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Journal of Clinical Medicine Dec 2021The current challenge worldwide is the administration of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine. Considering that the COVID-19... (Review)
Review
The current challenge worldwide is the administration of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine. Considering that the COVID-19 vaccination represents the best possibility to resolve this pandemic, this systematic review aims to clarify the major aspects of fatal adverse effects related to COVID-19 vaccines, with the goal of advancing our knowledge, supporting decisions, or suggesting changes in policies at local, regional, and global levels. Moreover, this review aims to provide key recommendations to improve awareness of vaccine safety. All studies published up to 2 December 2021 were searched using the following keywords: "COVID-19 Vaccine", "SARS-CoV-2 Vaccine", "COVID-19 Vaccination", "SARS-CoV-2 Vaccination", and "Autopsy" or "Post-mortem". We included 17 papers published with fatal cases with post-mortem investigations. A total of 38 cases were analyzed: 22 cases were related to ChAdOx1 nCoV-19 administration, 10 cases to BNT162b2, 4 cases to mRNA-1273, and 2 cases to Ad26.COV2.S. Based on these data, autopsy is very useful to define the main characteristics of the so-called vaccine-induced immune thrombotic thrombocytopenia (VITT) after ChAdOx1 nCoV-19 vaccination: recurrent findings were intracranial hemorrhage and diffused microthrombi located in multiple areas. Moreover, it is fundamental to provide evidence about myocarditis related to the BNT162B2 vaccine. Finally, based on the discussed data, we suggest several key recommendations to improve awareness of vaccine safety.
PubMed: 34945172
DOI: 10.3390/jcm10245876 -
Bone Marrow Transplantation Apr 2023Post-transplant lymphoproliferative disorder (PTLD) is a leading cause of cancer death in solid organ transplant recipients (SOTRs). Relapsed or refractory (R/R) PTLD... (Review)
Review
Post-transplant lymphoproliferative disorder (PTLD) is a leading cause of cancer death in solid organ transplant recipients (SOTRs). Relapsed or refractory (R/R) PTLD portends a high risk of death and effective management is not well established. CD19-targeted CAR-T cell therapy has been utilized, but the risks and benefits are unknown. We report the first case of diffuse large B-cell lymphoma (DLBCL) PTLD treated with lisocabtagene maraleucel and present a systematic literature review of SOTRs with PTLD treated with CD19 CAR-T therapy. Our patient achieved a complete response (CR) with limited toxicity but experienced a CD19 relapse 8 months after infusion despite CAR-T persistence. Literature review revealed 14 DLBCL and 2 Burkitt lymphoma PTLD cases treated with CD19 CAR-T cells. Kidney (n = 12), liver (n = 2), heart (n = 2), and pancreas after kidney (n = 1) transplant recipients were analyzed. The objective response rate (ORR) was 82.4% (14/17), with 58.5% (10/17) CRs and a 6.5-month median duration of response. Among kidney transplant recipients, the ORR was 91.7% (11/12). Allograft rejection occurred in 23.5% (4/17). No graft failure occurred. Our analysis suggests that CD19 CAR-T therapy offers short-term effectiveness and manageable toxicity in SOTRs with R/R PTLD. Further investigation through larger datasets and prospective study is needed.
