tbuckley/cabot-search huggingface dataset:
A prospective study of an inpatient febrile neutropenia clinical practice guideline in oncology patients.
Authors: Tri Minh Le, Tanya Thomas, Joshua Reuss, Gina Degennaro, Elizabeth Daniels, Jin Li, Mark Smolkin, Michael Kenneth Keng
Journal: Journal of Clinical Oncology (2016)

114 Background: Febrile neutropenia (FN) is a common complication in oncology patients and is associated with significant morbidity and mortality if untreated. Because of this, it is regarded as a medical emergency. FN treatment guidelines universally recommend the prompt initiation ( &lt; 60 minutes) of intravenous antibiotic therapy. We hypothesized that a quality initiative project creating a new FN clinical practice guideline (CPG) would reduce the time to antibiotic administration (TTA) for inpatient oncology patients with FN. Methods: This prospective study compared patients diagnosed with an initial episode of FN (4/2015-8/2015) with historical controls (4/2013-8/2013) on an inpatient oncology floor at a tertiary care academic hospital. Interventions included the development of an institutional CPG which standardized the definition of FN, implementation of a new clinical workflow, creation of education sessions for LIP’s and RN’s, and creation of an electronic FN order set. The primary outcome was TTA, with target goal being &lt; 60 minutes from the onset of fever. Secondary outcomes included time to antibiotic order, need for ICU care, and 30-day mortality. P-values were calculated using a chi-square test. Results: In total, 31 consecutive FN episodes were observed over the 5-month study period. The median TTA decreased from 112 minutes in 2013 to 37.5 minutes in 2015 (p &lt; 0.001). 30/31 (97%) patients in the 2015 group had their antibiotics ordered within 60 minutes vs 14/22 (64%) in 2013 (p = 0.002). 26/31 (84%) patients in the 2015 group had antibiotics administered within 60 minutes vs 4/22 (18%) in 2013 (p &lt; 0.001). There was no significant difference in need for ICU care (16% in 2015 vs 9% in 2013, p = NS) or 30-day mortality (6% in 2015 vs 5% in 2013, p = NS). Conclusions: The inpatient FN CPG is a significant quality improvement initiative that has shown significant improvements in TTA. We were able to demonstrate value by a significant decrease in median TTA compared to historical controls with a significantly increased percentage of patients having both antibiotics ordered and administered within 60 minutes. In our cohort of patients, no significant differences were noted in rates of ICU care or 30-day mortality.
Effect of KIT Inhibition by Imatinib on Airway Mast Cells in Patients with Severe Refractory Asthma (KIA)
Authors: Katherine N. Cahill, Howard Katz, Jing Cui, Juying Lai, Shamsah Kazani, Allison Crosby-Thompson, Denise Garofalo, Mario Castro, Nizar N. Jarjour, Emily DiMango, Serpil C. Erzurum, Jennifer L. Trevor, Kartik Shenoy, Vernon M. Chinchilli, Michael E. Wechsler, Tanya M. Laidlaw, Elliot Israel, Joshua A. Boyce
Journal: Journal of Allergy and Clinical Immunology (2017)
Elevated Blood Lead Levels Associated with Retained Bullet Fragments — United States, 2003–2012
Authors: Debora Weiss, Carrie D. Tomasallo, Jon G. Meiman, Walter Alarcon, Nathan M. Graber, Kristine M. Bisgard, Henry A. Anderson
Journal: MMWR Morbidity and Mortality Weekly Report (2017)

An estimated 115,000 firearm injuries occur annually in the United States, and approximately 70% are nonfatal (1). Retained bullet fragments (RBFs) are an infrequently reported, but important, cause of lead toxicity; symptoms are often nonspecific and can appear years after suffering a gunshot wound (2,3). Adult blood lead level (BLL) screening is most commonly indicated for monitoring of occupational lead exposure; routine testing of adults with RBFs is infrequent (3). States collaborate with CDC's National Institute for Occupational Safety and Health (NIOSH) to monitor elevated BLLs through the Adult Blood Lead Epidemiology and Surveillance (ABLES) program (4,5). To help assess the public health burden of RBFs, data for persons with BLLs ≥10 μg/dL reported to ABLES during 2003-2012 were analyzed. An RBF-associated case was defined as a BLL ≥10 μg/dL in a person with an RBF. A non-RBF-associated case was defined as a BLL ≥10 μg/dL without an RBF. During 2003-2012, a total of 145,811 persons aged ≥16 years with BLLs ≥10 μg/dL were reported to ABLES in 41 states. Among these, 457 RBF-associated cases were identified with a maximum RBF-associated BLL of 306 μg/dL. RBF-associated cases accounted for 0.3% of all BLLs ≥10 μg/dL and 4.9% of BLLs ≥80 μg/dL. Elevated BLLs associated with RBFs occurred primarily among young adult males in nonoccupational settings. Low levels of suspicion of lead toxicity from RBFs by medical providers might cause a delay in diagnosis (3). Health care providers should inquire about an RBF as the potential cause for lead toxicity in an adult with an elevated BLL whose lead exposure is undetermined.
