bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of complementary and alternative medicine in Korean cancer patients: Results of a survey from the Korean Cancer Study Group (KCSG)
Authors: Kim D. , Lee M. , Kim B. , Lee K. , Hong Y. 
Published: March 2020

17061 Background: The aim of this study was to explore the use of complementary and alternative medicine (CAM) in cancer patients of Korea. This study was performed to identify the prevalence, types, subjective effects, and side effects of CAM use, reasons for CAM use, and patients' expectations of doctors regarding their CAM use among Korean cancer patients. Methods: From August to December, 2006, face to face structured interviews were conducted and the data were analyzed in the KCSG. Results: A total 251 patients were recruited. 84% of patients had used at least one type of CAM since the time of initial diagnosis. The most prevalent types of CAM used by these patients included special diet (60%), ginseong (54%), medicinal mushrooms (50%). Energy therapies, acupuncture and spiritual therapy were used uncommonly. The main reported reason for the use of CAM was to feel hopeful. Patients expected that CAM could cure cancer (64%) and improve immune system (52%). 62 % of patients did not inform their physicians about their CAM use. Patients attributed the reason of nondisclosure that physicians never asked about CAM (43%) and physicians would disapprove the CAM use (23%). 6% of CAM users experienced side effects. Demographic variables were not predictive for the use of CAM. 60% of patients wanted to get more information about CAM with their doctors. Conclusions: More than two-thirds of cancer patients used various kinds of CAM. Physicians treating cancer patients should aware of the frequency of CAM use and should share their opinion about CAM use with cancer patients. In order to help patients make informed decisions, physician should pay more attention to CAM for making appropriate utilization of CAM. No significant financial relationships to disclose.
Attitudes about chemotherapy for Japanese patients with or without cancer: Doctors, nurses, and the general public
Authors: Kubota K. , Nagai K. , Nishiwaki Y. , Sugiura T. , Tsuchiya S. , Matsui K. , Tada A. , Nishimura Y. , Kawahara M. 
Published: March 2020

17062 Background: A prospective survey in England demonstrated that patients with cancer were much more likely to accept radical treatment with minimal chance of benefit than people who did not have cancer (Slevin et al. Br Med J 1990; 300: 1458–60). We compared responses of Japanese patients with cancer with those of a control group of physicians, nurses, and patients without cancer in assessing personal cost-benefit of chemotherapy using the same questionnaire with Slevin's study. Methods: Subjects were asked with questionnaires whether of not to accept intensive and mild chemotherapy with a supposed minimum chance of effectiveness. 153 patients with cancer, 265 controls, 213 doctors, 397 nurses, and 51 patients without cancer were subjects of the study. Results: Percentage of subjects who accepted intensive chemotherapy with a supposed minimum chance of effectiveness (1% chance of cure, 3-month prolonging life, 1% relief of symptoms) by subject group were as follows: cancer patients; 62/55/52, doctors; 27/32/4, nurses; 11/12/5, non-cancer patients; 35/40/36, controls; 23/24/15, respectively. Conclusions: More patients with cancer than people without cancer accepted treatments giving the minimal benefit for cure, prolonging life or palliation of symptoms. Interestingly, the results in Japanese survey were similar to the previous study in England. No significant financial relationships to disclose.
Using an interactive CD-ROM to gain informed consent for chemotherapy: Attempting to improve patient anxiety and depression during treatment
Authors: Olver I. N. , Whitford H. S. 
Published: March 2020

