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3. Data-driven flow cytometry classification of blast differentiation in older patients with acute myeloid leukemia

Author

Rojas, F., Longoni, H., Milone, G., Fernández, I., Conciencia, Clínica, Ramirez, R., Canepa, C., Saba, S., Balladares, G., Ventiurini, C., Mariano, R., Negri, P., Prates, M.V., Milone, J., Fazio, P., Gelemur, M., Ciarlo, S., Bezares, F., López, L., García, J. J, Giunta, M., Kruss, M., Lafalse, D., Marquesoni, E., Casale, M.F., Gimenez, A., Brulc, E.B., Perusini, M.A., Palmer, L., Correa, M.E., Jaramillo, F.J., Rosales, J., Sossa, C., Herrera, J.C., Arango, M., Holojda, J., Golos, A., Ejduk, A., Ochrem, B., Małgorzata, G., Waszczuk-Gajda, A., Drozd-Sokolowska, J., Czemerska, M., Paluszewska, M., Zarzycka, E., Masternak, A., Hawrylecka, Dr., Podhoreka, M., Giannopoulos, K., Gromek, T., Oleksiuk, J., Armatys, bA., Helbig, G., Sobas, M., Szczepaniak, A., Rzenno, E., Rodzaj, M., Piatkowska-Jakubas, B., Skret, A., Pluta, A., Barańska, E., Vasconcelos, G., Brioso, J., Nunes, A., Bogalho, I., Espadana, A., Coucelo, M., Marini, S., Azevedo, J., Crisostomo, A.I., Ribeiro, L., Pereira, V., Botelho, A., Mariz, J.M., Guimaraes, J.E., Aguiar, E., Coutinho, J., Noriega, V., García, L., Varela, C., Debén, G., González, M.R., Encinas, M., Bendaña, A., González, S., Bello, J.L., Albors, M., Algarra, L., Romero, J.R., Bermon, J.S., Varo, M.J., López, V., López, E., Mora, C., Amorós, C., Romero, A., Jaramillo, A., Valdez, N., Molina, I., Fernández, A., Sánchez, B., García, A., Castaño, V., López, T., Bernabeu, J., Sánchez, M.J., Fernández, C., Gil, C., Botella, C., Fernández, P., Pacheco, M., Tarín, F., Verdú, J.J., García, M.J., Mellado, A., García, M.C., González, J., Castillo, T., Colado, E., Alonso, S., Recio, I., Cabezudo, M., Davila, J., Rodríguez, M.J., Barez, A., Díaz, B., Prieto, J., Arnan, M., Marín, C., Mansilla, M., Balaberdi, A., Amutio, M.E., del Orbe, R.A., Ancin, I., Ruíz, J.C., Olivalres, M., Gómez, C., gonzález, I., Celis, M., Atutxa, K., Carrascosa, T., Artola, T., Lizuain, M., Rodriguez, J .I., Arce, O., Márquez, J.A., Atuch, J., Marco de Lucas, F., Díez, Z., Dávila, B., Cantalejo, R., Díaz, M., Labrador, J., Serra, F., Hermida, G., Díaz, F.J., de Vicente, P., Álvarez, R., Alonso, C., Bergua, J.M., Ugalde, N., Pardal, E., Saldaña, R., Rodríguez, F., Martín, E., Hermosín, L., Garrastazul, M.P., Marchante, I., Raposo, J.A., Capote, F.J., Colorado, M., Batlle, A., Yañez, L., García, S., González, P., Ocio, E.M., Briz, M., Bermúdez, A., Jiménez, C., Beltrán, S., Montagud, M., Castillo, I., García, R., Gascón, A., Clavel, J., Lancharro, A., Lnares, L., Herráez, M.M., Milena, A., Romero, M.J., Hernández, B., Calle, C., Benegas, R., Bolívar, Dr., Serrano, J., Dorado, F.J., Sánchez, J., Martínez, M.C., Cerveró, C.J., Busto, M.J., Bernal, M., Moratalla, L., Mesa, Z., Jurado, M., De Miguel, D., Santos, A.B., Arbeteta, J., Pérez, E., Caminos, N., Uresandi, N., Argoitiaituart, N., Swen, J., Uranga, A., Olazaba, I., Gainza, E., Romero, P., Gil, E., Palma, A.J., Gómez, K.G., Solé, M., Rodríguez, J.N., Murillo, I.M., Marco, J., Serena, J., Marco, V., Perella, M., Costilla, L., López, J.A., Baena, A., Almagro, P., Hermosilla, M., Esteban, A., Campeny, B.A., Nájera, M.J., Herrra, P., Fernández, R., González, J.D., Torres, L., Jiménez, S., Gómez, M.T., Bilbao, C., Rodríguez, C., Hong, A., Ramos de Laón, Y., Afonso, V., Ramos, F., Fuertes, M., de Cabo, E., Aguilera, C., Megido, M., García, T., Lavilla, E., Varela, M., Ferrero, S., Arias, J., Vizcaya, L., Roldán, A., Vilches, A., Penalva, M.J., Vázquez, J., Calderón, M.T., Matilla, A., Serí, C., Otero, M.J., García, N., Sandoval, E., Franco, C., Flores, R., Bravo, P., López, A., López, J.L., Blas, C., Díez, A., Alonso, J.M., Soto, C., Arenas, A., García, J., Martín, Y., Villafuerte, P.S., Magro, E., Bautista, G., De Laiglesia, A., Rodríguez, G., Solán, L., Chicano, M., Balsalobre, P., Monsalvo, S., Font, P., Carbonell, D., Martínez, C., Humala, K., Kerguelen, A.E., Hernández, D., Gasior, M., Gómez, P., Sánchez, I., Redondo, S., Llorente, L., Bengochea, M., Pérez, J., Sebrango, A., M. santero, Morales, A., Figuera, A., Villafuerte, P., Alegre, A., Fernández, E., Alonso, A., Martínez, M.P., Martínez, J., Cedena, M.T., Moreno, L., De