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- Chatzikonstantinou, T, et al.
(författare)
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COVID-19 severity and mortality in patients with CLL: an update of the international ERIC and Campus CLL study
- 2021
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Ingår i: Leukemia. - : Springer Science and Business Media LLC. - 1476-5551 .- 0887-6924. ; 3635:312, s. 3444-3454
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Tidskriftsartikel (refereegranskat)abstract
- Patients with chronic lymphocytic leukemia (CLL) may be more susceptible to Coronavirus disease 2019 (COVID-19) due to age, disease, and treatment-related immunosuppression. We aimed to assess risk factors of outcome and elucidate the impact of CLL-directed treatments on the course of COVID-19. We conducted a retrospective, international study, collectively including 941 patients with CLL and confirmed COVID-19. Data from the beginning of the pandemic until March 16, 2021, were collected from 91 centers. The risk factors of case fatality rate (CFR), disease severity, and overall survival (OS) were investigated. OS analysis was restricted to patients with severe COVID-19 (definition: hospitalization with need of oxygen or admission into an intensive care unit). CFR in patients with severe COVID-19 was 38.4%. OS was inferior for patients in all treatment categories compared to untreated (p < 0.001). Untreated patients had a lower risk of death (HR = 0.54, 95% CI:0.41–0.72). The risk of death was higher for older patients and those suffering from cardiac failure (HR = 1.03, 95% CI:1.02–1.04; HR = 1.79, 95% CI:1.04–3.07, respectively). Age, CLL-directed treatment, and cardiac failure were significant risk factors of OS. Untreated patients had a better chance of survival than those on treatment or recently treated.
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| 6. |
- van Gelder, M. L., et al.
(författare)
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VLT/X-shooter spectroscopy of massive young stellar objects in the 30 Doradus region of the Large Magellanic Cloud
- 2020
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 636
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Tidskriftsartikel (refereegranskat)abstract
- The process of massive star (M >= 8 M-circle dot) formation is still poorly understood. Observations of massive young stellar objects (MYSOs) are challenging due to their rarity, short formation timescale, large distances, and high circumstellar extinction. Here, we present the results of a spectroscopic analysis of a population of MYSOs in the Large Magellanic Cloud. We took advantage of the spectral resolution and wavelength coverage of X-shooter (300-2500 nm), which is mounted on the European Southern Observatory Very Large Telescope, to detect characteristic spectral features in a dozen MYSO candidates near 30 Doradus, the largest starburst region in the Local Group hosting the most massive stars known. The X-shooter spectra are strongly contaminated by nebular emission. We used a scaling method to subtract the nebular contamination from our objects. We detect H alpha, beta, [OI] 630.0 nm, CaII, infrared triplet [FeII] 1643.5 nm, fluorescent FeII 1687.8 nm, H-2 2121.8 nm, Br gamma, and CO bandhead emission in the spectra of multiple candidates. This leads to the spectroscopic confirmation of ten candidates as bona fide MYSOs. We compared our observations with photometric observations from the literature and find all MYSOs to have a strong near-infrared excess. We computed lower limits to the brightness and luminosity of the MYSO candidates, confirming the near-infrared excess and the massive nature of the objects. No clear correlation is seen between the Br gamma luminosity and metallicity. Combining our sample with other LMC samples results in a combined detection rate of disk features, such as fluorescent FeII and CO bandheads, which is consistent with the Galactic rate (40%). Most of our MYSOs show outflow features.
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- Schetelig, J, et al.
(författare)
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Haplotype Motif-Based Models for KIR-Genotype Informed Selection of Hematopoietic Cell Donors Fail to Predict Outcome of Patients With Myelodysplastic Syndromes or Secondary Acute Myeloid Leukemia
- 2021
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Ingår i: Frontiers in immunology. - : Frontiers Media SA. - 1664-3224. ; 11, s. 584520-
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Tidskriftsartikel (refereegranskat)abstract
- Results from registry studies suggest that harnessing Natural Killer (NK) cell reactivity mediated through Killer cell Immunoglobulin-like Receptors (KIR) could reduce the risk of relapse after allogeneic Hematopoietic Cell Transplantation (HCT). Several competing models have been developed to classify donors as KIR-advantageous or disadvantageous. Basically, these models differ by grouping donors based on distinct KIR–KIR–ligand combinations or by haplotype motif assignment. This study aimed to validate different models for unrelated donor selection for patients with Myelodysplatic Syndromes (MDS) or secondary Acute Myeloid Leukemia (sAML). In a joint retrospective study of the European Society for Blood and Marrow Transplantation (EBMT) and the Center for International Blood and Marrow Transplant Research (CIBMTR) registry data from 1704 patients with secondary AML or MDS were analysed. The cohort consisted mainly of older patients (median age 61 years) with high risk disease who had received chemotherapy-based reduced intensity conditioning and anti-thymocyte globulin prior to allogeneic HCT from well-matched unrelated stem cell donors. The impact of the predictors on Overall Survival (OS) and relapse incidence was tested in Cox regression models adjusted for patient age, a modified disease risk index, performance status, donor age, HLA-match, sex-match, CMV-match, conditioning intensity, type of T-cell depletion and graft type. KIR genes were typed using high-resolution amplicon-based next generation sequencing. In univariable and multivariable analyses none of the models predicted OS and the risk of relapse consistently. Our results do not support the hypothesis that optimizing NK-mediated alloreactivity is possible by KIR-genotype informed selection of HLA-matched unrelated donors. However, in the context of allogeneic transplantation, NK-cell biology is complex and only partly understood. KIR-genes are highly diverse and current assignment of haplotype motifs based on the presence or absence of selected KIR genes is over-simplistic. As a consequence, further research is highly warranted and should integrate cutting edge knowledge on KIR genetics, and NK-cell biology into future studies focused on homogeneous groups of patients and treatment modalities.
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