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Cortina Chandler S. Bergom Carmen Craft Morgan Ashley Fields British Brazauskas Ruta Currey Adam Kong Amanda L. 《Annals of surgical oncology》2021,28(10):5568-5579
Annals of Surgical Oncology - Management of axillary lymph nodes in breast cancer has undergone significant change over the past decade through landmark clinical trials. This study aimed to assess... 相似文献
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Health and surgical outcomes in Canada and the United States. 总被引:2,自引:0,他引:2
L L Roos E S Fisher R Brazauskas S M Sharp E Shapiro 《Health affairs (Project Hope)》1992,11(2):56-72
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Maxim Norkin Bronwen E. Shaw Ruta Brazauskas Heather R. Tecca Helen L. Leather Juan Gea-Banacloche Rammurti T. Kamble Zachariah DeFilipp David A. Jacobsohn Olle Ringden Yoshihiro Inamoto Kimberly A. Kasow David Buchbinder Peter Shaw Peiman Hematti Raquel Schears Sherif M. Badawy Hillard M. Lazarus John R. Wingard 《Biology of blood and marrow transplantation》2019,25(2):362-368
We analyzed late fatal infections (LFIs) in allogeneic stem cell transplantation (HCT) recipients reported to the Center for International Blood and Marrow Transplant Research. We analyzed the incidence, infection types, and risk factors contributing to LFI in 10,336 adult and 5088 pediatric subjects surviving for ≥2 years after first HCT without relapse. Among 2245 adult and 377 pediatric patients who died, infections were a primary or contributory cause of death in 687 (31%) and 110 (29%), respectively. At 12 years post-HCT, the cumulative incidence of LFIs was 6.4% (95% confidence interval [CI], 5.8% to 7.0%) in adults, compared with 1.8% (95% CI, 1.4% to 2.3%) in pediatric subjects; P < .001). In adults, the 2 most significant risks for developing LFI were increasing age (20 to 39, 40 to 54, and ≥55 years versus 18 to 19 years) with hazard ratios (HRs) of 3.12 (95% CI, 1.33 to 7.32), 3.86 (95% CI, 1.66 to 8.95), and 5.49 (95% CI, 2.32 to 12.99) and a history of chronic graft-versus-host disease GVHD (cGVHD) with ongoing immunosuppression at 2 years post-HCT compared with no history of GVHD with (HR, 3.87; 95% CI, 2.59 to 5.78). In pediatric subjects, the 3 most significant risks for developing LFI were a history of cGVHD with ongoing immunosuppression (HR, 9.49; 95% CI, 4.39 to 20.51) or without ongoing immunosuppression (HR, 2.7; 95% CI, 1.05 to 7.43) at 2 years post-HCT compared with no history of GVHD, diagnosis of inherited abnormalities of erythrocyte function compared with diagnosis of acute myelogenous leukemia (HR, 2.30; 95% CI, 1.19 to 4.42), and age >10 years (HR, 1.92; 95% CI, 1.15 to 3.2). This study emphasizes the importance of continued vigilance for late infections after HCT and institution of support strategies aimed at decreasing the risk of cGVHD. 相似文献
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Majhail NS Brazauskas R Rizzo JD Sobecks RM Wang Z Horowitz MM Bolwell B Wingard JR Socie G 《Blood》2011,117(1):316-322
Risks of secondary solid cancers among allogeneic hematopoietic cell transplant (HCT) recipients who receive conditioning without total body irradiation are not well known. We evaluated the incidence and risk factors for solid cancers after HCT using high-dose busulfan-cyclophosphamide conditioning in 4318 recipients of first allogeneic HCT for acute myeloid leukemia in first complete remission (N = 1742) and chronic myeloid leukemia in first chronic phase (N = 2576). Our cohort represented 22 041 person-years at risk. Sixty-six solid cancers were reported at a median of 6 years after HCT. The cumulative-incidence of solid cancers at 5 and 10 years after HCT was 0.6% and 1.2% among acute myeloid leukemia and 0.9% and 2.4% among chronic myeloid leukemia patients. In comparison to general population incidence rates, HCT recipients had 1.4× higher than expected rate of invasive solid cancers (95% confidence interval, 1.08-1.79, P = .01). Significantly elevated risks were observed for tumors of the oral cavity, esophagus, lung, soft tissue, and brain. Chronic graft-versus-host disease was an independent risk factor for all solid cancers, and especially cancers of the oral cavity. Recipients of allogeneic HCT using busulfan-cyclophosphamide conditioning are at risk for developing solid cancers. Their incidence continues to increase with time, and lifelong cancer surveillance is warranted in this population. 相似文献
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Lindsay Hammons Ruta Brazauskas Marcelo Pasquini Mehdi Hamadani Parameswaran Hari Anita DSouza 《Hematology/oncology and stem cell therapy》2018,11(2):105-111
Objective/Background
To assess abnormalities found on CD138-enriched fluorescent in situ hybridization (FISH) studies on pre-treatment bone marrow in systemic amyloid light-chain amyloidosis (AL) and correlate findings between these abnormalities with organ involvement and 1-year survival.Methods
We reviewed 107 patients with systemic AL to identify the impact of a diagnostic FISH study done on plasma cell-enriched bone marrow in our institution between January 2010 and January 2015; 77 had pre-treatment testing performed.Results
A total of 77 (61%) patients had abnormal FISH including: hyperdiploidy (29%), t(11;14), (20%), hypodiploidy (16%), t(4;14), (1%), del17p (5%), and + 1q21 (5%). Abnormal FISH studies were more likely in those patients with plasma cell involvement ≥ 10% (p = .002). FISH abnormalities were not shown to correlate with stage, cardiac involvement, or survival at 1 year. One-year survival was significantly affected by stage at diagnosis and presence of cardiac and hepatic amyloid involvement.Conclusion
We conclude that in AL, FISH abnormalities are associated with clonal burden. We found no impact of these markers on the type of organ involvement or 1-year survival. 相似文献8.
