Safety and efficacy of chimeric antigen receptor T-cell therapy for acute myeloid leukemia: A subgroup based meta-analysis.

INTRODUCTION: Acute myeloid leukemia (AML) is a significant hematological malignancy in the United States, with a high mortality rate and limited treatment options. CAR T-cell therapy, a new and promising treatment, is being investigated for its efficacy and safety in AML. This meta-analysis aims to assess the safety and efficacy of CAR T-cell therapy in AML, considering various subgroups such as study location, study design, prior transplantation status, conditioning regimen, and CAR T-cell source. METHODS: We conducted a comprehensive literature review across multiple databases, adhering to PRISMA guidelines and focusing on studies concerning CAR T-cell therapy in AML. We included original articles in English and excluded non-original reviews, abstracts, and non-English studies. The risk of bias was assessed using the Cochrane ROBINS-I tool. Statistical analysis involved meta-analysis with Cochrane's Q-test and I² statistic, using both fixed-effect and random-effects models, and assessed for publication bias. RESULTS: Our search yielded studies encompassing 57 AML patients treated with CAR T-cell therapy. The meta-analysis revealed a 48% incidence of complete remission with CAR T-cell therapy, varying significantly across subgroups based on study design, location, prior transplantation, conditioning regimen, and CAR T-cell source. The highest complete remission rates were observed in patients from China, those who had undergone prior hematopoietic cell transplantation, and those treated with fludarabine and cyclophosphamide conditioning regimen. Adverse events included graft-versus-host disease (7%) and cytokine release syndrome (53%). CONCLUSIONS: This meta-analysis highlights the potential of CAR T-cell therapy in AML treatment, especially when integrated with certain prior treatments and conditioning regimens. The findings suggest a higher efficacy in patients with previous hematopoietic cell transplantation and specific conditioning regimens. Further large-scale, randomized trials are essential to confirm these findings and establish CAR T-cell therapy as a standard treatment for AML.

Venous sinus stenting for idiopathic intracranial hypertension: An updated Meta-analysis.

BACKGROUND: Idiopathic intracranial hypertension (IIH) is characterized by elevated intracranial pressure and primarily affects obese women of reproductive age. Venous sinus stenting (VSS) is a surgical procedure used to treat IIH, but its safety and efficacy are still controversial. METHODS: A systematic review and meta-analysis were conducted following PRISMA guidelines. Multiple databases were searched for studies evaluating the safety and efficacy of VSS in IIH patients and meta-analysis was performed to pool the data. RESULTS: A total of 36 studies involving 1066 patients who underwent VSS were included. After VSS, a significant reduction in trans-stenotic gradient pressure was observed. Patients also showed significantly lower cerebrospinal fluid (CSF) opening pressure. Clinical outcomes demonstrated improvement in tinnitus (95%), papilledema (89%), visual disturbances (88%), and headache (79%). However, 13.7% of patients experienced treatment failure or complications. The treatment failure rate was 8.35%, characterized by worsening symptoms and recurrence of IIH. The complications rate was 5.35%, including subdural hemorrhage, urinary tract infection, stent thrombus formation, and others. CONCLUSION: VSS appears to be a safe and effective treatment option for IIH patients who are unresponsive to medical therapy or have significant visual symptoms. However, long-term outcomes and safety of the procedure require further investigation.

Screening for metabolic liver diseases crucial to increase SVR to patients with CHC.

Liver diseases and its complications is common health problem worldwide. The emergence of metabolic disorders as a cause after exclusion of viral hepatitis nowadays is important. This is retrospective study on 200 patient's age range from 6months to 18 years old (50 females and 150 males). The patients divided into 2 groups according to age < 5 years & >5 years and all investigations done was collected and statistically processed. Abdominal enlargement was observed in 166/200 of all patients, 48/166 (67.6%) in patients <5 years old and 118/166 (91.5%) in patients >5 years old with statistical significant, jaundice was present in 34/200 of patients, 23/34 (32.4%) in patients <5 years old and 11/34(8.5%) in patients >5 years old, with statistical significant difference, CBC was normal in 58/200 of all age groups. 10/58 (14.1%) in patients <5 years old, 48/58 (73.2%) in patients <5 years old, with statistical significant difference and abnormal CBC in 142/200 (61/142, 62.8%) in age group > 5 years old, 81/142 (85.9%) in age group <5 years. Metabolic disorders was normal in 124/200 of all age groups, 23/124 (32.4%) in patients <5 years old. Metabolic disorders was abnormal in 76/200 of all, 48/76(67.6%) in patients >5 years old and 28/76 (21.7%) in patients < 5 years old, with statistical significant difference & for both age groups. The sensitivity of modalities used in the diagnosis of liver disease was as follow for US, study of metabolic profile, abnormal liver functions and abnormal CBC, 83.1%, 65.2%, 61.6% and 66.1% consequently.