1,720,979 research outputs found
Central nervous system involvement in pediatric acute lymphoblastic leukemia detected by 8-color flow cytometry: a prospective study
Full text linkIntroduction
Acute lymphoblastic leukemia (ALL) may involve central nervous system (CNS) in 3-6% of pediatric patients. Conventional cytology (CC) of cerebrospinal fluid (CSF), together with cell count, is the current standard test to define CNS infiltration, although sensitivity and specificity are low. Flow cytometry (FC) can identify blasts in CSF samples that are negative for cytology with higher sensitivity and specificity. Clinical significance of this occult CNS involvement in children with ALL is still not clearly understood.
The aim of this work is to explore the frequency of CNS involvement by FC analysis of CSF at diagnosis and at each lumbar puncture during therapy in primary and relapsed ALL. Moreover, we want to study prospectively its clinical significance in comparison with cytology and cell count.
Patient and methods
From 12.09.2013 to 12.09.2016 we included all consecutive patients (aged 1-18 years) with Philadelphia negative ALL and with ALL isolated bone marrow (iBM) relapse diagnosed at our Institution. Parent’s informed consent was acquired and the study was approved by the local ethical committee. Treatment schedule and definition of CNS involvement were as per AIEOP-BFM ALL 2009 Protocol.
Relapsed patients were mainly treated according to AIEOP ALL REC 2003 protocol.
At each time point of intrathecal therapy, CSF was collected and analyzed within 24 hours by cell count, cytology and 8-color FC (precursor-B or T lineage panel). A tiny cluster of events with immunophenotype compatible with blasts at diagnosis was considered positive by FC (FC+).
Results
Eighty-seven patients with primary diagnosis of ALL were included in the study, 1050 CSF samples were analyzed. At diagnosis, there were 34 (39%) samples that were positive by FC, 5 were also CC+. FC+ patients were mainly T-ALL, with higher peripheral blast percentage and high-risk features. Relapse incidence and mortality were not different between FC+ and FC- groups at diagnosis.
During ALL treatment, other 37 samples belonging to 19 patients resulted positive by FC only. Comparison between FC+ patients during treatment and FC- did not result in significantly different outcome.
Thirteen patients affected by iBM relapsed were included and 109 CSF samples analyzed for this cohort. At relapse, 7 patients were positive by FC (53.8%), none by CC. Characteristics of FC+ patients and FC- did not differ. Mortality and relapse incidence did not show any significan difference between the two groups. During relapse treatment, other 20 samples were FC+. In total 6 relapsed patients presented ≥2 FC+ samples during therapy, this group presented a higher incidence of subsequent relapses compared to FC- patients (83.3% vs 20%, p 0.04).
Conclusion
Our data demonstrated that CNS involvement detected by FC is a frequent finding in pediatric ALL at diagnosis and at relapse. The clinical significance is probably linked to the persistent CSF positivity rather than to the single sample positivity. Actual frontline treatment protocols seem to be able to control CNS submicroscopic leukemia. In relapsed ALL patients, persistent CSF positivity may be a sign of a more resistant disease and a negative prognostic factor. A larger group of patients and a longer follow up are needed to confirm our observations
Current status of umbilical cord blood transplantation in children
No full textThe first umbilical cord blood (UCB) transplantation was performed 30 years ago. UCB transplantation (UCBT) is now widely used in children with malignant and non-malignant disorders who lack a matched family donor. UCBT affords a lower incidence of graft-versus-host disease compared to alternative stem cell sources, but also presents a slower immune recovery and a high risk of infections if serotherapy is not omitted or targeted within the conditioning regimen. The selection of UCB units with high cell content and good human leucocyte antigen match is essential to improve the outcome. Techniques, such as double UCBT, ex vivo stem cell expansion and intra-bone injection of UCB, have improved cord blood engraftment, but clinical benefit remains to be demonstrated. Cell therapies derived from UCB are under evaluation as potential novel strategies to reduce relapse and viral infections following transplantation. In recent years, improvements within haploidentical transplantation have reduced the overall use of UCBT as an alternative stem cell source; however, each may have its relative merits and disadvantages and tailored use of these alternative stem cell sources may be the optimal approach
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
koamabayili/VECTRON-author-checklist: VECTRON author checklist
No full textWe have done our best to complete the author checklist relating to the use of animals in the hut study. Note that the objective for the hut study was to evaluate the IRS treatment applications for residual efficacy against Anopheles mosquitoes, including the local An. coluzzii mosquito population. Cows were only used to attract mosquitoes into the huts and no tests were carried out directly on the cows. The author checklist is intended for use with studies where experiments are carried out on animals, which is why we have had such difficulty in completing this for the hut study, as many of the questions do not relate to how the cows were used
Pathogenesis, risk factors and therapeutic options for autoimmune haemolytic anaemia in the post‐transplant setting
Full text linkAutoimmune haemolytic anaemia (AIHA) is a rare complication of allogeneic haematopoietic stem cell transplantation (HSCT), observed with an incidence of 1–5%. Paediatric age, diagnosis of non-malignant disease, lympho-depleting agents in the conditioning regimen, use of unrelated donor, graft versus host disease and infections have been associated with a higher risk of AIHA post HSCT. Post-HSCT AIHA is associated with high mortality and morbidity, and it is often very difficult to treat. Steroids and rituximab are used with a response rate around 30–50%. These and other therapeutic strategies are mainly derived from data on primary AIHA, although response rates in post-HSCT AIHA have been generally lower. Here we review the currently available data on risk factors and therapeutic options. There is a need for prospective studies in post-HSCT AIHA to guide clinicians in managing these complex patients
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