Clinical Outcomes in the First Year Following Introduction of the Electromagnetic Navigation Bronchoscopy Procedure at a Community Center

CHEST Journal ◽  
2015 ◽  
Vol 148 (4) ◽  
pp. 789A
Author(s):  
Susan Garwood ◽  
Nathanael Hevelone ◽  
Kristin Hood ◽  
Kevin McGinnis ◽  
Sean Pidgeon ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Community Center ◽  
First Year ◽  
Electromagnetic Navigation

scholarly journals One‐year clinically important deterioration and long‐term clinical course in Japanese patients with COPD: a multicenter observational cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yuki Abe ◽  
Masaru Suzuki ◽  
Hironi Makita ◽  
Hirokazu Kimura ◽  
Kaoruko Shimizu ◽  
...  
Keyword(s):  
Cohort Study ◽  
Disease Progression ◽  
Clinical Outcomes ◽  
Japanese Patients ◽  
Drop Out ◽  
Chronic Obstructive ◽  
First Year ◽  
Severe Exacerbation ◽  
Clinically Important Deterioration

Abstract Background Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease with a complex progression of many clinical presentations, and clinically important deterioration (CID) has been proposed in the Western studies as a composite endpoint of disease progression. The aim of this study was to investigate the relationships between 1-year CID and the following long-term clinical outcomes in Japanese patients with COPD who have been reported to have different characteristics compared to the Westerners. Methods Among Japanese patients with COPD enrolled in the Hokkaido COPD cohort study, 259 patients who did not drop out within the first year were analyzed in this study. Two definitions of CID were used. Definition 1 comprised ≥ 100 mL decrease in forced expiratory volume in 1 s (FEV1), ≥ 4-unit increase in St George’s Respiratory Questionnaire (SGRQ) score from baseline, or moderate or severe exacerbation. For Definition 2, the thresholds for the FEV1 and SGRQ score components were doubled. The presence of CID was evaluated within the first year from enrollment, and analyzed the association of the presence of CID with following 4-year risk of exacerbations and 9-year mortality. Results Patients with CID using Definition 1, but not any single CID component, during the first year had a significantly worse mortality compared with those without CID. Patients with CID using Definition 2 showed a similar trend on mortality, and had a shorter exacerbation-free survival compared with those without CID. Conclusions Adoption of CID is a beneficial and useful way for the assessment of long-term disease progression and clinical outcomes even in Japanese population with COPD. The definition of CID might be optimized according to the characteristics of COPD population and the observation period for CID.

Additional Chromosomal Abnormalities in Philadelphia Chromosome-Negative Metaphases Appearing during Therapy with Imatinib, Dasatinib, Nilotinib and Ponatinib in Patients with Newly Diagnosed Chronic Myeloid Leukemia

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 1577-1577 ◽  
Author(s):  
Ghayas C. Issa ◽  
Hagop M. Kantarjian ◽  
Elias Jabbour ◽  
Gautam Borthakur ◽  
Srdan Verstovsek ◽  
...  
Keyword(s):  
Chronic Myeloid Leukemia ◽  
Clinical Outcomes ◽  
Myeloid Leukemia ◽  
Research Funding ◽  
Chromosomal Abnormalities ◽  
Philadelphia Chromosome ◽  
Cytogenetic Response ◽  
Banding Technique ◽  
First Year ◽  
Additional Chromosomal Abnormalities

