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Binkley MS, Flerlage JE, Savage KJ, Akhtar S, Steiner R, Zhang XY, Dickinson M, Prica A, Major A, Hendrickson PG, Hopkins D, Ng A, Casulo C, Baron J, Roberts KB, Al Kendi J, Balogh A, Ricardi U, Torka P, Specht L, De Silva R, Pickard K, Blazin LJ, Henry M, Smith CM, Halperin D, Brady J, Brennan B, Senchenko MA, Reeves M, Hoppe BS, Terezakis S, Talaulikar D, Picardi M, Kirova Y, Fergusson P, Hawkes EA, Lee D, Doo NW, Barraclough A, Cheah CY, Ku M, Hamad N, Mutsando H, Gilbertson M, Marconi T, Viiala N, Maurer MJ, Eichenauer DA, Hoppe RT. International Prognostic Score for Nodular Lymphocyte-Predominant Hodgkin Lymphoma. J Clin Oncol 2024:JCO2301655. [PMID: 38531001 DOI: 10.1200/jco.23.01655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 09/20/2023] [Accepted: 01/11/2024] [Indexed: 03/28/2024] Open
Abstract
PURPOSE Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is a rare cancer, and large international cooperative efforts are needed to evaluate the significance of clinical risk factors and immunoarchitectural patterns (IAPs) for all stages of pediatric and adult patients with NLPHL. METHODS Thirty-eight institutions participated in the Global nLPHL One Working Group retrospective study of NLPHL cases from 1992 to 2021. We measured progression-free survival (PFS), overall survival (OS), transformation rate, and lymphoma-specific death rate. We performed uni- and multivariable (MVA) Cox regression stratified by management to select factors for the lymphocyte-predominant international prognostic score (LP-IPS) validated by five-fold cross-validation. RESULTS We identified 2,243 patients with a median age of 37 years (IQR, 23-51). The median follow-up was 6.3 years (IQR, 3.4-10.8). Most had stage I to II (72.9%) and few B symptoms (9.9%) or splenic involvement (5.4%). IAP was scored for 916 (40.8%). Frontline management included chemotherapy alone (32.4%), combined modality therapy (30.5%), radiotherapy alone (24.0%), observation after excision (4.6%), rituximab alone (4.0%), active surveillance (3.4%), and rituximab and radiotherapy (1.1%). The PFS, OS, transformation, and lymphoma-specific death rates at 10 years were 70.8%, 91.6%, 4.8%, and 3.3%, respectively. On MVA, IAPs were not associated with PFS or OS, but IAP E had higher risk of transformation (hazard ratio [HR], 1.81; P < .05). We developed the LP-IPS with 1 point each for age ≥45 years, stage III-IV, hemoglobin <10.5 g/dL, and splenic involvement. Increasing LP-IPS was significantly associated with worse PFS (HR, 1.52) and OS (HR, 2.31) and increased risk of lymphoma-specific death (HR, 2.63) and transformation (HR, 1.41). CONCLUSION In this comprehensive study of all ages of patients with NLPHL, we develop the LP-IPS to identify high-risk patients and inform upcoming prospective clinical trials evaluating de-escalation of therapy for patients with low LP-IPS scores (<2).
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Affiliation(s)
- Michael Sargent Binkley
- Department of Radiation Oncology, Stanford School of Medicine, Stanford University, Stanford, CA
| | - Jamie E Flerlage
- Department of Oncology, St Jude Children's Research Hospital, Memphis, TN
| | | | - Saad Akhtar
- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Raphael Steiner
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | | | - Anca Prica
- Princess Margaret Cancer Centre, Toronto, Canada
| | | | | | - David Hopkins
- Department of Haematology, Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom
| | - Andrea Ng
- Dana-Farber Cancer Institute, Boston, MA
| | | | | | | | | | | | | | - Pallawi Torka
- Roswell Park Comprehensive Cancer Center, Buffalo, NY
| | - Lena Specht
- Copenhagen University Hospital, Copenhagen, Denmark
| | - Ravindu De Silva
- Norfolk and Norwich University Hospital, Norfolk, United Kingdom
| | - Keir Pickard
- Newcastle upon Tyne Hospitals, Newcastle upon Tyne, United Kingdom
| | - Lindsay J Blazin
- Division of Hematology/Oncology, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN
| | | | | | - Daniel Halperin
- University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - Jessica Brady
- Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | | | - Maria Anatolevna Senchenko
- Oncology and Immunology, Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Moscow, Russian Federation
| | - Marie Reeves
- Royal Manchester Children's Hospital, Manchester, United Kingdom
| | - Bradford S Hoppe
- University of Florida, Gainesville, FL
- Mayo Clinic, Jacksonville, FL
| | | | - Dipti Talaulikar
- Canberra Health Services, Canberra, Australia
- College of Health and Medicine, Australian National University, Canberra, Australia
| | - Marco Picardi
- Department of Clinical Medicine and Surgery, AOU Federico II, Naples, Italy
| | | | | | - Eliza A Hawkes
- Olivia Newton-John Cancer Research Centre at Austin Health, Melbourne, Australia
- Lymphoma and Related Diseases Registry, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Denise Lee
- Austin Hospital, Eastern Health, Melbourne, Australia
| | - Nicole Wong Doo
- Lymphoma and Related Diseases Registry, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Department of Haematology, Concord Hospital, Concord Clinical School, University of Sydney, Sydney, Australia
| | | | - Chan Y Cheah
- Department of Haematology, Sir Charles Gairdner Hospital, Perth, Australia
- Medical School, University of Western Australia, Perth, Australia
| | - Matthew Ku
- Department of Haematology, St Vincent's Hospital, Melbourne, Australia
- University of Melbourne, Melbourne, Australia
| | - Nada Hamad
- Department of Haematology, St Vincent's Hospital Sydney, Sydney, Australia
- Faculty of Medicine and Health, School of Clinical Medicine, UNSW Sydney, Sydney, Australia
- School of Medicine, University of Notre Dame, Sydney, Australia
| | - Howard Mutsando
- Faculty of Medicine and Health, School of Clinical Medicine, UNSW Sydney, Sydney, Australia
- University of Queensland Rural Clinical School, Toowoomba, Australia
| | | | | | - Nicholas Viiala
- Department of Haematology, Liverpool Hospital, Liverpool, Australia
- South West Sydney Clinical School, UNSW Medicine, Liverpool, Australia
| | - Matthew J Maurer
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN
| | - Dennis A Eichenauer
- Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf, University Hospital Cologne, German Hodgkin Study Group, Cologne, Germany
| | - Richard T Hoppe
- Department of Radiation Oncology, Stanford School of Medicine, Stanford University, Stanford, CA
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Pra AD, Lyness J, Pollack A, Tran PT, Koontz BF, Abramowitz MC, Mahal BA, Martin AG, Michalski JM, Balogh A, Lukka H, Faria SL, Rodrigues G, Beauchemin MC, Lee RJ, Seaward SA, Coen SD, Allen AM, Pugh S, Feng FY. Impact of Testosterone Recovery on Clinical Outcomes of Patients Treated with Salvage Radiotherapy and Androgen Suppression: A Secondary Analysis of the NRG/RTOG 0534 Sport Phase 3 Trial. Int J Radiat Oncol Biol Phys 2023; 117:S82-S83. [PMID: 37784585 DOI: 10.1016/j.ijrobp.2023.06.403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Testosterone (T) kinetics and its relationship with clinical outcomes has not been studied in trials using salvage radiotherapy and androgen deprivation therapy (ADT). We performed a secondary analysis of the NRG Oncology/RTOG 0534 SPPORT trial, which compared prostate bed radiotherapy (PBRT) (arm 1), PBRT + short-term androgen deprivation therapy (ADT) (arm 2), or PBRT + pelvic lymph node radiotherapy (PLNRT) + short-term ADT (arm 3). We assessed longitudinal serum T levels and the impact of testosterone recovery (TR) on clinical outcomes. MATERIALS/METHODS ADT was given for 4-6 months in arms 2 and 3, starting 2 months prior to radiotherapy. The trial excluded patients with baseline T < 40% of the lower limit of normal. TR was defined in 3 ways: 1) return to non-castrate level (>50 ng/dL), 2) return to normal level (>300 ng/dL), and 3) return to baseline level. Time to TR was estimated using cumulative incidence and death without an event considered a competing risk. Unadjusted and adjusted hazard ratios and 95% confidence intervals (CIs) were calculated using Cox proportional hazards model. Freedom from progression (FFP) was defined as biochemical failure according to the Phoenix definition (PSA ≥2 ng/mL over the nadir PSA), clinical failure (local, regional, or distant), or death from any cause. RESULTS A total of 1699 patients with T at baseline and at least 1 follow-up assessment were included. The median age was 64 years (IQR 59 - 69), 12.8% were black, 14.9% had diabetes, and 54.1% were former or current smokers. Median baseline T in arms 1, 2 and 3 was 320 ng/dL (IQR 239 - 424), 319 ng/dL (IQR 237 - 438) and 330 ng/dL (IQR 252 - 446), respectively. At 6 months, median T in arms 1, 2 and 3 was 290 ng/dL (IQR 210 - 390), 190.4 ng/dL (IQR 66 - 296) and 191 ng/dL (IQR 40.5 - 313). At 2 years, in arms 2 and 3, TR to non-castrate, normal and baseline levels were 95%, 55% and 23%, respectively. At 5 years, in arms 2 and 3, TR to non-castrate, normal and baseline levels were 98%, 73% and 42%, respectively. FFP was superior in arms 2 and 3 vs. arm 1 in patients with TR by all three definitions. In patients with recovered T to normal levels by 2 years (n = 904), the 5-year FFP rates were 71.8% (95% CI 66.9-76.6) in arm 1, 77.2% (72.1-82.2) in arm 2, and 86.3% (82.3-90.3) in arm 3 (arm 2 vs arm 1: HR 0.74, 95% CI 0.56-0.98, p = 0.034; arm 3 vs arm 1: HR 0.54, 95% CI 0.40-0.72, p<.0001). CONCLUSION This work represents the largest study of T kinetics in patients treated with salvage radiation and ADT. Approximately half of patients did not normalize their T levels by 2 years. Our data validate an incremental and meaningful FFP benefit of adding short-term ADT and PLNRT to PBRT independent of T recovery.