Topics: Humans; Antigens, CD19; Epstein-Barr Virus Infections; Immunotherapy, Adoptive; Lymphoma, Large B-Cell, Diffuse; Lymphoproliferative Disorders; Neoplasm Recurrence, Local; Organ Transplantation; Receptors, Chimeric Antigen; Transplant Recipients
PubMed: 36575360
DOI: 10.1038/s41409-022-01907-z -
Neuroscience and Biobehavioral Reviews Sep 2013Nowadays, chemotherapy-induced cognitive impairment or 'chemobrain' is a well-established clinical syndrome, consisting of moderate to subtle cognitive changes across... (Review)
Review
Nowadays, chemotherapy-induced cognitive impairment or 'chemobrain' is a well-established clinical syndrome, consisting of moderate to subtle cognitive changes across various domains, especially working memory, executive function and episodic verbal memory that persist only in a subgroup of long-term cancer survivors. In recent years, several studies using neuroimaging techniques have reported structural and functional neural changes associated with chemotherapy. This review provides an overview of the relevant advances that neuroimaging techniques have added to the understanding of the underlying mechanisms of chemotherapy-induced cognitive impairment. In summary, our review showed: (i) a pre-treatment (prior to chemotherapy) widespread decrease in white matter (WM) volume as well as an increased level of activation of the frontoparietal attentional network of cancer patients compared to controls; (ii) an early diffuse decrease of gray matter (GM) and WM volume together with a decrease of the overactivation in frontal regions in chemotherapy-treated patients compared to controls and (iii) a long-term persisting decrease in GM and WM volumes together with a predominantly frontal cortex hypoactivation in only a subgroup of chemotherapy-treated patients.
Topics: Brain; Cognition Disorders; Drug-Related Side Effects and Adverse Reactions; Humans; Neuroimaging; Neuropsychological Tests
PubMed: 23660455
DOI: 10.1016/j.neubiorev.2013.04.015 -
Cancer Imaging : the Official... Nov 2022Advances in molecular diagnostics accomplished the discovery of two malignant glioma entities harboring alterations in the H3 histone: diffuse midline glioma, H3... (Review)
Review
BACKGROUND
Advances in molecular diagnostics accomplished the discovery of two malignant glioma entities harboring alterations in the H3 histone: diffuse midline glioma, H3 K27-altered and diffuse hemispheric glioma, H3 G34-mutant. Radiogenomics research, which aims to correlate tumor imaging features with genotypes, has not comprehensively examined histone-altered gliomas (HAG). The aim of this research was to synthesize the current published data on imaging features associated with HAG.
METHODS
A systematic search was performed in March 2022 using PubMed and the Cochrane Library, identifying studies on the imaging features associated with H3 K27-altered and/or H3 G34-mutant gliomas.
RESULTS
Forty-seven studies fulfilled the inclusion criteria, the majority on H3 K27-altered gliomas. Just under half (21/47) were case reports or short series, the remainder being diagnostic accuracy studies. Despite heterogeneous methodology, some themes emerged. In particular, enhancement of H3 K27M-altered gliomas is variable and can be less than expected given their highly malignant behavior. Low apparent diffusion coefficient values have been suggested as a biomarker of H3 K27-alteration, but high values do not exclude this genotype. Promising correlations between high relative cerebral blood volume values and H3 K27-alteration require further validation. Limited data on H3 G34-mutant gliomas suggest some morphologic overlap with 1p/19q-codeleted oligodendrogliomas.
CONCLUSIONS
The existing data are limited, especially for H3 G34-mutant gliomas and artificial intelligence techniques. Current evidence indicates that imaging-based predictions of HAG are insufficient to replace histological assessment. In particular, H3 K27-altered gliomas should be considered when occurring in typical midline locations irrespective of enhancement characteristics.
Topics: Humans; Artificial Intelligence; Brain Neoplasms; Glioma; Histones; Mutation
PubMed: 36397143
DOI: 10.1186/s40644-022-00500-3 -
Clinical Otolaryngology : Official... Jun 2017Diagnosis and management of recurrent or residual cholesteatoma can be problematic. Diffusion-weighted imaging magnetic resonance imaging (MRI) sequences have been used... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Diagnosis and management of recurrent or residual cholesteatoma can be problematic. Diffusion-weighted imaging magnetic resonance imaging (MRI) sequences have been used for follow-up of such lesions. More recent non-echoplanar imaging (non-EPI) sequences are thought to be superior to older echoplanar imaging (EPI) sequences.
OBJECTIVE OF REVIEW
Evaluate whether diffusion-weighted magnetic resonance imaging is useful in the diagnosis of recurrent or residual cholesteatoma.
