51
|
Yasui Y, Hosokawa M, Kohno H, Tanaka T, Miyashita K. Troglitazone and 9cis,11trans,13trans-conjugated linolenic acid: comparison of their antiproliferative and apoptosis-inducing effects on different colon cancer cell lines. Chemotherapy 2006; 52:220-5. [PMID: 16899971 DOI: 10.1159/000094865] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2005] [Accepted: 09/06/2005] [Indexed: 01/25/2023]
Abstract
BACKGROUND We have previously reported that troglitazone, a synthetic ligand for peroxisome proliferator-activated receptor gamma (PPARgamma), and bitter gourd seed oil rich in 9cis,11trans,13trans-conjugated linolenic acid (9c,11t,13t-CLN) prevent colon carcinogenesis. To evaluate the chemotherapeutic effect and potency of these compounds on colon cancer cells, we investigated their antiproliferative and apoptosis-inducing effects using different human colon cancer cell lines. METHODS The antiproliferative and apoptosis-inducing effects of troglitazone and 9c,11t,13t-CLN were evaluated and compared using HT-29, DLD-1 and Caco-2 cells at different stages of enterocytic differentiation. RESULTS Troglitazone and 9c,11t,13t-CLN decreased cell viability and induced apoptosis in three colon cancer cell lines. The susceptibility of HT-29, which expresses PPARgamma at high levels, to troglitazone and 9c,11t,13t-CLN was higher than that of Caco-2 cells with low levels of PPARgamma. CONCLUSION Troglitazone and 9c,11t,13t-CLN exhibited more effective chemotherapeutic effects on HT-29 cells than on Caco-2 cells.
Collapse
|
52
|
Robien K, Schubert MM, Chay T, Bigler J, Storb R, Yasui Y, Potter JD, Ulrich CM. Methylenetetrahydrofolate reductase and thymidylate synthase genotypes modify oral mucositis severity following hematopoietic stem cell transplantation. Bone Marrow Transplant 2006; 37:799-800. [PMID: 16501586 DOI: 10.1038/sj.bmt.1705330] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
53
|
Robien K, Schubert MM, Yasui Y, Martin P, Storb R, Potter JD, Ulrich CM. Folic acid supplementation during methotrexate immunosuppression is not associated with early toxicity, risk of acute graft-versus-host disease or relapse following hematopoietic transplantation. Bone Marrow Transplant 2006; 37:687-92. [PMID: 16501595 DOI: 10.1038/sj.bmt.1705303] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Methotrexate (MTX) is used as an immunosuppressive agent for acute graft-versus-host disease (GVHD) prophylaxis following hematopoietic cell transplantation (HCT). Concerns that folate intake may impair MTX effectiveness or selectively rescue leukemic cells have led to variations in clinical practice regarding supplemental folic acid during MTX administration. A retrospective, observational study was undertaken to determine the association between folic acid intake (days 0-18 post transplant) and MTX toxicity and efficacy following HCT. The study population consisted of 311 adult patients who received a myeloablative HCT for chronic myelogenous leukemia, all four scheduled doses of MTX, and did not require leucovorin rescue. Multiple linear regression models were used to assess the relationships between folic acid intake (days 0-18 post-HCT) and oral mucositis index (OMI) scores, time to engraftment and risk of detectable acute GVHD. No statistically significant differences in mean OMI scores, time to engraftment, risk of acute GVHD, days to acute GVHD, risk of relapse or survival were observed when comparing patients taking, on average, <400 (14%), 400 (58%) or >400 microg (28%) folic acid per day. Our results suggest that concurrent folic acid supplementation does not change MTX effectiveness or toxicity in this patient population.
