3 results on '"Lakhwani, Sunil"'
Search Results
2. Valor pronóstico de la amplitud de distribución eritrocitaria al diagnóstico en el linfoma difuso de células grandes B
- Author
-
Reyes Goya, Cristian David, López García, Paula María, Raya Sánchez, José María, Lakhwani, Sunil, and Grado En Medicina
- Subjects
Supervivencia ,Linfoma difuso de células grandes B ,Factores pronósticos ,Amplitud de distribución eritrocitaria ,ADE - Abstract
El linfoma difuso de células grandes B (LDCGB) se define como una neoplasia linfoide de fenotipo B compuesta por células de tamaño grande que infiltra de forma difusa el tejido linfoide. Se trata del subtipo más frecuente dentro de los linfomas no Hodgkin en adultos y está considerado un linfoma agresivo. Actualmente, la única herramienta validada para establecer una aproximación pronóstica es el Índice Pronóstico Internacional (IPI) que tiene en cuenta edad, ECOG, estadio y afectación extraganglionar, pero tiene sus limitaciones, sobre todo en pacientes clasificados como de alto riesgo. Es por ello, que en los últimos años ha surgido la necesidad de buscar otras herramientas. La amplitud de distribución eritrocitaria (ADE) es una variable cuantitativa de la serie roja que mide el grado de heterogeneidad del volumen de los hematíes (anisocitosis), tradicionalmente utilizada en el diagnóstico diferencial de las anemias, pero a la que cada vez se le presta mayor atención como marcador pronóstico en algunas enfermedades oncológicas. En este trabajo revisamos de forma retrospectiva las historias clínicas de 53 pacientes diagnosticados de LDCGB entre 2010 y 2015 en el Complejo Hospitalario Universitario de Canarias, analizando, entre otros parámetros, el ADE al momento del diagnóstico, para ver su impacto en la supervivencia libre de progresión (SLP) y en la supervivencia global (SG) de los pacientes. Un total de 21 enfermos presentaron un ADE elevado (superior al punto de corte establecido, del 15%), y al comparar este grupo con los pacientes con ADE normal se encontró que tanto la SLP como la SG estaban significativamente acortadas en el primer grupo. En definitiva, demostramos en nuestra serie el valor pronóstico de este parámetro, de fácil obtención y muy bajo coste, en el LDCGB, lo cual avala su eventual inclusión en sistemas de puntuación pronóstica que puedan complementar los scores pronósticos actuales. Diffuse large B-cell lymphoma (DLBCL) is defined as a phenotype B lymphoid neoplasm composed of large cells that diffusely infiltrate lymphoid tissue. It is the most common subtype of non-Hodgkin lymphomas in adults and is considered an aggressive lymphoma. Currently, the only validated tool to establish a prognostic approach is the International Prognostic Index (IPI) that takes into account age, ECOG, stage and extranodal involvement, but this index has its limitations, especially in patients classified as high risk. That is why the need to look for other tools has arisen in the last years. Red cell distribution width (RDW) is a quantitative variable of the erythroid linage that measures the degree of heterogeneity in the volume of red blood cells (anisocytosis), traditionally used in the differential diagnosis of anemias, but which is increasingly being used as a prognostic marker in some oncological diseases. In this work, we retrospectively review the medical records of 53 patients diagnosed with DLBCL between 2010 and 2015 at the Complejo Hospitalario Universitario de Canarias, analyzing, among other parameters, the RDW at the time of diagnosis, to see its impact on progression-free survival (PFS) and overall survival (OS) of the patients. A total of 21 patients had a high RDW (higher than the established cut-off point of 15%), and when compared with patients with normal RDW, it was found that both PFS and OS were significantly shortened in the first group. In short, we demonstrated in our series the prognostic value of this parameter in the DLBCL, easily obtained and very low cost, which supports its possible inclusion in prognostic scoring systems that can complement current prognostic scores.
- Published
- 2022
3. Identification of patient-reported outcomes measures (PROMs) and patient-reported experiences measures (PREMs) in Gaucher disease in Spain.
- Author
-
Giraldo P, Camprodón M, Alcolea PC, Gras-Colomer E, Ibarretxe D, Lakhwani S, Mora E, Calderón MPV, and Morales-Conejo M
- Subjects
- Humans, Spain, Male, Surveys and Questionnaires, Female, Adult, Gaucher Disease therapy, Patient Reported Outcome Measures, Delphi Technique, Quality of Life
- Abstract
Background: Patient-reported outcome measures (PROMs) and patient-reported experiences measures (PREMs) are crucial for understanding the impact of GD on quality of life and patient's perceptions on care, but also to guide decision-making processes. Nevertheless, no specific PREMs in GD have been published, neither PROMs for Spanish GD patients have been developed., Methods: Two project coordinators selected key-points to be included in a PROMs/PREMs questionnaire, and the scientific committee and a group of expert patients contributed to the initial draft. Then, 9 meetings with experts were held to discuss controversial points. After, a questionnaire with 103 items regarding symptomatology, aspects of daily life and care experience was developed. Finally, it was conducted a Delphi survey among a multidisciplinary group of experts in GD., Results: Consensus was reached on 85 out of the 103 items. Recommendations on PROMs and PREMs regarding symptomatology, aspects of daily life and care experience were obtained. Consensus was reached on the importance of considering fatigue, concentration problems, and communication issues in GD patients using 5-step analog scales. Panelists recommended asking GD patients about the impact on social functioning and work/school performance. Finally, consensus was reached on considering care experiences, such as treatment satisfaction, treatment interruptions or transitions and healthcare professionals involved in patient's management to perceive patient's perceptions., Conclusion: This expert consensus may help developing GD-specific PROMs/PREMs for improving GD management. Properly developed and validated PROMs/PREMs may help decision-making, establishing patient-tailored therapeutic and follow-up goals., (Copyright © 2024 The Authors. Published by Elsevier España, S.L.U. All rights reserved.)
- Published
- 2024
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.