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Lang Kuhs KA, Faden DL, Chen L, Smith DK, Pinheiro M, Wood CB, Davis S, Yeager M, Boland JF, Cullen M, Steinberg M, Bass S, Wang X, Liu P, Mehrad M, Tucker T, Lewis JS, Ferris RL, Mirabello L. Genetic variation within the human papillomavirus type 16 genome is associated with oropharyngeal cancer prognosis. Ann Oncol 2022; 33:638-648. [PMID: 35306154 PMCID: PMC9350957 DOI: 10.1016/j.annonc.2022.03.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/08/2022] [Accepted: 03/11/2022] [Indexed: 01/02/2023] Open
Abstract
PURPOSE A significant barrier to adoption of de-escalated treatment protocols for human papillomavirus-driven oropharyngeal cancer (HPV-OPC) is that few predictors of poor prognosis exist. We conducted the first large whole-genome sequencing (WGS) study to characterize the genetic variation of the HPV type 16 (HPV16) genome and to evaluate its association with HPV-OPC patient survival. PATIENTS AND METHODS A total of 460 OPC tumor specimens from two large United States medical centers (1980-2017) underwent HPV16 whole-genome sequencing. Site-specific variable positions [single nucleotide polymorphisms (SNPs)] across the HPV16 genome were identified. Cox proportional hazards model estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for overall survival by HPV16 SNPs. Harrell C-index and time-dependent positive predictive value (PPV) curves and areas under the PPV curves were used to evaluate the predictive accuracy of HPV16 SNPs for overall survival. RESULTS A total of 384 OPC tumor specimens (83.48%) passed quality control filters with sufficient depth and coverage of HPV16 genome sequencing to be analyzed. Some 284 HPV16 SNPs with a minor allele frequency ≥1% were identified. Eight HPV16 SNPs were significantly associated with worse survival after false discovery rate correction (individual prevalence: 1.0%-5.5%; combined prevalence: 15.10%); E1 gene position 1053 [HR for overall survival (HRos): 3.75, 95% CI 1.77-7.95; Pfdr = 0.0099]; L2 gene positions 4410 (HRos: 5.32, 95% CI 1.91-14.81; Pfdr = 0.0120), 4539 (HRos: 6.54, 95% CI 2.03-21.08; Pfdr = 0.0117); 5050 (HRos: 6.53, 95% CI 2.34-18.24; Pfdr = 0.0030), and 5254 (HRos: 7.76, 95% CI 2.41-24.98; Pfdr = 0.0030); and L1 gene positions 5962 (HRos: 4.40, 95% CI 1.88-10.31; Pfdr = 0.0110) and 6025 (HRos: 5.71, 95% CI 2.43-13.41; Pfdr = 0.0008) and position 7173 within the upstream regulatory region (HRos: 9.90, 95% CI 3.05-32.12; Pfdr = 0.0007). Median survival time for patients with ≥1 high-risk HPV16 SNPs was 3.96 years compared with 18.67 years for patients without a high-risk SNP; log-rank test P < 0.001. HPV16 SNPs significantly improved the predictive accuracy for overall survival above traditional factors (age, smoking, stage, treatment); increase in C-index was 0.069 (95% CI 0.019-0.119, P < 0.001); increase in area under the PPV curve for predicting 5-year survival was 0.068 (95% CI 0.015-0.111, P = 0.008). CONCLUSIONS HPV16 genetic variation is associated with HPV-OPC prognosis and can improve prognostic accuracy.
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Affiliation(s)
- K A Lang Kuhs
- Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, USA; Department of Medicine, Vanderbilt University Medical Cancer, Nashville, USA.
| | - D L Faden
- Department of Otolaryngology, Massachusetts Eye and Ear, Massachusetts General Hospital, Harvard Medical School, Boston, USA; Broad Institute of MIT and Harvard, Cambridge, USA
| | - L Chen
- Division of Cancer Biostatistics, Department of Internal Medicine and Biostatistics and Bioinformatics Shared Resource Facility, Markey Cancer Center, University of Kentucky, Lexington, USA
| | - D K Smith
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, USA
| | - M Pinheiro
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, USA
| | - C B Wood
- Department of Otolaryngology - Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, USA; Department of Otolaryngology - Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, USA
| | - S Davis
- Department of Otolaryngology - Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, USA
| | - M Yeager
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, USA; Cancer Genomics Research Laboratory, Leidos Biomedical Research, Inc., Frederick, USA
| | - J F Boland
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, USA; Cancer Genomics Research Laboratory, Leidos Biomedical Research, Inc., Frederick, USA
| | - M Cullen
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, USA; Cancer Genomics Research Laboratory, Leidos Biomedical Research, Inc., Frederick, USA
| | - M Steinberg
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, USA; Cancer Genomics Research Laboratory, Leidos Biomedical Research, Inc., Frederick, USA
| | - S Bass
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, USA; Cancer Genomics Research Laboratory, Leidos Biomedical Research, Inc., Frederick, USA
| | - X Wang
- Department of Pharmacology and Regenerative Medicine, The University of Illinois at Chicago, Chicago, USA
| | - P Liu
- Department of Radiation Oncology, Washington University School of Medicine, St. Louis, USA
| | - M Mehrad
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, USA
| | - T Tucker
- Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, USA
| | - J S Lewis
- Department of Otolaryngology - Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, USA; Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, USA
| | - R L Ferris
- University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh, USA; Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, USA
| | - L Mirabello
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, USA
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Tewkesbury D, Looi E, Green H, Barry P, Edwards G, Smith M, Cullen M, Jones. A. WS13.6 Clinical outcomes in patients with cystic fibrosis with Exophiala dermatitidis grown in sputum. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)00992-9] [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: 11/30/2022]
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Barnes C, Ashton JJ, Borca F, Cullen M, Walker DM, Beattie RM. Children and young people with inflammatory bowel disease attend less school than their healthy peers. Arch Dis Child 2020; 105:671-676. [PMID: 31937567 DOI: 10.1136/archdischild-2019-317765] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 12/09/2019] [Accepted: 12/12/2019] [Indexed: 01/26/2023]
Abstract
OBJECTIVE Chronic diseases, such as inflammatory bowel disease (IBD), can impact negatively on education and social development. Examining the impact of IBD on school/college attendance for children and young people (CYP) is vital to provide targeted support to patients, families and schools. METHODS We performed a cross-sectional survey to determine the school/college attendance rates, the reasons for absence related to IBD and facilitators or barriers to school/college attendance. In a subset of patients followed up locally, we performed a detailed review of hospital attendance data to assess healthcare burden. RESULTS Two hundred and thirty-one questionnaires were given to CYP with IBD aged 5-17 years. Response rate was 74% (final sample 169). The median school/college attendance rate was 92.5%, significantly lower than all children in England (95.2%). 39.6% of children with IBD were persistently absent, defined nationally as missing 10% or more of school. Only five children (3%) had a 100% attendance record. Increasing age and use of monoclonal therapy were predictors of poor school attendance. Concerns about feeling unwell at school/college, access to toilets, keeping up with work and teachers' understanding of IBD are the main issues for CYP with IBD. There was a significant negative correlation between number of days in hospital and school attendance. CONCLUSION IBD has a significant impact on school/college attendance, with hospital attendance, disease burden and school difficulties being major factors. Employing strategies to minimise healthcare burden and developing a partnership between health and education to support children with IBD will serve to facilitate school/college attendance.
