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Giri S.,University of Tennessee Health Science Center | Chi M.,The West Cancer Center | Johnson B.,The West Cancer Center | McCormick D.,University of Tennessee Health Science Center | And 3 more authors.
Leukemia Research | Year: 2015

Compared to secondary acute myeloid leukemia, secondary acute lymphoblastic leukemia (sALL) is poorly characterized. We utilized data from the Surveillance, Epidemiology, and End Results (SEER) 13 database to further elucidate patient characteristics and prognostic factors in sALL. Cases of adult de novo acute lymphoblastic leukemia (ALL) and sALL in patients with primary breast, rectum, cervix, or ovarian cancers or lymphoma with a latency period of at least 12 months were identified within the SEER 13 database. Survival in sALL and de novo ALL were compared after propensity matching based on age, gender, race, ALL subtype, and year of diagnosis. 4124 cases of de novo ALL and 79 cases of sALL were identified. sALL patients were older at diagnosis (median 62 years vs 44 years; p <. 0.01). Overall survival (OS) in sALL was lower than de novo ALL (median 8 months vs 11 months), 1 year OS: 35% vs 47% (p =0.05), 2 year OS: 16% vs 31% (p <. 0.01), and 5 year OS: 7% vs 21% (p <. 0.01). Multivariate analysis revealed sALL as an independent predictor of worsened survival (adjusted HR 1.54; 95% CI 1.16-2.04, p <. 0.01) after propensity matching. © 2015 Elsevier Ltd. Source

Hahn A.W.,University of Tennessee Health Science Center | Li B.,University of Tennessee Health Science Center | Li B.,The West Cancer Center | Prouet P.,University of Tennessee Health Science Center | And 2 more authors.
Blood Reviews | Year: 2016

Acute megakaryocytic leukemia (AMegL) is a biologically heterogenous subtype of acute myeloid leukemia (AML) that arises from megakaryocytes. Improvements in the accuracy of diagnosing AMegL as well as interest in the molecular analysis of leukemias have led to an increased amount of data available on this rare AML subtype. In this review, we will analyze the diverse molecular features unique to AMegL and how they have influenced the development of novel treatment strategies, including polyploidization. The review will also consider the data available on clinical outcomes in AMegL and how it is a poor individual prognostic factor for AML. Finally, the role of allogeneic hematopoietic stem cell transplant in AMegL will be explored. © 2015 Elsevier Ltd. Source

Owens L.D.,University of Memphis | Koch R.W.,The West Cancer Center
Nursing Clinics of North America | Year: 2015

Nurses play a vital role in improving the safety and quality of patient care. The authors provide the front-line nurse providers with an overview of critical concepts related to quality management of patient care. A historical approach provides the reader with an overview of the trajectory or the quality in health care movement. Furthermore, the article provides the nurse with a basic understanding of national and international organizations that focus on quality patient care. A brief introduction of measures of quality care is presented as well as implications for nursing practice. © 2015 Elsevier Inc. Source

Hahn A.,University of Tennessee Health Science Center | Giri S.,University of Tennessee Health Science Center | Yaghmour G.,University of Tennessee Health Science Center | Yaghmour G.,The West Cancer Center | Martin M.G.,The West Cancer Center
Leukemia Research | Year: 2015

The Southwest Oncology Group (SWOG) described the expected early mortality rate (EMR) for patients with non-M3 AML by age enrolled in clinical trials, but it is unclear how generalizable this data is. We sought to compare SWOG's reported EMR to that of the general population by utilizing the case listing session of SEER 18 matched to the accrual periods of the SWOG studies. 26,272 patients were identified within SEER compared to 968 in the SWOG cohort with mortality data. The EMR was 26.7% (7022 events) in the SEER cohort versus 12.2% (116) in the SWOG cohort. The EMR was higher in the SEER cohort in every studied age group and definition of EMR. Stepwise logistic regression analysis identified increasing age, black race (OR 1.15, CI 1.03-1.29, p. <. 0.01), and monocytic differentiation (OR 1.55, CI 1.27-1.89, p. <. 0.01) as predictors of higher EMR. This study demonstrates that EMR in patients with non-M3 AML is higher in the general patient population than reported in SWOG clinical trials. © 2015 Elsevier Ltd. Source

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