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Johnsen JM, Fletcher SN, Dove A, McCracken H, Martin BK, Kircher M, Josephson NC, Shendure J, Ruuska SE, Valentino LA, Pierce GF, Watson C, Cheng D, Recht M, Konkle BA. Results of genetic analysis of 11 341 participants enrolled in the My Life, Our Future hemophilia genotyping initiative in the United States. J Thromb Haemost 2022; 20:2022-2034. [PMID: 35770352 DOI: 10.1111/jth.15805] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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: 09/12/2021] [Revised: 06/21/2022] [Accepted: 06/25/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Hemophilia A (HA) and hemophilia B (HB) are rare inherited bleeding disorders. Although causative genetic variants are clinically relevant, in 2012 only 20% of US patients had been genotyped. OBJECTIVES My Life, Our Future (MLOF) was a multisector cross-sectional US initiative to improve our understanding of hemophilia through widespread genotyping. METHODS Subjects and potential genetic carriers were enrolled at US hemophilia treatment centers (HTCs). Bloodworks performed genotyping and returned results to providers. Clinical data were abstracted from the American Thrombosis and Hemostasis Network dataset. Community education was provided by the National Hemophilia Foundation. RESULTS From 2013 to 2017, 107 HTCs enrolled 11 341 subjects (68.8% male, 31.2% female) for testing for HA (n = 8976), HB (n = 2358), HA/HB (n = 3), and hemophilia not otherwise specified (n = 4). Variants were detected in most male patients (98.2%% HA, 98.1% HB). 1914 unique variants were found (1482 F8, 431 F9); 744 were novel (610 F8, 134 F9). Inhibitor data were available for 6986 subjects (5583 HA; 1403 HB). In severe HA, genotypes with the highest inhibitor rates were large deletions (77/80), complex intron 22 inversions (9/17), and no variant found (7/14). In severe HB, the highest rates were large deletions (24/42). Inhibitors were reported in 27.3% of Black versus 16.2% of White patients. CONCLUSIONS The findings of MLOF are reported, the largest hemophilia genotyping project performed to date. The results support the need for comprehensive genetic approaches in hemophilia. This effort has contributed significantly towards better understanding variation in the F8 and F9 genes in hemophilia and risks of inhibitor formation.
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Affiliation(s)
- Jill M Johnsen
- Research Institute, Bloodworks, Seattle, Washington, USA
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | | | - Angela Dove
- Research Institute, Bloodworks, Seattle, Washington, USA
| | | | - Beth K Martin
- Genome Sciences, University of Washington, Seattle, Washington, USA
| | - Martin Kircher
- Genome Sciences, University of Washington, Seattle, Washington, USA
| | - Neil C Josephson
- Research Institute, Bloodworks, Seattle, Washington, USA
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Jay Shendure
- Genome Sciences, University of Washington, Seattle, Washington, USA
| | - Sarah E Ruuska
- Research Institute, Bloodworks, Seattle, Washington, USA
| | | | | | - Crystal Watson
- American Thrombosis and Hemostasis Network, Rochester, New York, USA
| | - Dunlei Cheng
- American Thrombosis and Hemostasis Network, Rochester, New York, USA
| | - Michael Recht
- American Thrombosis and Hemostasis Network, Rochester, New York, USA
| | - Barbara A Konkle
- Research Institute, Bloodworks, Seattle, Washington, USA
- Department of Medicine, University of Washington, Seattle, Washington, USA
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Law JW, Gul Z, Berry A, Thompson MA, Willner C, Vuyyala S, McCracken H, Geverd K, Wolf FM, Brown TD, Kuriakose P. Abstract 6259: Molecular biomarker testing and targeted therapy patterns in patients with acute myelogenous leukemia (AML): A real-world data analysis. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-6259] [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: 11/16/2022]
Abstract
Abstract
Background and Objective: Molecular testing and targeted treatments for patients (pts) diagnosed with AML have evolved in recent years. Real-world testing patterns, including next-generation sequencing (NGS), and clinical management of pts with AML were analyzed in 2 large U.S. community health systems.
Methods: Pts >18 years, diagnosed with AML from January 1, 2015 to December 31, 2020, were identified in a database containing clinical and genomic data from integrated community delivery networks. Study end was March 31, 2021, allowing for 3 months minimum follow up. Actionable biomarkers were defined by NCCN guidelines version 3, 2021.
Results: The study included 685 pts, median age of 70 and median follow up of 5.4 months; 55% were male, 73% non-Hispanic White (NHW), 10% non-Hispanic Black (NHB). 69% had de novo AML. Cytogenetic prognostic classification was: 4% favorable; 33% intermediate; 30% adverse; and 33% unknown. 541 (79%) pts, median age of 69, received NGS or single gene/small panel tests. 144 (21%) pts with no testing had a median age of 78. Pts with de novo AML were more likely to be tested compared to secondary AML (84% vs. 67%, p<0.001). No significant difference was found in testing receipt between NHW and NHB pts (82% vs. 76%, p=0.3). 80% of pts received NGS testing in upfront setting, 15% in relapse setting (>30 days after diagnosis), 5% were unknown. 77% of pts diagnosed in 2020 received NGS tests (Table 1). 52/100 (52%) of pts with FLT3 (ITD or TKD) mutation, 5/27 (19%) with IDH1 mutation and 11/44 (25%) with IDH2 mutation received targeted therapy.
