79 results on '"Pérez Encinas, M."'
Search Results
2. P1032: REAL-LIFE VALIDATION OF MIPSS70: A RETROSPECTIVE MULTICENTER AND NGS ANALYSIS FROM THE GEMFIN DATABASE
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Hernández-Sánchez, A., primary, Villaverde-Ramiro, Á., additional, Álvarez-Larrán, A., additional, Arellano-Rodrigo, E., additional, Pérez Encinas, M., additional, Ferrer Marín, F., additional, Such, E., additional, Carreño Gómez-Tarragona, G., additional, de las Heras Rodríguez, N., additional, Durán Pastor, M. A., additional, Mata Vázquez, M. I., additional, Fox, L., additional, Raya Sánchez, J. M., additional, Magro Mazo, E., additional, Gómez Casares, M. T., additional, Ramírez Sánchez, M. J., additional, Xicoy Cirici, B., additional, Ramírez Páyer, Á., additional, Fernández Llavador, M. J., additional, Martín López, A. Á., additional, Mosquera Orgueira, A., additional, Martínez Elicegui, J., additional, Garrote, M., additional, Bellosillo, B., additional, González, T., additional, Hernández-Rivas, J., additional, and Hernández Boluda, J. C., additional
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- 2022
- Full Text
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3. P1001: DNMT3A/TET2/ASXL1 MUTATIONS DETERMINE THROMBOTIC RISK IN POLYCYTHAEMIA VERA
- Author
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Segura Diaz, A., primary, Stuckey, R., additional, Florido Ortega, Y., additional, Sobas, M., additional, Álvarez Larrán, A., additional, Ferrer-Marín, F., additional, Pérez Encinas, M., additional, Carreño, G., additional, Fox, M., additional, Tazón Vega, B., additional, Cuevas, B., additional, López Rodriguez, J., additional, Farías Sánchez, N., additional, Bilbao Sieyro, C., additional, and Gómez Casares, M., additional
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- 2022
- Full Text
- View/download PDF
4. Real-life analysis on safety and efficacy of asciminib for ponatinib pretreated patients with chronic myeloid leukemia
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Luna, A, Pérez-Lamas, L, Boque, C, Giraldo, P, Xicoy, B, Ruiz Nuño, C, Vega, M Moreno, Alvarez-Larrán, A, Salamanca, A, García-Noblejas, A, Vall-Llovera, F, Villalon, L, De Las Heras, N, Ramila, E, Pérez-Encinas, M, Cuevas, B, Perez-Lopez, R, Sanchez-Guijo, F, Jiménez-Velasco, A, Lakhwani, S, Casado, L Felipe, Rosell, A, Escola, A, Fernández, M J, Garcia-Hernandez, C, Cervero, C, Mora, E, Sagüés, M, Suarez-Varela, S, Vélez, P, Carrascosa Mastell, P, Bitaube, R F, Serrano, L, Cortes, M, Vera Goñi, J A, Steegmann, J L, de Soria, V Gomez Garcia, Alonso-Dominguez, J M, Araujo, M Colorado, Coll, A Paz, Hernandez-Boluda, J C, García-Gutiérrez, V, [Luna A, Pérez-Lamas L] Hematology Department, Hospital Universitario Ramón y Cajal, IRYCIS, Universidad de Alcala, Madrid, Spain. [Boque C] Institut Catala d’Oncologia, Hospital Duran Y Reynals, L’Hospitalet de Llobregat, Barcelona, Spain. [Giraldo P] Hospital Quirón Zaragoza, Zaragossa, Spain. [Xicoy B] Institut Català d’Oncologia-Hospital Germans Trias I Pujol, Badalona, Spain. [Ruiz Nuño C] Hospital Regional Universitario de Málaga, Málaga, Spain. [Cortes M] Hospital General de Granollers, Granollers, Spain, and Hospital General de Granollers
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Niacinamide ,Leukemia ,Inhibitors ,Fusion Proteins, bcr-abl ,Imidazoles ,Otros calificadores::Otros calificadores::/farmacoterapia [Otros calificadores] ,Hemic and Lymphatic Diseases::Hematologic Diseases::Bone Marrow Diseases::Myeloproliferative Disorders::Leukemia, Myelogenous, Chronic, BCR-ABL Positive [DISEASES] ,Antineoplastic Agents ,Hematology ,General Medicine ,Asciminib ,Other subheadings::Other subheadings::/drug therapy [Other subheadings] ,acciones y usos químicos::acciones farmacológicas::mecanismos moleculares de acción farmacológica::inhibidores enzimáticos [COMPUESTOS QUÍMICOS Y DROGAS] ,Pyridazines ,Leucèmia - Tractament ,Inhibidors enzimàtics ,Drug Resistance, Neoplasm ,Leukemia, Myelogenous, Chronic, BCR-ABL Positive ,Chemical Actions and Uses::Pharmacologic Actions::Molecular Mechanisms of Pharmacological Action::Enzyme Inhibitors [CHEMICALS AND DRUGS] ,Humans ,Pyrazoles ,enfermedades hematológicas y linfáticas::enfermedades hematológicas::enfermedades de la médula ósea::trastornos mieloproliferativos::leucemia mielogenosa crónica BCR-ABL positiva [ENFERMEDADES] ,Protein Kinase Inhibitors ,Retrospective Studies - Abstract
Failure of second-generation tyrosine kinase inhibitors (2GTKI) is a challenging situation in patients with chronic myeloid leukemia (CML). Asciminib, recently approved by the US Federal Drug Administration, has demonstrated in clinical trials a good efficacy and safety profile after failure of 2GTKI. However, no study has specifically addressed response rates to asciminib in ponatinib pretreated patients (PPT). Here, we present data on responses to asciminib from 52 patients in clinical practice, 20 of them (38%) with prior ponatinib exposure. We analyzed retrospectively responses and toxicities under asciminib and compared results between PPT and non-PPT patients.After a median follow-up of 30 months, 34 patients (65%) switched to asciminib due to intolerance and 18 (35%) due to resistance to prior TKIs. Forty-six patients (88%) had received at least 3 prior TKIs. Regarding responses, complete cytogenetic response was achieved or maintained in 74% and 53% for non-PPT and PPT patients, respectively. Deeper responses such as major molecular response and molecular response 4.5 were achieved in 65% and 19% in non-PPT versus 32% and 11% in PPT, respectively. Two patients (4%) harbored the T315I mutation, both PPT.In terms of toxicities, non-PPT displayed 22% grade 3–4 TEAE versus 20% in PPT. Four patients (20% of PPT) suffered from cross-intolerance with asciminib as they did under ponatinib.Our data supports asciminib as a promising alternative in resistant and intolerant non-PPT patients, as well as in intolerant PPT patients; the resistant PPT subset remains as a challenging group in need of further therapeutic options.
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- 2022
5. 2019 SEFH National Survey: service portfolio, care activities, education and research in Spain's hospital pharmacy departments
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Pérez-Encinas M, Lozano-Blázquez A, García-Pellicer J, Torre-Lloveras I, Poveda-Andrés JL, and Calleja-Hernández MÁ
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Service portfolio ,Care activities ,Research ,education ,Hospital pharmacy department ,Survey ,humanities ,Education - Abstract
To report on the results obtained from the 2019 SEFH National Survey regarding the service portfolio, care activities, training programs and research work of Spanish hospital pharmacy departments.
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- 2021
6. SEFH National Survey-2019: general characteristics, staffing, material resources and information systems in Spain's hospital pharmacy departments
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Pérez-Encinas M, Lozano-Blázquez A, García-Pellicer J, Torre-Lloveras I, Poveda-Andrés JL, and Calleja-Hernández MÁ
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Humans resources ,Electronic prescription ,Outpatients ,Automated dispensing system ,Safety ,Robotic system ,Hospital Pharmacy Department ,humanities - Abstract
To publicize the results regarding the general characteristics, human resources, materials and information systems of Spanish hospital pharmacy departments arising from SEFH's 2019 Survey on the Situation of Spanish Hospital Pharmacy Departments.
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- 2020
7. An analysis of the impact of CD56 expression in de novo acute promyelocytic leukemia patients treated with upfront all-trans retinoic acid and anthracycline-based regimens
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Sobas M, Montesinos P, Boluda B, Bernal T, Vellenga E, Nomdedeu J, González-Campos J, Chillón M, Holowiecka A, Esteve J, Bergua J, González-Sanmiguel JD, Gil-Cortes C, Tormo M, Salamero O, Manso F, Fernández I, de la Serna J, Moreno MJ, Pérez-Encinas M, Krsnik I, Ribera JM, Escoda L, Lowenberg B, Sanz MA, and PETHEMA H
- Published
- 2019
8. Real life outcomes of patients aged =75 years old with acute promyelocytic leukemia: experience of the PETHEMA registry
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Salamero O, Martínez-Cuadrón D, Sobas M, Benavente C, Vives S, De la Serna J, Pérez-Encinas M, Escoda L, Gil C, Brunet S, Ramos F, Esteve J, Amigo M, Krsnik I, Manso F, Arias J, González-Campos J, Serrano J, Oleksiuk J, Barrios M, García-Boyero R, Novo A, Sanz MA, Montesinos P, and PETHEMA and PALG Groups
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APL prognostic factors, APL real life outcomes, Elderly APL, induction mortality in APL ,neoplasms - Abstract
Acute promyelocytic leukemia is infrequent among patients aged =75 years old, a population that is rarely eligible for clinical protocols. This study aims to analyze the treatment strategies and clinical outcomes of very old APL patients reported to the international PETHEMA registry. Between 1997 and 2017, among 2501 APL cases registered 120 were =75 years old. Treatment approaches were: AIDA regimen, 79 patients; ATRA alone, 23; 16, supportive care (SC) and 2, other strategies. Patients treated with AIDA were younger, had better ECOG and lower leukocytes. Complete remission (CR) was achieved in 65% of AIDA-group vs. 45% in the ATRA-group, being infections followed by bleeding the most frequent causes of induction death. Patients in CR after AIDA showed 3-year DFS of 73%. Our real-life series of very old APL patients provides a reference basis for future treatment strategies aiming to improve clinical outcomes in this challenging population.
- Published
- 2019
9. Comparison of the traditional pharmaceutical validation method versus an assisted pharmaceutical validation in hospitalized patients
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García Marco,D., Hernández Sánchez,M. V., Sanz Márquez,S., Pérez Encinas,M., Fernández-Shaw Toda,C., Jiménez Cerezo,M. J., Ferrari Piquero,J. M., and Martínez Camacho,M.
