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OBJECTIVES/AIMS: With the Euro-Qol-5 dimension (EQ-5D) system, we investigated the relationship between the number of remaining teeth and QoL using data from the Korean National Health and Nutrition Examination Survey (KNHANES), 2010-2012. A total of 17,417 participants, more than 19 years old, were finally included in this study (men = 7394 and women = 10,023). Through this study, we have discovered that the remaining teeth affect overall health and that the fewer number of them may indicate a lower quality of life, as well. The quality of life according to the number of remaining teeth was assessed among Koreans using the Euro-Qol-5 dimension (EQ-5D) system. METHOD: The Euro-Qol-5 dimension (EQ-5D) system was used to measure the health-related QoL. Its five dimensions included mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. The respondents were asked to choose one of the followings: G 1, no problems; G 2, some problems; and G 3, problematic, to best describe their health status for the five dimensions. Then, we assigned low QoL to G2 + G3 and high QoL to G1. We used age, gender, economic income, educational level, residence, and marital status for the demographic variables and, drinking, smoking, exercise, BMI, and metabolic syndrome for health behaviors. Multiple logistic regression analysis was performed to examine the odds ratios (ORs) and confidence intervals (CIs) for the high QoL (G1) on the five categories of EQ-5D according to the number of remaining teeth. On the basis of the 0-15 remaining teeth group, we drew a comparison of the QoL between the 16-20 and 21-28 remaining teeth groups. RESULTS: Subjects with 21-28 remaining teeth had higher QoL scores and had higher ORs of high QoL, especially for mobility (OR = 1.256, 95% CI = 1.056-1.495), self-care (OR = 1.441, 95% CI = 1.096-1.894), and usual activities (OR = 1.241, 95% CI = 1.022-1.508, respectively), than those with 0-15 remaining teeth after adjusting for age, sex, body mass index, smoking, drinking, exercise, income, education, and metabolic syndrome. ORs from the high QoL had the tendency to increase as the number of remaining teeth increased (all p for trend < 0.05). However, there was no relationship between the number of remaining teeth and QoL in the pain/discomfort and anxiety/depression dimensions. CONCLUSION: The number of remaining teeth was associated with QoL, and subjects who had more teeth obtained higher QoL scores. The subjects in the high QoL group were especially associated with the components of EQ-5D such as mobility, self-care, and daily living.
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Nível de Saúde , Qualidade de Vida , Perda de Dente/psicologia , Atividades Cotidianas , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Autocuidado , Perda de Dente/complicações , Adulto JovemRESUMO
The aim of the Korean Imatinib Discontinuation Study was to identify predictors for safe and successful imatinib discontinuation. A total of 90 patients with a follow-up of ≥12 months were analyzed. After a median follow-up of 26.6 months after imatinib discontinuation, 37 patients lost the major molecular response. The probability of sustained major molecular response at 12 months and 24 months was 62.2% and 58.5%, respectively. All 37 patients who lost major molecular response were retreated with imatinib therapy for a median of 16.9 months, and all achieved major molecular response again at a median of 3.9 months after resuming imatinib therapy. We observed newly developed or worsened musculoskeletal pain and pruritus in 27 (30%) patients after imatinib discontinuation. Imatinib withdrawal syndrome was associated with a higher probability of sustained major molecular response (P=0.003) and showed a trend for a longer time to major molecular response loss (P=0.098). Positivity (defined as ≥ 17 positive chambers) of digital polymerase chain reaction at screening and longer imatinib duration before imatinib discontinuation were associated with a higher probability of sustained major molecular response. Our data demonstrated that the occurrence of imatinib withdrawal syndrome after imatinib discontinuation and longer duration of imatinib were associated with a lower rate of molecular relapse. In addition, minimal residual leukemia measured by digital polymerase chain reaction had a trend for a higher molecular relapse. (Trial registered at ClinicalTrials.gov: NCT01564836).
