bluuebunny/crossref_metadata_2025_split huggingface dataset:
HIV-associated anaplastic large cell lymphoma
Authors: Castillo J. , Milani C. , Pantanowitz L. 
Published: August 2020

e19563 Background: Anaplastic large cell lymphoma (ALCL) is a CD30+ T-cell lymphoma that is generally unrelated to EBV in the non-HIV setting. Based upon anaplastic lymphoma kinase (ALK) expression, the new WHO classification provisionally distinguishes between ALK+ (favorable) and ALK- (unfavorable) ALCL. The characteristics of ALCL, such as ALK expression and EBV coinfection, in individuals with HIV infection have not been adequately evaluated. The aim of this study was to investigate these features in HIV-associated ALCL cases. Methods: A MEDLINE search for all cases of HIV-associated non-cutaneous ALCL was undertaken. Data regarding patient age, gender, HIV status (CD4 count, viral load, opportunistic infections), HAART, lymphoma features (B symptoms, stage, sites of involvement, immunophenotype, ALK expression, molecular studies), EBV coinfection, therapy and outcome (survival, cause of death) were extracted and analyzed. Results: A total of 23 cases were included. Patients were of median age 39 years with a male:female ratio of 7:1. Median CD4+ count was 76 cells/mm3 and HIV viral load 416,500 copies/ml. Most (67%) patients had an opportunistic infection, although only 3 (17%) were on HAART. ALCL was extranodal in 22 cases (96%) affecting most commonly lung, soft tissue and liver. Many (78%) patients had stage IV disease and B symptoms were reported in 9 cases (50%). T-cell receptor gene rearrangement was present in all cases, CD30 was positive in 22 (96%), and the vast majority (90%) were ALK-negative. EBV was identified in 8 (35%) cases. Therapy for ALCL was documented in 15 (67%) cases; 64% received CHOP. In 2 of the 3 patients who were on HAART, long-term survival was achieved. Many (68%) patients died, with a median survival of 9 months. Death was caused by either lymphoma progression (42%) or infection (58%). Conclusions: HIV-associated non-cutaneous ALCL appears to affect younger individuals and is associated with EBV infection in a subset of cases. Apart from marked immunosuppression, the poor prognosis of HIV-associated ALCL appears to be related to the absence of ALK expression, advanced stage at presentation with prominent extranodal disease, inadequate therapy including HAART, and poor response to CHOP. Further research is needed to better understand and treat this unique HIV-associated lymphoma. No significant financial relationships to disclose.
sFLC in healthy Indian subjects and myeloma patients
Authors: Kumar R. , Gupta D. , Raina V. , Sharma A. , Kumar L. , Irshad M. , Singh S. , Chopra A. 
Published: August 2020

e19565 Background: Serum free light chain (sFLC) analysis for detection and monitoring of monoclonal gammopathies has been validated by several studies but none from India. We report sFLC in Indian healthy subjects and myeloma patients. Methods: Serum samples from 73 healthy subjects and 39 myeloma patients were analyzed using serum protein electrophoresis, immunofixation where appropriate and estimation of sFLC, the latter using FREELITE reagent kit and Hitachi-912 autoanalyzer. Parameters evaluated were κ and λ levels, κ/λ ratio and dFLC (involved-uninvolved chain). Results: Median age of controls (50 males, 23 females) was 40 years (range 20–65 years) and of patients (34 males, 5 females) was 53.5 years (range 35–80 years). In control group, λ levels were significantly higher than κ. There were 26 of kappa- and 13 of lambda- type myeloma as judged by immunofixation. Results were significantly different between myeloma and control group for κ, λ and κ/λ ratio (p=0.00). Only thirteen patients had iFLC >100 mg/L but ratios were abnormal in all (100%) patients (26 κ, 13 λ) when judged by the full range of normal κ/λ (0.51–1.66). dFLC >50 mg/L with abnormal ratio was seen in 28 (70%) patients. All patients had concordance with immunofixation. Conclusions: Healthy Indian subjects have higher κ and λ values than reported, possibly because of greater incidence of subclinical infections. However κ/λ range is comparable and iFLC >100mg/l appears uncommon. The κ/λ ratio is highly sensitive method for myeloma detection. Results need validation in larger cohort of healthy subjects and patients. No significant financial relationships to disclose.
The prognostic value of FDG-PET measured by standardized uptake value in patients with melanoma stage III evaluated in a prospective study
Authors: Bastiaannet E. , De Jong J. R. , Brouwers A. H. , Suurmeijer A. J. , Hoekstra H. J. 
Published: August 2020