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Affiliation(s)
- A Dal Pra
- Department of Radiation Oncology, University of Miami/Sylvester Comprehensive Cancer Center, Miami, FL
| | - J Lyness
- NRG Oncology Statistics and Data Management Center, Philadelphia, PA
| | - A Pollack
- Department of Radiation Oncology, University of Miami/Sylvester Comprehensive Cancer Center, Miami, FL
| | - P T Tran
- Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD
| | | | - M C Abramowitz
- Department of Radiation Oncology, University of Miami/Sylvester Comprehensive Cancer Center, Miami, FL
| | - B A Mahal
- Department of Radiation Oncology, University of Miami/Sylvester Comprehensive Cancer Center, Miami, FL
| | - A G Martin
- Department of Radiation Oncology CHU de Québec-Université Laval, Québec, QC, Canada
| | - J M Michalski
- Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO
| | - A Balogh
- Tom Baker Cancer Centre, Calgary, AB, Canada
| | - H Lukka
- Juravinski Cancer Centre, Hamilton, ON, Canada
| | - S L Faria
- McGill University Health Centre, Montreal, QC, Canada
| | - G Rodrigues
- London Health Sciences Centre, London, ON, Canada
| | - M C Beauchemin
- Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, QC, Canada
| | - R J Lee
- Intermountain Medical Center, Murray, UT
| | | | - S D Coen
- Southeast Clinical Oncology Research Consortium, Winston Salem, NC
| | - A M Allen
- Rabin Medical Center - Beilinson Hospital, Petah Tickva, Israel
| | - S Pugh
- NRG Oncology Statistics and Data Management Center, Philadelphia, PA
| | - F Y Feng
- Department of Radiation Oncology, University of California San Francisco, San Francisco, CA
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Bruner DW, Karrison TG, Pollack A, Michalski JM, Balogh A, Rodrigues G, Horwitz EM, Faria S, Camarata AS, Lee RJ, Lukka H, Zelefsky MJ, Seiferheld W, Sandler HM, Movsas B. Quality of Life Results of Addition of Androgen Deprivation Therapy and Pelvic Lymph Node Treatment to Prostate Bed Salvage Radiotherapy: NRG Oncology/RTOG 0534 SPPORT. Int J Radiat Oncol Biol Phys 2023; 117:S24. [PMID: 37784459 DOI: 10.1016/j.ijrobp.2023.06.281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Report the quality of life (QOL) analysis of the SPPORT trial of men with a detectable prostate specific antigen (PSA) after prostatectomy for prostate cancer randomized to (Arm 1) salvage prostate bed radiotherapy (PBRT), (Arm 2) 4-6 months of short-term androgen deprivation therapy (STADT) + PBRT, and (Arm 3) pelvic lymph node radiotherapy (PLNRT) + STADT + PBRT. Primary analysis established a benefit of adding PLNRT and STADT to PBRT. There was higher short term but no statistically significant difference in long term adverse events with the exception of blood or bone marrow events. MATERIALS/METHODS QOL endpoints were assessed at baseline, 6 weeks after RT start, 1 and 5 years, including Expanded Prostate Cancer Index Composite (EPIC) (bowel, urinary, sexual, and hormonal domains), Hopkins Symptom Checklist (HSCL-25) (depressive symptoms), and the EuroQol (EQ-5D) (health state weights used in quality adjusted life years (QALYs). In addition to statistical significance, differences in scores were assessed using 0.5 standard deviation (SD) as the criterion for clinical importance. Difference among arms was assessed using pairwise t-tests, Fisher's exact test, and mixed effects regression modeling. To control for multiplicity, the p-value required for statistical significance is p<0.025. RESULTS Six hundred forty-four patients consented to QOL, about 210 on each arm. Baseline characteristics were not significantly different among arms: 81% were white and 54% <65 years. For EPIC, bowel domain scores decreased at 6 weeks post-RT then increased by years 1 and 5, although not to baseline levels. One clinically significant difference in bowel scores was Arm 3 vs. Arm 1 at 6 weeks. For the urinary domain, scores decreased at 6 weeks post-RT and remained below baseline at 1 and 5 years, but there were no significant differences among arms. For the sexual domain, there were statistically significant differences between arms at 6 weeks and 1 year with patients receiving STADT exhibiting poorer sexual QOL scores. By year 5 the differences were no longer significant. A similar pattern was seen for the hormonal domain. For HSCL-25, differences at 6 weeks were statistically but not clinically significant, and there were no significant differences at the later time points. Comparisons of QALYs for overall survival over an 8-year horizon showed no significant group differences, with a mean of about 7.8 in each arm. Regarding freedom from progression, QALY means were 5.7, 6.5, and 7.4 years for Arms 1, 2, and 3, respectively, with a significant difference between Arms 3 and 1 (p = <.001) favoring the more intensive treatment. CONCLUSION While QOL generally declined among all arms at 6 weeks post RT, there were no clinically significant differences in QOL among arms at 5 years. QALYs for freedom from progression favored STADT + PLNRT + PBRT for salvage treatment of prostate cancer.
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Affiliation(s)
| | | | - A Pollack
- Department of Radiation Oncology, University of Miami/Sylvester Comprehensive Cancer Center, Miami, FL
| | - J M Michalski
- Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO
| | - A Balogh
- Tom Baker Cancer Centre, Calgary, AB, Canada
| | - G Rodrigues
- London Health Sciences Centre, London, ON, Canada
| | - E M Horwitz
- Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA
| | - S Faria
- McGill University Health Center, Montreal, QC, Canada
| | | | - R J Lee
- Intermountain Medical Center, Murray, UT
| | - H Lukka
- Juravinski Cancer Centre, Hamilton, ON, Canada
| | - M J Zelefsky
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | | | - H M Sandler
- Cedars-Sinai Medical Center, Los Angeles, CA
| | - B Movsas
- Henry Ford Hospital, Detroit, MI
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Tseng Y, Stevenson P, Lee D, Paydar I, Kim A, Ravella R, Barbour A, Ababneh H, Binkley M, Lo A, Dedeckova K, Hoppe R, Ballas L, Patel C, Kelsey C, Jr KAK, Balogh A, Plastaras J. Impact of Myc-Altered Pathology on Radiotherapy Efficacy among Patients with Relapsed/Refractory Large-B Cell Lymphoma: A Collaborative Retrospective Study. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Hall W, Pugh S, Pollack A, Lawton C, Spratt D, Efstathiou J, Morgan T, Mckay R, Simko J, Martin A, Michalski J, Balogh A, Lukka H, Faria S, Hagerty M, Beauchemin M, Lee R, Seaward S, Seiferheld W, Feng F. The Influence of Pelvic Lymph Node Dissection Volumes on Clinical Outcomes in NRG/RTOG 0534. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Kotmayer L, László T, Kiss R, Hegyi LL, Mikala G, Farkas P, Balogh A, Masszi T, Demeter J, Weisinger J, Alizadeh H, Gergely L, Sulák A, Egyed M, Plander M, Pettendi P, Lévai D, Schneider T, Pauker Z, Masszi A, Szász R, Bödör C, Alpár D. P615: BCL2 RESISTANCE MUTATIONS IN A REAL-WORLD COHORT OF PATIENTS WITH VENETOCLAX-TREATED CHRONIC LYMPHOCYTIC LEUKAEMIA. Hemasphere 2022. [DOI: 10.1097/01.hs9.0000845348.59055.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Samson N, Khanolkar RA, Quirk S, Quon H, Roumeliotis M, Balogh A, Sia M, Thind K, Husain S, Martell K. Clinical Outcomes from Dose-Reduced Radiotherapy to the Prostate in Elderly Patients with Localized Prostate Cancer. Curr Oncol 2021; 28:3729-3737. [PMID: 34677236 PMCID: PMC8534720 DOI: 10.3390/curroncol28050318] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 09/13/2021] [Accepted: 09/23/2021] [Indexed: 11/29/2022] Open
Abstract
Radical treatment of localized prostate cancer in elderly patients may lead to unacceptable treatment-associated toxicities that adversely impact quality of life without improving survival outcomes. This study reports on a cohort of 54 elderly (>70 years) patients that received 4000–5000 cGy of palliative external beam radiotherapy (EBRT) as an alternative to androgen deprivation therapy (ADT). The primary outcome of interest was the period of ADT-free survival, and secondary outcomes included overall survival (OS) and metastases-free survival (MFS). Kaplan–Meier regression was used to estimate survival outcomes. Thirty-six (67%) patients achieved a break in ADT post-radiotherapy, with a median time to ADT reinitiation of 20 months. Common Terminology Criteria for Adverse Events (CTCAE) were limited to low-grade gastrointestinal (GI) or genitourinary (GU) toxicities, with no skin toxicities observed. Grade 1 GI toxicity was observed in 9 (17%) patients, and grades 1 and 2 GU toxicities were observed in 13 (24%) and 3 (6%) patients, respectively, with no higher-grade toxicities reported. Five-year MFS and OS were 56% and 78%, respectively. In summary, the treatment regimen was well-tolerated and achieved durable ADT-free survival in most patients. Dose-reduced EBRT appears to be a viable alternative to ADT in elderly patients with localized prostate cancer.
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Affiliation(s)
- Nina Samson
- Department of Oncology, University of Calgary, Calgary, AB T2N 4N2, Canada; (N.S.); (R.A.K.); (H.Q.); (A.B.); (M.S.); (S.H.)
- Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada; (S.Q.); (M.R.); (K.T.)
| | - Rutvij A. Khanolkar
- Department of Oncology, University of Calgary, Calgary, AB T2N 4N2, Canada; (N.S.); (R.A.K.); (H.Q.); (A.B.); (M.S.); (S.H.)
- Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada; (S.Q.); (M.R.); (K.T.)
| | - Sarah Quirk
- Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada; (S.Q.); (M.R.); (K.T.)
- Department of Physics and Astronomy, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Harvey Quon
- Department of Oncology, University of Calgary, Calgary, AB T2N 4N2, Canada; (N.S.); (R.A.K.); (H.Q.); (A.B.); (M.S.); (S.H.)
- Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada; (S.Q.); (M.R.); (K.T.)
| | - Michael Roumeliotis
- Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada; (S.Q.); (M.R.); (K.T.)
- Department of Physics and Astronomy, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Alex Balogh
- Department of Oncology, University of Calgary, Calgary, AB T2N 4N2, Canada; (N.S.); (R.A.K.); (H.Q.); (A.B.); (M.S.); (S.H.)
- Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada; (S.Q.); (M.R.); (K.T.)
| | - Michael Sia
- Department of Oncology, University of Calgary, Calgary, AB T2N 4N2, Canada; (N.S.); (R.A.K.); (H.Q.); (A.B.); (M.S.); (S.H.)
- Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada; (S.Q.); (M.R.); (K.T.)
| | - Kundan Thind
- Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada; (S.Q.); (M.R.); (K.T.)
- Department of Physics and Astronomy, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Siraj Husain
- Department of Oncology, University of Calgary, Calgary, AB T2N 4N2, Canada; (N.S.); (R.A.K.); (H.Q.); (A.B.); (M.S.); (S.H.)
- Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada; (S.Q.); (M.R.); (K.T.)
| | - Kevin Martell
- Department of Oncology, University of Calgary, Calgary, AB T2N 4N2, Canada; (N.S.); (R.A.K.); (H.Q.); (A.B.); (M.S.); (S.H.)
- Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada; (S.Q.); (M.R.); (K.T.)
