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Nagaraja C, Shashibhushan B, Vivek K, Arun B, Makandar I, Sandesh S. Detection of coronavirus disease 2019 in patients presenting with influenza-like illness. Egypt J Chest Dis Tuberc 2022. [DOI: 10.4103/ecdt.ecdt_2_20] [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] Open
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Qayyum A, Hwang KP, Stafford J, Verma A, Maru DM, Sandesh S, Sun J, Pestana RC, Avritscher R, Hassan MM, Amin H, Rashid A, Wistuba II, Ehman RL, Ma J, Kaseb AO. Immunotherapy response evaluation with magnetic resonance elastography (MRE) in advanced HCC. J Immunother Cancer 2019; 7:329. [PMID: 31779702 PMCID: PMC6883599 DOI: 10.1186/s40425-019-0766-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [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: 02/19/2019] [Accepted: 10/02/2019] [Indexed: 02/16/2023] Open
Abstract
Background Currently, there are no imaging predictors of immunotherapy outcome in hepatocellular carcinoma (HCC). The study aim was to determine if stiffness changes measured by magnetic resonance elastography (MRE) can be a predictor of immunotherapy response in patients with advanced HCC. Materials and methods This was a prospective study of 15 patients with biopsy proven-advanced HCC treated with Pembrolizumab. All patients had liver MRE and liver biopsy at baseline and at 6 weeks of therapy. Change in HCC stiffness on MRE was compared with overall survival (OS), time to disease progression (TTP), and number of intratumoral CD3+ T lymphocytes. Analysis was performed using descriptive statistics and Spearman correlation (R); p-value < 0.05 was considered statistically significant. Results Nine patients were evaluable. Median age was 71 years (range, 54–78). Etiology of liver disease was HCV (n = 4), HBV (n = 1) and NASH (n = 4). Median OS and TTP were 44 weeks and 13 weeks, respectively. Average baseline HCC stiffness and change in HCC stiffness were 5.0 kPa and 0.12 kPa, respectively. In contrast, average non-tumor liver stiffness was 3.2 kPa, and did not significantly change at 6 weeks (p = 0.42). Average size of measured tumor and change in size were 4 cm and − 0.32 cm, respectively. Change in HCC stiffness at 6 weeks correlated significantly with OS (R = 0.81), and TTP (R = 0.88,p < 0.01). Abundance of intratumoral T lymphocytes on tumor biopsy correlated significantly with HCC stiffness (R = 0.79,p = 0.007). Conclusion Our pilot MRE data suggests early change in tumor stiffness may be an indicator of immunotherapy response in patients with advanced HCC.
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Affiliation(s)
- Aliya Qayyum
- Department of Abdominal Imaging, UT MD Anderson Cancer Center, 1400 Pressler Street, Houston, Texas, USA.
| | - Ken-Pin Hwang
- Department of Imaging Physics, UT MD Anderson Cancer Center, Houston, Texas, USA
| | - Jason Stafford
- Department of Imaging Physics, UT MD Anderson Cancer Center, Houston, Texas, USA
| | - Anuj Verma
- Department of Translational Molecular Pathology, UT MD Anderson Cancer Center, Houston, Texas, USA
| | - Dipen M Maru
- Department of Pathology, UT MD Anderson Cancer Center, Houston, Texas, USA
| | - Subramanya Sandesh
- Department of Translational Molecular Pathology, UT MD Anderson Cancer Center, Houston, Texas, USA
| | - Jia Sun
- Department of Biostatstistics, UT MD Anderson Cancer Center, Houston, Texas, USA
| | | | - Rony Avritscher
- Department of Interventional Radiology, UT MD Anderson Cancer Center, Houston, Texas, USA
| | - Manal M Hassan
- Department of Epidemiology, UT MD Anderson Cancer Center, Houston, Texas, USA
| | - Hesham Amin
- Department of Hemopathology, UT MD Anderson Cancer Center, Houston, Texas, USA
| | - Asif Rashid
- Department of Pathology, UT MD Anderson Cancer Center, Houston, Texas, USA
| | - Ignacio I Wistuba
- Department of Translational Molecular Pathology, UT MD Anderson Cancer Center, Houston, Texas, USA
| | - Richard L Ehman
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Jingfei Ma
- Department of Imaging Physics, UT MD Anderson Cancer Center, Houston, Texas, USA
| | - Ahmed O Kaseb
- Department of GI Medical Oncology, UT MD Anderson Cancer Center, Houston, USA.
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Abstract
In less than a decade after discovery, RNA interference-mediated gene silencing is already being tested as potential therapy in clinical trials for a number of diseases. Lentiviral vectors provide a means to express short hairpin RNA (shRNA) to induce stable and long-term gene silencing in both dividing and non-dividing cells and thus, are being intensively investigated for this purpose. However, induction of long-term shRNA expression can also cause toxicities by inducing off-target effects and interference with the endogenous micro-RNA (miRNA) pathway that regulates cellular gene expression. Recently, several advances have been made in the shRNA vector design to mimic cellular miRNA processing and to express multiplex siRNAs in a tightly regulated and reversible manner to overcome toxicities. In this review we describe some of these advances, focusing on the progress made in the development of lentiviral shRNA delivery strategies to combat viral infections.
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Affiliation(s)
- N Manjunath
- Paul L Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, Texas 79905
| | - Wu Haoquan
- Paul L Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, Texas 79905
| | - Subramanya Sandesh
- Paul L Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, Texas 79905
| | - Shankar Premlata
- Paul L Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, Texas 79905
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Abstract
The objective of this study was to identify patterns of fever and neutropenia in pediatric patients undergoing initial hospitalization for hematopoietic stem cell transplantation. A retrospective review of 75 HSCTs over a 4-year period at a single institution was performed, of which 68% were allogeneic and 32% were autologous. Stem cell sources included bone marrow (29%), PBSC (52%) and umbilical cord blood (16%). Fever occurred in 74 (98%) of the episodes. Unexplained fever (FUO) occurred in 43%. Bacteremia without an anatomic focus occurred in 29%, while CVC associated infections occurred in 17%. In 49% of transplants at least one blood culture was positive. The incidence of bacteremia was higher in allogeneic HSCTs (58%) than in autologous transplants (29%). Gram-positive bacteria accounted for 71% of the isolates. Lower rates of bacteremia were observed in patients receiving oral fluoroquinolone prophylaxis. The median duration of fever was 12.5 days and time to engraftment 14 days. Regression analysis demonstrated that duration of fever was strongly associated with time to engraftment, and that time to engraftment was associated with source of cells and number of CD34+ cells/kg administered. Recipients of autologous PBSC had the shortest durations of fever and time to engraftment, while recipients of allogeneic umbilical cord blood had the longest. Bone Marrow Transplantation (2000) 25, 59-65.
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Affiliation(s)
- C A Mullen
- Department of Pediatrics, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
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