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Intern Med J ; 50(2): 214-221, 2020 02.
Article in English | MEDLINE | ID: mdl-32037713

ABSTRACT

BACKGROUND: The Townsville Hospital is a tertiary hospital in North Queensland with one of the largest regional transplant centres in Australia, performing primarily autologous haemopoietic stem cell transplants (HSCT) for various haematological malignancies. AIMS: This single-centre, retrospective, observational study aims to describe the activity and outcomes of autologous HSCT at The Townsville Hospital between 2003 and 2017 to verify safety standards. METHODS: Patient-level data were collected, including demographics, frequency and indication for transplant, conditioning, current clinical status and cause of death. Key outcomes included overall survival, non-relapse mortality, incidence of therapy-related neoplasm and causes of death. Progression-free survival in the multiple myeloma (MM) subgroup was also assessed. RESULTS: There were 319 autologous HSCT in 286 patients, with a median age of 58 years (range 14-71 years); 62% of patients were male. Indications for transplantation were: MM 53.7%, non-Hodgkin lymphoma 29.4%, Hodgkin lymphoma 5.0% and other 11.9%. Causes of death were: disease progression/relapse (65.2%), second malignancy (17.0%), infection (9.8%) and other (8.0%). Non-relapse mortality was 1.2% (95% confidence interval 0.4-3.0) and 3.2% (1.7-5.7) at 100 days and 1 year, respectively, post-HSCT. Overall survival at 2 years was 81.0% (73.8-86.4) for MM and 69.6% (58.8-78.1) for non-Hodgkin lymphoma. The median progression-free survival in the MM cohort was 3.3 years. CONCLUSION: The Townsville Hospital transplant centre provides an important transplant service in regional Queensland, with outcomes comparable to national data. We reported a relatively high rate of second malignancy as a cause of death.


Subject(s)
Hematopoietic Stem Cell Transplantation/mortality , Hodgkin Disease/surgery , Lymphoma, Non-Hodgkin/surgery , Multiple Myeloma/surgery , Adolescent , Adult , Aged , Disease-Free Survival , Female , Humans , Male , Middle Aged , Queensland/epidemiology , Retrospective Studies , Transplantation, Autologous , Young Adult
2.
Lipids Health Dis ; 12: 147, 2013 Oct 19.
Article in English | MEDLINE | ID: mdl-24139088

ABSTRACT

BACKGROUND: Consumption of marine-based oils high in omega-3 polyunsaturated fatty acids (n3PUFAs), eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) is known to protect against obesity-related pathologies. It is less clear whether traditional vegetable oils with high omega-6 polyunsaturated fatty acid (n6PUFA) content exhibit similar therapeutic benefits. As such, this study examined the metabolic effects of a plant-based n3PUFA, stearidonic acid (SDA), in polygenic obese rodents. METHODS: Lean (LZR) and obese Zucker (OZR) rats were provided either a standard westernized control diet (CON) with a high n6PUFA to n3PUFA ratio (i.e., 16.2/1.0) or experimental diet modified with flaxseed (FLAX), menhaden (FISH), or SDA oil that resulted in n6PUFA to n3PUFA ratios of 1.7/1.0, 1.3/1.0, and 1.0/0.8, respectively. RESULTS: After 12 weeks, total adiposity, dyslipidemia, glucose intolerance, and hepatic steatosis were all greater, whereas n3PUFA content in liver, adipose, and muscle was lower in OZR vs. LZR rats. Obese rodents fed modified FISH or SDA diets had lower serum lipids and hepatic fat content vs. CON. The omega-3 index (i.e., ΣEPA + DHA in erythrocyte membrane) was 4.0, 2.4, and 2.0-fold greater in rodents provided FISH, SDA, and FLAX vs. CON diet, irrespective of genotype. Total hepatic n3PUFA and DHA was highest in rats fed FISH, whereas both hepatic and extra-hepatic EPA was higher with FISH and SDA groups. CONCLUSIONS: These data indicate that SDA oil represents a viable plant-derived source of n3PUFA, which has therapeutic implications for several obesity-related pathologies.


Subject(s)
Adipose Tissue/drug effects , Fatty Acids, Omega-3/administration & dosage , Linseed Oil/administration & dosage , Liver/drug effects , Muscle, Skeletal/drug effects , Obesity/diet therapy , Soybean Oil/administration & dosage , Adipose Tissue/metabolism , Animals , Docosahexaenoic Acids/administration & dosage , Docosahexaenoic Acids/metabolism , Dyslipidemias/etiology , Dyslipidemias/metabolism , Eicosapentaenoic Acid/administration & dosage , Eicosapentaenoic Acid/metabolism , Erythrocyte Membrane/drug effects , Fatty Acids, Omega-3/metabolism , Fatty Acids, Omega-6/administration & dosage , Fatty Acids, Omega-6/metabolism , Fatty Liver/etiology , Fatty Liver/metabolism , Glucose Intolerance/etiology , Glucose Intolerance/metabolism , Linseed Oil/metabolism , Liver/metabolism , Male , Muscle, Skeletal/metabolism , Obesity/metabolism , Rats , Rats, Zucker , Soybean Oil/metabolism
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