- Correspondence: ; Tel.: +1-403-521-3515
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Jackson W, Tang M, Schipper M, Sandler H, Zumsteg Z, Efstathiou J, Shipley W, Seiferheld W, Lukka H, Bahary J, Zietman A, Pisansky T, Zeitzer K, Hall W, Dess R, Lovett R, Balogh A, Feng F, Spratt D. Metastasis-Free Survival, but Not Biochemical Failure, is a Strong Surrogate Endpoint for Overall Survival in Recurrent Prostate Cancer: Analysis of NRG Oncology/RTOG 9601. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.2197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Samson N, Quirk S, Husain S, Balogh A, Quon H, Skarsgard D, Martell K. Clinical Outcomes of High-Dose Palliative Radiotherapy for Elderly Patients with Localized Prostate Cancer. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Mugahid DA, Sengul TG, You X, Wang Y, Steil L, Bergmann N, Radke MH, Ofenbauer A, Gesell-Salazar M, Balogh A, Kempa S, Tursun B, Robbins CT, Völker U, Chen W, Nelson L, Gotthardt M. Author Correction: Proteomic and Transcriptomic Changes in Hibernating Grizzly Bears Reveal Metabolic and Signaling Pathways that Protect against Muscle Atrophy. Sci Rep 2020; 10:4381. [PMID: 32127597 PMCID: PMC7054357 DOI: 10.1038/s41598-020-61340-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- D A Mugahid
- Neuromuscular and Cardiovascular Cell Biology, Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | - T G Sengul
- Neuromuscular and Cardiovascular Cell Biology, Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | - X You
- Berlin Institute for Medical Systems Biology, Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | - Y Wang
- Berlin Institute for Medical Systems Biology, Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | - L Steil
- Interfaculty Institute for Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany
| | - N Bergmann
- Neuromuscular and Cardiovascular Cell Biology, Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | - M H Radke
- Neuromuscular and Cardiovascular Cell Biology, Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | - A Ofenbauer
- Berlin Institute for Medical Systems Biology, Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | - M Gesell-Salazar
- Interfaculty Institute for Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany
| | - A Balogh
- Experimental and Clinical Research Center, Charité & Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | - S Kempa
- Berlin Institute for Medical Systems Biology, Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | - B Tursun
- Berlin Institute for Medical Systems Biology, Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | - C T Robbins
- School of the Environment and School of Biological Sciences, Washington State University, Pullman, Washington, USA
| | - U Völker
- Interfaculty Institute for Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Greifswald, Germany
| | - W Chen
- Berlin Institute for Medical Systems Biology, Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | - L Nelson
- College of Veterinary Medicine and Department of Veterinary Clinical Science, Washington State University, Pullman, Washington, USA
| | - M Gotthardt
- Neuromuscular and Cardiovascular Cell Biology, Max Delbrück Center for Molecular Medicine, Berlin, Germany. .,Charité Universitätsmedizin Berlin, Berlin, Germany. .,DZHK (German Center for Cardiovascular Research), partner site Berlin, Berlin, Germany.
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11
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Frederick R, Hudson A, Balogh A, Cao JQ, Pierce G. Standardized flattening filter free volumetric modulated arc therapy plans based on anteroposterior width for total body irradiation. J Appl Clin Med Phys 2020; 21:75-86. [PMID: 32043760 PMCID: PMC7075390 DOI: 10.1002/acm2.12827] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 01/09/2020] [Accepted: 01/10/2020] [Indexed: 12/17/2022] Open
Abstract
In this work, the feasibility of using flattening filter free (FFF) beams in volumetric modulated arc therapy (VMAT) total body irradiation (TBI) treatment planning to decrease protracted beam‐on times for these treatments was investigated. In addition, a methodology was developed to generate standardized VMAT TBI treatment plans based on patient physical dimensions to eliminate plan optimization time. A planning study cohort of 47 TBI patients previously treated with optimized VMAT ARC 6 MV beams was retrospectively examined. These patients were sorted into six categories depending on height and anteroposterior (AP) width at the umbilicus. Using Varian Eclipse, clinical 40 cm × 10 cm open field arcs were substituted with 6 MV FFF. Mid‐plane lateral dose profiles in conjunction with relative arc output factors (RAOF) yielded how far a given multileaf collimator (MLC) leaf must move in order to achieve a mid‐plane 100% isodose for a specific control point. Linear interpolation gave the dynamic MLC aperture for the entire arc for each patient AP width category, which was subsequently applied through Python scripting. All FFF VMAT TBI plans were then evaluated by two radiation oncologists and deemed clinically acceptable. The FFF and clinical VMAT TBI plans had similar Body–5 mm D98% distributions, but overall the FFF plans had statistically significantly increased or broader Body–5 mm D2% and mean lung dose distributions. These differences are not considered clinically significant. Median beam‐on times for the FFF and clinical VMAT TBI plans were 11.07 and 18.06 min, respectively, and planning time for the FFF VMAT TBI plans was reduced by 34.1 min. In conclusion, use of FFF beams in VMAT TBI treatment planning resulted in dose homogeneity similar to our current VMAT TBI technique. Clinical dosimetric criteria were achieved for a majority of patients while planning and calculated beam‐on times were reduced, offering the possibility of improved patient experience.
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Affiliation(s)
- Rebecca Frederick
- Department of Medical Physics, Tom Baker Cancer Centre, Calgary, AB, Canada.,Department of Physics and Astronomy, University of Calgary, Calgary, AB, Canada
| | - Alana Hudson
- Department of Medical Physics, Tom Baker Cancer Centre, Calgary, AB, Canada.,Department of Oncology, University of Calgary, Calgary, AB, Canada
| | - Alex Balogh
- Department of Oncology, University of Calgary, Calgary, AB, Canada.,Division of Radiation Oncology, Tom Baker Cancer Centre, Calgary, AB, Canada
| | - Jeffrey Q Cao
- Department of Oncology, University of Calgary, Calgary, AB, Canada.,Division of Radiation Oncology, Tom Baker Cancer Centre, Calgary, AB, Canada
| | - Greg Pierce
- Department of Medical Physics, Tom Baker Cancer Centre, Calgary, AB, Canada.,Department of Physics and Astronomy, University of Calgary, Calgary, AB, Canada.,Department of Oncology, University of Calgary, Calgary, AB, Canada
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12
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Mugahid DA, Sengul TG, You X, Wang Y, Steil L, Bergmann N, Radke MH, Ofenbauer A, Gesell-Salazar M, Balogh A, Kempa S, Tursun B, Robbins CT, Völker U, Chen W, Nelson L, Gotthardt M. Proteomic and Transcriptomic Changes in Hibernating Grizzly Bears Reveal Metabolic and Signaling Pathways that Protect against Muscle Atrophy. Sci Rep 2019; 9:19976. [PMID: 31882638 PMCID: PMC6934745 DOI: 10.1038/s41598-019-56007-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 12/05/2019] [Indexed: 12/31/2022] Open
Abstract
Muscle atrophy is a physiological response to disuse and malnutrition, but hibernating bears are largely resistant to this phenomenon. Unlike other mammals, they efficiently reabsorb amino acids from urine, periodically activate muscle contraction, and their adipocytes differentially responds to insulin. The contribution of myocytes to the reduced atrophy remains largely unknown. Here we show how metabolism and atrophy signaling are regulated in skeletal muscle of hibernating grizzly bear. Metabolic modeling of proteomic changes suggests an autonomous increase of non-essential amino acids (NEAA) in muscle and treatment of differentiated myoblasts with NEAA is sufficient to induce hypertrophy. Our comparison of gene expression in hibernation versus muscle atrophy identified several genes differentially regulated during hibernation, including Pdk4 and Serpinf1. Their trophic effects extend to myoblasts from non-hibernating species (including C. elegans), as documented by a knockdown approach. Together, these changes reflect evolutionary favored adaptations that, once translated to the clinics, could help improve atrophy treatment.
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Affiliation(s)
- D A Mugahid
- Neuromuscular and Cardiovascular Cell Biology, Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | - T G Sengul
- Neuromuscular and Cardiovascular Cell Biology, Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | - X You
- Berlin Institute for Medical Systems Biology, Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | - Y Wang
- Berlin Institute for Medical Systems Biology, Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | - L Steil
- Interfaculty Institute for Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany
| | - N Bergmann
- Neuromuscular and Cardiovascular Cell Biology, Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | - M H Radke
- Neuromuscular and Cardiovascular Cell Biology, Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | - A Ofenbauer
- Berlin Institute for Medical Systems Biology, Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | - M Gesell-Salazar
- Interfaculty Institute for Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany
| | - A Balogh
- Experimental and Clinical Research Center, Charité & Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | - S Kempa
- Berlin Institute for Medical Systems Biology, Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | - B Tursun
- Berlin Institute for Medical Systems Biology, Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | - C T Robbins
- School of the Environment and School of Biological Sciences, Washington State University, Pullman, Washington, USA
| | - U Völker
- Interfaculty Institute for Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Greifswald, Germany
| | - W Chen
- Berlin Institute for Medical Systems Biology, Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | - L Nelson
- College of Veterinary Medicine and Department of Veterinary Clinical Science, Washington State University, Pullman, Washington, USA
| | - M Gotthardt
- Neuromuscular and Cardiovascular Cell Biology, Max Delbrück Center for Molecular Medicine, Berlin, Germany. .,Charité Universitätsmedizin Berlin, Berlin, Germany. .,DZHK (German Center for Cardiovascular Research), partner site Berlin, Berlin, Germany.
