TY - JOUR A1 - Proetel, Ulrike A1 - Pletsch, Nadine A1 - Lauseker, Michael A1 - Müller, Martin C. A1 - Hanfstein, Benjamin A1 - Krause, Stefan W. A1 - Kalmanti, Lida A1 - Schreiber, Annette A1 - Heim, Dominik A1 - Baerlocher, Gabriela M. A1 - Hofmann, Wolf-Karsten A1 - Lange, Elisabeth A1 - Einsele, Hermann A1 - Wernli, Martin A1 - Kremers, Stephan A1 - Schlag, Rudolf A1 - Müller, Lothar A1 - Hänel, Mathias A1 - Link, Hartmut A1 - Hertenstein, Bernd A1 - Pfirrmann, Markus A1 - Hochhaus, Andreas A1 - Hasford, Joerg A1 - Hehlmann, Rüdiger A1 - Saußele, Susanne T1 - Older patients with chronic myeloid leukemia (≥65 years) profit more from higher imatinib doses than younger patients: a subanalysis of the randomized CML-Study IV JF - Annals of Hematology N2 - The impact of imatinib dose on response rates and survival in older patients with chronic myeloid leukemia in chronic phase has not been studied well. We analyzed data from the German CML-Study IV, a randomized five-arm treatment optimization study in newly diagnosed BCR-ABL-positive chronic myeloid leukemia in chronic phase. Patients randomized to imatinib 400 mg/day (IM400) or imatinib 800 mg/day (IM800) and stratified according to age (≥65 years vs. <65 years) were compared regarding dose, response, adverse events, rates of progression, and survival. The full 800 mg dose was given after a 6-week run-in period with imatinib 400 mg/day. The dose could then be reduced according to tolerability. A total of 828 patients were randomized to IM400 or IM800. Seven hundred eighty-four patients were evaluable (IM400, 382; IM800, 402). One hundred ten patients (29 %) on IM400 and 83 (21 %) on IM800 were ≥65 years. The median dose per day was lower for patients ≥65 years on IM800, with the highest median dose in the first year (466 mg/day for patients ≥65 years vs. 630 mg/day for patients <65 years). Older patients on IM800 achieved major molecular remission and deep molecular remission as fast as younger patients, in contrast to standard dose imatinib with which older patients achieved remissions much later than younger patients. Grades 3 and 4 adverse events were similar in both age groups. Five-year relative survival for older patients was comparable to that of younger patients. We suggest that the optimal dose for older patients is higher than 400 mg/day. ClinicalTrials.gov identifier: NCT00055874 KW - chronic myeloid leukemia KW - older patients KW - different imatinib dose regimens KW - early applied higher imatinib dosages Y1 - 2014 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-121574 SN - 0939-5555 VL - 93 IS - 7 ER - TY - JOUR A1 - Hanfstein, Benjamin A1 - Lauseker, Michael A1 - Hehlmann, Rüdiger A1 - Saussele, Susanne A1 - Erben, Philipp A1 - Dietz, Christian A1 - Fabarius, Alice A1 - Proetel, Ulrike A1 - Schnittger, Susanne A1 - Haferlach, Claudia A1 - Krause, Stefan W. A1 - Schubert, Jörg A1 - Einsele, Hermann A1 - Hänel, Mathias A1 - Dengler, Jolanta A1 - Falge, Christiane A1 - Kanz, Lothar A1 - Neubauer, Andreas A1 - Kneba, Michael A1 - Stengelmann, Frank A1 - Pfreundschuh, Michael A1 - Waller, Cornelius F. A1 - Spiekerman, Karsten A1 - Baerlocher, Gabriela M. A1 - Pfirrmann, Markus A1 - Hasford, Joerg A1 - Hofmann, Wolf-Karsten A1 - Hochhaus, Andreas A1 - Müller, Martin C. T1 - Distinct characteristics of e13a2 versus e14a2 BCR-ABL1 driven chronic myeloid leukemia under first-line therapy with imatinib JF - Haematologica N2 - The vast majority of chronic myeloid leukemia patients express a BCR-ABL1 fusion gene mRNA encoding a 210 kDa tyrosine kinase which promotes leukemic transformation. A possible differential impact of the corresponding BCR-ABL1 transcript variants e13a2 ("b2a2") and e14a2 ("b3a2") on disease phenotype and outcome is still a subject of debate. A total of 1105 newly diagnosed imatinib-treated patients were analyzed according to transcript type at diagnosis (e13a2, n=451; e14a2, n=496; e13a2+e14a2, n=158). No differences regarding age, sex, or Euro risk score were observed. A significant difference was found between e13a2 and e14a2 when comparing white blood cells (88 vs. 65 x 10(9)/L, respectively; P<0.001) and platelets (296 vs. 430 x 109/L, respectively; P<0.001) at diagnosis, indicating a distinct disease phenotype. No significant difference was observed regarding other hematologic features, including spleen size and hematologic adverse events, during imatinib-based