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Medication review ,lcsh:Pharmacy and materia medica ,Automation ,Medications errors ,lcsh:R ,lcsh:Medicine ,lcsh:RS1-441 ,Clinical alarms ,Drug prescriptions ,Decision support - Abstract
Objective: To analyze pharmaceutical interventions that have been carried out with the support of an automated system for validation of treatments vs. the traditional method without computer support. Method: The automated program, ALTOMEDICAMENTOS® version 0, has 925 052 data with information regarding approximately 20 000 medicines, analyzing doses, administration routes, number of days with such a treatment, dosing in renal and liver failure, interactions control, similar drugs, and enteral medicines. During eight days, in four different hospitals (high complexity with over 1 000 beds, 400-bed intermediate, geriatric and monographic), the same patients and treatments were analyzed using both systems. Results: 3,490 patients were analyzed, with 42 155 different treatments. 238 interventions were performed using the traditional system (interventions 0.56% / possible interventions) vs. 580 (1.38%) with the automated one. Very significant pharmaceutical interventions were 0.14% vs. 0.46%; significant was 0.38% vs. 0.90%; non-significant was 0.05% vs. 0.01%, respectively. If both systems are simultaneously used, interventions are performed in 1.85% vs. 0.56% with just the traditional system. Using only the traditional model, 30.5% of the possible interventions are detected, whereas without manual review and only the automated one, 84% of the possible interventions are detected. Conclusions: The automated system increases pharmaceutical interventions between 2.43 to 3.64 times. According to the results of this study the traditional validation system needs to be revised relying on automated systems. The automated program works correctly in different hospitals.
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- 2016
10. Essential thrombocythaemia with mutation in MPL : clinicopathological correlation and comparison with JAK 2V617F-mutated and CALR- mutated genotypes
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Alvarez-Larran A, Martínez D, Arenillas L, Rubio A, Arellano-Rodrigo E, Hernández Boluda JC, Papaleo N, Caballero G, Martínez C, Ferrer-Marín F, Mata MI, Pérez-Encinas M, Durán MA, Alonso JM, Carreño-Tarragona G, Noya S, Magro E, Pérez R, López-Guerra M, Pastor-Galán I, Cervantes F, Besses C, Colomo L, and Rozman M
- Published
- 2018
11. PF419 ANALYSIS OF THE INFLUENCE OF AGE ON MAJOR MOLECULAR RESPONSE,DEEP MOLECULAR RESPONSE AND SURVIVAL OUTCOMES IN CHRONIC MYELOID LEUKEMIA (CML) PATIENTS TREATED WITH TYROSINE KINASE INHIBITORS (TKIS)
- Author
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Casado Montero, L.F., primary, García-Ormeña, N., additional, J Valentín, G.-G., additional, Giraldo, P., additional, Pérez-Encinas, M., additional, De Paz, R., additional, Ayala, R., additional, Bautista, G., additional, Osorio, S., additional, Requena, M.J., additional, Palomera, L., additional, Peñarrubia, M.J., additional, Calle, C., additional, Hernádez-Rivas, J.A., additional, Mba, C., additional, and Steegmann, J.L., additional
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- 2019
- Full Text
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12. Comparison of the traditional pharmaceutical validation method versus an assisted pharmaceutical validation in hospitalized patients
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García Marco, D., Hernández Sánchez, M. V., Sanz Márquez, S., Pérez Encinas, M., Fernández-Shaw Toda, C., Jiménez Cerezo, M. J., Ferrari Piquero, J. M., and Martínez Camacho, M.
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Medication review ,Automation ,Automatización ,Revisión de la medicación ,Medications errors ,Alarmas clínicas ,Clinical alarms ,Soporte de decisión ,Prescripción de medicamentos ,Drug prescriptions ,Errores de medicación ,Decision support - Abstract
Objective: To analyze pharmaceutical interventions that have been carried out with the support of an automated system for validation of treatments vs. the traditional method without computer support. Method: The automated program, ALTOMEDICAMENTOS® version 0, has 925 052 data with information regarding approximately 20 000 medicines, analyzing doses, administration routes, number of days with such a treatment, dosing in renal and liver failure, interactions control, similar drugs, and enteral medicines. During eight days, in four different hospitals (high complexity with over 1 000 beds, 400-bed intermediate, geriatric and monographic), the same patients and treatments were analyzed using both systems. Results: 3,490 patients were analyzed, with 42 155 different treatments. 238 interventions were performed using the traditional system (interventions 0.56% / possible interventions) vs. 580 (1.38%) with the automated one. Very significant pharmaceutical interventions were 0.14% vs. 0.46%; significant was 0.38% vs. 0.90%; non-significant was 0.05% vs. 0.01%, respectively. If both systems are simultaneously used, interventions are performed in 1.85% vs. 0.56% with just the traditional system. Using only the traditional model, 30.5% of the possible interventions are detected, whereas without manual review and only the automated one, 84% of the possible interventions are detected. Conclusions: The automated system increases pharmaceutical interventions between 2.43 to 3.64 times. According to the results of this study the traditional validation system needs to be revised relying on automated systems. The automated program works correctly in different hospitals. Objetivo: Analizar las intervenciones farmacéuticas realizadas con el apoyo de un sistema automático de validación de tratamientos vs. el método tradicional sin apoyo informático. Métodos: El programa automatizado, ALTOMEDICAMENTOS® version 0, cuenta con 925.052 celdas con información de aproximadamente 20.000 medicamentos, analizando dosis, vías de administración, días de tratamiento, dosificación en insuficiencia renal y hepática, control de interacciones, de medicamentos semejantes y de medicamentos por vía enteral. Durante ocho días distribuidos en cuatro hospitales diferentes (alta complejidad con más de 1.000 camas, intermedio de 400 camas, geriátrico y monográfico), los mismos pacientes y tratamientos se analizaron mediante los dos sistemas. Resultados: Se han analizado 3.490 pacientes diferentes con 42.155 tratamientos. Por el sistema tradicional se han realizado 238 intervenciones (0,56% intervenciones/posibles intervenciones) vs. 580 (1,38%) con el automatizado. Las intervenciones farmacéuticas muy significativas fueron 0,14 vs. 0,46%, las significativas 0,38 vs. 0,90%, las no significativas 0,05 vs. 0,01%. Las intervenciones fueron del 1,85% al utilizar los dos sistemas vs. 0.56% usando solo el sistema tradicional. El sistema tradicional detectó el 30,5% de las posibles intervenciones, sin embargo con el sistema automático se detectaron el 84% de dichas intervenciones. Conclusiones: La automatización multiplica entre 2,43 a 3,64 veces las intervenciones farmacéuticas. En base a los resultados de este estudio el sistema tradicional de validación debería ser modificado, apoyándose en sistemas automatizados. El programa automático funciona en diferentes hospitales.
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- 2016
13. Oral formulation of pyridoxine for the treatment of pyridoxine-dependent epilepsy in a paediatric patient
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Leganés-Ramos, Alejandro, Álvaro-Alonso, E.A., Martín de Rosales-Cabrera, A.M., and Pérez-Encinas, M.
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- 2016
14. A prognostic model for survival after salvage treatment with FLAG-Ida plus /- gemtuzumab-ozogamicine in adult patients with refractory/relapsed acute myeloid leukaemia
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Bergua JM, Montesinos P, Martinez-Cuadrón D, Fernández-Abellán P, Serrano J, Sayas MJ, Prieto-Fernandez J, García R, García-Huerta AJ, Barrios M, Benavente C, Pérez-Encinas M, Simiele A, Rodríguez-Macias G, Herrera-Puente P, Rodríguez-Veiga R, Martínez-Sánchez MP, Amador-Barciela ML, Riaza-Grau R, Sanz MA, and PETHEMA group
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hemic and lymphatic diseases ,salvage treatment ,FLAG-Ida ,prognostic factors ,genetic risk ,relapsed-refractory acute myeloid leukaemia - Abstract
The combination of fludarabine, cytarabine, idarubicin, and granulocyte colony-stimulating factor (FLAG-Ida) is widely used in relapsed/refractory acute myeloid leukaemia (AML). We retrospectively analysed the results of 259 adult AML patients treated as first salvage with FLAG-Ida or FLAG-Ida plus Gentuzumab-Ozogamicin (FLAGO-Ida) of the Programa Espanol de Tratamientos en Hematologia (PETHEMA) database, developing a prognostic score system of survival in this setting (SALFLAGE score). Overall, 221 patients received FLAG-Ida and 38 FLAGO-Ida; 92 were older than 60years. The complete remission (CR)/CR with incomplete blood count recovery (CRi) rate was 51%, with 9% of induction deaths. Three covariates were associated with lower CR/CRi: high-risk cytogenetics and t(8;21) at diagnosis, no previous allogeneic stem cell transplantation (allo-SCT) and relapse-free interval
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- 2016
15. Oral anticoagulation to prevent thrombosis recurrence in polycythemia vera and essential thrombocythemia
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Hernández-Boluda JC, Arellano-Rodrigo E, Cervantes F, Alvarez-Larrán A, Gómez M, Barba P, Mata MI, González-Porras JR, Ferrer-Marín F, García-Gutiérrez V, Magro E, Moreno M, Kerguelen A, Pérez-Encinas M, Estrada N, Ayala R, Besses C, Pereira A, and Grupo Español de Enfermedades Mieloproliferativas Filadelfia Negativas (GEMFIN)
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Anticoagulation ,Bleeding ,Thrombosis ,Essential thrombocythemia ,Polycythemia vera - Abstract
It is unclear whether anticoagulation guidelines intended for the general population are applicable to patients with polycythemia vera (PV) and essential thrombocythemia (ET). In the present study, the risk of thrombotic recurrence was analyzed in 150 patients with PV and ET treated with vitamin K antagonists (VKA) because of an arterial or venous thrombosis. After an observation period of 963 patient-years, the incidence of re-thrombosis was 4.5 and 12 per 100 patient-years under VKA therapy and after stopping it, respectively (P < 0.0005). After a multivariate adjustment for other prognostic factors, VKA treatment was associated with a 2.8-fold reduction in the risk of thrombotic recurrence. Notably, VKA therapy offset the increased risk of re-thrombosis associated with a prior history of remote thrombosis. Both the protective effect of VKA therapy and the predisposing factors for recurrence were independent of the anatomical site involved in the index thrombosis. Treatment periods with VKA did not result in a higher incidence of major bleeding as compared with those without VKA. These findings support the use of long-term anticoagulation for the secondary prevention of thrombosis in patients with PV and ET, particularly in those with history of remote thrombosis.