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Affiliation(s)
- Claire Barnes
- Department of Paediatric Gastroenterology, Southampton Children's Hospital, Southampton, UK
| | - James John Ashton
- Department of Paediatric Gastroenterology, Southampton Children's Hospital, Southampton, UK .,Human Genetics and Genomic Medicine, University of Southampton, Southampton, UK
| | - Florina Borca
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton, Southampton, UK
| | - Mick Cullen
- Department of Paediatric Gastroenterology, Southampton Children's Hospital, Southampton, UK
| | | | - Robert Mark Beattie
- Department of Paediatric Gastroenterology, Southampton Children's Hospital, Southampton, UK
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Panaviene J, Zakharchenko L, Olteanu D, Cullen M, EL-Khuffash A. Factors Contributing to Non-Exclusive Breastfeeding in Primigravid Mothers. Ir Med J 2019; 112:1003. [PMID: 31651134] [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: 06/10/2023]
Abstract
Aims We aimed to examine the factors contributing to non-exclusive breastfeeding in primigravid mothers in a large Irish tertiary maternity hospital. Methods This was a retrospective cohort study carried out at the Rotunda Hospital, Dublin, Ireland. Maternal demographics, antenatal, perinatal, delivery-related information and neonatal outcomes were collected and analysed. Results 569 eligible mothers were delivered during the study period. Out of the 416 mothers intending to breastfeed, 278 (67%) mothers were exclusively breastfeeding at discharge. On univariate analysis, a higher body mass index, unemployment, an Asian background, gestational diabetes, antenatal steroids, low birth weight and hypernatremia were all associated with non-exclusive breastfeeding (all p<0.05). On logistic regression, only gestational diabetes, a birthweight < 2500 grams and hypernatremia remained significantly associated with non-exclusive breastfeeding on discharge. Conclusion Addressing barriers to breast feeding through antenatal and early neonatal education, counselling and support, by qualified healthcare personnel may increase the number of infants exclusively breastfeeding on discharge.
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Affiliation(s)
- J Panaviene
- Department of Neonatology, Rotunda Hospital, Dublin, Ireland
| | - L Zakharchenko
- Department of Neonatology, Rotunda Hospital, Dublin, Ireland
| | - D Olteanu
- Department of Neonatology, Rotunda Hospital, Dublin, Ireland
| | - M Cullen
- Department of Neonatology, Rotunda Hospital, Dublin, Ireland
| | - A EL-Khuffash
- Department of Neonatology, Rotunda Hospital, Dublin, Ireland
- Department of Paediatrics, School of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
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Fordyce C, Langman H, Driver K, Johnson S, Barry P, Green H, Cullen M, Smith M, Kenna D, Jones A. P395 An audit of cleaning regimens reported by patients and contamination of their inhalation devices. J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30687-3] [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: 10/26/2022]
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Affiliation(s)
- James John Ashton
- Department of Paediatric Gastroenterology, Southampton Children's Hospital, Southampton, UK.,Human Genetics and Genomic Medicine, University of Southampton, Southampton, UK
| | - Mick Cullen
- Department of Paediatric Gastroenterology, Southampton Children's Hospital, Southampton, UK
| | - Nadeem A Afzal
- Department of Paediatric Gastroenterology, Southampton Children's Hospital, Southampton, UK
| | - Tracy Coelho
- Department of Paediatric Gastroenterology, Southampton Children's Hospital, Southampton, UK
| | - Akshay Batra
- Department of Paediatric Gastroenterology, Southampton Children's Hospital, Southampton, UK
| | - R Mark Beattie
- Department of Paediatric Gastroenterology, Southampton Children's Hospital, Southampton, UK
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Huddart R, Cafferty F, White J, Shamash J, Hennig I, Cullen M, Stenning S. Long term follow-up of the MRC TE23 randomized phase II trial of intensive induction chemotherapy (CBOP/BEP) in poor prognosis germ cell tumours (GCT) (CRUK/05/014; ISRCTN53643604). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy283.124] [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: 11/14/2022] Open
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8
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Looi E, Geatrix S, Barry P, Edwards G, Smith M, Cullen M, Brennen A, Jones A. P063 Extended SABC incubation for Exophiala species in cystic fibrosis sputa. J Cyst Fibros 2018. [DOI: 10.1016/s1569-1993(18)30360-6] [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: 10/14/2022]
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9
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Pigat S, Connolly A, Cushen M, Cullen M, O'Mahony C. A probabilistic intake model to estimate the impact of reformulation by the food industry among Irish consumers. Int J Food Sci Nutr 2018; 69:938-945. [PMID: 29457511 DOI: 10.1080/09637486.2018.1438375] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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: 10/18/2022]
Abstract
This project quantified the impact that voluntary reformulation efforts of the food industry had on the Irish population's nutrient intake. Nutrient composition data on reformulated products were collected from 14 major food companies for two years, 2005 and 2012. Probabilistic intake assessments were performed using the Irish national food consumption surveys as dietary intake data. The nutrient data were weighted by market shares replacing existing food composition data for these products. The reformulation efforts assessed, significantly reduced mean energy intakes by up to 12 kcal/d (adults), 15 kcal/d (teens), 19 kcal/d (children) and 9 kcal/d (pre-schoolers). Mean daily fat intakes were reduced by up to 1.3 g/d, 1.3 g/d, 0.9 g/d and 0.6 g/d, saturated fat intakes by up to 1.7 g/d, 2.3 g/d, 1.8 g/d and 1 g/d, sugar intakes by up to 1 g/d, 2 g/d, 3.5 g/d and 1 g/d and sodium intakes by up to 0.6 g/d, 0.5 g/d, 0.2 g/d, 0.3 g/d for adults, teenagers, children and pre-school children, respectively. This model enables to assess the impact of industry reformulation amongst Irish consumers' nutrient intakes, using consumption, food composition and market share data.