therapies. Cumulative molecular response was inferior in e13a2 patients (P=0.002 for major molecular response; P<0.001 for MR4). No difference was observed with regard to cytogenetic response and overall survival. In conclusion, e13a2 and e14a2 chronic myeloid leukemia seem to represent distinct biological entities. However, clinical outcome under imatinib treatment was comparable and no risk prediction can be made according to e13a2 versus e14a2 BCR-ABL1 transcript type at diagnosis. (clinicaltrials.gov identifier: 00055874) KW - chronic myelogenous leukemia KW - polymerase-chain-reaktion KW - hybrid messenger RNA KW - chronic phase KW - cytogenetic response KW - no correlation KW - ABL gene KW - transcripts KW - breakpoint KW - survival Y1 - 2014 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-115476 SN - 1592-8721 VL - 99 IS - 9 ER - TY - THES A1 - Hofmann, Markus T1 - Die palliative und kurative Behandlung von Hernien am St. Johanns Spital in Salzburg im frühen 19. Jahrhundert T1 - Palliative and curative treatment of hernias at St. Johanns Hospital in Salzburg in the early 19th century N2 - Die Palliativmedizin gilt oft als ein vergleichsweise junges Themengebiet, welches in den zurückliegenden Jahrzehnten kontinuierlich an Bedeutung gewinnen konnte. Palliativmedizin ist jedoch keine reine Erfindung des 20. Jahrhunderts. So galt die Versorgung Schwerkranker oder Sterbender bereits viel früher als ärztliche Pflicht. Grundgedanke der Arbeit war es, palliativmedizinische Facetten im ärztlichen Handeln zu Beginn des 19. Jahrhunderts nachzuweisen. Hierzu erfolgte eine beispielhafte Betrachtung der chirurgische Hernien-Therapie des St. Johanns Spitals in Salzburg. Als Grundlage dienten handschriftlich verfasste Krankengeschichten des St. Johanns Spitals aus der ersten Hälfte des 19. Jahrhunderts. Neben der Detektion und einer vergleichenden Darstellung palliativmedizinischer Handlungsweisen gelang mit Hilfe der in ihrer Ausführlichkeit bemerkenswerten Primärquelle eine Darstellung der damaligen chirurgischen Hernientherapie am Salzburger St. Johanns Spital. Ergänzend erfolgt ein Vergleich mit zeitgenössischen Veröffentlichungen zur Thematik der Hernienchirurgie, welche sich zum damaligen Zeitpunkt am Vorabend zur Asepsis bereits in einem Prozess des Umbruchs befand. N2 - Palliative medicine is often regarded as a relatively young subject area, which has steadily gained in importance over the past decades. However, palliative care is not an invention of the 20th century. The care of the seriously ill or dying has been considered a medical duty much earlier. The basic idea of this thesis has been to document the palliative medical aspects of medical procedures in use at the beginning of the 19th century. For this purpose, a study of surgical hernia therapy at St. Johanns Hospital in Salzburg is provided as an example. Handwritten medical records of St. Johanns Hospital from the first half of the 19th century served as a basis. In addition to the detection and a comparative presentation of palliative medical procedures, a description of surgical hernia therapy at St. Johanns Hospital in Salzburg at that time has been achieved with the help of the primary source, which is remarkable in its comprehensiveness. In addition, a comparison is made with contemporary publications which describe hernia surgery, which at that time was already undergoing a process of change on the eve of asepsis. KW - Hernie KW - Leistenhernie KW - Schenkelhernie KW - Palliativoperation KW - Palliativversorgung KW - Hernienchirurgie KW - 19. Jahrhundert KW - Palliative Care KW - St. Johanns Spital Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-235175 ER - TY - THES A1 - Hofmann, Markus T1 - Signal transduction during defense response and source-sink transition in tomato T1 - Signaltransduktion während source-sink-Übergang und Pathogenabwehr in Tomate N2 - Plants have evolved an elaborate system to cope with a variety of biotic and abiotic stresses. Typically, under stress conditions an appropriate defense response is invoked which is accompanied by changes in the metabolic status of the plant. Photosynthesis is downregulated and sucrose is imported into the tissue, which provides a faster and more constant flux of energy and carbon skeletons to perform the defense response. Interestingly, these processes are co-ordinately regulated and the signal transduction chains