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- 2015
16. Azacitidine frontline therapy for unfit acute myeloid leukemia patients: Clinical use and outcome prediction
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Ramos F., Maurillo L., Itzykson R., Bargay J., Stauder R., Venditti A., Seegers V., Gaidano G., Gardin C., Musto P., Greil R., Sánchez-Guijo F., Fenaux P., Thépot S., Récher C., Raffoux E., Quesnel B., Delaunay J., Cluzeau T., Koka A.M., Stamatoullas A., Chaury M.-P., Gyan E., Cheze S., Banos A., Morel P., Plantier I., Taksin A.-L., Shanti A., Sanhes L., De Botton S., Marolleau J.P., Pautas C., Wattel E., Isnard F., Guerci A., Vey N., Dreyfus F., Ifrah N., Ades L., Martínez-Robles V., Debén G., Garrido A., Casaño J., Salamero O., Bergua J.M., Colado E., García R., Pedro C., Redondo S., Tormo M., Bonanad S., Díez-Campelo M., Pérez-Encinas M., de la Fuente A., Xicoy B., Falantes J.F., Font P., González-López T.J., Martín-Núñez G., Montesinos P., Pleyer L., Burgstaller S., Schreder M., Tinchon C., Pfeilstoecker M., Steinkirchner S., Melchardt T., Mitrovic M., Girschikofsky M., Lang A., Krippl P., Sliwa T., Egle A., Linkesch W., Voskova D., Angermann H., Spagnoli A., Lunghi M., Pietrantuono G., and Villani O.
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blood toxicity ,cancer patient ,leukocyte count ,very elderly ,retrospective study ,blast cell ,ear disease ,cytogenetics ,middle aged ,neurotoxicity ,Leukemia ,antineoplastic antimetabolite ,Aged, 80 and over ,adult ,nephrotoxicity ,European ALMA score ,clinical trial ,acute granulocytic leukemia ,aged ,Leukemia, Myeloid, Acute ,female ,Italy ,priority journal ,validation study ,drug withdrawal ,Azacitidine ,France ,survival rate ,Antimetabolites, Antineoplastic ,overall survival ,cardiotoxicity ,Article ,eye toxicity ,multiple cycle treatment ,remission ,male ,follow up ,Humans ,controlled study ,drug fatality ,human ,gastrointestinal toxicity ,survival time ,lung toxicity ,human cell ,practice guideline ,Australia ,scoring system ,treatment response ,hearing impairment ,major clinical study ,skin toxicity ,mortality ,infection ,multicenter study ,Spain ,treatment outcome ,population research ,musculoskeletal disease ,Follow-Up Studies - Abstract
Hypomethylating agents are able to prolong the overall survival of some patients diagnosed with acute myeloid leukemia. The aim of this study was to evaluate the clinical use of azacitidine as front-line therapy in unfit acute myeloid leukemia (AML) patients and to develop a clinical prediction model to identify which patients may benefit more from the drug. One hundred and ten untreated unfit AML patients received front-line azacitidine therapy in Spain, and response and survival were evaluated in them following European LeukemiaNet (ELN) guidelines. A clinical prediction rule was obtained from this population that was validated and refined in 261 patients treated in France, Austria and Italy. ELN response was achieved in 21.0% of the 371 patients (CI95% 17.0-25.5) and did not depend on bone marrow blast cell percentage. Median overall survival was 9.6 months (CI95% 8.5-10.8) and 40.6% of the patients were alive at 1 year (CI95% 35.5-45.7). European ALMA score (E-ALMA), based on performance status, white blood cell counts at azacitidine onset and cytogenetics, discriminated three risk groups with different survival and response rates. Azacitidine seems a reasonable therapeutic option for most unfit AML patients, i.e. those displaying a favorable or intermediate E-ALMA score. © 2014 Elsevier Ltd.
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- 2015
17. Oclusión arterial asociada a la interacción entre ritonavir y ergotamina en paciente VIH
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Collado Borrell, R., Sanz Márquez, S., and Pérez Encinas, M.
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- 2013
18. Oclusión arterial asociada a la interacción entre ritonavir y ergotamina en paciente VIH
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Collado Borrell,R., Sanz Márquez,S., and Pérez Encinas,M.
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- 2013
19. PCN298 - The Clinical and Economic Burden of Skeletal Related Events in Austria, Czech Republic, Germany, Greece, Italy, Spain and Switzerland: a Comparison Between the use of Denosumab and Zoledronic Acid In Patients with Prostate Cancer And Bone Metastases
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Cristino, J, Finek, J, Maniadakis, N, Perez Encinas, M, Ikenberg, R, Campos Tapias, I, Jandova, P, Zahn, DP, Moser, C, Bolognese, L, Tritaki, G, Gatta, F, and Hechmati, G
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- 2015
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20. PCN299 - The Clinical and Economic Burden of Skeletal Related Events in Austria, Czech Republic, Germany, Greece, Italy, Spain and Switzerland: A Comparison Between the use of Denosumab and Zoledronic acid in Patients With Breast Cancer and Bone Metastases
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Cristino, J, Diel, I, Finek, J, Perez Encinas, M, Maniadakis, N, Ikenberg, R, Campos Tapias, I, Jandova, P, Zahn, DP, Moser, C, Bolognese, L, Tritaki, G, Gatta, F, and Hechmati, G
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- 2015
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21. Acidosis metabólica y anemia severas relacionadas con linezolid
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Prieto-Callejero, A., primary, Sanz Márquez, S., additional, and Pérez Encinas, M., additional
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- 2012
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22. Sindrome neuroléptico maligno asociado a antidepresivos tricíclicos
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Toro-Chico, P., primary, Gil Navarro, I., additional, and Pérez Encinas, M., additional
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- 2006
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23. Performance of the myelofibrosis secondary to PV and ET-prognostic model (MYSEC-PM) in a series of 262 patients from the Spanish registry of myelofibrosis
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Hernández-Boluda, J-C, Pereira, A, Correa, J-G, Alvarez-Larrán, A, Ferrer-Marín, F, Raya, J-M, Martínez-López, J, Pérez-Encinas, M, Estrada, N, Velez, P, Fox, M-L, García-Gutiérrez, V, Payer, A, Kerguelen, A, Cuevas, B, Durán, M-A, Ramírez, M-J, Gómez-Casares, M-T, Mata-Vázquez, M-I, Mora, E, Martínez-Valverde, C, Gómez, M, and Cervantes, F
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- 2018
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24. Familial myeloproliferative syndrome
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Pérez-Encinas, M., primary, Bello, J. L., additional, Pérez-Crespo, S., additional, De Miguel, R., additional, and Tome, S., additional
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- 1994
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25. Screening of JAK2 V617F Mutation in 84 Patients with Thrombocythemia and Erythrocytosis. Is Necesary for Diagnosis of a Chronic Myeloproliferative Disorders?.
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Sobas, Marta A., Martinez, M., Perez-Encinas, M., Gonzalez, T., Quinteiro, C., Barros, F., Bendana, A., Ansoar, E., Rabunal, M., Gonzalez, S., Alonso, N., Diaz, J., and Bello, J.
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- 2006
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26. Machine Learning Improves Risk Stratification in Myelofibrosis: An Analysis of the Spanish Registry of Myelofibrosis
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Mosquera Orgueira, Adrián, Pérez Encinas, Manuel, Hernández Sánchez, Alberto, González Martínez, Teresa, Arellano Rodrigo, Eduardo, Martínez Elicegui, Javier, Villaverde Ramiro, Ángela, Raya, José María, Ayala, Rosa, Ferrer Marín, Francisca, Fox, María Laura, Velez, Patricia, Mora, Elvira, Xicoy, Blanca, Mata Vázquez, María Isabel, García Fortes, María, Angona, Anna, Cuevas, Beatriz, Senín, María Alicia, Ramírez Payer, Angel, Ramírez, María José, Pérez López, Raúl, González de Villambrosía, Sonia, Martínez Valverde, Clara, Gómez Casares, María Teresa, García Hernández, Carmen, Gasior, Mercedes, Bellosillo Paricio, Beatriz, Steegmann, Juan Luis, Álvarez Larrán, Alberto, Hernández Rivas, Jesús María, Hernández Boluda, Juan Carlos, The Spanish MPN Group (GEMFIN)., Institut Català de la Salut, [Mosquera-Orgueira A, Pérez-Encinas M] Hospital Clínico Universitario, Santiago de Compostela, Spain. [Hernández-Sánchez A, González-Martínez T, Martínez-Elicegui J] Hospital Clínico, Salamanca, Spain. [Arellano-Rodrigo E] Hospital Clínic, Institut d’Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain. [Fox ML] Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain. Vall d’Hebron Hospital Universitari, Barcelona, Spain, and Vall d'Hebron Barcelona Hospital Campus
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Intel·ligència artificial - Aplicacions a la medicina ,Pronòstic mèdic ,Mielofibrosi ,Immunology ,Myelofibrosis ,Neoplasms::Neoplasms by Histologic Type::Leukemia::Leukemia, Myeloid::Leukemia, Myeloid, Acute [DISEASES] ,enfermedades hematológicas y linfáticas::enfermedades hematológicas::enfermedades de la médula ósea::trastornos mieloproliferativos [ENFERMEDADES] ,Cell Biology ,Hematology ,Prognosis ,Biochemistry ,Ciencias de la información::metodologías computacionales::algoritmos::inteligencia artificial::aprendizaje automático [CIENCIA DE LA INFORMACIÓN] ,neoplasias::neoplasias por tipo histológico::leucemia::leucemia mieloide::leucemia mieloide aguda [ENFERMEDADES] ,Aprenentatge automàtic ,Machine learning ,Sang - Malalties ,Hemic and Lymphatic Diseases::Hematologic Diseases::Bone Marrow Diseases::Myeloproliferative Disorders [DISEASES] ,Information Science::Computing Methodologies::Algorithms::Artificial Intelligence::Machine Learning [INFORMATION SCIENCE] - Abstract
Aprendizaje automático; Mielofibrosis Aprenentatge automàtic; Mielofibrosi Machine learning; Myelofibrosis Myelofibrosis (MF) is a myeloproliferative neoplasm (MPN) with heterogeneous clinical course. Allogeneic hematopoietic cell transplantation remains the only curative therapy, but its morbidity and mortality require careful candidate selection. Therefore, accurate disease risk prognostication is critical for treatment decision-making. We obtained registry data from patients diagnosed with MF in 60 Spanish institutions (N = 1386). These were randomly divided into a training set (80%) and a test set (20%). A machine learning (ML) technique (random forest) was used to model overall survival (OS) and leukemia-free survival (LFS) in the training set, and the results were validated in the test set. We derived the AIPSS-MF (Artificial Intelligence Prognostic Scoring System for Myelofibrosis) model, which was based on 8 clinical variables at diagnosis and achieved high accuracy in predicting OS (training set c-index, 0.750; test set c-index, 0.744) and LFS (training set c-index, 0.697; test set c-index, 0.703). No improvement was obtained with the inclusion of MPN driver mutations in the model. We were unable to adequately assess the potential benefit of including adverse cytogenetics or high-risk mutations due to the lack of these data in many patients. AIPSS-MF was superior to the IPSS regardless of MF subtype and age range and outperformed the MYSEC-PM in patients with secondary MF. In conclusion, we have developed a prediction model based exclusively on clinical variables that provides individualized prognostic estimates in patients with primary and secondary MF. The use of AIPSS-MF in combination with predictive models that incorporate genetic information may improve disease risk stratification.
