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1.
Kostas Fasoulas Athanasios Beltsis Taxiarchis Katsinelos Eleni Dimou Mary Arvaniti Anna Charsoula Victor Gourvas Stefanos Atmatzidis Grigoris Chatzimavroudis Panagiotis Katsinelos 《Saudi Journal Of Gastroenterology》2012,18(2):146-148
Mesenteric panniculitis (MP) is a rare inflammatory and fibrotic disease of the mesentery of unknown etiology. It has various clinical and radiological manifestations, posing a diagnostic challenge for clinicians. Its diagnosis is indicated via radiologic imaging and is usually confirmed via peritoneal biopsies. We describe a case of a patient with histopathologically proven MP, in which steroid dependence was successfully managed with colchicine. 相似文献
2.
Eli Muchtar Morie A. Gertz Martha Q. Lacy Nelson Leung Francis K. Buadi David Dingli Suzanne R. Hayman Ronald S. Go Prashant Kapoor Wilson Gonsalves Taxiarchis V. Kourelis Rahma Warsame Yi Lisa Hwa Amie Fonder Miriam Hobbs Stephen Russell John A. Lust Mustaqeem Siddiqui S. Vincent Rajkumar Robert A. Kyle Shaji K. Kumar Angela Dispenzieri 《American journal of hematology》2020,95(11):1280-1287
Response assessment in light chain (AL) amyloidosis is based on serum and urine monoclonal protein studies. Newly diagnosed patients (n = 373) who achieved very good partial response or complete response (CR) to first line therapy were assessed for the survival impact of each of the monoclonal protein studies. At end of therapy (EOT), negative serum/urine immunofixation (IFE) was achieved in 61% of patients, 72% achieved normal serum free light chain ratio (sFLCR), and the median involved free light chain (iFLC) and difference between involved to uninvolved light chain (dFLC) were 17 mg/L and 5 mg/L, respectively. Overall, 46% of patients achieved a CR at EOT. At EOT, iFLC ≤20 mg/L and dFLC ≤10 mg/L were additive in survival discrimination to negative serum/urine IFE and were independent predictors of overall survival. In contrast, normalization of sFLCR did not add survival discrimination to serum/urine IFE and was not independent predictor of survival. We propose a new definition for hematological CR to include serum/urine IFE negativity plus iFLC ≤20 mg/L or dFLC ≤10 mg/L, instead of the current definition of serum/urine IFE negativity and normal sFLCR. Complete response using dFLC ≤10 mg/L had the best performance in those with significant renal dysfunction and by light chain isotype, making it the preferred partner to IFE. Validation of these results in a multicenter cohort is warranted. 相似文献
3.
Katsinelos P Paroutoglou G Kountouras J Chatzimavroudis G Zavos C Terzoudis S Katsinelos T Fasoulas K Gelas G Tzovaras G Pilpilidis I 《World journal of gastroenterology : WJG》2010,16(40):5077-5083
AIM: To prospectively compare partially covered vs uncovered sphincterotome use on post-endoscopic biliary sphincterotomy (ES) hemorrhage and other complications. METHODS: All patients referred for therapeutic endoscopic retrograde cholangiopancreatography (ERCP) were randomly assigned to undergo ES either with a partially covered or an uncovered sphincterotome. Both patient and technical risk factors contributing to the development of post-ES bleeding were recorded and analyzed. The characteristics of blee... 相似文献
4.
