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  • Wiley  (3)
  • 1
    In: eJHaem, Wiley, Vol. 3, No. 4 ( 2022-11), p. 1220-1230
    Abstract: Background : Long‐term treatment‐free remission (TFR) represents a new goal for chronic myeloid leukemia (CML). Optimizing dose of tyrosine kinase inhibitors (TKIs) in the CML treatment maybe a new challenge to maintain effective and improving patients’ quality of life. We hypothesized that administration of low‐dose TKIs does not compromise major molecular response (MMR) in patients with CML who have a deep molecular response (DMR). Methods : We did an open‐label, randomized trial at eight hospitals in China. Eligible CML‐CP patients (aged 18–70 years) had shown continuous response to TKI more than 5 years and maintained MR4.5 (BCR‐ABLIS ≤ 0.0032%) in recent 18 months. Patients were randomly assigned (1:1) to the TKI de‐escalation group or the discontinuation group. Randomization was done with permuted blocks (block size four) and implemented through an interactive web‐based randomization system. Recurrence was defined as the single sample with real time Quantitative PCR (RT‐qPCR) measurement greater than 0.1% (MMR). The primary endpoint was 12‐month MMR rate in patients who received de‐escalation or discontinuation of TKIs. This study was registered at ClinicalTrials.gov (NCT04143087). Results : Around 125 patients were enrolled between October 23, 2019 and October 31, 2020, 62 patients received dose de‐escalation of TKIs, while 63 patients in the discontinuation group. In the de‐escalation group, molecular recurrence‐free survival at 12 months was 88.32% (95% CI 79%–98%), whereas molecular recurrence‐free survival in the discontinuation group at 12 months was 59.98% (95% CI 47–73). No progressions occurred at the data cut‐off date. All 29 recurrence cases restart TKI treatment returned to MMR. Cytolytic NK cells as a proportion of lymphocyte cells were significantly increased from baseline after 6 months whether in the de‐escalation or TKIs cessation group ( P  = 0.048, 0.001, respectively); compared with the relapsing patients, Tregs proportion was decreased ( P  = 0.003), and higher proportion of NK cells were found in non‐relapsing patients whether in TKI de‐escalation or discontinuation group ( P  = 0.011, 0.007, respectively). We also found that the de‐escalation group showed better disease‐specific HRQOL in regards to its impact on emotional functioning, fatigue, pain, and financial difficulties. Conclusion : With 88.32% MMR in 12‐months follow‐up after de‐escalation TKIs’ treatment, dose‐halving could become a new treatment paradigm for CML patients who with DMR under continuing maintenance therapy with TKIs.
    Type of Medium: Online Resource
    ISSN: 2688-6146 , 2688-6146
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 3021452-X
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  • 2
    Online Resource
    Online Resource
    Wiley ; 2024
    In:  International Wound Journal Vol. 21, No. 4 ( 2024-04)
    In: International Wound Journal, Wiley, Vol. 21, No. 4 ( 2024-04)
    Abstract: Surgical site infections (SSIs) following ankle fracture fixation pose significant challenges in patient recovery and healthcare management. Identifying risk factors contributing to SSIs can aid in developing targeted prevention and treatment strategies. This systematic review and meta‐analysis were conducted according to the PRISMA guidelines and the PICO framework. A comprehensive literature search across major databases, including PubMed, Embase, Web of Science and the Cochrane Library, was completed on September 26, 2023. The inclusion criteria encompassed peer‐reviewed studies of various designs that investigated risk factors for SSIs post‐ankle fracture fixation. Quality assessment was performed using the Newcastle‐Ottawa Scale. Statistical analyses assessed heterogeneity and calculated combined effect sizes using fixed‐ or random‐effects models, depending on the heterogeneity observed. The initial search yielded 1250 articles, with seven meeting the inclusion criteria after rigorous screening and full‐text review. The included studies, conducted between 2006 and 2019, predominantly utilized case–control designs. The meta‐analysis identified diabetes, open fractures, smoking, age, alcohol consumption, ASA score ≥3, high BMI, contaminated incisions, fracture dislocation and heart disease as significant risk factors for postoperative SSIs. Publication bias assessment showed no significant bias across studies. The identification of key risk factors such as diabetes, open fractures, smoking, advanced age, alcohol consumption, high ASA score, elevated BMI, contaminated incisions, fracture dislocation and heart disease is essential in managing SSIs post‐ankle fracture fixation. Targeted interventions addressing these risk factors are crucial to reduce the incidence of SSIs and improve overall patient outcomes.
    Type of Medium: Online Resource
    ISSN: 1742-4801 , 1742-481X
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2024
    detail.hit.zdb_id: 2152163-3
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  • 3
    In: Cancer, Wiley, Vol. 124, No. 9 ( 2018-05), p. 1954-1963
    Abstract: Sorafenib before transplantation, sorafenib maintenance after transplantation, and their combined application all can improve the outcomes for patients with acute myeloid leukemia with FMS‐like tyrosine kinase 3–internal tandem duplication. Further study is needed to determine whether the use of sorafenib both before and after transplantation might be ideal.
    Type of Medium: Online Resource
    ISSN: 0008-543X , 1097-0142
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2018
    detail.hit.zdb_id: 1479932-7
    detail.hit.zdb_id: 2599218-1
    detail.hit.zdb_id: 2594979-2
    detail.hit.zdb_id: 1429-1
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