Clinical Scales as Predictors of Mortality in Patients with Acute Leukemia During Intensive Induction Therapy
Camila Dias Pastana,
Dafne Rosa Benzecry,
Josy Marinho de Lima,
Marcos Laércio Pontes Reis,
Thiago Xavier Carneiro
Issue:
Volume 4, Issue 2, April 2019
Pages:
5-9
Received:
29 March 2019
Accepted:
6 May 2019
Published:
4 June 2019
Abstract: Therapy guidelines for acute leukemias (ALs) have focused on an arbitrary age cut-off as a guide for intensity of therapy. However, treatment outcomes depend on more important prognostic factors, such as performance status (PS) and the presence of comorbidities. This study aims to evaluate clinical scales as predictors of mortality in patients with acute leukemia during intensive induction therapy. This prospective cohort study included all patients diagnosed with Acute Myeloid Leukemia (AML) or Acute Lymphoblastic Leukemia (ALL) who received induction treatment at Ophir Loyola Hospital (HOL) in Belém-PA, from February 2018 to February 2019. The following scales were assessed: Eastern Cooperative Oncology Group (ECOG), Haematopoetic Cell Transplantation Comorbidity Index (HCT-CI), Cumulative Illness Rating Scale (CIRS), Charlson Comorbidity Index (CCI), Adult Comorbidity Evaluation 27 (ACE-27), Katz and Lawton scales, G8 Questionnaire and Mini Nutritional Assessment (MAN). The median age of the 40 patients included was 37 years old (range, 19-65) and sex distribution was equal. Univariate analysis showed that higher age (OR = 5.74, p 0.024), ACE 27 >0 (OR = 5.7, p 0.003) and HCT-CI >0 (OR = 3.87, p 0.02) were contributing factors to 40-day mortality, but no meaningful association was noticed with the other scales. Therefore, this study reaffirms the significant impact of comorbidities on the survival of patients with AL, suggesting that comorbidity assessment may be extremely helpful for making decisions on intensive induction therapy.
Abstract: Therapy guidelines for acute leukemias (ALs) have focused on an arbitrary age cut-off as a guide for intensity of therapy. However, treatment outcomes depend on more important prognostic factors, such as performance status (PS) and the presence of comorbidities. This study aims to evaluate clinical scales as predictors of mortality in patients with...
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Ommaya Reservoir Related Complications: A Single Center Experience and Review of Current Literature
Azka Ali,
Raphael Charles Bosse,
Bently Patrick Doonan,
Preeti Narayan,
Grant Alan Jester,
Jess David Delaune,
Jacob Leo Barish,
Samantha Leigh Welniak,
Hannah Friggle Norton,
Coy Don Heldermon
Issue:
Volume 4, Issue 2, April 2019
Pages:
10-24
Received:
21 February 2019
Accepted:
8 April 2019
Published:
11 June 2019
Abstract: First introduced in 1963, ommaya reservoirs (OmRs) are indwelling intraventricular catheters used for decompression of hydrocephalus, antibiotics, and chemotherapy delivery. They are important alternatives when lumbar punctures are not practical or when long-term administration of medications is needed. Despite being used for over 50 years, placement of these devices can still contribute to significant morbidity and mortality. We performed a single-center retrospective review at the University of Florida Cancer Center evaluating OmR related complications in patients in whom OmR was placed for chemotherapy. We also conducted a systematic review of OmR related and LP complications in setting of chemotherapy delivery. 13 patients met criteria for inclusion in this retrospective study. Time points evaluated for complications were: placement, up to 6 months, 6-12 months, > 12 months, removal and post-discharge. Our institutional data showed a complicated rate of <7% at each time point. For systematic review, 38 studies were reviewed for OmR data, and 8 studies were reviewed for LP data. Infectious complications were more prevalent in OmR studies with statistical significance (p=0.0017), whereas noninfectious complications were more prevalent in LP studies with statistical significance (p=0.0004). This study compared complication rates from infectious and non-infectious sources between patients receiving intrathecal chemotherapy through Ommaya reservoirs versus lumbar puncture. OmR can be very useful in long-term administration of medication, and the relatively high complication rate (especially infectious) can be deemed an acceptable risk for patient population with high morbidity.
Abstract: First introduced in 1963, ommaya reservoirs (OmRs) are indwelling intraventricular catheters used for decompression of hydrocephalus, antibiotics, and chemotherapy delivery. They are important alternatives when lumbar punctures are not practical or when long-term administration of medications is needed. Despite being used for over 50 years, placeme...
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Tumors Registry in Low Income Countries’ Hospital: A Retrospective Study of 350 Cases in the Democratic Republic of Congo from 2007 to 2017
Mwenze Didier,
Kyabu Véronique,
Mulenga Phillipe,
Mukalay Abdon,
Ilunga Julien
Issue:
Volume 4, Issue 2, April 2019
Pages:
25-28
Received:
2 April 2019
Accepted:
21 May 2019
Published:
11 June 2019
Abstract: Tumors had been misdiagnosed and under- documented for longtime in Africa. The Democratic Republic of Congo (DRC) has not any cancer registry available up today. The National Cancer Registry is an important tool to deal with cancer management, especially for the National Cancer Plan and cancer prevention. The African Cancer Registry Network (AFCRN) is trying to help many Countries to hold their national Registries in hope to provide tumors’ data. Despite National Cancer Registry, hospital Registries can be used for preliminary researches. This is a retrospective study performed to determine epidemiological and clinical data of tumors in Lubumbashi City, the second city in DRC, especially in the mines’ hospital during the period from 2007 to 2017. The authors collected data from 350 patients aged from 2 and 94 years. The average age was 46.3 ± 17.9 years. There were 299 Females and 51 males; means 85.4 vs 14.6%. Tumors of the female reproductive system accounted for 72.9%. Diagnosis was made by echography in 59.7% of cases. Palliative care was the main treatment in 51% of cases. This study has enlightened the fact that tumors are a serious problem of health in the Democratic Republic of Congo and there are many challenges to improve cancer survival in this country.
Abstract: Tumors had been misdiagnosed and under- documented for longtime in Africa. The Democratic Republic of Congo (DRC) has not any cancer registry available up today. The National Cancer Registry is an important tool to deal with cancer management, especially for the National Cancer Plan and cancer prevention. The African Cancer Registry Network (AFCRN)...
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