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Rafiye Ciftciler Haluk Demiroglu Yahya Buyukasık Elifcan Aladag Salih Aksu Ibrahim C. Haznedaroglu Nilgun Sayınalp Osman Ozcebe Umit Yavuz Malkan Hakan Goker 《Clinical Lymphoma, Myeloma & Leukemia》2019,19(3):177-182
Background
Refractory acute myeloid leukemia (AML) includes AML includes failure of disease to respond to standard induction chemotherapy, relapse within 6 months after first CR, and 2 or more relapses. The outcome of these patients is usually very poor; only a small proportion can be rescued by allogenic hematopoietic stem-cell transplantation (allo-HSCT). The aim of this study was to evaluate the efficacy and feasibility of allo-HSCT in patients with refractory AML.Patients and Methods
We retrospectively analyzed the clinical outcome of 91 patients who were diagnosed with treatment-refractory AML at Hacettepe University Hospital between January 2002 and June 2018. Patients' disease status included refractory AML, defined as failure to respond to standard induction chemotherapy and relapse within 6 months after first complete remission.Results
The median follow-up was 12 months (range, 0.5-184 months) for the entire group. Kaplan-Meier estimates of the 3-year overall survival for patients who underwent allo-HSCT and patients who received only salvage chemotherapy were 67% and 12%, respectively. Additionally, the Kaplan-Meier estimates of 5-year overall survival for patients who underwent allo-HSCT and patients who received only salvage chemotherapy were 44% and 4%, respectively (P < .001). Complete remission was obtained in 25 patients (83.3%) who underwent allo-HSCT; however, the disease of only 3 patients (3.8%) exhibited complete response after salvage chemotherapy.Conclusion
Allo-HSCT is still the best-known treatment option with curative potential in patients with treatment-refractory AML. Therefore, all efforts should be made in an attempt to find a suitable matched donor in order to perform allo-HSCT. 相似文献103.
Provocation of Atrial Fibrillation Triggers During Ablation: Does the Use of General Anesthesia Affect Inducibility? 下载免费PDF全文
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A case of bullous pemphigoid associated with psoriasis vulgaris showing Hailey–Hailey disease‐like histopathological changes in regenerated epidermis without genomic mutation in ATP2C1 or ATP2A2 gene 下载免费PDF全文
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异常毒性最初是一种确保复杂成分制剂生产工艺一致性及安全性的辅助检测手段,后来成为针对外源性毒性污染物的通用安全性检测项,曾在世界范围内被各国药典收载。由于该检测与药品质量、安全性之间的关联性受到质疑,各国药典逐渐在各论及通则中删除该检测项,目前仅《中国药典》保留异常毒性。由于该检测存在设定限值难以统一、给药体积及给药剂量不合理、结果易受干扰且缺乏明确的判定标准等试验原理及设计上的缺陷,导致其试验结果没有实际参考意义。基于对历史数据的回顾分析,国际监管机构及卫生组织对异常毒性有了更为科学的认知,并已逐渐形成统一的监管共识:严格的生产控制措施和有效的质量检测手段,比异常毒性检测更为重要;异常毒性检测结果或与产品质量及污染不具相关性;在异常毒性检查中使用大量动物不符合动物福利和“3R”原则。本文从科学角度试论异常毒性作为药品质量控制指标的合理性,并总结异常毒性修订的科学原则,希望能为我国监管机构、制药行业修订异常毒性相关内容提供思考角度。 相似文献
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C. Dessinioti C.C. Zouboulis V. Bettoli D. Rigopoulos 《Journal of the European Academy of Dermatology and Venereology》2020,34(10):2229-2240
Guidelines and consensus on the management of patients with acne aim to give evidence-based, expert-group recommendations. This review compares current guidelines and consensus articles to provide a compilation of recommendations on the treatment of acne with oral isotretinoin. Ten common, relevant, clinical questions are addressed, based on published recommendations, including the indications of isotretinoin, the proposed daily dose, the cumulative isotretinoin dose and the laboratory monitoring needed. Recommendations on special considerations are also addressed, including the timing of procedures and the question of an association of depression or inflammatory bowel disease with isotretinoin. A major limitation is the use of different classification systems for acne across guidelines. The recommended daily dose ranges from 0.3 to 0.5 mg/kg in the European guidelines to up to 1 mg/kg in the US guidelines. A specific duration of treatment of at least 6 months is only recommended in the European guidelines. All guidelines report the need of strict pregnancy prevention measures. The European, French and US guidelines recommend to monitor for symptoms of depression. Important clinical questions that are inconsistently addressed in guidelines include the age indication, the recommendation for a cumulative dose, the timing of procedures, the association of isotretinoin with IBD, the recommendation for preventing acne flares and for appropriate laboratory monitoring. These topics should be clearly included in the recommendations of guidelines as they are often raised in everyday clinical practice. 相似文献
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Francois Rheault Alessandro De Benedictis Alessandro Daducci Chiara Maffei Chantal M. W. Tax David Romascano Eduardo Caverzasi Felix C. Morency Francesco Corrivetti Franco Pestilli Gabriel Girard Guillaume Theaud Ilyess Zemmoura Janice Hau Kelly Glavin Kesshi M. Jordan Kristofer Pomiecko Maxime Chamberland Muhamed Barakovic Nil Goyette Philippe Poulin Quentin Chenot Sandip S. Panesar Silvio Sarubbo Laurent Petit Maxime Descoteaux 《Human brain mapping》2020,41(7):1859-1874
Investigative studies of white matter (WM) brain structures using diffusion MRI (dMRI) tractography frequently require manual WM bundle segmentation, often called “virtual dissection.” Human errors and personal decisions make these manual segmentations hard to reproduce, which have not yet been quantified by the dMRI community. It is our opinion that if the field of dMRI tractography wants to be taken seriously as a widespread clinical tool, it is imperative to harmonize WM bundle segmentations and develop protocols aimed to be used in clinical settings. The EADC‐ADNI Harmonized Hippocampal Protocol achieved such standardization through a series of steps that must be reproduced for every WM bundle. This article is an observation of the problematic. A specific bundle segmentation protocol was used in order to provide a real‐life example, but the contribution of this article is to discuss the need for reproducibility and standardized protocol, as for any measurement tool. This study required the participation of 11 experts and 13 nonexperts in neuroanatomy and “virtual dissection” across various laboratories and hospitals. Intra‐rater agreement (Dice score) was approximately 0.77, while inter‐rater was approximately 0.65. The protocol provided to participants was not necessarily optimal, but its design mimics, in essence, what will be required in future protocols. Reporting tractometry results such as average fractional anisotropy, volume or streamline count of a particular bundle without a sufficient reproducibility score could make the analysis and interpretations more difficult. Coordinated efforts by the diffusion MRI tractography community are needed to quantify and account for reproducibility of WM bundle extraction protocols in this era of open and collaborative science. 相似文献