicular/uso terapêutico
Tratamento do Canal Radicular/métodos
Estatísticas não Paramétricas
Irrigação Terapêutica/instrumentação
Irrigação Terapêutica/métodos
Fatores de Tempo
Terapia por Ultrassom/métodos
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Root Canal Filling Materials); 0 (Root Canal Irrigants)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:D; IM
[Da] Data de entrada para processamento:171222
[St] Status:MEDLINE


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[PMID]:29378530
[Au] Autor:Li Z; Zhang Y; Liao Y; Zeng R; Zeng P; Lan Y
[Ad] Endereço:Department of Ophthalmology, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.
[Ti] Título:Comparison of efficacy between anti-vascular endothelial growth factor (VEGF) and laser treatment in Type-1 and threshold retinopathy of prematurity (ROP).
[So] Source:BMC Ophthalmol;18(1):19, 2018 Jan 30.
[Is] ISSN:1471-2415
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Retinopathy of Prematurity (ROP) is one of the most common causes of childhood blindness worldwide. Comparisons of anti-VEGF and laser treatments in ROP are relatively lacking, and the data are scattered and limited. The objective of this meta-analysis is to compare the efficacy of both treatments in type-1 and threshold ROP. METHODS: A comprehensive literature search on ROP treatment was conducted using PubMed and Embase up to March 2017 in all languages. Major evaluation indexes were extracted from the included studies by two authors. The fixed-effects and random-effects models were used to measure the pooled estimates. The test of heterogeneity was performed using the Q statistic. RESULTS: Ten studies were included in this meta-analysis. Retreatment incidence was significantly increased for anti-VEGF (OR 2.52; 95% CI 1.37 to 4.66; P = 0.003) compared to the laser treatment, while the incidences of eye complications (OR 0.29; 95% CI 0.10 to 0.82; P = 0.02) and myopia were significantly decreased with anti-VEGF compared to the laser treatment. However, there was no difference in the recurrence incidence (OR 1.86; 95% CI 0.37 to 9.40; P = 0.45) and time between treatment and retreatment (WMD 7.54 weeks; 95% CI 2.00 to 17.08; P = 0.12). CONCLUSION: This meta-analysis indicates that laser treatment may be more efficacious than anti-VEGF treatment. However, the results of this meta-analysis also suggest that laser treatment may cause more eye complications and increase myopia. Large-scale prospective RCTs should be performed to assess the efficacy and safety of anti-VEGF versus laser treatment in the future.
[Mh] Termos MeSH primário: Bevacizumab/administração & dosagem
Fotocoagulação a Laser/métodos
Retinopatia da Prematuridade/tratamento farmacológico
Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores
[Mh] Termos MeSH secundário: Inibidores da Angiogênese/administração & dosagem
Seres Humanos
Recém-Nascido
Injeções Intravítreas
Retinopatia da Prematuridade/metabolismo
Retratamento/estatística & dados numéricos
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Nm] Nome de substância:
0 (Angiogenesis Inhibitors); 0 (Vascular Endothelial Growth Factor A); 2S9ZZM9Q9V (Bevacizumab)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180131
[St] Status:MEDLINE
[do] DOI:10.1186/s12886-018-0685-6


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[PMID]:29237360
[Au] Autor:Modaghegh MS; Hafezi S
[Ad] Endereço:1 Vascular and Endovascular Surgery Research Center, Alavi Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
[Ti] Título:Endovascular Treatment of Thromboangiitis Obliterans (Buerger's Disease).
[So] Source:Vasc Endovascular Surg;52(2):124-130, 2018 Feb.
[Is] ISSN:1938-9116
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: When critical limb ischemia (CLI) occurs in patients with thromboangiitis obliterans (TAO) or Buerger's disease, smoking cessation alone may be insufficient to relieve rest pain and promote wound healing. Accordingly, adjunctive measures are warranted to restore adequate blood flow required for limb salvage. This study aimed to evaluate the feasibility and efficacy of percutaneous transluminal angioplasty (PTA) for the treatment of patients with TAO and CLI. In addition, a review of the literature on endovascular management of TAO is included. METHODS: Between April 2012 and June 2017, all patients with TAO and CLI who underwent PTA were studied retrospectively. Patient demographics, presentation, procedural details, and clinical response were recorded. Patients were monitored at 1 week, 1, 2, 3, and 6 months after revascularization and at least every 6 months thereafter. RESULTS: Thirteen patients with TAO and CLI, who presented with rest pain only (n = 1), ischemic ulcer (n = 4), or gangrene (n = 8) underwent endovascular interventions with primary and assisted primary technical success of 85% and 92%, respectively. A below-knee amputation was eventually done in the only patient with technical failure (limb salvage rate: 92%). Following the procedures, 11 patients had clinical response, one of whom also received intra-arterial vasodilator to achieve complete symptom relief. The other patient who failed PTA underwent a successful lumbar sympathectomy. In addition, all ulcers healed and eight minor amputations were performed due to already established gangrene. During follow-up (mean: 19.4 months), four patients needed reintervention. Patients who continued to smoke experienced more severe ischemia ( P = .017) and were more likely to require reintervention ( P = .009). CONCLUSION: Percutaneous transluminal angioplasty can be considered as a technically feasible and potentially effective treatment for patients with TAO and CLI, as well as a last resort for limb salvage when other options have failed. However, reintervention may be required, especially in patients who continue smoking.