e20000 Background: FDG-PET is a sensitive modality to detect melanoma metastases; melanomas are typically FDG-avid and melanoma shows an unpredictable pattern of spread. Furthermore, FDG-PET is able to quantify FDG uptake and the amount of FDG uptake, measured by the standardized uptake value (SUV), might be important for the prediction of disease specific survival (DSS) or disease free survival (DFS). Therefore, aim of this study was to perform a prospective analysis to determine whether SUV is of prognostic value in the DFS and DSS of melanoma patients with palpable lymph node metastases. Methods: From July 2002 until December 2007, all consecutive patients with palpable, histology or cytology proven lymph node metastases of melanoma referred to the University Medical Centre Groningen for examination with FDG-PET were prospectively included. The SUVmean (70% isocontour) and SUVmax in the lymph node metastasis were calculated for patients who showed no distant metastases on chest X-Ray, FDG-PET and CT. Univariate and multivariate survival analysis was performed to determine whether SUV was associated with DFS and DSS (Cox Proportional Hazard analysis). Results: Overall, 70 patients were eligible. High SUV values were present in axillary metastases (p=0.118), in patients who had more than 15 nodes removed (p=0.061) and in patients with a large tumor size in the lymph node (p=0.0001). Patients with a low SUVmean had a 3-years DFS of 54.3% as compared to 28.1% for patients with a high SUVmean (HR 2.02;p=0.051). In multivariate analysis SUVmean seems to be associated with DFS (p=0.063). DSS for patients with a high SUV was decreased, however not statistically significant (HR 1.71; p=0.182). Conclusions: The SUV in the lymph node metastasis seems to be associated with disease-free survival for melanoma patients clinically stage III. No significant financial relationships to disclose.
Randomized trial of two schedules of palonosetron for the prevention of nausea and vomiting in patients with metastatic melanoma receiving interleukin-2–based concurrent biochemotherapy
Authors: Homsi J. , Bedikian A. Y. , Kim K. B. , Papadopoulos N. E. , Hwu W. , Mahoney S. , Vardeleon A. G. , Davies M. , Hwu P. 
Published: August 2020

e20008 Background: Interleukin-2–based biochemotherapy (BCT) is a common therapy for patients (pts) with metastatic melanoma (MM). BCT induced nausea and vomiting (N/V) remains a significant problem (26% grade 3 and 4). Palonosetron (PALO) is a 5-HT3 receptor antagonist indicated for the prevention of N/V associated with chemotherapy. The recommended dosing schedule of PALO for patients on BCT is unknown. Methods: Chemo-naïve MM pts undergoing their first BCT cycle were randomized to receive PALO 0.25 mg as premedication intravenously on days 1 and 4, or the same dose on days 1, 3, and 5. The BCT regimen included: cisplatin (20 mg/m2) and vinblastine (1.6 mg/m2) on days 1–4, dacarbazine (800 mg/m2) on day 1, interleukin-2 (9 MIU/m2/day) by continuous infusion on days 1–4 and interferon alpha (5 MU/m2/day) on days 1–5. A nausea episode was defined as nausea of any severity reported by the patient or documented by the nursing staff at anytime. Pts with N/V due to known central nervous system or gastrointestinal metastases were excluded. The use of additional antiemetics was recorded. Pts were followed for 21 days (days 1–7 as inpatients). The Functional Living Index-Emesis (FLIE), an emesis- and nausea-specific questionnaire, was completed starting on day 1. Results: 30 pts were enrolled. Median age was 53 years (range 23–64). Eighteen (60%) were men. The incidences of BCT related N/V and those of nausea interfering with appetite, sleep, physical activity, social life and enjoyment of life are summarized by schedule of PALO in the table below. Conclusions: PALO administered on alternate days was more effective at controlling BCT-related N/V and reduced the need for PRN antiemetics. Better control of N/V reduced the impact of N/V on patient functioning in this population. [Table: see text] No significant financial relationships to disclose.
Invasive melanoma of the face: Patterns of local and regional disease in 261 patients managed at a single institution
Authors: Chambers A. J. , Murynka T. , Arlette J. P. , Mckinnon J. G. 
Published: August 2020