Vi Lier Goh MD CNSC Martin K. Wakeham MD Ruta Brazauskas PhD Theresa A. Mikhailov MD PhD Praveen S. Goday MBBS CNSC 《JPEN. Journal of parenteral and enteral nutrition》2013,37(1):102-108
Aim: To evaluate the effect of obesity on mortality, length of mechanical ventilation, and length of stay (LOS) in critically ill children. Methods: Retrospective cohort study in 2‐ to 18‐year‐olds, admitted to the pediatric intensive care unit (PICU) at the Children's Hospital of Wisconsin from 2005–2009 who required invasive ventilation. Weight z score was used to categorize patients as normal (–1.89 to 1.04), overweight (1.05–1.65), obese (1.66–2.33), and severely obese (>2.33). Underweight patients were excluded. Age, gender, admission type, Pediatric Index of Mortality 2 score, operative status, trauma status, admission Pediatric Outcome Performance Category, and diagnosis categories were also collected. The outcomes were mortality, total ventilator days, and PICU LOS. Univariate analysis was used to compare the groups, and multivariate logistic regression was used to compare mortality. Total ventilation days and LOS were modeled with linear regression. Results: In total, 1030 patients were included in the study, with 753 normal weight, 137 overweight, 76 obese, and 64 severely obese. The risk‐adjusted mortality rates in overweight (odds ratio [OR], 1.06; 95% confidence interval [CI], 0.62–1.82), obese (OR, 0.68; 95% CI, 0.31–1.48), and severely obese patients (OR, 1.02; 95% CI, 0.45–2.34) were not significantly different compared with the normal‐weight group. Total ventilation days (P = .9628) and PICU LOS (P = .8431) were not significantly different between the groups after adjusting for risk factors. Conclusion: Critically ill overweight, obese, and severely obese children who require invasive mechanical ventilation have similar mortality, length of stay in the PICU, and ventilator days as compared with normal‐weight children. 相似文献
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Kristjan Paulson Ruta Brazauskas Nandita Khera Naya He Navneet Majhail Gorgun Akpek Mahmoud Aljurf David Buchbinder Linda Burns Sara Beattie Cesar Freytes Anne Garcia James Gajewski Theresa Hahn Jennifer Knight Charles LeMaistre Hillard Lazarus David Szwajcer Wael Saber 《Biology of blood and marrow transplantation》2019,25(10):2086-2090
Allogeneic hematopoietic cell transplantation (alloHCT) is offered in a limited number of medical centers and is associated with significant direct and indirect costs. The degree to which social and geographic barriers reduce access to alloHCT is unknown. Data from the Surveillance, Epidemiology and End Results Program (SEER) and the Center for International Blood and Marrow Transplant Research (CIBMTR) were integrated to determine the rate of unrelated donor (URD) alloHCT for acute myelogenous leukemia (AML), acute lymphoblastic leukemia (ALL), and myelodysplastic syndrome (MDS) performed between 2000 and 2010 in the 612 counties covered by SEER. The total incidence of AML, ALL, and MDS was determined using SEER, and the number of alloHCTs performed in the same time period and geographic area were determined using the CIBMTR database. We then determined which sociodemographic attributes influenced the rate of alloHCT (rural/urban status, median family size, percentage of residents below the poverty line, and percentage of minority race). In the entire cohort, higher levels of poverty were associated with lower rates of alloHCT (estimated rate ratio [ERR], .86 for a 10% increase in the percentage of the population below the poverty line; P < .01), whereas rural location was not (ERR, .87; P = .11). Thus, patients from areas with higher poverty rates diagnosed with ALL, AML, and MDS are less likely patients from wealthier counties to undergo URD alloHCT. There is need to better understand the reasons for this disparity and to encourage policy and advocacy efforts to improve access to medical care for all. 相似文献
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