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Artigo em Inglês | MEDLINE | ID: mdl-34750085


BACKGROUND: Core binding factor acute myeloid leukemia (CBF-AML) belongs to favorable risk group in AML. However, approximately 50% of patients with CBF-AML remain incurable and their outcomes are also determined by the various co-occurring mutations. Though, FMS-like tyrosine kinase-3(FLT3) mutation in AML is associated with poor survival, the prevalence and prognostic significance of FLT3 mutations among CBF-AML is unknown. PATIENTS AND METHODS: We performed a systematic review and meta-analysis to assess the prevalence of FLT3 mutations (ITD and TKD) among patients with CBF-AML. The pooled prevalence of FLT3 mutations was estimated for patients with CBF-AML, t(8;21) and Inv(16). Pooled odds ratio was calculated to compare the prevalence of various FLT3 mutations within the 2 subsets of CBF-AML. A random effects model was adopted for analysis when heterogenicity existed (Pheterogenicity< 0.05 or I2 > 50%). Otherwise, a fixed effects model was used. RESULTS: The pooled prevalence of any FLT3 mutations among patients with CBF-AML was available from 18 studies and was 13% (95% CI: 10%-16%; I2 = 79%). Comparison of prevalence of FLT3 mutations between the 2 subgroups of CBF-AML showed that patients with t(8;21) had a higher prevalence of FLT3-ITD [pooled odds ratio(OR): 2.23 (95% CI:1.41-3.53, P < .01)] and lower prevalence of FLT3-TKD [pooled OR: 0.29 (95% CI:0.19-0.44; P < .01)] compared to patients with Inv(16). Additionally, we have discussed the prognostic significance of FLT3 mutations in CBF-AML patients. CONCLUSION: The prevalence of FLT3-TKD mutation was commoner among Inv(16) AML while FLT3-ITD mutation was commoner among t(8;21) AML. Uniform reporting of outcomes is essential to understand the prognostic significance of FLT3 mutations among CBF-AML.

Expert Opin Pharmacother ; 22(6): 755-767, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33350868


Introduction: Despite advances in surgical and anesthetic techniques, perioperative cardiovascular complications are a major cause of 30-day perioperative mortality. Major cardiovascular complications after noncardiac surgery include myocardial ischemia, congestive heart failure, arrhythmias, and cardiac arrest. Along with surgical risk assessment, perioperative medical optimization can reduce the rates and clinical impact of these complications.Areas Covered: In this review, the authors discuss the pharmacological basis, existing evidence, and professional society recommendations for drug management in preventing cardiovascular complications in patients undergoing noncardiac surgery.Expert opinion: Perioperative management of cardiovascular disease is an increasingly important and growing area of clinical practice. Societal guidelines regarding the use of most routine cardiovascular medications are based on a number of large clinical studies and provide a basic foundation to guide management. However, the heterogeneous nature of patients, as well as surgeries, makes it practically impossible to devise a 'one size fits all' recommendation in this setting. Thus, the importance of a more individualized approach to perioperative risk stratification and management is being increasingly recognized. The underlying comorbidities and cardiac profile as well as the risk of cardiac complications associated with the planned surgery must be factored in to understand the nuance of the management strategies.

Doenças Cardiovasculares , Cardiopatias , Isquemia Miocárdica , Preparações Farmacêuticas , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/prevenção & controle , Cardiopatias/etiologia , Cardiopatias/prevenção & controle , Humanos , Assistência Perioperatória , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/prevenção & controle
Pharmacogenomics ; 22(2): 67-71, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33305611


The Indo-Swiss symposium on advances in pharmacogenomic strategies for implementation of personalized medicine was conducted as a part of the JIPMER Integrated Pharmacogenomics Program (JIPP), held in Puducherry, India on 23 November 2019. The symposium focused on the growing contribution of pharmacogenomic information in designing treatment strategies and promoting better approaches to personalized medicine. The primary objective of this symposium was to bridge gaps in understanding the basics and recent advances in the field of pharmacogenomics. This symposium sought to promote interaction between the Indian and Swiss researchers to initiate future collaborative research projects. This symposium also served as a platform for young researchers to present their research findings as posters to the audience.

Farmacogenética , Medicina de Precisão , Humanos