Publications by authors named "Tavitian S"
The aim of our study was to analyze the potential survival benefit associated with HSCT according to clinico-biological scores which incorporate molecular data (MIPSS70 and MIPSS70+V2) to facilitate decision-making in this context. One transplant (n=241) and one non-transplant cohorts (n=239) were used to test the hypothesis that PMF patients with higher risk molecular score benefit from HSCT. A weighted propensity score was applied to balance confounding factors with the transplanted cohort as reference.
View Article and Find Full Text PDFAccording to current recommendations, older AML patients in first complete remission (CR) after induction chemotherapy should receive consolidation with intermediate-dose cytarabine (IDAC). However, no study has demonstrated the superiority of IDAC over other regimen. In this retrospective study, we compared the efficacy of mini-consolidations (idarubicin 8 mg/m day 1, cytarabine 50 mg/m/12 h, day 1-5) and IDAC.
View Article and Find Full Text PDFArticle Synopsis
- The study examines outcomes of 67 patients (average age 20.6 years) who underwent their first allogeneic hematopoietic stem cell transplant (HSCT) due to GATA2 deficiency across 21 centers in June 2022, showing varied indications for the transplant.
- The findings reveal significant rates of acute graft versus host disease (GvHD) and chronic GvHD; the incidence of relapses was low, with overall survival rates at 1 and 5 years being 83% and 72%, respectively.
- The analysis highlights that monitoring bone marrow for clonal evolution is crucial to initiate HSCT before the development of excessive blasts, noting that factors like earlier years of HSCT and certain
Article Synopsis
- Adult T-cell acute lymphoblastic leukemia (T-ALL) has a low survival rate after it relapses, particularly the early T-cell precursor subtype, which shares similarities with acute myeloid leukemia.
- A case study is presented where a patient relapsed just 3 months post allogeneic stem cell transplantation but achieved complete remission through treatment with azacitidine and has remained on therapy for 9 years.
- The discussion highlights the biological factors contributing to this long-term response and explores the potential benefits of combining hypomethylating agents like azacitidine with other drugs, such as venetoclax, for improved outcomes.
Article Synopsis
- Acute myeloid leukemia (AML) with BCR::ABL1 is classified as an adverse-risk group in the 2022 ELN classification, but its outcomes with modern treatment options like tyrosine kinase inhibitors are not well understood.
- In a study of 20 patients with de novo BCR::ABL1 AML from a large registry, most received standard chemotherapy with imatinib, leading to a high complete remission rate of 94.4%.
- The survival rates suggest BCR::ABL1 AML patients have better outcomes than those classified in traditional adverse-risk categories, indicating they may need reclassification in future treatment guidelines.
Article Synopsis
- Iptacopan, an oral factor B inhibitor, shows promise in treating paroxysmal nocturnal hemoglobinuria patients suffering from persistent hemolytic anemia, especially those not responding to anti-C5 therapy.
- In two phase 3 trials, iptacopan significantly improved hemoglobin levels in patients with low baseline hemoglobin (under 10 g/dL), with many experiencing increases of at least 2 g/dL without needing blood transfusions.
- The results revealed that 85% of patients in the first trial and nearly all in the second trial experienced a notable increase in hemoglobin levels, leading to reduced fatigue and dependency on transfusions.
Article Synopsis
- A low allele burden (<20%) of the CALR driver mutation is present in 10.8% of patients with CALR-mutated myeloproliferative neoplasms (MPNs), primarily seen in essential thrombocythemia.
- Patients with this low allele burden tend to have a milder disease phenotype.
- Those with less than 20% allele burden also experience a slower progression of their condition compared to patients with a higher allele burden (≥20%).
Article Synopsis
- Acute myeloid leukemia (AML) with myelodysplasia-related characteristics presents a mixed prognosis, and there's limited understanding of patient outcomes after first-line treatment in refractory or relapsed cases.
- A study involving 183 patients found that the median overall survival was 4.2 months, with no significant survival difference between refractory and relapsed patients; however, patients receiving best supportive care had markedly poorer outcomes.
- The research suggests that both intensive chemotherapy and azacitidine are viable treatment options for this tough-to-treat population, and emphasizes the need for further exploration of new targeted therapies.
Article Synopsis
- Researchers created AI-based prediction models using data from 3,687 acute myeloid leukemia patients, focusing on two treatment types: intensive chemotherapy and azacitidine.
- A multilayer perceptron neural network demonstrated prediction accuracies of 68.5% for intensive chemotherapy patients and 62.1% for those treated with azacitidine.
- The Boruta algorithm effectively identified key diagnostic features needed for predictions, streamlining the complexity of data analysis for hematologists and potentially improving treatment decisions.
Article Synopsis
- Recent research indicates that vitamins C and D may play a role in supporting patients with acute myeloid leukemia (AML) during intensive chemotherapy.!
- A study tracking 431 AML patients from 2015 to 2020 found that those who received vitamin supplementation showed higher vitamin levels and fewer complications like infections compared to those who didn’t.!
- The analysis revealed that vitamin C/D supplementation significantly improved overall survival for patients with the NPM1 mutation, suggesting it could be a beneficial addition to AML treatment protocols.!
Article Synopsis
- The study investigates the role of autophagy induced by ruxolitinib in JAK2-driven myeloproliferative neoplasms (MPNs), highlighting its association with treatment resistance.