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13
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Tawbi H, Forsyth P, Hodi F, Lao C, Moschos S, Hamid O, Atkins M, Lewis K, Thomas R, Glaspy J, Jang S, Algazi A, Khushalani N, Postow M, Pavlick A, Ernstoff M, Reardon D, Balogh A, Rizzo J, Margolin K. Efficacité et tolérance de l’association du nivolumab (NIVO) et de l’ipilimumab (IPI) chez des patients atteints d’un mélanome et présentant des métastases cérébrales symptomatiques. Ann Dermatol Venereol 2019. [DOI: 10.1016/j.annder.2019.09.561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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14
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Larkin J, Chiarion-Sileni V, Gonzalez R, Grob J, Rutkowski P, Lao C, Cowey C, Schadendorf D, Wagstaff J, Dummer R, Ferrucci P, Smylie M, Hogg D, Hill A, Marquez-Rodas I, Haanen JBAG, Rizzo J, Balogh A, Hodi F, Wolchok J. 5-year survival outcomes of the CheckMate 067 phase III trial of nivolumab plus ipilimumab (NIVO+IPI) combination therapy in advanced melanoma. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz394.065] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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15
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Binkley MS, Brady JL, Hajj C, Chelius M, Chau K, Balogh A, Levis M, Filippi AR, Jones M, Ahmed S, MacManus M, Wirth A, Oguchi M, Vistisen AK, Andraos TY, Ng AK, Aleman BMP, Choi SH, Kirova YM, Hardy S, Reinartz G, Eich HT, Bratman SV, Constine LS, Suh CO, Dabaja B, El-Galaly TC, Hodgson DC, Ricardi U, Yahalom J, Mikhaeel NG, Hoppe RT. Salvage Treatment and Survival for Relapsed Follicular Lymphoma Following Primary Radiation Therapy: A Collaborative Study on Behalf of ILROG. Int J Radiat Oncol Biol Phys 2019; 104:522-529. [PMID: 30858143 DOI: 10.1016/j.ijrobp.2019.03.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 02/18/2019] [Accepted: 03/02/2019] [Indexed: 12/11/2022]
Abstract
PURPOSE We previously reported that ∼30% of patients with localized follicular lymphoma (FL) staged by 18F-fluorodeoxyglucose positron emission tomography-computed tomography receiving primary radiation therapy (RT) will relapse within 5 years. We sought to report outcomes for those who relapsed. METHODS AND MATERIALS We conducted a multicenter, retrospective study of patients aged ≥18 years who received RT ≥ 24 Gy for stage I to II, grade 1 to 3A FL, staged with 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography-computed tomography. Observation was defined as >6 months without treatment from relapse. Overall survival (OS) and freedom from progression (FFP) were estimated with Kaplan-Meier analysis and univariable and multivariable analyses with Cox regression. RESULTS Of 512 patients with median follow-up of 52 months, 149 (29.1%) developed recurrent lymphoma at a median of 23 months (range, 1-143) after primary RT. Median follow-up was 33 months after relapse. Three-year OS was 91.4% after recurrence. OS was significantly worse for those with relapse ≤12 months from date of diagnosis versus all others-88.7% versus 97.6%, respectively (P = .01)-and remained significantly worse on multivariable analyses (follicular lymphoma international prognostic index-adjusted hazard ratio, 3.61; P = .009). Histology at relapse included 93 indolent (grade 1-3A), 3 FL grade 3B/not otherwise specified, and 18 diffuse large B-cell lymphoma; 35 patients did not undergo biopsy. Of those with follow-up ≥3 months who underwent biopsy (n = 74) or had presumed (n = 23) indolent recurrence, 58 patients (59.8%) were observed, 19 (19.6%) had systemic therapy, 16 (16.5%) had RT, and 4 (4.1%) had systemic therapy + RT. For patients with indolent recurrences that were observed, 3-year FFP or freedom from treatment was 56.6% (median, 48 months). For all patients with biopsied/presumed indolent recurrence receiving salvage treatment (n = 59, including 20 initially observed) 3-year FFP was 73.9%. CONCLUSIONS Prognosis for patients with relapsed FL after primary radiation therapy is excellent, supporting the role of primary radiation in the management of early stage disease. Patients with localized FL treated with primary RT who experience early relapse (<12 months) have inferior survival compared with those with longer disease-free interval.
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Affiliation(s)
- Michael S Binkley
- Stanford Cancer Institute and Stanford University School of Medicine, Stanford, CA.
| | - Jessica L Brady
- Guy's Cancer Centre, Guy's and St Thomas' NHS Hospital, London, United Kingdom
| | - Carla Hajj
- Memorial Sloan Kettering Cancer Center, New York, NY
| | | | - Karen Chau
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - Alex Balogh
- Tom Baker Cancer Center, Calgary, AB, Canada
| | - Mario Levis
- Department of Oncology, University of Turin, Torino, Italy
| | | | - Michael Jones
- Princess Margaret Cancer Center, Toronto, ON, Canada
| | - Sameera Ahmed
- Princess Margaret Cancer Center, Toronto, ON, Canada
| | - Michael MacManus
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; Trans-Tasman Radiation Oncology Group, Waratah, NSW, Australia
| | - Andrew Wirth
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | | | | | | | - Andrea K Ng
- Dana Farber and Harvard University School of Medicine, Boston, MA
| | - Berthe M P Aleman
- Department of Radiation Oncology, the Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Seo Hee Choi
- Yonsei Cancer Center, Yonsei University Health System, Seoul, South Korea
| | | | | | - Gabriele Reinartz
- Department of Radiation Oncology, Munster University, Munster, Germany
| | - Hans T Eich
- Department of Radiation Oncology, Munster University, Munster, Germany
| | - Scott V Bratman
- Stanford Cancer Institute and Stanford University School of Medicine, Stanford, CA
| | | | - Chang-Ok Suh
- Yonsei Cancer Center, Yonsei University Health System, Seoul, South Korea
| | | | | | | | | | | | - N George Mikhaeel
- Guy's Cancer Centre, Guy's and St Thomas' NHS Hospital, London, United Kingdom
| | - Richard T Hoppe
- Stanford Cancer Institute and Stanford University School of Medicine, Stanford, CA
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16
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Pierce G, Balogh A, Frederick R, Gordon D, Yarschenko A, Hudson A. Extended SSD VMAT treatment for total body irradiation. J Appl Clin Med Phys 2018; 20:200-211. [PMID: 30592152 PMCID: PMC6333187 DOI: 10.1002/acm2.12519] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 11/09/2018] [Accepted: 11/13/2018] [Indexed: 12/17/2022] Open
Abstract
In this work, we develop a total body irradiation technique that utilizes arc delivery, a buildup spoiler, and inverse optimized multileaf collimator (MLC) motion to shield organs at risk. The current treatment beam model is verified to confirm its applicability at extended source‐to‐surface distance (SSD). The delivery involves 7–8 volumetric modulated arc therapy arcs delivered to the patient in the supine and prone positions. The patient is positioned at a 90° couch angle on a custom bed with a 1 cm acrylic spoiler to increase surface dose. Single‐step optimization using a patient CT scan provides enhanced dose homogeneity and limits organ at risk dose. Dosimetric data of 109 TBI patients treated with this technique is presented along with the clinical workflow. Treatment planning system (TPS) verification measurements were performed at an extended SSD of 175 cm. Measurements included: a 4‐point absolute depth‐dose curve, profiles at 1.5, 5, and 10 cm depth, absolute point‐dose measurements of an treatment field, 2D Gafchromic® films at four locations, and measurements of surface dose at multiple locations of a Alderson phantom. The results of the patient DVH parameters were: Body‐5 mm D98 95.3 ± 1.5%, Body‐5 mm D2 114.0 ± 3.6%, MLD 102.8 ± 2.1%. Differences between measured and calculated absolute depth‐dose values were all <2%. Profiles at extended SSD had a maximum point difference of 1.3%. Gamma pass rates of 2D films were greater than 90% at 5%/1 mm. Surface dose measurements with film confirmed surface dose values of >90% of the prescription dose. In conclusion, the inverse optimized delivery method presented in the paper has been used to deliver homogenous dose to over 100 patients. The method provides superior patient comfort utilizing a commercial TPS. In addition, the ability to easily shield organs at risk is available through the use of MLCs.
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Affiliation(s)
- Greg Pierce
- Department of Medical Physics, Tom Baker Cancer Centre, Calgary, AB, Canada.,Department of Physics & Astronomy, University of Calgary, Calgary, AB, Canada.,Department of Oncology, University of Calgary, Calgary, AB, Canada
| | - Alex Balogh
- Department of Oncology, University of Calgary, Calgary, AB, Canada.,Division of Radiation Oncology, Tom Baker Cancer Centre, Calgary, AB, Canada
| | - Rebecca Frederick
- Department of Medical Physics, Tom Baker Cancer Centre, Calgary, AB, Canada.,Department of Physics & Astronomy, University of Calgary, Calgary, AB, Canada
| | - Deborah Gordon
- Department of Radiation Therapy, Tom Baker Cancer Centre, Calgary, AB, Canada
| | - Adam Yarschenko
- Department of Medical Physics, Tom Baker Cancer Centre, Calgary, AB, Canada
| | - Alana Hudson
- Department of Medical Physics, Tom Baker Cancer Centre, Calgary, AB, Canada.,Department of Oncology, University of Calgary, Calgary, AB, Canada
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17
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Parr R, Dey A, McCloskey E, Aras N, Balogh A, Borelli A, Krishnan S, Lobo G, Qin L, Zhang Y, Cvijetic S, Zaichick V, Lim-Abraham M, Bose K, Wynchank S, Iyengar G. Contribution of Calcium and Other Dietary Components to Global Variations in Bone Mineral Density in Young Adults. Food Nutr Bull 2018. [DOI: 10.1177/15648265020233s135] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A research project on comparative international studies of osteoporosis using isotope techniques was organized by the International Atomic Energy Agency (IAEA) with the participation of 12 countries (Brazil, Canada, Chile, China, Croatia, Hungary, Philippines, Russia, Singapore, South Africa, Turkey, and the United Kingdom). Participating centers in 11 countries (all but the UK) made measurements and collected data on men and women aged 15 to 49 years. In addition to studies of bone mineral density (BMD) at the femoral neck and lumbar spine using DEXA, anthropometric, lifestyle, and nutritional data were also collected. The results of the nutritional studies are reviewed in this paper. Overall, about 8% of the observed variability in spine BMD could be attributed to nutritional factors in men and women; in men, no such relationship could be determined. No single nutritional component (not even calcium) stood out as being of particular importance across all participating centers.
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Affiliation(s)
- R.M. Parr
- Department of Nuclear Sciences and Applications, International Atomic Energy Agency in Vienna, Austria
| | - A. Dey
- WHO Collaborating Centre for Metabolic Bone Diseases in Sheffield, UK
| | - E.V. McCloskey
- WHO Collaborating Centre for Metabolic Bone Diseases in Sheffield, UK
| | - N. Aras
- Middle East Technical University in Ankara, Turkey
| | - A. Balogh
- University of Debrecen in Debrecen, Hungary
| | - A. Borelli
- Hospital das Clinicas in Sao Paulo, Brazil
| | | | - G. Lobo
- Clinica Indisa in Santiago, Chile
| | - L.L. Qin
- China-Japan Friendship Hospital in Beijing, China
| | - Y. Zhang
- Institute of Nuclear Research in Shanghai, China
| | - S. Cvijetic
- Institute for Medical Research in Zagreb, Croatia
| | - V. Zaichick
- Medical Radiological Research Centre in Obninsk, Russian Federation
| | | | - K. Bose
- National University Hospital in Singapore
| | - S. Wynchank
- Medical Research Council in Tygerberg, South Africa
| | - G.V. Iyengar
- Department of Nuclear Sciences and Applications, International Atomic Energy Agency in Vienna, Austria
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18
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Démuth B, Galata DL, Balogh A, Szabó E, Nagy B, Farkas A, Hirsch E, Pataki H, Vigh T, Mensch J, Verreck G, Nagy ZK, Marosi G. Application of hydroxypropyl methylcellulose as a protective agent against magnesium stearate induced crystallization of amorphous itraconazole. Eur J Pharm Sci 2018; 121:301-308. [PMID: 29902510 DOI: 10.1016/j.ejps.2018.06.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 04/16/2018] [Accepted: 06/11/2018] [Indexed: 12/27/2022]
Abstract
Itraconazole is a fungicide drug which has low bioavailability due to its poor water solubility. Amorphous solid dispersion (ASD) is a tool that has the potential to greatly increase the dissolution rate and extent of compounds. In this work, the dissolution of tablets containing the ASD of itraconazole with either hydroxypropyl methylcellulose (HPMC) or vinylpyrrolidone-vinyl acetate copolymer (PVPVA) was compared in order to find a formulation which can prevent the drug from the precipitation caused by magnesium stearate. Formulations containing the PVPVA-based ASD with HPMC included in various forms could reach 90% dissolution in 2 h, while HPMC-based ASDs could release 100% of the drug. However, HPMC-based ASD had remarkably poor grindability and low bulk density, which limited its processability and applicability. The latter issue could be resolved by roller compacting the ASD, which significantly increases the bulk density and the flowability of the powder blends used for tableting. This roller compaction step might be a base for the industrial application of HPMC-based, electrospun ASDs.