Collapse
|
54
|
Meyers JA, McTiernan A, Wener MH, Wood B, Weigle DS, Sorensen B, Chen-Levy Z, Yasui Y, Lacroix K, Boynton A, Potter JD, Ulrich CM. Serum Leptin Concentrations and Markers of Immune Function in Postmenopausal Women. Am J Epidemiol 2006. [DOI: 10.1093/aje/163.suppl_11.s38-c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
55
|
Kim HM, Yasui Y, Burstyn I. Estimation of Parameters in Logistic Regression Models with Multiplicative Measurement Error. Am J Epidemiol 2006. [DOI: 10.1093/aje/163.suppl_11.s154-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
56
|
Burstyn I, Kim HM, Cherry N, Yasui Y. Metamodels of bias in Cox proportional-hazards and logistic regressions with heteroscedastic measurement error under group-level exposure assessment. ACTA ACUST UNITED AC 2005; 50:271-9. [PMID: 16371413 DOI: 10.1093/annhyg/mei073] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
In occupational epidemiology, group-based exposure assessment entails estimating the average exposure level in a group of workers and assigning the average to all members of the group. The assigned exposure values can be used in epidemiological analyses and have been shown to produce virtually unbiased relative-risk estimates in many situations. Although the group-based exposure assessment continues to be used widely, it is unclear whether it produces unbiased relative-risk estimates in all circumstance, specifically in Cox proportional-hazards and logistic regressions when between-worker variance is not constant but proportional to the true group mean. This question is important because (i) between-worker variance has been shown to differ among exposure groups in occupational epidemiological studies and (ii) recent theoretical work has suggested that bias may exist in such situations. We conducted computer simulations of occupational epidemiological studies to address this question and analysed simulation results using 'metamodelling'. The results indicate that small-to-negligible bias can be expected to result from heteroscedastic between-worker variance. Cox proportional-hazards models can produce attenuated risk estimates, while logistic regression may result in overestimation of risk gradient. Bias caused by ignoring the heteroscedastic measurement error is unlikely to be large enough to alter the conclusion about the direction of exposure-disease association in occupational epidemiology.
Collapse
|
57
|
Burstyn I, Kim HM, Kromhout H, Cherry N, Yasui Y. 347: Is There a Correlation Between Variability and Level of Exposure that Biases Risk Estimates in Occupational Epidemiology? Am J Epidemiol 2005. [DOI: 10.1093/aje/161.supplement_1.s87b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
58
|
Kim HM, Yasui Y, Cherry N, Burstyn I. 351: Attenuation in Risk Estimates in Logistic and Cox Proportional-Hazards Models Due to Group-Based Exposure Assessment Strategy. Am J Epidemiol 2005. [DOI: 10.1093/aje/161.supplement_1.s88b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
59
|
Mertens AC, Yasui Y, Liu Y, Neglia JP, Robison LL. Late cause-specific mortality in long-term survivors of childhood and adolescent cancer: An update from the Childhood Cancer Survivor Study (CCSS). J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.8536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
60
|
Nagarajan R, Clohisy DR, Neglia JP, Yasui Y, Mitby PA, Sklar C, Finklestein JZ, Greenberg M, Reaman GH, Zeltzer L, Robison LL. Function and quality-of-life of survivors of pelvic and lower extremity osteosarcoma and Ewing's sarcoma: the Childhood Cancer Survivor Study. Br J Cancer 2005; 91:1858-65. [PMID: 15534610 PMCID: PMC2410143 DOI: 10.1038/sj.bjc.6602220] [Citation(s) in RCA: 118] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Limb-sparing surgeries have been performed more frequently than amputation based on the belief that limb-sparing surgeries provide improved function and quality-of-life (QOL). However, this has not been extensively studied in the paediatric population, which has unique characteristics that have implications for function and QOL. Using the Childhood Cancer Survivor Study, 528 adult long-term survivors of pediatric lower extremity bone tumours, diagnosed between 1970 and 1986, were contacted and completed questionnaries assessing function and QOL. Survivors were an average of 21 years from diagnosis with an average age of 35 years. Overall they reported excellent function and QOL. Compared to those who had a limb-sparing procedure, amputees were not more likely to have lower function and QOL scores and self-perception of disability included general health status, lower educational attainment, older age and female gender. Findings from this study suggest that, over time, amputees do as well as those who underwent limb-sparing surgeries between 1970 and 1986. However, female gender, lower educational attainment and older current age appear to influence function, QOL and disability.
