bluuebunny/crossref_metadata_2025_split huggingface dataset:
HIV-associated lung cancer in New York City.
Authors: Levy Benjamin , Chintapatla Rangaswamy , Suarez Jaime , Connery Cliff P. , Bhora Faiz Y. , Evans Andrew , Choi Walter , Rohs Nicholas , Becker Daniel Jacob 
Published: March 2020

e17589 Background: Recent evidence suggests that HIV may be a risk factor of lung cancer, independent of smoking . Due to the expanding population of HIV patients with lung cancer, there is a need to define the clinical course and tumor biology of these patients. Our analysis seeks to characterize the clinical and molecular features of HIV associated non small cell lung cancer (HIV-NSCLC) and evaluate outcomes in a New York City Cancer center that serves a racially and economically diverse population. Methods: We searched the Continuum Cancer Center Registry for cases of HIV-NSCLC diagnosed from 2002 to 2012. Charts were reviewed to determine patient and tumor characteristics, treatment and outcomes. Kaplan-Meier curves were constructed for survival and compared by means of the log rank test. Patient characteristics were compared to national data from the SEER database. Mutational analysis of archival tissue was performed by OnkoMatch Tumor genotyping. Results: HIV-NSCLC was idenfied in 74 patients. Median age (MA) was 55 compared to MA of 70 for non HIV-NSCLC. Patients were predominantly male (72%). Histology distribution was reflective of the non-HIV population (SEER): adenocarcinoma [31 (42%)], squamous [18 (24%)], NSCLC NOS [8 (11%)], poorly differentiated [6 (8%)], and other [9 (15%)]. Distribution of stage was similar to SEER with 39 (53%) patients presenting with stage IV. Lowest recorded CD4 count was <200 in 34 patients (68%) with available CD4 counts. Chemotherapy and radiation were administered to 28 (49%) and 19 patients (31%), respectively. Median survival was 5.2 months. Kaplan-Meier curves were not statistically different by CD4 count (> or < 200), or by receipt of chemo or radiation. Mutational analysis on 7 patients demonstrated 3 with cMet overexpression, 2 KRAS mutations and 1 BRAF mutation. Conclusions: Among our HIV-NSCLC cohort, patients were diagnosed at younger age, but had similar stage and histology distributions as SEER database averages. HIV associated lung cancer appears to have a poor prognosis similar to that of the general population. Rates of treatment were low in our cohort and the potential for undertreatment warrants further study. Observed increased rate of cMET overexpression should prompt further molecular profiling in this population.
The risk of debilitating falls (DF) in Manitobans living with cancer.
Authors: Gingerich Joel Roger , Lambert Pascal , Doupe Malcolm , Pitz Marshall W. , Daeninck Paul Joseph 
Published: March 2020

e17596 Background: Falls and fall-related injuries pose important patient safety challenges. We sought to measure if cancer patients are at increased risk of DF. Methods: This retrospective population-based study was conducted by linking the Manitoba Cancer Registry with health care use records from Manitoba, Canada. All community-dwelling patients who were diagnosed with cancer from 2005-08 were matched with up to three cancer-free controls. DF were defined as falls requiring hospitalization and were identified using ICD-9 and -10 billing codes. A competing risk model was used to compare DF between cancer and cancer-free cohorts and expressed as sub-hazard ratios (SHR). Comparisons across groups were adjusted for age, sex, medication use, region of residence, and the presence of co-morbidities. Results: 22,327 cancer patients were matched to 67,927 controls. The median age was 66.5 years, and the median length of follow-up was 1.98 years. The cumulative 1 and 3-year incidence of DF are shown in the Table. (The adjusted risk of DF was significantly decreased in cancer patients versus matched controls ≥ 80 years old; SHR = 0.82 (95% CI: 0.57 – 0.97, p = 0.03). The adjusted SHR for stages I, II, III and IV in those ≥ 80 were 0.83 (95% CI: 0.64 - 1.09, p 0.18), 0.69 (95% CI: 0.51 - 0.93, p = 0.02), 0.56 (95% CI: 0.38 - 0.83, p < 0.01), and 0.45 (95% CI: 0.31 - 0.66, p < 0.01), respectively. Conclusions: The risk of DF in cancer and non-cancer patients increases with age. When compared to matched controls, only cancer patients ≥ 80 with advanced stage cancers were at decreased risk of DF. This finding is likely due to the higher competing risk of death in cancer patients (i.e., of those ≥ 80, 40.2% with cancer versus 4.0% without cancer die within one year). [Table: see text]
Survival trends among patients with acute myeloid leukemia in the United States.
Authors: Uprety Dipesh , Ghimire Krishna Bilas , Nepal Barsha , Shah Binay Kumar 
Published: March 2020

