Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.555
Filtrar
1.
Int J Biol Macromol ; 2020 Feb 11.
Artigo em Inglês | MEDLINE | ID: mdl-32057867

RESUMO

Octenyl succinic anhydride (OSA) modified gum arabic (GA) was synthesized and used as an emulsifier to stabilize cinnamon essential oil (CEO) emulsions. The structure and properties of chitosan based polyelectrolyte films incorporated with above OSA-GA stabilized CEO emulsions were investigated. Results showed that OSA modification introduced the hydrophobic groups, which greatly influenced the emulsification capability of GA. The antimicrobial activities of CEO emulsions were significantly enhanced by the synergistic effect of GA modification and ultrasonic treatment. When the proportions of CEO emulsion increased, the improved water barrier properties but deteriorated tensile properties of films were observed. The retention of CEO during storage was prolonged to 20 days and the release of CEO in food simulant was effectively inhibited as emulsion ratios increased to 20%, indicating the effectiveness of the system for CEO delivery. As a result, the antimicrobial activities of films significantly enhanced with the innovative incorporation of OSA-GA stabilized CEO emulsions.

2.
Biomed Pharmacother ; 125: 109568, 2020 Feb 10.
Artigo em Inglês | MEDLINE | ID: mdl-32058209

RESUMO

Long non-coding RNAs (lncRNAs) exert critical effects in the process of malignant cancers and lncRNA LOXL1 Antisense RNA 1 (LOXL1-AS1) has been demonstrated to be a pro-oncogene in multiple tumor types. In the current study, we illuminated the precise roles of LOXL1-AS1 in the development of ovarian cancer. LOXL1-AS1 is significantly overexpressed in ovarian carcinoma tissue compared with adjacent non-cancerous sample. The luciferase reporter gene assay reveals the relationship between LOXL1-AS1 and miR-18b-5p, miR-18b-5p and its target gene, Vacuolar ATPase Assembly Factor VMA21 (VMA21). Transfection of LOXL1-AS1 siRNA or miR-18b-5p mimics inhibits the growth and aggressive phenotypes of SKOV3 and OVCAR3 cell. Furthermore, miR-18b-5p suppresses ovarian carcinoma cell proliferation and metastasis by targeting VMA21 and LOXL1-AS1 regulates ovarian carcinoma cell growth and metastasis through sponging miR-18b-5p. These findings suggest that lncRNA LOXL1-AS1 promotes ovarian cancer cell growth, migratory and invasiveness via modulating miR-18b-5p/VMA21 axis.

3.
Sleep Med ; 69: 71-77, 2020 Jan 16.
Artigo em Inglês | MEDLINE | ID: mdl-32058229

RESUMO

OBJECTIVE: The association between sleep duration and general and abdominal obesity in adults, especially in the rural Chinese population, remains unclear. Therefore, we conducted this study to evaluate the association between sleep duration and general and abdominal obesity in rural Chinese adults. METHODS: We included 12,446 adults aged 18-75 years old who completed a baseline examination during 2007-2008 and follow-up during 2013-2014. We prospectively investigated the sleep-obesity association over an average of six-year follow-up. Multivariable logistic regression was performed to assess the probability of new-onset general and abdominal obesity, estimating odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: As compared with sleep duration 6.5-7.5 h, short sleep duration (<6.5 h) was significantly associated with increased probability of abdominal obesity in men (OR = 1.60, 95% CI: 1.05-2.45) after controlling for multiple covariates. A similar association was found in men aged >60 years but not in women or in men ≤60 years. We found no significant association between sleep duration and general obesity. The results were consistent when restricting the analysis to participants without cardiovascular disease, type 2 diabetes mellitus or cancer at baseline. CONCLUSIONS: Short sleep duration was significantly associated with abdominal obesity in rural Chinese adults, and the association varied by sex and age.