underlying these cellular programs appear to share at least some common elements. Both the induction of sink metabolism and defense response is dependent on signal transduction pathways involving protein phosphorylation. Furthermore, regulation of extracellular invertase (INV) and phenylalanine ammonia lyase (PAL) which are markers for sink metabolism and defense response is preceded by the transient activation of MAP kinases. In depth analysis of MAP kinase activation by partial purification led to the discovery that, depending on the stimulus, different subsets of MAP kinases are activated. This differential MAPK activation is likely to possess a signal encoding function. In addition, the partial purification of MAP kinases was found to be suitable to address specific cellular functions to individual MAP kinase isoenzymes. By this way, LpWIPK was identified as the major MAP kinase activity induced after stimulation of tomato cells with different elicitors. LpWIPK is thus considered as a key regulator of defense response together with sink induction in tomato. A study using nonmetabolisable sucrose analogs revealed that the regulation of photosynthesis is not directly coupled to this signal transduction pathway since it is independent of MAP kinase activation. Nonetheless, downregulation is induced by the same stimuli that induce the defense response and sink metabolism and it will therefore be interesting to uncover the branch points of this signalling network in the future. MAP kinases are not only central components regulating the response to biotic stresses. In addition to e.g. pathogens, MAP kinases are as well involved in signal transduction events invoked by abiotic stresses like cold and drought. In a recent study, we could show that a MAP kinase is activated by heat stress, under conditions a plant will encounter in nature. This previously unknown MAP kinase is able to specifically recognise the heat stress transcription factor HsfA3 as a substrate, which supports a role of this MAP kinase in the regulation of the heat stress response. Moreover, the observation that HsfA3 is phosphorylated by the heat activated MAP kinase in vitro provides a promising basis to identify HsfA3 as the first physiological substrate of a plant MAP kinase. Intracellular protons have been implicated in the signal transduction of defense related signals. In a study using Chenopodium rubrum cells, we could show that cytosolic changes in pH values do not precede the regulation of the marker genes INV and PAL. Depending on the stimulus applied, cytosolic acidification or alkalinisation can be observed, which excludes a role for protons as signals in this pathway. Together with the concomitant changes of the pH value of the extracellular space, these variations can thus be considered as terminal part of the defense response itself rather than as a second messenger. WRKY transcription factors have only recently been identified as indirect targets of a central plant MAP kinase cascade. In addition, the identification of cognate binding sites in the promoters of INV and PAL supports a role for these proteins in the co-ordinate regulation of defense response and sink induction. A novel elicitor responsive WRKY transcription factor, LpWRKY1, was cloned from tomato and characterised with respect to its posttranslational modification. This immediate early transcription factor is transiently induced upon pathogen attack and the induction is dependent on phosphorylation. Furthermore, it was shown for the first time with respect to WRKY transcription factors, that LpWRKY1 is phosphorylated in vivo. Analysis of the role of this phosphorylation by in gel assays using recombinant WRKY protein as the substrate revealed two protein kinases that are transiently activated during the defense response to phosphorylate LpWRKY1. This data demonstrates that WRKY proteins require phosphorylation to modulate their DNA binding or transactivating activity. N2 - Pflanzen haben ein aufwendiges System entwickelt um auf verschiedene Umweltreize zu reagieren. Meist wird unter Stressbedingungen ein passendes Abwehrprogramm aktiviert. Gleichzeitig wird die Photosynthese im jeweils betroffenen Gewebe abgeschaltet und stattdessen Saccharose importiert. Dieser Source-Sink Übergang stellt sicher, dass Energie und Kohlenstoffbausteine für die Abwehr schnell zur Verfügung stehen. Diese beiden Prozesse sind