[Mh] Termos MeSH primário: Angioplastia com Balão
Tromboangiite Obliterante/terapia
[Mh] Termos MeSH secundário: Adulto
Amputação
Angioplastia com Balão/efeitos adversos
Intervalo Livre de Doença
Estudos de Viabilidade
Feminino
Seres Humanos
Salvamento de Membro
Masculino
Meia-Idade
Retratamento
Estudos Retrospectivos
Fatores de Risco
Fumar/efeitos adversos
Tromboangiite Obliterante/diagnóstico por imagem
Tromboangiite Obliterante/etiologia
Tromboangiite Obliterante/fisiopatologia
Fatores de Tempo
Resultado do Tratamento
Cicatrização
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171215
[St] Status:MEDLINE
[do] DOI:10.1177/1538574417744085


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[PMID]:29193019
[Au] Autor:Arcaini L; Lamy T; Walewski J; Belada D; Mayer J; Radford J; Jurczak W; Morschhauser F; Alexeeva J; Rule S; Cabeçadas J; Campo E; Pileri SA; Biyukov T; Patturajan M; Casadebaig Bravo ML; Trnený M; SPRINT Trial Investigators
[Ad] Endereço:Department of Molecular Medicine, University of Pavia, Pavia, Italy.
[Ti] Título:Prospective subgroup analyses of the randomized MCL-002 (SPRINT) study: lenalidomide versus investigator's choice in relapsed or refractory mantle cell lymphoma.
[So] Source:Br J Haematol;180(2):224-235, 2018 01.
[Is] ISSN:1365-2141
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:In the mantle cell lymphoma (MCL)-002 study, lenalidomide demonstrated significantly improved median progression-free survival (PFS) compared with investigator's choice (IC) in patients with relapsed/refractory MCL. Here we present the long-term follow-up data and results of preplanned subgroup exploratory analyses from MCL-002 to evaluate the potential impact of demographic factors, baseline clinical characteristics and prior therapies on PFS. In MCL-002, patients with relapsed/refractory MCL were randomized 2:1 to receive lenalidomide (25 mg/day orally on days 1-21; 28-day cycles) or single-agent IC therapy (rituximab, gemcitabine, fludarabine, chlorambucil or cytarabine). The intent-to-treat population comprised 254 patients (lenalidomide, n = 170; IC, n = 84). Subgroup analyses of PFS favoured lenalidomide over IC across most characteristics, including risk factors, such as high MCL International Prognostic Index score, age ≥65 years, high lactate dehydrogenase (LDH), stage III/IV disease, high tumour burden, and refractoriness to last prior therapy. By multivariate Cox regression analysis, factors associated with significantly longer PFS (other than lenalidomide treatment) included normal LDH levels (P < 0·001), nonbulky disease (P = 0·045), <3 prior antilymphoma treatments (P = 0·005), and ≥6 months since last prior treatment (P = 0·032). Overall, lenalidomide improved PFS versus single-agent IC therapy in patients with relapsed/refractory MCL, irrespective of many demographic factors, disease characteristics and prior treatment history.