17071 Background: In a previous study, we found that an interactive CD-ROM did not adequately improve patients’ recall of chemotherapy treatment information compared to standard written information enough to warrant changes to the consent procedure. However, we further investigated whether this alternative mode of information delivery helped improve patients’ anxiety and depression over the treatment phase. Methods: Ninety-eight new patients about to commence chemotherapy were randomized to receive written information or an interactive CD-ROM containing treatment information before giving informed consent. Patients’ anxiety and depression were assessed pre- treatment using the Hospital Anxiety and Depression Scale (HADS) and once again at their second chemotherapy session along with their recall of treatment related information. Seventy patients completed all assessments. Results: Results indicated that anxiety and depression levels of the current sample were greater than those of normative groups including general population and cancer samples. Between/within subjects ANOVAs revealed that anxiety did decrease over the first phase of patients’ treatment (p = .001), but that written and CD-ROM groups did not differ in that increase (p = .99). Alternatively, depression scores increased during treatment but not significantly (p = .58) and once again, scores did not differ between the two information groups (p = .64). Conclusions: Given the results of some additional correlational analyses it appears that anxiety and depression scores are negatively associated with patients’ ability to recall and essentially understand aspects of treatment information given to them prior to chemotherapy. However, changing the mode of treatment information delivery does not appear to affect these psychological problems, and in turn, how they affect informed consent. No significant financial relationships to disclose.
The risk of hepatocellular carcinoma in patients with previous malignancy
Authors: Siegel A. B. , McBride R. B. , El-Serag H. , Hershman D. , Zablotska L. , Brown R. , Neugut A. I. 
Published: March 2020

17075 Background: Hepatocellular carcinoma (HCC) is one of the most common malignancies in the world. Its incidence has doubled over the past 20 years in the United States. Determination of the pattern of occurrence of HCC as a second primary malignancy might give clues for new risk factors for HCC, or may reveal common genetic or environmental risks. Methods: We identified patients with a diagnosis of a second primary HCC between 1973 and 2002 using the Surveillance, Epidemiology, and End-Results Program (SEER) a compilation of population-based cancer registries in the United States, to calculate the observed to expected (O/E) frequency of second primary HCC after a different primary cancer. We stratified by ethnicity, latency from the year of diagnosis of primary cancer to HCC diagnosis, and period of diagnosis of primary cancer as early (1973–1987) or late (1987–2002). Results: We reviewed 1,931,911 subjects with cancer, and identified 1,185 second primary HCC cases. Overall, a second primary HCC after any primary cancer was less frequent than expected (O/E=0.82, 95% CI=0.77–0.87). We found positive associations with head and neck cancers (oral cavity/pharynx O/E=2.1, 95% CI=1.7–2.5), Kaposi's sarcoma (O/E=3.3, 95% CI=1.2–7.1) and Hodgkin's disease (O/E=2.3, 95% CI=1.2–4.0). Negative associations were seen for breast cancer (O/E=0.7, 95% CI=0.6–0.8), colorectal cancer (O/E=0.6, 95% CI=0.6–0.8), and prostate cancer (O/E=0.7, 95%CI=0.6–0.8). Overall, lower O/E ratios were seen in whites, while in African Americans and those of other races, the O/E ratios were close to one. Latency times were relatively short for head and neck cancers and Kaposi's sarcoma (most within 12–59 months), and greater than 120 months for most cases of HCC after Hodgkin's disease. All cases of Kaposi's sarcoma were seen in the later time period. Conclusions: These results highlight possible shared risk factors of alcohol ingestion and viral exposures which may predispose to second primary HCC after other primary malignancies. Providers should maintain heightened alertness for second primary HCC in these patients, especially those with head and neck cancers and HIV. No significant financial relationships to disclose.
Incidence of grade 3/4 adverse events in imatinib resistant/intolerant chronic phase CML (CP-CML): A comparison of nilotinib and dasatinib
Authors: Carpiuc K. T. , Stephens J. M. , Liou S. Y. , Botteman M. F. 
Published: March 2020