e17598 Background: The chemotherapy regimen for acute myeloid leukemia (AML) has not changed significantly over the last two decades. Better patient care may have improved survival in AML patients. This study was conducted to evaluate the relative survival rates in AML patients over two decades in the United States. Methods: Adult patients (age≥20 years) diagnosed with AML were selected from the Surveillance, Epidemiology, and End Results (SEER) database. Several cohorts categorized by race (Caucasians & African-Americans (AA)), gender & age (20-59, ≥60 years) were compared to see survival differences from 1992-2000 & 2001-2009. We used SEER Stat software to calculate 1- and 5-year relative survival rates (RS). The survival rates accompany standard errors. Results: The database comprised of 28,217 patients. The relative survival rates of AML improved significantly during 2001-2009 compared to 1992-2000 1-year 39.2±0.4 vs 33.7±0.5,( Z score 9.079, p<0.0005); 5- year 20.1±0.4 vs 15.3±0.4, (Z score 10.357, p<0.0005). The 1-and 5-year RS for men during 1992-2000 vs 2001-2009 were 32.3±0.7% vs 39.2±0.5% (Zscore=8.392, p<0.0005) & 13.9±0.5% vs 18.7±0.5% (Zscore= 8.710, p<0.0005) respectively. For women, the survival rates during 1992-2000 vs 2001-2009 were 35.3±0.7% vs 39.1±0.5% (Zscore=4.318, p<0.0005) at 1-year & 16.9±0.6% vs 21.7±0.5% (Z score=5.917, p<0.0005) at 5-years. For younger patients (<60 years), relative survival rates at during 1992-2000 and 2001-2009 were: 1- year: 56.7±0.9 vs 63.5±0.6, (Z score=6.462, p<0.0005); 5- year: 33.0±0.8 vs 40.6±0.7, (Z score= 7.070, p <0.0005). Similarly, the survival rates were significantly better for older patients and for all ethnic groups during 2001-2009 compared to 1992-2000. Conclusions: The relative survival in AML has increased significantly during 2001-2009 compared to 1992-2000. This may be secondary to improvement in supportive care.
Outcomes of invasive fungal infections in hematopoietic stem cell transplant patients.
Authors: Shaheen Shagufta , Upadhyay Shivanck , Marak Creticus Petrov , Kumar Gagan , Guddati Achuta Kumar 
Published: March 2020

e18008 Background: Invasive fungal infections are associated with higher mortality in hematopoietic stem cell transplant (HSCT) recipients despite the use of broad spectrum antifungal agents. With the increase in the number of patients undergoing HSCT and a newer array of immunosuppressants, it is necessary to examine the incidence and outcomes of fungal infection in this population. Methods: We used Nationwide Inpatient Sample from years 2000 to 2008 to examine the trends and outcomes of fungal infections in patients admitted for HSCT. We used ICD-9-CM codes to identify those with HSCT. Similarly we identified invasive fungal infection using ICD-9-CM codes. The engraftment period and subsequent admissions were examined separately. Outcomes studied were in-hospital mortality and length of hospital stay. Logistic regression analysis was used to identify independent association of fungal infection with mortality. The model was adjusted for demographic and hospital characteristics, Charlson's co-morbidity index and severity of sepsis using number of organ failures. Results: There were 291,182 admissions with HSCT from 2000 to 2008. Of these, 3.4% patients had invasive fungal infections. They were more frequent in allogenic transplant during the engraftment period (4.2%) and in those with graft versus host disease (GVHD) in subsequent admission (7.1%). The unadjusted in-hospital mortality was significantly higher in those with invasive fungal infection (28% vs. 7%, p<0.001). On adjusted analysis, the odds of mortality were highest for those with mucor (OR 4.3;95%CI 2.5-7.5) and aspergillus (OR 3.7; 95%CI 3.1-4.5) infections while the results did not reach significance for candidemia. The length of hospital stay was significantly longer in those with invasive fungal infections (median 19 days vs. 7 days, p<0.001). Conclusions: Fungal infections are common in HSCT recipients - especially in those with allografts and with GVHD. Mortality is high and is mostly associated with aspergillus and mucor. A higher index of suspicion for fungal infections in HSCT patients, strict isolation precautions and increased surveillance for aspergillus and mucor in HSCT patients may help decrease the length of hospital stay and mortality.
Transforming growth factor-beta gene polymorphisms and acute graft-versus-host disease.
Authors: Kanangat Sivadasan , Basu Sanjib , Kurbecovic Ina , Prod Michele , Maciejewski John Joseph , Nathan Sunita , Fung Henry C. , Rich Elizabeth Shima 
Published: March 2020