[Mh] Termos MeSH primário: Antineoplásicos/uso terapêutico
Linfoma de Célula do Manto/tratamento farmacológico
Linfoma de Célula do Manto/patologia
Talidomida/análogos & derivados
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Antineoplásicos/administração & dosagem
Antineoplásicos/efeitos adversos
Resistência a Medicamentos Antineoplásicos
Feminino
Seguimentos
Seres Humanos
Estimativa de Kaplan-Meier
Linfoma de Célula do Manto/mortalidade
Masculino
Meia-Idade
Estadiamento de Neoplasias
Modelos de Riscos Proporcionais
Recidiva
Retratamento
Talidomida/administração & dosagem
Talidomida/efeitos adversos
Talidomida/uso terapêutico
Resultado do Tratamento
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Antineoplastic Agents); 4Z8R6ORS6L (Thalidomide); F0P408N6V4 (lenalidomide)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171202
[St] Status:MEDLINE
[do] DOI:10.1111/bjh.15025


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[PMID]:27776351
[Au] Autor:Park JO; Ryoo BY; Yen CJ; Kudo M; Yang L; Abada PB; Cheng R; Orlando M; Zhu AX; Okusaka T
[Ad] Endereço:Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
[Ti] Título:Second-line ramucirumab therapy for advanced hepatocellular carcinoma (REACH): an East Asian and non-East Asian subgroup analysis.
[So] Source:Oncotarget;7(46):75482-75491, 2016 Nov 15.
[Is] ISSN:1949-2553
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: REACH investigated second-line ramucirumab therapy for advanced hepatocellular carcinoma. RESULTS: Median overall survival was 8.2 months for ramucirumab and 6.9 months for placebo (HR, 0.835; 95% CI, 0.634-1.100; p = 0.2046) for East Asians, and 10.1 months for ramucirumab and 8.0 months for placebo (HR, 0.895; 95% CI, 0.690-1.161; p = 0.4023) for non-East Asians. Median overall survival in patients with baseline alpha-fetoprotein ≥ 400 ng/mL was 7.8 months for ramucirumab and 4.2 months for placebo (HR, 0.749; 95% CI, 0.519-1.082; p = 0.1213) for East Asians (n = 139), and 8.2 months for ramucirumab and 4.5 months for placebo (HR, 0.579; 95% CI, 0.371-0.904; p = 0.0149) for non-East Asians (n = 111). The most common grade ≥ 3 treatment-emergent adverse events in East Asians and non-East Asians included hypertension and malignant neoplasm progression. MATERIALS AND METHODS: A post-hoc analysis of East Asians (N = 252) and non-East Asians (N = 313) in the intent-to-treat population was performed. CONCLUSIONS: In East Asians and non-East Asians, ramucirumab did not significantly prolong overall survival. In patients with baseline alpha-fetoprotein ≥ 400 ng/mL, a potentially larger survival benefit was observed in both subgroups. Safety for East Asians was similar to non-East Asians.
[Mh] Termos MeSH primário: Anticorpos Monoclonais/uso terapêutico
Antineoplásicos/uso terapêutico
Carcinoma Hepatocelular/tratamento farmacológico
Carcinoma Hepatocelular/patologia
Neoplasias Hepáticas/tratamento farmacológico
Neoplasias Hepáticas/patologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Anticorpos Monoclonais/administração & dosagem
Anticorpos Monoclonais/efeitos adversos
Antineoplásicos/administração & dosagem
Antineoplásicos/efeitos adversos
Grupo com Ancestrais do Continente Asiático
Carcinoma Hepatocelular/mortalidade
Feminino
Seres Humanos
Estimativa de Kaplan-Meier
Neoplasias Hepáticas/mortalidade
Masculino
Meia-Idade
Estadiamento de Neoplasias
Retratamento
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antibodies, Monoclonal); 0 (Antineoplastic Agents); D99YVK4L0X (ramucirumab)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE
[do] DOI:10.18632/oncotarget.12780


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[PMID]:29265184
[Au] Autor:Cony-Makhoul P; Gardembas M; Coiteux V; Carpentier N; Pommier C; Violet I; Quittet P; Berger MG; TARGET-RMC Investigators
[Ad] Endereço:Centre Hospitalier Annecy Genevois, Pringy, France.
[Ti] Título:Nilotinib after imatinib first-line: a real-life longitudinal cohort of patients with chronic myeloid leukaemia in chronic phase.
[So] Source:Br J Haematol;180(3):356-364, 2018 02.