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Affiliation(s)
- B Démuth
- Department of Organic Chemistry and Technology, Budapest University of Technology and Economics, 1111 Budapest, Műegyetem rkp. 3, Hungary
| | - D L Galata
- Department of Organic Chemistry and Technology, Budapest University of Technology and Economics, 1111 Budapest, Műegyetem rkp. 3, Hungary
| | - A Balogh
- Department of Organic Chemistry and Technology, Budapest University of Technology and Economics, 1111 Budapest, Műegyetem rkp. 3, Hungary
| | - E Szabó
- Department of Organic Chemistry and Technology, Budapest University of Technology and Economics, 1111 Budapest, Műegyetem rkp. 3, Hungary
| | - B Nagy
- Department of Organic Chemistry and Technology, Budapest University of Technology and Economics, 1111 Budapest, Műegyetem rkp. 3, Hungary
| | - A Farkas
- Department of Organic Chemistry and Technology, Budapest University of Technology and Economics, 1111 Budapest, Műegyetem rkp. 3, Hungary
| | - E Hirsch
- Department of Organic Chemistry and Technology, Budapest University of Technology and Economics, 1111 Budapest, Műegyetem rkp. 3, Hungary
| | - H Pataki
- Department of Organic Chemistry and Technology, Budapest University of Technology and Economics, 1111 Budapest, Műegyetem rkp. 3, Hungary
| | - T Vigh
- Janssen Research and Development, 2340 Beerse, Turnhoutseweg 30, Belgium
| | - J Mensch
- Janssen Research and Development, 2340 Beerse, Turnhoutseweg 30, Belgium
| | - G Verreck
- Janssen Research and Development, 2340 Beerse, Turnhoutseweg 30, Belgium
| | - Z K Nagy
- Department of Organic Chemistry and Technology, Budapest University of Technology and Economics, 1111 Budapest, Műegyetem rkp. 3, Hungary.
| | - G Marosi
- Department of Organic Chemistry and Technology, Budapest University of Technology and Economics, 1111 Budapest, Műegyetem rkp. 3, Hungary
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19
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Szabo E, Demuth B, Nagy B, Molnar K, Farkas A, Szabo B, Balogh A, Hirsch E, Nagy B, Marosi G, Nagy ZK. Scaled-up preparation of drug-loaded electrospun polymer fibres and investigation of their continuous processing to tablet form. EXPRESS POLYM LETT 2018. [DOI: 10.3144/expresspolymlett.2018.37] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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20
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Démuth B, Galata DL, Szabó E, Nagy B, Farkas A, Balogh A, Hirsch E, Pataki H, Rapi Z, Bezúr L, Vigh T, Verreck G, Szalay Z, Demeter Á, Marosi G, Nagy ZK. Investigation of Deteriorated Dissolution of Amorphous Itraconazole: Description of Incompatibility with Magnesium Stearate and Possible Solutions. Mol Pharm 2017; 14:3927-3934. [PMID: 28972782 DOI: 10.1021/acs.molpharmaceut.7b00629] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Disadvantageous crystallization phenomenon of amorphous itraconazole (ITR) occurring in the course of dissolution process was investigated in this work. A perfectly amorphous form (solid dispersion) of the drug was generated by the electroblowing method (with vinylpyrrolidone-vinyl acetate copolymer), and the obtained fibers were formulated into tablets. Incomplete dissolution of the tablets was noticed under the circumstances of the standard dissolution test, after which a precipitated material could be filtered. The filtrate consisted of ITR and stearic acid since no magnesium content was detectable in it. In parallel with dissolution, ITR forms an insoluble associate, stabilized by hydrogen bonding, with stearic acid deriving from magnesium stearate. This is why dissolution curves do not have the plateaus at 100%. Two ways are viable to tackle this issue: change the lubricant (with sodium stearyl fumarate >95% dissolution can be accomplished) or alter the polymer in the solid dispersion to a type being able to form hydrogen bonds with ITR (e.g., hydroxypropyl methylcellulose). This work draws attention to one possible phenomenon that can lead to a deterioration of originally good dissolution of an amorphous solid dispersion.
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Affiliation(s)
- B Démuth
- Department of Organic Chemistry and Technology, Budapest University of Technology and Economics (BME) , Műegyetem rkp. 3, H-1111 Budapest, Hungary
| | - D L Galata
- Department of Organic Chemistry and Technology, Budapest University of Technology and Economics (BME) , Műegyetem rkp. 3, H-1111 Budapest, Hungary
| | - E Szabó
- Department of Organic Chemistry and Technology, Budapest University of Technology and Economics (BME) , Műegyetem rkp. 3, H-1111 Budapest, Hungary
| | - B Nagy
- Department of Organic Chemistry and Technology, Budapest University of Technology and Economics (BME) , Műegyetem rkp. 3, H-1111 Budapest, Hungary
| | - A Farkas
- Department of Organic Chemistry and Technology, Budapest University of Technology and Economics (BME) , Műegyetem rkp. 3, H-1111 Budapest, Hungary
| | - A Balogh
- Department of Organic Chemistry and Technology, Budapest University of Technology and Economics (BME) , Műegyetem rkp. 3, H-1111 Budapest, Hungary
| | - E Hirsch
- Department of Organic Chemistry and Technology, Budapest University of Technology and Economics (BME) , Műegyetem rkp. 3, H-1111 Budapest, Hungary
| | - H Pataki
- Department of Organic Chemistry and Technology, Budapest University of Technology and Economics (BME) , Műegyetem rkp. 3, H-1111 Budapest, Hungary
| | - Z Rapi
- Department of Organic Chemistry and Technology, Budapest University of Technology and Economics (BME) , Műegyetem rkp. 3, H-1111 Budapest, Hungary
| | - L Bezúr
- Department of Inorganic and Analytical Chemistry, Budapest University of Technology and Economics (BME) , Szent Gellért tér 4, H-1111, Budapest, Hungary
| | - T Vigh
- Drug Product Development, Janssen R&D , Turnhoutseweg 30, B-2340 Beerse, Belgium
| | - G Verreck
- Drug Product Development, Janssen R&D , Turnhoutseweg 30, B-2340 Beerse, Belgium
| | - Z Szalay
- Drug Polymorphism Research, Gedeon Richter Plc. , Gyömrői út 30-32, H-1103 Budapest, Hungary
| | - Á Demeter
- Drug Polymorphism Research, Gedeon Richter Plc. , Gyömrői út 30-32, H-1103 Budapest, Hungary
| | - G Marosi
- Department of Organic Chemistry and Technology, Budapest University of Technology and Economics (BME) , Műegyetem rkp. 3, H-1111 Budapest, Hungary
| | - Z K Nagy
- Department of Organic Chemistry and Technology, Budapest University of Technology and Economics (BME) , Műegyetem rkp. 3, H-1111 Budapest, Hungary
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21
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Démuth B, Farkas A, Szabó B, Balogh A, Nagy B, Vágó E, Vigh T, Tinke A, Kazsu Z, Demeter Á, Bertels J, Mensch J, Van Dijck A, Verreck G, Van Assche I, Marosi G, Nagy Z. Development and tableting of directly compressible powder from electrospun nanofibrous amorphous solid dispersion. ADV POWDER TECHNOL 2017. [DOI: 10.1016/j.apt.2017.03.026] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Jakab E, Kalina E, Petho Z, Pap Z, Balogh A, Grant WB, Bhattoa HP. Standardizing 25-hydroxyvitamin D data from the HunMen cohort. Osteoporos Int 2017; 28:1653-1657. [PMID: 28321506 DOI: 10.1007/s00198-017-3924-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Accepted: 01/11/2017] [Indexed: 12/31/2022]
Abstract
UNLABELLED Standardization of 25-hydroxyvitamin D (25OHD) values is still a challenge. We propose standardization by correction of the measured 25OHD values using the linear regression bias from the National Institute of Standards and Technology (NIST) 'total' target values reported by Vitamin D External Quality Assessment Scheme (DEQAS). Our approach could perhaps be a practical solution to the anomaly surrounding non-standardized 25OHD values. INTRODUCTION Standardization of 25OHD values is still a challenge. We propose standardization by correction of the measured 25OHD values using the linear regression equation derived from the analysis of relationship between total 25OHD values measured by the methodology used by the laboratory and the NIST total target values (TV) reported by the DEQAS for all 5 of the DEQAS samples in a given survey. METHODS We applied our approach to standardize total 25OHD values of the HunMen cohort. RESULTS All 206 samples for the HunMen cohort were evaluated using the automated Liaison DiaSorin total 25OHD chemiluminescence immunoassay (CLIA). The timing of these measurements coincided with that of the October 2015 DEQAS survey using samples 481 to 485. Following standardization, the mean total 25OHD changed from 53 to 62 nmol/L and the prevalence of hypovitaminosis D (<75 nmol/L) decreased significantly from 84 to 72%. CONCLUSION A simple approach readily applicable at the routine diagnostic laboratory could perhaps be a practical solution to the anomaly surrounding non-standardized 25OHD values.
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Affiliation(s)
- E Jakab
- Department of Laboratory Medicine, University of Debrecen, Nagyerdei Blvd 98, Debrecen, H-4032, Hungary
| | - E Kalina
- Department of Laboratory Medicine, University of Debrecen, Nagyerdei Blvd 98, Debrecen, H-4032, Hungary
| | - Z Petho
- Department of Rheumatology, University of Debrecen, Debrecen, H-4032, Hungary
| | - Z Pap
- Department of Traumatology, University of Debrecen, Debrecen, H-4032, Hungary
| | - A Balogh
- Department of Obstetrics and Gynecology, University of Debrecen, Debrecen, H-4032, Hungary
| | - W B Grant
- Sunlight, Nutrition and Health Research Center, San Francisco, CA, 94164-1603, USA
| | - H P Bhattoa
- Department of Laboratory Medicine, University of Debrecen, Nagyerdei Blvd 98, Debrecen, H-4032, Hungary.