4.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 28(1): 153-159, 2020 Feb.
Artigo em Chinês | MEDLINE | ID: mdl-32027269

RESUMO

OBJECTIVE: To investigate the value of red blood cell distribution width (RDW) and fibrinogen (Fib) level for the evaluation of therapeutic efficacy and prognosis in patients with diffuse large B-cell lymphoma (DLBCL). METHODS: The relationship between RDW/Fib at initial diagnosis and efficacy and the clinical outcome was retro-spectively analyzed based on the study of 105 patients with DLBCL. The patients were divided into two groups: low RDW group (≤15%) and high RDW group (>15%), low Fib group (Fib≤4 g/L) and high Fib group (Fib>4 g/L) according to the normal values of RDW and Fib. Therapeutic efficacy, overall survival (OS) time and progression free survival (PFS) time were compared between two groups. The correlation between each factors and efficacy, prognosis was analyzed by univariate and multivariate regression. RESULTS: The therapeutic efficacy (P<0.001), OS time(P=0.004), and PFS time(P=0.007) were poorer in the high RDW group as compared with the low RDW group. The efficacy (P=0.015) and PFS time(P=0.04) were poorer in the high Fib group as compared with the low Fib group. Multivariate analysis showed that high RDW was the independent risk factor for efficacy of DLBCL patients (OR=3.394, 95% CI 1.093-10.539, P=0.035). CONCLUSION: High RDW and high Fib associate with poor efficacy in DLBCL patients.

5.
J Biol Chem ; 2020 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-32005667

RESUMO

Most of Gram-positive bacteria anchor surface proteins to the peptidoglycan cell wall by sortase, a cysteine transpeptidase that targets proteins displaying a cell wall sorting signal. Unlike other bacteria, Clostridium difficile, the major human pathogen responsible for antibiotic-associated diarrhea, has only a single functional sortase (SrtB). Sortase's vital importance in bacterial virulence has been long recognized, and C. difficile sortase B (Cd-SrtB) has become an attractive therapeutic target for managing C. difficile infection (CDI). A better understanding of the molecular activity of Cd-SrtB may help spur the development of effective agents against CDI. In this study, using site-directed mutagenesis, biochemical and biophysical tools, LC-MS/MS, and crystallographic analyses, we identified key residues essential for Cd-SrtB catalysis and substrate recognition. To the best of our knowledge, we report first evidence that a conserved serine residue near the active site participates in the catalytic activity of Cd-SrtB and also SrtB from Staphylococcus aureus The serine residue indispensable for SrtB activity may be involved in stabilizing a thioacyl-enzyme intermediate because it is neither a nucleophilic residue nor a substrate-interacting residue, based on the LC-MS/MS data and available structural models of SrtB-substrate complexes. Furthermore, we also demonstrated that residues 163-168 located on the ß6/ß7 loop of Cd-SrtB dominate specific recognition of the peptide substrate PPKTG. The results of this work reveal key residues with roles in catalysis and substrate specificity of Cd-SrtB.

6.
Cell Mol Immunol ; 2020 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-32005951

RESUMO

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

7.
J Hazard Mater ; 391: 122205, 2020 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-32045805

RESUMO

Up to now, the environmental damage by heavy metal is getting worse and worse as the development of industry. Meanwhile, hexavalent chromium (Cr(VI)) in wastewater get special attention as its acute toxicity and potential carcinogencity. To solve this problem, we introduce a simple and efficient way to prepare a photocatalyst, ZnIn2S4 grown on nitrogen-doped hollow carbon spheres (ZIS-NHC), which is an effective catalyst that can used to reduce aqueous Cr(VI). This photocatalyst prepared by a three-step strategy. Benefiting from the excellent electrical conductivity and high specific surface area of the NHC which is superior to other carbon material and the favorable band gap of ZnIn2S4 makes ZIS-NHC has superior light-driven photocatalytic efficiency. The ZIS-NHC exhibits an excellent rate of degradation of aqueous Cr(VI) at a concentration of 50 mg/L within 50 min. Moreover, the ZIS-NHC retained excellent stability after five rounds of cycling experiments which was also discussed.

8.
Plant Reprod ; 2020 Feb 13.
Artigo em Inglês | MEDLINE | ID: mdl-32055991

RESUMO

The funding section of the original publication gave a wrong funding number.

9.
Phytochemistry ; 172: 112282, 2020 Feb 06.
Artigo em Inglês | MEDLINE | ID: mdl-32036186

RESUMO

Seventeen highly oxygenated and rearranged limonoids, including nine previously undescribed phragmalin-type limonoids with 1,8,9- and 8,9,30-orthesters (entanutilins C-K, 1-9), three undescribed limonoids with rare rearranged-6/6/7/5 skeleton (entanutilins L-N, 10-12), and 5 known limonoids, were isolated from the stem barks of Entandrophragma utile from Ghana (Africa). Their structures including absolute configurations were elucidated based on comprehensive spectroscopic analyses, such as HRESIMS, 1D/2D-NMR, CD exciton chirality method, time-dependent density functional theory (TDDFT)/ECD calculations, and single-crystal X-ray diffraction. Bioactivity screenings suggested that some of these compounds effectively reversed resistance in MCF-7/DOX cells at a nontoxic concentration of 30 µM with 6- to 19-fold enhancing effects.

