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- Hellstrom-Lindberg, E., et al.
(författare)
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A validated decision model for treating the anaemia of myelodysplastic syndromes with erythropoietin + granulocyte colony-stimulating factor : Significant effects on quality of life
- 2003
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Ingår i: British Journal of Haematology. - : Wiley. - 0007-1048 .- 1365-2141. ; 120, s. 1037-
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Tidskriftsartikel (refereegranskat)abstract
- We have published previously a prototype of a decision model for anaemic patients with myelodysplastic syndromes (MDS), in which transfusion need and serum erythropoietin (S-Epo) were used to define three groups with different probabilities of erythroid response to treatment with granulocyte colony-stimulating factor (G-CSF) + Epo. S-Epo = 500 U/l and a transfusion need of < 2 units/month predicted a high probability of response to treatment, S-Epo > 500 U/l and =2 units/month for a poor response, whereas the presence of only one negative prognostic marker predicted an intermediate response. A total of 53 patients from a prospective study were included in our evaluation sample. Patients with good or intermediate probability of response were treated with G-CSF + Epo. The overall response rate was 42% with 28.3% achieving a complete and 13.2% a partial response to treatment. The response rates were 61% and 14% in the good and intermediate predictive groups respectively. The model retained a significant predictive value in the evaluation sample (P < 0.001). Median duration of response was 23 months. Scores for global health and quality of life (QOL) were significantly lower in MDS patients than in a reference population, and fatigue and dyspnoea was significantly more prominent. Global QOL improved in patients responding to treatment (P = 0.01). The validated decision model defined a subgroup of patients with a response rate of 61% (95% confidence interval 48-74%) to treatment with G-CSF + Epo. The majority of these patients have shown complete and durable responses.
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- Rantapää-Dahlqvist, Solbritt, et al.
(författare)
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Antibodies against cyclic citrullinated peptide and IgA rheumatoid factor predict the development of rheumatoid arthritis
- 2003
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Ingår i: Arthritis and Rheumatism. - : Wiley-Blackwell. - 0004-3591 .- 1529-0131. ; 48:10, s. 2741-2749
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Tidskriftsartikel (refereegranskat)abstract
- Methods: A case–control study was nested within the Northern Sweden Health and Disease Study and the Maternity cohorts of Northern Sweden. Patients with RA were identified among blood donors whose samples had been taken years before the onset of symptoms. Control subjects matched for age, sex, date of sampling, and residential area were selected randomly from the same cohorts. Anti‐CCP antibody and RFs were determined using enzyme immunoassays.Results: Eighty‐three individuals with RA were identified as having donated blood before presenting with any symptoms of joint disease (median 2.5 years [interquartile range 1.1–4.7] before RA). In samples obtained before the onset of RA, the prevalence of autoantibodies was 33.7% for anti‐CCP, 16.9% for IgG‐RF, 19.3% for IgM‐RF, and 33.7% for IgA‐RF (all highly significant compared with controls). The sensitivities for detecting these autoantibodies >1.5 years and ≤1.5 years before the appearance of any RA symptoms were 25% and 52% for anti‐CCP, 15% and 30% for IgM‐RF, 12% and 27% for IgG‐RF, and 29% and 39% for IgA‐RF. In conditional logistic regression models, anti‐CCP antibody and IgA‐RF were found to be significant predictors of RA.Conclusion: Anti‐CCP antibody and RFs of all isotypes predated the onset of RA by several years. The presence of anti‐CCP and IgA‐RF predicted the development of RA, with anti‐CCP antibody having the highest predictive value. This indicates that citrullination and the production of anti‐CCP and RF autoantibodies are early processes in RA.
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