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Mathen P, Molnar C, Trotter T, Stewart D, Balogh A. 253: Meeting the International Lymphoma Radiation Oncology Group Criteria to Deliver Radiotherapy for Lymphomas - A Quality Improvement Study at the Tom Baker Cancer Centre. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)33652-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Hudson A, Gordon D, Moore R, Balogh A, Pierce G. Sci-Thur PM - Colourful Interactions: Highlights 08: ARC TBI using Single-Step Optimized VMAT Fields. Med Phys 2016. [DOI: 10.1118/1.4961768] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Démuth B, Farkas A, Pataki H, Balogh A, Szabó B, Borbás E, Sóti P, Vigh T, Kiserdei É, Farkas B, Mensch J, Verreck G, Van Assche I, Marosi G, Nagy Z. Detailed stability investigation of amorphous solid dispersions prepared by single-needle and high speed electrospinning. Int J Pharm 2016; 498:234-44. [DOI: 10.1016/j.ijpharm.2015.12.029] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 12/08/2015] [Accepted: 12/10/2015] [Indexed: 12/15/2022]
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Shipley W, Seiferheld W, Lukka H, Major P, Heney N, Grignon D, Sartor O, Patel M, Bahary J, Zietman A, Pisansky T, Zeitzer K, Lawton C, Feng F, Lovett R, Balogh A, Souhami L, Rosenthal S, Kerlin K, Sandler H. Report of NRG Oncology/RTOG 9601, A Phase 3 Trial in Prostate Cancer: Anti-androgen Therapy (AAT) With Bicalutamide During and After Radiation Therapy (RT) in Patients Following Radical Prostatectomy (RP) With pT2-3pN0 Disease and an Elevated PSA. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2015.10.048] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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27
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Haase N, Wilck N, Marko L, Balogh A, Heuser A, Brockschnieder D, Kretschmer A, Stasch JP, Müller N, Dechend R. The sGC stimulator BAY 41-8543 in a rat model of hypertension-induced heart failure. BMC Pharmacol Toxicol 2015. [PMCID: PMC4565162 DOI: 10.1186/2050-6511-16-s1-a57] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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28
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Petho Z, Kulcsar-Jakab E, Kalina E, Balogh A, Pusztai A, Gulyas K, Horvath A, Szekanecz Z, Bhattoa HP. Vitamin D status in men with psoriatic arthritis: a case-control study. Osteoporos Int 2015; 26:1965-70. [PMID: 25693749 DOI: 10.1007/s00198-015-3069-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Accepted: 02/04/2015] [Indexed: 12/31/2022]
Abstract
UNLABELLED We determined hypovitaminosis D prevalence in men with psoriatic arthritis. This is a cross-sectional, analyst blinded, age- and sex-matched, case-control study. Men with psoriatic arthritis have significantly lower 25-hydroxyvitamin D levels. Men with psoriatic arthritis are at increased odds of suffering from hypovitaminosis D. INTRODUCTION Skeletal manifestations as a result of abrupted bone metabolism may be predominant in psoriatic arthritis (PsA). Vitamin D plays a vital role in maintenance of skeletal health and is known to modulate the immune system in various autoimmune diseases including PsA. The aim of the present study was to determine the prevalence of hypovitaminosis D in a treatment naïve, de novo psoriatic arthritis male cohort in a cross-sectional, analyst blinded, age- and sex-matched, case-control study. METHODS 25 hydroxyvitamin D (25OHD), parathyroid (PTH), osteocalcin (OC) and C-terminal telopeptides of type-I collagen (CTx) levels, and lumbar spine and femoral neck bone mineral density were compared between 53 PsA and controls. RESULTS The prevalence of hypovitaminosis D (25 hydroxyvitamin D (25OHD) levels <75 nmol/L) was 81 and 57 % in the PsA and control groups, respectively. Compared to the healthy controls, 25OHD (67.2 (12-137) nmol/L vs. 51.9 (15-95) nmol/L; p = 0.001) was significantly lower, and osteocalcin (13.6 (5-33) μg/L vs. 18.2 (6-35) μg/L; p = 0.003) and C-terminal telopeptides of type-I collagen (0.20 (0.01-0.71) μg/L vs. 0.28 (0.06-0.69) μg/L; p = 0.008) were significantly higher in the PsA group. A significant association was found between hypovitaminosis D and PsA; the odds for patients with PsA of having hypovitaminosis D was 3.297 (95 % confidence interval 1.372 to 7.922). CONCLUSION The results of this study suggest that men with PsA have significantly lower 25-hydroxyvitamin D levels, and furthermore, men with PsA are at statistically significant increased odds of suffering from hypovitaminosis D.
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Affiliation(s)
- Z Petho
- Department of Rheumatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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Than NG, Romero R, Xu Y, Erez O, Xu Z, Bhatti G, Leavitt R, Chung TH, El-Azzamy H, LaJeunesse C, Wang B, Balogh A, Szalai G, Land S, Dong Z, Hassan SS, Chaiworapongsa T, Krispin M, Kim CJ, Tarca AL, Papp Z, Bohn H. Evolutionary origins of the placental expression of chromosome 19 cluster galectins and their complex dysregulation in preeclampsia. Placenta 2014; 35:855-65. [PMID: 25266889 PMCID: PMC4203431 DOI: 10.1016/j.placenta.2014.07.015] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Revised: 07/04/2014] [Accepted: 07/28/2014] [Indexed: 12/13/2022]
Abstract
INTRODUCTION The dysregulation of maternal-fetal immune tolerance is one of the proposed mechanisms leading to preeclampsia. Galectins are key regulator proteins of the immune response in vertebrates and maternal-fetal immune tolerance in eutherian mammals. Previously we found that three genes in a Chr19 cluster encoding for human placental galectin-13 (PP13), galectin-14 and galectin-16 emerged during primate evolution and may confer immune tolerance to the semi-allogeneic fetus. MATERIALS AND METHODS This study involved various methodologies for gene and protein expression profiling, genomic DNA methylation analyses, functional assays on differentiating trophoblasts including gene silencing, luciferase reporter and methylation assays. These methods were applied on placental specimens, umbilical cord blood cells, primary trophoblasts and BeWo cells. Genomic DNA sequences were analyzed for transposable elements, transcription factor binding sites and evolutionary conservation. RESULTS AND DISCUSSION The villous trophoblastic expression of Chr19 cluster galectin genes is developmentally regulated by DNA methylation and induced by key transcription factors of villous placental development during trophoblast fusion and differentiation. This latter mechanism arose via the co-option of binding sites for these transcription factors through promoter evolution and the insertion of an anthropoid-specific L1PREC2 transposable element into the 5' untranslated region of an ancestral gene followed by gene duplication events. Among placental Chr19 cluster galectin genes, the expression of LGALS13 and LGALS14 is down-regulated in preterm severe preeclampsia associated with SGA. We reveal that this phenomenon is partly originated from the dysregulated expression of key transcription factors controlling trophoblastic functions and galectin gene expression. In addition, the differential DNA methylation of these genes was also observed in preterm preeclampsia irrespective of SGA. CONCLUSIONS These findings reveal the evolutionary origins of the placental expression of Chr19 cluster galectins. The complex dysregulation of these genes in preeclampsia may alter immune tolerance mechanisms at the maternal-fetal interface.
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Affiliation(s)
- N G Than
- Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, and Detroit, MI, USA; Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA; Maternity Private Department, Kutvolgyi Clinical Block, Semmelweis University, Budapest, Hungary; Institute of Enzymology, Research Centre for Natural Sciences, Hungarian Academy of Sciences, Budapest, Hungary.
| | - R Romero
- Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, and Detroit, MI, USA.
| | - Y Xu
- Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, and Detroit, MI, USA
| | - O Erez
- Department of Obstetrics and Gynecology, Ben-Gurion University, Beer-Sheva, Israel
| | - Z Xu
- Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, and Detroit, MI, USA
| | - G Bhatti
- Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, and Detroit, MI, USA
| | - R Leavitt
- Zymo Research Corporation, Irvine, CA, USA
| | - T H Chung
- Zymo Research Corporation, Irvine, CA, USA
| | - H El-Azzamy
- Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, and Detroit, MI, USA
| | - C LaJeunesse
- Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, and Detroit, MI, USA
| | - B Wang
- Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, and Detroit, MI, USA
| | - A Balogh
- Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, and Detroit, MI, USA; Department of Immunology, Eotvos Lorand University, Budapest, Hungary
| | - G Szalai
- Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, and Detroit, MI, USA
| | - S Land
- Center for Molecular Medicine and Genetics, Wayne State University, Detroit, MI, USA
| | - Z Dong
- Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, and Detroit, MI, USA
| | - S S Hassan
- Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, and Detroit, MI, USA; Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
| | - T Chaiworapongsa
- Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, and Detroit, MI, USA; Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
| | - M Krispin
- Zymo Research Corporation, Irvine, CA, USA
| | - C J Kim
- Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, and Detroit, MI, USA; Department of Pathology, Wayne State University School of Medicine, Detroit, MI, USA
| | - A L Tarca
- Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, and Detroit, MI, USA; Center for Molecular Medicine and Genetics, Wayne State University, Detroit, MI, USA
| | - Z Papp
- Maternity Private Department, Kutvolgyi Clinical Block, Semmelweis University, Budapest, Hungary
| | - H Bohn
- Behringwerke AG, Marburg/Lahn, Germany
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Benkirane A, Idrissi A, No author NA, Balogh A. Innocuity and immune response to Brucella melitensis Rev.1 vaccine in camels (Camelus dromedarius). Open Vet J 2014. [DOI: 10.5455/ovj.2014.v4.i2.p96] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
A field trial was conducted in a camel brucellosis-free herd to evaluate antibody response to the Brucella melitensis Rev.1 vaccine in camels and assess shedding of the vaccine strain in milk. Twenty eight camels were divided into four groups according to their age and vaccination route. Groups A (n=3) and B (n=3) consisted of non-pregnant lactating female camels, vaccinated through subcutaneous and conjunctival routes, respectively. Groups C (n=10) consisted of 8-11 months old calves vaccinated through conjunctival route. The rest of the herd (n=12) composed of female and young camels were not vaccinated and were considered as the control group. Each animal from groups A, B and C was given the recommended dose of 2 x 109 colony forming units of Rev.1 vaccine irrespective of age or route of vaccination. Blood samples were collected from all the animals at the time of vaccination and at weekly, bi-weekly and monthly interval until 32 weeks post vaccination and from controls at weeks 8 and 24. The serological tests used were modified Rose Bengal Test, sero-agglutination test, and an indirect Enzyme Linked Immunosorbent Assay. Milk samples were collected from all vaccinated female camels and tested for the presence of Rev.1 vaccine strain. Most vaccinated animals started to show an antibody response at week 2 and remained positive until week 16. By week 20 post-vaccination all animals in the three groups were tested negative for Brucella antibodies. Bacteriological analysis of milk samples did not allow any isolation of Brucella melitensis. All samples were found Brucella negative in PCR analysis. The results of this study indicate that the Rev.1 vaccine induces seroconversion in camels. Rev.1 vaccine strain is not excreted in the milk of camels. These findings are promising as to the safe use of the Rev.1 vaccine in camels.