Abstract Background Additional chromosomal abnormalities (ACAs) in the Philadelphia chromosome (Ph)-negative metaphases that emerge as patients with chronic myeloid leukemia (CML) are treated with tyrosine kinase inhibitors (TKIs) have been reported during treatment with imatinib. It has been suggested that these might be associated with an inferior outcome and in rare instances lead to the emergence of a new malignant clone resulting in myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML) (Jabbour et. al, Blood 2007). This phenomenon has not been well characterized when other TKIs are used. We conducted a retrospective analysis of patients treated on imatinib, dasatinib, nilotinib, and ponatinib frontline trials to assess the frequency and prognostic impact of ACAs appearing during the treatment after achieving cytogenetic response. Patients and Methods A total of 524 patients with CML were evaluated with a median age at diagnosis of 48 years (range 15 to 86). These included 236 patients treated with imatinib, 125 with nilotinib, 118 with dasatinib and 45 with ponatinib. All the patients were treated in clinical trials approved by the institutional board review and signed an informed consent in accordance with institutional guidelines and in accordance with the declaration of Helsenki. Conventional cytogenetic analysis was done in bone marrow cells using standard G-banding technique at baseline, every 3 months during the first year, then every 6-12 months. Clonal ACAs were identified as abnormalities present in ≥2/20 metaphases or, if only one metaphase, present in ≥2 consecutive assessments. Results After a median follow-up of 83.8 months (range 0.3-176.6 months) 13% (72/524) patients had ACAs, of which 7% (41/524) were clonal. ACAs were seen in 11% (27/236) of patients on imatinib compared to 11% (13/118, p=0.9) on dasatinib, 19 % (24/125, p= 0.04) on nilotinib, and 17% (8/45, p=0.2) on ponatinib. Six patients had both clonal evolution (CE) and ACAs at different times. The median number of metaphases containing ACAs was 5/20 (range 1 to 20) with an average of 7/20. Most appeared within the first year of the start of the TKI (median 6 months, range 3-72 months); they first appeared after 12 months of therapy in 21 of the 72 (29%) patients. ACAs were transient and were detected in 2 or less time points in 52 of the 72 (72%) cases. The most common clonal ACAs were - Y (13/41) and +8 (4/41). The rates of cytogenetic and molecular responses were similar for patients with and without clonal ACAs (CCyR: 88% vs 91%; p=0.55) (MMR: 78% vs 86%, p=0.20). Having clonal ACAs did not affect the rate of deep molecular response either (MR4.5 71% vs 67%; p =0.65). There was no significant difference in EFS and OS (5y EFS 73% vs 86%; p=0.19) (5y OS 77% vs 93%; p=0.06) although there was a trend for lower rates for both. Responses and clinical outcomes were similar between different TKIs for patients with and without clonal ACAs. One patient with -7 treated with ponatinib developed MDS. Monosomy 7 appeared 9 months from the start of treatment in 9/20 metaphases and persisted. He was taken off ponatinib because of pancytopenia. He subsequently received bosutinib, achieved and maintained a CCyR. A high-risk MDS was documented approximately 1 year after appearance of the -7 clone. He was started on decitabine and achieved a partial cytogenetic response for MDS. Another patient in the imatinib cohort with -7 developed secondary AML (CCyR for CML) and died from a multiple organ failure after allogeneic stem cell transplant from a one antigen-mismatched unrelated donor. There was a third patient with -7 that later had CE and developed Ph+ CML blast phase. Conclusion ACAs are rare and mostly transient events that appear during the treatment of CML with TKIs. These changes do not affect responses or clinical outcomes, independent of what TKI is used. A small subset of patients with -7 may develop AML or MDS warranting close monitoring of patients with changes that are reminiscent of those diseases. Molecular analysis after appearance of ACAs could help identify mutations driving the Ph-clone into AML or MDS. Disclosures Pemmaraju: Stemline: Research Funding; Incyte: Consultancy, Honoraria; Novartis: Consultancy, Honoraria, Research Funding; LFB: Consultancy, Honoraria. Cortes:BerGenBio AS: Research Funding; Pfizer: Consultancy, Research Funding; Novartis: Consultancy, Research Funding; Teva: Research Funding; BMS: Consultancy, Research Funding; Ariad: Consultancy, Research Funding; Astellas: Consultancy, Research Funding; Ambit: Consultancy, Research Funding; Arog: Research Funding; Celator: Research Funding; Jenssen: Consultancy.

Compliance and persistency with imatinib

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 6038-6038 ◽  
Author(s):  
W. Feng ◽  
H. Henk ◽  
S. Thomas ◽  
J. Baladi ◽  
A. Hatfield ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Multivariate Analyses ◽  
Medication Possession Ratio ◽  
Patient Characteristics ◽  
Myelogenous Leukemia ◽  
Imatinib Therapy ◽  
First Year ◽  
Optimal Dosing ◽  
Medical Benefits ◽  
N 93