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- 2023
27. Low-risk polycythemia vera treated with phlebotomies: clinical characteristics, hematologic control and complications in 453 patients from the Spanish Registry of Polycythemia Vera
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Triguero, Ana, Pedraza, Alexandra, Pérez-Encinas, Manuel, Mata-Vázquez, María Isabel, Vélez, Patricia, Fox, Laura, Gómez-Calafat, Montse, García-Delgado, Regina, Gasior, Mercedes, Ferrer-Marín, Francisca, García-Gutiérrez, Valentín, Angona, Anna, Gómez-Casares, María Teresa, Cuevas, Beatriz, Martínez, Clara, Pérez, Raúl, Raya, José María, Guerrero, Lucía, Murillo, Ilda, Bellosillo, Beatriz, Hernández-Boluda, Juan Carlos, Sanz, Cristina, Álvarez-Larrán, Alberto, On behalf of the MPN Spanish Group (GEMFIN), Institut Català de la Salut, [Triguero A, Pedraza A] Hospital Clinic de Barcelona, Barcelona, Spain. [Pérez-Encinas M] Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain. [Mata-Vázquez MI] Hospital Costa del Sol, Marbella, Spain. [Vélez P] Hospital del Mar, Barcelona, Spain. [Fox L] Vall d’Hebron Hospital Universitari, Barcelona, Spain. Experimental Hematology Group, Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain, and Vall d'Hebron Barcelona Hospital Campus
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Neoplasms::Neoplasms by Site::Hematologic Neoplasms::Bone Marrow Neoplasms::Polycythemia Vera [DISEASES] ,Correction ,Myelofibrosis ,Otros calificadores::Otros calificadores::/cirugía [Otros calificadores] ,Thrombosis ,Hematology ,General Medicine ,Middle Aged ,Otros calificadores::Otros calificadores::/efectos adversos [Otros calificadores] ,Polycythemia vera ,Phlebotomies ,Other subheadings::Other subheadings::/surgery [Other subheadings] ,Diagnosis::Diagnostic Techniques and Procedures::Clinical Laboratory Techniques::Specimen Handling::Blood Specimen Collection::Phlebotomy [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT] ,Low-risk ,diagnóstico::técnicas y procedimientos diagnósticos::técnicas de laboratorio clínico::manejo de muestras::extracción de muestras sanguíneas::flebotomía [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS] ,Leukemia, Myeloid, Acute ,Phlebotomy ,Policitèmia - Cirurgia ,Sagnia - Complicacions ,Primary Myelofibrosis ,neoplasias::neoplasias por localización::neoplasias hematológicas::neoplasias de la médula ósea::policitemia vera [ENFERMEDADES] ,Other subheadings::Other subheadings::/adverse effects [Other subheadings] ,Humans ,Registries ,Polycythemia Vera - Abstract
Myelofibrosis; Phlebotomies; Thrombosis Mielofibrosi; Flebotomies; Trombosi Mielofibrosis; Flebotomías; Trombosis Hematological control, incidence of complications, and need for cytoreduction were studied in 453 patients with low-risk polycythemia vera (PV) treated with phlebotomies alone. Median hematocrit value decreased from 54% at diagnosis to 45% at 12 months, and adequate hematocrit control over time ( 60 years, and microvascular symptoms constituted the main indications for starting cytoreduction. Median duration without initiating cytoreduction was significantly longer in patients younger than 50 years (
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- 2022
28. Real-world analysis of main clinical outcomes in patients with polycythemia vera treated with ruxolitinib or best available therapy after developing resistance/intolerance to hydroxyurea
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Alvarez-Larrán, Alberto, Garrote, Marta, Ferrer-Marín, Francisca, Pérez-Encinas, Manuel, Mata-Vazquez, M Isabel, Bellosillo, Beatriz, Arellano-Rodrigo, Eduardo, Gómez, Montse, García, Regina, García-Gutiérrez, Valentín, Gasior, Mercedes, Cuevas, Beatriz, Angona, Anna, Gómez-Casares, María Teresa, Martínez, Clara M, Magro, Elena, Ayala, Rosa, Del Orbe-Barreto, Rafael, Pérez-López, Raúl, Fox, Maria Laura, Raya, José-María, Guerrero, Lucía, García-Hernández, Carmen, Caballero, Gonzalo, Murillo, Ilda, Xicoy, Blanca, Ramírez, M José, Carreño-Tarragona, Gonzalo, Hernández-Boluda, Juan Carlos, Pereira, Arturo, MPN Spanish Group (Grupo Español de Enfermedades Mieloproliferativas Filadelfia Negativas), Institut Català de la Salut, [Alvarez-Larrán A, Garrote M] Hospital Clínic, Institut d’Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain. [Ferrer-Marín F] Hospital Morales Messeguer, Universidad Católica San Antonio de Murcia, Murcia, Centro de Investigación Biomédica en Red de Enfermedades Raras, Murcia, Spain. [Pérez-Encinas M] Hospital Clínico Universitario, Santiago de Compostela, Spain. [Mata-Vazquez MI] Hospital Costa del Sol, Marbella, Spain. [Bellosillo B] Hospital del Mar, Barcelona, Spain. [Fox ML] Vall d’Hebron Hospital Universitari, Barcelona, Spain, and Vall d'Hebron Barcelona Hospital Campus
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Cancer Research ,Medicaments antineoplàstics - Ús terapèutic ,Otros calificadores::Otros calificadores::/farmacoterapia [Otros calificadores] ,Myelofibrosis ,Hemorrhage ,Other subheadings::Other subheadings::/drug therapy [Other subheadings] ,Otros calificadores::Otros calificadores::/efectos adversos [Otros calificadores] ,Myeloproliferative neoplasms ,neoplasias::neoplasias por localización::neoplasias hematológicas::neoplasias de la médula ósea::policitemia vera [ENFERMEDADES] ,Nitriles ,Other subheadings::Other subheadings::/adverse effects [Other subheadings] ,Humans ,Hydroxyurea ,Retrospective Studies ,Neoplasms::Neoplasms by Site::Hematologic Neoplasms::Bone Marrow Neoplasms::Polycythemia Vera [DISEASES] ,acciones y usos químicos::acciones farmacológicas::usos terapéuticos::antineoplásicos [COMPUESTOS QUÍMICOS Y DROGAS] ,diagnóstico::pronóstico::resultado del tratamiento [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS] ,Neoplasms, Second Primary ,Thrombosis ,Diagnosis::Prognosis::Treatment Outcome [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT] ,Polycythemia vera ,Leukemia, Myeloid, Acute ,Pyrimidines ,Ruxolitinib ,Oncology ,Policitèmia - Tractament ,Primary Myelofibrosis ,Avaluació de resultats (Assistència sanitària) ,Pyrazoles ,Therapy ,Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Antineoplastic Agents [CHEMICALS AND DRUGS] - Abstract
Altres ajuts: Novartis. Background: Ruxolitinib is approved for patients with polycythemia vera (PV) who are resistant/intolerant to hydroxyurea, but its impact on preventing thrombosis or disease-progression is unknown. Methods: A retrospective, real-world analysis was performed on the outcomes of 377 patients with resistance/intolerance to hydroxyurea from the Spanish Registry of Polycythemia Vera according to subsequent treatment with ruxolitinib (n = 105) or the best available therapy (BAT; n = 272). Survival probabilities and rates of thrombosis, hemorrhage, acute myeloid leukemia, myelofibrosis, and second primary cancers were calculated according to treatment. To minimize biases in treatment allocation, all results were adjusted by a propensity score for receiving ruxolitinib or BAT. Results: Patients receiving ruxolitinib had a significantly lower rate of arterial thrombosis than those on BAT (0.4% vs 2.3% per year; P =.03), and this persisted as a trend after adjustment for the propensity to have received the drug (incidence rate ratio, 0.18; 95% confidence interval, 0.02-1.3; P =.09). There were no significant differences in the rates of venous thrombosis (0.8% and 1.1% for ruxolitinib and BAT, respectively; P =.7) and major bleeding (0.8% and 0.9%, respectively; P =.9). Ruxolitinib exposure was not associated with a higher rate of second primary cancers, including all types of neoplasia, noncutaneous cancers, and nonmelanoma skin cancers. After a median follow-up of 3.5 years, there were no differences in survival or progression to acute leukemia or myelofibrosis between the 2 groups. Conclusions: The results suggest that ruxolitinib treatment for PV patients with resistance/intolerance to hydroxyurea may reduce the incidence of arterial thrombosis. Lay Summary: Ruxolitinib is better than other available therapies in achieving hematocrit control and symptom relief in patients with polycythemia vera who are resistant/intolerant to hydroxyurea, but we still do not know whether ruxolitinib provides an additional benefit in preventing thrombosis or disease progression. We retrospectively studied the outcomes of 377 patients with resistance/intolerance to hydroxyurea from the Spanish Registry of Polycythemia Vera according to whether they subsequently received ruxolitinib (n = 105) or the best available therapy (n = 272). Our findings suggest that ruxolitinib could reduce the incidence of arterial thrombosis, but a disease-modifying effect could not be demonstrated for ruxolitinib in this patient population.