la Fuente, A., García, D., Chamorro, C., Pradillo, V., Martí, E., Sánchez, J.M., Delgado, I., Rosado, B., Velasco, A., Miranda, C., Salvatierra, G., Foncillas, M., Hernández, J.A., Escolano, C., Benabente, C., Martínez, R., Polo, M., Anguita, E., Riaza, R., Amores, G., Requena, M.J., Javier, F., Villaloón, L., Aláez, C., Nistal, S., Navas, B., Andreu, M.A., Herrera, P., López, J., García, M., Moreno, M.J., Queipo, M.P., Hernández, A., Barrios, M., Heiniger, A., Jiménez, A., Contento, A., López, F., Alcalá, M., Lorente, S., González, M., Morales, E.M., Gutierrez, J., Serna, M.J., Beltrán, V., Romera, M., Berenguer, M., MArtínez, A., Tejedor, A., Amigo, M.L., Ortuño, F., Jerez, A., López, O., Moraleda, J.M., Rosique, P., Gómez, J., Garay, M.C., Cerezuela, P., MArtínez, A.B., González, A., Ibáñez, J., Alfaro, M.J., Mateos, M., Goñi, M.A., Araiz, M.A., Gorosquieta, A., Zudaire, M., Viguria, M., Zabala, A., Alvarellos, M., Quispe, I., Sánchez, M.P., Hurtado, G., Pérez, M., Burguete, Y., Areizaga, N., Galicia, T., Rifón, J., Alfonso, A., Prósper, F., Marcos, M., Tamariz, L.E., Riego, V., Manubens, A., Larrayoz, M.J., Calasanz, M.J., Mañú, A., Paiva, B., Vázquez, I., Burgos, L., Pereiro, M., Rodríguez, M., Pastoriza, M.C., Mendez, J.A., Sastre, J.L., Iglesias, M., Ulibarrena, C., Campoy, F., Jaimes, D., Albarrán, B., Solano, J., Silvestre, A., Albo, C., Suarez, S., Loureiro, C., Figueroa, I., Fernández, M.A., Martínez, A., Poderós, C., Vazquez, J., Iglesias, L., Nieto, A., Torrado, T., Martínez, A.M., Amador, M.L., Oubiña, P., Feijó, E., Dios, A., Loyola, I., Roreno, R., Simiele, A., Álvarez, L., Turcu, V., Vidriales, B., Avendaño, A., Chillón, C., González, V., Govantes, J.V., Rubio, S., Tapia, M., Olivier, C., Queizán, J.A., Pérez, O., Vera, J.A., Muñoz, C., rodriguez, A., González, N., Pérez, J.A., Soria, E., I.Espigado, Falantes, J., Montero, I., García, P., Rodríguez, E., Carrillo, E., Caballero, T., García, C., Couto, C., Simón, I., Gómez, M., Aguilar, C., González, B.J., Lakhwani, S., Bienert, A., González, B., Cabello, A., Oliva, A.Y., González, H., Sancho, L., Paricio, M., Perdiguer, L., Solano, F., Lerma, A., Martínez, M.D., Gómez, M.I., Yeguas, A., Montesinos, P., Barragán, E., Sargas, C., Amigo, R., Martinez, D., Boluda, B., Rodríguez, R., Acuña, E., Cano, I., Escrivá, A., Pedreño, M., Navalón, A., Orts, M., Sayas, M.J., Fernández, M.J., Juan, M.L., Gómez, E., Gimeno, M., Donato, E., Cejalvo, M., Tormo, M., Calabuig, M., Navarro, B., Martin, I., Villamont, E., Miralles, A., Lluch, R., Moragues, M., Ruiz, M.A., Benet, C., Valero, M., Linares, M., Collado, R., Orero, M., Ibañez, P., Lis, M.J., Pérez, P.L., Roig, M., López, M., Mena, A.V., Picón, I., Cánovas, V., Palacios, A., Cuello, R., Borrego, J., burgois, M., Cantalapiedra, A., Norberto, O., Angomas, E., Cidoncha, B., Cuevas, L., Robles, D., Mendiazabal, A., Oiartzabal, I., Guinea de Castro, J.M., Montes, C., Carrasco, V., Pérez, A., Moneva, J.J., Olave, M., Bonafonte, E., Mayor, L., Azaceta, G., Palomera, L., Malo, M., Escobar, M.J., Grasa, J.M., De Rueda, B., Aulés, A., Salvador, C., Ansó, V., Iborra, A., Delagado, P., Rubio, A., Stevenazzi, M., Alpire, I., Irigoin, V., Díaz, L., Guillermo, C., Guadagna, R., Grille, S., Oliver, C., Boada, M., Vales, V., Prado, A.I., De los Santos, A.P., Simoes, Catia, Gonzalez, Carmen, Vergez, François, Sarry, Audrey, Bertoli, Sarah, Ariceta, Beñat, Martínez-Cuadrón, David, Bergua, Juan-Miguel, Vives, Susana, Algarra, Lorenzo, Tormo, Mar, Martinez, Pilar, Serrano, Josefina, Herrera, Pilar, Ramos, Fernando, Salamero, Olga, Lavilla, Esperanza, Gil, Cristina, Lopez-Lorenzo, Jose-Luis, Vidriales, Maria-Belen, Chillon, Carmen, Labrador, Jorge, Falantes, Jose-Francisco, Sayas, María-José, Ayala, Rosa, Martinez-Lopez, Joaquin, Villar, Sara, Calasanz, Maria-Jose, Prosper, Felipe, San-Miguel, Jesús F., Sanz, Miguel Á., Récher, Christian, Paiva, Bruno, and Montesinos, Pau