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Affiliation(s)
- S Pigat
- a Creme Global Ltd , Dublin , Ireland
| | | | - M Cushen
- a Creme Global Ltd , Dublin , Ireland
| | - M Cullen
- b Nutrition & Health Foundation, Food and Drink Industry Ireland , Dublin , Ireland
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10
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Hashmi F, Fairhurst C, Cockayne S, Cullen M, Bell K, Coleman E, Harrison‐Blount M, Torgerson D. The
EV
erT2 (Effective Verruca Treatments 2) trial: a randomized controlled trial of needling vs. nonsurgical debridement for the treatment of plantar verrucae. Br J Dermatol 2017; 177:1285-1292. [DOI: 10.1111/bjd.15751] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2017] [Indexed: 11/29/2022]
Affiliation(s)
- F. Hashmi
- School of Health Sciences University of Salford Brian Blatchford Building Salford M6 6PU U.K
| | - C. Fairhurst
- Department of Health Sciences University of York York Trials Unit, ARRC Building, Ground Floor York YO10 5DD U.K
| | - S. Cockayne
- Department of Health Sciences University of York York Trials Unit, ARRC Building, Ground Floor York YO10 5DD U.K
| | - M. Cullen
- School of Health Sciences University of Salford Brian Blatchford Building Salford M6 6PU U.K
| | - K. Bell
- Department of Health Sciences University of York York Trials Unit, ARRC Building, Ground Floor York YO10 5DD U.K
| | - E. Coleman
- Department of Health Sciences University of York York Trials Unit, ARRC Building, Ground Floor York YO10 5DD U.K
| | - M. Harrison‐Blount
- School of Health Sciences University of Salford Brian Blatchford Building Salford M6 6PU U.K
| | - D. Torgerson
- Department of Health Sciences University of York York Trials Unit, ARRC Building, Ground Floor York YO10 5DD U.K
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11
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Cullen M, Turner K, Evans P, Taylor J, Martin-Cabrera P, Barrans S, Cargo C. SNP Array is not a Direct Replacement for Conventional Cytogenetics in MDS But can Identify Additional Prognostically Relevant Abnormalities. Leuk Res 2017. [DOI: 10.1016/s0145-2126(17)30285-0] [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: 11/30/2022]
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12
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Cullen M, Richards S, Bowen D, Martin-Cabrera P, Tooze R, Cargo C. The Application of Machine Learning Algorithms to Immunophenotypic Data to Aid in the Diagnosis of MDS. Leuk Res 2017. [DOI: 10.1016/s0145-2126(17)30266-7] [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: 10/19/2022]
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13
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O'Brien L, Edwards G, Hardy A, Smith M, Green H, Barry P, Jones A, Cullen M. 93 The use of MALDI-TOF MS for the identification of non-fermenting Gram-negative bacilli isolated from cystic fibrosis patients. J Cyst Fibros 2016. [DOI: 10.1016/s1569-1993(16)30332-0] [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: 11/16/2022]
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14
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Miller J, Drew L, Green O, Dukovski D, McEwan B, Villella A, Patel N, Bastos C, Cullen M, Danh H, Wachi S, Giuliano K, Longo K, Bhalla A, Qiu D, Zou C, Ivarsson M, Munoz B, Mehmet H. WS13.5 CFTR amplifiers are mutation-agnostic modulators that increase CFTR protein levels and complement other CF therapeutic modalities. J Cyst Fibros 2016. [DOI: 10.1016/s1569-1993(16)30137-0] [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: 10/21/2022]
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15
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Cullen M, Barnes C. Crohn's disease in adolescence: presentation and treatment. Nurs Stand 2015; 29:50-8. [PMID: 25967447 DOI: 10.7748/ns.29.37.50.e9711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 11/09/2022]
Abstract
Crohn's disease is a chronic inflammatory bowel condition that affects more than 115,000 people in the UK. This article focuses on Crohn's disease in adolescents. Management of the condition in this group should address adolescent-specific characteristics and treatment goals. Key elements include optimising growth, pubertal development and social functioning, including education. The condition can affect an individual's mental and emotional wellbeing significantly, as well as their physical health. As adolescence is a time of great change, the additional burden of a chronic illness can prove difficult to manage. The authors provide information on the presentation of Crohn's disease in adolescence and insights into the particular issues encountered by this group.
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Affiliation(s)
- Mick Cullen
- Southampton Children's Hospital, Southampton, England
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Oldenburg J, Cullen M, Tandstad T. Primum non nocere: do we harm stage I testicular cancer patients less by applying adjuvant chemotherapy than by failing to present this option? Ann Oncol 2015; 26:255-6. [DOI: 10.1093/annonc/mdu520] [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: 11/14/2022] Open
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Oldenburg J, Aparicio J, Beyer J, Cohn-Cedermark G, Cullen M, Gilligan T, De Giorgi U, De Santis M, de Wit R, Fosså SD, Germà-Lluch JR, Gillessen S, Haugnes HS, Honecker F, Horwich A, Lorch A, Ondruš D, Rosti G, Stephenson AJ, Tandstad T. Personalizing, not patronizing: the case for patient autonomy by unbiased presentation of management options in stage I testicular cancer. Ann Oncol 2014; 26:833-838. [PMID: 25378299 DOI: 10.1093/annonc/mdu514] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Accepted: 10/28/2014] [Indexed: 11/12/2022] Open
Abstract
Testicular cancer (TC) is the most common neoplasm in males aged 15-40 years. The majority of patients have no evidence of metastases at diagnosis and thus have clinical stage I (CSI) disease [Oldenburg J, Fossa SD, Nuver J et al. Testicular seminoma and non-seminoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2013; 24(Suppl 6): vi125-vi132; de Wit R, Fizazi K. Controversies in the management of clinical stage I testis cancer. J Clin Oncol 2006; 24: 5482-5492.]. Management of CSI TC is controversial and options include surveillance and active treatment. Different forms of adjuvant therapy exist, including either one or two cycles of carboplatin chemotherapy or radiotherapy for seminoma and either one or two cycles of cisplatin-based chemotherapy or retroperitoneal lymph node dissection for non-seminoma. Long-term disease-specific survival is ∼99% with any of these approaches, including surveillance. While surveillance allows most patients to avoid additional treatment, adjuvant therapy markedly lowers the relapse rate. Weighing the net benefits of surveillance against those of adjuvant treatment depends on prioritizing competing aims such as avoiding unnecessary treatment, avoiding more burdensome treatment with salvage chemotherapy and minimizing the anxiety, stress and life disruption associated with relapse. Unbiased information about the advantages and disadvantages of surveillance and adjuvant treatment is a prerequisite for informed consent by the patient. In a clinical scenario like CSI TC, where different disease-management options produce indistinguishable long-term survival rates, patient values, priorities and preferences should be taken into account. In this review, we provide an overview about risk factors for relapse, potential benefits and harms of adjuvant chemotherapy and active surveillance and a rationale for involving patients in individualized decision making about their treatment rather than adopting a uniform recommendation for all.