TYPE OF REVIEW
Systematic review and meta-analysis.
SEARCH STRATEGY
MEDLINE, EMBASE, CINAHL, Web of Science and the Cochrane Database were searched, with no limits on date or language.
STUDY SELECTION
Adults or children who had previously undergone tympanomastoid surgery by any method with confirmation of recurrence/residual disease by second-look/revision surgery.
EVALUATION METHODS
Two reviewers independently reviewed studies. Data extracted on 11 domains and rechecked.
DATA SYNTHESIS
Statistical analysis with SPSS.
RESULTS
A total of 575 studies were identified of which 27 met the inclusion criteria. These covered 727 patient episodes. For EPI studies: sensitivity (sd) 71.82 (24.5), specificity (sd) 89.36 (13.4), PPV (sd) 93.36 (8.1) and NPV (sd) 73.36 (15.8). For non-EPI studies: sensitivity 89.79 (12.1), specificity (sd) 94.57 (5.8), PPV (sd) 96.50 (4.2) and NPV 80.46 (20.2). Improved sensitivity of non-EPI sequences reached significance (P = 0.02).
CONCLUSIONS
Diffusion-weighted MRI is both sensitive and specific for the detection of recurrent or residual cholesteatoma following ear surgery. Non-EPI techniques are superior to EPI techniques.
Topics: Cholesteatoma, Middle Ear; Diffusion Magnetic Resonance Imaging; Humans; Otologic Surgical Procedures; Recurrence
PubMed: 27701821
DOI: 10.1111/coa.12762 -
British Journal of Haematology Jul 2015This study systematically reviewed and meta-analysed the prognostic value of complete remission status at end-of-treatment (18) F-fluoro-2-deoxy-d-glucose positron... (Meta-Analysis)
Meta-Analysis Review
This study systematically reviewed and meta-analysed the prognostic value of complete remission status at end-of-treatment (18) F-fluoro-2-deoxy-d-glucose positron emission tomography (FDG-PET) in diffuse large B-cell lymphoma (DLBCL) patients treated with rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP). The systematic PubMed/MEDLINE search yielded seven suitable studies comprising a total of 737 R-CHOP-treated DLBCL patients who were in complete remission at end-of-treatment FDG-PET. Overall, the methodological quality of included studies was reasonable. The disease relapse rate among all patients with complete remission status according to end-of-treatment FDG-PET ranged from 7·0% to 20·0%, with a weighted summary proportion of 13·7%. Five of seven studies reported progression-free survival (PFS) of these patients at various specific time points, i.e., 2-year PFS (n = 1), estimated 3-year PFS (n = 3) and 5-year PFS (n = 1), which was 83%, 85-86·4% and 75%, respectively. Three of seven studies reported overall survival (OS) of these patients at various specific time points, i.e., estimated 3-year OS (n = 2) and estimated 5-year OS (n = 1), which were 90%, 93·6% and 83%, respectively. In conclusion, a non-negligible proportion of R-CHOP-treated DLBCL patients who achieve complete remission according to end-of-treatment FDG-PET experiences disease relapse during follow-up.
Topics: Antibodies, Monoclonal, Murine-Derived; Antineoplastic Combined Chemotherapy Protocols; Cyclophosphamide; Doxorubicin; Fluorodeoxyglucose F18; Humans; Lymphoma, Large B-Cell, Diffuse; Positron-Emission Tomography; Prednisone; Prognosis; Remission Induction; Rituximab; Treatment Outcome; Vincristine
PubMed: 25833790
DOI: 10.1111/bjh.13420 -
Clinical Lymphoma, Myeloma & Leukemia Dec 2022Previous studies have shown that diffuse large B-cell lymphoma (DLBCL) subtype with both B-cell antigen receptor complex-associated protein beta chain (CD79B) and... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Previous studies have shown that diffuse large B-cell lymphoma (DLBCL) subtype with both B-cell antigen receptor complex-associated protein beta chain (CD79B) and myeloid differentiation primary response 88 mutations (MYD88) had inferior outcome under standard immunochemotherapy. However, the prognostic significance of CD79B alone in DLBCL has not been fully elucidated. We conducted a meta-analysis to investigate the role of CD79B mutation on overall survival (OS) in patients with DLBCL.
