Determination of the biological variation of S100β and lactate dehydrogenase in disease-free patients with malignant melanoma

2012 ◽  
Vol 50 (5) ◽  
Author(s):  
Jaume Trapé ◽  
Jesús Montesinos ◽  
Josefina Franquesa ◽  
Maria Sala ◽  
Cristina Fígols ◽  
...  
Keyword(s):  
Lactate Dehydrogenase ◽  
Malignant Melanoma ◽  
Tumor Resection ◽  
Disease Recurrence ◽  
Sampling Interval ◽  
Biological Variation ◽  
Analytical Goals ◽  
Analytical Variation

AbstractBiological variation is important for determining analytical goals and for establishing the magnitude of change between two consecutive measurements. The aim of this study was to determine the biological variation for S100β and lactate dehydrogenase in patients diagnosed with malignant melanoma but without evidence of disease recurrence.The biological variation of S100β and lactate dehydrogenase was estimated from a mean of four consecutive measurements in 32 patients diagnosed with malignant melanoma but without evidence of disease recurrence, 3 months after tumor resection or 4 months after finishing adjuvant treatment. The mean sampling interval was 3 months.Mean concentrations of S100β and lactate dehydrogenase were 0.0557 μg/L and 6.3 μkat/L, respectively. Between-run analytical variation was 3.5% at 0.181 μg/L for S100β and 3.5% at 2.83 μkat/L for lactate dehydrogenase. Biological variations obtained for S100β and lactate dehydrogenase were 14.2% and 8.2%, respectively. The analytical goals (defined as 50% of biological variation) were 7.1% for S100β and 4.1% for lactate dehydrogenase.The estimation of biological variation allows us to calculate analytical goals and reference change values. These are necessary tools for the correct interpretation of serial measurements in patient follow-up.

scholarly journals The Outcome of Children With Acute Lymphoblastic Leukemia Without Receiving Sufficient Dose of L-Asparaginase

2020 ◽  
Author(s):  
Gholamreza Bahoush ◽  
Gholamreza Bahoush ◽  
Marzieh Nojomi
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Hypersensitivity Reaction ◽  
Lymphoblastic Leukemia ◽  
Accurate Determination ◽  
Drug Regimen ◽  
Disease Recurrence ◽  
Free Survival ◽  
Complete Treatment

In acute lymphoblastic leukemia (ALL) patients treated with L-asparaginase, discontinuation of the drug occasionally occur due to severe drug complications or resistance, however, due to the high efficacy of this drug in the recovery of patients and the prevention of disease recurrence, resuming the drug regimen is preferred in most patients. What we did in this study was to evaluate and compare the effects of clinical outcomes in the two modes of continuing and discontinuing drug use. In this retrospective cohort study, all children with ALL who had been treated with L-asparaginase during the years 2005 to 2015 were included in the study and categorized into two groups receiving complete treatment regimen (n=160) and those who had to discontinue the drug due to appearing complications (n=9). The rate of relapse and mortality rate was determined and compared across the two groups with a median follow-up time of more than 5 years. 5-yrs Overall survival of all enrolled patients in the groups continued and discontinued was 91.4±2.5% and 71.4±17.1%, respectively (P=0.792). Also, 5-yrs event-free survival of the two groups was 75.8±3.5% and 71.4±17.1%, respectively (P=0.557. Relapse was revealed in 17.5% and 33.3% respectively and mortality in 16.9% and 0.0% (P=0.261). However, the overall prevalence of hypersensitivity reaction to the drug was significantly higher in those patients who discontinued their drug regimen (100% versus 24.4%, P<0.001). Hypersensitivity reaction to drugs may be an important factor in discontinuing L-asparaginase in patients with ALL. The discontinuation of L-asparaginase supplementation due to various complications such as hypersensitivity reactions may be effective in the survival of these patients. However, accurate determination of the effect of discontinuation of this drug on the outcome of children with ALL requires a more comprehensive study with more complicated cases.