Collapse
|
61
|
Suzuki S, Kurata A, Ohmomo T, Oka H, Nakayama S, Hirayama H, Yasui Y, Fujii K. Experimental determination of minimal stimulation current and period for electrical thrombosis in dogs. Interv Neuroradiol 2004; 10:225-30. [PMID: 20587234 DOI: 10.1177/159101990401000304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2004] [Accepted: 07/18/2004] [Indexed: 11/15/2022] Open
Abstract
SUMMARY Endovascular surgery has been proposed as an alternative treatment for cerebral aneurysms. However, for wide neck and large sized lesions it is very difficult to obtain complete occlusion and tissue organization. The present study was conducted to examine the efficacy of electrical thrombosis for cerebral aneurysms and parent arterial occlusions using Interlocking Detachable Coils (IDCs), focusing on the minimum current volume and stimulation time required for stable electrical thrombosis formation. We used ten mixed-breed adult dogs (in the study body weights 9-12 kg; males: 5, females: 5). Guiding catheter sand microcatheters were introduced into both sides of the distal external carotid artery (ECA) and placed at the same level. To prevent migration, IDCs (4 mm x 12 cm) were placed in the ECA without being detached. After confirming no vessel occlusion, we applied a positive current (2-6 mA) to the coil on one side and performed angiography every ten minutes to observe whether vessel occlusion with electrothrombosis had occurred. It was determined that to achieve complete occlusion of the external carotid arteries in mixedbreed dogs, a minimum stimulation current of 4mA and a minimum stimulation time of ten to 20 minutes are required.
Collapse
|
62
|
Friedman DL, Whitton J, Yasui Y, Mertens AC, Hammond S, Stovall M, Donaldson S, Meadows AT, Robison LL, Neglia JP. Risk of second malignant neoplasms (SMN) 20 years after childhood cancer: The updated experience of the Childhood Cancer Survivor Study (CCSS). J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.8509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
63
|
Termuhlen A, Tersak J, Hudson M, Mertens A, Gimpel N, Bleyer W, Yasui Y, Robison L, Oeffinger K. Health status, medical care, preventive screening, and risk behaviors in adult survivors of cancer diagnosed during adolescence: A report from the Childhood Cancer Survivor Study (CCSS). J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.6023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
64
|
Bowers DC, McNeil DE, Liu Y, Yasui Y, Stoval M, Gurney JG, Hudson MM, Robison LL, Oeffinger KC. Stroke following therapy for Hodgkin's Disease (HD): A report from the Childhood Cancer Survivor Study (CCSS). J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.8523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
65
|
Bassal M, Kadan-Lottick NS, Neglia J, Taylor L, Yasui Y, Friedman DL, Mertens AC, Robison LL, Meadows AT. Risk of rare adult-type carcinomas as a subsequent malignant neoplasm in survivors of childhood cancer: The Childhood Cancer Survivor Study. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.8530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
66
|
Benach J, Yasui Y, Martínez JM, Borrell C, Pasarín MI, Daponte A. The geography of the highest mortality areas in Spain: a striking cluster in the southwestern region of the country. Occup Environ Med 2004; 61:280-1. [PMID: 14985525 PMCID: PMC1740734 DOI: 10.1136/oem.2002.001933] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIMS To determine the areas of Spain with the most increased mortality risk. METHODS Age adjusted relative risk of death by gender was estimated in each of 2218 small areas of the country using a non-parametric empirical Bayes method. To determine areas with "significantly increased risk" a Poisson based score test was used. RESULTS Mapping of the highest risk areas showed a striking geographical clustering in the southwestern region of the country. This region, comprising 8% of the Spanish population, accounts for about one third (2884 deaths) of the total excess mortality.