e20015 Background: The face is a common site of melanoma occurrence, and lesions in this location present specific management challenges. The purpose of this study was to examine outcomes associated with invasive melanoma of the face, with respect to local, regional and distant recurrence. Methods: Patients with invasive melanoma of the face managed from 1997–2008 were identified from a large population-based tumor registry and retrospectively reviewed. Details of lesion histopathology, initial management, sentinel node biopsy (SNB), and local, regional or distant recurrences were recorded. Results: 261 patients were reviewed, mean age 68 and median tumor thickness 0.87mm. Three patients (1.1%) had clinically involved nodes at presentation and underwent nodal dissection. Of 108 patients who were eligible for SNB (with tumor thickness >1mm, Clark level ≥IV or ulceration) this was performed in only 29 (27%). SNB was successfully identified in 28 (97%). No facial nerve injuries occurred. A mean of 1.5 nodes were removed; from parotid region in 24, cervical chain in 12, submandibular in 5, submental in 1 and retroauricular in 1. SNB was positive in 3 (11%) who subsequently underwent neck dissection/parotidectomy. Mean follow-up duration was 37 months. Local recurrence occurred in 13 (5%), in-transit recurrence in 4 (1.5%) and distant recurrence in 20 (7.7%). Regional nodal recurrence occurred in 10 (3.8%); after negative SNB in 1 (SNB failure rate 3.7%), after unsuccessful SNB in 1, following neck dissection for nodal disease at presentation in 1, and in 7 who did not undergo SNB (including 6 patients who were eligible). During the study period there were 60 deaths (crude mortality 23%); due to melanoma in 16, unrelated causes in 41, and indeterminate in 3. Conclusions: Facial melanoma is associated with low rates of regional recurrence despite a low rate of SNB for eligible lesions. Sentinel nodes were most commonly found in the parotid region and could be safely removed without nerve injury. Most regional recurrences occurred in patients eligible for SNB not undergoing this procedure. Due to the older age of patients with facial melanoma, most deaths occurring are from unrelated conditions, and distant metastatic disease was seen in only a small percentage of cases. No significant financial relationships to disclose.
Cervical and colorectal cancer screening among breast cancer (BrCa) survivors followed in either a breast center (BC) or a breast survivorship clinic (SvC) at The University of Texas M.D. Anderson Cancer Center
Authors: Olson A. L. , Bevers T. , Guzman M. , Theriault R. L. , Hortobagyi G. N. , Hahn K. M. 
Published: August 2020

e20506 Background: An essential component of cancer survivorship care includes the prevention and early detection of new cancers. We sought to determine if documentation of appropriate cervical and/or colon cancer screening differed between BrCa survivors followed in our BC (patients < 5 yrs from diagnosis of invasive BrCa or with active BrCa issues) and those seen in our SvC (patients with history of DCIS or ≥ 5 yrs from invasive BrCa diagnosis). Methods: IRB approval was obtained for this retrospective study. 5,982 BrCa survivors were seen for follow-up in our BC or SvC between 7/1/05 and 12/31/06. 2,811 BC patients and 1191 SvC patients (total = 4,002) met inclusion criteria: 1) not receiving chemotherapy, radiation, or undergoing surgical evaluation; 2) no evidence of recurrent BrCa; 3) ≥ 12 months from BrCa diagnosis, 4) no active GYN or GI complaints. Results: BrCa survivors followed our SvC were significantly more likely to have provider documentation of both cervical and colon cancer screening than those followed in our BC (72% versus 22.7%, and 68.4% versus 14.5%, respectively; both p values <0.001). Although nursing documentation of cervical cancer screening is required in both centers, SvC patients were more likely to have this documented than those in the BC (95.3% versus 56.5%, respectively; p <0.001). Nursing documentation of colon cancer screening is required in SvC (84.2% documented) but not in the BC (3.5% documented). Conclusions: BrCa survivors receiving care in our survivorship clinic were more likely to have nursing or provider documentation of cervical and/or colon cancer screening. Strategies that trigger documentation of non-BrCa screening take advantage of the “teachable moment” during a routine visit- thereby promoting the long-term health of cancer survivors. No significant financial relationships to disclose.
Correlates of clinically significant fatigue in women with newly diagnosed breast cancer
Authors: Gerber N. L. , Diao G. , Stout N. , Soballe P. , McGarvey C. , Pfalzer L. , Springer B. , Shieh C. 
Published: August 2020