Circulating tumor DNA (ctDNA) utilizing a high-sensitivity panel to detect minimal residual disease post liver hepatectomy and predict disease recurrence.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 3522-3522 ◽  
Author(s):  
Michael J. Overman ◽  
Jean-Nicolas Vauthey ◽  
Thomas A. Aloia ◽  
Claudius Conrad ◽  
Yun Shin Chun ◽  
...  
Keyword(s):  
Minimal Residual Disease ◽  
Residual Disease ◽  
Tumor Resection ◽  
High Sensitivity ◽  
Disease Recurrence ◽  
Circulating Tumor Dna ◽  
High Rate ◽  
Curative Intent ◽  
Minimal Residual

3522 Background: Preliminary data suggests that ctDNA can serve as a marker of minimal residual disease following colorectal cancer (CRC) tumor resection. Applicability of current ctDNA testing is limited by the requirement of sequencing known individual tumor mutations. We explored the applicability of a multi-gene panel ctDNA detection technology in CRC. Methods: Plasma was prospectively collected from CRC patients (pts) undergoing hepatic resections with curative intent between 1/2013 to 9/2016. In a blinded manner 5ml of preoperative (preop) and immediate post-operative (postop) plasma were tested using a novel 30kb ctDNA digital sequencing panel (Guardant Health) covering SNVs in 21 genes and indels in 9 genes based on the landscape of genomic alterations in ctDNA from over 10,000 advanced cancer pts with a high theoretical sensitivity (96%) for CRC. Median unique molecule coverage for this study is 9000 for cfDNA inputs ranging from 10 – 150 ng (media input preop = 27 ng, median input postop = 49 ng) with 120,000X sequencing depth on an IIlumina HiSeq2500. Results: A total of 54 pts underwent liver metastectomies with curative intent with a median follow-up of 33 months. Preop blood was a median of 49 days from last systemic chemotherapy and 3 days prior to surgery; postop blood was a median of 17 days after resection. Tumor mutations from standard of care hotspot multigene panel testing (at MDACC) were identified in 46 of 54 pts (85%). Preop ctDNA mutation detection rate was 80% (43/54) and 44% (24/54) in postop setting, with postop median allele frequency of 0.16% (range 0.01% to 20%). In pts with a minimum of 1 year follow up, sensitivity of postop ctDNA for residual disease was 58% (95%CI; 41%-74%), and specificity was 100% (66%-100%). In 43 patients who underwent successful resection of all visible disease, postop detection of ctDNA significantly correlated with RFS (P = 0.002, HR 3.1; 95% CI 1.7-9.1) with 2-year RFS of 0% vs. 47%. Recurrence was detected in ctDNA a median of 5.1 months prior to radiographic recurrence. Conclusions: The detection of postop ctDNA using an NGS panel-based approach is feasible and is associated with a very high rate of disease recurrence.

scholarly journals Determination of lactate dehydrogenase (LDH) and Bcr-Abl transcript in the follow-up of patients with chronic myeloid leukemia

2010 ◽  
Vol 32 (2) ◽  
Author(s):  
Maria Angelica Ehara Watanabe ◽  
Roberto Iemirsu Tatakihara ◽  
Marla Karine Amarante ◽  
Mateus Nóbrega Aoki ◽  
Julie Massayo Maeda Oda ◽  
...  
Keyword(s):  
Lactate Dehydrogenase ◽  
Chronic Myeloid Leukemia ◽  
Myeloid Leukemia

scholarly journals Anterior Clinoid Metastasis Removed Extradurally: First Case Report

2018 ◽  
Vol 79 (02) ◽  
pp. e55-e62 ◽  
Author(s):  
Mirza Pojskić ◽  
Blazej Zbytek ◽  
Kenan Arnautović
Keyword(s):  
Case Report ◽  
Malignant Tumors ◽  
Tumor Resection ◽  
Disease Recurrence ◽  
Double Vision ◽  
Anterior Clinoid Process ◽  
First Case ◽  
Magnetic Resonance Imaging Mri ◽  
The Right