Aerobic Glycolysis Predicts Outcome in Early Chronic Lymphocytic Leukemia.
Authors: Jeffrey R Gardner, Sean Devlin, Kristina Knapp, Francesco Bauli, Nicole Lamanna, Mark G. Frattini, Renier J Brentjens, Peter G. Maslak, Joseph G. Jurcic, Mark Weiss, David A. Scheinberg, Mark Heaney
Journal: Blood (2012)
Prediction of peanut allergy in adolescence by early childhood storage protein-specific IgE signatures: The BAMSE population-based birth cohort
Authors: Anna Asarnoj, Carl Hamsten, Christian Lupinek, Erik Melén, Niklas Andersson, Josep M. Anto, Jean Bousquet, Rudolf Valenta, Marianne van Hage, Magnus Wickman
Journal: Journal of Allergy and Clinical Immunology (2017)
All-Trans Retinoic Acid and Interferon-Alpha Increase CD38 Expression on Adult T-Cell Leukemia Cells and Sensitize Them to T Cells Bearing Anti-CD38 Chimeric Antigen Receptors
Authors: Keichiro Mihara, Tetsumi Yoshida, Seiko Ishida, Yoshifumi Takei, Akira Kitanaka, Kazuya Shimoda, Kazuhiro Morishita, Yoshihiro Takihara, Tatsuo Ichinohe
Journal: Blood (2015)
Pilot immunotherapy trial in high-risk pediatric sarcomas.
Authors: M. O. Amoako, M. S. Merchant, D. B. Bernstein, K. Baird, C. Mackall
Journal: Journal of Clinical Oncology (2011)

9541 Background: The prognosis for children and young adults with metastatic pediatric sarcomas remains poor. While many of these patients can achieve a complete response with intensive therapy, greater than 70% will have disease relapse within 5 years. This pilot study investigated the feasibility and safety of administering immunotherapy with immune reconstitution and dendritic cell-based autologous tumor vaccines in high-risk patients with metastatic or recurrent pediatric sarcomas. Methods: Six patients with recurrent or metastatic Ewing sarcoma family of tumors (ESFT) underwent a tumor biopsy and leukapheresis for collection of peripheral blood mononuclear cells prior to the initiation of standard therapy. Following cytoreductive therapy, patients received an autologous lymphocyte infusion depleted of regulatory T cells plus six vaccines of monocyte-derived dendritic cells pulsed with tumor lysate and keyhole limpet hemocyanin (KLH). The primary endpoints were feasibility, identification of immune responses, and evaluation of toxicity. Secondary endpoints included determination of event free/overall survival and assessment of regulatory T cell reconstitution. Results: Six patients with ESFT, age range 8–28 years (median age =15 years), were enrolled. Sufficient tumor samples were obtained from five patients. One patient with a recurrence in bone had enough tumor harvested to receive only three vaccinations. Each patient received an autologous T-cell infusion with a median pre and post depletion percentage of CD25+ T cells of 9.66 and 0.05 respectively. One patient had a positive immune response to tumor lysate and all six patients had a positive KLH response as measured by interferon (IFN) gamma Elispot assay. Five patients remain with no evidence of disease at 2.5– 3.5 years (median follow up = 3.15 years). One patient relapsed. All six patients are alive at time of analysis. Toxicity was minimal. Conclusions: Analysis of this completed cohort reveals that immunotherapy is a feasible and safe adjunct to standard multimodal therapy in high-risk patients with metastatic or recurrent pediatric sarcomas. A second cohort of patients is receiving recombinant interleukin (IL)-7 to test if the efficacy of the immunotherapy can be enhanced.