Taxiarchis Botsis Thomas Buttolph Michael D Nguyen Scott Winiecki Emily Jane Woo Robert Ball 《J Am Med Inform Assoc》2012,19(6):1011-1018
Objective
To develop and evaluate a text mining system for extracting key clinical features from vaccine adverse event reporting system (VAERS) narratives to aid in the automated review of adverse event reports.Design
Based upon clinical significance to VAERS reviewing physicians, we defined the primary (diagnosis and cause of death) and secondary features (eg, symptoms) for extraction. We built a novel vaccine adverse event text mining (VaeTM) system based on a semantic text mining strategy. The performance of VaeTM was evaluated using a total of 300 VAERS reports in three sequential evaluations of 100 reports each. Moreover, we evaluated the VaeTM contribution to case classification; an information retrieval-based approach was used for the identification of anaphylaxis cases in a set of reports and was compared with two other methods: a dedicated text classifier and an online tool.Measurements
The performance metrics of VaeTM were text mining metrics: recall, precision and F-measure. We also conducted a qualitative difference analysis and calculated sensitivity and specificity for classification of anaphylaxis cases based on the above three approaches.Results
VaeTM performed best in extracting diagnosis, second level diagnosis, drug, vaccine, and lot number features (lenient F-measure in the third evaluation: 0.897, 0.817, 0.858, 0.874, and 0.914, respectively). In terms of case classification, high sensitivity was achieved (83.1%); this was equal and better compared to the text classifier (83.1%) and the online tool (40.7%), respectively.Conclusion
Our VaeTM implementation of a semantic text mining strategy shows promise in providing accurate and efficient extraction of key features from VAERS narratives. 相似文献5.
Patrick W. Mellors Surendra Dasari Mindy C. Kohlhagen Taxiarchis Kourelis Ronald S. Go Eli Muchtar Morie A. Gertz Shaji K. Kumar Francis. K. Buadi Maria A. V. Willrich John A. Lust Prashant Kapoor Martha Q. Lacy David Dingli Yi Hwa Amie Fonder Miriam Hobbs Susan Hayman Rahma Warsame Nelson R. Leung Yi Lin Wilson Gonsalves Mustaqeem Siddiqui Robert A. Kyle S. Vincent Rajkumar David L. Murray Angela Dispenzieri 《Blood cancer journal》2021,11(6)
6.
Jonas?Paludo Jithma?P.?Abeykoon Amanda?Shreders Stephen?M.?Ansell Shaji?Kumar Sikander?Ailawadhi Rebecca?L.?King Amber?B.?Koehler Craig?B.?Reeder Francis?K.?Buadi Angela?Dispenzieri Martha?Q.?Lacy David?Dingli Thomas?E.?Witzig Ronald?S.?Go Wilson?I.?Gonsalves Taxiarchis?Kourelis Rahma?Warsame Nelson?Leung Thomas?M.?Habermann Suzanne?Hayman Yi?Lin Robert?A.?Kyle S.?Vincent?Rajkumar Morie?A.?Gertz Prashant?KapoorEmail author 《Annals of hematology》2018,97(8):1417-1425
The treatment approaches for Waldenstrom macroglobulinemia (WM) are largely based upon information from single-arm phase II trials, without comparative data. We compared the efficacy of two commonly used regimens in routine practice (bendamustine-rituximab (BR) and dexamethasone, rituximab plus cyclophosphamide (DRC)) and evaluated their activity with respect to the patients’ MYD88L265P mutation status. Of 160 consecutive patients, 60 received BR (43 with relapsed/refractory WM) and 100 received DRC (50 had relapsed/refractory WM). In the treatment-naïve setting, overall response rate (ORR) was 93% with BR versus 96% with DRC (p?=?0.55). Two-year progression-free survival (PFS) with BR and DRC was 88 and 61%, respectively (p?=?0.07). In salvage setting, ORR was 95% with BR versus 87% with DRC, p?=?0.45; median PFS with BR was 58 versus 32 months with DRC (2-year PFS was 66 versus 53%; p?=?0.08). Median disease-specific survival was not reached with BR versus 166 months with DRC (p?=?0.51). The time-to-event endpoints and depth of response were independent of the MYD88 mutation status. Grade ≥?3 adverse events of both regimens were comparable. A trend for longer PFS was observed with BR although the regimens have comparable toxicities. The activity of BR and DRC appears to be unaffected by patients’ MYD88 mutation status. 相似文献
7.
