Comparison of factors associated with leukemia and lymphoma mortality in Brazil

Mortality trend and analysis of potential years of life lost due to leukemia and lymphoma in Brazil and Mato Grosso

OBJECTIVE

To estimate the mortality trend and to analyze the potential years of life lost (PYLL) due to leukemias and lymphomas in Brazil and Mato Grosso, from 2001 to 2019.

METHODS

Time-series study on deaths from leukemias and lymphomas with data obtained from the Mortality Information System. Trends were calculated by age group by the Joinpoint regression method, using calendar year as regressor variable, estimated annual percentage change (APC) and mean annual percentage change, considering 95% confidence intervals. PYLL rates were collected from the Cancer Mortality Atlas.

RESULTS

In Brazil, the mortality rate trend remained stable for both diseases in the period: leukemias (APC=0.2; 95%CI 0.0-0.3) and lymphomas (APC=0.2; 95%CI 0.4-0.1). In Mato Grosso state, the rate for leukemias was also stable (APC=0.3; 95%CI 1.0-1.6). For lymphomas, the trend was ascendant (APC=2.3; 95%CI 0.5-4.2), but descending among people younger than 59 years. For leukemias, PYLL rates were 64 and 65/100,000 in Brazil and Mato Grosso, respectively. For lymphomas, 27 and 22/100,000, respectively, with the highest rates found among males.

CONCLUSION

The behavior of mortality rates from leukemia and lymphoma in Mato Grosso was different from that observed nationally, with an upward trend for lymphomas and no differences between age groups for both diseases. PYLL rates for leukemias were similar, while for lymphomas they were higher among men and lower in Mato Grosso when compared to Brazil.

Treatment Outcomes and Its Associated Factors Among Adult Patients with Selected Solid Malignancies at Kenyatta National Hospital: A Hospital-Based Prospective Cohort Study

Introduction

The treatment outcome of cancer is poor in the African setting due to inadequate treatment and diagnostic facilities. However, there is a paucity of data on solid cancers in Kenya. Hence, this study aimed to investigate the treatment outcomes and its determinant factors among adult patients diagnosed with selected solid malignancies at Kenyatta National Hospital (KNH).

Materials and Methods

A prospective cohort study was employed at the Oncology Department of KNH from 1^st July 2020 to 31^st December 2021. All new patients with a confirmed diagnosis of lymphoma, prostate cancer and breast cancer were studied. A consecutive sample of 99 breast cancer, 50 lymphomas, and 82 prostate cancer patients was included in the study. Semi-structured questionnaires consisting of socio-demographics, clinical characteristics, and quality of life were employed to collect the data. All enrolled patients were followed prospectively for 12 months. Treatment outcomes were reported as mortality, cancer-specific survival and health-related quality of life. The data were entered and analyzed using the SPSS 20.0 statistical software. Survival outcomes and its predictors were evaluated using the Kaplan–Meier analysis and Cox regression analyses, respectively.

Results

The study showed that the mortality rate among breast and prostate cancer patients was 3% and 4.9%, respectively. In contrast, the mortality rate was 10% among lymphoma patients. Most of the patients had partial remission and a good overall global health-related quality of life. Older age above 60 years, co-morbidity, distant metastasis and advanced stages of disease were significant predictors of mortality.

Conclusion

Although the mortality was not high at 12 months, only a few patients had complete remission. For many patients, the disease was progressing, despite 12-month mortality was not high. Therefore, longer follow-up will be required to report cancer mortality accurately. In addition, most of the patients had a good overall global health-related quality of life.

Tendência de mortalidade e análise de anos potenciais de vida perdidos por leucemias e linfomas no Brasil e em Mato Grosso

RESUMO: Objetivos: Estimar a tendência de mortalidade e analisar os anos potenciais de vida perdidos (APVP) por leucemias e linfomas no Brasil e em Mato Grosso, entre os anos de 2001 e 2019. Métodos: Estudo de série temporal de óbitos por leucemias e linfomas obtidos do Sistema de Informação sobre Mortalidade. As tendências foram calculadas por faixa etária pelo método de regressão joinpoint, usando ano calendário como variável regressora, e estimaram-se a variação percentual anual (APC) e a variação percentual média anual, considerando intervalos de confiança de 95% (IC95%). As taxas de APVP foram coletadas do Atlas de Mortalidade por Câncer. Resultados: No Brasil, a tendência da taxa de mortalidade apresentou estabilidade para ambos os agravos, leucemias (APC=0,2; IC95% 0,0–0,3) e linfomas (APC=0,2; IC95% 0,4–0,1). No estado, a taxa por leucemias também apontou estabilidade (APC=0,3; IC95% 1,0–1,6). Para os linfomas, a tendência foi de aumento (APC=2,3; IC95% 0,5–4,2), contudo tendência decrescente foi observada entre aqueles com menos de 59 anos. Para leucemias, as taxas de APVP foram de 64 e 65/100 mil no Brasil e em Mato Grosso, respectivamente. Para linfomas, esses valores foram de 27 e 22/100 mil, respectivamente, sendo as maiores taxas encontradas no sexo masculino. Conclusão: As taxas de mortalidade por leucemias e linfomas em Mato Grosso apresentam comportamento diferente do observado nacionalmente, com tendência crescente para linfomas e sem diferenças entre as faixas etárias, para ambos os agravos. As taxas de APVP por leucemias foram semelhantes, no entanto para os linfomas foram maiores entre os homens e menores para o estado, quando comparadas com as do Brasil.

A canthin-6-one derivative induces cell death by apoptosis/necroptosis-like with DNA damage in acute myeloid cells

Natural products have long been considered a relevant source of new antitumor agents. Despite advances in the treatment of younger patients with acute myeloid leukemia (AML), the prognosis of elderly patients remains poor, with a high frequency of relapse. The cytotoxicity of canthin-6-one alkaloids has been extensively studied in different cell types, including leukemic strains. Among the canthin-6-one analogs tested, 10-methoxycanthin-6-one (Mtx-C) showed the highest cytotoxicity in the malignant AML cells Kasumi-1 and KG-1. Thus, we evaluated the cytotoxicity and cell death mechanisms related to Mtx-C using the EC50 (80 µM for Kasumi-1 and 36 µM for KG-1) treatment for 24 h. Our results identify reactive oxygen species production, mitochondrial depolarization, annexin V-FITC/7-AAD double staining, caspase cleave and upregulation of mitochondria-dependent apoptosis proteins (Bax, Bim, Bik, Puma and phosphorylation of p53) for both cell lineages. However, downregulation of Bcl-2 and the simultaneous execution of the apoptotic and necroptotic programs associated with the phosphorylation of the proteins receptor-interacting serine/threonine-protein kinase 3 and mixed lineage kinase domain-like pseudokinase occurred only in Kasumi-1 cells. About the lasted events, Kasumi-1 cell death was inhibited by pharmacological agents such as Zvad-FMK and necrostatin-1. The underlying molecular mechanisms of Mtx-C still include participation in the DNA damage and stress-signaling pathways involving p38 and c-Jun N-terminal mitogen-activated protein kinases and interaction with DNA. Thus, Mtx-C represents a promising tool for the development of new antileukemic molecules.