Once-daily Tiotropium Respimat® Add-on Therapy Has a Safety Profile Comparable with Placebo in Children and Adolescents
Authors: Mark L. Vandewalker, Eckard Hamelmann, Michael Engel, Georges El Azzi, Petra Moroni-Zentgraf, Anna Unseld, Christian Vogelberg, Stanley J. Szefler
Journal: Journal of Allergy and Clinical Immunology (2017)
Immunized Against Hepatitis B Virus Allografted Recipients Are at High Risk for Gradual Surface Antibody (HbsAb) Disappearance Post Transplant, Regardless of Adoptive Immunity Transfer: A Study of 82 Allografted Long Term Survivors.
Authors: Panayotis Kaloyannidis, Evangelia Yannaki, Ioannis Batsis, Despoina Adamidou, Demetrios Bartzoudis, Maria Papathanasiou, Despoina Mallouri, Ioanna Sakellari, Athanasios Fassas, Achilles Anagnostopoulos
Journal: Blood (2006)
Why do cancer patients die in the emergency department (ED)? Analysis of 283 deaths in North Carolina EDs in 2008.
Authors: Ashley Nicole Leak, Deborah K. Mayer, Debbie Travers, Annah Wyss, Anna Waller
Journal: Journal of Clinical Oncology (2012)

6119 Background: Emergency departments (ED) in the US are utilized by cancer patients for symptom management, treatment side effects, oncologic emergencies, and/or end of life care. EDs have become a place where acute care needs are addressed and there are discussions about end of life care. The purpose of this study was to describe characteristics of cancer patients who died in the ED, highlighting lung cancer patients and their ED visit characteristics. Methods: A secondary data analysis of ED visit data fromthe North Carolina Disease Event Tracking and Epidemiologic Collection Tool (NC DETECT), a population database of 110 of the 112 EDs in NC in 2008. This was a descriptive, retrospective analysis providing descriptive statistics of patient demographics including: sex, age at death, insurance, cancer type, and visit categories (hour, day, month). Free text chief complaints, as recorded by the health care provider, were cleaned and categorized. Results: There were37,760 ED visits by 27,644 patients associated with cancer; 283 (1%) of these visits resulted in death in the ED. The most common chief complaints of those who died were respiratory distress (17.3%), neurological changes (13.4%), and pain (5.7%). Of all cancer deaths, 63% were male with a mean age of 66 (SD 14.2). Over a third (N= 104, 36.7%) of cancer ED visits resulting in death had a code for lung cancer listed. Medicare was the insurance provided for almost half (47.3%) of these patients. Majority of deaths occurred on a patient’s first ED visit (70.9%). Although a third (34.7%) of deaths occurred during weekends, over a third (37.5%) occurred during weekday clinic hours. Conclusions: Even though deaths in the ED were infrequent, this study provides insight into reasons patients visit the ED. Some patients were enrolled in Hospice and/or had a DNR documented. This study can inform future research associated with precipitating factors leading up to the ED visit (e.g. worsening shortness of breath, location of care prior to ED visit). This study illustrates the importance of research on discussion of end of life care needs (advanced directives, code status, use of Hospice services) with cancer patients and their family before they reach the final stage of their disease.