Surbhi Sidana M. Hasib Sidiqi Angela Dispenzieri Francis K. Buadi Martha Q. Lacy Eli Muchtar David Dingli Suzanne R. Hayman Wilson I. Gonsalves Prashant Kapoor Nelson Leung Rahma Warsame Taxiarchis V. Kourelis Robert C. Wolf William J. Hogan Shaji K. Kumar Morie A. Gertz 《American journal of hematology》2019,94(9):1020-1026
In appropriately selected patients with AL amyloidosis, autologous stem cell transplant (ASCT) is an established treatment modality with excellent outcomes and decreasing transplant related mortality (TRM) over time. We report on 15-year overall survival (OS) in 159 patients undergoing ASCT from 1996 to 2003, with median follow up of 17.1 years. Day 100 TRM was 13.2% (n = 21). The OS of ≥15 years was observed in 30% (47/159) of patients. Patients surviving ≥15 years were younger (53 vs 56 years, P = .02), less likely to have lambda as the involved light chain (62% vs 78%, P = .03) and were less likely to have heart involvement (32% vs 56%, P = .005). Median OS of patients with heart involvement vs not was 4.0 vs 11.1 years, P = .006 and actuarial 15-year OS was 23% vs 43%, respectively. A higher proportion of patients with OS ≥15 years received full-dose melphalan conditioning (81% vs 61%, P = .01), and achieved day 100 complete response (CR) (64% vs 24%, P < .001). Median OS amongst patients who achieved CR vs not was 19.3 vs 5.4 years, P < .001. Heart involvement, receiving full-dose melphalan and achieving CR remained independent predictors of OS. AL amyloidosis and related complications were the cause of death in 52% of patients overall (1-5 years post-transplant: 81%; 5-10 years: 62% and 10-15 years: 55%). These results reinforce the key role of ASCT in AL amyloidosis. With improvements in TRM and more options for relapsed disease, we expect the long-term survival post-transplant to improve significantly in the future. 相似文献
8.
Moritz Binder S. Vincent Rajkumar Martha Q. Lacy Morie A. Gertz Francis K. Buadi Angela Dispenzieri Yi L. Hwa Amie Fonder Miriam Hobbs Suzanne R. Hayman Steven R. Zeldenrust John A. Lust Stephen J. Russell Nelson Leung Prashant Kapoor Ronald S. Go Wilson I. Gonsalves Taxiarchis Kourelis Rahma Warsame Robert A. Kyle Shaji K. Kumar 《American journal of hematology》2019,94(3):306-311
Peripheral blood biomarkers of tumor microenvironment and immune surveillance are independent prognostic factors in multiple myeloma. The timing and prognostic impact of immune reconstitution has been studied after autologous hematopoietic stem cell transplantation, less is known about its significance in newly diagnosed multiple myeloma. We studied absolute lymphocyte (ALC) and absolute monocyte (AMC) counts at the time of treatment initiation and 1 month thereafter in 771 newly diagnosed patients. Two hundred and thirty-four patients (31%) had evidence of immune dysregulation at baseline (abnormal biomarkers). Eighty-seven of these patients (37%) recovered normal biomarkers at 1 month (early immune reconstitution). The absence of immune dysregulation at baseline (compared to the presence thereof) was associated with better overall survival (HR 0.77, 95% CI 0.61-0.97, P = 0.025, n = 771). The absence of immune dysregulation at 1 month (compared to the persistence or development thereof) was associated with better overall survival (HR 0.63, 95% CI 0.50-0.80, P < 0.001, n = 771). Early immune reconstitution (compared to the persistence or development of immune dysregulation) was associated with better overall survival (HR 0.62, 95% CI 0.43-0.92, P = 0.016, n = 771). Cytogenetic high-risk disease was negatively, and treatment with immunomodulators positively, associated with early immune reconstitution. The presence or development of immune dysregulation in newly diagnosed multiple myeloma is an independent risk factor. The favorable impact of early immune reconstitution suggests immune dysregulation to be a potentially modifiable risk factor that may be exploited for therapeutic benefit. 相似文献
9.