METHODS
We performed literature search in PubMed and Embase databases and followed PRISMA guidelines to select publications for analysis. The primary and secondary outcome was OS and progression-free survival (PFS) respectively. Hazard ratio (HR) for OS/PFS in CD79B mutant group with that in wild-type group in R-chemotherapy patients was either estimated using Cox proportional hazard model from the studies with individual participant level data or extracted from the original publication with aggregated results.
RESULTS
Nine eligible studies with survival information according to CD79B mutation status were included in this meta-analysis. The pooled hazard ratio for OS was 1.38 (95% CI, 1.13-1.70; p = 0.0021) for CD79B mutation, providing evidence that CD79B mutation was unfavorable prognostic factor for survival in DLBCL patients treated with immunochemotherapy. We identified the inferior prognostic impact of CD79B mutation was independent from well-established prognostic model in DLBCL, International Prognostic Index. The predictive power of CD79B mutation was stronger than that of MYD88 mutation.
CONCLUSION
This meta-analysis revealed that CD79B mutation could be a key biomarker for DLBCL disease progression and future mechanism-based target therapy in DLBCL needs to be studied.
Topics: Humans; Prognosis; Myeloid Differentiation Factor 88; Lymphoma, Large B-Cell, Diffuse; Mutation; Immunotherapy; CD79 Antigens
PubMed: 36182550
DOI: 10.1016/j.clml.2022.08.006 -
Journal of Cellular and Molecular... Jul 2023Cancer initiation and progression have been associated with dysregulated long non-coding RNA (lncRNA) expression. However, the lncRNA expression profile in aggressive... (Review)
Review
Cancer initiation and progression have been associated with dysregulated long non-coding RNA (lncRNA) expression. However, the lncRNA expression profile in aggressive B-cell non-Hodgkin lymphoma (NHL) has not been comprehensively characterized. This systematic review aims to evaluate the role of lncRNAs as a biomarker to investigate their future potential in the diagnosis, real-time measurement of response to therapy and prognosis in aggressive B-cell NHL. We searched PubMed, Web of Science, Embase and Scopus databases using the keywords "long non-coding RNA", "Diffuse large B-cell lymphoma", "Burkitt's lymphoma" and "Mantle cell lymphoma". We included studies on human subjects that measured the level of lncRNAs in samples from patients with aggressive B-cell NHL. We screened 608 papers, and 51 papers were included. The most studied aggressive B-cell NHL was diffuse large B-cell lymphoma (DLBCL). At least 79 lncRNAs were involved in the pathogenesis of aggressive B-cell NHL. Targeting lncRNAs could affect cell proliferation, viability, apoptosis, migration and invasion in aggressive B-cell NHL cell lines. Dysregulation of lncRNAs had prognostic (e.g. overall survival) and diagnostic values in patients with DLBCL, Burkitt's lymphoma (BL), or mantle cell lymphoma (MCL). Furthermore, dysregulation of lncRNAs was associated with response to treatments, such as CHOP-like chemotherapy regimens, in these patients. LncRNAs could be promising biomarkers for the diagnosis, prognosis and response to therapy in patients with aggressive B-cell NHL. Additionally, lncRNAs could be potential therapeutic targets for patients with aggressive B-cell NHL like DLBCL, MCL or BL.
