13 results on '"Jäger, Ulrich"'
Search Results
2. Prevalence of pain and its association with symptoms of post-traumatic stress disorder, depression, anxiety and distress in 846 cancer patients: A cross sectional study.
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Unseld M, Zeilinger EL, Fellinger M, Lubowitzki S, Krammer K, Nader IW, Hafner M, Kitta A, Adamidis F, Masel EK, Preusser M, Jäger U, and Gaiger A
- Subjects
- Anxiety epidemiology, Cross-Sectional Studies, Depression epidemiology, Female, Humans, Pain epidemiology, Prevalence, Neoplasms epidemiology, Stress Disorders, Post-Traumatic epidemiology
- Abstract
Objective: Pain depicts a severe physical symptom but its relationship to mental health problems is not well studied in cancer patients. The aim of this study was to investigate the prevalence of pain and its correlation with symptoms of post-traumatic stress disorder (PTSD), depression, anxiety and psychological distress in a large sample of cancer patients., Methods: From 2010 to 2019, cancer patients who received outpatient treatment at the Medical University of Vienna were assessed with the Post-Traumatic Symptom Scale (PTSS-10) and the Hospital Anxiety and Depression Scales. A visual analogue scale was used to assess pain perception. For statistical analysis, linear regression models were applied to log-transformed data., Results: Of the 846 cancer patients included in the study, 63.5% experienced pain (mild 43.5%, moderate 13.6%, severe 6.4%). About a third (31.2%) of the total sample presented with significant PTSD symptoms. Significant symptoms of depression, anxiety and distress were present in 13.9%, 15.1% and 25.3%, respectively. Women more often reported symptoms of PTSD, anxiety and distress. Pain scores were significantly related to symptoms of PTSD, depression and psychological distress (all with p < .001), but not to anxiety., Conclusions: Results show a high prevalence of experienced pain and indicate a clear association of elevated pain levels with psychiatric symptoms in oncological patients in a large Austrian sample. In order to decrease experienced pain and to enable better treatment of mental health problems in cancer patients, diagnostic procedures and interventions based on a biopsychosocial model need to be intensified., (© 2020 The Authors. Psycho-Oncology published by John Wiley & Sons Ltd.)
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- 2021
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3. Normal and pathological erythropoiesis in adults: from gene regulation to targeted treatment concepts.
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Valent P, Büsche G, Theurl I, Uras IZ, Germing U, Stauder R, Sotlar K, Füreder W, Bettelheim P, Pfeilstöcker M, Oberbauer R, Sperr WR, Geissler K, Schwaller J, Moriggl R, Béné MC, Jäger U, Horny HP, and Hermine O
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- Adult, Anemia pathology, Erythroid Cells pathology, Humans, Neoplasms pathology, Polycythemia pathology, Anemia metabolism, Erythroid Cells metabolism, Erythropoiesis, Gene Expression Regulation, Neoplastic, Neoplasms metabolism, Polycythemia metabolism
- Abstract
Pathological erythropoiesis with consequent anemia is a leading cause of symptomatic morbidity in internal medicine. The etiologies of anemia are complex and include reactive as well as neoplastic conditions. Clonal expansion of erythroid cells in the bone marrow may result in peripheral erythrocytosis and polycythemia but can also result in anemia when clonal cells are dysplastic and have a maturation arrest that leads to apoptosis and hinders migration, a constellation typically seen in the myelodysplastic syndromes. Rarely, clonal expansion of immature erythroid blasts results in a clinical picture resembling erythroid leukemia. Although several mechanisms underlying normal and abnormal erythropoiesis and the pathogenesis of related disorders have been deciphered in recent years, little is known about specific markers and targets through which prognosis and therapy could be improved in anemic or polycythemic patients. In order to discuss new markers, targets and novel therapeutic approaches in erythroid disorders and the related pathologies, a workshop was organized in Vienna in April 2017. The outcomes of this workshop are summarized in this review, which includes a discussion of new diagnostic and prognostic markers, the updated WHO classification, and an overview of new drugs used to stimulate or to interfere with erythropoiesis in various neoplastic and reactive conditions. The use and usefulness of established and novel erythropoiesis-stimulating agents for various indications, including myelodysplastic syndromes and other neoplasms, are also discussed., (Copyright © 2018 Ferrata Storti Foundation.)
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- 2018
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4. Review of cancer treatment with immune checkpoint inhibitors : Current concepts, expectations, limitations and pitfalls.
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Thallinger C, Füreder T, Preusser M, Heller G, Müllauer L, Höller C, Prosch H, Frank N, Swierzewski R, Berger W, Jäger U, and Zielinski C
- Subjects
- Drug-Related Side Effects and Adverse Reactions, Humans, Molecular Targeted Therapy, Motivation, Immunotherapy, Neoplasms therapy
- Abstract
Immunotherapy by checkpoint inhibition is about to profoundly change cancer therapy. The number of indications are growing at an unprecedented speed. Clinical studies have demonstrated efficacy in a variety of solid tumors and in hematologic malignancies, although some clinical trials have produced negative results. Thus, it is fair to assume that there are obvious limitations and pitfalls in immunotherapy. Future concepts for combination treatment of immune checkpoint inhibitors have to be developed, but there is also urgent need for better and standardized biomarkers to identify those cancer patients who will benefit from treatment by checkpoint inhibition. The current overview summarizes current knowledge on immune checkpoint inhibitor treatment in malignancies, its outlook and limitations, diagnostic means and, finally, side effect management.
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- 2018
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5. Association of mean platelet volume with risk of venous thromboembolism and mortality in patients with cancer. Results from the Vienna Cancer and Thrombosis Study (CATS).
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Riedl J, Kaider A, Reitter EM, Marosi C, Jäger U, Schwarzinger I, Zielinski C, Pabinger I, and Ay C
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- Aged, Austria, Blood Platelets pathology, Cell Count, Cohort Studies, Disease Progression, Female, Follow-Up Studies, Humans, Male, Middle Aged, Neoplasms mortality, P-Selectin blood, Prognosis, Prospective Studies, Risk, Survival Analysis, Venous Thromboembolism mortality, Mean Platelet Volume statistics & numerical data, Neoplasms diagnosis, Neoplasms epidemiology, Venous Thromboembolism diagnosis, Venous Thromboembolism epidemiology
- Abstract
Venous thromboembolism (VTE) is a frequent complication in cancer patients. Mean platelet volume (MPV) has been associated with arterial and venous thrombosis in patients without cancer. We analysed MPV in cancer patients and investigated the association of MPV with risk of VTE and mortality. MPV was routinely determined in the Vienna Cancer and Thrombosis Study, a prospective, observational cohort study of patients with newly diagnosed or progressive cancer after remission. Study endpoints were occurrence of symptomatic VTE or death during a maximum follow-up of two years. Out of 1,544 included patients, 114 (7.4%) developed VTE and 573 (37.1%) died during a median observation time of 576 days. High MPV ≥75th percentile of the study population; ≥10.8 fL) was associated with decreased risk of VTE compared to MPV below the 75th percentile (HR [95% CI]: 0.59 [0.37-0.95], p=0.031). In multivariable analysis, including age, sex, cancer groups, newly diagnosed vs recurrent disease, platelet count and soluble P-selectin, this association remained statistically significant (0.65 [0.37-0.98], p=0.041). Mortality of patients with MPV (≥75th percentile was significantly decreased compared to those with lower MPV (0.72 [0.59-0.88], p=0.001). Two-year probability of VTE and overall survival was 5.5% and 64.7% in patients with high MPV compared to 9% and 55.7% in those with lower MPV. In conclusion, high MPV is associated with decreased VTE risk and improved survival in cancer patients. This finding is contrary to results observed in patients without cancer. Further studies are needed to confirm our results and elucidate underlying mechanisms.
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- 2014
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6. Pandemic whole-virion, Vero-cell-derived, adjuvant-free influenza A H1N1 vaccine in patients with solid tumors and hematologic malignancies receiving concurrent anticancer treatment: Immunogenicity, tolerability, and acceptability during the pandemic situation.
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Lagler H, Tobudic S, Ramharter M, Elandt K, Sperr WR, Redlberger-Fritz M, Popow-Kraupp T, Jäger U, Zielinski CC, and Burgmann H
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- Adult, Aged, Antibodies, Viral blood, Antineoplastic Agents administration & dosage, Enzyme-Linked Immunosorbent Assay, Female, Hemagglutination Inhibition Tests, Humans, Influenza Vaccines administration & dosage, Male, Middle Aged, Neoplasms drug therapy, Neoplasms immunology, Patient Acceptance of Health Care statistics & numerical data, Influenza A Virus, H1N1 Subtype immunology, Influenza Vaccines adverse effects, Influenza Vaccines immunology, Influenza, Human prevention & control, Neoplasms complications
- Abstract
Patients with malignancies are considered to be at increased risk of acquiring influenza. Because of higher complication and case fatality rates, preventive measures such as vaccination are of great interest. The objective of this study was to assess the acceptability, tolerability and immunogenicity of an adjuvant-free whole-virion pandemic influenza A (H1N1) vaccine in cancer patients with ongoing anticancer treatment during a 'pandemic situation'. Adult patients with hematologic malignancies or solid tumors and concurrent cytotoxic, targeted, and/or hormone therapy were recruited during the influenza A (H1N1) pandemic in 2009/2010 and were offered free vaccine. Antibody titers were measured using virus-specific hemagglutination inhibition assay and ELISA. Among 285 patients with solid tumors who were offered vaccination during their therapy, 260 (91.2%) declined and 25 (8.8%) accepted. Seventeen patients with hematologic malignancies were also vaccinated during therapy; 23 healthy individuals served as a control group. When measured using hemagglutination-inhibition assays, rates of seroprotection, seroconversion, and geometric mean titer ratios after the second vaccination were 96%, 70%, and 4.1 respectively among the healthy individuals, 90%, 52%, and 4.3 among patients with solid tumors, and 67%, 13%, and 1.5 among patients with hematologic malignancies during therapy (P<0.05). When measured using ELISA, seropositivity differed significantly among the three groups after the second vaccination: healthy individuals 74%, patients with solid tumors 57%, those with hematologic malignancies 13% (P<0.001). The vaccine was well tolerated. Our results demonstrate a low uptake of the well tolerated adjuvant-free influenza A (H1N1) vaccine by cancer patients receiving anticancer treatment during the pandemic of 2009/2010. Among the vaccinated patients, the immune response was weaker than that in healthy individuals. The immune response in patients with hematological malignancies was low. Two doses of vaccine are needed in these immunosuppressed patients., (Copyright © 2012 Elsevier Ltd. All rights reserved.)
- Published
- 2012
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7. Neoplastic stem cells: current concepts and clinical perspectives.
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Schulenburg A, Brämswig K, Herrmann H, Karlic H, Mirkina I, Hubmann R, Laffer S, Marian B, Shehata M, Krepler C, Pehamberger H, Grunt T, Jäger U, Zielinski CC, and Valent P
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- Animals, Humans, Neoplasms pathology, Neoplastic Stem Cells pathology
- Abstract
Neoplastic stem cells have initially been characterized in myeloid leukemias where NOD/SCID mouse-repopulating progenitors supposedly reside within a CD34+/Lin- subset of the malignant clone. These progenitors are considered to be self-renewing cells responsible for the in vivo long-term growth of neoplastic cells in leukemic patients. Therefore, these cells represent an attractive target of therapy. In some lymphoid leukemias, NOD/SCID mouse-repopulating cells were also reported to reside within the CD34+/Lin- subfraction of the clone. More recently, several attempts have been made to transfer the cancer stem cell concept to solid tumors and other non-hematopoietic neoplasms. In several of these tumors, the cell surface antigens AC133 (CD133) and CD44 are considered to indicate the potential of a cell to initiate permanent tumor formation in vivo. However, several questions concerning the phenotype, self-renewal capacity, stroma-dependence, and other properties of cancer- or leukemia-initiating cells remain to be solved. The current article provides a summary of our current knowledge on neoplastic (cancer) stem cells, with special emphasis on clinical implications and therapeutic options as well as a discussion about conceptual and technical limitations., (Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.)
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- 2010
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8. [Tumor stem cell research - basis and challenge for diagnosis and therapy].
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Karlic H, Herrmann H, Schulenburg A, Grunt TW, Laffer S, Mirkina I, Hubmann R, Shehata M, Marian B, Selzer E, Pfeilstöcker M, Pittermann E, Jäger U, Pehamberger H, Zielinski C, and Valent P
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- Animals, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Apoptosis drug effects, Apoptosis physiology, Cell Division drug effects, Cell Division physiology, Drug Resistance, Neoplasm, Humans, Leukemia pathology, Mice, Mice, Nude, Neoplasms pathology, Neoplastic Stem Cells drug effects, Prognosis, Antineoplastic Agents therapeutic use, Leukemia diagnosis, Leukemia drug therapy, Neoplasms diagnosis, Neoplasms drug therapy, Neoplastic Stem Cells pathology, Tumor Stem Cell Assay
- Abstract
Biological features of tumor cells relevant to progression, metastasis, and prognosis in cancer patients have been investigated for many years. During the past few years, the concept of tumor stem cells has gained widespread acceptance. The cancer stem cell (CSC) model is based on the observation that continuous growth of tumors depends on a small population of immature neoplastic cells with unlimited proliferative potential. In contrast to these CSC, more mature clonal cells in the same neoplasm undergo apoptosis and die after a variable number of cell divisions. The self-renewal capacity of CSC plays a central role in this scenario and enables permanent tumor cell repopulation in vivo in patients as well as in experimental animals, e.g., immunodeficient mice. Based on the stem cell concept, it is clear that the success of an anti-neoplastic approach depends on efficient targeting and elimination of CSC. An important aspect of CSC is their intrinsic resistance against conventional drugs. Therefore, a major focus in current research is molecular targets and their expression in CSC, with the goal to use targeted drugs for CSC elimination. It is the hope for the future that therapeutic approaches involving CSC-targeting concepts will lead to sustained remission and thus improvement of prognosis in leukemia and cancer patients.
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- 2010
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9. [Autoimmune hemolytic anemia in solid tumors: an underdiagnosed phenomenon?].
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Jäger U
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- Anemia, Hemolytic, Autoimmune immunology, Anemia, Hemolytic, Autoimmune therapy, Autoantibodies blood, Erythrocytes immunology, Humans, Neoplasms immunology, Neoplasms therapy, Paraneoplastic Syndromes immunology, Paraneoplastic Syndromes therapy, Risk Factors, Anemia, Hemolytic, Autoimmune diagnosis, Neoplasms diagnosis, Paraneoplastic Syndromes diagnosis
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- 2010
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10. [The use of erythropoiesis-stimulating proteins in anemic patients with malignant diseases].
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Ludwig H, Auberger T, Burghuber OCh, Gnant M, Hopfinger G, Jäger U, Keil F, Kornek G, Linkesch W, Petru E, Pirker R, Pittermann E, Reinthaller A, Samonigg H, Steger G, Stockenhuber F, Studnicka M, Weiss G, and Zielinski C
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- Austria, Hematinics, Humans, Recombinant Proteins, Anemia complications, Anemia drug therapy, Erythropoietin administration & dosage, Neoplasms complications, Neoplasms drug therapy, Practice Guidelines as Topic
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- 2008
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11. Salvage therapy for relapsed posttransplant lymphoproliferative disorders (PTLD) with a second progression of PTLD after Upfront chemotherapy: the role of single-agent rituximab.
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Trappe RU, Choquet S, Reinke P, Dreyling M, Mergenthaler HG, Jäger U, Kebelmann-Betzing C, Jonas S, Lehmkuhl H, Anagnostopoulos I, Leblond V, Hetzer R, Dörken B, Riess H, and Oertel S
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- Adult, Antibodies, Monoclonal, Murine-Derived, Antineoplastic Combined Chemotherapy Protocols administration & dosage, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Cyclophosphamide administration & dosage, Disease Progression, Disease-Free Survival, Doxorubicin administration & dosage, Humans, Immunosuppression Therapy, Lymphoproliferative Disorders etiology, Neoplasms mortality, Prednisone administration & dosage, Rituximab, Salvage Therapy, Survival Analysis, Survivors, Treatment Failure, Treatment Outcome, Vincristine administration & dosage, Antibodies, Monoclonal therapeutic use, Antineoplastic Agents therapeutic use, Lymphoproliferative Disorders complications, Lymphoproliferative Disorders drug therapy, Neoplasms drug therapy
- Abstract
Currently no standard treatment exists for patients with posttransplant lymphoproliferative disorders relapsed or refractory to chemotherapy after failure of reduction in immunosuppression. We have analyzed the effects of single-agent rituximab treatment in eight patients (seven adult, one pediatric) in this setting. Three patients had been salvaged with rituximab several times. In the seven adults, rituximab salvage therapy achieved complete remission (CR) in three patients (43%) and partial remission in one (14%). In the pediatric patient, a PR was obtained that could be reinduced on relapse with repeated administrations of rituximab. Patients achieving CR either remained in CR or were successfully salvaged again with single-agent rituximab. At a median follow-up of 69 months, median progression-free survival was 9 months and no relevant therapy-associated toxicity was observed. Single-agent rituximab salvage therapy is an effective treatment option in this setting of intensively pretreated patients, with virtually no therapy-associated toxicity.
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- 2007
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12. Review of cancer treatment with immune checkpoint inhibitors
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Thallinger, Christiane, Füreder, Thorsten, Preusser, Matthias, Heller, Gerwin, Müllauer, Leonhard, Höller, Christoph, Prosch, Helmut, Frank, Natalija, Swierzewski, Rafal, Berger, Walter, Jäger, Ulrich, and Zielinski, Christoph
- Subjects
Motivation ,Drug-Related Side Effects and Adverse Reactions ,Neoplasms ,PD-1 ,Humans ,Review Article ,Immunotherapy ,Review ,Molecular Targeted Therapy ,Cancer ,Experts - Abstract
Summary Immunotherapy by checkpoint inhibition is about to profoundly change cancer therapy. The number of indications are growing at an unprecedented speed. Clinical studies have demonstrated efficacy in a variety of solid tumors and in hematologic malignancies, although some clinical trials have produced negative results. Thus, it is fair to assume that there are obvious limitations and pitfalls in immunotherapy. Future concepts for combination treatment of immune checkpoint inhibitors have to be developed, but there is also urgent need for better and standardized biomarkers to identify those cancer patients who will benefit from treatment by checkpoint inhibition. The current overview summarizes current knowledge on immune checkpoint inhibitor treatment in malignancies, its outlook and limitations, diagnostic means and, finally, side effect management.
- Published
- 2017
13. TP53 aberrations in chronic lymphocytic leukemia: an overview of the clinical implications of improved diagnostics
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Šárka Pospíšilová, Anna Schuh, Ulrich Jäger, Richard Rosenquist, Paolo Ghia, Florence Cymbalista, Elias Campo, Stephan Stilgenbauer, Campo, Elia, Cymbalista, Florence, Ghia, Paolo, Jäger, Ulrich, Pospisilova, Sarka, Rosenquist, Richard, Schuh, Anna, Stilgenbauer, Stephan, and Universitat de Barcelona
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0301 basic medicine ,Oncology ,medicine.medical_specialty ,Diagnostic methods ,Pronòstic mèdic ,endocrine system diseases ,Chronic lymphocytic leukemia ,Review Article ,Tp53 mutation ,medicine.disease_cause ,03 medical and health sciences ,0302 clinical medicine ,Chemoimmunotherapy ,Internal medicine ,Medicine ,Leucèmia limfocítica crònica ,Chronic Lymphocytic Leukemia ,Allele ,neoplasms ,Mutation ,business.industry ,Mutació (Biologia) ,Hematology ,Mutation (Biology) ,medicine.disease ,Prognosis ,Cell Therapy and Immunotherapy ,3. Good health ,Clinical trial ,Leukemia ,030104 developmental biology ,030220 oncology & carcinogenesis ,Lymphocyte ,business - Abstract
Chronic lymphocytic leukemia is associated with a highly heterogeneous disease course in terms of clinical outcomes and responses to chemoimmunotherapy. This heterogeneity is partly due to genetic aberrations identified in chronic lymphocytic leukemia cells such as mutations of TP53 and/or deletions in chromosome 17p [del(17p)], resulting in loss of one TP53 allele. These aberrations are associated with markedly decreased survival and predict impaired response to chemoimmunotherapy thus being among the strongest predictive markers guiding treatment decisions in chronic lymphocytic leukemia. Clinical trials demonstrate the importance of accurately testing for TP53 aberrations [both del(17p) and TP53 mutations] before each line of treatment to allow for appropriate treatment decisions that can optimize patients’ outcomes. The current report reviews the diagnostic methods to detect TP53 disruption better, the role of TP53 aberrations in treatment decisions and current therapies available for patients with chronic lymphocytic leukemia carrying these abnormalities. The standardization in sequencing technologies for accurate identification of TP53 mutations and the importance of continued evaluation of TP53 aberrations throughout initial and subsequent lines of therapy remain unmet clinical needs as new therapeutic alternatives become available.
- Published
- 2018
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