Published
2024
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4. Different Diagnostic Criteria for Determining the Prevalence of Sarcopenia in Older Adults: A Systematic Review.

Author

Pedauyé-Rueda B, García-Fernández P, Maicas-Pérez L, Maté-Muñoz JL, and Hernández-Lougedo J

Abstract

Background : Sarcopenia is defined as a loss of muscle mass, strength, and physical function associated with aging. It is due to a combination of genetic, environmental, and physiological factors. It is also associated with an increased risk of health problems. Since there are many different researchers in the field, with their own algorithms and cut-off points, there is no single criterion for diagnosis. This review aims to compare the prevalence of sarcopenia according to these different diagnostic criteria in older adult populations by age group and sex. Methods : Different databases were searched: Web of Science, Pubmed, Dialnet, Scopus, and Cochrane. The keywords used were "sarcopenia", "diagnosis", "prevalence", "assessment", "aged", "aging" and "older". Studies conducted in a population aged ≥65 assessing the prevalence of sarcopenia were selected. Results : Nineteen articles met the inclusion criteria, with a total of 33,515 subjects, 38.08% female and 61.42% male, at a mean age of 74.52. The diagnostic algorithms used were 52.63% AWGS2, 21.05% EWGSOP2, 10.53% AWGS1 and EWGS1, and 5.26% FNIH. Prevalence ranged from 1.7% to 37.47%, but was higher in males and increased with age. Conclusions : The prevalence of sarcopenia varies depending on the diagnostic algorithm used, but it increases with age and is higher in men. The EWGSOP2 and AWGS2 are the most used diagnostic criteria and measure the same variables but have different cut-off points. Of these two diagnostic algorithms, the one with the highest prevalence of sarcopenia and severe sarcopenia is the AWGS2. These differences may be due to the use of different tools and cut-off points. Therefore, a universal diagnostic criterion should be developed to allow early diagnosis of sarcopenia.