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- 2022
29. The prognostic impact of non-driver gene mutations and variant allele frequency in primary myelofibrosis.
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Hernández-Sánchez A, Villaverde-Ramiro Á, Arellano-Rodrigo E, Garrote M, Martín I, Mosquera-Orgueira A, Gómez-Casares MT, Ferrer-Marín F, Such E, Velez P, Ayala R, Angona A, de Las Heras N, Magro E, Mata-Vázquez MI, Fox ML, de Villambrosía SG, Ramírez MJ, García A, García-Gutiérrez V, Cáceres A, Durán MA, Senín A, Raya JM, González JA, Cuevas B, Xicoy B, Pérez-Encinas M, Bellosillo B, Álvarez-Larrán A, Hernández-Rivas JM, and Hernández-Boluda JC
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- Humans, Prognosis, Mutation, Janus Kinase 2 genetics, Gene Frequency, Primary Myelofibrosis diagnosis, Primary Myelofibrosis genetics
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Prognostic impact of non-MPN driver gene mutations in primary myelofibrosis. MIPSS70: Mutation-Enhanced International Prognostic Score System., (© 2024 Wiley Periodicals LLC.)
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- 2024
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30. Integrating AIPSS-MF and molecular predictors: A comparative analysis of prognostic models for myelofibrosis.
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Mosquera-Orgueira A, Arellano-Rodrigo E, Garrote M, Martín I, Pérez-Encinas M, Gómez-Casares MT, Hernández-Sánchez A, Ferrer-Marín F, Mora E, Velez P, Ayala R, Angona A, Heras NL, Magro E, Pérez-Míguez C, Crucitti D, Mata-Vázquez MI, Fox ML, González de Villambrosía S, Ramírez MJ, García A, García-Gutiérrez V, Cáceres A, Durán MA, Senín MA, Raya JM, González JA, Cuevas B, Xicoy B, Nangalia J, Hernández-Rivas JM, Bellosillo B, Álvarez-Larrán A, and Hernández-Boluda JC
- Abstract
Competing Interests: The authors declare no conflict of interest.
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- 2024
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31. [Translated article] Analysis of the degree of implementation of medication error prevention practices in Spanish hospitals (2022).
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Otero MJ, Pérez-Encinas M, Tortajada-Goitia B, Rodríguez-Camacho JM, Paniagua SP, Fernández-Megía MJ, Cartelle HE, and Caro-Teller JM
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- Humans, Hospitals, Medication Reconciliation, Surveys and Questionnaires, Medication Errors prevention & control, Medication Systems
- Abstract
Objective: To assess the degree of implementation of medication error prevention practices in Spanish hospitals., Method: Descriptive multicenter study of the degree of implementation of the safety practices included in the "Medication use-system safety self-assessment for hospitals. Version. II". Spanish hospitals that completed the questionnaire between October, 2021 and September, 2022 participated. The survey contains 265 items for evaluation grouped into 10 key elements. Mean score and mean percentages based on the maximum possible values for the overall survey, for the key elements, and for each individual item of evaluation were calculated. The results were compared with those of the previous 2011 study., Results: A total of 131 hospitals from 15 autonomous regions participated in the study. The mean score of the overall questionnaire in all hospitals was 898.2 (57.4% of the maximum possible score). No differences were found according to dependency, size, or type of hospital, either in the overall questionnaire or in the key elements. The lowest values were found for key elements VIII, I and VI, on competence and training of health professionals in safety practices (45.1%), availability and accessibility of essential information on patients (48%), and devices for administering drugs (52.3%). With respect to 2011, significant increases were found both in the overall questionnaire and in the key elements, except V and VII, referring to standardization, storage, and distribution of medications, and environmental factors and human resources. Several evaluation items on the safe management of high-risk drugs, medication reconciliation, incorporation of clinical pharmacists into the healthcare teams, and implementation of technologies that allow full traceability throughout the medication system, showed low percentages., Conclusions: There has been appreciable progress in the degree of implementation of some medication error prevention practices in Spanish hospitals, but many proven efficacy practices recommended by the World Health Organization and safety organizations are still poorly implemented. The information obtained can be useful for prioritizing the practices to be addressed and as a new baseline for monitoring progress., Competing Interests: Conflict of interest All the authors state that they have no conflicts of interest., (Copyright © 2023 Sociedad Española de Farmacia Hospitalaria (S.E.F.H). Publicado por Elsevier España, S.L.U. All rights reserved.)
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- 2023
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32. Analysis of the degree of implementation of medication error prevention practices in Spanish hospitals (2022).
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Otero MJ, Pérez-Encinas M, Tortajada-Goitia B, Rodríguez-Camacho JM, Plata Paniagua S, Fernández-Megía MJ, Cartelle HE, and Caro-Teller JM
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- Humans, Hospitals, Medication Reconciliation, Surveys and Questionnaires, Medication Errors prevention & control, Medication Systems
- Abstract
Objective: To assess the degree of implementation of medication error prevention practices in Spanish hospitals., Method: Descriptive multicenter study of the degree of implementation of the safety practices included in the "Medication use-system safety self-assessment for hospitals. Version. II". Spanish hospitals that completed the questionnaire between October/2021 and September/2022 participated. The survey contains 265 items for evaluation grouped into 10 key elements. Mean score and mean percentages based on the maximum possible values for the overall survey, for the key elements and for each individual item of evaluation were calculated. The results were compared with those of the previous 2011 study., Results: A total of 131 hospitals from 15 autonomous regions participated in the study. The mean score of the overall questionnaire in all hospitals was 898.2 (57.4% of the maximum possible score). No differences were found according to dependency, size or type of hospital, either in the overall questionnaire or in the key elements. The lowest values were found for key elements 8, 1 and 6, on competence and training of health professionals in safety practices (45.1%), availability and accessibility of essential information on patients (48%), and devices for administering drugs (52.3%). With respect to 2011, significant increases were found both in the overall questionnaire and in the key elements, except 5 and 7, referring to standardization, storage and distribution of medications, and environmental factors and human resources. Several evaluation items on the safe management of high-risk drugs, medication reconciliation, incorporation of clinical pharmacists into the healthcare teams and implementation of technologies that allow full traceability throughout the medication system, showed low percentages CONCLUSIONS: There has been appreciable progress in the degree of implementation of some medication error prevention practices in Spanish hospitals, but many proven efficacy practices recommended by the World Health Organization and safety organizations are still poorly implemented. The information obtained can be useful for prioritizing the practices to be addressed and as a new baseline for monitoring progress., (Copyright © 2023 Sociedad Española de Farmacia Hospitalaria (S.E.F.H). Publicado por Elsevier España, S.L.U. All rights reserved.)
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- 2023
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33. Response to inhaled granulocyte-macrophage colony-stimulating factor in patient with mild-to-moderate autoimmune pulmonary alveolar proteinosis-24 months of follow-up.
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Oterino-Moreira I, Linares-Asensio MJ, Sanz-Márquez S, and Pérez-Encinas M
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- Humans, Granulocyte-Macrophage Colony-Stimulating Factor therapeutic use, Follow-Up Studies, Administration, Inhalation, Pulmonary Alveolar Proteinosis diagnostic imaging, Pulmonary Alveolar Proteinosis drug therapy, Autoimmune Diseases drug therapy
- Abstract
Introduction: Autoimmune pulmonary alveolar proteinosis (aPAP) is a disease caused by IgG antibodies against granulocyte-macrophage colony-stimulating factor (GM-CSF). Whole lung lavage (WLL) allows to remove the lipo-proteinaceous material accumulated by the poor clearance of alveolar surfactant. However, it is a complex technique that is not exempt from complications, and in some cases, the patients are refractory, requiring the performance of several WLLs spaced apart in time., Materials and Methods: We present the clinical, functional, and radiological evolution after 24 months of follow-up of a patient diagnosis of aPAP refractory to WLL, with performed three therapeutic WLLs spaced 16 and 36 months and serious potentially fatal complications in the last one., Results and Disscusion: After 24 months, no adverse effects have appeared and the great clinical, functional and radiological response is maintained. The patient has been successfully treated with inhaled recombinant human GM-CSF sargramostim., (© 2023 The Authors. The Clinical Respiratory Journal published by John Wiley & Sons Ltd.)
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- 2023
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34. Application of IPSET-thrombosis in 1366 Patients Prospectively Followed From the Spanish Registry of Essential Thrombocythemia.
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Alvarez-Larrán A, Cuevas B, Velez P, Noya S, Caballero-Navarro G, Ferrer-Marín F, Carbonell S, Pérez-Encinas M, Gómez-Casares MT, Pérez-López R, Magro E, Moretó A, Pastor-Galán I, Angona A, Mata-Vázquez MI, Guerrero-Fernández L, Guerra JM, Carreño-Tarragona G, Fox L, Murillo I, García-Gutiérrez V, Mora E, Stuckey R, Arellano-Rodrigo E, Hernández-Boluda JC, and Pereira A
- Abstract
The International Prognostic Score of thrombosis in Essential Thrombocythemia (IPSET-thrombosis) and its revised version have been proposed to guide thrombosis prevention strategies. We evaluated both classifications to prognosticate thrombosis in 1366 contemporary essential thrombocythemia (ET) patients prospectively followed from the Spanish Registry of ET. The cumulative incidence of thrombosis at 10 years, taking death as a competing risk, was 11.4%. The risk of thrombosis was significantly higher in the high-risk IPSET-thrombosis and high-risk revised IPSET-thrombosis, but no differences were observed among the lower risk categories. Patients allocated in high-risk IPSET-thrombosis (subdistribution hazard ratios [SHR], 3.7 [95% confidence interval, CI, 1.6-8.7]) and high-risk revised IPSET-thrombosis (SHR, 3.2 [95% CI, 1.4-7.45]) showed an increased risk of arterial thrombosis, whereas both scoring systems failed to predict venous thrombosis. The incidence rate of thrombosis in intermediate risk revised IPSET-thrombosis (aged >60 years, JAK2 -negative, and no history of thrombosis) was very low regardless of the treatment administered (0.9% and 0% per year with and without cytoreduction, respectively). Dynamic application of the revised IPSET-thrombosis showed a low rate of thrombosis when patients without history of prior thrombosis switched to a higher risk category after reaching 60 years of age. In conclusion, IPSET-thrombosis scores are useful for identifying patients at high risk of arterial thrombosis, whereas they fail to predict venous thrombosis. Controlled studies are needed to determine the appropriate treatment of ET patients assigned to the non-high-risk categories., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the European Hematology Association.)
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- 2023
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35. CNL and aCML should be considered as a single entity based on molecular profiles and outcomes.
