Mphedziseni Esther Rangwaneni;Ndidzulafhi Selina Raliphaswa;Mary Maluleke;Vusiwana Patricia Letlalo;Thingahangwi Cecilia Masutha;Duppy Manyuma;Langanani Makhado;Tinyiko Nelly Rikhotso; 《Nursing Open》2024,11(9):e70041

To explore related support needs of general nurses in specialty mental health units and provide references for formulating a model to support this population working in mental health care units.  相似文献   

    

Cecilia C. S. Yeung;David W. Woolston;Vicky Wu;Jenna M. Voutsinas;Ryan Basom;Chris Davis;Alexandre V. Hirayama;Kikkeri N. Naresh; 《European journal of haematology》2024,112(1):111-121

Bone marrow (BM) assessment after CAR-T cell immunotherapy infusion is not routinely performed to monitor adverse events such as cytopenias, hemophagocytic lymphohistiocytosis, or infections. Our institution has performed BM biopsies as part of CAR-T cell treatment protocols, encompassing pre- and post-treatment time points and during long-term follow-up.  相似文献   

    

Laura L. Daniel  Alyson L. Dickson  Jacy T. Zanussi  Tyne W. Miller&#x;Fleming  Peter S. Straub  Wei&#x;Qi Wei  W. Dale Plummer  William D. Dupont  Ge Liu  Prathima Anandi  Tyler S. Reese  Kelly A. Birdwell  Vivian K. Kawai  Adriana M. Hung  Nancy J. Cox  QiPing Feng  C. Michael Stein  Cecilia P. Chung 《CTS Clinical and Translational Science》2022,15(4):859

TPMT and NUDT15 variants explain less than 25% of azathioprine‐associated myelotoxicity. There are 25 additional genes in the thiopurine pathway that could also contribute to azathioprine myelotoxicity. We hypothesized that among TPMT and NUDT15 normal metabolizers, a score combining the genetically predicted expression of other proteins in the thiopurine pathway would be associated with a higher risk for azathioprine discontinuation due to myelotoxicity. We conducted a retrospective cohort study of new users of azathioprine who were normal TPMT and NUDT15 metabolizers. In 1201 White patients receiving azathioprine for an inflammatory disease, we used relaxed Least Absolute Shrinkage and Selection Operator (LASSO) regression to select genes that built a score for discontinuing azathioprine due to myelotoxicity. The score incorporated the predicted expression of AOX1 and NME1. Patients in the highest score tertile had a higher risk of discontinuing azathioprine compared to those in the lowest tertile (hazard ratio [HR] = 2.15, 95% confidence interval [CI] = 1.11–4.19, p = 0.024). Results remained significant after adjusting for a propensity score, including sex, tertile of calendar year at initial dose, initial dose, age at baseline, indication, prior TPMT testing, and the first 10 principal components of the genetic data (HR = 2.11, 95% CI = 1.08–4.13, p = 0.030). We validated the results in a cohort (N = 517 non‐White patients and those receiving azathioprine to prevent transplant rejection) that included all other patients receiving azathioprine (HR = 2.00, (95% CI = 1.09–3.65, p = 0.024). In conclusion, among patients who were TPMT and NUDT15 normal metabolizers, a score combining the predicted expression of AOX1 and NME1 was associated with an increased risk for discontinuing azathioprine due to myelotoxicity.

Study Highlights

• WHAT IS THE CURRENT KNOWLEDGE ON THE TOPIC?

Azathioprine is an immunosuppressant that causes myelotoxicity in some people. Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines provide azathioprine dosing recommendations based on TPMT and NUDT15 genotype; however, these genotypes explain only 25% of azathioprine‐induced myelotoxicity.

• WHAT QUESTION DID THIS STUDY ADDRESS?

The aim of this study was to determine if a risk score composed of the genetically predicted expression of genes that encode proteins in the thiopurine pathway within the liver tissue would be associated with azathioprine discontinuation attributed to myelotoxicity.

• WHAT DOES THIS STUDY ADD TO OUR KNOWLEDGE?

This study showed that a risk score composed of genetically predicted risk expression of AOX1 and NME1 is associated with azathioprine discontinuation due to myelotoxicity.

• HOW MIGHT THIS CHANGE CLINICAL PHARMACOLOGY OR TRANSLATIONAL SCIENCE?