[Is] ISSN:1365-2141
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:This prospective, observational study enrolled 150 adult patients with chronic myeloid leukaemia (CML) in chronic phase (CP) treated with nilotinib as second-line after imatinib, in a real life setting in France. Two-thirds of patients switched to nilotinib treatment due to lack of imatinib efficacy. Of 146 evaluable patients, 16 (11·0%) (95% confidence interval: 6·4-17·2%) achieved uMR , defined as undetectable molecular disease in cDNA with MR sensitivity (≥10 000 ABL1 transcripts) at 18 months and confirmed at 24 months (primary endpoint). Among patients without major molecular response (MMR) or deep molecular response (DMR) at study entry, 66·3% achieved MMR and 44·2% DMR within a median of 5·7 and 6·24 months, respectively. Fifty-three patients (36·3%) have prematurely terminated the study before 24 months of follow-up, primarily due to nilotinib treatment discontinuation (n = 43; 29·5%), mainly motivated by treatment intolerance (n = 27; 18·5%) and inefficacy (n = 10; 6·8%). The most frequent extra-haematological adverse events (AEs) reported as related to treatment with nilotinib were pruritus (16·4%), asthenia (13·7%) and dry skin (13·0%). Ischaemic cardiovascular AEs were reported in 18 patients (12·3%). This French nationwide large cohort adds valuable information to the body of evidence on the efficiency and safety of nilotinib in the treatment of patients with CP-CML.
[Mh] Termos MeSH primário: Antineoplásicos/uso terapêutico
Leucemia Mieloide de Fase Crônica/tratamento farmacológico
Leucemia Mieloide de Fase Crônica/patologia
Inibidores de Proteínas Quinases/uso terapêutico
Pirimidinas/uso terapêutico
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Antineoplásicos/administração & dosagem
Antineoplásicos/efeitos adversos
Estudos de Coortes
Resistência a Medicamentos Antineoplásicos
Feminino
Proteínas de Fusão bcr-abl/genética
Seres Humanos
Mesilato de Imatinib/administração & dosagem
Mesilato de Imatinib/efeitos adversos
Mesilato de Imatinib/uso terapêutico
Leucemia Mieloide de Fase Crônica/genética
Leucemia Mieloide de Fase Crônica/mortalidade
Estudos Longitudinais
Masculino
Meia-Idade
Inibidores de Proteínas Quinases/administração & dosagem
Inibidores de Proteínas Quinases/efeitos adversos
Pirimidinas/administração & dosagem
Pirimidinas/efeitos adversos
Retratamento
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (4-methyl-N-(3-(4-methylimidazol-1-yl)-5-(trifluoromethyl)phenyl)-3-((4-pyridin-3-ylpyrimidin-2-yl)amino)benzamide); 0 (Antineoplastic Agents); 0 (BCR-ABL1 fusion protein, human); 0 (Protein Kinase Inhibitors); 0 (Pyrimidines); 8A1O1M485B (Imatinib Mesylate); EC 2.7.10.2 (Fusion Proteins, bcr-abl)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171222
[St] Status:MEDLINE
[do] DOI:10.1111/bjh.15042


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[PMID]:29230799
[Au] Autor:Solal-Céligny P; Leconte P; Bardet A; Hernandez J; Troussard X
[Ad] Endereço:Institut de Cancérologie de l'Ouest, Saint Herblain, France.
[Ti] Título:A retrospective study on the management of patients with rituximab refractory follicular lymphoma.
[So] Source:Br J Haematol;180(2):217-223, 2018 01.
[Is] ISSN:1365-2141
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Given that there are currently no clear recommendations regarding therapeutic options for rituximab refractory/relapsed follicular lymphoma patients, this study aimed to describe the real-life management of patients with refractory follicular lymphoma after systemic rituximab-containing regimens (rFL), and rFL patient characteristics. In this retrospective, national, multicentre study, descriptive analyses were mainly performed according to rituximab-containing regimen at rFL diagnosis [rituximab monotherapy (R-MONO), rituximab + chemotherapy (R-COMBO), and ongoing rituximab maintenance (R-MAINTAIN)]. The 459 analysed patients experienced rituximab-refractoriness between October 2013 and September 2015: R-MONO: 58 (13%), R-COMBO: 197 (43%), R-MAINTAIN: 204 (44%). Post-refractoriness strategies were heterogeneous: idelalisib ± rituximab (22%), without anti-lymphoma treatment (21%), rituximab-chemotherapy (21%) and stem cell transplantation (18%). Rituximab was continued in combination in 41% of cases. Chosen strategies varied according to patient age (without anti-lymphoma treatment: 28% of patients if ≥65 years vs. 12% if <65 years old; stem-cell transplantation: 4% vs. 38%), treatment line at rFL, FL International Prognostic Index score and prior treatment. This French retrospective study, the first one conducted in a large cohort of rFL patients, showed that further strategies were highly heterogeneous, depending notably on patient characteristics and previous treatment. These data are the basis for a better understanding of rFL management and for the design of clinical trials in these patients.