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Carreño-Tarragona G, Álvarez-Larrán A, Harrison C, Martínez-Ávila JC, Hernández-Boluda JC, Ferrer-Marín F, Radia DH, Mora E, Francis S, González-Martínez T, Goddard K, Pérez-Encinas M, Narayanan S, Raya JM, Singh V, Gutiérrez X, Toth P, Amat-Martínez P, Mcilwaine L, Alobaidi M, Mayani K, McGregor A, Stuckey R, Psaila B, Segura A, Alvares C, Davidson K, Osorio S, Cutting R, Sweeney CP, Rufián L, Moreno L, Cuenca I, Smith J, Morales ML, Gil-Manso R, Koutsavlis I, Wang L, Mead AJ, Rozman M, Martínez-López J, Ayala R, and Cross NCP
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- Humans, Epigenesis, Genetic, Mutation, Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative diagnosis, Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative genetics, Leukemia, Neutrophilic, Chronic diagnosis, Leukemia, Neutrophilic, Chronic genetics, Myelodysplastic-Myeloproliferative Diseases genetics
- Abstract
Chronic neutrophilic leukemia (CNL) and atypical chronic myeloid leukemia (aCML) are rare myeloid disorders that are challenging with regard to diagnosis and clinical management. To study the similarities and differences between these disorders, we undertook a multicenter international study of one of the largest case series (CNL, n = 24; aCML, n = 37 cases, respectively), focusing on the clinical and mutational profiles (n = 53 with molecular data) of these diseases. We found no differences in clinical presentations or outcomes of both entities. As previously described, both CNL and aCML share a complex mutational profile with mutations in genes involved in epigenetic regulation, splicing, and signaling pathways. Apart from CSF3R, only EZH2 and TET2 were differentially mutated between them. The molecular profiles support the notion of CNL and aCML being a continuum of the same disease that may fit best within the myelodysplastic/myeloproliferative neoplasms. We identified 4 high-risk mutated genes, specifically CEBPA (β = 2.26, hazard ratio [HR] = 9.54, P = .003), EZH2 (β = 1.12, HR = 3.062, P = .009), NRAS (β = 1.29, HR = 3.63, P = .048), and U2AF1 (β = 1.75, HR = 5.74, P = .013) using multivariate analysis. Our findings underscore the relevance of molecular-risk classification in CNL/aCML as well as the importance of CSF3R mutations in these diseases., (© 2023 by The American Society of Hematology. Licensed under Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0), permitting only noncommercial, nonderivative use with attribution. All other rights reserved.)
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- 2023
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36. Toxicity of Asciminib in Real Clinical Practice: Analysis of Side Effects and Cross-Toxicity with Tyrosine Kinase Inhibitors.
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Pérez-Lamas L, Luna A, Boque C, Xicoy B, Giraldo P, Pérez López R, Ruiz Nuño C, De Las Heras N, Mora Casterá E, López Marín J, Segura Díaz A, Gómez V, Vélez Tenza P, Sierra Pacho M, Vera Goñi JA, Moreno Vega M, Alvarez-Larrán A, Cortés M, Pérez Encinas M, Carrascosa Mastell P, Angona A, Rosell A, Lakhwani S, Colorado M, Ramila E, Cervero C, Cuevas B, Villalón Blanco L, de Paz R, Paz Coll A, Fernández MJ, Felipe Casado L, Alonso-Domínguez JM, Anguita Arance MM, Salamanca Cuenca A, Jiménez-Velasco A, Prendes SO, Santaliestra M, Lis Chulvi MJ, Hernández-Boluda JC, and García-Gutiérrez V
- Abstract
(1) Background: Despite the prognostic improvements achieved with tyrosine kinase inhibitors (TKIs) in chronic myeloid leukemia (CML), a minority of patients still fail TKIs. The recent introduction of asciminib may be a promising option in intolerant patients, as it is a first-in-class inhibitor with a more selective mechanism of action different from the ATP-competitive inhibition that occurs with TKIs. Therefore, our goal was to analyze toxicities shown with asciminib as well as to study cross-toxicity with previous TKIs. (2) Methods: An observational, multicenter, retrospective study was performed with data from 77 patients with CML with therapeutic failure to second-generation TKIs who received asciminib through a managed-access program (MAP) (3) Results: With a median follow-up of 13.7 months, 22 patients (28.5%) discontinued treatment: 32% (7/22) due to intolerance and 45% (10/22) due to resistance. Fifty-five percent of the patients reported adverse effects (AEs) with asciminib and eighteen percent grade 3-4. Most frequent AEs were: fatigue (18%), thrombocytopenia (17%), anemia (12%), and arthralgias (12%). None of the patients experienced cardiovascular events or occlusive arterial disease. Further, 26%, 25%, and 9% of patients required dose adjustment, temporary suspension, or definitive discontinuation of treatment, respectively. Toxicities under asciminib seemed lower than with prior TKIs for anemia, cardiovascular events, pleural/pericardial effusion, diarrhea, and edema. Cross-toxicity risk was statistically significant for thrombocytopenia, anemia, neutropenia, fatigue, vomiting, and pancreatitis. (4) Conclusion: Asciminib is a molecule with a good safety profile and with a low rate of AEs. However, despite its new mechanism of action, asciminib presents a risk of cross-toxicity with classical TKIs for some AEs.
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- 2023
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37. Machine Learning Improves Risk Stratification in Myelofibrosis: An Analysis of the Spanish Registry of Myelofibrosis.
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Mosquera-Orgueira A, Pérez-Encinas M, Hernández-Sánchez A, González-Martínez T, Arellano-Rodrigo E, Martínez-Elicegui J, Villaverde-Ramiro Á, Raya JM, Ayala R, Ferrer-Marín F, Fox ML, Velez P, Mora E, Xicoy B, Mata-Vázquez MI, García-Fortes M, Angona A, Cuevas B, Senín MA, Ramírez-Payer A, Ramírez MJ, Pérez-López R, González de Villambrosía S, Martínez-Valverde C, Gómez-Casares MT, García-Hernández C, Gasior M, Bellosillo B, Steegmann JL, Álvarez-Larrán A, Hernández-Rivas JM, and Hernández-Boluda JC
- Abstract
Myelofibrosis (MF) is a myeloproliferative neoplasm (MPN) with heterogeneous clinical course. Allogeneic hematopoietic cell transplantation remains the only curative therapy, but its morbidity and mortality require careful candidate selection. Therefore, accurate disease risk prognostication is critical for treatment decision-making. We obtained registry data from patients diagnosed with MF in 60 Spanish institutions (N = 1386). These were randomly divided into a training set (80%) and a test set (20%). A machine learning (ML) technique (random forest) was used to model overall survival (OS) and leukemia-free survival (LFS) in the training set, and the results were validated in the test set. We derived the AIPSS-MF (Artificial Intelligence Prognostic Scoring System for Myelofibrosis) model, which was based on 8 clinical variables at diagnosis and achieved high accuracy in predicting OS (training set c-index, 0.750; test set c-index, 0.744) and LFS (training set c-index, 0.697; test set c-index, 0.703). No improvement was obtained with the inclusion of MPN driver mutations in the model. We were unable to adequately assess the potential benefit of including adverse cytogenetics or high-risk mutations due to the lack of these data in many patients. AIPSS-MF was superior to the IPSS regardless of MF subtype and age range and outperformed the MYSEC-PM in patients with secondary MF. In conclusion, we have developed a prediction model based exclusively on clinical variables that provides individualized prognostic estimates in patients with primary and secondary MF. The use of AIPSS-MF in combination with predictive models that incorporate genetic information may improve disease risk stratification., (Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the European Hematology Association.)
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- 2022
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38. Correction: Gene expression profiling identifies FLT3 mutation-like cases in wild-type FLT3 acute myeloid leukemia.
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Mosquera Orgueira A, Peleteiro Raíndo A, Cid López M, Antelo Rodríguez B, Díaz Arias JÁ, Ferreiro Ferro R, Alonso Vence N, Bendaña López Á, Abuín Blanco A, Bao Pérez L, Melero Valentín P, Sonia González Pérez M, Cerchione C, Martinelli G, Montesinos Fernández P, Mateo Pérez Encinas M, and Luis Bello López J
- Abstract
[This corrects the article DOI: 10.1371/journal.pone.0247093.].
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- 2022
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39. Comparison of Three Comorbidity Measures for Predicting In-Hospital Death through a Clinical Administrative Nacional Database.
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Oterino-Moreira I, Lorenzo-Martínez S, López-Delgado Á, and Pérez-Encinas M
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- Adolescent, Adult, Aged, Comorbidity, Databases, Factual, Female, Hospital Mortality, Humans, Male, Retrospective Studies, Hospitalization
- Abstract
Background: Various authors have validated scales to measure comorbidity. However, the prognosis capacity variation according to the comorbidity measurement index used needs to be determined in order to identify which is the best predictor., Aims: To quantify the differences between the Charlson (CCI), Elixhauser (ECI) and van Walraven (WCI) comorbidity indices as prognostic factors for in-hospital mortality and to identify the best comorbidity measure predictor., Methods: A retrospective observational study that included all hospitalizations of patients over 18 years of age, discharged between 2017 and 2021 in the hospital, using the Minimum Basic Data Set (MBDS). We calculated CCI, ECI, WCI according to ICD-10 coding algorithms. The correlation and concordance between the three indices were evaluated by Spearman's rho and Intraclass Correlation Coefficient (ICC), respectively. The logistic regression model for each index was built for predicting in-hospital mortality. Finally, we used the receiver operating characteristic (ROC) curve for comparing the performance of each index in predicting in-hospital mortality, and the Delong method was employed to test the statistical significance of differences., Results: We studied 79,425 admission episodes. The 54.29% were men. The median age was 72 years (interquartile range [IQR]: 56-80) and in-hospital mortality rate was 4.47%. The median of ECI was = 2 (IQR: 1-4), ICW was 4 (IQR: 0-12) and ICC was 1 (IQR: 0-3). The correlation was moderate: ECI vs. WCI rho = 0.645, p < 0.001; ECI vs. CCI rho = 0.721, p < 0.001; and CCI vs. WCI rho = 0.704, p < 0.001; and the concordance was fair to good: ECI vs. WCI Intraclass Correlation Coefficient type A (ICC
A ) = 0.675 (CI 95% 0.665-0.684) p < 0.001; ECI vs. CCI ICCA = 0.797 (CI 95% 0.780-0.812), p < 0.001; and CCI vs. WCI ICCA = 0.731 (CI 95% 0.667-0.779), p < 0.001. The multivariate regression analysis demonstrated that comorbidity increased the risk of in-hospital mortality, with differences depending on the comorbidity measurement scale: odds ratio [OR] = 2.10 (95% confidence interval [95% CI] 2.00-2.20) p > |z| < 0 using ECI; OR = 2.31 (CI 95% 2.21-2.41) p > |z| < 0 for WCI; and OR = 2.53 (CI 95% 2.40-2.67) p > |z| < 0 employing CCI. The area under the curve [AUC] = 0.714 (CI 95% 0.706-0.721) using as a predictor of in-hospital mortality CCI, AUC = 0.729 (CI 95% 0.721-0.737) for ECI and AUC = 0.750 (CI 95% 0.743-0.758) using WCI, with statistical significance ( p < 0.001)., Conclusion: Comorbidity plays an important role as a predictor of in-hospital mortality, with differences depending on the measurement scale used, the van Walraven comorbidity index being the best predictor of in-hospital mortality.- Published
- 2022
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40. Azacitidine vs. Decitabine in Unfit Newly Diagnosed Acute Myeloid Leukemia Patients: Results from the PETHEMA Registry.