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Bhattoa HP, Nagy E, More C, Kappelmayer J, Balogh A, Kalina E, Antal-Szalmas P. Prevalence and seasonal variation of hypovitaminosis D and its relationship to bone metabolism in healthy Hungarian men over 50 years of age: the HunMen Study. Osteoporos Int 2013; 24:179-86. [PMID: 22422303 DOI: 10.1007/s00198-012-1920-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2011] [Accepted: 01/25/2012] [Indexed: 10/28/2022]
Abstract
UNLABELLED This study reports a high prevalence of hypovitaminosis D and low bone mineral density (BMD) in a healthy Hungarian male cohort over 50 years of age. Men with 25-hydroxyvitamin D levels of <75 nmol/L had a significantly higher 10-year hip and major osteoporotic fracture probability using the country-specific fracture risk assessment (FRAX) algorithm. INTRODUCTION The aim of this study is to characterize the prevalence and seasonal variation of hypovitaminosis D and its relationship to bone metabolism in healthy Hungarian men over 50 years of age. METHODS We determined levels of 25-hydroxyvitamin D (25-OH-D), PTH, osteocalcin (OC), C-terminal telopeptides of type-I collagen (CTX-I), procollagen type 1 amino-terminal propeptide (PINP), BMD at L1-L4 (LS) and femur neck (FN), daily dietary calcium intake, and the 10-year probability of hip fracture and a major osteoporotic fracture using the country-specific FRAX algorithm in 206 randomly selected ambulatory men. RESULTS The mean (range) age of the volunteers was 60 (51-81) years. The prevalence of hypovitaminosis D (25-OH-D, <75 nmol/L) was 52.9%. The prevalence of low (T-score < -1.0) BMD at the FN and LS was 45% and 35.4%, respectively. The mean (range) FRAX hip fracture and FRAX major osteoporotic fracture was 0.8% (0-9.4%) and 3.8% (1.7-16%), respectively. On comparing the vitamin D sufficient to the insufficient group, there was a statistically significant difference between the FRAX hip fracture and FRAX major osteoporotic fracture indexes. There was significant seasonal variation in the vitamin D levels; the lowest levels were measured in winter and the highest in summer. CONCLUSIONS A high prevalence of hypovitaminosis D and low BMD were observed in the studied Hungarian male population. This is the first study reporting higher 10-year hip and major osteoporotic fracture probability using the country-specific FRAX algorithm in individuals with hypovitaminosis D.
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Affiliation(s)
- H P Bhattoa
- Department of Laboratory Medicine, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary.
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Kellogg PJ, Goetz K, Howard RL, Monson SJ, Balogh A, Forsyth RJ. Measurement of direct current electric fields and plasma flow speeds in Jupiter's magnetosphere. ACTA ACUST UNITED AC 2012. [DOI: 10.1029/92ja02982] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Ruzmaikin AA, Feynman J, Goldstein BE, Smith EJ, Balogh A. Intermittent turbulence in solar wind from the south polar hole. ACTA ACUST UNITED AC 2012. [DOI: 10.1029/94ja02808] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Lawrence D, McDermott D, Hamid O, Weber J, Wolchok J, Richards J, Amin A, Bennett K, Balogh A, Hodi F. Ipilimumab (IPI) Expanded Access Program (EAP) for Patients (PTS) with Stage III/IV Melanoma: Safety Data by Subgroups. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)33684-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Balogh Z, Reiniger L, Rajnai H, Csomor J, Szepesi A, Balogh A, Deak L, Gagyi E, Bodor C, Matolcsy A. P1.17 High Rate of Genetic Abnormalities of Neoplastic Cells in Pseudofollicles of Cll. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)31308-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Einert TR, Schmidt G, Binnig G, Balacescu O, Balacescu L, Rus M, Buiga R, Tudoran O, Todor N, Nagy V, Irimie A, Neagoe I, Yacobi R, Ustaev E, Berger RR, Barshack I, Kaur K, Henderson S, Cutts A, Domingo E, Woods J, Motley C, Dougherty B, Middleton M, Hassan B, Wang Y, Beasley E, Naley M, Schuh A, Tomlinson I, Taylor J, Planchard D, Lueza B, Rahal A, Lacroix L, Ngocamus M, Auger N, Saulnier P, Dorfmuller P, Le Chevalier T, Celebic A, Pignon JP, Soria JC, Besse B, Sun YH, Wang R, Li CG, Pan YJ, Chen HQ, Chouchane L, Shan J, Kizhakayil D, Aigha I, Dsouza S, Noureddine B, Gabbouj S, Mathew R, Hassen E, Chouchane L, Shan S, al-Rumaihi K, al-Bozom I, al-Said S, Rabah D, Farhat K, Kizhakayil D, Aigha I, Jakobsen Falk IA, Green KHZ, Lotfi K, Fyrberg A, Pejovic T, Li H, Mhawech-Fauceglia P, Hoatlin M, Guo MG, Huang M, Ge Y, Hess K, Wei C, Zhang W, Bogush TA, Dudko EA, Nureev MV, Kamensky AA, Polotsky BE, Tjulandin SA, Davydov MI, Caballero M, Hasmats J, Green H, Quanz M, Buhler C, Sun JS, Dutreix M, Cebotaru CL, Buiga R, Placintar AN, Ghilezan N, Balogh ZB, Reiniger L, Rajnai H, Csomor J, Szepesi A, Balogh A, Deak L, Gagyi E, Bodor C, Matolcsy A, Bozhenko VK, Rozhkova NI, Kudinova EA, Bliznyukov OP, Vaskevich EN, Trotsenko ID, Bozhenko VK, Rozhkova NI, Kharchenko NV, Kudinova EA, Bliznyukov OP, Kiandarian IV, Trotsenko ID, Pulito C, Terrenato I, Sacconi A, Biagioni F, Mottolese M, Blandino G, Muti P, Falvo E, Strano S, Mori F, Sacconi A, Ganci F, Covello R, Zoccali C, Biagini R, Blandino G, Strano S, Palmer GA, Wegdam W, Meijer D, Kramer G, Langridge J, Moerland PD, de Jong SM, Vissers JP, Kenter GG, Buist MR, Aerts JMFG, Milione M, de Braud F, Buzzoni R, Pusceddu S, Mazzaferro V, Damato A, Pelosi G, Garassino M, de Braud F, Broggini M, Marabese M, Veronese S, Ganzinelli M, Martelli O, Ganci F, Bossel N, Sacconi A, Fontemaggi G, Manciocco V, Sperduti I, Falvo E, Strigari L, Covello R, Muti P, Strano S, Spriano G, Domany E, Blandino G, Donzelli S, Sacconi A, Bellissimo T, Alessandrini G, Strano S, Carosi MA, Pescarmona E, Facciolo F, Telera S, Pompili A, Blandino G, de Vriendt V, de Roock W, di Narzo AF, Tian S, Biesmans B, Jacobs B, de Schutter J, Budzinska E, Sagaert X, Delorenzi M, Simon I, Tejpar S, Zhu Y, Wang HK, Ye DW, Denisov E, Tsyganov M, Tashireva L, Zavyalova M, Perelmuter V, Cherdyntseva N, Kim YC, Jang T, Oh IJ, Kim KS, Ban H, Na KJ, Ahn SJ, Kang H, Kim WJ, Park C, Abousamra NK, El-Din MS, Azmy EA. Diagnostics. Ann Oncol 2012. [DOI: 10.1093/annonc/mds161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Shafey M, Duan Q, Russell J, Duggan P, Balogh A, Stewart DA. Double high-dose therapy with dose-intensive cyclophosphamide, etoposide, cisplatin (DICEP) followed by high-dose melphalan and autologous stem cell transplantation for relapsed/refractory Hodgkin lymphoma. Leuk Lymphoma 2012; 53:596-602. [DOI: 10.3109/10428194.2011.624227] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Mikolás E, Cseh J, Pap M, Szijárto IA, Balogh A, Laczy B, Bekő V, Fisi V, Molnár GA, Mérei A, Szeberényi J, Wittmann I. Effects of erythropoietin on glucose metabolism. Horm Metab Res 2012; 44:279-85. [PMID: 22351476 DOI: 10.1055/s-0032-1301901] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
We purposed to determine the impact of erythropoietin on altering glucose metabolism in the settings of in vitro and in vivo experiments. The acute effect of erythropoietin on lowering blood glucose levels was studied in animal experiments. In [³H]-deoxy-D-glucose isotope studies we measured glucose uptake with insulin and erythropoietin using 3T3-L1 cells cultured under normal or high glucose conditions. Altered activation of Akt and ERK pathways was evaluated in immunoblot analyses. Immunocytochemistry was conducted to determine the glucose transporter 4 translocation to the plasma membrane. Addition of erythropoietin significantly lowered blood glucose levels in vivo in rats. The glucose uptake was markedly increased by erythropoietin treatment (at concentrations 0.15, 0.3, and 0.625 ng/ml) in adipocytes grown in high glucose medium (p<0.05), but it remained unaltered in cells under normal glucose conditions. Significant increase of phosphorylation of ERK and Akt was detected due to erythropoietin (p<0.05). Co-administration of erythropoietin and insulin resulted in higher phosphorylation of Akt and [³H]-deoxy-D-glucose uptake in adipocytes than insulin treatment alone. We found that erythropoietin induced the trafficking of glucose transporter 4 to the plasma membrane. Our data showed that erythropoietin significantly decreased blood glucose levels both in vivo and in vitro, in part, by increasing glucose uptake via the activation of Akt pathway. Preliminary data revealed that adipocytes most likely exhibit a specific receptor for erythropoietin.