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Antineoplásicos/uso terapêutico , Mesilato de Imatinib/uso terapêutico , Leucemia Mielogênica Crônica BCR-ABL Positiva/diagnóstico , Leucemia Mielogênica Crônica BCR-ABL Positiva/tratamento farmacológico , Neoplasia Residual/diagnóstico , Inibidores de Proteínas Quinases/uso terapêutico , Adulto , Idoso , Idoso de 80 Anos ou mais , Antineoplásicos/administração & dosagem , Antineoplásicos/efeitos adversos , Feminino , Seguimentos , Proteínas de Fusão bcr-abl/genética , Humanos , Mesilato de Imatinib/administração & dosagem , Mesilato de Imatinib/efeitos adversos , Leucemia Mielogênica Crônica BCR-ABL Positiva/genética , Masculino , Pessoa de Meia-Idade , Neoplasia Residual/genética , Reação em Cadeia da Polimerase , Prognóstico , Inibidores de Proteínas Quinases/administração & dosagem , Inibidores de Proteínas Quinases/efeitos adversos , Recidiva , Retratamento , Fatores de Tempo , Resultado do TratamentoRESUMO
KEY MESSAGE: The resistance to Diamondback moth insect in cabbage is governed by many minor loci in quantitative nature, and at least four genetic loci should be incorporated in marker-assisted breeding program for developing partially resistant DBM cabbage cultivars. The Diamondback moth (DBM), Plutella xylostella (L.), is the most destructive insect infesting cruciferous plants worldwide. Earlier studies have reported that the glossy leaves of cabbage are associated with resistance to this insect. However, until now, genetics of DBM resistance has not been studied in detail, and no QTL/gene mapping for this trait has been reported. In this paper, we report quantitative trait loci (QTL) mapping of DBM-resistant trait using 188 randomly selected segregating F 3 population derived from crossing a partially DBM-resistant glossy leaf cabbage (748) with a susceptible smooth cabbage line (747). Quantitative trait loci mapping using phenotypic data of four consecutive years (2008, 2009, 2010, and 2011) on DBM insect infestation detected a total of eight QTL on five linkage groups suggesting that DBM resistance is a quantitative in nature. Of these QTL, four QTL, i.e., qDbm 1 on LG1, qDbm5 and qDbm6 on LG7, and qDbm8 on LG9, were detected in different tests and years. The QTL, qDbm6 on LG7, was consecutively detected over 3 years. Tightly linked molecular markers have been developed for qDbm8 QTL on LG9 which could be used in marker-assisted breeding program. Our research demonstrated that for desired DBM resistance cultivar breeding, those four genetic loci have to be taken into consideration. Furthermore, the comparative study revealed that DBM resistance QTL is conserved between close relative model plant Arabidopsis thaliana and Brassica oleracea genome.
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Brassica/genética , Mapeamento Cromossômico , Herbivoria , Mariposas , Locos de Características Quantitativas , Animais , Cruzamento , Ligação Genética , Marcadores Genéticos , FenótipoRESUMO
PURPOSE: We aimed to explore the perceived timeliness of referral to hospice palliative care unit (HPCU) among bereaved family members in Korea and factors associated therewith. METHODS: Cross-sectional questionnaire survey was performed for bereaved family members of patients who utilized 40 designated HPCUs across Korea. The questionnaire assessed whether admission to the HPCU was "too late" or "appropriate" and the Good Death Inventory (GDI). RESULTS: A total of 383 questionnaires were analyzed. Of participants, 25.8 % replied that admission to HPCU was too late. Patients with hepatobiliary cancer, poor performance status, abnormal consciousness level, and unawareness of terminal status were significantly related with the too late perception. Family members with younger age and being a child of the patient were more frequently noted in the too late group. Ten out of 18 GDI scores were significantly lower in the too late group. Multiple logistic regression analysis revealed patients' unawareness of terminal status, shorter stay in the HPCU, younger age of bereaved family, and lower scores for two GDI items (staying in a favored place, living without concerning death or disease) were significantly associated with the too late group. CONCLUSIONS: To promote timely HPCU utilization and better quality of end of life care, patients need to be informed of the terminal status and their preference should be respected.