Having a risk score for discontinuation composed of the genetically predicted expression of NME1 and AOX1 could help discriminate patients at high risk of discontinuing azathioprine due to hematologic side effects in people who are normal TPMT and NUDT15 metabolizers.  相似文献   

    

Dinorah Hern&#  ndez-Melchor  Cecilia Palafox-G&#  mez  Ivan Madrazo  Ginna Ortiz  America Padilla-Viveros  Esther L&#  pez-Bayghen 《World Journal of Clinical Cases》2022,10(33):12295-12304

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Cecilia C. Rabayda BA  Sharon Hoover PhD 《The Journal of school health》2023,93(1):88-91

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Marcelo Luiz Balancin  Walcy Rosolia Teodoro  Cecilia Farhat  Tomas Jurandir de Miranda  Aline Kawassaki Assato  Neila Aparecida de Souza Silva  Ana Paula Velosa  Roberto Falzoni  Alexandre Muxfeldt Ab'Saber  Anja C. Roden  Vera Luiza Capelozzi 《Cancer Medicine》2020,9(13):4836-4849

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Constantina Constantinou  Ourania Kolokotroni  Maria‐Cecilia Mosquera  Alexandros Heraclides  Christiana Demetriou  Peter Karayiannis  Annalisa Quattrocchi  Andreas Charalambous 《Cancer Medicine》2020,9(17):6082-6092

During the first quarter of 2020 the world is experiencing a pandemic of Severe Acute Respiratory Syndrome‑Coronavirus‑2 (SARS‑CoV‑2), a novel beta coronavirus that is responsible for the 2019 novel coronavirus disease (COVID‐19). The COVID‐19 pandemic revealed that healthcare systems around the world were not prepared to deal with either the direct effects of the pandemic or with the indirect effects that are imposed on the health of patients with chronic disorders such as cancer patients. Some challenges and dilemmas currently faced during the pandemic include the management of cancer patients during the treatment and follow‐up phases, the assessment of the safety of treatments currently used for the management of SARS‑CoV‑2 for use in cancer patients, the development of psychoeducation and emotional support for cancer patients and the safe conduct of clinical trials involving participation of cancer patients. Evidence from the literature supports the need for the urgent development of a holistic contingency plan which will include clear guidelines for the protection and comprehensive care of cancer patients. The implementation of such a plan is expected to have many beneficial effects by mainly minimizing the increased morbidity and mortality of cancer patients that could result as an adverse consequence of the COVID‐19 or future pandemics.  相似文献   

    

Erika Borlenghi  Chiara Cattaneo  Elisa Cerqui  Silvana Archetti  Diego Bertoli  Daniela Bellotti  Doriana Gramegna  Giulia Soverini  Margherita Oberti  Francesca Schieppati  Chiara Pagani  Angela Passi  Margherita Sciumé  Mirko Farina  Cecilia Carbone  Claudia Crippa  Daniela Dalceggio  Alessandra Tucci  Giuseppe Rossi 《Hematological oncology》2020,38(5):754-762

Consolidation treatment in acute myeloid leukemia (AML) patients achieving complete remission (CR) is warranted. High-dose cytarabine (HDAC) is considered first choice in favorable risk and an option in intermediate-risk AML. However, its optimal dose and schedule, as well as the benefit of additional chemotherapy agents remain controversial. Herein, we report on the long-term outcome of consecutive unselected AML patients treated with repeated courses of HDAC, with the addition of idarubicin, followed by autologous peripheral blood stem cell (PBSC) support, in order to limit toxicity, according to Northern Italy Leukemia Group (NILG) AML-01/00 study (EUDRACT number 00400673). Among 338 patients consecutively diagnosed from 2001 to 2017 at our center, 148 with high-risk AML (adverse cytogenetic, isolated FLT3-internal tandem duplication mutation, refractory to first induction) were addressed to allogeneic stem cell transplant. All other cases, 186 patients (55%), median age 53 (range 19–75), were considered standard-risk and received the NILG AML-01/00 program. After achieving CR, patients were mobilized with cytarabine 8 g/sqm to collect autologous CD34+-PBSC and received three consolidation cycles with HDAC (20 g/sqm) plus idarubicin (20 mg/sqm) per cycle, followed by reinfusion of limited doses of CD34+ PBSC (1-2x106/kg). The program was completed by 160 (86%) patients. Toxicity was acceptable. Neutrophils recovered a median of 10 days. Treatment-related mortality was 3/160 (1.8%). After a median follow-up of 66.4 months, overall survival (OS) and relapse-free survival (RFS) at 5-years were 61.4% and 52.4%, respectively. Twenty-eight selected patients aged >65 had similar outcomes. According to European leukemia net-2010 classification, the OS and RFS at 5-years were 76.4% and 65% in favorable risk, without differences between molecular subgroups, 52.3% and 47.2% in Intermediate-I, 45.2% and 36.5% in Intermediate-II risk patients, respectively. In conclusion, consolidation including repeated courses of high dose cytarabine and idarubicin, with limited PBSC support, proved feasible and very effective in nonhigh risk patients. The incorporation of novel agents in its backbone may be tested to further improve patient's prognosis.  相似文献   

    

Nis Brix  Andreas Ernst  Lea Lykke Braskhøj Lauridsen  Erik Thorlund Parner  Onyebuchi A. Arah  Jørn Olsen  Tine Brink Henriksen  Cecilia Høst Ramlau-Hansen 《Paediatric and perinatal epidemiology》2020,34(6):668-677

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Cecilia Klingberg  Daniel Kornhall  Dan Gryth  Andreas J. Krüger  Hans Morten Lossius  Mikael Gellerfors 《Acta anaesthesiologica Scandinavica》2020,64(1):124-130

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