- Ruxolitinib activates protein phosphatase 2A (PP2A), leading to autophagy in JAK2 cells, and inhibiting either autophagy or PP2A enhances the drug's effectiveness by reducing cell proliferation and increasing their death.
- Using a strong autophagy inhibitor, Lys05, alongside ruxolitinib improved treatment outcomes in mice by reducing leukemia burden and extending survival, suggesting that targeting autophagy could make JAK2 MPN therapies more effective.
Article Synopsis
- The study explores the role of the transcription factor CCAAT-enhancer binding protein α (C/EBPα) in lipid metabolism and cellular homeostasis in acute myeloid leukemia (AML), particularly with mutations in FLT3.
- Researchers found that C/EBPα and FLT3 activation enhance lipid production and desaturation in AML cells, leading to increased vulnerability to oxidative stress.
- Inhibiting C/EBPα or FLT3 demonstrates potential for therapeutic strategies targeting lipid metabolism to promote ferroptotic cell death in FLT3-mutant AML, a type of leukemia affecting 30% of patients.
Brachytherapy for uterine cervix-limited acute myeloid leukemia relapse.
J Contemp Brachytherapy
December 2022
Article Synopsis
- Acute myeloid leukemia (AML) can occur outside the bone marrow during diagnosis or relapse, sometimes affecting areas like the uterine cervix.
- Granulocytic sarcoma in the uterine cervix is a rare condition, with no standard treatment available.
- Two cases of limited AML relapse in the cervix demonstrated that combining brachytherapy with chemotherapy may be an effective and well-tolerated treatment option.
Article Synopsis
- Germline mutations in the GATA2 gene increase the risk of developing myeloid cancers, particularly as patients acquire additional genetic mutations over time.
- An analysis of 78 patients revealed an exhaustion of myeloid progenitor cells and frequent somatic mutations in specific genes (STAG2, ASXL1, SETBP1) along with notable chromosomal abnormalities.
- Patients were categorized into three groups based on their bone marrow cell composition, with each group's mutations corresponding to their disease stage, indicating that understanding these mutations can improve patient management and illuminate cancer progression associated with GATA2 mutations.
Article Synopsis
- Acute myeloid leukemia (AML) is linked to leukemic stem cells (LSC), which affect patient responses to chemotherapy and overall survival, highlighting the importance of measuring LSC levels.
- A study evaluated 155 AML patients post-chemotherapy to assess the effectiveness of detecting measurable residual disease (MRD) in both bulk and LSC populations, using unsupervised clustering methods.
- Results showed a significant difference in overall survival rates between patients with positive MRD and those who tested negative, with some patients having negative Bulk MRD but positive LSC MRD, indicating these individuals have an intermediate prognosis.
Article Synopsis
- Researchers have developed a new classification system for acute myeloid leukemia (AML) using flow cytometry to identify six stages of differentiation arrest in leukemic cells based on specific protein expressions.
- The study analyzed two patient cohorts and found that different types of AML (stem cell-like versus progenitor-like) display distinct genetic characteristics, proliferation rates, and treatment responses, which influence patient outcomes.
- Factors such as NPM1 mutations are associated with more mature leukemia stages, while other genetic mutations (like CEBPA and RUNX1) help predict the severity and treatment efficacy for AML patients.
Article Synopsis
- A new scoring system was developed using data from three European registries involving 1,199 older AML patients (aged 70+) to help select treatment options based on factors like age and performance status.* -
- The scoring system identified three risk groups with varying 5-year overall survival probabilities: lower risk (≥12%), intermediate risk (3-12%), and higher risk (<3%).* -
- This European Scoring System for patients aged 70 and older is practical for everyday use and effectively predicts long-term survival, complete remission, and relapse-free survival in those undergoing intensive chemotherapy.*
Article Synopsis
- The study involved 526 acute myeloid leukemia patients who were not responding to or were relapsing after chemotherapy, with treatment options including intensive salvage chemotherapy, azacitidine, and best supportive care.
- Complete response rates varied significantly among the treatment groups, with intensive chemotherapy showing the best outcomes, while azacitidine had limited effectiveness.
- Predictive factors for worse survival included certain leukemia history, high bone marrow blasts, and adverse genetics, with AZA being beneficial in the short term but lacking in long-term survival for older patients.
Article Synopsis
- A phase 3 clinical trial evaluated the effectiveness and safety of adding eltrombopag to standard immunosuppressive therapy (horse ATG plus cyclosporine) in treating patients with severe aplastic anemia.
- Results showed a higher complete response rate at 3 months (22% with eltrombopag vs. 10% without) and improved overall response rates at 6 months (68% vs. 41%).
- The addition of eltrombopag enhanced the treatment's efficacy without increasing severe side effects, suggesting it could be a beneficial option for newly diagnosed patients.
Background: A large portion of COVID-19 cases and deaths in the United States have occurred in nursing homes; however, current literature including the frontline perspective of staff working in nursing homes is limited. The objective of this qualitative assessment was to better understand what individual and facility level factors may have contributed to the impact of COVID-19 on Certified Nursing Assistants (CNAs) and Environmental Services (EVS) staff working in nursing homes.
Methods: Based on a simple random sample from the National Healthcare Safety Network (NHSN), 7,520 facilities were emailed invitations requesting one CNA and/or one EVS staff member for participation in a voluntary focus group over Zoom.