Enteric helminth-induced type I interferon signaling protects against pulmonary virus infection through interaction with the microbiota
Authors: Amanda J. McFarlane, Henry J. McSorley, Donald J. Davidson, Paul M. Fitch, Claire Errington, Karen J. Mackenzie, Eva S. Gollwitzer, Chris J.C. Johnston, Andrew S. MacDonald, Michael R. Edwards, Nicola L. Harris, Benjamin J. Marsland, Rick M. Maizels, Jürgen Schwarze
Journal: Journal of Allergy and Clinical Immunology (2017)
A placebo-controlled trial of aprepitant for cough in lung cancer.
Authors: Amelie Sylvia Mary Harle, Jaclyn A Smith, Alex Molassiotis, Kimberley Lofthouse, Rachel Dockry, Philip Russell, Katy Burns, Fiona Helen Blackhall
Journal: Journal of Clinical Oncology (2015)

2 Background: There are no evidence-based therapies for cough in lung cancer (LC).The neurokinin-1 (NK-1) pathway is implicated in cough. Aprepitant is an NK-1 antagonist used as an antiemetic. We assess aprepitant as an antitussive, using objective daytime ambulatory cough monitoring (ACM) as the primary endpoint. Methods: LC patients with a “bothersome” cough were enrolled on an exploratory single-arm randomised double-blind crossover trial and received 125mg aprepitant on day 1 and 80mg on days 2 and 3 or matched placebo capsules. After a 3 day wash out,patients crossed over to placebo or aprepitant for 3 days (days 7-9). They completed ACM and validated subjective cough tools. Results: 20 LC patients were enrolled between 7th Oct 2013-3rd Nov 2014; mean age 66 yrs (SD 7.69); 60% (n=12) female; 70% (n=14) ex, 25% (n=5) current and 5% (n=1) never smokers respectively. 20% (n=4), 55% (n=11) and 25% (n=5) had a performance status of 0, 1 and 2 respectively. The majority (80% n=16) had non-small cell LC; half (n=10) had advanced stage; 20% (n=4) were on anticancer therapy. Daytime cough frequency was 15.9 (95%CI 10.1-28.3 n=19), 12.8 (95% CI 8.7-18.8 n=18) and 16.2 (11.3-23.0 n=19) coughs/hr at baseline, on aprepitant and on placebo respectively: p=0.03. Visual analogue scale scores (range 0-100, high score=worse severity) were 57.0mm (95% CI 47.4-67.2 n=19), 40.8mm, (95%CI 34.3-47.3 n=18), and 49.8mm (95%CI 44.2-55.4 n=19) at baseline, on aprepitant and on placebo respectively: p=0.008. The Manchester Cough in Lung Cancer Scale score (range 1-50, high score = worse cough impact) was 25.2 (95%CI 23.0-28.0 n=19), 19.5 (95%CI 17.8-21.2 n=18) and 21.7 (20.3-23.1 n=18) at baseline, on aprepitant and on placebo respectively: p&lt;0.001.There were no serious adverse events. Conclusions: This is the first trial to assess the efficacy of a novel antitussive using validated subjective and objective cough tools in LC and the first to investigate a centrally acting NK-1 antagonist in humans. Aprepitant treatment was associated with statistically significant improvements in objective and subjective scores. The NK-1 receptors may be key mediators in cough in LC. It is possible to run a robust trial using validated measures with clinically meaningful endpoints in a LC population. Clinical trial information: ISRCTN16200035.
MOZ and MOZ-CBP Cooperate with NFκB To Induce Expression of NFκB-Dependent Genes.
Authors: Edward M. Chan, Rebecca J. Chan, Elisha M. Comer, Robert J. Goulet, Colin D. Crean, Zachary D. Brown, Amy M. Fruehwald, Zhenyun Yang, Howard S. Boswell, Harikrishna Nakshatri, Theodore G. Gabig
Journal: Blood (2007)
Treatment of rectal cancer with synchronous metastasis at diagnosis: 65 consecutive Italian cases of the Bologna Multidisciplinary Rectal Cancer Group.