Conclusions: Molecular biomarker testing has increased over time with NGS becoming the dominant modality. Testing uptake did not differ by race. Half of pts with FLT3 mutation received targeted therapy, one fifth with IDH1 and one quarter with IDH2 mutations. Future research should explore targeted therapy receipt over time and address gaps in uptake for pts with AML in the community setting.
Table 1. Proportion of patients with molecular biomarker testing by diagnosis year among (n=685) Diagnosis Year 2015(N = 77) 2016(N = 92) 2017(N = 113) 2018(N = 138) 2019(N = 129) 2020(N = 136) Overall(N = 685) NGS testing, n (%) 7 (9%) 17 (18%) 46 (41%) 100 (72%) 100 (78%) 105 (77%) 375 (55%) Other non-NGS molecular biomarker testing only, n (%) 48 (62%) 52 (57%) 38 (34%) 14 (10%) 14 (11%) 0 (0%) 166 (24%) Molecular biomarker testing (NGS and/or other), n (%) 55 (71%) 69 (75%) 84 (74%) 114 (83%) 114 (88%) 105 (77%) 541 (79%) Proportion tested by actionable biomarker, n (%) FLT3-ITD 51 (66%) 64 (70%) 77 (68%) 108 (78%) 106 (82%) 94 (69%) 500 (73%) FLT3-TKD 50 (65%) 63 (68%) 76 (67%) 105 (76%) 106 (82%) 90 (66%) 490 (72%) IDH2 5 (6%) 10 (11%) 34 (30%) 95 (69%) 100 (78%) 102 (75%) 346 (51%) IDH1 5 (6%) 10 (11%) 28 (25%) 91 (66%) 101 (78%) 102 (75%) 337 (49%)
Citation Format: Jeanna Wallenta Law, Zartash Gul, Anna Berry, Michael A. Thompson, Christopher Willner, Sowjanya Vuyyala, Haley McCracken, Katherine Geverd, Frank M. Wolf, Thomas D. Brown, Philip Kuriakose. Molecular biomarker testing and targeted therapy patterns in patients with acute myelogenous leukemia (AML): A real-world data analysis [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 6259.
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Affiliation(s)
| | - Zartash Gul
- 2Aurora Cancer Care, Advocate Aurora Health, Milwaukee, WI
| | | | | | | | - Sowjanya Vuyyala
- 3Henry Ford Cancer Institute, Henry Ford Health System, Detroit, MI
| | | | | | | | | | - Philip Kuriakose
- 3Henry Ford Cancer Institute, Henry Ford Health System, Detroit, MI
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Law JW, Mitra D, Kaplan HG, Alfred T, Brufsky AM, Emir B, McCracken H, Liu X, Broome RG, Zhang C, DiCristo C, Chen C. Real-World Treatment Patterns and Clinical Effectiveness of Palbociclib Plus an Aromatase Inhibitor as First-Line Therapy in Advanced/Metastatic Breast Cancer: Analysis from the US Syapse Learning Health Network. Curr Oncol 2022; 29:1047-1061. [PMID: 35200588 PMCID: PMC8871271 DOI: 10.3390/curroncol29020089] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 01/28/2022] [Accepted: 02/04/2022] [Indexed: 11/30/2022] Open
Abstract
This retrospective single-arm study assessed real-world treatment patterns and clinical outcomes in patients with hormone receptor—positive/human epidermal growth factor receptor 2—negative (HR+/HER2−) advanced/metastatic breast cancer (A/MBC) who received palbociclib plus an aromatase inhibitor as first-line therapy in US community health systems. Using electronic health records from the Syapse Learning Health Network, 242 patients were identified as having received first-line palbociclib plus an aromatase inhibitor between 3 February 2015, and 31 July 2019 (data cutoff 1 February 2020) resulting in a minimum potential 6-month follow-up period. In total, 56.6% of patients had de novo A/MBC at initial breast cancer diagnosis, 50.8% had bone-only disease, and 32.2% had visceral disease. Median follow-up was 22.4 months. Disease progression (26.4%) and intolerance/toxicity (14.9%) were the main reasons for treatment discontinuation. The median (95% CI) real-world progression-free survival was 31.7 (27.9—not estimable (NE)) months and 2-year estimated overall survival (OS) rate was 78.0%. In total, 25.6% of patients died; however, OS data are limited by the small population size and insufficient follow-up time. These real-world effectiveness outcomes complement findings from other real-world studies and randomized controlled trials and support palbociclib plus an aromatase inhibitor as first-line therapy for HR+/HER2− A/MBC.
