Comparison of Clinical Efficacy of Cytarabine with Different Regimens in Postremission Consolidation Therapy for Adult t(8;21) AML Patients: A Multicenter Retrospective Study in China
Dan GongWei LiLiangding HuJianliang ShenMeiyun FangQingming YangHeng‐Xiang WangXiaoyan KeHui‐Ren ChenZhao WangHui LiuFeng LiuYi-Gai MaJingwen WangHonghua LiQuanshun WangYu JingXiaoning GaoLiping DouYonghui LiJianmin LuoLi Yu
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Abstract:
<b><i>Background:</i></b> The survival of patients with acute myeloid leukemia (AML) with t(8;21) was reported to be shorter in China than in other countries. <b><i>Patients:</i></b> We analyzed the correlation between different cytarabine (Ara-c) regimens and outcome in 255 t(8;21) AML patients in China who received postremission consolidation chemotherapy only. <b><i>Results:</i></b> The 5-year overall survival (OS) of the high-dose Ara-c group (HDAC; 2≤ Ara-c ≤3 g/m<sup>2</sup>), intermediate-dose Ara-c group (MDAC; 1.0≤ Ara-c <2.0 g/m<sup>2</sup>), low-dose Ara-c group (LDAC; 0.2< Ara-c <1.0 g/m<sup>2</sup>) and standard-dose Ara-c group (SDAC; 0.1≤ Ara-c ≤0.2 g/m<sup>2</sup>) were 65.3, 39.4, 25.2 and 27.9%, respectively (p = 0.003). In the HDAC group, but not in the MDAC group, the 5-year OS of patients who achieved 3-4 cycles of chemotherapy was superior to those who underwent 1-2 cycles (84.4 vs. 43.6%, p < 0.05), and the 3-year OS of patients who achieved an accumulated 36 g/m<sup>2</sup> of Ara-c was significantly higher compared to those who did not (85.3 vs. 39.2%, p < 0.05). Multivariate analysis indicated that factors such as WBC >3.5 × 10<sup>9</sup>/l, PLT ≤30 × 10<sup>9</sup>/l, and extramedullary infiltration were associated with a poor prognosis. <b><i>Conclusion:</i></b> The survival of t(8;21) AML patients treated with high-dose Ara-c (≥2 g/m<sup>2</sup>) was superior to other dose levels in postremission consolidation chemotherapy. Patient survival was improved by 3-4 cycles of chemotherapy with an accumulated concentration of 36 g/m<sup>2</sup> of Ara-c. WBC >3.5 × 10<sup>9</sup>/l, PLT ≤30 × 10<sup>9</sup>/l and extramedullary infiltration could be indicative of a poor clinical prognosis.Cite
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Seperti pada dewasa, teknik regional anestesi pada pediatrik kini makin popular digunakan oleh ahli anestesikarena keuntungannya. Namun demikian selalu ada risiko dan kemungkinan timbulnya komplikasi dari setiap tindakan yang dilakukan, termasuk tindakan anestesi regional pada pediatrik. Insidensi komplikasi anestesi regional pada pediatrik tidak banyak, dan kalaupun terjadi komplikasi adalah minor. Komplikasi bisa diakibatkan dari identifikasi ruang saraf, alat, obat, teknis tindakan anestesi regionalnya dan komplikasi lainnya.Walaupun tidak banyak kejadian komplikasi regional anestesi yang dilaporkan pada pediatrik, dan bukanlah komplikasi yang fatal, teknik regional anestesi pada pediatrik harus dilakukan dengan lebih hatihati, pertimbangan risiko dan keuntungannya untuk menghindari terjadinya komplikasi, terlebih karena kebanyakan komplikasi dapat dihindari dengan mempelajari teknik yang benar, menggunakan peralatan yang sesuai, dan sangat menerapkan prinsip keamanan pada pasien dengan baik.
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Genentech is partnering with the German cancer company Affimed to develop immunotherapies for multiple kinds of solid and blood cancers. Affimed is developing therapies that engage natural killer cells of the innate immune system to help direct them to attack cancer cells. Genentech will pay Affimed $96 million up front and up to $5 billion more in potential payments.
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ABSTRACT Airway management is particularly difficult in children with severe congenital anomalies. Such patients are extre- mely sensitive to the respiratory depressant effects of anaesthetic agents. We describe the successful and safe app- lication of caudal anaesthesia for inguinal hernia repair in three cases with severe congenital anomalies (Joubert syndrome, I-cell syndrome). The three patients concerned had congenital anomalies including serious facial defor- mity, respiratory failure and cardiovascular defects. They were administered a single dose of caudal epidural anaest- hesia for inguinal hernia surgery in order to avoid complications associated with general anaesthesia. Caudal block was performed and 1 mL/kg levobupivacaine 0.25% administered. We conclude that caudal epidural anaesthesia can be an effective, suitable and safe anaesthetic technique for inguinal herniotomy without the need for general anaesthesia or endotracheal intubation in children with severe congenital anomalies. Key Words: Caudal anaesthesia, children, congenital anomaly OZET Havayolu yonetimi, ciddi konjenital anomalileri olan cocuklarda ozellikle zordur. Bu tur hastalar anestezik ilaclarin solunum depresan etkilerine karsi asiri derecede duyarlidir. Kaudal anestezinin inguinal herni onarimindaki basarili ve guvenli uygulamasi konjenital anomalileri (Joubert sendromu, I-cell hastaligi) olan uc olguda gosterilmistir. Ilgili uc cocuk hastada, ciddi yuz deformitesi, solunum yetmezligi ve kardiyovaskuler bozukluk dahil konjenital bozuk- luklar vardi. Genel anesteziyle iliskili komplikasyonlari onlemek icin inguinal herni cerrahisinde tek doz kaudal epi- dural anestezi uygulandi. Kaudal anestezide %0.25 levobupivakain 1 mL/kg kullanildi. Kaudal epidural anestezinin, ciddi konjenital bozukluklari olan cocuklarda inguinal herni onarimi acisindan genel anesteziye veya endotrakeal entubasyona gerek duyulmadan etkili, uygun ve guvenli bir alternatif anestezi teknigi olabilecegi sonucuna varildi. A na h ta r Sozcukler: Kaudal anestezi, cocuk, konjenital bozukluk
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The nationally-recognized Susquehanna
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