Authors: Carmine Pinto, Sara Pini, Francesca Di Fabio, Dajana Cuicchi, Bruno Iacopino, Ferdinando Lecce, Giorgio Ercolani, Fabiola Lorena Rojas Llimpe, Stefania Giaquinta, Andrea Martoni
Journal: Journal of Clinical Oncology (2012)

676 Background: Twenty per cent of middle/low rectal cancer pts have synchronous distant metastasis (M1) at diagnosis. At present, the treatment strategy in this pt setting is not well defined. This mono-institutional retrospective analysis evaluates the treatment strategy and clinical outcome of three different pt group. Methods: Between January 2000-July 2011 the Bologna Multidisciplinary Rectal Group of S. Orsola-Malpighi Hospital evaluated 65 pts with rectal cancer M1 disease. Three different groups were defined: rectal cancer with resectable metastatic disease (Group A); rectal cancer with potentially resectable metastatic disease (Group B); and rectal cancer with unresectable metastatic disease (Group C). Treatment strategy in the different groups entailed an individualized approach. Results: The distribution per group was: Group A 11 (17%) pts, Group B 28 (43%), and Group C 26 (40%). The pt characteristics were: M 42 (64.6%), F 23 (35.4%); median age 62 years (35-83); median ECOG PS 0 (0-2); cT3 45(69.2%), cT4 20 (30.8%); cN- 10 (15.4%), cN+ 55 (84.6%); M1 sites: liver 32 (49.2%), lung 8 (12.3%), liver + lung 11 (16.9%), ovary/peritoneal carcinosis/abdominal lymph nodes 7 (10.8%), liver + bone 2 (3.1%), &gt;2 sites 5 (7.7%). Forty-three (66.2%) pts underwent to surgery for primary rectal tumor, and 30 (46.2%) pts for metastasis resection (23 liver, 5 lung, 2 liver + lung). Treatments for different groups are shown (Table). Median OS according to the three different groups was: Group A not reached, Group B 32 months (95% CI 24-40), and Group C 16 months (95% CI 7-26). Patients undergoing metastasis resection have higher median OS than those not resected: 44 months (95%CI 12-76) vs 15 months (95% CI 8-23) (p=0.0006). Conclusions: Treatment strategy in synchronous metastatic rectal cancer must consider the possibility of distant metastasis resection. Long-term survival can be achieved using an integrated approach. [Table: see text]
Update of the Modified Hyper-CVAD Regimen with or without Rituximab as Frontline Therapy of Adults with Acute Lymphocytic Leukemia (ALL) or Lymphoblastic Lymphoma (LL).
Authors: Deborah A. Thomas, Hagop Kantarjian, Stefan Faderl, Charles Koller, Farhad Ravandi-Kashani, Miloslav Beran, Susan O’Brien
Journal: Blood (2007)
Overall survival of men with metastatic castration-resistant prostate cancer (mCRPC) receiving first-line docetaxel-containing chemotherapy according to their participation (or not) in clinical trials.