Published
2024
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5. Focal-to-bilateral tonic-clonic seizures and High-grade CMV-infection are poor survival predictors in Tumor-related Epilepsy Adult-type diffuse gliomas-A single-center study and literature review.

Author

De la Cerda-Vargas MF, Pantalone MR, Söderberg Nauclér C, Medrano-Guzman R, Jauregui Renaud K, Nettel Rueda B, Reynoso-Sanchez MJ, Lopez-Quintana B, Rodriguez-Florido MA, Feria-Romero IA, Trejo-Rosales RR, Arreola-Rosales RL, Candelas-Rangel JA, Navarro-Dominguez P, Meza-Mata E, Muñoz-Hernandez MA, Segura-Lopez FK, Gonzalez-Martinez MDR, Delgado-Aguirre HA, and Sandoval-Bonilla BA

Abstract

Introduction: Previous studies have reported a correlation between a high-grade CMV-infection and an unfavorable prognosis in glioblastoma (GB). Coversely, epilepsy has been associated with a more favorable outcome in GB patients. Despites epilepsy and CMV share similar molecular mechanisms in GB tumoral microenvironment, the correlation between Tumor-Related-Epilepsy (TRE) and CMVinfection remains unexplored. The aim of our study is to examine the correlation between the dregree of CMV infection and seizure types on the survival of TRE Adult-type-diffuse-glioma. To achieve this objective, we conducted a comprehensive literature review to assess our results regarding previous publications., Methods: We conducted a retrospective-observational study on TRE Adult-type-diffuse-gliomas treated at a single center in Mexico from 2010 to 2018. Tumor tissue and cDNA were analyzed by immunochemistry (IHC) for CMV (IE and LA antigens) at the Karolinska Institute in Sweden, and RT-PCR for CMV-gB in Torreon Mexico, respectively. Bivariate analysis ( X 2- test ) was performed to evaluate the association between subtypes of Adult-type-diffuse-glioma (IDH-mut grade 4 astrocytoma vs. IDH-wt glioblastoma) and the following variables: type of hemispheric involvement (mesial vs. neocortical involvement), degree of CMV infection (<25%vs. >25% infected-tumoral cells) and seizure types [Focal awareness, focal impaired awareness, and FBTCS]. Kaplan Meier and Cox analyses were performed to determine the risk, p < 0.05 was considered statistically significant., Results: Sixty patients with TRE Adult type diffuse gliomas were included (80% IDH-wt glioblastoma and 20% IDH-mut grade 4astrocytomas). The mean age was 61.5 SD ± 18.4, and 57% were male. Fifty percent of the patients presented with mesial involvement of the hemysphere. Seizure types included focal awareness (15%), focal impaired awareness (43.3%), and FBTCS (41.7%). Ninety percent of cases were treated with Levetiracetam and 33.3% presented Engel-IA postoperative seizure control. More than 90% of samples were positive for CMV-immunohistochemistry (IHC). However, all cDNA analyzed by RT-PCR return negative results. The median of overall survival (OS) was 15 months. High-grade CMV-IE infection (14 vs. 25 months, p<0.001), mesial involvement (12 vs. 18 months, p<0.001), and FBTCS were associated with worse OS (9 vs.18 months for non-FBTCS). Multivariate analysis demonstrated that high-grade CMV infection (HR = 3.689, p=0.002) and FBTCS (HR=7.007, p<0.001) were independent unfavorable survival factors., Conclusions: CMV induces a proinflammatory tumoral microenvironment that contributes to the developmet of epilepsy. Tumor progression could be associated not only with a higher degree of CMV infection but also to epileptogenesis, resulting in a seizure phenotype chracterized by FBTCS and poor survival outcomes. This study represents the first survival analysis in Latin America to include a representative sample of TRE Adult-type diffuse gliomas considering CMV-infection-degree and distinguishing features (such as FBTCS) that might have potential clinical relevance in this group of patients. Further prospective studies are required to validate these results., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Author(s).)

Published
2024
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6. Impact of Medicaid expansion on the multimodal treatment of biliary tract cancer.