Background We report a case of isolated metastasis on the anterior clinoid process (ACP) mimicking meningioma. Clinical Presentation A 58-year-old male presented with headaches, right-sided visual disturbances, and blurred and double vision. The cause of double vision was partial weakness of the right III nerve, resulting from compression of the nerve by “hypertrophied” tumor-involved right anterior clinoid. Medical history revealed two primary malignant tumors—male breast cancer and prostate cancer (diagnosed 6 and 18 months prior, respectively). The patient was treated with chemotherapy and showed no signs of active disease, recurrence, or metastasis. Postcontrast head magnetic resonance imaging (MRI) showed extra-axial well-bordered enhancing mass measuring 1.6 × 1.1 × 1 × 1 cm (anteroposterior, transverse, and craniocaudal dimensions) on the ACP, resembling a clinoidal meningioma. Extradural clinoidectomy with tumor resection was performed via right orbitozygomatic pretemporal skull base approach. Visual symptoms improved. Follow-up MRI showed no signs of tumor residual or recurrence. Conclusion This is the first case report of a metastasis of any kind on ACP. Metastasis should be included as a part of the differential diagnosis of lesions of the anterior clinoid. Extradural clinoidectomy is a safe and effective method in the treatment of these tumors.

Abstract 15015: Prognostic Value of Serial Changes of High-Sensitivity Cardiac Troponin I and T Using Reference Change Values Among Hemodialysis Patients

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Yader Sandoval ◽  
Charles A Herzog ◽  
Sara A Love ◽  
Alan H Wu ◽  
Yan Hu ◽  
...  
Keyword(s):  
Cardiac Troponin ◽  
Troponin I ◽  
High Sensitivity ◽  
Biological Variation ◽  
Patient Demographics ◽  
Hazard Ratios ◽  
All Cause Mortality ◽  
Serial Measurements

Introduction: Measurement of the biological variation of cardiac troponin (cTn) allows determination of reference change values (RCVs) to use for interpreting serial testing. Using plasma collected serially over 12-months from a stable outpatient hemodialysis (HD) population, our goals were two-fold. First, we calculated RCVs for hs-cTnI and hs-cTnT assays. Second, we determined outcomes based on hs-cTnI and hs-cTnT RCVs. Methods: hs-cTnI (Abbott) and hs-cTnT (Roche) were measured in 677 stable outpatient HD patients (enrolled May 2011-November 2012). Hazard ratios (HR), based on RCVs calculated for each hs-cTn assay, for ‘all-cause’, ‘sudden cardiac death (SCD)’ and ‘infectious’ mortality were determined with serial measurements obtained 3 months apart. Results: Patient demographics were: mean age 59±14y; mean dialysis duration 5.2±4.2y; 53% male; 59% African American and 50% diabetic ESRD. 18.6% of patients died during a 3-year follow-up. RCVs were: hs-cTnI, +37% and -30%; hs-cTnT, +25% and -20%. Patients with serial hs-cTnI and hs-cTnT changes >RCV had all-cause mortality of 25.2% and 23.8% respectively, compared to 15.0% and 16.5% with ≤RCV (both p<0.05). Outcomes and adjusted HRs are shown in Table. Patients with serial hs-cTnI and hs-cTnT changes >RCV showed a greater risk of all-cause mortality compared to ≤RCV (HR: 1.9 (95% CI: 1.4, 2.8), p=0.0003; and HR: 1.7 (95% CI: 1.2, 2.4), p=0.0066; respectively). However, only hs-cTnI changes >RCV were predictive of SCD (HR: 2.6 (95% CI: 1.3, 5.1), p=0.005). Conclusions: Our findings are unique in two ways. First we determined the biological variation of hs-cTnI and hs-cTnT in a large HD population. Second, based on the RCV for each hs-assay, serial changes in hs-cTnI and hs-cTnT >RCV identify patients at greater risk of all-cause mortality, with hs-cTnI also predictive of SCD. These findings support the use of serial changes >RCV for risk-stratification in HD patients.

