Category: Statistics

Eur J Psychotraumatol. 2024;15(1):2416834. doi: 10.1080/20008066.2024.2416834. Epub 2024 Oct 31.

ABSTRACT

Background: Prevalence rates for posttraumatic stress symptoms (PTSS) in unaccompanied young refugees (UYRs) are high. Research with biological parents indicates low agreement rates between self and caregiver reports for PTSS, although caregivers play an important role as gatekeepers to ensure appropriate treatment.Objective: This study examines youth and caregiver agreement on the endorsement of different trauma types, the PTSS severity score and symptom clusters, as well as the potential association between youth factors (age, comorbidity, and duration in facility) and disagreement.Method: The sample consisted of N = 610 UYRs, aged M = 16.75 (SD = 1.33, range: 12-20) years. Of these, 91.0% were male, and 43.4% were from Afghanistan, currently residing in German children and youth welfare facilities.Results: Agreement rates across trauma types were poor (accidental trauma: Cohen’s k = .13; community violence: Cohen’s k = .07; domestic violence: Cohen’s k = .19; sexual abuse: Cohen’s k = .38). Agreement rates for the PTSS severity score (ICC = .22) and symptom clusters were poor (re-experiencing: ICC = .27; avoidance: ICC = .02; negative alterations in cognitions and mood ICC = .12; hyperarousal: ICC = .25), with youth reporting significantly higher scores. Regression models showed that having comorbid symptoms and a shorter duration in the facility were associated with higher disagreement at the PTSS severity score (Adjusted –R² = .21) and across symptom clusters (re-experiencing: Adjusted –R² = .13; avoidance: Adjusted –R² = .07; negative alterations in cognitions and mood: Adjusted –R² = .16; hyperarousal: Adjusted- R² = .16). Age was not significantly associated with disagreement rates.Conclusion: It is important to enhance the awareness and comprehension of caregivers regarding recognition of mental illnesses and their symptoms as well as assessing mental health among UYRs.

PMID:39479874 | DOI:10.1080/20008066.2024.2416834

Haematologica. 2024 Oct 31. doi: 10.3324/haematol.2024.285828. Online ahead of print.

ABSTRACT

This study assessed the comparative efficacy of lisocabtagene maraleucel (liso-cel) in PILOT (NCT03483103), an open-label, phase II study, versus conventional second-line (2L) chemotherapy regimens in the real world administered to patients with relapsed or refractory (R/R) large B-cell lymphoma (LBCL) who were not intended for hematopoietic stem cell transplantation (HSCT). The liso-cel-treated cohort (n=61) was based on patients who received liso-cel in the PILOT study. The conventional chemotherapy cohort included patients who met PILOT eligibility criteria and received conventional 2L chemotherapy in the real-world clinical setting (n=273). After using the trimmed stabilized inverse probability of treatment weighting method to balance cohorts according to baseline characteristics, there were statistically significant differences in all tested measures of efficacy. Compared with real-world conventional chemotherapy regimens, liso-cel demonstrated higher overall response rates (79.6% with liso-cel vs. 50.5% with conventional chemotherapy; relative risk [RR], 1.6; P.

PMID:39479862 | DOI:10.3324/haematol.2024.285828

Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2024 Oct;32(5):1594-1600. doi: 10.19746/j.cnki.issn.1009-2137.2024.05.045.

ABSTRACT

OBJECTIVE: To investigate the clinical characteristics of patients with hemophagocytic lymphohistiocytosis (HLH) and quantify the diagnostic value of various indexes in patients with elevated soluble interleukin-2 receptor (sCD25), so as to construct a diagnostic prediction model of HLH.

METHODS: The clinical characteristics of 121 patients with elevated sCD25 (≥2 400 U/ml) in the Third Affiliated Hospital of Sun Yat-Sen University were analyzed retrospectively. The patients were divided into HLH group and non-HLH group according to the diagnostic criteria of HLH. The patients with HLH were divided into infection group, tumor group, macrophage activation syndrome (MAS) group and unknown etiology group according to their etiology. The basic data and treatment of the patients were collected for univariate and multivariate logistic analysis to establish a diagnostic prediction model of HLH.