10.
Blood ; 2020 Feb 06.
Artigo em Inglês | MEDLINE | ID: mdl-32027741

RESUMO

Treatment-related mortality is common among children with acute lymphoblastic leukemia (ALL) treated in poor-resource settings. We applied a simplified flow-cytometric assay to identify patients with precursor B-cell ALL (B-ALL) at very low risk (VLR) of relapse and treated them with a reduced-intensity treatment plan (RELLA05). VLR criteria include favorable presenting features (age ≥1 and <10 years), white blood cell (WBC) count of <50 × 109/L, lack of extramedullary leukemia, and minimal residual disease (MRD) levels of <0.01% on remission induction day 19. Except for two doses of daunorubicin, treatment for patients with VLR B-ALL consisted of a combination of agents with a relatively low myelotoxicity profile, including corticosteroids, vincristine, L-asparaginase, methotrexate, and 6-mercaptopurine. Cyclophosphamide, systemic cytarabine, and CNS radiotherapy were not used. Of 454 patients with ALL treated at the Instituto de Medicina Integral Fernando Figueira in Recife, Brazil, between December 2005 and June 2015, 101 were classified as having VLR B-ALL. There were no cases of toxic death or treatment abandonment during remission induction. At a median follow-up of 6.6 years, there were eight major adverse events: six relapses, one treatment-related death (from septicemia) during remission, and one secondary myeloid leukemia. The estimated 5-year event-free and overall survival rates were 92.0% ± 3.9% and 96.0% ± 2.8%, respectively. The 5-year cumulative risk of relapse was 4.24% ± 2.0%. The treatment was well tolerated. Episodes of neutropenia were of short duration. Patients with B-ALL selected by a combination of presenting features and the degree of early response can be successfully treated with a mildly myelosuppressive chemotherapy regimen.

12.
Medicine (Baltimore) ; 99(7): e18763, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32049782

RESUMO

RATIONALE: Warthin's tumor is the second most common tumor arising from the parotid gland, but it rarely occurs concomitantly with tuberculous granulomatous inflammation with only 13 documented case reports in the English literature. PATIENT CONCERNS: An 82-year-old woman had a left infraauricular mass for approximately 3 years that had significantly increased in size over the previous 1 month. DIAGNOSES: A diagnosis of Warthin's tumor was made by ultrasonography (US)-guided core needle biopsy. Pathological examinations of the specimen obtained by total extirpation confirmed that the tumor was superimposed with tuberculous granuloma. INTERVENTIONS: The core biopsy wound did not heal and there was formation of a skin fistula tract with persistent discharge. During the operation with en bloc resection of the necrotic parotid tumor, adhesion between the branches of the facial nerve was too tight to allow preservation. OUTCOMES: A diagnosis of necrotic Warthin's tumor superimposed with tuberculous granuloma was made. Due to the high-clinical suspicion of tuberculosis (TB) due to Mycobacterium tuberculosis infection, anti-TB chemotherapy was given. LESSONS: Poor wound healing from a core biopsy and formation of a skin fistulous tract with persistent discharge should raise concern regarding potential extrapulmonary tuberculous infection. Although very rare, tuberculous granuloma concomitant with Warthin's tumor should be considered in the differential diagnosis of a parotid mass lesion. Adhesion of branches of the facial nerve should be expected, and sacrifice of the nerve may be planned. This consideration can be explained to the patient in preoperative counseling and planning. Anti-TB chemotherapy should be given in cases with a definite pathological report associated with speculative clinical presentation.