Collapse
|
67
|
Hislop TG, Deschamps M, Teh C, Jackson C, Tu SP, Yasui Y, Schwartz SM, Kuniyuki A, Taylor V. Facilitators and barriers to cervical cancer screening among Chinese Canadian women. Canadian Journal of Public Health 2003. [PMID: 12583683 DOI: 10.1007/bf03405056] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Chinese Canadian women have higher cervical cancer incidence, and lower Pap testing, rates than the general Canadian population. Predisposing, enabling and reinforcing factors associated with ever having a Pap test, and having a recent Pap test within the last 2 years, were assessed in Chinese women in British Columbia using the PRECEDE-PROCEED model. METHOD Chinese women (n=512) between the ages of 20 and 79 years and residing in Greater Vancouver were interviewed about Pap testing, health care, traditional health beliefs, acculturation and sociodemographic characteristics. Two analyses were done, comparing women who had ever and never had a Pap test, and comparing women who had and had not received a recent Pap test. Focus groups and qualitative interviews ensured cultural sensitivity in the survey questionnaire. RESULTS Seventy-six percent reported ever having a Pap test and 57% reported having a Pap test within the last 2 years. Traditional health beliefs were not associated with ever or recent Pap testing. However, belief that Pap testing prevented cancer and general knowledge about the Pap test were associated with screening. Concern about pain/discomfort with the test, availability of time, culturally sensitive health care services and recommendation for Pap testing by a physician were also associated with screening. Factors differed for ever, and recently, having a Pap test. INTERPRETATION Pap testing is less common among Chinese Canadian women. Continuing education about Pap testing is recommended for physicians serving underscreened Chinese women. Culturally and linguistically appropriate educational materials are needed for the Chinese community.
Collapse
|
68
|
Ono K, Kagawa T, Tsumori T, Yokota S, Yasui Y. Morphological changes and cellular dynamics of oligodendrocyte lineage cells in the developing vertebrate central nervous system. Dev Neurosci 2002; 23:346-55. [PMID: 11756750 DOI: 10.1159/000048718] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Oligodendrocyte precursor cells (OPCs) originate in multiple restricted regions of the developing central nervous system (CNS). Here, we focus on morphological changes of oligodendrocyte lineage cells and their cellular dynamics including cell motility and proliferation. Morphological studies with molecular markers for OPCs suggest distinct spatiotemporal patterns of OPC migration in vivo, which are directly demonstrated by application of exogenous fluorescent markers to OPCs. Extensive proliferation of OPCs in the CNS parenchyma is also demonstrated by pulse labeling of the cells with bromodeoxyuridine. The results strongly suggest that oligodendrocyte lineage cells are highly motile and actively proliferate with an elongated morphology. These data provide insights into the potential molecular mechanisms of OPC dispersal throughout the CNS.
Collapse
|
69
|
Yasui Y. [V2Cl3(thf)6]2[Zn2Cl6]: Reagent for a Highly Selective Pinacol-Coupling Reaction. Aust J Chem 2002. [DOI: 10.1071/ch02170] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
70
|
Yasui Y, Yokota S, Ono K, Tsumori T. Projections from the red nucleus to the parvicellular reticular formation and the cervical spinal cord in the rat, with special reference to innervation by branching axons. Brain Res 2001; 923:187-92. [PMID: 11743987 DOI: 10.1016/s0006-8993(01)03196-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
After biotinylated dextranamine injection into the dorsal part of the red nucleus (RN) in the rat, labeled axons were distributed contralaterally in the lateral tegmental field including the parvicellular reticular formation (RFp), and ipsilaterally in the medial reticular formation. In the cervical spinal cord, labeled axons were present bilaterally with a contralateral dominance mainly in laminae V-VI and the dorsal part of laminae VII. After ipsilateral injections of rhodamine dextranamine, Fluoro-ruby (FR) into the RFp and Fluoro-gold (FG) into the upper cervical spinal cord, a population of FR-labeled neurons was found in the dorsal part of the contralateral RN, whereas the majority of FG-labeled neurons were located more ventrally. However, some of them were intermingled with FR-labeled neurons, and as many as one-third of FR-labeled neurons were labeled with FG. After combined injections of FR into the RFp and FG into the lower cervical spinal cord, RN neurons labeled with FG existed more ventrally than those retrogradely labeled from the upper cervical spinal cord, and less than 10% of FR-labeled neurons were labeled with FG. The present data suggest that axon collateral innervation of the RFp and the upper cervical spinal cord by single RN neurons may be responsible for coordinating head and orofacial movements.