[Mh] Termos MeSH primário: Linfoma Folicular/terapia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Antineoplásicos Imunológicos/administração & dosagem
Antineoplásicos Imunológicos/efeitos adversos
Antineoplásicos Imunológicos/uso terapêutico
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
Tomada de Decisão Clínica
Terapia Combinada
Comorbidade
Gerenciamento Clínico
Resistência a Medicamentos Antineoplásicos
Feminino
Seres Humanos
Linfoma Folicular/diagnóstico
Linfoma Folicular/mortalidade
Masculino
Meia-Idade
Estadiamento de Neoplasias
Retratamento
Estudos Retrospectivos
Rituximab/administração & dosagem
Rituximab/efeitos adversos
Rituximab/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Antineoplastic Agents, Immunological); 4F4X42SYQ6 (Rituximab)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171213
[St] Status:MEDLINE
[do] DOI:10.1111/bjh.15023


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[PMID]:29205259
[Au] Autor:Mainardi C; Ebinger M; Enkel S; Feuchtinger T; Teltschik HM; Eyrich M; Schumm M; Rabsteyn A; Schlegel P; Seitz C; Schwarze CP; Müller I; Greil J; Bader P; Schlegel PG; Martin D; Holzer U; Döring M; Handgretinger R; Lang P
[Ad] Endereço:Department of Paediatric Oncology, Children's University Hospital, University of Padova, Padova, Italy.
[Ti] Título:CD34 selected stem cell boosts can improve poor graft function after paediatric allogeneic stem cell transplantation.
[So] Source:Br J Haematol;180(1):90-99, 2018 01.
[Is] ISSN:1365-2141
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Poor graft function (PGF) is a severe complication of haematopoietic stem cell transplantation (HSCT) and administration of donor stem cell boosts (SCBs) represents a therapeutic option. We report 50 paediatric patients with PGF who received 61 boosts with CD34 selected peripheral blood stem cells (PBSC) after transplantation from matched unrelated (n = 25) or mismatched related (n = 25) donors. Within 8 weeks, a significant increase in median neutrophil counts (0·6 vs. 1·516 × 10 /l, P < 0·05) and a decrease in red blood cell and platelet transfusion requirement (median frequencies 1 and 7 vs. 0, P < 0·0001 and <0·001), were observed, and 78·8% of patients resolved one or two of their cytopenias. 36·5% had a complete haematological response. Median lymphocyte counts for CD3 , CD3 CD4 , CD19 and CD56 increased 8·3-, 14·2-, 22.- and 1·6-fold. The rate of de novo acute graft-versus-host disease (GvHD) grade I-III was only 6% and resolved completely. No GvHD grade IV or chronic GvHD occurred. Patients who responded to SCB displayed a trend toward better overall survival (OS) (P = 0·07). Thus, administration of CD34 selected SCBs from alternative donors is safe and effective. Further studies are warranted to clarify the impact on immune reconstitution and survival.
[Mh] Termos MeSH primário: Sobrevivência de Enxerto
Transplante de Células-Tronco Hematopoéticas
Células-Tronco Hematopoéticas
[Mh] Termos MeSH secundário: Adolescente
Adulto
Antígenos CD34/metabolismo
Linhagem da Célula
Criança
Pré-Escolar
Estudos de Coortes
Feminino
Doença Enxerto-Hospedeiro/etiologia
Hematopoese
Transplante de Células-Tronco Hematopoéticas/efeitos adversos
Transplante de Células-Tronco Hematopoéticas/métodos
Células-Tronco Hematopoéticas/metabolismo
Seres Humanos
Lactente
Masculino
Prognóstico
Retratamento
Estudos Retrospectivos
Quimeras de Transplante
Condicionamento Pré-Transplante
Transplante Homólogo
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antigens, CD34)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171206
[St] Status:MEDLINE
[do] DOI:10.1111/bjh.15012


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[PMID]:29193007
[Au] Autor:Kuhlen M; Willasch AM; Dalle JH; Wachowiak J; Yaniv I; Ifversen M; Sedlacek P; Guengoer T; Lang P; Bader P; Sufliarska S; Balduzzi A; Strahm B; von Luettichau I; Hoell JI; Borkhardt A; Klingebiel T; Schrappe M; von Stackelberg A; Glogova E; Poetschger U; Meisel R; Peters C
[Ad] Endereço:Department of Paediatric Oncology, Haematology and Clinical Immunology, Medical Faculty, University Children's Hospital, Heinrich Heine University, Duesseldorf, Germany.