e18013 Background: Despite allele level HLA matching, graft-versus-host disease (GVHD) remains a major complication of allogeneic hematopoietic cell transplantation (HCT). Differences in minor histocompatibility antigens impact GVHD and HCT outcome via activation of donor T cells that also mediate a graft-versus-leukemia (GVL) effect. Non-HLA determinants, such as immunomodulatory cytokines can promote or protect against GVHD. Certain cytokine gene polymorphisms have been associated with acute GVHD in related and unrelated donor HCT. Methods: 17 patients (pts) who underwent related or unrelated donor HCT for hematologic malignancies and their donors were retrospectively analyzed for polymorphisms in gene sequences for interleukin (IL)-6, IL-10, tumor necrosis factor-alpha (TNF-α), transforming growth factor-beta (TGF-β) and interferon gamma (IFN-γ) using SSP-PCR reagents from One Lambda Inc. (Canaga Park, CA, USA). Pts and donors were categorized into low, intermediate or high producers of respective cytokines based on single nucleotide polymorphisms (SNPs) identified by sequence specific primers as per manufacturer’s instructions. Conditioning regimens included tacrolimus/sirolimus or alemtuzumab/cyclosporine. Results: A marginal association was found between development of acute GVHD and donor intermediate producers of TGF-β (p=0.056). None of the other cytokine gene polymorphisms tested showed significant relationships to either acute or chronic GVHD. Of seven pts tested who received alemtuzumab conditioning, only one pt developed GVHD; both pt and donor were high producers of all five cytokine genes tested. Conclusions: These results suggest that TGF-β gene polymorphisms may affect risk of developing acute GVHD following allogeneic HCT. Further study is warranted in larger cohorts with measurement of low, intermediate, and high cytokine producers, as well as evaluation of the interplay of cytokines and alemtuzumab in GVHD.
Impact of antithymocyte globulin on new HLA groups for unrelated donor allogeneic stem cell transplantation.
Authors: Lee Yoo Jin , Kim Jong Gwang , Lee Soo Jung , Kang Byung Woog , Chae Yee Soo , Moon Joon Ho , Sohn Sang Kyun 
Published: March 2020

e18017 Background: The outcomes of unrelated donor transplantation have improved with refinements in HLA testing. Recently, grouping of HLA matching for unrelated donor was suggested, defining by well-matched, partially-matched, and mismatched. In the current study, the role of anti-thymocyte globulin (ATG) for each group was evaluated. Methods: A total of 120 patients diagnosed as hematologic diseases and received allogeneic stem cell transplantation (SCT) from unrelated donor were retrospectively analyzed. Results: 28 patients were classified as well-matched, 52 as partially-matched, and 40 as mismatched. Among them, 73 patients received ATG as graft-versus-host disease (GVHD) prophylaxis. The overall survival (OS) rate was higher for well-matched group (82%) compared to partially-matched (53%) and mismatched (34%, p=0.076). For partially-matched group, the OS was significantly improved with ATG (83.3% vs. 38.6%, p=0.018). But, the OS was not different between groups with or without ATG for well-matched (87.5% vs. 66.7%, p=0.487) and mismatched (32.4% vs. 41.7%, p=0.215). ATG decreased the cumulative incidence of grade 3-4 acute GVHD (10% vs. 40.2%, p=0.068) and severe chronic GVHD (21.2% vs. 52.2%, p=0.037). The use of ATG (HR=0.248, p=0.029) was related with favorable OS for partially-matched group. However, the favorable effect of ATG was not observed in well-matched and mismatched groups. Conclusions: ATG effectively improved survival rate for partially-matched group in unrelated donor transplantation. However, the positive effect of ATG was not observed in well-matched and mismatched group.
Evaluation of elderly patients with extended disease small-cell lung cancer.
Authors: Montella Tatiane Caldas , Vasco Marina Mendes , Silva Ana Licia Maia , Rossi Morgana Stelzer , Sena Carla Valéria Santos , Oliveira Leandro Nascimento , Baldotto Clarissa Serodio , Ferreira Carlos Gil Moreira 
Published: March 2020

