ABSTRACT
Rearrangements in MLL (MLL-r) are common within very young children with leukemia and affect the prognosis and treatment. Previous studies have suggested the use of the NG2 molecule as a marker for MLL-r but these studies were performed using a small number of infants. We analyzed 148 patients (all less than 24 months, 86 less than 12 months) from various centers in Brazil to determine the predictive power of NG2 within that cohort. We show that NG2 can be used for MLL-r prediction; however, proper staff training and standardized sampling procedures are essential when receiving samples from multiple centers as the accuracy of the prediction varies greatly on a per center basis.
Subject(s)
Antigens/genetics , Gene Rearrangement , Leukemia, Myeloid, Acute/genetics , Myeloid-Lymphoid Leukemia Protein/genetics , Precursor Cell Lymphoblastic Leukemia-Lymphoma/genetics , Proteoglycans/genetics , Female , Histone-Lysine N-Methyltransferase , Humans , Immunophenotyping , Infant , Infant, Newborn , Leukemia, Myeloid, Acute/diagnosis , Leukemia, Myeloid, Acute/immunology , Male , Precursor Cell Lymphoblastic Leukemia-Lymphoma/diagnosis , Precursor Cell Lymphoblastic Leukemia-Lymphoma/immunology , Prognosis , ROC Curve , Sensitivity and SpecificityABSTRACT
OBJECTIVE: To compare the accuracy of 4 different indices of cardiac risk currently used for predicting perioperative cardiac complications. METHODS: We studied 119 patients at a university-affiliated hospital whose cardiac assessment had been required for noncardiac surgery. Predictive factors of high risk for perioperative cardiac complications were assessed through clinical history and physical examination, and the patients were followed up after surgery until the 4th postoperative day to assess the occurrence of cardiac events. All patients were classified according to 4 indices of cardiac risk: the Goldman risk-factor index, Detsky modified risk index, Larsen index, and the American Society of Anesthesiologists' physical status classification and their compared accuracies, examining the areas under their respective receiver operating characteristic (ROC) curves. RESULTS: Cardiac complications occurred in 16% of the patients. The areas under the ROC curves were equal for the Goldman risk-factor index, the Larsen index, and the American Society of Anesthesiologists' physical status classification: 0.48 (SEM +/- 0.03). For the Detsky index, the value found was 0.38 (SEM +/- 0.03). This difference in the values was not statistically significant. CONCLUSION: The cardiac risk indices currently used did not show a better accuracy than that obtained randomly. None of the indices proved to be significantly better than the others. Studies to improve our ability to predict such complications are still required.
Subject(s)
Heart Diseases/etiology , Intraoperative Complications/etiology , Postoperative Complications/etiology , Surgical Procedures, Operative/adverse effects , Adult , Aged , Aged, 80 and over , Epidemiologic Studies , Female , Humans , Male , Middle Aged , Prospective StudiesABSTRACT
OBJECTIVE: To compare the accuracy of 4 different indices of cardiac risk currently used for predicting perioperative cardiac complications. METHODS: We studied 119 patients at a university-affiliated hospital whose cardiac assessment had been required for noncardiac surgery. Predictive factors of high risk for perioperative cardiac complications were assessed through clinical history and physical examination, and the patients were followed up after surgery until the 4th postoperative day to assess the occurrence of cardiac events. All patients were classified according to 4 indices of cardiac risk: the Goldman risk-factor index, Detsky modified risk index, Larsen index, and the American Society of Anesthesiologists' physical status classification and their compared accuracies, examining the areas under their respective receiver operating characteristic (ROC) curves. RESULTS: Cardiac complications occurred in 16 percent of the patients. The areas under the ROC curves were equal for the Goldman risk-factor index, the Larsen index, and the American Society of Anesthesiologists' physical status classification: 0.48 (SEM ± 0.03). For the Detsky index, the value found was 0.38 (SEM ± 0.03). This difference in the values was not statistically significant. CONCLUSION: The cardiac risk indices currently used did not show a better accuracy than that obtained randomly. None of the indices proved to be significantly better than the others. Studies to improve our ability to predict such complications are still required