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Família/psicologia , Cuidados Paliativos na Terminalidade da Vida/estatística & dados numéricos , Neoplasias/terapia , Cuidados Paliativos/estatística & dados numéricos , Inquéritos e Questionários , Adulto , Idoso , Estudos Transversais , Feminino , Hospitais para Doentes Terminais , Humanos , Masculino , Pessoa de Meia-Idade , Percepção , Inventário de Personalidade , Encaminhamento e Consulta/estatística & dados numéricos , República da Coreia , Percepção do TempoRESUMO
Introduction: Previous studies on adolescent smoking cessation behavior based on the transtheoretical model have primarily focused on the development of cessation programs. Attempting to quit smoking is a prerequisite for executing smoking cessation. Appropriate methods must be selected based on the characteristics and intentions of individuals to increase smokers' satisfaction and success rates in quitting. Therefore, this study aimed to identify changing processes influencing the stages of change associated with successful smoking cessation among adolescents and examined the related factors. This descriptive study explored a transtheoretical model of different stages of changes in smoking cessation behavior among adolescent smokers. Methods: The participants included 237 middle and high school students in South Korea. We examined the differences in stages of changes in smoking cessation behaviors based on general characteristics, smoking-related characteristics, smoking cessation change processes (cognitive and behavioral), smoking decisional balance (pros and cons of smoking), and self-efficacy. Results: The probability of reaching the preparation stage of smoking cessation was significantly lower among participants who did not know their father's educational level than among those who knew their father's educational level. Conversely, this probability was significantly higher among participants whose mothers had a college or higher education level and those who did not know their mother's educational level than in those whose mothers had a high school or lower education level. Conclusion: These findings indicated that parental education is a significant predictor of the preparation stage of smoking cessation, highlighting the importance of the family environment in facilitating smoking cessation among adolescents. Accordingly, communication and support at home could help reinforce adolescents' determination to quit smoking and make relevant plans. Thus, smoking cessation support should stress the need to enhance communication at home.
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Abandono do Hábito de Fumar , Modelo Transteórico , Humanos , Abandono do Hábito de Fumar/psicologia , Abandono do Hábito de Fumar/estatística & dados numéricos , Adolescente , Masculino , Feminino , República da Coreia , Comportamento do Adolescente/psicologia , Inquéritos e Questionários , Autoeficácia , Fumar/psicologia , IntençãoRESUMO
Introduction: Humanized mouse models to recapitulate human biological systems still have limitations, such as the onset of lethal graft-versus-host disease (GvHD), a variable success rate, and the low accessibility of total body irradiation (TBI). Recently, mice modified with the CD47-SIRPA axis have been studied to improve humanized mouse models. However, such trials have been rarely applied in NOD mice. In this study, we created a novel mouse strain, NOD-CD47nullRag2nullIL-2rγnull (RTKO) mice, and applied it to generate humanized mice. Methods: Four-week-old female NOD-Rag2nullIL-2rγnull (RID) and RTKO mice pre-conditioned with TBI or busulfan (BSF) injection were used for generating human CD34+ hematopoietic stem cell (HSC) engrafted humanized mice. Clinical signs were observed twice a week, and body weight was measured once a week. Flow cytometry for human leukocyte antigens was performed at intervals of four weeks or two weeks, and mice were sacrificed at 48 weeks after HSC injection. Results: For a long period from 16 to 40 weeks post transplantation, the percentage of hCD45 was mostly maintained above 25% in all groups, and it was sustained the longest and highest in the RTKO BSF group. Reconstruction of human leukocytes, including hCD3, was also most prominent in the RTKO BSF group. Only two mice died before 40 weeks post transplantation in all groups, and there were no life-threatening GvHD lesions except in the dead mice. The occurrence of GvHD has been identified as mainly due to human T cells infiltrating tissues and their related cytokines. Discussion: Humanized mouse models under all conditions applied in this study are considered suitable models for long-term experiments based on the improvement of human leukocytes reconstruction and the stable animal health. Especially, RTKO mice pretreated with BSF are expected to be a valuable platform not only for generating humanized mice but also for various immune research fields.