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Affiliation(s)
- J Oldenburg
- Department of Oncology, Akershus University Hospital, Lørenskog; Department of Oncology, University of Oslo, Oslo, Norway.
| | - J Aparicio
- Department of Oncology, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - J Beyer
- Department of Oncology, Universitätsspital Zürich, Zürich, Switzerland
| | - G Cohn-Cedermark
- Department of Oncology-Pathology, Karolinska Institute and Karolinska University Hospital, Stockholm, Sweden
| | - M Cullen
- Department of Medical Oncology, Queen Elizabeth Hospital, University Hospital Birmingham Foundation Trust, Birmingham, UK
| | - T Gilligan
- Department of Solid Tumor Oncology, Cleveland Clinic, Cleveland, USA
| | - U De Giorgi
- Department of Medical Oncology, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), Meldola, Italy
| | - M De Santis
- Kaiser Franz Josef Hospital and ACR-ITR and LBI-ACR Vienna-CTO, Vienna, Austria
| | - R de Wit
- Erasmus University Medical Center, Rotterdam, The Netherlands
| | - S D Fosså
- Department of Oncology, Oslo University Hospital, University of Oslo, Oslo, Norway
| | - J R Germà-Lluch
- Department of Oncology, Institut Català d'Oncologia, Gran Via de l'Hospitalet Hospitalet de Llobregat, Barcelona, Spain
| | - S Gillessen
- Department of Medical Oncology, Kantonsspital, St Gallen, Switzerland
| | - H S Haugnes
- Oncology Department, University Hospital of North Norway, Tromsø, Norway
| | - F Honecker
- Tumor and Breast Center ZeTuP, St. Gallen, Switzerland
| | - A Horwich
- Department of Clinical Oncology, Royal Marsden Hospital and Institute of Cancer Research, Sutton, UK
| | - A Lorch
- Klinik für Urologie, konservative Uroonkologie, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - D Ondruš
- Department of Oncology, Comenius University Faculty of Medicine, St Elisabeth Cancer Institute, Bratislava, Slovak Republic
| | - G Rosti
- Medical Oncology, Ospedale Generale, Treviso, Italy
| | | | - T Tandstad
- The Cancer Clinic, St Olavs University Hospital, Trondheim, Norway
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Weichselbaum E, Hooper B, Buttriss J, Theobald C, Sgarabottolo V, Combris P, Strigler F, Oberritter H, Cullen M, Valero T, Ruiz E, del Pozo S, Ávila JM, Varela-Moreiras G, Jost E, Stowell J, Mutus B, Besler HT. Behaviour change initiatives to promote a healthy diet and physical activity in European countries. NUTR BULL 2013. [DOI: 10.1111/nbu.12011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
| | - B. Hooper
- British Nutrition Foundation (BNF); London; UK
| | - J. Buttriss
- British Nutrition Foundation (BNF); London; UK
| | - C. Theobald
- British Nutrition Foundation (BNF); London; UK
| | | | | | - F. Strigler
- Fonds Français pour l'Alimentation et la Santé (FFAS); Paris; France
| | | | - M. Cullen
- Nutrition and Health Foundation (NHF); Dublin; Ireland
| | - T. Valero
- Fundación Española de la Nutrición (FEN); Madrid; Spain
| | - E. Ruiz
- Fundación Española de la Nutrición (FEN); Madrid; Spain
| | - S. del Pozo
- Fundación Española de la Nutrición (FEN); Madrid; Spain
| | - J. M. Ávila
- Fundación Española de la Nutrición (FEN); Madrid; Spain
| | | | - E. Jost
- Swiss Society for Nutrition (SSN); Bern; Switzerland
| | - J. Stowell
- Sabri Ülker Food Research Foundation (SUGAV); Istanbul; Turkey
| | - B. Mutus
- Sabri Ülker Food Research Foundation (SUGAV); Istanbul; Turkey
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Kalina T, Flores-Montero J, van der Velden VHJ, Martin-Ayuso M, Böttcher S, Ritgen M, Almeida J, Lhermitte L, Asnafi V, Mendonça A, de Tute R, Cullen M, Sedek L, Vidriales MB, Pérez JJ, te Marvelde JG, Mejstrikova E, Hrusak O, Szczepański T, van Dongen JJM, Orfao A. EuroFlow standardization of flow cytometer instrument settings and immunophenotyping protocols. Leukemia 2012; 26:1986-2010. [PMID: 22948490 PMCID: PMC3437409 DOI: 10.1038/leu.2012.122] [Citation(s) in RCA: 514] [Impact Index Per Article: 42.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The EU-supported EuroFlow Consortium aimed at innovation and standardization of immunophenotyping for diagnosis and classification of hematological malignancies by introducing 8-color flow cytometry with fully standardized laboratory procedures and antibody panels in order to achieve maximally comparable results among different laboratories. This required the selection of optimal combinations of compatible fluorochromes and the design and evaluation of adequate standard operating procedures (SOPs) for instrument setup, fluorescence compensation and sample preparation. Additionally, we developed software tools for the evaluation of individual antibody reagents and antibody panels. Each section describes what has been evaluated experimentally versus adopted based on existing data and experience. Multicentric evaluation demonstrated high levels of reproducibility based on strict implementation of the EuroFlow SOPs and antibody panels. Overall, the 6 years of extensive collaborative experiments and the analysis of hundreds of cell samples of patients and healthy controls in the EuroFlow centers have provided for the first time laboratory protocols and software tools for fully standardized 8-color flow cytometric immunophenotyping of normal and malignant leukocytes in bone marrow and blood; this has yielded highly comparable data sets, which can be integrated in a single database.
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Affiliation(s)
- T Kalina
- Department of Pediatric Hematology and Oncology, 2nd Faculty of Medicine, Charles University (DPH/O), Prague, Czech Republic
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van Dongen JJM, Lhermitte L, Böttcher S, Almeida J, van der Velden VHJ, Flores-Montero J, Rawstron A, Asnafi V, Lécrevisse Q, Lucio P, Mejstrikova E, Szczepański T, Kalina T, de Tute R, Brüggemann M, Sedek L, Cullen M, Langerak AW, Mendonça A, Macintyre E, Martin-Ayuso M, Hrusak O, Vidriales MB, Orfao A. EuroFlow antibody panels for standardized n-dimensional flow cytometric immunophenotyping of normal, reactive and malignant leukocytes. Leukemia 2012; 26:1908-75. [PMID: 22552007 PMCID: PMC3437410 DOI: 10.1038/leu.2012.120] [Citation(s) in RCA: 649] [Impact Index Per Article: 54.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2011] [Revised: 02/14/2012] [Accepted: 04/19/2012] [Indexed: 12/21/2022]
Abstract
Most consensus leukemia & lymphoma antibody panels consist of lists of markers based on expert opinions, but they have not been validated. Here we present the validated EuroFlow 8-color antibody panels for immunophenotyping of hematological malignancies. The single-tube screening panels and multi-tube classification panels fit into the EuroFlow diagnostic algorithm with entries defined by clinical and laboratory parameters. The panels were constructed in 2-7 sequential design-evaluation-redesign rounds, using novel Infinicyt software tools for multivariate data analysis. Two groups of markers are combined in each 8-color tube: (i) backbone markers to identify distinct cell populations in a sample, and (ii) markers for characterization of specific cell populations. In multi-tube panels, the backbone markers were optimally placed at the same fluorochrome position in every tube, to provide identical multidimensional localization of the target cell population(s). The characterization markers were positioned according to the diagnostic utility of the combined markers. Each proposed antibody combination was tested against reference databases of normal and malignant cells from healthy subjects and WHO-based disease entities, respectively. The EuroFlow studies resulted in validated and flexible 8-color antibody panels for multidimensional identification and characterization of normal and aberrant cells, optimally suited for immunophenotypic screening and classification of hematological malignancies.
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Affiliation(s)
- J J M van Dongen
- Department of Immunology, Erasmus MC, University Medical Center Rotterdam (Erasmus MC), Rotterdam, The Netherlands.