e18515 Background: At diagnosis approximately 25-40% of patients with small cell lung cancer (SCLC) are over age 65 and more than 60% of them have extended disease (ED). There is a scarcity of data on this subpopulation. The aim of this study was to report clinical characteristics of this subpopulation, highlighting some challenges in their clinical management. Methods: In this retrospective cohort, data from 96 patients aged >65 years with SCLC diagnosed between 1997 and 2007 at a single institution were analyzed. Results: At diagnosis median age at presentation was 71, and most patients (n=65; 67.7%) had ED_SCLC and became the focus of our analysis. In this particular population the median survival time was 5 compared to 9 months for limited disease patients. Further, 63% of these patients had performance status (PS)≥2 and that was correlated with worse survival (PS0-1=9 months, PS2=4 months and PS3-4=3months; p=0.05). Additionally, 70% of this group with ED had at least one comorbidity and 30% had more than one. Of note, chemotherapy (CT) or radiotherapy (RT) were not administered in 23% of those patients, due to the lack of clinical conditions. CT was administered in 49 patients (75%), being carboplatin and etoposide the preferred regimen in contrast to cisplatin and etoposide (71 vs 28%). However, 44% of patients received less than 4 cycles of CT and 34% received only one cycle. Number of CT cycles were correlated with survival (1 cycle 1.5 months and 2-4cycles 8.7 months). Conclusions: Our data show that elderly patients with ED-SCLC constitutes a frail subpopulation, with poor PS and associated comorbidities, leading to suboptimal treatment and a dismal prognosis. Moreover, most of those patients were considered unfit for current treatment. These results highlight the urgent need for an individualized approach and clinical trials focused on elderly patients, in order to provide them an optimal care and improve their outcomes.
Analysis of surgical strategy of treating thymomas: A single center experience.
Authors: Yu Lei , Ma Shan 
Published: March 2020

e18519 Background: Thymomas are epithelial thymic tumors, generally considered to have an indolent growth pattern but are malignant. 20-40% of patients with thymomas have paraneoplastic syndromes,including myasthenia gravis(MG). The objective of this study is to evaluate outcome of surgical treatment to thymoma and determine whether the different pathological and clinical characteristics of thymomas influences the prognosis in thymoma patients. Methods: We retrospectively studied data from 228 consecutive patients operated on from1992 to 2007. All thymic epithelial tumors were reclassified according to the WHO histologic classification, and the Masaoka clinical staging system. Patients with type A and stage I thymoma had no adjuvant therapy. Most patients with types AB and B1 thymomas had radiotherapy postoperatively. Patients (stageII, III) were treated with adjuvant mediastinal radiation therapy, and both adjuvant radiation therapy and chemotherapy was administered to stage IV and type C one month after operation. For patients with tumor nodules found on the pleural surface, cytoreductive surgery was performed. After that, patients had both adjuvant radiation therapy and chemotherapy. Results: There were no peri-operative deaths. 19 cases were inoperable. 16.2% patients had postoperative complications: The proportions of type A, AB, B1, B2, B3, and C thymoma in this data were 0%, 22.4%, 26.4%, 30.4%, 20.8%, and 0% respectively in patients with MG. Microthymoma was identified in the paraneoplastic thymus of 3 patients. There were 198 patients followed up. There was no recurrence in patients with type A and a few patients with type AB, B1, B2, B3 and C recurred. The actuarial 5- and 10-year survival rates were 89.6% and 80.5% respectively. Within 5 years postoperatively, 6 of 16 deaths died of myasthenia crisis, 6 were attributable to inoperable tumors (stageIV) and type C thymoma. Conclusions: Surgical treatment to thymoma has a sound prognosis. Multimodality treatment of stage III or IV thymomas may be critical to improve the 5-year survival rate. MG seldom occurs in type A and C thymoma. The main cause of death is myasthenia crisis for thymoma patients with MG and stage IV and /or type C for thymoma patients without MG.
The therapeutic effects of vitamin C on lung cancer cells.
Authors: Mahenthiran Ashorne Krithiesh , Sittampalam Gurusingham Sitta , Somasundaram Raj , Nirmalanandhan Sanjit 
Published: March 2020