13.
J Nurs Scholarsh ; 2020 Feb 03.
Artigo em Inglês | MEDLINE | ID: mdl-32017388

RESUMO

PURPOSE: To determine whether illness perceptions, coping strategies, and sociodemographic and clinical variables are related to the quality of life (QoL) in adults with multiple chronic conditions (MCCs) living in China. DESIGN: By employing a cross-sectional design based on the transactional stress and coping theory, a convenience sample of adults with MCCs were recruited from a university-affiliated hospital between November 2017 and May 2018 in Northern Anhui, China. METHODS: A self-reported questionnaire, including the Brief Illness Perceptions Questionnaire, the Brief Coping Orientation to Problems Experienced inventory, and the Short Form Survey version 2, was administered. Sociodemographic and clinical data regarding MCCs were also collected. Descriptive statistics including frequencies, means, standard deviations, and correlation coefficients were calculated to examine the relationship between illness perceptions, coping, and QoL. Hierarchical multiple regression models were used to identify variables associated with physical and mental QoL. FINDINGS: A total of 351 participants (50% male) were recruited, with a mean age of 58.9 years (SD = 14.6). Of the participants, 83% had two chronic conditions. Participants reported impaired physical and mental QoL when compared with the general population in China. Poorer QoL was correlated with stronger illness perceptions of consequences and timeline and increased use of denial and disengagement and self-blame. Increasing age and more chronic conditions were associated with worse QoL. A higher education level was significantly associated with better physical and mental QoL. CONCLUSIONS: This study found that adults with MCCs living in China experienced impaired QoL. The strong relationship found between the participants' perceptions of MCCs, coping strategies, and QoL suggested that healthcare professionals should recognize the physical and psychological impacts of MCCs and address the significance of adaptations to MCCs in future treatment programs. The findings will help healthcare professionals design more specific interventions to modify illness perceptions and enhance certain coping strategies to improve the QoL of people with MCCs. Healthcare professionals can mobilize available resources from healthcare and social systems to enhance people's coping and adaptation to MCCs. CLINICAL RELEVANCE: With an understanding of the illness perceptions of people with MCCs, healthcare professionals could offer information related to consequences, timeline, and personal control to enable better alignment between people's expectations and their actual situations. By knowing people's coping strategies, healthcare professionals can offer additional support to people who prefer strategies of denial and disengagement and self-blame.

14.
Head Neck ; 2020 Jan 13.
Artigo em Inglês | MEDLINE | ID: mdl-31930772

RESUMO

BACKGROUND: Older age is one of the factors associated with malignant transformation of oral leukoplakia (OL). The purpose of this study is to analyze the clincopathological features and treatment outcomes of OL in the elderly patients. METHODS: The demographic data and histopathological results of the patients (age ≥ 65) who received carbon dioxide laser surgery for OL from 2002 to 2017 were analyzed statistically. RESULTS: There were 53 males and 16 females, with a mean age 71.2 ± 4.9. The follow-up time was 42.5 ± 35.2 months. In the univariate analysis, morphology, pathology, and area were found to be factors associated with postoperative recurrence. Among these factors, pathology and area were the independent predictive factors for recurrence in the multivariate logistic regression model. Malignant transformation occurred in 8 of 69 patients (11.6%). CONCLUSIONS: The pathological high-risk dysplasia and area of OL were the two prognostic factors for postoperative recurrence.

15.
Future Microbiol ; 2020 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-31989838

RESUMO

Aim: The global of spread multidrug-resistant Pseudomonas aeruginosa has become a public health threat. Cold atmospheric plasma (CAP) is reported to have bactericidal efficacy; however, its effects on clinical super multidrug-resistant P. aeruginosa are unclear. The aim of this study was to investigate the bactericidal efficacy of CAP on a strain of super multidrug-resistant P. aeruginosa. Materials & methods: The effects of CAP treatments were evaluated using assays for the detection of growth, viability, metabolism, virulence factors and reactive oxygen species (ROS) levels. Results: Both CAP treatments dose-dependently inhibited cell viability and metabolic activity, and decreased the expression of several virulence factors. CAP treatment induced a significant increase in intracellular ROS levels, and ROS scavengers inhibited this effect. Conclusion: CAP treatment is a promising option for the clinical inhibition of multidrug-resistant P. aeruginosa, and the development of CAP technologies might be the key to solving the long-standing problem of drug-resistant bacteria.

16.
Food Funct ; 2020 Jan 23.
Artigo em Inglês | MEDLINE | ID: mdl-31971532

RESUMO

The beneficial effects of nonpolar DHA/EPA in triacylglycerol (TG) and ethyl ester (EE) forms as well as terrestrial phospholipids on physical fatigue have been widely reported. However, the results involving the effects were inconsistent, and the reason might be that the differences in physical fatigue induced by aerobic and anaerobic exercises were usually ignored. In addition, it has been reported the significant improvement of DHA/EPA esterified to phospholipids (DHA/EPA-PLs) on many fields but not physical fatigue. Therefore, the effects of DHA/EPA-PLs on physical fatigue induced by aerobic and anaerobic exercises were evaluated and compared with those of l-carnitine and astaxanthin using swimming and running exhaustion tests in mice, respectively. The results indicated that DHA/EPA-PLs and l-carnitine have significant effects on the performance of aerobic exercise, while astaxanthin had remarkable effects on the performance of anaerobic exercise. The possible underlying mechanisms indicated that DHA/EPA-PLs significantly promoted the carbohydrate and lipid metabolism as well as the mitochondrial respiratory chain and tricarboxylic acid cycle in muscles. The study presented a potential novel candidate or targeted dietary patterns for alleviating physical fatigue.