[Ti] Título:Outcome of relapse after allogeneic HSCT in children with ALL enrolled in the ALL-SCT 2003/2007 trial.
[So] Source:Br J Haematol;180(1):82-89, 2018 01.
[Is] ISSN:1365-2141
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Relapse remains the major cause of treatment failure in children with high-risk acute lymphoblastic leukaemia (ALL) undergoing allogeneic haematopoietic stem-cell transplantation (allo-SCT). Prognosis is considered dismal but data on risk factors and outcome are lacking from prospective studies. We analysed 242 children with recurrence of ALL after first allo-SCT enrolled in the Berlin-Frankfurt-Munster (BFM) ALL-SCT-BFM 2003 and ALL-SCT-BFM international 2007 studies. Median time from allo-SCT to relapse was 7·7 months; median follow-up from relapse after allo-SCT until last follow-up was 3·4 years. The 3-year event-free survival (EFS) was 15% and overall survival (OS) was 20%. The main cause of death was disease progression or relapse (86·5%). The majority of children (48%) received salvage therapy without second allo-SCT, 26% of the children underwent a second allo-SCT and 25% received palliative treatment only. In multivariate analyses, age, site of relapse, time to relapse and type of salvage therapy were identified as significant prognostic factors for OS and EFS, whereas factors associated with first SCT were not statistically significant. Combined approaches incorporating novel immunotherapeutic treatment options and second allo-SCT hold promise to improve outcome in children with post allo-SCT relapse.
[Mh] Termos MeSH primário: Leucemia-Linfoma Linfoblástico de Células Precursoras/diagnóstico
Leucemia-Linfoma Linfoblástico de Células Precursoras/mortalidade
[Mh] Termos MeSH secundário: Adolescente
Criança
Pré-Escolar
Terapia Combinada
Feminino
Transplante de Células-Tronco Hematopoéticas/efeitos adversos
Transplante de Células-Tronco Hematopoéticas/métodos
Seres Humanos
Lactente
Masculino
Leucemia-Linfoma Linfoblástico de Células Precursoras/terapia
Prognóstico
Modelos de Riscos Proporcionais
Recidiva
Indução de Remissão
Retratamento
Terapia de Salvação
Análise de Sobrevida
Fatores de Tempo
Transplante Homólogo
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171202
[St] Status:MEDLINE
[do] DOI:10.1111/bjh.14965


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[PMID]:29193012
[Au] Autor:Kayser S; Levis MJ
[Ad] Endereço:Department of Internal Medicine V, University Hospital of Heidelberg, Heidelberg, Germany.
[Ti] Título:Advances in targeted therapy for acute myeloid leukaemia.
[So] Source:Br J Haematol;180(4):484-500, 2018 02.
[Is] ISSN:1365-2141
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:In the past few years, research in the underlying pathogenic mechanisms of acute myeloid leukaemia (AML) has led to remarkable advances in our understanding of the disease. Cytogenetic and molecular aberrations are the most important factors in determining response to chemotherapy as well as long-term outcome, but beyond prognostication are potential therapeutic targets. Our increased understanding of the pathogenesis of AML, facilitated by next-generation sequencing, has spurred the development of new compounds in the treatment of AML, particularly the creation of small molecules that target the disease on a molecular level. Various new agents, such as tyrosine kinase inhibitors, immune checkpoint inhibitors, monoclonal or bispecific T-cell engager antibodies, metabolic and pro-apoptotic agents are currently investigated within clinical trials. The highest response rates are often achieved when new molecularly targeted therapies are combined with standard chemotherapy. Presented here is an overview of novel therapies currently being evaluated in AML.
[Mh] Termos MeSH primário: Antineoplásicos/uso terapêutico
Biomarcadores Tumorais
Leucemia Mieloide Aguda/tratamento farmacológico
Leucemia Mieloide Aguda/etiologia
Terapia de Alvo Molecular
[Mh] Termos MeSH secundário: Animais
Antineoplásicos/administração & dosagem
Antineoplásicos/efeitos adversos
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
Ensaios Clínicos como Assunto
Terapia Combinada
Descoberta de Drogas
Seres Humanos
Leucemia Mieloide Aguda/metabolismo
Leucemia Mieloide Aguda/mortalidade
Retratamento
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Nm] Nome de substância:
0 (Antineoplastic Agents); 0 (Biomarkers, Tumor)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180221
[Lr] Data última revisão:
180221
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171202
[St] Status:MEDLINE
[do] DOI:10.1111/bjh.15032



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