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Bussulfano , Transplante de Células-Tronco Hematopoéticas , Células-Tronco Hematopoéticas , Camundongos Endogâmicos NOD , Camundongos Knockout , Condicionamento Pré-Transplante , Animais , Bussulfano/farmacologia , Humanos , Camundongos , Transplante de Células-Tronco Hematopoéticas/métodos , Condicionamento Pré-Transplante/métodos , Células-Tronco Hematopoéticas/metabolismo , Feminino , Subunidade gama Comum de Receptores de Interleucina/genética , Subunidade gama Comum de Receptores de Interleucina/deficiência , Doença Enxerto-Hospedeiro/prevenção & controle , Doença Enxerto-Hospedeiro/imunologia , Modelos Animais de Doenças , Irradiação Corporal TotalRESUMO
A paleoparasitological survey to detect helminth eggs was performed in archaeological sites of Jeolla-do and Jeju-do, the Republic of Korea. Total 593 soil samples were collected in 12 sites of Jeolla-do and 5 sites of Jeju-do from April to November 2011, and examined by the methods of Pike and coworkers. A total of 4 helminth eggs, 2 eggs each for Trichuris trichiura and Ascaris sp., were found in soil samples from 1 site, in Hyangyang-ri, Jangheung-eup, Jangheung-gun, Jeollanam-do. The egg-recovery layer was presumed to represent a 19th century farm, which fact suggested the use of human manures. This is the third archaeological discovery of parasite eggs in Jeolla-do. Additionally, no helminth eggs in archaeological sites of Jeju-do is an interesting problem to be solved in the further investigations.
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Arqueologia , Ascaris/isolamento & purificação , Paleontologia , Parasitologia/história , Solo/parasitologia , Trichuris/isolamento & purificação , Animais , Ascaris/classificação , História Antiga , Humanos , Óvulo/classificação , Contagem de Ovos de Parasitas , República da Coreia , Trichuris/classificaçãoRESUMO
The COVID-19 pandemic has been one of the worst infectious disasters in human history. The best way to minimize COVID-19 transmission is to follow preventive measures. This study aimed to examine the factors influencing adolescents' COVID-19 prevention behaviors. The study was conducted online from 1 to 15 February 2023 with 196 adolescents aged between 13 and 18 years of age. The collected data were analyzed using descriptive statistics, Pearson's correlation, the independent t-test, analysis of variance (ANOVA), and multiple hierarchical regression analysis. Adolescents' COVID-19 prevention behaviors were influenced by intrapersonal factors, such as knowledge of and attitudes toward COVID-19, and interpersonal factors, such as social support. Community and governmental factors had no impact. Public health education strategies should be planned to include friends and family members in programs for preventing new infectious diseases such as COVID-19 so that adolescents can learn and share what they have learned, correct wrong behavior, and understand and change infection prevention behavior. In addition, it is necessary to actively support the development of public health education with appropriate contents in accordance with the characteristics and preferences of adolescents.
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Introduction: Adolescents may perpetrate cyberbullying in cyberspace, which they perceive as a medium of social communication, and cyberbullying perpetration is closely related to adolescent behavior, mental health, and development. This study aimed to examine the relationship of certain factors related to cyberbullying in adolescents using the framework of Jessor's problem behavior theory. Methods: This cross-sectional study investigated the mediating effect of adolescent self-esteem and smartphone addiction in the relationship between positive parenting and adolescent cyberbullying perpetration. The secondary analysis used data from the 2018 Korean Children and Youth Panel Survey. The data on positive parenting, adolescent self-esteem, smartphone addiction, and perpetration of cyberbullying of 2,394 Korean adolescents (boys: 1,297, 54.2%) were analyzed. Hayes' PROCESS macro program was used to confirm the mediating role. Results: The results revealed that 26.5% (n = 634) of adolescents had perpetrated cyberbullying. Positive parenting did not directly relate to cyberbullying perpetration. Adolescent self-esteem and smartphone addiction played a mediating role between positive parenting and adolescent cyberbullying. Discussion: Individual adolescent characteristics and parent/family system characteristics should be considered in policies aimed at preventing adolescent cyberbullying perpetration, preceded by the management of appropriate smartphone use. Improving young people's self-esteem and teaching them how to use smartphones correctly can help prevent cyberbullying.
