Autoloogsete vereloome tüvirakkude siirdamine süsteemse skleroosi ravis: kirjanduse ülevaade ja Põhja-Eesti Regionaalhaigla haigusjuhtude analüüs

Süsteemne skleroos (SS) on harva esinev autoimmuunhaigus, mida põeb Eestis umbes 100–150 inimest. Haiguse konventsionaalne ravi põhineb immuunsupressiooni ning sümptomaatilise ravi kombinatsioonil, kuid ka ravi foonil progresseerub haigus sageli edasi, põhjustades olulist elukvaliteedi halvenemist ning raskematel juhtudel ka surma. Uus suund SSi ravis on autoloogsete vereloome tüvirakkude siirdamine (AVTS), mis toimus Eestis esimest korda 2019. aastal. Artiklis on analüüsitud kuue ehk kõigi kuni 2023. aasta märtsini Põhja Eesti Regionaalhaiglas AVTSi läbinud SSi-patsientide haigusjuhtusid. Erinevalt konventsionaalsest ravist on siirdamisega võimalik peatada progresseerumist ja muuta seeläbi haiguse kulgu

Äge müeloidleukeemia

Äge müeloidleukeemia on geneetiliselt, fenotüübiliselt ja prognostiliselt heterogeenne vereloome tüvirakkude haigus, mida on seni ravitud tavapärase keemiaravi ja allogeensete tüvirakkude siirdamisega. Viimase kahe aastakümne jooksul on molekulaarsete tehnikate tohutu areng võimaldanud avastada ägeda müeloidleukeemia patsientidel suurel hulgal molekulaarseid kõrvalekaldeid, oluliselt on edenenud arusaamad haiguse patofüsioloogiast ja riskidest, võimalik on haiguse submikroskoopiline jälgimine. Uued teadmised võimaldavad välja töötada personaliseeritud ravimeetodeid

Impact of body mass index on outcome and treatment-related toxicity in young adults with acute lymphoblastic leukemia

Background: Data on outcome for patients in different body mass index (BMI) categories in young adults with acute lymphoblastic leukemia (ALL) are scarce. We explored survival and toxicities in different BMI categories in young adults with ALL. Material and methods: Patients aged 18–45 years, diagnosed with ALL between July 2008 and June 2022 in the Nordic countries, Estonia, or Lithuania, and treated according to the NOPHO ALL2008 protocol, were retrospectively enrolled and classified into different BMI categories. Endpoints were overall survival (OS), event-free survival (EFS) and cumulative incidence of relapse as well as incidence rate ratio (IRR) of severe predefined toxic events, and treatment delays. Results: The group comprised 416 patients, of whom 234 (56%) were stratified to non-high-risk (non-HR) treatment. In the non-HR group, patients with severe obesity, BMI ≥35 kg/m2 had worse EFS due to relapses but there was no effect on toxicity or treatment delays compared with the healthy-weight patients. There was no association between BMI category and OS, overall toxicity, or treatment delays in the patients with high-risk treatment. Conclusion: Severe obesity is associated with worse EFS in young adults treated according to the non-HR arms of the NOPHO ALL2008 protocol. Poorer outcome is explained with a higher risk of relapse, possibly due to under treatment, and not caused by excess therapy-related mortality

Toxicity profile and treatment delays in NOPHO ALL2008-comparing adults and children with Philadelphia chromosome-negative acute lymphoblastic leukemia.

To access publisher's full text version of this article click on the hyperlink at the bottom of the pageCure rates improve when adolescents and young adults with acute lymphoblastic leukemia (ALL) are treated according to pediatric protocols. Assumed risks of toxicities and associated delays in treatment have played a role in setting upper age limits. The aim of this study was to examine the toxicity profile and treatment delays in NOPHO ALL2008 comparing children and adults.We collected information on 19 treatment-related toxicities, systematically captured at 3-month intervals throughout therapy, and time intervals between 12 consecutive treatment phases for 1076 patients aged 1-45 yrs treated according to the Nordic/Baltic ALL2008 protocol.No adults died during induction. The duration of induction therapy and postinduction treatment phases did not differ between children and adults, except for patients 18-45 yrs being significantly delayed during two of nine high-risk blocks (median number of days for patients 1-9, 10-17, and 18-45 yrs; the glucocorticosteroid/antimetabolite-based block B1: 24, 26, and 29 d, respectively, P = 0.001, and Block 5 (in most cases also a B block): 29, 29, and 37 d, respectively, P = 0.02). A higher incidence of thrombosis with increasing age was found; highest odds ratio 5.4 (95% CI: (2.6;11.0)) for patients 15-17 yrs compared with children 1-9 yrs (P < 0.0001). Risk of avascular osteonecrosis was related to age with the highest OR for patients 10-14 yrs (OR = 10.4 (95% CI: (4.4;24.9)), P < 0.0001).Adults followed and tolerated the NOPHO ALL2008 protocol virtually as well as children, although thrombosis and avascular osteonecrosis was most common among adolescents.Danish Cancer Society Danish Childhood Cancer Foundation Herlev University Hospital Research Counci

Digiefekti projekti koondfail (DigiEfekt project merged data)

DigiEfekti projekti (DIGIVARA5) koondandmekogu koosneb järgmistest osadest: a) koondandmefail (“digiefekt_merged_data”), mis sisaldab konstruktispetsiifilisi tunnuseid ja taustatunnuseid; b) DigiEfekti uuringu lõppraport (“digiefekt_project_final_report_est”); c) hariduslike erivajaduste raport (“edspecialneeds_report_est”); ja d) DigiEfekti projektis kasutatud õpilaste ja lapsevanemate taustaandmete küsimustikud (“background_instrument_est”). Koodiraamat on lisatud andmefaili teisele lehele (“Codebook”).[ENG] The aggregated data set of the DigiEfekt project (DIGIVARA5) comprises the following parts: a) merged data set (“digiefekt_merged_data”), which contains construct-specific variables and background variables; b) the final report of the Digiefekt study (“digiefekt_project_final_report_est”); c) the special educational needs report (“edspecialneeds_report_est”); and d) students’ and parents’ background data questionnaires used in the Digiefekt project (“background_instrument_est”). The codebook is found on the second sheet of the data file (“Codebook”).DigiEfekti projekti lõppraporti soovituslik viide eestikeelses allikas: Pedaste, M., Raave, D. K., & Baucal, A. (2023) Digitaalsete õppematerjalide kasutamise efekt õpilaste õpitulemustele. Tartu Ülikool. https://datadoi.ee/handle/33/552Raporti soovituslik viide ingliskeelses allikas: Pedaste, M., Raave, D. K., & Baucal, A. (2023). Digitaalsete õppematerjalide kasutamise efekt õpilaste õpitulemustele [The effect of using digital learning materials on students’ academic outcomes]. University of Tartu. http://doi.org/10.23673/re-41