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High-Dose Immune Suppression without Hematopoietic Stem Cells for Autoimmune Diseases
Published in Richard K. Burt, Alberto M. Marmont, Stem Cell Therapy for Autoimmune Disease, 2019
Hematopoietic stem cell transplantation holds great promise for treating autoimmunity. The source of hematopoietic stem cells can be from a normal donor (allogeneic) or from the patient (autologous). Due to the high morbidity and mortality of traditional allogeneic stem cell transplantation, most centers are pursuing the use of autologous stem cell transplantation for the treatment of autoimmune diseases. There are three major components to autologous stem cell transplantation: (1) stem cell collection (mobilization); (2) conditioning with high-doses of chemotherapy; and (3) stem cell infusion. However, for treating autoimmunity with autologous stem cell transplantation, the therapeutic efficacy (high-dose immunosuppression) is derived from the conditioning regimen; hematopoietic stem cells are used as a rescue procedure. Most centers utilize mobilized peripheral blood progenitors as a source of stem cells. Cyclophosphamide (2 to 4 g/m2) combined with granulocyte-colony stimulating factor (G-CSF) is the most frequently employed regimen to mobilize hematopoietic stem cells, but other regimens including G-CSF and corticosteroids have been used successfully. A concern with autologous stem cell transplantation for autoimmunity is that the mobilized product contains several logs of effector cells (lymphocytes) which may, theoretically, re-establish the disease. Therefore, most groups purge the autograft of contaminating lymphocytes. Due to its potent immunosuppressive activity, high-dose cyclophosphamide forms the basis of most conditioning regimens used for autoimmunity. High-dose cyclophosphamide is non- myeloablative; thus, high-dose cyclophosphamide without stem cell rescue has been employed to treat autoimmune disease.
A Novel Multi-Neural Ensemble Approach for Cancer Diagnosis
Published in Applied Artificial Intelligence, 2022
Surbhi Gupta, Manoj Kumar Gupta, Rakesh Kumar
Leukemia: In 2018, a research study (Mei et al. 2018) applied neural Learning to predict acute myeloid leukemia (AML). The dataset used in the study was taken from TCGA (The Cancer Genome Atlas) database. The implementation used stacked Autoencoders to formulate a categorized DL model. The model implemented in R language attained exceptional correctness of 83% in forecasting prognosis. A review article published in 2019 (Salah et al. 2019) emphasized the utilization of ML models to predict leukemia diagnosis. A total of 58 research studies were revised. A significant factor observed in this study was that none of the articles applied ML models in real‐world scenarios. More than 90% of articles utilized small and homogenous samples. A research study was done in 2019 (Shouval et al. 2019) worked on predicting the survival of leukemia patients after the Autologous Stem Cell Transplantation. A recent research study 2020 (Maria, Devi, and Ravi 2020) employed ML to predict diagnosis. The respective research presented a comparative study of SVM, KNN, Neural Networks, and NB for the classification of leukemia into its subtypes.
Theranostic approaches in nuclear medicine: current status and future prospects
Published in Expert Review of Medical Devices, 2020
Luca Filippi, Agostino Chiaravalloti, Orazio Schillaci, Roberto Cianni, Oreste Bagni
As concerns the imaging of NB with 123I-MIBG, it has to be pointed out that several semiquantitative score methods were proposed for standardizing the interpretation of the images acquired before and after therapy, among them the so-called Curie-score in which patient’s body is divided into several regions for each of whom a score ranging from 0 to 3 was assigned for defining the extent of the disease [28]. In a study including a large cohort of patients (n = 280) at stage 4, Curie score was applied for the interpretation of the 123I-MIBG images at diagnosis, after induction chemotherapy and after an autologous stem cell transplantation [29]. The authors found that the Curie score presented high prognostic value in the management of children with NB; in particular, those subjects with a score >2 after the induction therapy were characterized by a poor prognosis.
Variability in body temperature in healthy adults and in patients receiving chemotherapy: prospective observational cohort study
Published in Journal of Medical Engineering & Technology, 2019
J. S. Frazer, G. E. Barnes, V. Woodcock, E. Flanagan, T. Littlewood, R. J. Stevens, S. Fleming, H. F. Ashdown
Attempts were made to contact those who did not return booklets. One patient stated the booklet was lost in postage, three patients stated they had lost booklets or filling them in was too much effort, and we were unable to contact the remaining patients despite two attempts. Of the patients we failed to contact, investigation of their medical notes revealed that six changed chemotherapy regimens following recruitment, either due to side-effects or poor response, one underwent assessment for a clinical trial, one changed treatment following autologous stem cell transplantation, and one underwent surgery shortly after recruitment, subsequently developing complications resulting in several intensive care admissions and a prolonged stay in hospital. A further uncontactable patient died within two months of recruitment.