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Affiliation(s)
- Jeanna Wallenta Law
- Syapse, San Francisco, CA 94107, USA; (H.M.); (R.G.B.); (C.Z.)
- Correspondence: ; Tel.: +1-415-238-8254
| | - Debanjali Mitra
- Pfizer Inc., New York, NY 10017, USA; (D.M.); (T.A.); (B.E.); (X.L.); (C.D.); (C.C.)
| | | | - Tamuno Alfred
- Pfizer Inc., New York, NY 10017, USA; (D.M.); (T.A.); (B.E.); (X.L.); (C.D.); (C.C.)
| | - Adam M. Brufsky
- Comprehensive Breast Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA;
| | - Birol Emir
- Pfizer Inc., New York, NY 10017, USA; (D.M.); (T.A.); (B.E.); (X.L.); (C.D.); (C.C.)
| | - Haley McCracken
- Syapse, San Francisco, CA 94107, USA; (H.M.); (R.G.B.); (C.Z.)
| | - Xianchen Liu
- Pfizer Inc., New York, NY 10017, USA; (D.M.); (T.A.); (B.E.); (X.L.); (C.D.); (C.C.)
| | - Ronda G. Broome
- Syapse, San Francisco, CA 94107, USA; (H.M.); (R.G.B.); (C.Z.)
| | - Chenan Zhang
- Syapse, San Francisco, CA 94107, USA; (H.M.); (R.G.B.); (C.Z.)
| | - Caroline DiCristo
- Pfizer Inc., New York, NY 10017, USA; (D.M.); (T.A.); (B.E.); (X.L.); (C.D.); (C.C.)
| | - Connie Chen
- Pfizer Inc., New York, NY 10017, USA; (D.M.); (T.A.); (B.E.); (X.L.); (C.D.); (C.C.)
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Haynes L, Arzey E, Bell C, Buchanan N, Burgess G, Cronan V, Dickason C, Field H, Gibbs S, Hansbro PM, Hollingsworth T, Hurt AC, Kirkland P, McCracken H, O’Connor J, Tracey J, Wallner J, Warner S, Woods R, Bunn C. Australian surveillance for avian influenza viruses in wild birds between July 2005 and June 2007. Aust Vet J 2009; 87:266-72. [DOI: 10.1111/j.1751-0813.2009.00446.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [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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Miller DS, Mitchel GF, Biggs B, McCracken H, Myroniuk P, Hewish M. Agglutinating antibodies to Toxoplasma gondii in sera from captive eastern barred bandicoots in Australia. J Wildl Dis 2000; 36:213-8. [PMID: 10813601 DOI: 10.7589/0090-3558-36.2.213] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [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: 11/20/2022]
Abstract
Toxoplasmosis is considered a severe health risk for many marsupial species. The mainland Australian population of bandicoot is endangered. Therefore, a preliminary serosurvey was conducted to evaluate exposure to Toxoplasma gondii in 57 captive eastern barred bandicoot and to estimate the possible impact of Toxoplasma on recovering populations. Five (9%) bandicoot were classified as seropositive using a modified agglutination test. Nineteen additional bandicoot (33%) were classified as serosuspect using a direct agglutination test. No bandicoot showed signs of clinical disease. Seropositive titers were IgG associated, suggesting that infections were chronic and latent. Serostatus was not associated with either sex or being wild-caught, although each seropositive bandicoot was wild-caught. Seropositive animals ranged from 1.25- to 2.5-yr-old. Computer simulations using Vortex 5.1, based on the proportion of seropositive and seronegative bandicoot in this study, indicate that mortalities from T. gondii should have little impact upon captive populations. However, the potential impact of toxoplasmosis on recovery efforts for wild, mainland bandicoot populations is not clear.
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Affiliation(s)
- D S Miller
- University of Wisconsin, Madison 53706, USA
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Richmond DE, McCracken H. Older adults and healthy lifestyle issues: results of a community study. N Z Med J 1996; 109:264. [PMID: 8692456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Maslen M, Whitehead J, Forsyth WM, McCracken H, Hocking AD. Systemic mycotic disease of captive crocodile hatchling (Crocodylus porosus) caused by Paecilomyces lilacinus. J Med Vet Mycol 1988; 26:219-25. [PMID: 3216279 DOI: 10.1080/02681218880000311] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The sudden death occurred of a captive Estuarine crocodile hatchling (Crocodylus porosus). On autopsy, granuloma-like lesions were seen in the liver, left lung and spleen, and branching, septate fungal hyphae were observed in sections of liver and spleen. The fungus isolated from the liver showed characteristics of both Paecilomyces lilacinus and Paecilomyces marquandii but was closer to the former species. This is apparently the first report of the isolation of this fungus from a reptile in Australia.
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Affiliation(s)
- M Maslen
- Department of Microbiology, University of Melbourne, Parkville, Victoria, Australia
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McCracken H. Health care delivery in rural Alaska. Hosp Forum 1978; 21:13-5. [PMID: 10239748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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