Publications by authors named "Wun T"

Article Synopsis
  • * The STOP trial established chronic transfusions as a key treatment for SCD in children at high risk for stroke, leading to a review of stroke rates in a large patient cohort from California.
  • * Data from 1991-2019 indicated rising rates of ischemic strokes and TIAs in younger and adult SCD patients, pointing to the importance of managing risk factors such as age, hypertension, and hyperlipidemia for stroke prevention.
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  • * A multidisciplinary team of experts from various medical fields contributes to these guidelines, ensuring comprehensive care for patients with cancer-associated VTE.
  • * The guidelines provide specific evaluation processes and recommended treatment options tailored to the different types of cancer-associated VTE.
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Acute myeloid leukemia (AML) often requires allogeneic hematopoietic cell transplantation (alloHCT) for cure, but historically alloHCT has been strikingly underutilized. Reasons for this remain uncertain at the population level. We examined alloHCT utilization over time and explored associations between demographic/healthcare factors and use of alloHCT by age group (AYA 15-39y, adult 40-64y, older adult 65-79y) using a linked dataset merging the Center for International Blood and Marrow Transplant Research, California Cancer Registry, and California Patient Discharge Database.

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Background: The association between cancer and venous thromboembolism (VTE) is well-established with cancer patients accounting for approximately 20% of all VTE incidents. In this paper, we have performed a comparison of machine learning (ML) methods to traditional clinical scoring models for predicting the occurrence of VTE in a cancer patient population, identified important features (clinical biomarkers) for ML model predictions, and examined how different approaches to reducing the number of features used in the model impact model performance.

Methods: We have developed an ML pipeline including three separate feature selection processes and applied it to routine patient care data from the electronic health records of 1910 cancer patients at the University of California Davis Medical Center.

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  • Sickle cell disease (SCD) has different types, with HbSS being the most common and HbSC being the second most common.
  • A study showed that people with HbSC disease, which was thought to be milder, actually experience more severe health problems compared to those with sickle cell anemia (SCA).
  • The findings suggest that HbSC disease needs more research and better treatments because it can cause serious complications.
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Compared with the general population, hematopoietic cell transplantation (HCT) survivors are at elevated risk for developing solid subsequent neoplasms (SNs). The Center for International Blood and Marrow Transplant Research (CIBMTR) is a key resource for quantifying solid SN incidence following HCT, but the completeness of SN ascertainment is uncertain. Within a cohort of 18 450 CIBMTR patients linked to the California Cancer Registry (CCR), we evaluated the completeness of solid SN data reported to the CIBMTR from 1991 to 2018 to understand the implications of using CIBMTR data alone or combined with CCR data to quantify the burden of solid SNs after HCT.

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Background: Cancer survivors have increased risk of endocrine complications, but there is a lack of information on the occurrence of specific endocrinopathies at the population-level.

Methods: We used data from the California Cancer Registry (2006-2018) linked to statewide hospitalisation, emergency department, and ambulatory surgery databases. We estimated the cumulative incidence of and factors associated with endocrinopathies among adolescents and young adults (AYA, 15-39 years) who survived ≥2 years after diagnosis.

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Introduction: Venous thromboembolism (VTE), a common complication in cancer patients, occurs more often during the initial phase of treatment. However, information on VTE beyond the first two years after diagnosis ('late VTE') is scarce, particularly in young survivors.

Methods: We examined the risk of, and factors associated with, late VTE among adolescents and young adults (AYA, 15-39 years) diagnosed with cancer (2006-2018) who survived ≥2 years.

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Purpose: Autologous hematopoietic cell transplantation (autoHCT) is associated with survival benefits in multiple myeloma (MM), but utilization remains low and differs by sociodemographic factors. Prior population-based studies have not fully captured autoHCT utilization or examined relationships between sociodemographic factors and autoHCT trends over time.

Patients And Methods: We used a novel data linkage between the California Cancer Registry, Center for International Blood and Marrow Transplant Research, and hospitalizations to capture autoHCT in a population-based MM cohort (n = 29, 109; 1991-2016).

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Excessive CO and food shortage are two grand challenges of human society. Directly converting CO into food materials can simultaneously alleviate both, like what green crops do in nature. Nevertheless, natural photosynthesis has a limited energy efficiency due to low activity and specificity of key enzyme D-ribulose-1,5-bisphosphate carboxylase/oxygenase (RuBisCO).

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Article Synopsis
  • This study evaluates the challenges of tracking outcomes after hematopoietic cell transplantation (HCT) by comparing data from two sources: the Center for International Blood and Marrow Transplant Research (CIBMTR) and the California Cancer Registry (CCR).
  • It finds high agreement in patient vital status (97%+) but significant discrepancies in the cause of death reporting, with CIBMTR reporting more noncancer-related deaths and CCR showing a higher number of cancer-related deaths.
  • The analysis reveals that the CCR provides longer follow-up durations, indicating potential benefits of integrating cancer registry data to improve understanding of patient outcomes post-HCT.
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There are >1.9 million survivors of adolescent and young adult cancers (AYA, diagnosed at ages 15-39) living in the U.S.