e20517 Background: Cancer related fatigue (CRF) is common in cancer survivors. CRF has been reported to be one of the most distressing symptoms associated with cancer and its treatment. Activity and biological profiles of those who suffer from CRF, have been poorly characterized. This IRB approved prospective, natural history study reports fatigue and associated findings in women newly diagnosed with breast cancer (BrCa), receiving standard treatment. Methods: All women were evaluated pre-operatively and at >9 months after diagnosis. Variables measured: Age, height, marital status, presence of children, menopausal status, tumor size, node status, estrogen receptor (ER+), hemoglobin, white blood cell count, fasting blood glucose, and BMI. Patient reported outcomes included visual analog scale (VAS) of fatigue (F), SF-36 version2, Physical Activity Questionnaire (PAQ, Harvard Alumni Health Study) and Sleep Questionnaire. Some variables were dichotomized to maximize the statistical power for the relatively small sample size. Bivariate correlations, and logistic regression analyses were performed using two fatigue conditions: presence of any F, or presence of clinically significant fatigue (CSF) defined as >=4 on the VAS. Results: 61 women, mean age of 51y, 39% had BMI >=25, 85% had >= 1 child, 52% were post-menopause, 92% ER+. Increased F at follow-up was statistically significant when compared to baseline (p=<0.0001, using paired t-test). Significant correlations (p<0.1) are reported between CSF and the following: node+, BMI>=25; inverse correlations with amount of vigorous activity (PAQ), physical function and vitality on SF-36. Physical function (SF-36) had significant inverse correlations with: age, menopause, and BMI. Low vitality was associated with: large tumor size, high WBC, longer time sleeping. Node+, BMI>=25, low physical function and vitality levels retained statistically significant relationships to CSF in the regression analyses. Conclusions: Node+ BrCa, BMI>=25, low level of physical activity and vitality (SF-36) are correlated with CSF. Except node status, each is treatable and may reduce CSF No significant financial relationships to disclose.
Significance of MTHFR gene mutation with normal homocysteine level in vascular events
Authors: Gadiyaram V. K. , Khan M. A. , Hogan T. , Altaha R. , Crowell E. , Hobbs G. , Perrota P. 
Published: August 2020

e20520 Background: Hyperhomocysteinemia, due to a combination of genetic and environmental factors, is considered to be a risk factor for vascular disease. Two common variations of the MTHFR gene (C677T and A1298C) result in amino acid substitutions and enhanced thermolability of the enzyme. Individuals with MTHFR gene mutations appear to have raised plasma level of homocysteine which may lead to increased risk of vascular events. However, significance of MTHFR gene mutations with normal homocysteine levels is unknown. Objective: To assess the relation of MTHFR gene mutations with normal homocysteine level and risk of Vascular events (deep venous thrombosis (DVT), pulmonary embolism (PE), Ischemic Heart disease (IHD), cerebrovascular accidents (CVA),recurrent fetal loss). Methods: We reviewed the records of 90 patients referred to our benign hematology clinic for thrombophilia evaluation between 2006 and 2008. All available medical history for risk factors and laboratory test results, obtained from first vascular event through time of consultation, including genetic testing, were reviewed. Anti-cardiolipin antibody, MTHFR genotyping and Protein C and Protein S assays were performed at Warde Medical Laboratory, Ann Arbor, MI. Results: 61 patients with documented vascular events were tested for MTHFR gene mutations. Forty one of these patients also had homocysteine levels available. Thirty-eight of these 41 (92 %) patients had an MTHFR gene mutation with normal homocysteine levels. Eighteen (47%) of these 38 patients had only an MTHFR gene mutation with normal homocysteine level and no other congenital or acquired risk factors for vascular events identified. Conclusions: In our clinic population, many patients with documented vascular events had MTHFR gene polymorphisms with normal homocysteine levels with no other thrombophilia risk factors identified, raising the question of whether MTHFR gene polymorphisms alone, without hyperhomocysteinemia, may somehow contribute to thrombophilia. [Table: see text] No significant financial relationships to disclose.
Coping styles and psychological outcomes in men with advanced cancer
Authors: Schmidt K. , Monahan P. , Tong Y. , Rawl S. , Rand K. , Cripe L. D. 
Published: August 2020