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Weichselbaum E, Hooper B, Ballam R, Buttriss J, Strigler F, Oberritter H, Bagus T, Cullen M, Palacios N, Valero T, Ruiz E, del Pozo S, Ávila JM, Varela-Moreiras G. Physical activity in schools across Europe. NUTR BULL 2012. [DOI: 10.1111/j.1467-3010.2012.01983.x] [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: 11/28/2022]
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Ptasinska A, Assi SA, Mannari D, James SR, Williamson D, Dunne J, Hoogenkamp M, Wu M, Care M, McNeill H, Cauchy P, Cullen M, Tooze RM, Tenen DG, Young BD, Cockerill PN, Westhead DR, Heidenreich O, Bonifer C. Depletion of RUNX1/ETO in t(8;21) AML cells leads to genome-wide changes in chromatin structure and transcription factor binding. Leukemia 2012; 26:1829-41. [PMID: 22343733 PMCID: PMC3419980 DOI: 10.1038/leu.2012.49] [Citation(s) in RCA: 136] [Impact Index Per Article: 11.3] [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] [Indexed: 12/15/2022]
Abstract
The t(8;21) translocation fuses the DNA-binding domain of the hematopoietic master regulator RUNX1 to the ETO protein. The resultant RUNX1/ETO fusion protein is a leukemia-initiating transcription factor that interferes with RUNX1 function. The result of this interference is a block in differentiation and, finally, the development of acute myeloid leukemia (AML). To obtain insights into RUNX1/ETO-dependant alterations of the epigenetic landscape, we measured genome-wide RUNX1- and RUNX1/ETO-bound regions in t(8;21) cells and assessed to what extent the effects of RUNX1/ETO on the epigenome depend on its continued expression in established leukemic cells. To this end, we determined dynamic alterations of histone acetylation, RNA Polymerase II binding and RUNX1 occupancy in the presence or absence of RUNX1/ETO using a knockdown approach. Combined global assessments of chromatin accessibility and kinetic gene expression data show that RUNX1/ETO controls the expression of important regulators of hematopoietic differentiation and self-renewal. We show that selective removal of RUNX1/ETO leads to a widespread reversal of epigenetic reprogramming and a genome-wide redistribution of RUNX1 binding, resulting in the inhibition of leukemic proliferation and self-renewal, and the induction of differentiation. This demonstrates that RUNX1/ETO represents a pivotal therapeutic target in AML.
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Affiliation(s)
- A Ptasinska
- Section of Experimental Haematology, Leeds Institute of Molecular Medicine, University of Leeds, Leeds, UK
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Westers TM, Ireland R, Kern W, Alhan C, Balleisen JS, Bettelheim P, Burbury K, Cullen M, Cutler JA, Della Porta MG, Dräger AM, Feuillard J, Font P, Germing U, Haase D, Johansson U, Kordasti S, Loken MR, Malcovati L, te Marvelde JG, Matarraz S, Milne T, Moshaver B, Mufti GJ, Ogata K, Orfao A, Porwit A, Psarra K, Richards SJ, Subirá D, Tindell V, Vallespi T, Valent P, van der Velden VHJ, de Witte TM, Wells DA, Zettl F, Béné MC, van de Loosdrecht AA. Standardization of flow cytometry in myelodysplastic syndromes: a report from an international consortium and the European LeukemiaNet Working Group. Leukemia 2012; 26:1730-41. [PMID: 22307178 DOI: 10.1038/leu.2012.30] [Citation(s) in RCA: 181] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Flow cytometry (FC) is increasingly recognized as an important tool in the diagnosis and prognosis of myelodysplastic syndromes (MDS). However, validation of current assays and agreement upon the techniques are prerequisites for its widespread acceptance and application in clinical practice. Therefore, a working group was initiated (Amsterdam, 2008) to discuss and propose standards for FC in MDS. In 2009 and 2010, representatives from 23, mainly European, institutes participated in the second and third European LeukemiaNet (ELN) MDS workshops. In the present report, minimal requirements to analyze dysplasia are refined. The proposed core markers should enable a categorization of FC results in cytopenic patients as 'normal', 'suggestive of', or 'diagnostic of' MDS. An FC report should include a description of validated FC abnormalities such as aberrant marker expression on myeloid progenitors and, furthermore, dysgranulopoiesis and/or dysmonocytopoiesis, if at least two abnormalities are evidenced. The working group is dedicated to initiate further studies to establish robust diagnostic and prognostic FC panels in MDS. An ultimate goal is to refine and improve diagnosis and prognostic scoring systems. Finally, the working group stresses that FC should be part of an integrated diagnosis rather than a separate technique.
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Affiliation(s)
- T M Westers
- Department of Hematology, VU University Medical Center, Amsterdam, The Netherlands
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Cullen M. Peter Arbuthnot Watt. West J Med 2012. [DOI: 10.1136/bmj.d8102] [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: 11/03/2022]
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Jones AM, Flight W, Isalska B, Cullen M, Mutton K, Bowling A, Riley D, Webb K, Bright-Thomas R. Diagnosis of respiratory viral infections in cystic fibrosis by PCR using sputum samples. Eur Respir J 2011; 38:1486-7. [DOI: 10.1183/09031936.00061711] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Horsley A, Carassale E, Cullen M, Isalska B, Bright-Thomas R, Webb K, Jones A. 132 Non-respiratory swabs have little role in the detection of methicillin resistant Staphylococcus aureus in cystic fibrosis. J Cyst Fibros 2011. [DOI: 10.1016/s1569-1993(11)60149-5] [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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Westers T, Ireland R, Kern W, Alhan C, Balleisen J, Béné M, Bettelheim P, Burbury K, Cullen M, Cutler J, Porta MD, Drager A, Feuillard J, Font P, Germing U, Haase D, Johansson U, Kordasti S, Loken M, Malcovati L, te Marvelde J, Matarraz S, Milne T, Moshaver B, Mufti G, Ogata K, Orfao A, Porwit A, Psarra K, Richards S, Subirá D, Tindell V, Vallespi T, Valent P, van der Velden V, de Witte T, Wells D, Zettl F, van de Loosdrecht A. 137 Standardization of flow cytometry in myelodysplastic syndromes: A report from an international consortium and the European LeukemiaNet Working Group. Leuk Res 2011. [DOI: 10.1016/s0145-2126(11)70139-4] [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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Gorsuch TT, Crossingham I, Cullen M, Al-Aloul M. P61 Pulmonary nontuberculous mycobacterial (NTM) culture is common following lung transplantation, and NTM lung disease is associated with poor prognosis. Thorax 2010. [DOI: 10.1136/thx.2010.150979.12] [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: 11/04/2022]