Surbhi Sidana Nidhi Tandon Morie A. Gertz Angela Dispenzieri Marina Ramirez-Alvarado David L. Murray Taxiarchis V. Kourelis Francis K. Buadi Prashant Kapoor Wilson Gonsalves Rahma Warsame Martha Q. Lacy Robert A. Kyle S. Vincent Rajkumar Shaji K. Kumar Nelson Leung 《British journal of haematology》2019,185(4):701-707
This study evaluated the differences in clinical features of 1077 newly diagnosed AL amyloidosis patients with renal involvement (n = 229, 21%), both cardiac and renal involvement (n = 443, 41%) and cardiac involvement (n = 405, 38%). Significant differences in dFLC (difference in involved and uninvolved light chains) were noted (renal, both, cardiac median: 83, 234 and 349 mg/l, P < 0.001). The proportion of patients with ≥ 10% bone marrow plasma cells (BMPCs) was lowest in renal only patients: 44%, 57%, 64%, respectively, P < 0.001. In a multivariate linear regression model incorporating organ involvement type and BMPCs ≥10%, organ involvement was a significant predictor of dFLC (P < 0.001). Median overall survival (OS) across the three groups was 83 vs. 19 vs. 16 months (P < 0.001) in patients not undergoing transplant and 5-year OS in patients undergoing transplant was 90% vs. 75% vs. 64% (P = 0.007), respectively. In conclusion, renal involvement alone or renal + cardiac involvement in AL amyloidosis is associated with lower circulating light chain burden, which cannot be fully explained by BMPC burden alone. Increased sensitivity of the kidney to light chains, given significant interactions with the renal tubular system and secretion of modified light chain products may play a role in pathogenesis of renal AL amyloidosis and warrants further investigation. 相似文献
10.
Rahma Warsame Shaji K. Kumar Morie A. Gertz Martha Q. Lacy Francis K. Buadi Suzanne R. Hayman Nelson Leung David Dingli John A. Lust Yi Lin Stephen Russell Prashant Kapoor Ronald S. Go Taxiarchis Kourelis Wilson Gonsalves Steven R. Zeldenrust Robert A. Kyle S. Vincent Rajkumar Tyler Zemla Jeffrey Sloan Angela Dispenzieri 《American journal of hematology》2017,92(5):435-440
Patients with light chain amyloidosis (AL) often have delayed diagnosis and present with significant symptomatology; this may result in decreased quality of life (QOL). We prospectively employ a “Hematology Patient Reported Symptom Screen” (HPRSS), which is three questions about fatigue, pain, and QOL, scored 0–10. The aim of this study is to better understand QOL and determine if HPRSS parameters predict for clinical outcomes. From 2009 to 2014, 302 newly diagnosed AL patients were included. Baseline median scores [interquartile range] for fatigue, pain, and QOL were 6 [3,7], 2 [0,5], 5 [3,8], respectively. Median overall survival was 53 months, with 102 (34%) deaths in the first year. There were significant differences in baseline HPRSS between those that lived longer than one year and early death patients in the domains of fatigue (5 [IQR 3, 7] vs. 7 [IQR 5, 8], P < 0.0001) and QOL (6 [IQR 4, 8] vs. 5 [IQR 3, 7], P = 0.006). On univariate analysis fatigue, QOL, physician‐reported performance status, autologous stem cell transplant (ASCT), and Mayo stage were prognostic for survival. On multivariate analysis Mayo stage, ASCT, and baseline fatigue remained independently prognostic. When analyses were restricted to the 125 patients with HPRSS measurements at 12 months, we found that over time QOL scores improved significantly 6 [IQR 3.5, 8] → 7 [IQR 5, 8] (P = 0.01). Asking AL patients to rate their fatigue and QOL has predictive value. Baseline patient reported fatigue is an independent prognostic factor for survival. Survival at one year was associated with significant improvement in QOL. 相似文献