e18523 Background: In this in-vitro study, we determined the effects of vitamin C (Ascorbic acid), an essential vitamin, on two different lung cancer cell lines (H358 – Bronchioalveolar Carcinoma and A549 – Epithelial Lung carcinoma) and two normal lung cell lines as control groups (MRC5 – Human lung fibroblast tissue and NL20 – Lung epithelial cells). Methods: In the study, the four cell lines were treated with Vitamin C starting from 0.005 molar concentrations and serially diluted down 1:3 ratios to low nM concentrations. All experiments were carried out in a period of 4 weeks. The viability of the cell lines after the drug treatment was measured using a MTS cell proliferation assay. Results: The study was inconclusive since the viability of both normal and lung cells were equally affected under the experimental conditions except that the dosage of vitamin C that killed 50% of H358 was at a slightly lower concentration than the dosage of vitamin C that killed 50% of the normal lung cells. These results show that there is a possibility of an optimal dosage that will only harm cancerous cells in specific cancers and not on all cancers. Conclusions: These results were inconclusive; probably due to the fact that experimental conditions in this in-vitro study may not be appropriate to show the effects of Vitamin C on lung cancer cells. It is possible that lower dosages of vitamin C may still kill cancer cells selectively, and may also be more effective in cancers in ther tissues. Despite these drawbacks, in-vivo experiments in animal models with lung cancer may show the benefits of Vitamin C in combination with standard of care cancer drugs. Future experiments will examine combinations experiments in vitro and in animals to study the beneficial effects of Vitamin C.
Selective expression of the Sp17/AKAP4/PTTG1 in NSCLC for detection and therapy.
Authors: Radhi Saba , Saadeh Charles , Wade Raymond , Mer Jesse , Yu Yuefei , Mirandola Leonardo , Konala Venu , Aulakh Amardeep , Chiaramonte Raffaella , Platonova Natalia , Zepeda Kristopher , Colombo Michela , Jenkins Marjorie , Figueroa Jose A. , Cobos Everardo , Jumper Cynthia A. , Alalawi Raed , Chiriva-Internati Maurizio 
Published: March 2020

e18527 Background: Cancer testis antigens (CTA) are a class of tumor associated antigens, showing a restricted expression in cancer, strong immunogenicity, and weak expression in normal tissues. Sp17/AKAP4/PTTG1 have been previously investigated, showing promising results as a target antigens. Our aim was to investigate the expression of Sp17/AKAP4/PTTG1 in lung cancer patients. Methods: We analyzed two lung cancer cell lines, one normal bronchus cell line, a panel of normal tissues and patient’s cells by RT-PCR, flow-cytometry, immunocytochemistry (ICC), and immunofluorescence (IF). CTA immunogenicity was investigated by measuring circulating specific antibodies in the sera of lung cancer patients. Results: ELISA analyses show the presence of circulating CTA-specific antibodies in the sera of lung cancer patients, indicating the immunogenicity of Sp17, AKAP-4 and PTTG-1. We showed that CTA, Sp17, AKAP-4 and PTTG-1 can be detected in both sera and tissue of patients with NSCLC. Furthermore, CTA can elicit an immunogenic response in patients affected with this disease. Conclusions: Our results provide the first evidence that the CTAs SP17/AKAP4/PTTG1 are expressed in both non-small cell lung cancer cell lines and primary tumor tissues and can elicit an immunogenic response in patients afflicted with this disease. Based on our findings we believe further studies are warranted to explore the feasibility of developing CTA-tailored immunotherapeutic strategies for non-small cell lung cancer.
Outcomes of North American, Japanese, and European extensive-disease small cell lung cancer (ED-SCLC) patients under irinotecan-platinum or etoposide-platinum therapy: Systematic review and meta-analysis.
Authors: Lima Joao Paulo Da S.N. , Sasse Andre Deeke , Sasse Emma C. , dos Santos Lucas Vieira 
Published: March 2020

e18534 Background: Superiority of irinotecan-platinum (IP) regimens over etoposide-platinum (EP) in ED-SCLC has been extensively debated, with ethnic and pharmacogenomics issues hypothesized as causes of the divergent findings. We undertook a systematic review to scrutinize the data according to geographic origin. Methods: Randomized controlled trials comparing first-line EP doublets versus IP in ED-SCLC patients were searched in major meeting proceedings and databases. The outcomes were overall survival (OS), one-year survival, two-year survival, and safety. Meta-analyses were performed using random-effects model. Subgroup analyses and meta-regression were undertaken to compare and measure the impact of geographical origin of study over the estimated effect size. Results: Seven studies (2,029 patients) were included. IP improved OS worldwide (HR = 0.83; 95% CI 0.76-0.92; P>0.001; I²=0%). However, the impact of IP on OS was different according to geographic origin, with relevant benefit for Japanese, little benefit for North American/Australian and intermediate for European patients (P for interaction = 0.029, table 1). One year survival was homogenously improved from 34% with EP to 40% with IP (P=0.006). IP improved two year survival just for Japanese and European patients but not to North American ones (Table). Toxicity was not impacted by trial origin. Conclusions: IP improved survival for both Western and Eastern patients, but seems to exist a gradient of benefit according to geographic origins, with maximal benefit for Japanese, some relevant for European ones and little, if any, for North American/Australian patients. These findings should be taken in account when considering IP or EP as first-line therapy for ED-SCLC patients worldwide. [Table: see text]