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Niven A, Nevill A, Sayers F, Cullen M. Predictors of rehabilitation intention and behavior following anterior cruciate ligament surgery: an application of the Theory of Planned Behavior. Scand J Med Sci Sports 2010; 22:316-22. [DOI: 10.1111/j.1600-0838.2010.01236.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Hope R, Mushtaq S, James D, Pllana T, Warner M, Livermore DM, Brown D, Rooney P, Palmer R, Croal J, Weinbren M, Hogue S, Gould K, Cumberland N, Logan M, Pillay DG, Thomas C, Want S, Oppenheim B, Kent R, Manjula, Rizkalla, Wade J, Wilcox M, Swann A, Leonard A, Galloway, Al-Wali W, Hudson SJ, Rogers J, Winstanley T, Riley UBG, Johnstone DJ, El-Bouri K, Jones G, MacGowan A, Jepson A, Unsworth, James E, Shetty N, Shemko M, Hastings M, Lafong C, Richards S, Nash J, Waghorn D, Cullen M, Todd N, Anderson AN, D'Arcy S, Goodburn C, Bignardi G. Tigecycline activity: low resistance rates but problematic disc breakpoints revealed by a multicentre sentinel survey in the UK. J Antimicrob Chemother 2010; 65:2602-9. [DOI: 10.1093/jac/dkq370] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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34
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Chu C, Cullen M. P29.03 Mupirocin resistance in MRSA: local incidence and impact on decolonisation. J Hosp Infect 2010. [DOI: 10.1016/s0195-6701(10)60265-4] [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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35
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Polson AG, Williams M, Gray AM, Fuji RN, Poon KA, McBride J, Raab H, Januario T, Go M, Lau J, Yu SF, Du C, Fuh F, Tan C, Wu Y, Liang WC, Prabhu S, Stephan JP, Hongo JA, Dere RC, Deng R, Cullen M, de Tute R, Bennett F, Rawstron A, Jack A, Ebens A. Anti-CD22-MCC-DM1: an antibody-drug conjugate with a stable linker for the treatment of non-Hodgkin's lymphoma. Leukemia 2010; 24:1566-73. [DOI: 10.1038/leu.2010.141] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.1] [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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Abstract
Febrile neutropenia (FN) causes significant morbidity and mortality in patients receiving cytotoxic chemotherapy and can lead to reduced chemotherapy dose intensity and increased overall treatment costs. Antibiotic prophylaxis reduces the incidence of FN. Recent research and meta-analyses confirm that prophylactic fluoroquinolones decrease FN and infection-related mortality in patients with acute leukaemia and those receiving high-dose chemotherapy. Fluoroquinolone prophylaxis also lowers the incidence of FN and all-cause mortality following the first cycle of myelosuppressive chemotherapy for solid tumours. Levofloxacin has been the agent studied most thoroughly in this context. Although there is no convincing evidence that colonisation of individuals with resistant organisms due to antibiotic prophylaxis increases FN or mortality, such concerns must be taken seriously and the use of prophylaxis should be limited responsibly for patients with the greatest chance of benefit. Fluoroquinolone prophylaxis is well tolerated and cost-effective and should be offered to patients receiving chemotherapy for haematological malignancies and high-dose chemotherapy for solid tumours in which prolonged (>7 days) neutropenia is expected. It should also be considered for those receiving chemotherapy for solid tumours and lymphomas during the first cycle of chemotherapy when grade 4 neutropenia is anticipated.
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Affiliation(s)
- M Cullen
- University Hospital Birmingham Cancer Centre, Queen Elizabeth Hospital, Edgbaston, Birmingham B15 2TH, UK.
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Affiliation(s)
- M P Tighe
- Paediatric Medical Unit, Southampton General Hospital, Southampton, UK
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Hussain S, Palmer D, Swinson D, Riley P, Wills A, Brown C, Draycott C, El-Modir A, Peake D, Rea D, Chetiyawardana A, Cullen M. A phase II clinical trial of gemcitabine and split dose cisplatin in advanced non-small cell lung cancer in an outpatient setting. Oncol Rep 2008. [DOI: 10.3892/or.20.1.233] [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: 11/06/2022] Open
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40
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Cullen M, Zatloukal P, Sörenson S, Novello S, Fischer JR, Joy A, Zereu M, Peterson P, Visseren-Grul C, Iscoe N. Pemetrexed in advanced non-small cell lung cancer: A randomized trial of 500 mg/m2 vs 900 mg/m2 in 588 patients who progressed after platinum-containing chemotherapy. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.lba7727] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
LBA7727 Introduction: The mild toxicity profile of pemetrexed (P), seen in a phase III trial of P 500 mg/m2 vs docetaxel 75 mg/m2 in vitamin-supplemented patients (pts), suggests higher doses of P can be given in pts with previously treated advanced non-small cell lung cancer (NSCLC) without significant toxicity. We conducted a phase III trial to determine if a higher dose of P (900 mg/m2) could improve survival vs the standard P dose in pts with NSCLC. Methods: Pts with stage III/IV NSCLC, previously treated with platinum-based chemotherapy, were randomized to P 500 or 900 mg/m2 iv q3week. After the second planned interim analysis, the Data Safety Monitoring Board recommended discontinuation of enrollment due to low probability of demonstrating a survival advantage and a greater incidence of some toxicities on the P 900 arm. Patients were allowed to continue treatment at the P 500 dose. Results: 588 randomized pts were evaluated for efficacy and 581 pts, who received =1 dose, for safety. Safety data for pts who transitioned from P 900 to P 500 were analyzed separately. The treatment arms were balanced regarding baseline characteristics and prior treatment. Both arms had: ∼67% males, median age 62 yrs, 87% pts with an ECOG PS of 0 or 1, and 77% pts with stage IV disease. Key results are shown in the table . There was no statistical difference between arms for any efficacy measure. In general, the incidence of adverse events (AEs) was comparable or numerically higher in the P 900 arm. Some AEs (all grades) reported a >5% difference between the P 900 (N=240) and P 500 arms: fatigue (41.7% vs 32.8%), anemia (32.9% vs 22.1%), vomiting (20.0% vs 13.1%), stomatitis (17.9% vs 10.0%), diarrhea (15.4% vs 10.0%), and thrombocytopenia (11.3% vs 5.5%). Conclusion: P 900 offers no advantage over P 500 mg/m2 as second-line therapy for pts with advanced NSCLC. Certain toxicities were somewhat more pronounced in the P 900 group. No significant financial relationships to disclose. [Table: see text]
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Affiliation(s)
- M. Cullen
- University Hospital Birmingham, Birmingham, United Kingdom; Charles University, Prague, Czech Republic; University Hospital, Linkoping, Sweden; Ospedale S Luigi, Orbassano, Torino, Italy; Klinik Loewenstein, Loewenstein, Germany; Cross Cancer Institute, Edmonton, AB, Canada; Santa Casa de Porto Alegre, Porto Alegre, Brazil; Eli Lilly and Company, Indianapolis, IN
| | - P. Zatloukal