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As the portion of older adults in the population in rural areas of South Korea exceeds 20%, the importance of health-related quality of life is increasing. The aim of the study was to examine the health-related quality of life through the ecological model and its basic determining factors for older adults. The study was conducted on 184 respondents aged 65 and over living in rural areas of South Korea. The measurements were health-related quality of life, health care service needs, sleep quality, social support, and personal characteristics. The collected data were tested using descriptive, t-test, ANOVA, and hierarchical multiple regression. The results showed that older adults in rural areas experienced a low quality of life. Religion, having a helper, and social support were significantly related to health-related quality of life in older adults. This directly shows that the government should make efforts to build a social support system to improve the gap between urban and rural areas. To improve the health-related quality of life of older adults in rural areas, it would be helpful to increase physical activity and to form a community, leading to a social network.
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Qualidade de Vida , População Rural , Idoso , Humanos , República da Coreia/epidemiologia , Apoio SocialRESUMO
This study aims to examine the relationship between intrapersonal factors, interpersonal factors, smartphone screen time, and the moderating roles of interpersonal factors, on the basis of the ecological model. This study is a cross-sectional and descriptive study. A total of 428 participants from four public middle schools were selected through convenience sampling (55.1% female; Mean age 13.0 ± 0.78). Data were collected through self-report questionnaires that contained questions about sociodemographic characteristics, intrapersonal factors (types of smartphone use, Fear of missing out-FoMO), interpersonal factors (support from parents, teachers, and peers), and smartphone screen time. The collected data were analysed using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients, and hierarchical regression. The daily smartphone screen time was 4.05 ± 2.16 h. Results showed that social media (ß = 0.155), games (ß = 0.140), and FoMO (ß = 0.227) were positively associated with smartphone screen time, while educational videos (ß = -0.130) and parental support (ß = -0.212) were negatively associated with smartphone screen time. Peers support moderated the association between games and smartphone screen time. Parental support moderated the association between educational videos, videos/movies/TV, and smartphone screen time. The findings highlight the direct and interactive roles of intrapersonal and interpersonal factors in predicting adolescents' smartphone screen time. Based on this study, the intrapersonal and interpersonal factors of adolescents should be comprehensively considered to intervene in their proper smartphone use.
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Tempo de Tela , Smartphone , Apoio Social , Adolescente , Criança , Estudos Transversais , Medo , Feminino , Humanos , Masculino , República da CoreiaRESUMO
The present study used a cross-sectional, descriptive survey design to investigate the influencing factors of COVID-19-related infection prevention behaviors of workers in the automobile manufacturing sector. An online survey was conducted on 157 workers in the automobile manufacturing sector of a company in Korea. We analyzed the collected data using SPSS to test whether there were significant differences in COVID-19 risk perception, crisis communication, health literacy, and infection prevention behaviors according to the general characteristics of the participants. An independent sample t-test and a one-way analysis of variance (ANOVA) were performed. A Pearson's correlation analysis was performed to identify the correlations among COVID-19 risk perception, crisis communication, health literacy, and infection prevention behaviors. Multiple regression analysis was performed to identify the influencing factors of COVID-19 infection prevention behaviors. The regression model was found to be significant, and the employment period at current job, COVID-19 prevention education, source of information, COVID-19 risk perception, crisis communication, and health literacy were also found to be significant. Among the demographic variables, employment period at current job of 5−10 years showed a higher level of infection prevention behaviors than that of <5 years. Moreover, the level of infection prevention behaviors was also significantly higher when COVID-19-related information was acquired through the KDCA/health center. Higher COVID-19 risk perception, crisis communication, and health literacy were associated with significantly higher levels of infection prevention behaviors. Therefore, based on the results, health managers need to develop programs and educate and improve information comprehension and crisis communication skills in order to promote workers' infection prevention behaviors of emerging infectious diseases in an era of global change.