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Purpose: To report the incidence and risk factors for secondary neoplasm after transplantation for sickle cell disease.

Methods: Included are 1,096 transplants for sickle cell disease between 1991 and 2016. There were 22 secondary neoplasms.

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Adverse pregnancy outcomes occur frequently in women with sickle cell disease (SCD) across the globe. In the United States, Black women experience disproportionately worse maternal health outcomes than all other racial groups. To better understand how social determinants of health impact SCD maternal morbidity, we used California's Department of Health Care Access and Information data (1991-2019) to estimate the cumulative incidence of pregnancy outcomes in Black women with and without SCD-adjusted for age, insurance status, and Distressed Community Index (DCI) scores.

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Advances in hematopoietic cell transplantation (HCT) have substantially improved patient survival, increasing the importance of studying outcomes and long-term adverse effects in the rapidly growing population of HCT survivors. Large-scale registry data from the Center for International Blood and Marrow Transplant Research (CIBMTR) are a valuable resource for studying mortality and late effects after HCT, providing detailed data reported by HCT centers on transplantation-related factors and key outcomes. This study was conducted to evaluate the robustness of CIBMTR outcome data and assess health-related outcomes and healthcare utilization among HCT recipients.

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Article Synopsis
  • A phase 3 clinical trial assessed the safety and effectiveness of rivipansel, an E-selectin antagonist, in 345 patients (adults and children) with vaso-occlusive crises (VOC) requiring hospitalization.
  • The study found that rivipansel did not significantly improve the primary endpoint of time to readiness for discharge compared to placebo, although it did notably reduce soluble E-selectin levels in the treatment group.
  • A post hoc analysis suggested that administering rivipansel early after VOC pain onset could significantly decrease the time to discharge and reduce opioid use, indicating that the timing of treatment may be key for better outcomes.
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Importance: Sickle cell disease (SCD) is an inherited disorder of hemoglobin, characterized by formation of long chains of hemoglobin when deoxygenated within capillary beds, resulting in sickle-shaped red blood cells, progressive multiorgan damage, and increased mortality. An estimated 300 000 infants are born annually worldwide with SCD. Most individuals with SCD live in sub-Saharan Africa, India, the Mediterranean, and Middle East; approximately 100 000 individuals with SCD live in the US.

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Venous thromboembolism (VTE) is a life-threatening complication observed among patients with sickle cell disease (SCD) and also among those with severe COVID-19 infection. Although prior studies show that patients with SCD are at risk of severe COVID-19 illness, it remains unclear if COVID-19 infection further increases VTE risk for this population. We hypothesized that patients with SCD hospitalized for COVID-19 would have higher VTE rates than those hospitalized for other causes.

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Background: Hyper-CVAD is an established regimen for adult ALL that was developed at the MD Anderson Cancer Center (MDACC). However, results can vary across different institutions given the heterogeneity of patient populations and institutional practices. Moreover, while a MDACC study demonstrated that the combination of ponatinib plus hyper-CVAD produced remarkable activity in untreated Ph+ ALL, it remains to be externally validated.

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Purpose: To examine the relations between patient-reported outcomes (PROs) within a conceptual model for adults with sickle cell disease (SCD) ages 18 - 45 years enrolled in the multi-site Sickle Cell Disease Implementation Consortium (SCDIC) registry. We hypothesized that patient and SCD-related factors, particularly pain, and barriers to care would independently contribute to functioning as measured using PRO domains.

Methods: Participants (N = 2054) completed a 48-item survey including socio-demographics and PRO measures, e.

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Race and ethnicity are associated with risk of venous thromboembolism in population-based studies. Blacks/African Americans have a higher incidence, whereas Asians/Pacific Islanders and Hispanics have a lower incidence of venous thromboembolism compared with non-Hispanic Whites. The impact of race/ethnicity on the incidence of cancer-associated thrombosis (CAT), a common complication in patients with malignancy, has not been well defined.

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Introduction:  The epidemiology of isolated distal deep venous thrombosis (iDDVT) among cancer patients is not well described, particularly the incidence of recurrent venous thromboembolism (rVTE) and effect on mortality by cancer type.

Methods:  The cumulative incidence (CI) of iDDVT was determined for patients with 13 common cancers between 2005 and 2017 using the California Cancer Registry linked to the California Patient Discharge and Emergency Department Utilization datasets. The CI of rVTE was calculated and association of incident cancer-associated thrombosis (CT) location with rVTE was determined using Cox proportional hazards regression models.

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