EVALUASI KESESUAIAN PELAKSANAAN PROBITY AUDIT PADA BPKP PUSAT DENGAN PEDOMAN PROBITY AUDIT PENGADAAN BARANG/JASA PEMERINTAH

INFO ARTHA ◽  
2017 ◽  
Vol 1 (1) ◽  
pp. 17-34
Author(s):  
Fadlil Usman
Keyword(s):  
Public Sector ◽  
Real Time ◽  
Procurement Process ◽  
Assessment Activity

Probity audit is an independence assessment activity to ensure the goods/services procurement processes have been implemented consistently appropriate with the principle of upholding integrity, uprightness, honesty and fulfill certain occur legislation aimed for improving the accountability for the use of public sector fund. Probity audit is done in real time simultaneously with the goods/services procurement process. This study aims to evaluate the suitability of the implementation of probity audit conducted by BPKP Headquarter as agency that initiated the implementation of probity audit in Indonesia compared with the Probity audit Guidelines for Procurement of Goods/Services as criteria. The results of this study indicate that the implementation of probity audit conducted by BPKP Headquarter has been implemented adequately, but there are activities that do not fit the criteria, especially in the activities of the determination of the scope of the audit, the preparation of working papers and the follow-up monitoring of the audit results. Probity audit merupakan kegiatan penilaian (independen) untuk memastikan bahwa proses pengadaan barang/jasa telah dilaksanakan secara konsisten sesuai dengan prinsip penegakan integritas, kebenaran, kejujuran dan memenuhi ketentuan perundangan yang berlaku yang bertujuan meningkatkan akuntabilitas penggunaan dana sektor publik. Probity audit dilakukan secara real time yaitu bersamaan dengan pelaksanaan pengadaan barang/jasa. Penelitian ini bertujuan untuk melakukan evaluasi kesesuaian pelaksanaan probity audit yang dilakukan oleh BPKP Pusat selaku instansi yang menginisiasi pelaksanaan probity audit di Indonesia dibandingkan dengan kriteria berupa Pedoman Probity audit Pengadaan Barang/Jasa Pemerintah. Hasil dari penelitian ini menunjukkan bahwa pelaksanaan probity audit yang dilakukan oleh BPKP Pusat sudah dilaksanakan secara memadai, namun masih terdapat hal yang belum sesuai dengan kriteria terutama dalam kegiatan penentuan ruang lingkup audit, penyusunan kertas kerja dan pemantauan terhadap tindak lanjut hasil audit.

scholarly journals A Case of Malignant Melanoma Arising in Mediastinal Malignant Teratoma

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Ikuma Nozaki ◽  
Yumi Tone ◽  
Junko Yamanaka ◽  
Hideko Uryu ◽  
Yuko Shimizu-Motohashi ◽  
...  
Keyword(s):  
Malignant Melanoma ◽  
Malignant Transformation ◽  
Poor Prognosis ◽  
Mediastinal Mass ◽  
Bone Biopsy ◽  
Systematic Evaluation ◽  
Anterior Mediastinal Mass ◽  
Malignant Teratoma ◽  
Experienced Pain

We report about a 14-year-old boy who presented with an anterior mediastinal mass that was diagnosed as malignant teratoma. Surgical resection was performed along with pre- and postoperative chemotherapy. Although elevated alpha-fetoprotein became negative, he experienced pain in his right hip joint 3 months after resection. Systematic evaluation revealed multiple locations of metastasis, and the pathological diagnosis based on bone biopsy was malignant melanoma originating from malignant teratoma, which rapidly progressed. He died 15 months after diagnosis of the original malignant teratoma. Diagnosing and treating malignant transformation of teratoma, including malignant melanoma, is difficult because it is very rare. To our knowledge, this is the second reported case of malignant melanoma arising from a mediastinum malignant teratoma, with both cases having a poor prognosis. In addition to the follow-up of tumor markers, systematic evaluation, including imaging, should be considered even after remission to monitor malignant transformation of teratoma. We expect to establish a successful therapy and improve mortality rate after more such cases are accumulated.