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PURPOSE: To investigate the association between smoking behavior in out-of-school youths (OSY) and individual, interpersonal, and organizational factors through an ecological model. METHODS: Participants were 297 OSY aged 13-18 years, who visited J area's counseling center. The independent variables were self-control (intrapersonal factor), parental attachment and social network (interpersonal factors), and exposure to no-smoking policy (community factor). The dependent variable was smoking. Descriptive statistics, χ2-tests, correlation analyses, and logistic regression analysis were performed. RESULTS: The predictors of smoking in OSY were analyzed using demographic, intrapersonal, interpersonal, and community factors. Period after discontinuation of school, self-control, parental attachment, and friends' smoking behavior were significant predictors. Smoking behavior was found to decrease when the period after discontinuation of school was over than one year, when the parents attachment increased and when self-control increased. Conversely, smoking increased when friends' smoking increased. CONCLUSIONS: When administering smoking prevention programs for OSY, parental attachment and psychological traits, such as self-control, should be taken into consideration. Therefore, for effective results, such programs need to strengthen self-control, stress the importance of parental attachment through parent education, and enroll adolescents along with their friends who smoke. Implications and Contribution: Based on an ecological model, this descriptive survey, conducted to investigate the association between smoking behavior among out-of-school youths and individual, interpersonal, and organizational factors, proposes that smoking prevention programs should consider parental attachment and psychological traits, including self-control, for optimal effectiveness.
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Comportamento do Adolescente , Fumar , Adolescente , Amigos , Humanos , Instituições Acadêmicas , Fumar/epidemiologia , Prevenção do Hábito de FumarRESUMO
13 nm-sized highly-dispersible TiO2 nanoparticle was synthesized by solvothermal reaction of titanium isopropoxide in a basic condition with tetrabutylammonium hydroxide (TBAH). The prepared TiO2 nanoparticle was applied to fabrication of the transparent nanoporous TiO2 layer with 1.2 microm-thickness. By introducing this buffer layer between FTO and main TiO2 layer in the dye-sensitized solar cell (DSSC), the photovoltaic conversion efficiency was improved from 5.92% to 7.13%. Due to the excellent antireflective role of nanoporous TiO2 buffer layer, the transmittance of FTO glass was increased by 9.2%, and this seemed to be one of the major factors in enhancing photovoltaic conversion efficiency. Moreover, the presence of nanoporous TiO2 buffer layer induces excellent adhesion between FTO and main TiO2 layer, as well as it suppresses the back reaction by blocking direct contact between I3- and FTO electrode.
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To analyze the pattern of multiple mutations detected by Sanger sequencing (SS), we performed subcloning sequencing using 218 samples from 45 patients with tyrosine kinase inhibitor resistant chronic myeloid leukemia. At the first time of multiple mutation detection by SS (baseline), a total of 19 major mutations from 45 samples were detected; these mutations were found in the following order: T315I (68.9%), E255 K (33.3%), Y253H (13.3%), G250E (13.3%), and F317 L (11.1%). Subcloning sequencing of 900 baseline colonies identified 556 different mutant types, and 791 among the 900 were colonies with major mutations (87.9%). The mutations were found in the following order: T315I (36.4%), E255 K (16.2%), Y253H (7.0%), G250E (6.7%), M351 T (6.6%), and E255 V (5.3%). In subcloning sequencing with 4357 colonies of 218 serial samples, 2506 colonies (57.5%) had compound mutations, among which 2238 colonies (89.3%) had at least one major mutation. The median number of mutations in compound mutant colonies was 2 (range, 2-7), and most were double (52.9%) or triple (28.7%) mutations. Additionally, some mutations in allosteric binding sites were detected as low level mutation in 13 patients. With the available retrospective samples before baseline, subcloning sequencing identified low-level mutations of various frequencies (median, 10%) to be major mutations in 20 patients. Thus, compound mutations involving T315I and P-loop mutations were the major components of multiple mutations, and some low-level mutations with potential clinical significance were detected by subcloning sequencing. Hence, more sensitive sequencing assays are needed in patients with multiple mutations.