RESULTS: Among the 121 enrolled patients with elevated sCD25, 68 were diagnosed as HLH. The proportion of patients using vasopressors, the incidence rate of disseminated intravascular coagulation (DIC), and the HScore in the HLH group were higher than those in the non-HLH group (P < 0.05). Hepatomegaly, splenomegaly, and hemophagocytosis were more common in HLH patients(P < 0.05). Compared with the patients in non-HLH group, patients in HLH group had lower levels of neutrophils, platelets, fibrinogen, IgG, and IgM, while the levels of triglycerides, ferritin (FER), sCD25, serum glutamic oxaloacetic transaminase (SGOT), alkaline phosphatase (ALP), total bilirubin (TBil), lactate dehydrogenase (LDH), and D-dimer were higher (P < 0.05). In subgroup analysis, the level of sCD25 in tumor group was higher than that in infection group. The level of sCD25/ferritin in tumor group was higher than that in infection group and MAS group. Compared with HLH patients in the tumor group, the procalcitonin (PCT) level, proportion of patients using vasopressors, positive rate of hemophagocytosis, and incidence rate of DIC were all higher in the infection group, and the differences were statistically significant (P < 0.05). The results of multivariate analysis showed that fever, splenomegaly, hemophagocytosis, cytopenias, IgM, M.sCD25 [multiple of sCD25 detection value relative to the diagnostic threshold (2400 U/ml)], fibrinogen, and triglycerides were independent predictive factors for HLH (P < 0.05).The diagnostic prediction model H constructed based on temperature, splenomegaly, hemophagocytosis, cytopenias, IgM, M.sCD25, fibrinogen, triglycerides showed good predictive accuracy. The optimal cutoff value of H was 39.45, the sensitivity of the model was 94.12%, the specificity was 83.02%.

CONCLUSION: sCD25, sCD25/FER, PCT, hemophagocytosis, hemodynamic instability and DIC could help to distinguish the underlying etiology of HLH. The prediction model H has high discrimination and calibration, which could be used as a relatively accurate clinical diagnostic tool for HLH.

PMID:39479853 | DOI:10.19746/j.cnki.issn.1009-2137.2024.05.045

Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2024 Oct;32(5):1571-1577. doi: 10.19746/j.cnki.issn.1009-2137.2024.05.042.

ABSTRACT

OBJECTIVE: To explore the effect of heterozygous deletion of histone methyltransferase Kmt2c gene on the hematological system of mice.

METHODS: CRISPR/Cas9 technology was used to construct mice model of Kmt2c heterozygous deletion (Kmt2c^+/-) and the changes of whole blood cell count in mice were continuously monitored by blood routine test. The clonal expansion ability of bone marrow cells was explored by colony formation assay in vitro and the proportion of primitive hematopoietic cells, including long-term hematopoietic stem cell (LT-HSC), short-term hematopoietic stem cell (ST-HSC), and multipotent progenitor cell in mutant mice was analyzed by flow cytometry.

RESULTS: Kmt2c^+/- mice model was successfully constructed, and the mRNA expression level of Kmt2c was 28% of that of C57BL/6J mice. The colony formation ability of bone marrow cells of Kmt2c^+/- mice in vitro increased with the passage times, and the colony number in the fourth generation was significantly higher than that of control group (P <0.05). The proportions of LT-HSC and ST-HSC in the primitive hematopoietic cell population of Kmt2c^+/- mice was 19.6%±3.3% and 28.9%±4.9%, respectively, which showed an increasing trend compared with 16.9%±2.6% and 18.9%±2.5% in control group, but the difference was not statistically significant (P >0.05). The white blood cell count of Kmt2c^+/- mice gradually increased after 12 weeks of monitoring and reached (9.8±1.0)×10⁹/L at the 14^th week, which was significantly higher than (7.3±1.4)×10⁹/L of control group (P < 0.05).

CONCLUSION: The bone marrow cells of Kmt2c^+/- mice have potential of clonal expansion.

PMID:39479850 | DOI:10.19746/j.cnki.issn.1009-2137.2024.05.042

Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2024 Oct;32(5):1524-1530. doi: 10.19746/j.cnki.issn.1009-2137.2024.05.034.

ABSTRACT

OBJECTIVE: To explore the clinical application value of the Bleeding Scoring Scales (2019 Pediatric ITP Scale) in the diagnosis and treatment of children with primary immune thrombocytopenia (ITP).