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Affiliation(s)
- E Mikolás
- 2nd Department of Medicine and Nephrological Center, University of Pécs, Pécs, Hungary
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Reginster JY, Kaufman JM, Goemaere S, Devogelaer JP, Benhamou CL, Felsenberg D, Diaz-Curiel M, Brandi ML, Badurski J, Wark J, Balogh A, Bruyère O, Roux C. Maintenance of antifracture efficacy over 10 years with strontium ranelate in postmenopausal osteoporosis. Osteoporos Int 2012; 23:1115-22. [PMID: 22124575 PMCID: PMC3277702 DOI: 10.1007/s00198-011-1847-z] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2011] [Accepted: 11/03/2011] [Indexed: 12/28/2022]
Abstract
UNLABELLED In an open-label extension study, BMD increased continuously with strontium ranelate over 10 years in osteoporotic women (P < 0.01). Vertebral and nonvertebral fracture incidence was lower between 5 and 10 years than in a matched placebo group over 5 years (P < 0.05). Strontium ranelate's antifracture efficacy appears to be maintained long term. INTRODUCTION Strontium ranelate has proven efficacy against vertebral and nonvertebral fractures, including hip, over 5 years in postmenopausal osteoporosis. We explored long-term efficacy and safety of strontium ranelate over 10 years. METHODS Postmenopausal osteoporotic women participating in the double-blind, placebo-controlled phase 3 studies SOTI and TROPOS to 5 years were invited to enter a 5-year open-label extension, during which they received strontium ranelate 2 g/day (n = 237, 10-year population). Bone mineral density (BMD) and fracture incidence were recorded, and FRAX® scores were calculated. The effect of strontium ranelate on fracture incidence was evaluated by comparison with a FRAX®-matched placebo group identified in the TROPOS placebo arm. RESULTS The patients in the 10-year population had baseline characteristics comparable to those of the total SOTI/TROPOS population. Over 10 years, lumbar BMD increased continuously and significantly (P < 0.01 versus previous year) with 34.5 ± 20.2% relative change from baseline to 10 years. The incidence of vertebral and nonvertebral fracture with strontium ranelate in the 10-year population in years 6 to 10 was comparable to the incidence between years 0 and 5, but was significantly lower than the incidence observed in the FRAX®-matched placebo group over 5 years (P < 0.05); relative risk reductions for vertebral and nonvertebral fractures were 35% and 38%, respectively. Strontium ranelate was safe and well tolerated over 10 years. CONCLUSIONS Long-term treatment with strontium ranelate is associated with sustained increases in BMD over 10 years, with a good safety profile. Our results also support the maintenance of antifracture efficacy over 10 years with strontium ranelate.
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Affiliation(s)
- J-Y Reginster
- Department of Public Health and Health Economics, University of Liège, Liège, Belgium.
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Petró E, Balogh A, Blazsó G, Erös I, Csóka I. In vitro and in vivo evaluation of drug release from semisolid dosage forms. Pharmazie 2011; 66:936-941. [PMID: 22312698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
This study presents the in vitro and in vivo testing of anti-inflammatory drug containing creams, hydrogels and organogels for dermal use. In vitro penetration studies were performed with products by measuring the diffused drug amount through synthetic membranes soaked in isopropyl myristate (IPM). Our developed preparations were investigated under in vitro conditions together with two marketed medicinal products used as reference preparations. In vivo studies were carried out on anaesthetized male Wistar rats; the carrageenan-induced paw oedema decreasing effect of twelve different formulations and the reference products were measured in comparison with a control group. All - previously in vitro screened - selected products reduced paw oedema in rats. Significant differences were found among the developed products both in vitro and in vivo. Correlation between the in vitro penetration studies and in vivo results were found in the case of o/w creams, organogels and hydrogels.
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Affiliation(s)
- E Petró
- Institute of Drug Regulatory Affairs, University of Szeged, Szeged, Hungary.
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Shafey M, Duan Q, Russell J, Duggan P, Balogh A, Stewart D. Double High Dose Salvage Therapy With Dose-Intensified Cyclophosphamide, Etoposide, and Cisplatin (DICEP) Re-Induction Followed by High-Dose Melphalan (HDM) and Autologous Stem Cell Transplantation (ASCT) Consolidation for Relapsed/Refractory Hodgkin Lymphoma. Biol Blood Marrow Transplant 2011. [DOI: 10.1016/j.bbmt.2010.12.136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Franke J, Balogh A, Mohorn M, Franke M, Heschel U, Franke C. Unspezifische bronchiale Provokation (UBP) im modifizierten 2-Stufen-Test, Vergleich der Provokationssubstanzen Carbachol und Metacholin mit der Provojet®- Methode. Pneumologie 2010. [DOI: 10.1055/s-2010-1268884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Rong Z, Shen C, Lucek E, Balogh A, Yao L. Statistical survey on the magnetic field in magnetotail current sheets: Cluster observations. Chin Sci Bull 2010. [DOI: 10.1007/s11434-010-3096-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Abstract
Schwannomatosis is a third major form of neurofibromatosis that has recently been linked to mutations in the SMARCB1 (hSnf5/INI1) tumor suppressor gene. We analyzed the coding region of SMARCB1 by direct sequencing and multiplex ligation-dependent probe amplification (MLPA) in genomic DNA from 19 schwannomatosis kindreds. Microsatellite markers in the SMARCB1 region were developed to determine loss of heterozygosity (LOH) in associated tumors. We detected four alterations in conserved splice acceptor or donor sequences of exons 3, 4 and 6. Two alterations that likely affect splicing were seen in introns 4 and 5. An additional four alterations of unclear pathogenicity were found to segregate on the affected allele in eight families including two non-conservative missense alterations in three families. No constitutional deletions or duplications were detected by MLPA. Nine of 13 tumors examined showed partial LOH of the SMARCB1 region consistent with 'second hits.' Alterations were detected in tumors both with and without somatic NF2 gene changes. These findings support the hypothesis that SMARCB1 is a tumor suppressor for schwannomas in the context of familial disease. Further work is needed to determine its role in other multiple and single tumor syndromes.
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Affiliation(s)
- C Boyd
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
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Remenyik E, Lecha M, Badenas C, Kószó F, Vass V, Herrero C, Varga V, Emri G, Balogh A, Horkay I. Childhood-onset mild cutaneous porphyria with compound heterozygotic mutations in the uroporphyrinogen decarboxylase gene. Clin Exp Dermatol 2008; 33:602-5. [PMID: 18462440 DOI: 10.1111/j.1365-2230.2008.02734.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Three children (two boys and one girl) from the same family presented with photosensitivity, hyperpigmentation, hypertrichosis, mild skin fragility, blistering and scarring in childhood. On examination, the cutaneous lesions were found to have improved since their previous examinations. Laboratory tests showed raised plasma and urine carboxyporphyrins and decreased uroporphyrinogen decarboxylase enzyme activity in red blood cells. Triggering factors for porphyria were not detected except for a hepatitis C virus infection in the younger boy. The girl's clinical symptoms recurred in late adolescence, after iron and oestrogen treatments. Mutation analysis of the UROD gene detected two missense mutations, 19 A-->G M1V (novel) and 703C-->T P235S (previously reported), in an uncommon compound heterozygous manner in the three siblings.
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Affiliation(s)
- E Remenyik
- Department of Dermatology, Medicaland Health Science Center, University of Debrecen, Debrecen, Hungary.
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Russell J, Duan Q, Chaudhry A, Brown C, Bahlis N, Savoie L, Daly A, Geddes M, Storek J, Balogh A, Zacarias N, Duggan P, Quinlan D, Turner R, Larratt L, Stewart D. 276: Myeloablative Transplantation from Matched Siblings (MSD) using a Daily Intravenous Busulfan (Bu)/fludarabine (Flu) Regimen with Thymoglobulin (TG): Analysis Involving 200 Patients Indicates Low Transplant-related Mortality (TRM) in all but Older Patients with High-risk Disease. Biol Blood Marrow Transplant 2008. [DOI: 10.1016/j.bbmt.2007.12.286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Delfraissy JF, Moreno S, Sanz-Moreno J, Carosi G, Pokrovsky V, Lazzarin A, Pialoux G, Balogh A, Vandeloise E, Leleu G. O415 Efficacy and safety of 48-week maintenance with QD ATV vs ATV/r (both + 2NRTIs) in patients with VL <50 c/mL after induction with ATV/r + 2NRTIs: study AI424136. J Int AIDS Soc 2008. [DOI: 10.1186/1758-2652-11-s1-o42] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Wright P, Eliasziw M, Gelfand G, Grondin S, McFadden S, Morris D, Balogh A. 6555 POSTER Treatment of thymomas and thymic carcinomas: a retrospective review of treatment outcomes at the Tom Baker Cancer Centre from 1982 to 2004. EJC Suppl 2007. [DOI: 10.1016/s1359-6349(07)71383-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Abstract
The aim of this study was to test for the presence of prohepcidin in cord blood, to gauge its alteration during the early postnatal period, and to look for a possible association with neonatal iron homeostasis. Cord blood and postnatal venous blood samples were taken from 20 healthy neonates. In both kinds of samples the presence prohepcidin could be detected. No association was found between cord blood and postnatal samples prohepcidin and iron homeostasis. However, an association is demonstrated between cord blood prohepcidin values and mean cell hemoglobin concentration (MCHC). Prohepcidin increased postnatally in half of the neonates, indicating the active synthesis of the molecule. Interestingly, neonates with detectable non-protein-bound iron levels in cord blood were presented with lower prohepcidin concentrations. Association between cord blood prohepcidin and MCHC may suggest a possible link between hepcidin and fetal iron homeostasis.
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Affiliation(s)
- A Balogh
- First Department of Pediatrics, Semmelweis University, Budapest, Hungary.
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Kuhn UD, Kirsch M, Merkel U, Eberhardt AM, Wenda B, Maurer I, Härtter S, Hiemke C, Volz HP, Balogh A. Reboxetine and cytochrome P450--comparison with paroxetine treatment in humans. Int J Clin Pharmacol Ther 2007; 45:36-46. [PMID: 17256449 DOI: 10.5414/cpp45036] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES The noradrenaline-selective antidepressant reboxetine in vitro is a weak inhibitor of both cytochrome P450 (CYP) 2D6 and CYP3A4. Thus, in this study the pharmacokinetics of reboxetine in relation to pharmacogenetics and the effects of reboxetine compared to paroxetine treatment on the CYP2D6 and CYP3A4 phenotype were analyzed in healthy control subjects. METHODS Healthy male volunteers were treated with either 6 mg reboxetine (n = 26) or 30 mg paroxetine (n = 25). On Days 10/11 of treatment, serum concentrations of the antidepressants were measured and pharmacokinetic parameters calculated. Volunteers were phenotyped at the end of treatment and after at least 3 weeks washout (true phenotype) using 30 mg dextromethorphan (DM) hydrobromide given orally and measuring DM and metabolites in serum 2 h after intake. CYP2D6 and CYP2C19 genotypes were determined in parallel. RESULTS AND CONCLUSION Reboxetine serum concentrations showed no correlation with the CYP2D6 genotype and the CYP2D6 phenotype, whereas paroxetine concentrations showed some dependence on CYP2D6. In contrast to in vitro investigations, indicating a major role of CYP3A4 in reboxetine metabolism, reboxetine concentrations in serum showed no correlation with the respective DM metabolic ratios. There was also no correlation between paroxetine concentrations and the CYP3A4 phenotype data. The CYP2C19 genotype (only heterozygosity) had no influence on reboxetine and paroxetine pharmacokinetics. There were only minor changes in the DM metabolite pattern on treatment with reboxetine and no evidence of enzyme inhibition was obtained. In contrast and as expected, paroxetine strongly inhibited CYP2D6. Thus, reboxetine treatment has no effect on the CYP2D6 genotype and no clinically relevant drug interactions involving CYP2D6 are anticipated.
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Affiliation(s)
- U D Kuhn
- Institute of Clinical Pharmacology, Friedrich Schiller University, Jena, Germany.
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