Primary Calvarial Ewing Sarcoma: A Case Series

2021 ◽  
Author(s):  
Sandeep Mohindra ◽  
Manjul Tripathi ◽  
Aman Batish ◽  
Ankur Kapoor ◽  
Ninad Ramesh Patil ◽  
...  
Keyword(s):  
Ewing Sarcoma ◽  
Tumor Resection ◽  
Case Series ◽  
Radical Excision ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Intradural Tumor ◽  
Age Range

Abstract Background Calvarial Ewing tumor is a relatively rare differential among bony neoplasms. We present our experience of managing primary calvarial Ewing sarcoma (EWS), highlighting their clinical and radiological findings. Method In a retrospective analysis, we evaluated our 12-year database for pathologically proven EWS. A literature search was conducted for the comparative presentation and update on the management and outcome. Result From January 2008 to December 2020, we managed eight patients (male:female = 5:3; age range 6 months to 19 years, mean 11.5 years) harboring primary calvarial EWS. All cases underwent wide local excision; two patients required intradural tumor resection, while one required rotation flap for scalp reconstruction. Mean hospital stay was 8 days. All patients received adjuvant chemo- and radiotherapy. Three patients remained asymptomatic at 5 years of follow-up, while two patients died. Conclusion Primary calvarial EWS is a rare entity. It usually affects patients in the first two decades of life. These tumors can be purely intracranial, causing raised intracranial pressure symptoms, which may exhibit rapidly enlarging subgaleal tumors with only cosmetic deformities or symptoms of both. Radical excision followed by adjuvant therapy may offer a favorable long-term outcome.

scholarly journals Retinoblastoma genetics screening and clinical management

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Himika Gupta ◽  
Sivasankar Malaichamy ◽  
Ashwin Mallipatna ◽  
Sakthivel Murugan ◽  
Nallathambi Jeyabalan ◽  
...  
Keyword(s):  
Clinical Management ◽  
Detection Rate ◽  
Mutation Detection ◽  
Gene Mutations ◽  
Disease Recurrence ◽  
Germline Mutations ◽  
Global Studies ◽  
Mutation Detection Rate ◽  
Gene Deletions

Abstract Background India accounts for 20% of the global retinoblastoma (RB) burden. However, the existing data on RB1 gene germline mutations and its influence on clinical decisions is minimally explored. Methods Fifty children with RB underwent complete clinical examination and appropriate multidisciplinary management. Screening of germline RB1 gene mutations was performed through next-generation sequencing and Multiplex Ligation-dependent Probe Amplification (MLPA) analysis. The mutation and non-mutation groups were compared for clinical parameters especially severity, progression and recurrence. Results Twenty-nine patients had bilateral RB (BLRB) and 21 had unilateral RB (ULRB). The genetic analysis revealed 20 RB1 variations in 29 probands, inclusive of 3 novel mutations, known 16 mutations and heterozygous whole gene deletions. The mutation detection rate (MDR) was 86.2% in BLRB and 19% in ULRB. Associations of disease recurrence (p = 0.021), progression (p = 0.000) and higher percentage of optic nerve invasion, subretinal seeds and high-risk pathological factors were observed in the mutation group. Clinical management was influenced by the presence of germline mutations, particularly while deciding on enucleation, frequency of periodic follow up and radiotherapy. Conclusions We identified novel RB1 mutations, and our mutation detection rate was on par with the previous global studies. In our study, genetic results influenced clinical management and we suggest that it should be an essential and integral component of RB-care in India and elsewhere.

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