METHODS: A total of 422 children with ITP were evaluated with the 2019 Pediatric ITP Scale and the 2013 ITP-BAT and their clinical data were analyzed. The correlation between the two bleeding scoring scales and disease stage, platelet count was analysed, the evaluation time, consistency of the two bleeding scoring scales was compared, and the correlation of the two methods. The changes of platelet count and the score of 2019 Pediatric ITP Scale before treatment and after treatment at 48 h and one week were analyzed to detect responsiveness of the 2019 Pediatric ITP Scale.

RESULTS: The score of the 2019 Pediatric ITP Scale was mainly one point and two points, the corresponding bleeding was skin and mucosal bleeding.404 patients (95.7%) had bleeding manifestations, including 249 patients of skin bleeding (59.0%), 144 patients of mucosal bleeding (34.1%), and 11 patients of organ bleeding (2.6%), of which 2 patients were severe bleeding. The two bleeding scoring scales were both negatively correlated with platelet counts in children with ITP (r _s=-0.5032, r _s=-0.6084) and no correlation with the stage of pediatric ITP(P ＞0.05). The 2019 Pediatric ITP Scale had good consistency with the 2013 ITP-BAT (r _s=0.7638). The average time required for the 2019 Pediatric ITP Scale was 88.64 (40-181) seconds, which was lower than that required for the 2013 ITP-BAT 104.12 (47-285) seconds (Z =17.792, P < 0.001). The 2019 Pediatric ITP Scale can well reflect the treatment of pediatric ITP. There were statistically significant differences in platelet count before treatment and after treatment at 48 h and one week among steroid group, IVIG group and steroid combined with IVIG group ( P < 0.05). There were also statistically significant differences in the score of the 2019 Pediatric ITP Scale before treatment and after treatment at one week among the three groups ( P < 0.05).

CONCLUSION: The 2019 Pediatric ITP Scale has good consistency and sensitivity in clinical application, and it takes less time to complete than the 2013 ITP-BAT, this scale can be used as an effective tool for disease assessment and efficacy determination in pediatric primary immune thrombocytopenia.

PMID:39479842 | DOI:10.19746/j.cnki.issn.1009-2137.2024.05.034

Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2024 Oct;32(5):1463-1471. doi: 10.19746/j.cnki.issn.1009-2137.2024.05.025.

ABSTRACT

OBJECTIVE: To explore and analyze the incidence rate, influencing factors and impact on prognosis of pulmonary hypertension (PH) in patients with Philadelphia chromosome negative myeloproliferative neoplasms (Ph^– MPNs).

METHODS: The clinical data of 271 patients with Ph^– MPNs were retrospectively analyzed, and different disease subtypes were classified. Patients with different disease types were further divided into PH⁺ and PH^– groups according to whether HP occurred. Statistical methods were used to analyze the incidence rate, risk factors, and impact on prognosis of PH in Ph^– MPNs patients.

RESULTS: The overall incidence rate of PH among 271 patients was 26.9%, and according to the classification of disease subtypes, it was found that the incidence rate of PH in patients with primary myelofibrosis (PMF) was significantly higher than those of patients with polycythemia vera and essential thrombocythemia (both P <0.05). Multivariate regression analysis showed that advanced age, long disease course, JAK2 positive and increased hematocrit, lactate dehydrogenase, monocyte count, and uric acid level were independent risk factors for PH in Ph^– MPNs patients (OR >1, P <0.05), and there were some differences in the independent risk factors between different disease subtypes. Survival analysis results showed that the overall survival (OS) rate of PH⁺ patients was significantly lower than that of PH^– patients in other types except for PMF (all P <0.05).

CONCLUSION: The incidence rate of PH in Ph^– MPNs patients is high, and its risk factors are diverse. The OS rate of Ph^– MPNs patients with PH is low. Therefore, we should be highly alert to the occurrence of PH in Ph^– MPNs patients clinically.

PMID:39479833 | DOI:10.19746/j.cnki.issn.1009-2137.2024.05.025

Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2024 Oct;32(5):1407-1413. doi: 10.19746/j.cnki.issn.1009-2137.2024.05.016.

ABSTRACT

OBJECTIVE: To explore the clinical characteristics and prognosis of patients with diffuse large B-cell lymphoma (DLBCL) of the breast.

METHODS: The clinical data of 28 DLBCL patients admitted to Shanxi Provincial Cancer Hospital from January 2013 to January 2023 were retrospectively analysed, including 13 cases of primary breast DLBCL (PB-DLBCL) and 15 cases of secondary breast DLBCL (SB-DLBCL), and the data of their clinical manifestations, laboratory tests, pathological examinations, treatment protocols, and follow-up were statistically analyzed.