17501 Background: Toxicities of new treatments may increase the care and resources required to manage patients (pts). The objective of this study was to compare the rates of Grade 3/4 AEs reported for nilotinib and dasatinib, the second generation tyrosine kinase inhibitors (TKIs) in imatinib resistant/intolerant CP-CML pts in preparation for an economic analysis. Methods: A systematic literature review was conducted to identify published articles, registration documents, or abstracts of clinical trials in CP-CML for nilotinib 400 mg bid and dasatinib 70 mg bid. The base case incidence rates were selected from the most rigorous sources, specifically data from the dasatinib product label and the nilotinib phase II trial, both populations having a median drug exposure of slightly >5 months. The AEs selected for the comparison were based on frequency (>5%) and/or high likelihood of incurring incremental costs for medical treatment/monitoring. The full ranges for the incidence of AEs (if available) were summarized from other papers/abstracts for sensitivity analyses in future economic analyses. Results: The Grade 3/4 hematologic AEs were the most common AEs (table below) and were ∼2 times higher for dasatinib than for nilotinib. Common Grade 3/4 biochemistry abnormalities included lipase elevations in 5% of nilotinib pts (1 pt developed a Grade 1/2 pancreatitis; no Grade 3/4 pancreatitis) and hypophosphatemia in 11% of dasatinib pts. Rates of Grade 3/4 non-hematologic AEs such as pleural effusion, GI bleeding, arrhythmia, and pneumonia/infection were >2–7 times higher for dasatinib than nilotinib, though they occurred in <5% of the population. Conclusions: The toxicity profiles of the second generation TKIs for imatinib resistant/intolerant CP-CML appear to be different and favor nilotinib with its reduced rates of Grade 3/4 AEs. Further analysis is required to understand the cost impact to health care payers of the differences in safety profiles among the new TKIs. [Table: see text] No significant financial relationships to disclose.
Complete blood count may provide risk stratification for survival and AML transformation in CMML
Authors: Cerny J. , Galili N. , Liu Q. , Devuni D. , Hassan K. , Upadhyay R. , Mumtaz M. , Mehdi M. , Raza A. 
Published: March 2020

17502 We performed a retrospective analysis of 120 patients with CMML (98 de novo CMML and 22 evolving from MDS) to examine clinical features that may influence survival and AML transformation. Univariate analysis showed low hemoglobin level; WBC > 13,000, platelet count < 50,000 and abnormal cytogenetics as poor prognostic features. Univariate analysis also determined that BM blasts >5% and Int2/High IPSS were associated with higher rates of AML but IPSS could not be used for survival assessment. Multivariate analysis showed hemoglobin < 12 g/dL, older age, abnormal cytogenetics as risk factors for shorter survival; older age, male sex, low platelet count, BM blasts > 5%, lymphocyte and monocyte counts were independent risk factors for AML transformation. Previous attempts to devise prognostic scoring systems for CMML have incorporated both peripheral blood and bone marrow features. We have used hemoglobin, lymphocyte count and platelet count to generate 3 prognostic scoring systems, which differed by severity of thrombocytopenia. Score 1 (>100, 50–100, <50) identified 3 different risk groups (low, intermediate, and high) with median OS: not reached (n/a), 18, and 9 months for all CMML patients (p<0.0001) as well as for the de novo CMML patients (p<0.0001). Score 2 (>50, <50) divided patients into 3 risk groups (low, intermediate, and high) with median OS: n/a, 19 and 10 months for all CMML (p=0.0002) versus n/a, 28 and 11 months for de novo CMML patients (p=0.0011). Score 3 (<100, >100) separated all CMML (p=0.0073) and de novo CMML patients (p=0.0054) into 2 risk groups (high, low) with median time to AML 53 months and n/a. In conclusion we suggest three new scoring systems for CMML patients that can be easily calculated after an initial CBC. Scores 1 and 2 help to assess survival while score 3 indicates risk for AML transformation. *Acknowledgements: This work has been partially supported by the AMA Foundation Seed Grant Research Program 2006. No significant financial relationships to disclose.
Compliance and persistency with a new oral iron chelator in patients with myelodysplastic syndromes
Authors: Faris R. J. , McCrone D. , Mody-Patel N. , Barghout V. , Dutta S. 
Published: March 2020