- University Hospital Birmingham, Birmingham, United Kingdom; Charles University, Prague, Czech Republic; University Hospital, Linkoping, Sweden; Ospedale S Luigi, Orbassano, Torino, Italy; Klinik Loewenstein, Loewenstein, Germany; Cross Cancer Institute, Edmonton, AB, Canada; Santa Casa de Porto Alegre, Porto Alegre, Brazil; Eli Lilly and Company, Indianapolis, IN
| | - S. Sörenson
- University Hospital Birmingham, Birmingham, United Kingdom; Charles University, Prague, Czech Republic; University Hospital, Linkoping, Sweden; Ospedale S Luigi, Orbassano, Torino, Italy; Klinik Loewenstein, Loewenstein, Germany; Cross Cancer Institute, Edmonton, AB, Canada; Santa Casa de Porto Alegre, Porto Alegre, Brazil; Eli Lilly and Company, Indianapolis, IN
| | - S. Novello
- University Hospital Birmingham, Birmingham, United Kingdom; Charles University, Prague, Czech Republic; University Hospital, Linkoping, Sweden; Ospedale S Luigi, Orbassano, Torino, Italy; Klinik Loewenstein, Loewenstein, Germany; Cross Cancer Institute, Edmonton, AB, Canada; Santa Casa de Porto Alegre, Porto Alegre, Brazil; Eli Lilly and Company, Indianapolis, IN
| | - J. R. Fischer
- University Hospital Birmingham, Birmingham, United Kingdom; Charles University, Prague, Czech Republic; University Hospital, Linkoping, Sweden; Ospedale S Luigi, Orbassano, Torino, Italy; Klinik Loewenstein, Loewenstein, Germany; Cross Cancer Institute, Edmonton, AB, Canada; Santa Casa de Porto Alegre, Porto Alegre, Brazil; Eli Lilly and Company, Indianapolis, IN
| | - A. Joy
- University Hospital Birmingham, Birmingham, United Kingdom; Charles University, Prague, Czech Republic; University Hospital, Linkoping, Sweden; Ospedale S Luigi, Orbassano, Torino, Italy; Klinik Loewenstein, Loewenstein, Germany; Cross Cancer Institute, Edmonton, AB, Canada; Santa Casa de Porto Alegre, Porto Alegre, Brazil; Eli Lilly and Company, Indianapolis, IN
| | - M. Zereu
- University Hospital Birmingham, Birmingham, United Kingdom; Charles University, Prague, Czech Republic; University Hospital, Linkoping, Sweden; Ospedale S Luigi, Orbassano, Torino, Italy; Klinik Loewenstein, Loewenstein, Germany; Cross Cancer Institute, Edmonton, AB, Canada; Santa Casa de Porto Alegre, Porto Alegre, Brazil; Eli Lilly and Company, Indianapolis, IN
| | - P. Peterson
- University Hospital Birmingham, Birmingham, United Kingdom; Charles University, Prague, Czech Republic; University Hospital, Linkoping, Sweden; Ospedale S Luigi, Orbassano, Torino, Italy; Klinik Loewenstein, Loewenstein, Germany; Cross Cancer Institute, Edmonton, AB, Canada; Santa Casa de Porto Alegre, Porto Alegre, Brazil; Eli Lilly and Company, Indianapolis, IN
| | - C. Visseren-Grul
- University Hospital Birmingham, Birmingham, United Kingdom; Charles University, Prague, Czech Republic; University Hospital, Linkoping, Sweden; Ospedale S Luigi, Orbassano, Torino, Italy; Klinik Loewenstein, Loewenstein, Germany; Cross Cancer Institute, Edmonton, AB, Canada; Santa Casa de Porto Alegre, Porto Alegre, Brazil; Eli Lilly and Company, Indianapolis, IN
| | - N. Iscoe
- University Hospital Birmingham, Birmingham, United Kingdom; Charles University, Prague, Czech Republic; University Hospital, Linkoping, Sweden; Ospedale S Luigi, Orbassano, Torino, Italy; Klinik Loewenstein, Loewenstein, Germany; Cross Cancer Institute, Edmonton, AB, Canada; Santa Casa de Porto Alegre, Porto Alegre, Brazil; Eli Lilly and Company, Indianapolis, IN
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Finn SP, Smyth P, Cahill S, Streck C, O’Regan EM, Flavin R, Sherlock J, Howells D, Henfrey R, Cullen M, Toner M, Timon C, O’Leary JJ, Sheils OM. Expression microarray analysis of papillary thyroid carcinoma and benign thyroid tissue: emphasis on the follicular variant and potential markers of malignancy. Virchows Arch 2007; 450:249-60. [PMID: 17252232 PMCID: PMC1888716 DOI: 10.1007/s00428-006-0348-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [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: 07/27/2006] [Accepted: 11/02/2006] [Indexed: 02/07/2023]
Abstract
The most common sub-variant of papillary thyroid carcinoma (PTC) is the so-called follicular variant (FVPTC), which is a particularly problematic lesion and can be challenging from a diagnostic viewpoint even in resected lesions. Although fine needle aspiration cytology is very useful in the diagnosis of PTC, its accuracy and utility would be greatly facilitated by the development of specific markers for PTC and its common variants. We used the recently developed Applied Biosystems 1700 microarray system to interrogate a series of 11 benign thyroid lesions and conditions and 14 samples of PTC (six with classic morphology and eight with follicular variant morphology). TaqMan(R) reverse transcriptase-polymerase chain reaction was used to validate the expression portfolios of 50 selected transcripts. Our data corroborates potential biomarkers previously identified in the literature, such as LGALS3, S100A11, LYN, BAX, and cluster of differentiation 44 (CD44). However, we have also identified numerous transcripts never previously implicated in thyroid carcinogenesis, and many of which are not represented on other microarray platforms. Diminished expression of metallothioneins featured strongly among these and suggests a possible role for this family as tumour suppressors in PTC. Fifteen transcripts were significantly associated with FVPTC morphology. Surprisingly, these genes were associated with an extremely narrow repertoire of functions, including the major histocompatibility complex and cathepsin families.
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Affiliation(s)
- S. P. Finn
- Department of Histopathology, University of Dublin, Trinity College, Dublin, Ireland
| | - P. Smyth
- Department of Histopathology, University of Dublin, Trinity College, Dublin, Ireland
| | - S. Cahill
- Department of Histopathology, University of Dublin, Trinity College, Dublin, Ireland
| | - C. Streck
- Applied Biosystems, Foster City, CA USA
| | | | - R. Flavin
- Department of Histopathology, University of Dublin, Trinity College, Dublin, Ireland
| | | | | | | | - M. Cullen
- Department of Endocrinology, St James’s Hospital, Dublin, Ireland
| | - M. Toner
- Dublin Dental School and Hospital, Dublin, Ireland
| | - C. Timon
- Department of Otolaryngology, St. James’s Hospital, Dublin, Ireland
| | - J. J. O’Leary
- Department of Histopathology, University of Dublin, Trinity College, Dublin, Ireland
| | - O. M. Sheils
- Department of Histopathology, University of Dublin, Trinity College, Dublin, Ireland
- Department of Histopathology, Institute of Molecular Medicine, Trinity Centre for Health Sciences, St. James’s Hospital, Dublin 8, Ireland
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Abstract
Clostridium difficile (CD)-associated diarrhoea and colitis may relapse in up to 20% of treated patients. We present a patient who failed to respond over a 6-month period to treatment either singly or in combination with metronidazole, vancomycin, rifampicin, cholestyramine and probiotics. Her diarrhoea rapidly resolved after a 3-day course of intravenous immunoglobulin. This treatment may compensate for a failed immune response to CD toxin and should be considered for relapsing CD-associated diarrhoea where there is no response to conventional treatment strategies.