Authors: Jatinder Goyal, Peng Huang, Prachi Tyagi, Daniel Oh, Michael Anthony Carducci, Mario A. Eisenberger, Emmanuel S. Antonarakis
Journal: Journal of Clinical Oncology (2012)

148 Background: There is insufficient evidence to determine whether clinical trial participation can itself lead to improved clinical outcomes in patients with mCRPC treated with docetaxel chemotherapy. We compared clinical characteristics and survival outcomes of patients with mCRPC receiving first-line docetaxel-containing therapy on a clinical study (trial participants) or outside of a clinical trial (non-participants). Methods: We retrospectively reviewed the records of 245 consecutive chemotherapy-naïve patients with mCRPC who received docetaxel-containing therapy between 1/1/1998 and 1/1/2010, either as trial participants (n=142; 11 separate studies) or as non-participants (n=103). Patient demographics, baseline clinical characteristics, treatment details and follow-up data were recorded. Results: In unadjusted analysis, trial participants were more likely to be white (83 vs 70%, p=0.005), to have better ECOG performance status (p=0.01), higher baseline hemoglobin (12.4 vs 11.6 g/dL, p=0.0003), higher albumin (4.3 vs 4.0 g/dL, p=0.009), lower creatinine (0.90 vs 1.04 mg/dL, p=0.01), and to have received a higher number of chemotherapy cycles (6.6 vs 5.1, p=0.001) than non-participants. In Kaplan-Meier analysis, median overall survival was significantly longer among trial participants vs non-participants (21.3 vs 17.1 months, p=0.024). In multivariable analysis, trial participation (HR 0.53, p=0.013), more chemotherapy cycles (HR 0.87; p=0.0002), baseline hemoglobin &gt;12 g/dL (HR 0.67, p=0.016), lower ECOG score (HR 0.57, p=0.026) and lower baseline (log) PSA (HR 0.85, p=0.012) were all found to be independent predictors of survival. Conclusions: Clinical trial participation is an independent positive predictor of overall survival in men undergoing first-line docetaxel-containing chemotherapy for mCRPC. Improved survival in trial participants may reflect better medical oversight typically seen in patients enrolled in clinical trials, more regimented follow-up schedules, or a positive effect on caregivers’ attitudes due to greater contact with medical services.
Treatment patterns by lines of therapy in metastatic breast cancer: Evidence from a large insured population in the United States.
Authors: Saurabh Ray, Vijayveer Bonthapally, Donna McMorrow, Machaon Bonafede, Pamela Landsman-Blumberg
Journal: Journal of Clinical Oncology (2012)

116 Background: Metastatic breast cancer (mBC) guidelines contain multiple lines of treatment (LOTs) and regimen options, however little data on treatment patterns is available from real world clinical practice. This study describes patterns of chemo and biologic therapy use by LOT observed within a large U.S. insured population. Methods: Adult women with newly diagnosed mBC and starting anti-neoplastic treatment were identified in the 2005-2009 MarketScan Database which contains medical, pharmacy claims of &gt; 40 million enrollees insured with &gt;100 health plans across the United States. The index date was the first prescription fill or administration of anti-neoplastic treatment following metastatic diagnosis. A 90-day gap in treatment or initiation of a new regimen defined the end of a LOT. Patient demographics and clinical characteristics were measured at index. Descriptive analyses included the distribution of patients, use of chemo and biologic therapies and their therapy duration, across the first 4 LOTs observed. Results: Of 7,767 patients identified (mean (SD) age=58.2 (11.9) years), ≥50% received a subsequent LOT across the 4 LOTs (2 nd LOT n=4,077, 3 rd LOT n=2,033, 4 th LOT n=1,059). Bone (44%) was the major metastatic site at diagnosis. The days on therapy (mean, SD, median) varied across LOTs: (162.7, 176.9, 108.0) in 1 st , (147.5, 146.7, 99.0) in 2 nd , (139.9, 131.1, 99.0) in 3 rd , and (130.9, 123.4, 94.0) in 4 th LOT. The most common backbone chemotherapies were: paclitaxel (26%), capecitabine (22%), docetaxel (22%) in 1 st ; paclitaxel (28%), capecitabine (18%), gemcitabine (16%) in 2 nd ; paclitaxel (22%), gemcitabine (19%), capecitabine (16%) in 3 rd , and gemcitabine (19%), paclitaxel (18%), capecitabine (16%) in 4 th LOT. Trastuzumab was the most frequently used biologic across all 4 lines (20%, 19%, 19%, 19% in 1 st to 4 th LOT respectively) followed by bevacizumab (20%, 19%, 19%, 19% in 1 st to 4 th LOT respectively). Lapatinib was used in 3 rd (6%) and 4 th LOTs (8%) only. Conclusions: Frequency and duration of chemo and biologic therapy use varied by LOT. The most frequently used agents across the 4 LOTs were paclitaxel (chemo backbones) and trastuzumab (biologics). Number of patients halved with each subsequent LOT.