Safe Provision of Systemic Anti-Cancer Treatment for Urological Cancer Patients During COVID-19: A Tertiary Centre Experience in the First Wave of COVID-19

Background Safe provision of systemic anti-cancer treatment (SACT) during the COVID-19 pandemic remains an ongoing concern amongst clinicians. Methods Retrospective analysis on uro-oncology patients who continued or started SACT between 1st March and 31st May 2020 during the pandemic (with 2019 as a comparator). Results 441 patients received SACT in 2020 (292 prostate, 101 renal, 38 urothelial, 10 testicular) compared to 518 patients in 2019 (340 prostate, 121 renal, 42 urothelial, 15 testicular). In 2020, there were 75.00% fewer patients with stage 3 cancers receiving SACT (p<0.0001) and 94.44% fewer patients receiving radical treatment (p=0.0019). The number of patients started on a new line of SACT was similar between both years (118 in 2019 vs 102 in 2020; p=N.S) but with 53.45% fewer patients started on chemotherapy in 2020 (p=0.00067). Overall, 5 patients tested positive for COVID-19 (one asymptomatic, two moderate pneumonitis, one severe pneumonitis). Compared to 2019, 30-day mortality was similar (1.69% in 2019 vs 0.98% in 2020; p=N.S) whereas the 6-month mortality was lower (9.32% in 2019 vs 1.96% in 2020; p=0.023) in 2020. Conclusion This single-centre study demonstrated that uro-oncology patients can safely receive SACT during COVID-19 pandemic with a low incidence of infection and mortality.

Pregnancy Outcomes of Non-Visualization of The Foetal Gallbladder From A Chinese Tertiary Single Centre And Literature Review

Objection To explore the clinical features and prognosis of non-visualization of fetal gallbladder (NVFGB). Methods 65 cases diagnosed of NVFGB in the Peking University First Hospital was collected retrospectively from January, 2019 to December, 2020. Results 49 cases were successfully followed up. Among them, the gallbladder of 21 fetuses (42.9%) was visible later, either in the later pregnancy or after birth. In the rest 28 cases (57.1%), the gallbladders were not seen during the whole pregnancy. 11 of 28 fetuses (39.3%) with NVFGB were complicated with other structure anomaly. In the remaining 17 cases of isolated NVFGB (60.7%), one case was diagnosed of congenital biliary atresia, 3 cases of small gallbladder, 1 case of gallstone and one case of irregular size of gallbladder. There are 9 cases who underwent prenatal diagnosis, with 4 cases of abnormal result. Conclusion Prenatal ultrasound plays a role in the early recognize of abnormal gallbladder, which will improve the postnatal prognosis.

Microtransplantation Improves the Outcome of Older Patients With Newly Diagnosed Acute Myeloid Leukaemia: a Single-centre Study With Long-term Follow-up

Purpose: This retrospective single-centre study was to validate the efficacy and safety of microtransplantation (or micro-stem cell transplantation, MST) in the treatment of older patients with acute myeloid leukemia (AML).Methods: MST combines chemotherapy and human leukocyte antigen (HLA)-mismatched peripheral blood stem cell infusion without graft-versus-host disease (GVHD) prophylaxis. In total, 26 newly diagnosed AML patients were enrolled in our study from April 2008 to April 2018. The deadline date of follow-up was December 31, 2019. All of them received MST. Patients were divided into 2 age groups: 60~70 years (n=17) and >70 years (n=9). The outcomes of complete remission (CR) rate, overall survival (OS), leukemia free survival (LFS), hematopoietic recovery time, and treatment related toxicities were analyzed and summarized in this study.Results: 10 patients were still alive with complete remission (CR) at the deadline date, and the median overall survival (OS) was 64 months (range, 21-135 months). The CR, relapse and nonrelapse mortality rates were 84.6%, 38.5% and 30%, respectively. Both OS (p < 0.0001) and leukaemia free survival (LFS) (p < 0.0001) were significantly higher in the younger group than in the older group. The median times of neutrophil and platelet recovery were 12 days and 14 days, respectively. Conclusions: These data showed that MST could be an alternative treatment for older AML patients.

Dynamic Contrast-enhanced breast magnetic resonance imaging findings that affect the magnetic Resonance-directed ultrasound correlation of Non-mass enhancement lesions: A Single-centre Retrospective Study

Objective: Our single-centre retrospective study aimed to evaluate the relationship between magnetic resonance (MR)-directed ultrasound (MDUS) detectability and magnetic resonance imaging (MRI) findings of non-mass enhancement (NME) lesions, regarding the morphologic and enhancement features, the distance from the skin and nipple, and the presence of concomitant landmarks. Methods: A total of 350 MRI-detected NME lesions that were determined between January 2015 and May 2019 and subsequently underwent MDUS were analyzed. The MRI findings, biopsy results, and follow-up outcomes of lesions were recorded. The correlation between the MRI findings of the lesions and MDUS detectability was analyzed. Results: One hundred fourteen (32.6%) of the 350 lesions had a counterpart in the MDUS. Respectively, 66 (37.9%), 38 (43.2%) and 59 (38.3%) of the lesions detected in MDUS were larger than 20 mm in size, with a distance of less than 20 mm to the nipple and 15 mm to the skin. The lesion size and lesion distance to the nipple and skin were significantly associated with a US correlate (p < 0.05). The MDUS detection rate was significantly higher in NME lesions with MR findings including diffuse distribution (p < 0.001), clustered-ring enhancement pattern (p < 0.001), washout kinetic curve (p = 0.006), and MR-BIRADS category 5 (p < 0.001). Multivariate logistic regression showed that only the clustered-ring enhancement pattern was significantly associated with an MDUS correlation (p < 0.001). Conclusion: Statistically significant correlations were found between the size, distance to the nipple and skin, distribution pattern, enhancement pattern and kinetic curve of the NME lesions on MRI and ultrasound detectability. Advances in knowledge: We found that clustered-ring enhancement patterns were significantly more frequent in MR-directed US detectable lesions.