Publications by authors named "Leora Comis"

Article Synopsis
  • A study evaluated 229 adult patients with chronic graft-versus-host disease (cGVHD) for the prevalence and impact of metabolic syndrome (MetS), finding that 54.1% met the diagnostic criteria for MetS.
  • Patients with higher body mass index and poorer performance status were more likely to have MetS, along with specific inflammatory and kidney function markers indicating its presence.
  • Despite the high prevalence of MetS, there were no significant differences in survival rates or cGVHD severity between patients with and without MetS, suggesting the need for proactive screening to prevent future complications.
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Article Synopsis
  • A study was conducted on kidney complications specifically among patients with chronic graft-versus-host disease (cGVHD) who underwent allogeneic hematopoietic stem cell transplants, involving 365 participants.
  • Out of the participants, 64 experienced kidney dysfunction, with 29 having moderate to severe issues, and those with dysfunction were more likely to have been treated with cyclosporine.
  • The analysis indicated that factors like cyclosporine use and protein levels were associated with kidney dysfunction, and lower overall survival was noted in patients with moderate-severe kidney issues, highlighting the need for better management of kidney health in these patients.
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Musculoskeletal symptoms in chronic graft-versus-host disease (cGVHD) are rare manifestations contributing to disease burden. This study assesses the frequency of muscle cramps, joint and muscle aches, and muscle weakness in a cohort of patients severely affected by cGVHD. Three hundred thirty-four patients participated in the NCI natural history study of cGVHD (NCT00092235) from October 2004 to March 2017.

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Introduction: Melorheostosis is a rare bone disorder with limited literature that describes the effect of this disease on functional and motor abilities. As part of a natural history study, four outcome measures were administered to better understand the burden this disease has on a person's ability to engage in basic and instrumental activities of daily living.

Objective: To investigate the relationship between functional engagement, fatigue, and motor ability in patients with melorheostosis.

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Grip myotonia and weakness are attractive treatment response biomarkers in clinical trials of myotonic dystrophy type 1 (DM1). There is a need to develop simple, patient-friendly and reproducible methods of quantifying grip myotonia in multisite trial settings. We designed a HandClench Relaxometer (HCR) that measures grip myotonia and strength.

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Bronchiolitis obliterans syndrome (BOS) is a severe manifestation of chronic graft-versus-host disease (cGVHD) following hematopoietic cell transplantation (HCT). Montelukast interrupts cysteinyl leukotriene (CysLT) activity and may diminish the activation and homing of cells to bronchioles and subsequent fibrosis. We performed a prospective phase II trial to test whether montelukast altered lung decline for patients with BOS after HCT.

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Adult-onset histiocytoses (AOH), primarily Rosai-Dorfman disease (RDD), Erdheim-Chester Disease (ECD), and adult Langerhans cell histiocytosis (ALCH), are a group of related histiocytic neoplastic disorders featuring multisystemic manifestations. The disorders are largely incurable, and are essentially chronic neoplastic diseases with a variable prognosis. Prompt diagnosis and treatment is important to prevent debilitating and even life-threatening complications.

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Subsequent cancer (SC) is a significant cause of morbidity and mortality in long-term survivors after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Chronic graft-versus-host disease (cGVHD) and treatment-related immunosuppression have been recognized as risk factors for SC. This study sought to investigate the incidence and risk factors for SC in patients with established cGVHD, assessed separately for onset of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC)-categorized into nonmelanoma skin cancer (NMSC)-and all cancers other than NMSC.

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Article Synopsis
  • Graft-versus-host disease (GVHD) affects a significant percentage of patients after allogeneic stem cell transplants, with sclerotic features impacting 10%-15% of these individuals, leading to diminished quality of life and functional limitations.
  • There is a lack of research on effective rehabilitation methods for sclerotic GVHD (sclGVHD), prompting a review of existing evidence and proposed multidisciplinary management strategies in this article.
  • The authors also discuss various techniques used for other sclerotic skin conditions that could potentially benefit sclGVHD patients, highlighting the need for tailored rehabilitation programs to optimize care.
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Steroid-refractory chronic graft-versus-host disease (cGVHD) is a therapeutic challenge. Sclerotic skin manifestations are especially difficult to treat. We conducted a randomized phase 2 clinical trial (#NCT01688466) to determine the safety, efficacy, and preferred dose of pomalidomide in persons with moderate to severe cGVHD unresponsive to corticosteroids and/or subsequent lines of therapy.

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The cognitive profile of Turner syndrome, a genetic disorder resulting from partial or complete X-chromosome deletion, presents characteristic deficits. Despite this, studies have yet to evaluate how deficits translate into and are compensated for in academic settings. This study seeks to explore cognitive functioning, as well as the accessibility and development of academic accommodations in females with Turner syndrome from adolescence to adulthood.

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Purpose: To explore improvement in motor ability, function, health-related quality of life (HRQOL), and symptom severity in patients with sclerotic chronic graft-versus-host disease (ScGVHD) in response to treatment as well as the relationship among changes on such measures.

Methods: This study was a secondary analysis of data from 13 individuals with severe ScGVHD enrolled in a clinical trial evaluating the efficacy of imatinib mesylate (clinicaltrials.gov identifier: NCT00702689).

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Article Synopsis
  • In 2005, NIH established criteria for diagnosing chronic graft-versus-host disease (cGVHD), which were revised in 2014 to enhance clarity and specificity.
  • A study involving 284 patients compared the 2005 and 2014 scoring, revealing that the newer criteria tended to categorize patients with milder scores, particularly in liver and lung assessments.
  • Both scoring systems were linked to physical limitations, such as reduced grip strength and joint motion, while the severe lung score from 2005 maintained its poor survival prediction, supporting the continued use of the updated 2014 criteria.
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Objectives: To characterize the psychosocial profiles of adult women diagnosed with Turner syndrome before (early diagnosis) and at or after (late diagnosis) 13 years of age.

Study Design: Women with Turner syndrome ages 22 and older at evaluation (n = 110) participated in a cross-sectional study at the National Institutes of Health. Researchers performed nonparametric and logistic regression analyses to assess early and late diagnosis cohorts on measures of depression, substance use, and perceptions of competence and identity.

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People who have cancer diagnoses often need care throughout their lives through all stages of their illness. These stages include diagnosis, primary treatment, survivorship, and end of life. The management of people with cancer, now a common and chronic illness with long-term survival improving, is complex, challenging, and rapidly changing.

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Sclerotic skin manifestations of chronic graft-versus-host disease (ScGVHD) lead to significant morbidity, including functional disability from joint range of motion (ROM) restriction. No superior second-line therapy has been established for steroid-refractory disease. Imatinib mesylate is a multikinase inhibitor of several signaling pathways implicated in skin fibrosis with in vitro antifibrotic activity.

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Between 2004 and 2010, 189 adult patients were enrolled on the National Cancer Institute's cross-sectional chronic graft-versus-host disease (cGVHD) natural history study. Patients were evaluated by multiple disease scales and outcome measures, including the 2005 National Institutes of Health (NIH) Consensus Project cGVHD severity scores. The purpose of this study was to assess the validity of the NIH scoring variables as determinants of disease severity in severely affected patients in efforts to standardize clinician evaluation and staging of cGVHD.

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