Topics: Humans; Adult; RNA, Long Noncoding; Lymphoma, Large B-Cell, Diffuse; Burkitt Lymphoma; Lymphoma, Mantle-Cell; Biomarkers
PubMed: 37246627
DOI: 10.1111/jcmm.17795 -
Abdominal Radiology (New York) Feb 2017A meta-analysis was performed to assess the diagnostic performance of diffusion-weighted imaging (DWI) in liver fibrosis (LF) staging. (Meta-Analysis)
Meta-Analysis Review
PURPOSE
A meta-analysis was performed to assess the diagnostic performance of diffusion-weighted imaging (DWI) in liver fibrosis (LF) staging.
METHODS
We conducted a comprehensive literature search to identify relevant articles. Diagnostic data were extracted for each METAVIR fibrosis stage (F0-F4). A bivariate binomial model was used to combine sensitivities and specificities. Summary receiver operating characteristics (SROC) curves were performed and areas under SROC curve (AUC) were calculated to indicate diagnostic accuracies. Subgroup analyses were performed between different study characteristics.
RESULTS
Twelve studies met the inclusion criteria for LF ≥F1, 16 for ≥F2, 18 for ≥F3, and 12 for F4. AUCs of DWI were 0.8554, 0.8770, 0.8836, and 0.8596 for ≥F1, ≥F2, ≥F3, and F4, respectively. Subgroup analyses showed that for LF ≥F2 and ≥F3, maximal b values (b ) ≥ 800 s/mm performed significantly better than b < 800 s/mm. The diagnostic accuracies of 3.0 T and intravoxel incoherent motion (IVIM)-DWI were significantly higher than those of 1.5 T and conventional DWI for diagnosing liver cirrhosis (F4).
CONCLUSIONS
DWI is a reliable noninvasive technique with good diagnostic accuracy for LF staging. Using b ≥ 800 s/mm, high-field strength (3.0 T) and IVIM-DWI can optimize the diagnostic performance of DWI.
Topics: Diffusion Magnetic Resonance Imaging; Humans; Liver Cirrhosis
PubMed: 27678393
DOI: 10.1007/s00261-016-0913-6 -
International Journal of Clinical... 2022Previous studies evaluating the influence of statins on the survival of patients with diffuse large B cell lymphoma (DLBCL) showed inconsistent results. This systematic... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Previous studies evaluating the influence of statins on the survival of patients with diffuse large B cell lymphoma (DLBCL) showed inconsistent results. This systematic review and meta-analysis was conducted to investigate whether statin use is correlated with the survival of DLBCL patients.
METHODS
Related cohort studies were obtained by searching PubMed, Embase, Cochrane's Library, and Web of Science databases. Study characteristics and outcome data were extracted independently by two authors. The random-effect model was used for meta-analysis, considering the possible influence of between-study heterogeneity.
RESULTS
Eight studies involving 9927 patients with DLBCL were included. Results did not show significant associations of statins with overall survival (OS, hazard ratio [HR]: 0.88, 95% confidence interval [CI]: 0.69∼1.11, =0.27; = 60%) or progression-free survival (PFS, HR: 0.92, 95% CI: 0.72∼1.17, =0.49; = 23%) in these patients. Subgroup analyses suggested that statin was be associated with survival of DLBCL patients from Asia (HR for OS: 1.19, 95% CI: 0.91∼1.56, =0.19, = 2%; HR for PFS: 1.13, 95% CI: 0.89∼1.44, =0.33, = 0%), but was associated with significantly improved survival of patients from Western countries (HR for OS: 0.73, 95% CI: 0.66∼0.81, < 0.001, = 0%; for PFS, HR: 0.72, 95% CI: 0.53∼0.96, =0.03, = 0%), which fully explained the heterogeneity ( for subgroup difference <0.05). Variables such as study design, patient age, and study quality were not shown to affect the findings.
CONCLUSIONS
Overall, statins did not affect the survival of patients with DLBCL. However, statin use may be associated with an improved survival rate of DLBCL patients from Western countries.
Topics: Asia; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Lymphoma, Large B-Cell, Diffuse; Prognosis; Proportional Hazards Models; Rituximab
PubMed: 35989867
DOI: 10.1155/2022/5618290