17510 Background: Patients with myelodysplastic syndromes (MDS) frequently receive blood transfusions and are at risk for iron overload (IO). The aim of this study was to estimate compliance and persistency rates of a new oral iron chelator, deferasirox, in patients with MDS in a real world setting. Methods: A retrospective analysis of patients provided deferasirox by Accredo Nova Factor database was conducted. Patients diagnosed with MDS and receiving deferasirox were followed from Jan 1, 2006 to Nov 30, 2006. Patients with at least 2 filled prescriptions were included in the analysis. Compliance was defined by medication possession ratio (MPR = # of days of medication supplied/# of days in refill interval). MPR>0.80 is categorized as good compliance. Persistency was defined as the continuous prescription refill without an interruption of longer than 30 days and Kaplan Meier curves were analyzed. Reasons for discontinuation and differences in compliance rates were explored. Results: A total of 294 patients with MDS and at least 2 filled prescriptions filled were included in the analysis. The average age was 72.2 ±12.3 years and 53.7% were male. 64.1%, 30.3%, and 3.7% of patients were covered by private insurance, Medicare, and Medicaid, respectively. The average compliance with deferasirox was 0.89 ± 0.17. 67.9% of patients had an MPR greater than 0.90 (data left-skewed as ratio truncated at 1.0). Overall, 86.4% of patients were considered persistent with deferasirox during the analysis period. Reasons for discontinuing therapy included side effects (n=14; 5%), physician choice (n =10; 3%), patient choice (n=4; 1%), or a change in provider (n=6; 2%). Conclusion: MDS patients with transfusional IO when treated with deferasirox are highly compliant and persistent. Given the decreased survival associated with IO due to chronic blood transfusions in low and intermediate-1 risk MDS patients, compliance and persistency are important factors to consider when selecting therapies. [Table: see text]
Results of BFM 90 protocol at a single institute in a developing country: Three years experience
Authors: Shah S. , Patel K. M. , Patel A. A. , Shah P. M. , Shukla S. N. , Parikh B. J. , Anand A. S. , Talati S. S. , Srivastav R. K. , Dave R. I. 
Published: March 2020

17524 Background: In a developing country the affordability status of a patient is the main factor in deciding the type of treatment a patient will receive. Majority of patients [>95%] at our institute have received MCP 841 protocol for acute lymphoblastic lymphoma .We have reviewed the treatment results of patients who had received chemotherapy as per the BFM 90 protocol over last 3 years. Methods: 18 patients (15 males and 3 females) with ALL who had received BFM 90 protocol as therapy during the period between January 2003 to January 2006 were analysed. 15 were of the pediatric age group (2–13 years) and 3 were adult patients (31 & 42 years). Median follow up period was 1 year 9 months. 5 patients were considered as high risk, 4 medium risk and the rest as standard risk. All patients were ph chromosome negative. Results: All paediatric patients are in CR. One patient had CNS relapse but he responded well to reinduction and is in CR. Three patients developed grade 4 toxicity after high dose methotrexate. The rest tolerated it well, however, leucoverin rescue had to be given empirically as methotrxeate level measurement was not available at that time. Two patients turned HCV positive during the course of treatment and had altered liver enzymes due to which maintenance treatment was interrupted. There were three instances of catheter removal and one port had to be removed due to infection. Both the adult patients had bone marrow relapse during treatment [one during maintenance and the other during reinduction] and could not be salvaged. Conclusions: BFM 90 protocol is a viable alternative to MCP 841 in developing countries where high dose methotrexate is given with empirical leucoverin rescue. High rates of catheter infection is of concern. Better patient education and improved techniques will probably improve the situation. No significant financial relationships to disclose.
Different kinases acting on stathmin (oncoprotein, Op18) in human healthy and malignant hematopoietic stem cells
Authors: Lannert H. , Able T. , Leicht S. , Saffrich R. , Eckstein V. , Lenze M. , Hofmann R. , Lenze A. , Franz T. , Ho A. D. 
Published: March 2020