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Resistencia a Medicamentos Antineoplásicos/genética , Proteínas de Fusão bcr-abl/genética , Leucemia Mielogênica Crônica BCR-ABL Positiva/genética , Mutação , Inibidores de Proteínas Quinases/farmacologia , Adolescente , Adulto , Idoso , Alelos , Antineoplásicos/farmacologia , Clonagem Molecular , Feminino , Proteínas de Fusão bcr-abl/química , Expressão Gênica , Humanos , Leucemia Mielogênica Crônica BCR-ABL Positiva/diagnóstico , Leucemia Mielogênica Crônica BCR-ABL Positiva/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
We conducted this study to identify the factors for predicting poor outcomes in chronic myeloid leukemia patients who failed to achieve a 3-month early molecular response (EMR). Of the 413 newly diagnosed, chronic phase, chronic myeloid leukemia patients receiving imatinib (IM), 120 (29.1%) failed to achieve a 3-month EMR. With a median follow-up of 67.0 months, 39 patients continued IM treatment with at least complete cytogenetic response (CCyR), and 81 patients permanently discontinued IM treatment. The cumulative incidence rates of CCyR and major molecular response (MMR) by 3 years were 90.1 ± 3.9% and 53.7 ± 7.3%, respectively. After adjusting for potential factors, multivariate analyses showed that a transcript type of e13a2, compared with e14a2, and a larger spleen size were independent factors for failure of overall MMR. The predictive factors outlined in this study may provide valuable information for high-risk patients who would benefit from early decision-making regarding therapy change.
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Proteínas de Fusão bcr-abl/genética , Leucemia Mieloide de Fase Crônica/genética , Leucemia Mieloide de Fase Crônica/patologia , Esplenomegalia , Transcrição Gênica , Adolescente , Adulto , Idoso , Antineoplásicos/uso terapêutico , Feminino , Humanos , Mesilato de Imatinib/uso terapêutico , Leucemia Mieloide de Fase Crônica/tratamento farmacológico , Leucemia Mieloide de Fase Crônica/mortalidade , Masculino , Pessoa de Meia-Idade , Prognóstico , Inibidores de Proteínas Quinases/uso terapêutico , Fatores de Tempo , Falha de Tratamento , Resultado do Tratamento , Adulto JovemRESUMO
The present study aimed to assess the clinical impact of BCR-ABL1 transcript levels determined at an earlier time point than the 3-month early molecular response (EMR) in chronic-phase chronic myeloid leukemia (CML-CP) patients. BCR-ABL1 transcript levels of CML-CP patients (n = 258; median age, 43 [range, 18-81] years) treated with various tyrosine kinase inhibitors (TKIs) were determined at 4 weeks (28 ± 3 days) and at every 3 months of treatment initiation. At 4 weeks, receiver operating characteristic curves revealed that cutoff values of BCR-ABL1 transcripts for achieving major molecular responses (MMRs) by 12 and 60 months were 40.89% and 39.16%, respectively (95% CI, 0.658-0.772 and 95% CI, 0.643-0.758; P < 0.0001). With 40% of BCR-ABL1 transcripts at 4 weeks (very early MR; VEMR), patients with VEMR achieved higher 3-month EMR and 4-week VEMR significantly associated with higher cumulative incidences of 5-year MMR (89.1% vs 72.3%; P < 0.001) and 5-year deep molecular response (DMR) (56.5% vs 29.4%; P = 0.001). Furthermore, event-free survival (EFS)-a (93.0% vs 84.8%; P = 0.068) and EFS-b (71.1% vs 57.9%; P = 0.061) by 5 years were also marginally significant. VEMR and 3-month EMR were achieved in 89 patients, with significantly superior outcomes. In multivariate analyses, lower leukocyte count (P = 0.008) and frontline second-generation TKI therapy size (P < 0.001) were significantly associated with VEMR achievement, but not baseline BCR-ABL1 level and CML duration. In conclusion, the 4-week BCR-ABL1 transcript levels including VEMR could be important to predict long-term outcomes and may provide additional information about innate intrinsic sensitivity to CML among individuals.
