Allogeneic blood transfusion in 163 children with acute lymphocytic leukemia (a STROBE-compliant article).

Little research has been done about the effects of allogeneic blood transfusion (ABT) on the recurrence and prognosis in the cases with childhood acute lymphocytic leukemia (cALL). In order to provide a basis for clinical safe blood transfusion, the data of 163 cases with cALL were retrospectively analyzed to explore the issue.The data of 163 cases with cALL between 2006 and 2011 were retrospectively analyzed. According to the frequency of blood transfusion, the 163 cases were divided into 4 groups including non-transfusion group, 1 to 10-time transfusion group, 11 to 25-time transfusion group, and >25-time transfusion group. Survival rates were compared with Log-Rank test. Cox regression analysis was used in the effects of risk factors on recurrence and death.ABT was performed in 152 cases with cALL (93.25%). In low-risk and intermediate-and-high risk cALL, the survival rate significantly decreased in all transfusion groups compared with that in non-transfusion group (all P < .01). Cox regression analysis showed that >25-time transfusion was an independent prognosis index of recurrence (odds ratio [OR] = 3.015, 95% confidence interval [CI]: 1.368-6.646) and death (OR = 3.979, 95% CI: 1.930-8.207) in cALL.Frequency of ABT appears to affect the recurrence and death in cALL. We should be careful with blood transfusion and avoid unnecessary blood transfusion as far as possible in the cases with cALL.

Impact of different sarcopenia stages on the postoperative outcomes after radical gastrectomy for gastric cancer.

BACKGROUND: The association between sarcopenia and postoperative outcomes has been well reported. However, the impact of different sarcopenia stages on postoperative outcomes has never been investigated. METHODS: We conducted a large, prospective study of patients who underwent radical gastrectomy for gastric cancer from August 2014 to December 2015. Sarcopenia was staged as "presarcopenia," "sarcopenia," and "severe sarcopenia" according to the definition of the European Working Group on Sarcopenia in Older People. Univariate and multivariate analyses evaluating the risk factors for total, surgical, and medical complications were performed. RESULTS: A total of 470 patients were included, in which 20.6%, 10%, and 6.8% of the patients were identified as having "presarcopenia," "sarcopenia," and "severe sarcopenia," respectively. Postoperative complications, duration of hospital stays, and costs increased with advancing sarcopenia stages. Severe sarcopenia, visceral fat area to total abdominal muscle area ratio, American Society of Anesthesiologists grade III, and tumor located at the cardia were independent risk factors for total complications. Visceral fat area to total abdominal muscle area ratio and tumor located at the cardia were independent risk factors for operative complications. Presarcopenia, sarcopenia, and severe sarcopenia were all identified as independent risk factors for medical complications, as well as age ≥75 years and Charlson Comorbidity Index. CONCLUSION: Patients had worse postoperative outcomes after gastric cancer operation with advancing sarcopenia stages. Severe sarcopenia, but not presarcopenia or sarcopenia, was an independent risk factor for total postoperative complications. The 3 sarcopenia stages independently influence medical but not surgical complications. Recognizing sarcopenia stages is important for preoperative risk stratification.