Collapse
|
71
|
Noguchi R, Yasui Y, Suzuki R, Hosokawa M, Fukunaga K, Miyashita K. Dietary effects of bitter gourd oil on blood and liver lipids of rats. Arch Biochem Biophys 2001; 396:207-12. [PMID: 11747298 DOI: 10.1006/abbi.2001.2624] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Bitter gourd is widely used as an edible plant in Asia. In this study, we evaluated the effects of bitter gourd oil (BGO) on the blood and liver lipids of rats. Three groups of rats were given a basal diet (AIN-93G) containing 7% fat by weight. The dietary fat consisted of soybean oil (control), soybean oil + BGO (6.5:0.5, w/w; 0.5% BGO), or soybean oil + BGO (5:2, w/w; 2.0% BGO). This fat treatment gave 3.4 and 15.4% of cis(c)9,trans(t)11,t13-18:3 in the dietary fat of 0.5 and 2.0% BGO, respectively. Fatty acid analysis showed the occurrence of c9,t11-18:2 in the liver of rats fed BGO diets, whereas this conjugated linoleic acid (CLA) isomer was not detected in the liver of rats fed the control diet. Furthermore, dietary BGO decreased the concentration of 18:2n-6 and increased the concentration of 22:6n-3. The formation of the CLA isomer in the liver lipids of rats fed BGO diets could be explained by either of the following two metabolic pathways, namely, enzymatic biohydrogenation of c9,t11,t13-18:3 or enzymatic isomerization of c9,c12-18:2. The BGO diets had significantly reduced free cholesterol levels with a trend toward an increase in HDL cholesterol, but there was no significant change in the total cholesterol. The dietary BGO also affected the level of plasma hydroperoxides. A slight but significant increase in hydroperoxides was found in the rats fed 2.0% BGO. This may be attributed to the lower oxidative stability of c9,t11,t13-18:3 in BGO.
Collapse
|
72
|
Pepe MS, Etzioni R, Feng Z, Potter JD, Thompson ML, Thornquist M, Winget M, Yasui Y. Phases of biomarker development for early detection of cancer. J Natl Cancer Inst 2001; 93:1054-61. [PMID: 11459866 DOI: 10.1093/jnci/93.14.1054] [Citation(s) in RCA: 1084] [Impact Index Per Article: 47.1] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
|
73
|
Tanakaya K, Konaga E, Takeuchi H, Yasui Y, Takeda A, Yunoki Y, Murakami I, Teramoto N. Penetrating colon ulcer of polyarteritis nodosa: report of a case. Dis Colon Rectum 2001; 44:1037-9. [PMID: 11496085 DOI: 10.1007/bf02235493] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
A 54-year-old Japanese female with polyarteritis nodosa was admitted to the hospital. She developed lower abdominal pain accompanied by melena. A penetrating ulcer and extensive hemorrhaging were endoscopically observed in the sigmoid colon, and a sigmoidectomy was performed. The pathologic findings were a granuloma formation with lymphocytic infiltration and luminal occlusion of branches of the mesenteric arteries. Although the gastrointestinal tract is frequently involved in polyarteritis nodosa, the colon is rarely affected. To our knowledge, this is the first report of polyarteritis nodosa causing a penetrating ulcer of the colon.