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Labrador J, Martínez-Cuadrón D, de la Fuente A, Rodríguez-Veiga R, Serrano J, Tormo M, Rodriguez-Arboli E, Ramos F, Bernal T, López-Pavía M, Trigo F, Martínez-Sánchez MP, Rodríguez-Gutiérrez JI, Rodríguez-Medina C, Gil C, Belmonte DG, Vives S, Foncillas MÁ, Pérez-Encinas M, Novo A, Recio I, Rodríguez-Macías G, Bergua JM, Noriega V, Lavilla E, Roldán-Pérez A, Sanz MA, Montesinos P, and On Behalf Of Pethema Group
- Abstract
The hypomethylating agents, decitabine (DEC) and azacitidine (AZA), allowed more elderly acute myeloid leukemia (AML) patients to be treated. However, there are little direct comparative data on AZA and DEC. This multicenter retrospective study compared the outcomes of AZA and DEC in terms of response and overall survival (OS). Potential predictors associated with response and OS were also evaluated. A total of 626 AML patients were included (487 treated with AZA and 139 with DEC). Response rates were similar in both groups: CR was 18% with AZA vs. 23% with DEC (p = 0.20), CR/CRi was 20.5% vs. 25% (p = 0.27) and ORR was 32% vs. 39.5% (p = 0.12), respectively. Patients with leukocytes < 10 × 109/L, bone marrow blasts < 50% and ECOG ≥ 2 had higher ORR with DEC than with AZA. OS was similar in both groups: 10.4 months (95% CI: 9.2−11.7) vs. 8.8 months (95% CI: 6.7−11.0, p = 0.455), for AZA and DEC, respectively. Age (≥80 years), leukocytes (≥ 10 × 109/L), platelet count (<20 × 109/L) and eGFR (≥45 mL/min/1.73 m2) were associated with higher OS with AZA compared to DEC. In conclusion, we found no differences in response and OS rates in AML patients treated with AZA or DEC.
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- 2022
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41. Use of Venetoclax in Patients with Relapsed or Refractory Acute Myeloid Leukemia: The PETHEMA Registry Experience.
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Labrador J, Saiz-Rodríguez M, de Miguel D, de Laiglesia A, Rodríguez-Medina C, Vidriales MB, Pérez-Encinas M, Sánchez-Sánchez MJ, Cuello R, Roldán-Pérez A, Vives S, Benzo-Callejo G, Colorado M, García-Fortes M, Sayas MJ, Olivier C, Recio I, Conde-Royo D, Bienert-García Á, Vahi M, Muñoz-García C, Seri-Merino C, Tormo M, Vall-Llovera F, Foncillas MÁ, Martínez-Cuadrón D, Sanz MÁ, and Montesinos P
- Abstract
The effectiveness of venetoclax (VEN) in relapsed or refractory acute myeloid leukemia (RR-AML) has not been well established. This retrospective, multicenter, observational database studied the effectiveness of VEN in a cohort of 51 RR-AML patients and evaluated for predictors of response and overall survival (OS). The median age was 68 years, most were at high risk, 61% received ≥2 therapies for AML, 49% had received hypomethylating agents, and ECOG was ≥2 in 52%. Complete remission (CR) rate, including CR with incomplete hematological recovery (CRi), was 12.4%. Additionally, 10.4% experienced partial response (PR). The CR/CRi was higher in combination with azacitidine (AZA; 17.9%) than with decitabine (DEC; 6.7%) and low-dose cytarabine (LDAC; 0%). Mutated NPM1 was associated with increased CR/CRi. Median OS was 104 days (95% CI: 56-151). For the combination with AZA, DEC, and LDAC, median OS was 120 days, 104 days, and 69 days, respectively; p = 0.875. Treatment response and ECOG 0 influenced OS in a multivariate model. A total of 28% of patients required interruption of VEN because of toxicity. Our real-life series describes a marginal probability of CR/CRi and poor OS after VEN-based salvage. Patients included had very poor-risk features and were heavily pretreated. The small percentage of responders did not reach the median OS.
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- 2022
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42. Erratum found in «Farmacia Hospitalaria. 2021;45(1):32-40».
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Pérez-Encinas M, Lozano-Blázquez A, García-Pellicer J, Torre-Lloveras I, Poveda-Andrés JL, and Calleja-Hernández MÁ
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- Humans, Bibliometrics, Pharmacy
- Published
- 2021
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43. Personalized Survival Prediction of Patients With Acute Myeloblastic Leukemia Using Gene Expression Profiling.
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Mosquera Orgueira A, Peleteiro Raíndo A, Cid López M, Díaz Arias JÁ, González Pérez MS, Antelo Rodríguez B, Alonso Vence N, Bao Pérez L, Ferreiro Ferro R, Albors Ferreiro M, Abuín Blanco A, Fontanes Trabazo E, Cerchione C, Martinnelli G, Montesinos Fernández P, Mateo Pérez Encinas M, and Luis Bello López J
- Abstract
Acute Myeloid Leukemia (AML) is a heterogeneous neoplasm characterized by cytogenetic and molecular alterations that drive patient prognosis. Currently established risk stratification guidelines show a moderate predictive accuracy, and newer tools that integrate multiple molecular variables have proven to provide better results. In this report, we aimed to create a new machine learning model of AML survival using gene expression data. We used gene expression data from two publicly available cohorts in order to create and validate a random forest predictor of survival, which we named ST-123. The most important variables in the model were age and the expression of KDM5B and LAPTM4B , two genes previously associated with the biology and prognostication of myeloid neoplasms. This classifier achieved high concordance indexes in the training and validation sets (0.7228 and 0.6988, respectively), and predictions were particularly accurate in patients at the highest risk of death. Additionally, ST-123 provided significant prognostic improvements in patients with high-risk mutations. Our results indicate that survival of patients with AML can be predicted to a great extent by applying machine learning tools to transcriptomic data, and that such predictions are particularly precise among patients with high-risk mutations., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Mosquera Orgueira, Peleteiro Raíndo, Cid López, Díaz Arias, González Pérez, Antelo Rodríguez, Alonso Vence, Bao Pérez, Ferreiro Ferro, Albors Ferreiro, Abuín Blanco, Fontanes Trabazo, Cerchione, Martinnelli, Montesinos Fernández, Mateo Pérez Encinas and Luis Bello López.)
- Published
- 2021
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44. GEMA5.0 - SPANISH GUIDELINE ON THE MANAGEMENT OF ASTHMA.
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Alobid I, Álvarez Rodríguez C, Blanco Aparicio M, Ferreira J, García G, Gómez-Outes A, Gómez Ruiz F, Hidalgo Requena A, Korta Murua J, Molina París J, Pellegrini Belinchón FJ, Pérez Encinas M, Plaza Moral V, Plaza Zamora J, Praena Crespo M, Quirce Gancedo S, and Sanz Ortega J
- Published
- 2021
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45. Predicting Survival after Allogeneic Hematopoietic Cell Transplantation in Myelofibrosis: Performance of the Myelofibrosis Transplant Scoring System (MTSS) and Development of a New Prognostic Model.
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Hernández-Boluda JC, Pereira A, Alvarez-Larran A, Martín AA, Benzaquen A, Aguirre L, Mora E, González P, Mora J, Dorado N, Sampol A, García-Gutiérrez V, López-Godino O, Fox ML, Reguera JL, Pérez-Encinas M, Pascual MJ, Xicoy B, Parody R, González-Pinedo L, Español I, Avendaño A, Correa JG, Vallejo C, Jurado M, García-Cadenas I, Osorio S, Durán MA, Sánchez-Guijo F, Cervantes F, and Piñana JL
- Subjects
- Humans, Prognosis, Transplantation Conditioning, Transplantation, Homologous, Treatment Outcome, Hematopoietic Stem Cell Transplantation, Primary Myelofibrosis therapy
- Abstract
Accurate prognostic tools are crucial to assess the risk/benefit ratio of allogeneic hematopoietic cell transplantation (allo-HCT) in patients with myelofibrosis (MF). We aimed to evaluate the performance of the Myelofibrosis Transplant Scoring System (MTSS) and identify risk factors for survival in a multicenter series of 197 patients with MF undergoing allo-HCT. After a median follow-up of 3.1 years, 47% of patients had died, and the estimated 5-year survival rate was 51%. Projected 5-year risk of nonrelapse mortality and relapse incidence was 30% and 20%, respectively. Factors independently associated with increased mortality were a hematopoietic cell transplantation-specific comorbidity index (HCT-CI) ≥3 and receiving a graft from an HLA-mismatched unrelated donor or cord blood, whereas post-transplant cyclophosphamide (PT-Cy) was associated with improved survival. Donor type was the only parameter included in the MTSS model with independent prognostic value for survival. According to the MTSS, 3-year survival was 62%, 66%, 37%, and 17% for low-, intermediate-, high-, and very high-risk groups, respectively. By pooling together the low- and intermediate-risk groups, as well as the high- and very high-risk groups, we pinpointed 2 categories: standard risk and high risk (25% of the series). Three-year survival was 62% in standard-risk and 25% in high-risk categories (P < .001). We derived a risk score based on the 3 independent risk factors for survival in our series (donor type, HCT-CI, and PT-Cy). The corresponding 5-year survival for the low-, intermediate-, and high-risk categories was 79%, 55%, and 32%, respectively (P < .001). In conclusion, the MTSS model failed to clearly delineate 4 prognostic groups in our series but may still be useful to identify a subset of patients with poor outcome. We provide a simple prognostic scoring system for risk/benefit considerations before transplantation in patients with MF., (Copyright © 2020 American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc. All rights reserved.)