Author

Ortiz Rueda B, Endo Y, Tsilimigras DI, Araujo Lima H, Munir MM, Woldesenbet S, Dillhoff M, Ejaz A, Cloyd J, and Pawlik TM

Subjects
United States epidemiology, Humans, Medically Uninsured, Combined Modality Therapy, Insurance Coverage, Medicaid, Biliary Tract Neoplasms therapy
Abstract

Introduction: The impact of Medicaid expansion (ME) on the treatment of patients with cancer remains controversial, especially individuals requiring complex multidisciplinary care. We sought to evaluate the impact of Medicaid expansion (ME) on receipt of multimodal care, including surgical resection, for Stage I-III biliary tract cancer (BTC)., Methods: Patients diagnosed with BTC between 40 and 65 years of age were identified from the National Cancer Database and divided into pre- (2008-2012) and post- (2015-2018) ME cohorts. Difference-in-difference (DID) analysis was used to determine the impact of ME on the utilization of surgery and multimodal chemotherapy and/or radiotherapy treatment for BTC., Results: Among 12,415 patients with BTC (extrahepatic, n = 5622, 45.3%; intrahepatic, n = 4352, 35.1%; gallbladder, n = 1944, 15.7%; overlapping, n = 497, 4.0%), 5835 (47.0%) and 6580 (53.0%) patients were diagnosed before versus after ME, respectively. Overall utilization of surgery (OR 1.13, 95% CI 1.02-1.26) and multimodality therapy (OR 1.13, 95% CI 1.01-1.27) increased in states that adopted ME. Utilization of surgery among uninsured/Medicaid patients in ME states increased relative to patients living in non-ME states (∆+10.1%, p = 0.01). Similarly, the use of multimodal treatment increased among uninsured/Medicaid patients living in ME versus non-ME states (∆+6.4%, p = 0.04); in contrast, there were no difference among patients with other insurance statuses (overall: ∆+1.5%, private: ∆-2.0%, other: ∆+3.9%, all p > 0.5). Uninsured/Medicaid patients with BTC who lived in a ME state had a lower risk of long-term death in the post-ME era (HR 0.81, 95% CI 0.67-0.98; p = 0.03)., Conclusions: Implementation of ME positively impacted survival among patients who underwent surgical and multimodal treatment for Stage I-III BTC., (© 2023 Wiley Periodicals LLC.)

Published
2024
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7. Outcomes after intensive chemotherapy for secondary and myeloid-related changes acute myeloid leukemia patients aged 60 to 75 years old: a retrospective analysis from the PETHEMA registry.

Author

Martínez-Cuadrón D, Megías-Vericat JE, Gil C, Bernal T, Tormo M, Martínez-Sánchez P, Rodríguez-Medina C, Serrano J, Herrera P, Simón JAP, Sayas MJ, Bergua J, Lavilla-Rubira E, Amigo ML, Benavente C, Lorenzo JLL, Pérez-Encinas MM, Vidriales MB, Colorado M, De Rueda B, García-Boyero R, Marini S, García-Suárez J, López-Pavía M, Gómez-Roncero MI, Noriega V, López A, Labrador J, Cabello A, Sossa C, Algarra L, Stevenazzi M, Solana-Altabella A, Boluda B, and Montesinos P

Subjects
Humans, Middle Aged, Aged, Retrospective Studies, Disease-Free Survival, Cytarabine, Remission Induction, Leukemia, Myeloid, Acute diagnosis, Leukemia, Myeloid, Acute drug therapy, Hematopoietic Stem Cell Transplantation
Abstract

Treatment options for patients with secondary acute myeloid leukemia (sAML) and AML with myeloid-related changes (AMLMRC) aged 60 to 75 years are scarce and unsuitable. A pivotal trial showed that CPX-351 improved complete remission with/without incomplete recovery (CR/CRi) and overall survival (OS) as compared with standard "3+7" regimens. We retrospectively analyze outcomes of 765 patients with sAML and AML-MRC aged 60 to 75 years treated with intensive chemotherapy, reported to the PETHEMA registry before CPX-351 became available. The CR/CRi rate was 48%, median OS was 7.6 months (95% confidence interval [CI]: 6.7-8.5) and event-free survival (EFS) 2.7 months (95% CI: 2-3.3), without differences between intensive chemotherapy regimens and AML type. Multivariate analyses identified age ≥70 years, Eastern Cooperative Oncology Group performance status ≥1 as independent adverse prognostic factors for CR/CRi and OS, while favorable/intermediate cytogenetic risk and NPM1 were favorable prognostic factors. Patients receiving allogeneic stem cell transplant (HSCT), autologous HSCT, and those who completed more consolidation cycles showed improved OS. This large study suggests that classical intensive chemotherapy could lead to similar CR/CRi rates with slightly shorter median OS than CPX-351.

Published
2024
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