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Affiliation(s)
- C Murphy
- Department of Geriatric Medicine, Wythenshawe Hospital, Manchester, UK.
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Billingham L, Cullen M, Steven N, Gaunt C, Hastings M. O-161 Efficacy of antibacterial prophylaxis following myelosuppressive chemotherapy: Results from a randomised, double-blind, placebo-controlled trial of levofloxacin including 220 small cell lung cancer patients. Lung Cancer 2005. [DOI: 10.1016/s0169-5002(05)80295-8] [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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44
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Affiliation(s)
- M Cullen
- Musgrave Park Hospital, Belfast BT9 7JB, Northern Ireland, UK.
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Cullen M. Atomic spectroscopy in elemental analysis. J Anal Chem 2005. [DOI: 10.1007/s10809-005-0019-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
Gemcitabine plus carboplatin is a widely used regimen for the treatment of advanced non-small-cell lung cancer (NSCLC). This two drug combination is effective, with a favorable safety profile, and is well tolerated in the outpatient setting. Gemcitabine/carboplatin prolongs survival compared with gemcitabine alone, but with greater hematological toxicity. The combination regimen appears to be superior to or equally effective as other regimens including mitomycin, ifosfamide and cisplatin (MIC), cisplatin/vinblastine, gemcitabine/paclitaxel, paclitaxel/carboplatin and gemcitabine/cisplatin. Gemcitabine combined with carboplatin is associated with more hematological toxicity, but the incidence of non-hematological toxicity is often significantly lower. Gemcitabine/carboplatin also improves patient quality of life, supporting its use in treating patients with advanced NSCLC in the outpatient setting.
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Affiliation(s)
- M Cullen
- Cancer Centre, Queen Elizabeth Hospital, University Hospital Birmingham NHS Trust, UK.
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Steven N, Cullen M, Billingham L, Gaunt C, Hastings M. Antibacterial prophylaxis with levofloxacin following myelosuppressive chemotherapy: results of a randomised, double-blind, placebo-controlled trial in 1565 patients. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.8006] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- N. Steven
- CR-UK Clinical Trials Unit / University Hospital, Birmingham, United Kingdom
| | - M. Cullen
- CR-UK Clinical Trials Unit / University Hospital, Birmingham, United Kingdom
| | - L. Billingham
- CR-UK Clinical Trials Unit / University Hospital, Birmingham, United Kingdom
| | - C. Gaunt
- CR-UK Clinical Trials Unit / University Hospital, Birmingham, United Kingdom
| | - M. Hastings
- CR-UK Clinical Trials Unit / University Hospital, Birmingham, United Kingdom
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Woskie SR, Sparer J, Gore RJ, Stowe M, Bello D, Liu Y, Youngs F, Redlich C, Eisen E, Cullen M. Determinants of isocyanate exposures in auto body repair and refinishing shops. ACTA ACUST UNITED AC 2004; 48:393-403. [PMID: 15148052 DOI: 10.1093/annhyg/meh021] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
As part of the Survey of Painters and Repairers of Auto bodies by Yale (SPRAY), the determinants of isocyanate exposure in auto body repair shops were evaluated. Measurements (n = 380) of hexamethylene diisocyanate-based monomer and polyisocyanate and isophorone diisocyanate-based polyisocyanate were collected from 33 auto body shops. The median total reactive isocyanate concentrations expressed as mass concentration of the NCO functional group were: 206 microg NCO/m3 for spray operations; 0.93 microg NCO/m3 for samples collected in the vicinity of spray operations done on the shop floor (near spray); 0.05 microg NCO/m3 for office or other shop areas adjacent to spray areas (workplace background); 0.17 microg NCO/m3 for paint mixing and gun cleaning operations (mixing); 0.27 microg NCO/m3 for sanding operations. Exposure determinants for the sample NCO mass load were identified using linear regression, tobit regression and logistic regression models. For spray samples in a spray booth the significant determinants were the number of milliliters of NCO applied, the gallons of clear coat used by the shop each month and the type of spray booth used (custom built crossdraft, prefabricated crossdraft or downdraft/semi-downdraft). For near spray (bystander) samples, outdoor temperature >65 degrees F (18 degrees C) and shop size >5000 feet2 (465 m2) were significant determinants of exposure levels. For workplace background samples the shop annual income was the most important determinant. For sanding samples, the shop annual income and outdoor temperature >65 degrees F (18 degrees C) were the most significant determinants. Identification of these key exposure determinants will be useful in targeting exposure evaluation and control efforts to reduce isocyanate exposures.
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Affiliation(s)
- S R Woskie
- Department of Work Environment, University of Massachusetts-Lowell, One University Avenue, 01854, USA.
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Cullen M, Nolan J, Cullen M, Moloney M, Kearney J, Lambe J, Gibney MJ. Effect of high levels of intense sweetener intake in insulin dependent diabetics on the ratio of dietary sugar to fat: a case–control study. Eur J Clin Nutr 2004; 58:1336-41. [PMID: 15054410 DOI: 10.1038/sj.ejcn.1601969] [Citation(s) in RCA: 5] [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: 11/09/2022]
Abstract
OBJECTIVE To examine the influence of intense sweetener consumption on nutrient intakes in insulin dependent diabetics compared to controls. DESIGN Case-control food consumption survey. SETTING Dietary data were collected from individuals in Ireland between 1998 and 1999. SUBJECTS Diabetics were recruited through diabetic outpatient departments of St. James's Hospital Dublin. Controls were friends of the patients or staff/students of Trinity College and University College Dublin. Of the 171 diabetics contacted, 122 agreed to participate (70% response rate) and 119 completed the study. INTERVENTIONS In all, 3-day food diaries were used to collect the food consumption data. MAIN OUTCOME MEASURES Fat--sugar seesaw, intense sweetness. RESULTS Patients had significantly higher % energy from starch, lower % energy from sugars and a high intake of fibre compared to controls. In both groups, there was an inverse relationship between % energy from fat and % en from sugar, with the diabetics at the lower level of sugar intake. A score of intense sweetness intakes was computed and across tertiles of this score, there were no significant effects on macronutrient intakes. CONCLUSION The fat-sugar seesaw present in the diabetic group was at a lower level compared to the control group. A high intake of intense sweeteners does not have a detrimental effect on macronutrient and micronutrient intakes.
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Affiliation(s)
- M Cullen
- Department of Clinical Medicine, Trinity Centre for Health Sciences, Trinity College, Dublin, Ireland.
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Abstract
The development of chemotherapy for NSCLC over the last 20 years is reviewed, particularly with regard to its palliative effects. New "fourth generation" agents designed to inhibit specific biological pathways thought to be crucial to tumour growth give cause for optimism in the future treatment of NSCLC.
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Affiliation(s)
- M Cullen
- Cancer Centre at the Queen Elizabeth Hospital, Birmingham, UK.
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