Collapse
|
74
|
Mertens AC, Yasui Y, Neglia JP, Potter JD, Nesbit ME, Ruccione K, Smithson WA, Robison LL. Late mortality experience in five-year survivors of childhood and adolescent cancer: the Childhood Cancer Survivor Study. J Clin Oncol 2001; 19:3163-72. [PMID: 11432882 DOI: 10.1200/jco.2001.19.13.3163] [Citation(s) in RCA: 558] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Survivors of childhood and adolescent cancer are at risk for long-term effects of disease and treatment. The Childhood Cancer Survivor Study assessed overall and cause-specific mortality in a retrospective cohort of 20,227 5-year survivors. PATIENTS AND METHODS Eligible subjects were individuals diagnosed with cancer (from 1970 to 1986) before the age of 21 who had survived 5 years from diagnosis. Underlying cause of death was obtained from death certificates and other sources and coded and categorized as recurrent disease, sequelae of cancer treatment, or non-cancer-related. Age and sex standardized mortality ratios (SMRs) were calculated using United States population mortality data. RESULTS The cohort, including 208,947 person-years of follow-up, demonstrated a 10.8-fold excess in overall mortality (95% confidence interval, 10.3 to 11.3). Risk of death was statistically significantly higher in females (SMR = 18.2), individuals diagnosed with cancer before the age of 5 years (SMR = 14.0), and those with an initial diagnosis of leukemia (SMR = 15.5) or CNS tumor (SMR = 15.7). Recurrence of the original cancer was the leading cause of death among 5-year survivors, accounting for 67% of deaths. Statistically significant excess mortality rates were seen due to subsequent malignancies (SMR = 19.4), along with cardiac (SMR = 8.2), pulmonary (SMR = 9.2), and other causes (SMR = 3.3). Treatment-related associations were present for subsequent cancer mortality (radiation, alkylating agents, epipodophyllotoxins), cardiac mortality (chest irradiation, bleomycin), and other deaths (radiation, anthracyclines). No excess mortality was observed for external causes (SMR = 0.8). CONCLUSION While recurrent disease remains a major contributor to late mortality in 5-year survivors of childhood cancer, significant excesses in mortality risk associated with treatment-related complications exist up to 25 years after the initial cancer diagnosis.
Collapse
|
75
|
Ulrich CM, Yasui Y, Storb R, Schubert MM, Wagner JL, Bigler J, Ariail KS, Keener CL, Li S, Liu H, Farin FM, Potter JD. Pharmacogenetics of methotrexate: toxicity among marrow transplantation patients varies with the methylenetetrahydrofolate reductase C677T polymorphism. Blood 2001; 98:231-4. [PMID: 11418485 DOI: 10.1182/blood.v98.1.231] [Citation(s) in RCA: 220] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
This study investigated whether a polymorphism in the 5,10-methylenetetrahydrofolate reductase (MTHFR) gene (C677T) modifies responses to methotrexate (MTX) in patients undergoing bone marrow transplantation. About 10% to 12% of the population carry the MTHFR TT genotype (enzyme activity, 30% of wild type [CC]). Patients (n = 220) with chronic myelogenous leukemia underwent marrow allografts and were given a short course of MTX. MTX toxicity measures included the oral mucositis index (OMI), speed of engraftment (platelet and granulocyte counts), and bilirubin. Patients with lower MTHFR activity (TT genotype) had 36% higher mean OMI during days 1 to 18 (+5.7, P =.046) and 20% higher OMI between days 6 and 12 (+3.8, P =.27). Platelet counts recovered more slowly among patients with the TT genotype compared to wild type (24% slower recovery to 10 000 platelets/microL, P =.23; 34% slower to 20 000/microL, P =.08). Patients with decreased MTHFR activity appear at risk of higher MTX toxicity. Because of the high prevalence of the TT genotype, these results may have implications for MTX dosage.
Collapse
|