RESULTS: There were significant differences in IPI score, LDH level and β₂– microglobulin between PB-DLBCL and SB-DLBCL patients (P < 0.05). Among the 23 patients with breast DLBCL who received regular treatment, 13 patients achieved complete remission (9 patients with PB-DLBCL and 4 patients with SB-DLBCL) after initial treatment. By the end of follow-up, 11 patients relapsed or progressed (5 patients with PB-DLBCL and 6 patients with SB-DLBCL) and 9 patients died (3 patients with PB-DLBCL and 6 patients with SB-DLBCL). The 5-year OS rate was (75.0±15.3)% in PB-DLBCL group and (32.3±17.1)% in SB-DLBCL group. The 5-year PFS rate was （59.1±19.8）% in PB-DLBCL and 0% in SB-DLBCL group. The 5-year OS rate and PFS rate of PB-DLBCL patients were higher than those of SB-DLBCL patients (P < 0.05); the 5-year OS rate of the combined central preventive treatment group was higher than that of the chemotherapy group (P < 0.05).

CONCLUSION: Breast DLBCL is divided into two categories: PB-DLBCL and SB-DLBCL. Compared with SB-DLBCL, PB-DLBCL has the characteristics of lower IPI score, LDH, and β₂-microglobulin levels. PB-DLBCL patients have a longer survival period. In addition, the prognosis of patients receiving central preventive treatment is more optimistic.

PMID:39479824 | DOI:10.19746/j.cnki.issn.1009-2137.2024.05.016

Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2024 Oct;32(5):1381-1387. doi: 10.19746/j.cnki.issn.1009-2137.2024.05.012.

ABSTRACT

OBJECTIVE: To investigate the clinical characteristics and prognosis of single center adult chronic myeloid leukemia in chronic phase (CML-CP).

METHODS: Clinical data of 41 adult CML-CP patients in Department of Hematology, Shanghai Fengxian District Central Hospital from January 2015 to May 2021 were retrospectively analyzed. The clinical characteristics and prognosis of patients between <60 years group and ≥60 years group were compared.

RESULTS: The 41 patients included 27 (65.9%) males and 14 (34.1%) females. The median age of the patients was 56(19-84) years, with 22 cases (53.7%) <60 years and 19 cases (46.3%) ≥60 years. Univariate analysis indicated that the proportions of patients with comorbidities, intermediate/high-risk Sokal score, myelofibrosis, and lactate dehydrogenase ≥1 000 U/L were significantly increased in ≥60 years group compared with <60 years group at initial diagnosis (all P <0.05). There were no statistical differences in the distribution of sex, ELST score, white blood cell count, platelet count, peripheral blood basophil percentage, peripheral blood eosinophil percentage and bone marrow primitive cell percentage between the two groups (P >0.05). The proportion of patients taking reduced-dose imatinib in ≥60 years group significantly increased (P <0.001). Patients <60 years had a higher proportion of molecular biological remission after treatment of tyrosine kinase inhibitors (TKIs) than patients ≥60 years (P <0.001). The incidence of non-hematologic adverse reactions to TKI therapy significantly increased in patients ≥60 years (P <0.001). Multivariate analysis showed that no adverse factors affecting the efficacy and prognosis of TKI.

CONCLUSION: Compared with adult CML-CP patients <60 years, patients ≥60 years gain fewer benefits from TKI treatment and increased adverse reactions.

PMID:39479820 | DOI:10.19746/j.cnki.issn.1009-2137.2024.05.012

Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2024 Oct;32(5):1356-1364. doi: 10.19746/j.cnki.issn.1009-2137.2024.05.008.

ABSTRACT

OBJECTIVE: To analyze the clinical characteristics and prognosis of children with hypodiploid B-cell precursor acute lymphoblastic leukemia (BCP-ALL).

METHODS: The clinical data of 1 287 children with BCP-ALL admitted to five hospital in Fujian province from April 2011 to December 2020 were retrospectively analyzed. According to the results of chromosome karyotype, all the patients were grouped into hypodiploid subgroup and non-hypodiploid subgroup. The clinical characteristics, early treatment response ［minimal residual disease (MRD) on middle stage of induction chemotherapy and end of induction chemotherapy］ and long-term efficacy ［overall survival (OS) and event-free survival (EFS)］ were compared. The prognostic factors of hypodiploid BCP-ALL were further explored.