e20521 Background: The psychological outcomes of men with advanced cancer may vary based upon their appraisal and response to the threat of cancer. Coping styles in other illnesses are influenced by gender and stage of disease, but little is known specifically about men with advanced cancer. Methods: We recruited 81 men with advanced cancer to complete surveys assessing coping (Mini-MAC), post-traumatic growth (PTGI), and psychological outcomes (Hospital Anxiety and Depression Scale). Psychological outcomes and coping styles were determined with means, and percentages above established cutoff points. Relationships were assessed using Pearson correlation coefficients. Results: The mean HADS anxiety and depression scores were 5.4 and 4.0, respectively. Fourteen men (17%) scored 8–10 and 8 (10%) scored ≥11 suggesting an anxiety state and disorder, respectively. Eight men (10%) had scores suggesting a depressive state and 4 (5%) a depressive disorder. Greater helplessness/hopelessness and anxious preoccupation scores were correlated with greater anxiety (r =.54, p<.0001; r =.66, p<.0001) and depression scores (r =.43, p<.0001; r=.47, p<.0001). Greater fighting spirit correlated with less anxiety (r =-.26, p=.018) and less depression (r = -.42, p < .0001) and with increased post-traumatic growth in the form of new possibilities (r = .26, p = .020), personal strength (r = .33, p = .003), and the total PTGI score (r = .23, p = .043). Greater fatalism was associated with lower total distress measured by the total HADS score (r = -.24, p = .032), and marginally so when assessed separately for anxiety (r = -.22, p = .052) and depression (r = -.21, p = .056). In addition, greater fatalism was significantly associated with greater post-traumatic growth in all five areas assessed by the PTGI subscales (.27 < r < .36; .001 p < .032). Conclusions: As expected men with advanced cancer report anxiety and depression. Coping styles were significantly associated with anxiety, depression, and post-traumatic growth. No significant financial relationships to disclose.
Impact of pegylated liposomal doxorubicin (PLD) plus docetaxel (D) versus single-agent D on health-related quality of life (HRQOL) of patients with advanced breast cancer (BC) previously treated with neoadjuvant-adjuvant anthracycline
Authors: Tjulandin S. A. , Bondarenko I. N. , Semiglazov V. F. , Balashova O. I. , Makhson A. N. , Bogdanova N. V. , Wu Y. , Chatikhine V. A. , Yuan Z. , Sparano J. A. 
Published: August 2020

e20522 Background: A randomized, multicenter phase 3 trial of PLD+D showed a significant improvement in the primary endpoint of time to progression (TTP) compared with D alone but with increased Grade 3/4 hand-foot syndrome (HFS: 24% vs. 0%) and mucositis/stomatitis (M/S: 12% vs. 1%) in patients (pts) with advanced breast cancer (BC). (Sparano JA et al. SABCS 2008. #80) This analysis evaluated HRQOL in these pts. Methods: Pts were randomized to D 75 mg/m2 (N=373) or PLD 30 mg/m2 + D 60 mg/m2 (N=378) on Day 1 every 21 days until progression or unacceptable toxicity. HRQOL was assessed using the Functional Assessment of Cancer Therapy - Breast (FACT-B) at baseline and at every cycle during treatment. FACT-B has 4 primary domains: physical, social/family, emotional, and functional, plus a BC-specific subscale. The primary analysis was a t-test comparison of change in the trial outcome index (TOI) from baseline to the last evaluation. TOI combined physical/functional domain scores with BC-specific scores. Other FACT-B endpoints analyzed included FACT-B total score and individual subscales. Also, % pts meeting an established minimally important difference (MID) of HRQOL improvement in TOI was assessed. Results: Median number of cycles was 6 for both arms. TOI was available for 97.9% of all scheduled assessments for both treatment groups. At baseline, mean FACT-B and TOI scores were similar for PLD+D vs D arms (94.2±18.6 vs 95.3±18.7 and 59.7±13.8 vs 60.2±13.4, respectively); other FACT-B domains were also similar. PLD+D vs D arms showed similar mean change from baseline to last evaluation in TOI (-4.6±12.2 vs -6.0±12.4; P=0.13). Other FACT-B subscales showed 1–2 point differences across domains over time. Likewise, % pts reaching MID was similar across arms. Pts in both arms experienced similar FACT-B declines as disease progressed. Conclusions: Despite increased HFS and M/S with PLD+D vs D alone, HRQOL was comparable for both arms. [Table: see text]