- Published
- 2020
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46. Assessing Pharmacists' Preferences towards Efficacy Attributes of Disease-Modifying Therapies in Relapsing-Remitting Multiple Sclerosis.
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Martínez-López I, Maurino J, Sanmartín-Fenollera P, Ontañon-Nasarre A, Santiago-Pérez A, Moya-Carmona I, García-Collado CG, Fernández-Del Olmo R, García-Arcelay E, Sarmiento M, Carreño Á, and Pérez-Encinas M
- Abstract
Introduction: Hospital pharmacists are increasingly playing a critical role in the care of patients with multiple sclerosis (MS). However, little is known about their preferences and perspectives towards different attributes of disease-modifying therapies (DMTs). The objective of this research was to assess pharmacists´ preferences for DMT efficacy attributes. Methods: A multicenter, non-interventional, cross-sectional, web-based study was conducted. Preventing relapses, delaying disease progression, controlling radiological activity, and preserving health-related quality of life (HRQoL) and cognition were the attributes selected based on a literature review and a focus group with six hospital pharmacists. Conjoint analysis was used to determine preferences in eight hypothetical treatment scenarios, combining different levels of each attribute and ranking them from most to least preferred. Results: Sixty-five hospital pharmacists completed the study (mean age: 43.5 ± 7.8 years, 63.1% female, mean years of professional experience: 16.1 ± 7.4 years). Participants placed the greatest preference on delaying disease progression (35.7%) and preserving HRQoL (21.6%) and cognition (21.6%). Importance was consistent in all groups of pharmacists stratified according to demographic characteristics, experience, research background, and volume of patients seen per year. Conclusions: Understanding which treatment characteristics are meaningful to hospital pharmacists may help to enhance their synergistic role in the multidisciplinary management of patients with MS.
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- 2020
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47. Persistence and adherence to interferon and glatiramer acetate in patients with multiple sclerosis.
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Bartolomé-García E, Usarralde-Pérez Á, Sanmartín-Fenollera P, and Pérez-Encinas M
- Abstract
Objectives: To analyse persistence and adherence in patients with multiple sclerosis receiving first-line treatment with subcutaneous glatiramer acetate 20 mg (GA), subcutaneous interferon β1a (IFNβ1a-sc), intramuscular interferon β1a (IFNβ1a-im) and subcutaneous interferon β1b (IFNβ1b-sc) and to identify associated factors and reasons for discontinuation., Methods: An observational retrospective study was performed between January 1999 and November 2014. Persistence was defined as the time from treatment initiation until discontinuation, and adherence as the number of units dispensed since treatment initiation until its interruption divided by the theoretical number of units needed to cover said period as a percentage. A patient was considered adherent if ≥95%. Persistence was measured using the Kaplan-Meier method and univariate Cox regression; adherence was measured using a univariate binary logistical regression model., Results: The study included 224 patients. The median persistence was 1349 days (95% CI 1017.4 to 1680.6). Patients receiving IFNβ1a-im continued treatment for a longer time (1720 days; 95% CI 1196.8 to 2243.2), while patients treated with IFNβ1a-sc had the lowest persistence (771 days; 95% CI 377.4 to 1164.6) (HR=1.7; 95% CI 1.02 to 2.72). Patients with Expanded Disability Status Scale (EDSS) 1.5-6 discontinued treatment earlier than those with EDSS 0-1 (HR 1.5; 95% CI 1.01 to 2.25); 94.4% of patients discontinued treatment due to medical decision, primarily due to lack of efficacy (24.6%) and adverse effects (17.4%), while 80.8% of patients had good adherence. GA had the highest adherence, with no major difference from IFNβ1a-im, while IFNβ1b-sc showed the highest non-adherence (OR 3.5; 95% CI 1.29 to 9.28)., Conclusions: The persistence levels obtained were lower than in similar studies. EDSS was identified as an independent predictor of treatment interruption. Acceptable adherence was achieved among the population, comparable to other studies and influenced by the drug., Competing Interests: Competing interests: None declared.
- Published
- 2019
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48. Feasibility of treatment discontinuation in chronic myeloid leukemia in clinical practice: results from a nationwide series of 236 patients.
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Hernández-Boluda JC, Pereira A, Pastor-Galán I, Alvarez-Larrán A, Savchuk A, Puerta JM, Sánchez-Pina JM, Collado R, Díaz-González A, Angona A, Sagüés M, García-Gutiérrez V, Boqué C, Osorio S, Vallansot R, Palomera L, Mendizábal A, Casado LF, Pérez-Encinas M, Pérez-López R, Ferrer-Marín F, Sánchez-Guijo F, García C, Heras NL, López-Lorenzo JL, Cervantes F, and Steegmann JL
- Subjects
- Aged, Anticarcinogenic Agents administration & dosage, Anticarcinogenic Agents adverse effects, Biomarkers, Drug Resistance, Neoplasm, Female, Follow-Up Studies, Fusion Proteins, bcr-abl antagonists & inhibitors, Fusion Proteins, bcr-abl genetics, Humans, Leukemia, Myelogenous, Chronic, BCR-ABL Positive genetics, Leukemia, Myelogenous, Chronic, BCR-ABL Positive mortality, Leukemia, Myelogenous, Chronic, BCR-ABL Positive pathology, Male, Middle Aged, Proportional Hazards Models, Protein Kinase Inhibitors administration & dosage, Protein Kinase Inhibitors adverse effects, Recurrence, Treatment Outcome, Anticarcinogenic Agents therapeutic use, Leukemia, Myelogenous, Chronic, BCR-ABL Positive drug therapy, Protein Kinase Inhibitors therapeutic use
- Abstract
Over half of chronic myeloid leukemia (CML) patients in deep molecular response do not lose the major molecular response (MMR) after stopping treatment with tyrosine kinase inhibitors (TKI). This strategy is safe in clinical trials, but its applicability in the real-life setting remains unsettled. We describe the outcomes after TKI discontinuation in a nationwide series of 236 CML patients. Median follow-up from treatment discontinuation was 21.5 months and 5 patients died from CML-unrelated causes. TKI therapy was reinitiated due to MMR loss (n = 52), increase ≥ 1 log in BCR-ABL transcript level without losing MMR (n = 12), patient preference (n = 2), and withdrawal syndrome (n = 1). Treatment-free remission rate at 4 years was 64% (95% confidence interval, CI: 55%-72%). Cumulative incidence of molecular recurrence at 3 years was 33% (95% CI: 26%-38%). TKI treatment for < 5 years and MR4.5 duration shorter than 4 years were both associated with higher incidence of molecular recurrence. No patient had disease progression. Response status at last control was: MR4.5 (n = 196), MR4 (n = 15), MMR (n = 14), complete cytogenetic response (n = 10), and other (n = 1). A significant increase in Hb and cholesterol levels was observed after imatinib withdrawal. Our results demonstrate that TKI treatment discontinuation is feasible in real-life clinical practice.
- Published
- 2018
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49. [Linagliptin-induced liver toxicity].
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Bartolomé-García E, Sanz-Márquez S, and Pérez-Encinas M
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- Aged, Diabetes Mellitus, Type 2 complications, Diabetes Mellitus, Type 2 drug therapy, Humans, Hypoglycemic Agents therapeutic use, Linagliptin therapeutic use, Liver Function Tests, Male, Chemical and Drug Induced Liver Injury etiology, Hypoglycemic Agents adverse effects, Linagliptin adverse effects
- Published
- 2017
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50. Risk of thrombosis according to need of phlebotomies in patients with polycythemia vera treated with hydroxyurea.
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Alvarez-Larrán A, Pérez-Encinas M, Ferrer-Marín F, Hernández-Boluda JC, Ramírez MJ, Martínez-López J, Magro E, Cruz Y, Mata MI, Aragües P, Fox ML, Cuevas B, Montesdeoca S, Hernández-Rivas JA, García-Gutiérrez V, Gómez-Casares MT, Steegmann JL, Durán MA, Gómez M, Kerguelen A, Bárez A, García MC, Boqué C, Raya JM, Martínez C, Albors M, García F, Burgaleta C, and Besses C
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Blood Cell Count, Combined Modality Therapy, Drug Resistance, Female, Hematocrit, Humans, Hydroxyurea administration & dosage, Male, Middle Aged, Multivariate Analysis, Phenotype, Polycythemia Vera diagnosis, Registries, Risk, Spain epidemiology, Thrombosis diagnosis, Time Factors, Treatment Outcome, Young Adult, Hydroxyurea therapeutic use, Phlebotomy, Polycythemia Vera complications, Polycythemia Vera therapy, Thrombosis epidemiology, Thrombosis etiology
- Abstract
Hematocrit control below 45% is associated with a lower rate of thrombosis in polycythemia vera. In patients receiving hydroxyurea, this target can be achieved with hydroxyurea alone or with the combination of hydroxyurea plus phlebotomies. However, the clinical implications of phlebotomy requirement under hydroxyurea therapy are unknown. The aim of this study was to evaluate the need for additional phlebotomies during the first five years of hydroxyurea therapy in 533 patients with polycythemia vera. Patients requiring 3 or more phlebotomies per year (n=85, 16%) showed a worse hematocrit control than those requiring 2 or less phlebotomies per year (n=448, 84%). There were no significant differences between the two study groups regarding leukocyte and platelet counts. Patients requiring 3 or more phlebotomies per year received significantly higher doses of hydroxyurea than the remaining patients. A significant higher rate of thrombosis was found in patients treated with hydroxyurea plus 3 or more phlebotomies per year compared to hydroxyurea with 0-2 phlebotomies per year (20.5% vs. 5.3% at 3 years; P<0.0001). In multivariate analysis, independent risk factors for thrombosis were phlebotomy dependency (HR: 3.3, 95%CI: 1.5-6.9; P=0.002) and thrombosis at diagnosis (HR: 4.7, 95%CI: 2.3-9.8; P<0.0001). The proportion of patients fulfilling the European LeukemiaNet criteria of resistance/intolerance to hydroxyurea was significantly higher in the group requiring 3 or more phlebotomies per year (18.7% vs. 7.1%; P=0.001) mainly due to extrahematologic toxicity. In conclusion, phlebotomy requirement under hydroxyurea therapy identifies a subset of patients with increased proliferation of polycythemia vera and higher risk of thrombosis., (Copyright© Ferrata Storti Foundation.)
- Published
- 2017
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- View/download PDF
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