6038 Background: Imatinib is an oral therapy with efficacy in chronic myelogenous leukemia (CML) and gastrointestinal stromal tumors (GIST). Optimal dosing and adherence to treatment is critical to achieve the best clinical outcomes. This study examined compliance and persistency with imatinib and identified the clinical and patient characteristics related to compliance. Methods: Claims data from a US health plan were used to identify imatinib-treated patients from 6/1/01–3/31/04 who had continuous pharmacy and medical benefits in the 3 months prior and 12 months following initiation of imatinib therapy, and a diagnosis of CML or GIST (ICD-9-CM 205.1, 205.10, or 205.11 for CML; 159.0, 159.8, or 159.9 for GIST). Compliance was defined by medication possession ratio (MPR = total days supply of imatinib in the first year divided by 365). Persistency was defined as failure to refill imatinib within 30 days from the run-out date of the prior prescription. Multivariate analyses were used to identify key factors associated with compliance. Results: Total 878 imatinib-treated patients were identified of whom 413 had at least 15 months’ continuous eligibility. Sixty-nine percent (n = 286) were diagnosed with CML, 8% (n = 34) with GIST, and 23% (n = 93) with neither. Results are presented for CML and GIST patients. The average age was 51 and 58% were males. The average starting daily dose was 424 mg, with 80% (n = 255) initiating on 400 mg daily. The mean MPR was 76%. Overall, 28% patients discontinued imatinib for at least 30 consecutive days during the 1-year follow up period. Multivariate analyses indicated MPR improved with age until age 51 and then deteriorated (p < 0.001) but at a diminishing rate, decreased as the number of medications increased (p < 0.001), and was lower in women (p = 0.005) and patients with more cancer complications (p < 0.001). In addition, women were more likely to discontinue than men (OR = 2.08; p = 0.003). Conclusions: Compliance to imatinib was about 75% with 30% of patients interrupting therapy for at least 30 consecutive days in the first year. It has been found that interruption of imatinib therapy may lead to rapid tumor progression in GIST (PASCO05 Le Cesne #9031). Not having patients take the correct doses on a regular basis may lead to sub therapeutical clinical outcomes. [Table: see text]

“Coming out” against cancer: How local outreach to the LGBT community can reduce cancer disparities.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 131-131
Author(s):  
S Timpet
Keyword(s):  
Health Care ◽  
Coming Out ◽  
Cancer Disparities ◽  
Community Center ◽  
First Year ◽  
Gender Minority ◽  
Lgbt Community ◽  
Lgbt People ◽  
Lgbt Populations ◽  
Lgbt Individuals

131 Background: Lesbian, Gay, Bisexual, and Transgender (LGBT) individuals make up an estimated 4% of the population, qualifying them as a sexual minority. LGBT individuals are also more likely to be a racial or gender minority, to live in poverty, and to have less social support than their heterosexual peers. LGBT populations are disproportionately affected by mental health issues such as depression, which are correlated not only with behavioral risk factors, but with less likelihood to comply with healthcare screening or treatment. Approximately 30% of LGBT adults do not seek health care services or lack a regular health care provider, compared with 10% of heterosexuals. Research studies demonstrate that knowledge about increased risks and need for screening is low in LGBT populations. Sub-populations are less likely to have had a recent mammogram, anal or cervical Pap, or a prostate exam. Methods: We implemented a population-oriented program into our community outreach team in 2019 to address LGBT cancer disparities. A program manager partnered with community resources and leaders, including the Cleveland LGBT Community Center, Plexus LGBT Chamber of Commerce, and Trans Ohio. First year programming included a mammogram clinic for sexual/gender minority (SGM) women, “Cancer is a DRAG” show, and a tobacco-free campaign for LGBT pride month. Results: Creating meaningful partnerships was extremely important to community leaders and organizations. Strategic plans include direct community input and engagement through a community council, in conjunction with the LGBT Community Center, a breast cancer awareness campaign, in conjunction with local entertainers, and a tobacco cessation program, through our Center for LGBT Care. We educated over 150 people and screened over 85 within the first year. Conclusions: When our healthcare institution met local LGBT people within their community, the result was quite impactful. This pilot program proved successful at educating members of the community about their increased cancer risk, which resulted in higher cancer screening rates for LGBT people. More programs tailored to LGBT-specific health concerns are important to continue reaching these populations and eventually decrease health disparities in the community.

scholarly journals 36 Clinical outcomes of cystic fibrosis patients during their first year of life after neonatal screening implementation

2013 ◽  
Vol 12 ◽  
pp. S57
Author(s):  
C.C.S. Gomez ◽  
M.F. Servidoni ◽  
J.F. Souza ◽  
M.A.G.O. Ribeiro ◽  
A.A.D.C. Toro ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Clinical Outcomes ◽  
Neonatal Screening ◽  
First Year ◽  
First Year Of Life
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