RESULTS: Among 1 287 BCP-ALL patients， 28 patients (2.2%) were hypodiploid BCP-ALL. The proportion of patients with white blood cell count （WBC）≥50×10⁹/L in the hypodiploid subgroup was significantly higher than that in the non-hypodiploid subgroup (P =0.004), while there was no statistically significant difference in gender ratio, age group at initial diagnosis, and early treatment response between the two groups (all P >0.05). The 5-year EFS and OS rate of the hypodiploid subgroup were 75.0%(95%CI ：66.8%-83.2%) and 77.8%(95%CI ：69.8%-85.8%), respectively, which were lower than those of non-hypodiploid subgroup ［EFS: 79.6%(95%CI ：78.4%-80.8%); OS: 86.4%(95%CI ：85.4%-87.5%)］, but the difference was not statistically significant (all P >0.05). Further subgroup analysis by risk stratification showed that the 5-year EFS and OS rates of the hypodiploid subgroup were significantly lower than those in the low-risk (LR) group ［LR group EFS: 91.4% (95%CI ：88.4%-93.6% ), P < 0.001; OS: 94.7% (95%CI ：92.1%-96.4%), P < 0.001］ ; it was similar to that of BCP-ALL children stratified into intermediate-risk (IR) excluding hypodiploid ［IR group EFS: 79.4%(95%CI ：74.9%-83.2%), P =0.343; OS: 87.3%(95%CI ：83.6%-90.2%), P =0.111］; while was higher than that of EFS in HR group, but the difference was not statistically significant ［HR group EFS: 58.7%(95%CI ：52.6%-64.8%), P =0.178. OS: 69.9%(95%CI ：63.5%-75.4%), P =0.417］. Univariate analysis showed that gender, age, white blood cell count, and MRD on middle stage of induction chemotherapy had no significant impact on OS and EFS; chromosome count< 40 was a risk factor for lower OS (P =0.026), but has no significant effect on EFS; MRD≥0.01% after induction therapy was a risk factor for lower OS and EFS (P =0.002, and 0.001, respectively).

CONCLUSION: Children with hypodiploid BCP-ALL have an intermediate prognosis, and MRD ≥0.01% after induction chemotherapy may be a risk factors for poor prognosis.

PMID:39479816 | DOI:10.19746/j.cnki.issn.1009-2137.2024.05.008

Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2024 Oct;32(5):1334-1342. doi: 10.19746/j.cnki.issn.1009-2137.2024.05.005.

ABSTRACT

OBJECTIVE: To establish a morphologic classification system for characterizing blast cells in patients with acute promyelocytic leukemia (APL) and analyze the correlation of different APL morphologic characteristics with conventional tests and genetic variants.

METHODS: Based on the morphological characteristics of APL blast cells, a classification system of 14 categories was established to characterize the inter- and intra-individual cellular morphological heterogeneity of patients. The classification system was used for the morphological analysis of 40 APL patients, and the classification results were statistically analyzed with the patients’ conventional test indexes and gene variant characteristics to analyze the correlation of different APL blast cell morphological features with conventional test indexes and gene variants.

RESULTS: In the FLT3-ITD mutation-positive group, there were significantly fewer cells with regular nuclear shape, hyper granularity, and missing Auer rods (category 1) than in the FLT3 mutation-negative group (P < 0.05). The activated partial thromboplastin (APTT) was significantly longer in the group with regular nucleus compared to the group with irregular nucleus (P < 0.05). In the hypo-granular group, the APTT was also significantly longer compared to the hyper-granular group (P < 0.01), and the proportion of myeloid blast cells was relatively lower (P < 0.05). The peripheral blood white blood cell counts, D-dimer, lactate dehydrogenase and proportion of bone marrow blast cells were significantly higher in the Auer rods (-) group than Auer rods increasing group (all P < 0.05).

CONCLUSION: The newly established morphologic classification system in this study can objectively characterize different types of APL blast cells, which helps to better assess the intra- and inter-individual heterogeneity of APL blast cells, and further use in accurately analyzing the correlation of morphological phenotypes with biological properties of APL.

PMID:39479813 | DOI:10.19746/j.cnki.issn.1009-2137.2024.05.005