17.
Sleep Breath ; 2020 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-31919717

RESUMO

PURPOSE: Drug-induced sleep endoscopy (DISE) is useful in children with obstructive sleep apnea (OSA) that persists after adenotonsillectomy (AT), but its utility in surgically naïve children is unclear. We report polysomnography outcomes of surgically naïve children who underwent DISE-directed intervention because they were considered high risk for persistent OSA after adenotonsillectomy. METHODS: This study is a case series of 62 surgically naïve children with OSA who were considered high risk for persistence after AT and underwent DISE-directed intervention with pre- and postoperative polysomnography between 2012 and 2016. Analysis was performed with the paired t test. RESULTS: Children were on average 5.9 (± 5.5, 0.2-18.6) years old at the time of surgery, 68% male, 18% obese, and 60% white. Thirty-eight percent had a syndromic diagnosis: 19% trisomy 21, 11% hypotonic neuromuscular disorder, and 8% craniofacial condition. The remaining 62% were non-syndromic but underwent DISE because they had at least one risk factor for OSA persistence after AT (age > 7 years, black race, 1+ tonsils, obesity, and/or severe OSA). Forty-two percent underwent AT, while 58% underwent treatment other than AT, including 18% who had multilevel surgery. Children improved significantly in 4 out of 5 polysomnography parameters tested, including obstructive apnea-hypopnea index (oAHI; 22.2 to 7.2, p < 0.01) and oxygen nadir (82 to 87, p < 0.01). Thirty-eight (61%) had a postoperative oAHI < 5; 16 (21%) had a postoperative oAHI < 2. CONCLUSION: DISE resulted in intervention other than AT in 58% of surgically naïve children at high risk for persistent OSA after AT. DISE-directed intervention resulted in significant mean improvement in postoperative OSA.

18.
Life Sci ; 245: 117357, 2020 Jan 25.
Artigo em Inglês | MEDLINE | ID: mdl-31991180

RESUMO

AIMS: Schisandra is a good choice in Traditional Chinese Medicine for the therapy of cardiovascular diseases, but whether it contains a or some specific component (s) responsible these effects are still unclear. In the present study, we explored whether Schisantherin A (SCA) causes vasorelaxation in isolated rat thoracic aorta. MAIN METHODS: We selected SCA, one of the main monomers of lignans from Schisandra, to examine its vasorelaxant effect on the isolated rat thoracic aorta and also exploited several tool inhibitors to probe its underlying mechanisms. KEY FINDINGS: SCA produced relaxation concentration-dependently on the endothelium-intact (43.56 ± 2.17%) and endothelium-denuded thoracic aorta strips (18.76 ± 3.95%) pre-contracted by phenylephrine (PE). However, after treated with indomethacin or L-NAME, SCA showed only partial vasorelaxant effects. Whereas, this vasorelaxation by SCA was not changed with specific K+-channel inhibitors, i.e. barium chloride (BaCl2), 4-aminopyridine (4-AP), tetraethylamine (TEA), and glibenclamide. SCA had no effect on the aorta strips pre-contracted by PE in neither Ca2+-free nor CaCl2 conditions. But, in the Ca2+ free and high K+ environment, SCA partly abolished the vasocontraction induced by CaCl2. SIGNIFICANCE: It was the first report to demonstrate that SCA had endothelium-dependent and -independent vasorelaxant effects on the isolated rat thoracic aorta, and the underlying mechanisms might be involved into its promoting the production of nitric oxide (NO) and prostacyclin (PGI2), and inhibiting the voltage-dependent calcium channels (VDCCs) opening. This study may partially explain the use of Schisandra in cardiovascular diseases and facilitate further drug development as well.