17527 Background: Stathmin/Op18 is a cytosolic phosphoprotein which regulates the dynamics of microtubules. This regulation is important in mitosis during cell division and in the migration of cells in modification of the cytoskeleton. The process of tumor proliferation and metastasis is characterized by high rates of mitosis and migration into distant tissues. Stathmin itself is regulated by kinases through phosphorylation of mainly 4 different serin sides. In this study, we investigated stathmin- and its kinases expression in native hematopoietic CD34+ stem cells (HSCs) from bone marrow (BM) in comparison to mobilized peripheral blood stem cells (mPBSCs) from G-CSF stimulated donors and leukemic CD34+ cells from patients with AML. Methods: Mononuclear cells were isolated by a standard Ficoll-Hypaque gradient separation method from the different blood sources. An Auto-MACS (Miltenyi) and FACS Vantage SE cell sorter (Becton Dickinson) was used to highly enrich (>99%) CD34+ cells fractions. In comparative proteome analysis, we detected the protein expression of stathmin in mPBSCs, AML CD34+ cells, and in native HSCs from BM. We performed microarray-based gene expression profiles of these cells and focused on kinases regulating stathmin’s activity. Furthermore, we monitored stathmin and its relevant kinases by FACS analyses of the enriched cell fractions and by fluorescence microscopy of bone marrow smears and cytospins. Results: In this study, we have shown in comparative proteome analysis (Q-TOF-MS/MS) that stathmin is expressed in G-CSF mobilized hematopoietic stem cells for the first time and in AML cells. In microarray analysis we indentified up- and down-regulated kinases: MAPK, PAK1, PKC beta/zeta, MEKK3 and CDKs. Accordingly, we demonstrated in FACS analyses and in immunofluorescence microscopy the high intracellular expression of PKCzeta in AML cells and MEKK3 as well PAK1 in mPBSCs. Conclusions: Our findings show that G-CSF stimulates Stathmin expression in mPBSCs and plays a key role in migration into peripheral blood. Furthermore, we show the different expression of kinases acting on stathmin in mPBSCs and AML cells. Consequently, stathmin and its relevant kinases promise to become a future target in therapies of malignant processes. No significant financial relationships to disclose.
Are skin reactions a surrogate marker in predicting response to therapy in patients with chronic myeloid leukemia receiving imatinib?
Authors: Attili S. V. , Bapsy P. , Lokanatha D. , Govindababu K. , George J. , Jacob L. A. , Dadhich H. K. , Anupama G. 
Published: March 2020

17539 Background: One of the common toxicities observed with small molecule tyrosine kinase inhibitors are skin rashes, which were proven to predict the response to therapy in cases of lung cancer (Ann. Onc., 2005; 16(5): 780 - 785). However, very few have evaluated the same in patients with chronic myeloid leukemia (CML) on treatment with imatinib. Therefore we thought of doing a prospective study to evaluate skin rashes, and compare it with the clinical, hematological, cytogenetic and molecular remission rates in CML patients on Imatinib therapy. Methods: It is a non randomized, prospective study conducted at a tertiary care cancer center with an approximate attendance of 15,000 new cases. The patients were stratified into those who had skin reactions and do not. CTC version 3.0 was used to assess the skin toxicity. Differences in the proportions were calculated with the help of Medcalc Version 7.5. Results: A total of 314 patients with CML were evaluated who were on regular treatment with Imatinib. Hematological response was assessed monthly, cytogenetic analysis (available in 212 patients) at the end of 3rd month and molecular response (available in 136 patients) at the end of 6th months respectively. The response rates in two groups are as follows. *Percentages calculated for the subset of patients in whom results of either cytogenetic or molecular response are available Conclusion: Our findings suggest that skin reactions are not a good marker to predict either response rates or progression free interval in cases of CML. This is further substantiated by the findings that the percent of skin reactions in west are far less compared to our results, who had a better molecular as well as cytogenetic responses. [Table: see text] No significant financial relationships to disclose.
Recent clinical experience with multimodality therapy in thymic carcinoma
Authors: Huang J. , Rizk N. , Park B. , Bains M. , Flores R. , Downey R. , Rusch V. 
Published: March 2020

18003 Background: Thymic carcinomas typically carry a poor prognosis and are quite rare. As such, their management has not been standardized. We reviewed our recent experience with multimodality treatment for thymic carcinoma for outcomes. Methods: Retrospective review of a single institution surgical database. Data included patient demographics, pre-operative staging and treatment, peri-operative events, pathologic findings, and postoperative outcomes. Results: During the 10 year period from 1996–2006, 115 thymic tumors were primarily resected, including 17 patients who had thymic carcinoma. Patient characteristics are listed in the table below. Twelve patients underwent preoperative, platinum-based chemotherapy, and nine patients underwent postoperative radiation. At a mean follow-up of 28.4 months (range 2.1–141.7, median 10.9), 59% (10/17) are disease-free, 2 have died of disease, 4 are alive with disease. In the 10 patients who underwent complete resection, there have been no recurrences. There was one operative mortality. There were no adverse events of CTCAE Grade III or higher. Median length of stay was 5 days (range 3–8). Median survival has not yet been reached. Overall 5-year survival was 80%. Conclusions: Multimodality therapy for thymic carcinoma can result in good long-term survival. [Table: see text] No significant financial relationships to disclose.