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Proteínas de Fusão bcr-abl/genética , Leucemia Mielogênica Crônica BCR-ABL Positiva/tratamento farmacológico , Inibidores de Proteínas Quinases/administração & dosagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Regulação Neoplásica da Expressão Gênica/efeitos dos fármacos , Humanos , Leucemia Mielogênica Crônica BCR-ABL Positiva/genética , Contagem de Leucócitos , Masculino , Pessoa de Meia-Idade , Prognóstico , Inibidores de Proteínas Quinases/farmacologia , Análise de Sobrevida , Resultado do Tratamento , Adulto JovemRESUMO
BACKGROUND/AIMS: The aim of this study was to identify the role of BCR-ABL1 transcript level as a predictor for post-transplant relapse and outcome in patients who underwent allogeneic stem cell transplantation (SCT) for chronic phase (CP) chronic myeloid leukemia (CML). METHODS: Of 101 patients receiving allograft in CML CP, 85 had available quantitative reverse transcriptase polymerase chain reaction data at post-transplant 3 months. These patients were divided into two groups according to molecular response (MR4.5), defined as a BCR-ABL1 transcript level ≤ 0.0032% on the international scale, at 3 months based on receiver operating characteristic curve analysis of relapse. RESULTS: The 4-year overall survival and event-free survival (EFS) were 80.6% and 57.3%, respectively, and the cumulative incidence of relapse at 4 years was 29.6% after a median follow-up of 126.4 months. We performed multivariate analyses including potential variables to evaluate the early predictive role of MR4.5 at 3 months and found that MR4.5 at 3 months was associated with a higher EFS (p = 0.028) and showed a trend for a lower relapse rate (p = 0.089). CONCLUSIONS: our results imply that frequent molecular monitoring and immune suppressive therapy modulation are required for patients without reduction of BCR-ABL1 transcripts to this level after SCT.
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Biomarcadores Tumorais/genética , Proteínas de Fusão bcr-abl/genética , Leucemia Mielogênica Crônica BCR-ABL Positiva/genética , Leucemia Mielogênica Crônica BCR-ABL Positiva/cirurgia , Transplante de Células-Tronco , Adolescente , Adulto , Área Sob a Curva , Intervalo Livre de Doença , Quimioterapia Combinada , Feminino , Doença Enxerto-Hospedeiro/etiologia , Humanos , Imunossupressores/uso terapêutico , Estimativa de Kaplan-Meier , Leucemia Mielogênica Crônica BCR-ABL Positiva/diagnóstico , Leucemia Mielogênica Crônica BCR-ABL Positiva/metabolismo , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Valor Preditivo dos Testes , Modelos de Riscos Proporcionais , Curva ROC , Recidiva , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Fatores de Risco , Transplante de Células-Tronco/efeitos adversos , Transplante de Células-Tronco/mortalidade , Fatores de Tempo , Transplante Homólogo , Resultado do Tratamento , Adulto JovemRESUMO
To explore the factors for achieving early molecular responses (EMR; BCR-ABL1 ≤10% at 3 months, ≤1% at 6 months) by imatinib (IM), baseline characteristics including individual BCR-ABL1 transcript level, dose intensity, and IM trough level on day 29 were analyzed in 286 chronic phase chronic myeloid leukemia patients. Distinct predictive factors for achieving EMR at 3 months and 6 months were noted. Blast count at diagnosis and IM trough level on day 29 were significantly associated with an achievement of 3-month EMR. Early decline of BCR-ABL1 transcript, low Sokal risk, and mean daily dose (≥350mg/day) by 6 months were associated with an achievement of 6-month EMR. Understanding the predictive factors for EMR may provide additional information to guide clinical decisions on the changing therapies at each landmark.
Assuntos
Antineoplásicos/uso terapêutico , Benzamidas/uso terapêutico , Biomarcadores Tumorais/genética , Leucemia Mielogênica Crônica BCR-ABL Positiva/tratamento farmacológico , Piperazinas/uso terapêutico , Pirimidinas/uso terapêutico , Adolescente , Adulto , Idoso , Feminino , Seguimentos , Proteínas de Fusão bcr-abl/genética , Humanos , Mesilato de Imatinib , Leucemia Mielogênica Crônica BCR-ABL Positiva/genética , Leucemia Mielogênica Crônica BCR-ABL Positiva/mortalidade , Leucemia Mielogênica Crônica BCR-ABL Positiva/patologia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prognóstico , RNA Mensageiro/genética , Reação em Cadeia da Polimerase em Tempo Real , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Taxa de Sobrevida , Fatores de Tempo , Adulto JovemRESUMO
In the course of our search for Acyl-CoA: cholesterol acyltransferase (ACAT) inhibitors from natural sources, a new type of ACAT inhibitor was isolated from a methanol extract of Diospyros kaki. On the basis of spectral and structural evidence, the compound was identified as pheophorbide A-methyl ester. Pheophorbide A-methyl ester inhibited ACAT activity in a dose dependent manner with an IC50 value of 1.85 microg/mL.