19.
Plant Reprod ; 2020 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-31997012

RESUMO

KEY MESSAGE: Sperm cells can be isolated from the mature pollen grains of medicinal wild rice (Oryza officinalis) using an osmotic shock method, and the viable egg cells can be isolated by enzymatic digestion and mechanical dissection steps. Favorable alleles for rice breeding have been identified in natural cultivars and wild rice by association analysis of known functional genes with target trait performance. Transferring these genes from wild rice into cultivated rice varieties is one of the important objectives for rice breeders. The isolation of the sperm and egg cells of wild and cultivated rice is a prerequisite for the in vitro hybridization of distantly related cultivated rice and wild rice lines. Here, we provide a technical approach for isolating the sperm and egg cells of wild rice (Oryza officinalis). In this method, sperm cells were isolated from the mature pollen grains of medicinal wild rice (O. officinalis) according to an osmotic shock method. Additionally, viable O. officinalis egg cells were isolated following enzymatic digestion and mechanical dissection steps. Specifically, ovules were digested in an enzymatic solution containing pectinase and cellulase for 30 min, after which the ovule was cut into two halves. Three egg apparatus cells were released by gently applying pressure to the micropylar end. Generally, six or seven egg cells could be isolated from 20 ovules in 60 min. The same method was used to isolate zygotes from flowers at 24 h after pollination. This technology solved the difficulty of isolating sperm and egg cells in O. officinalis and allowed the isolated sperm and egg cells to be combined by in vitro hybridization of distantly related wild and cultivated rice lines.

20.
JAMA Oncol ; 2020 Jan 16.
Artigo em Inglês | MEDLINE | ID: mdl-31944221

RESUMO

Importance: A randomized clinical trial is needed to determine whether the second-generation Abl-tyrosine kinase inhibitor dasatinib is more effective than the first-generation inhibitor imatinib mesylate for childhood Philadelphia chromosome-positive acute lymphoblastic leukemia (ALL). Objective: To determine whether dasatinib given at a daily dosage of 80 mg/m2 is more effective than imatinib mesylate at a daily dosage of 300 mg/m2 to improve event-free survival of children with Philadelphia chromosome-positive ALL in the context of intensive chemotherapy without prophylactic cranial irradiation. Design, Setting, and Participants: This open-label, phase 3 randomized clinical trial was conducted at 20 hospitals in China. Enrollment occurred from January 1, 2015, through September 18, 2018, and randomization was stopped on October 4, 2018, when the early stopping criterion of the trial was met. Patients aged 0 to 18 years were recruited. Of the 225 patients with the diagnosis, 35 declined participation and 1 died before treatment, leaving 189 patients available for analysis. Data were analyzed from January 1 through August 4, 2019. Interventions: Patients were randomized to receive daily dasatinib (n = 92) or imatinib (n = 97) continuously for the entire duration of ALL therapy from the time of diagnosis made during remission induction to the end of continuation therapy. Main Outcomes and Measures: The primary outcome was event-free survival, analyzed based on intention to treat. The secondary outcomes were relapse, death due to toxic effects, and overall survival. Results: Among the 189 participants (136 male [72.0%]; median age, 7.8 [interquartile range (IQR), 5.2-11.3] years) and a median follow-up of 26.4 (IQR, 16.3-34.1) months, the 4-year event-free survival and overall survival rates were 71.0% (95% CI, 56.2%-89.6%) and 88.4% (95% CI, 81.3%-96.1%), respectively, in the dasatinib group and 48.9% (95% CI, 32.0%-74.5%; P = .005, log-rank test) and 69.2% (95% CI, 55.6%-86.2%; P = .04, log-rank test), respectively, in the imatinib group. The 4-year cumulative risk of any relapse was 19.8% (95% CI, 4.2%-35.4%) in the dasatinib group and 34.4% (95% CI, 15.6%-53.2%) in the imatinib group (P = .01, Gray test), whereas the 4-year cumulative risk of an isolated central nervous system relapse was 2.7% (95% CI, 0.0%-8.1%) in the dasatinib group and 8.4% (95% CI, 1.2%-15.6%) in the imatinib group (P = .06, Gray test). There were no significant differences in the frequency of severe toxic effects between the 2 treatment groups. Conclusions and Relevance: Intensive chemotherapy including dasatinib at a dosage of 80 mg/m2 per day yielded superior results in the treatment of Philadelphia chromosome-positive ALL compared with imatinib mesylate at a dosage of 300 mg/m2 per day and provided excellent control of central nervous system leukemia without the use of prophylactic cranial irradiation. Trial Registration: Chinese Clinical Trial Registry: ChiCTR-IPR-14005706.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA