Implante hematopoyético de una serie de pacientes movilizados con Plerixafor. Estudio retrospectivo multicéntrico

Poster [PC-256] Introducción: Plerixafor (PLX) es un inhibidor del receptor CXCR4 de probada eficacia en la recolección de PHSP para autotrasplante hematopoyético (TASPE) en pacientes malos movilizadores. Los estudios llevados a cabo hasta la fecha se han centrado mayoritariamente en aspectos referentes a la cinética de movilización (Mx) y rendimiento. El objetivo de nuestro estudio es recoger una amplia experiencia multicéntrica sobre el injerto hematopoyético a corto y medio plazo de pacientes que habían sido movilizados con PLX. Paciente: s y Métodos: Estudiamos retrospectivamente todos los pacientes que recibieron PLX como parte del esquema de movilización de PHSP para TASPE durante los años 2008-18 en siete hospitales de la zona norte; las enfermedades de base fueron: 94 linfomas no Hogdkin, 14 con enfermedad de Hogdkin, 78 mieloma múltiple y 4 con otros diagnósticos. 108 pacientes eran varones (56%) y 82 mujeres (44%). Su edad mediana era 59 años (4-73). Su peso y su altura oscilaron entre 15-134 kg y 106-188 cm, respectivamente. La mediana de líneas de tratamiento de nuestra serie fue de 2 (1-5); veintiún pacientes habían recibido radioterapia extensa y 15 pacientes uno o varios TASPEs previos. El número de intentos de Mx previos osciló entre 0 y 4 (mediana: 1). La pauta de G-CSF empleada fue de 5-10 mcg/kg/12 h durante 1-14 días (mediana: 6 días) y la dosis de PLX fue la recomendada en ficha técnica (0.24mcg/Kg/24horas). En 36 casos (18, 95%) la movilización se realizó en la fase de recuperación tras un ciclo de la quimioterapia de tratamiento. Tabla 1. Características de la serie y empleo de PLX. Resultados: se realizaron un total de 159 TASPEs. El estatus de la hemopatía en el momento del trasplante era remisión completa en el 50% de los casos. En cuanto a los resultados de movilización y colecta, la mediana de sesiones de aféresis requeridas fue de 2, rango (0-5) y la cifra de células CD34+ recolectada fue de 2, 79 (x 106/kg) con un rango entre 0 y 30, 3. Tabla 2. Datos de implante a corto y medio plazo Conclusiones: 1) el empleo de Plerixafor permitió realizar el TASPE en un alto porcentaje de pacientes malos movilizadores; 2) la calidad del injerto a corto y medio plazo de los pacientes autotrasplantados movilizados con PLX fue óptimo en la gran mayoría de los casos; 3) en nuestro conocimiento, esta serie multicéntrica es una de las mayores comunicadas enfocada en la calidad del implante a corto y medio plazo de pacientes malos movilizadores sometidos a TASPE

Childhood asthma outcomes during the COVID-19 pandemic: Findings from the PeARL multi-national cohort.

BACKGROUND: The interplay between COVID-19 pandemic and asthma in children is still unclear. We evaluated the impact of COVID-19 pandemic on childhood asthma outcomes. METHODS: The PeARL multinational cohort included 1,054 children with asthma and 505 non-asthmatic children aged between 4-18 years from 25 pediatric departments, from 15 countries globally. We compared the frequency of acute respiratory and febrile presentations during the first wave of the COVID-19 pandemic between groups and with data available from the previous year. In children with asthma, we also compared current and historical disease control. RESULTS: During the pandemic, children with asthma experienced fewer upper respiratory tract infections, episodes of pyrexia, emergency visits, hospital admissions, asthma attacks and hospitalizations due to asthma, in comparison to the preceding year. Sixty-six percent of asthmatic children had improved asthma control while in 33% the improvement exceeded the minimal clinically important difference. Pre-bronchodilatation FEV1 and peak expiratory flow rate were improved during the pandemic. When compared to non-asthmatic controls, children with asthma were not at increased risk of LRTIs, episodes of pyrexia, emergency visits or hospitalizations during the pandemic. However, an increased risk of URTIs emerged. CONCLUSION: Childhood asthma outcomes, including control, were improved during the first wave of the COVID-19 pandemic, probably because of reduced exposure to asthma triggers and increased treatment adherence. The decreased frequency of acute episodes does not support the notion that childhood asthma may be a risk factor for COVID-19. Furthermore, the potential for improving childhood asthma outcomes through environmental control becomes apparent

Childhood asthma outcomes during the COVID-19 pandemic: Findings from the PeARL multinational cohort

Background The interplay between COVID-19 pandemic and asthma in children is still unclear. We evaluated the impact of COVID-19 pandemic on childhood asthma outcomes.Methods The PeARL multinational cohort included 1,054 children with asthma and 505 non-asthmatic children aged between 4 and 18 years from 25 pediatric departments, from 15 countries globally. We compared the frequency of acute respiratory and febrile presentations during the first wave of the COVID-19 pandemic between groups and with data available from the previous year. In children with asthma, we also compared current and historical disease control.Results During the pandemic, children with asthma experienced fewer upper respiratory tract infections, episodes of pyrexia, emergency visits, hospital admissions, asthma attacks, and hospitalizations due to asthma, in comparison with the preceding year. Sixty-six percent of asthmatic children had improved asthma control while in 33% the improvement exceeded the minimal clinically important difference. Pre-bronchodilatation FEV1 and peak expiratory flow rate were improved during the pandemic. When compared to non-asthmatic controls, children with asthma were not at increased risk of LRTIs, episodes of pyrexia, emergency visits, or hospitalizations during the pandemic. However, an increased risk of URTIs emerged.Conclusion Childhood asthma outcomes, including control, were improved during the first wave of the COVID-19 pandemic, probably because of reduced exposure to asthma triggers and increased treatment adherence. The decreased frequency of acute episodes does not support the notion that childhood asthma may be a risk factor for COVID-19. Furthermore, the potential for improving childhood asthma outcomes through environmental control becomes apparent.</p

Modelling human choices: MADeM and decision‑making

Research supported by FAPESP 2015/50122-0 and DFG-GRTK 1740/2. RP and AR are also part of the Research, Innovation and Dissemination Center for Neuromathematics FAPESP grant (2013/07699-0). RP is supported by a FAPESP scholarship (2013/25667-8). ACR is partially supported by a CNPq fellowship (grant 306251/2014-0)

Childhood asthma outcomes during the COVID-19 pandemic: findings from the PeARL multinational cohort

Background: The interplay between COVID-19 pandemic and asthma in children is still unclear. We evaluated the impact of COVID-19 pandemic on childhood asthma outcomes. Methods: The PeARL multinational cohort included 1,054 children with asthma and 505 non-asthmatic children aged between 4 and 18 years from 25 pediatric departments, from 15 countries globally. We compared the frequency of acute respiratory and febrile presentations during the first wave of the COVID-19 pandemic between groups and with data available from the previous year. In children with asthma, we also compared current and historical disease control. Results: During the pandemic, children with asthma experienced fewer upper respiratory tract infections, episodes of pyrexia, emergency visits, hospital admissions, asthma attacks, and hospitalizations due to asthma, in comparison with the preceding year. Sixty-six percent of asthmatic children had improved asthma control while in 33% the improvement exceeded the minimal clinically important difference. Pre-bronchodilatation FEV1 and peak expiratory flow rate were improved during the pandemic. When compared to non-asthmatic controls, children with asthma were not at increased risk of LRTIs, episodes of pyrexia, emergency visits, or hospitalizations during the pandemic. However, an increased risk of URTIs emerged. Conclusion: Childhood asthma outcomes, including control, were improved during the first wave of the COVID-19 pandemic, probably because of reduced exposure to asthma triggers and increased treatment adherence. The decreased frequency of acute episodes does not support the notion that childhood asthma may be a risk factor for COVID-19. Furthermore, the potential for improving childhood asthma outcomes through environmental control becomes apparent.</p

Childhood asthma outcomes during the COVID-19 pandemic: Findings from the PeARL multi-national cohort

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