koordiniert reguliert und die zugrundeliegenden Singnaltransduktionswege scheinen wenigstens einige Komponenten gemeinsam zu haben. Sowohl die Induktion des Sink Metabolismus (gemessen an der Induktion der extrazellulären Invertase, INV) als auch des Abwehrprogramms (gemessen an der Induktion der Phenylalanin Ammonia-Lyase, PAL) sind von Phosphorylierungen abhängig. Außerdem geht der Induktion beider Gene die transiente Aktivierung von MAP Kinasen voran. Eine genauere Analyse der MAP Kinase Aktivierung durch partielle Reinigung zeigte, dass abhängig vom Stimulus mehrere MAP Kinasen aktiviert werden. Diese differentielle MAP Kinase Aktivierung stellt somit eine Möglichkeit der Signalcodierung dar. Die partielle Reinigung der MAP Kinasen wurde auch verwendet, um einzelnen MAP Kinase Isoenzymen spezifische zelluläre Funktionen zuzuweisen. Dadurch konnte LpWIPK (wound induced protein kinase) als Hauptaktivität nach Stimulation on Tomatenzellen mit Elicitoren bestimmt werden. LpWIPK könnte also sowohl die Pathogenabwehr als auch den source-sink Übergang gleichzeitig steuern. Allerdings ist die Regulation der Photosynthese unabhängig von diesem Signaltransduktionsweg. Eine Untersuchung mit nichtmetabolisierbaren Saccharose-Analoga zeigte, dass die Regulation der Photosynthese unabhängig von einer MAP Kinase Aktivierung stattfindet. Das abschalten der Photosynthese wird durch die gleichen Stimuli hervorgerufen, die auch Pathogenabwehr und Sink Metabolismus induzieren. Eine Interaktion der beiden Signaltransduktionswege ist somit wahrscheinlich. MAP Kinases spielen nicht nur bei der Antwort auf biotischen Stress eine wichtige Rolle. Zusätzlich werden MAP Kinasen auch durch abiotischen Stress wie Kälte und Dürre aktiviert. Kürzlich konnten wir zeigen, dass Hitzestress unter natürlichen Bedingungen ebenfalls eine MAP Kinase aktiviert. Diese bisher unbekannte MAP Kinase akzeptiert den Hitzestress Transkriptionsfaktor HsfA3 als in vitro Substrat. Dies unterstützt die Vermutung, dass diese MAP Kinase eine Rolle in der Regulation der Hitzestress Antwort spielt. Außerdem stellt die Beobachtung, dass die hitzeaktivierte MAP Kinase HsfA3 in vitro phosphoryliert eine vielversprechende Ausgangssituation dar, um HsfA3 als erstes physiologisches MAP Kinase Substrat in Pflanzen zu identifizieren. Intrazelluläre pH Änderungen wurden als Komponenten der Signaltransduktion für die Pathogenabwehr diskutiert. In Zellen von Chenopodium rubrum konnten wir zeigen, dass solche Änderungen nicht in Zusammenhang mit der Induktion der beiden Markergene INV und PAL stehen. Die Änderung des intrazellulären pH Wertes erfolgt nach der Induktion der Markergene, und kann je nach Stimulus Alkalisierung oder Ansäuerung zur Folge haben. Diese Beobachtungen schließen eine Rolle der pH Änderungen in der Signaltransduktion von Stressreizen aus. Die gefundenen pH Wert Änderungen sind somit eher als Teil der Pathogenabwehr und nicht als vorgelagerte Komponente zu verstehen. WRKY Transkriptionsfaktoren wurden erst kürzlich als indirekte Ziele einer MAP Kinase Kaskade beschrieben. Außerdem finden sich in den Promotoren von INV und PAL Bindestellen für WRKY Transkriptionsfaktoren, was eine Beteiligung dieser Proteine an der koordinierten Regulation von Abwehr und Sink Metabolismus wahrscheinlich macht. Ein neuer WRKY Transkriptionsfaktor, LpWRKY1 wurde aus Tomate kloniert und in Hinblick auf mögliche posttranslationelle Modifikationen charakterisiert. Dieser Trankriptionsfaktor zählt zu den schnellen frühen Genen und wird in Antwort auf Elicitoren transient induziert. Die Induktion des Faktors in abhängig von Phosphorylierungen. Es konnte weiterhin erstmalig gezeigt werden, dass LpWRKY1 in vivo phosphoryliert wird. Eine weitere Analyse durch in gel Kinase Tests mit rekombinantem LpWRKY1 als Substrat zeigte, dass zwei Proteinkinasen während der Abwehrantwort transient aktiviert werden und LpWRKY1 phosphorylieren. Diese Daten legen nahe, dass die DNA Bindeaktivität oder die Transaktivierungsaktivität von WRKY Transkriptionsfaktoren durch Phosphorylierung gesteuert wird. KW - Tomate KW - WRKY KW - MAP Kinase KW - Signaltransduktion KW - tomato KW - WRKY KW - MAP kinase KW - signal transduction Y1 - 2003 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-5421 ER - TY - JOUR A1 - Kolling, Markus A1 - Backhaus, Joy A1 - Hofmann, Norbert A1 - Keß, Stefan A1 - Krastl, Gabriel A1 - Soliman, Sebastian A1 - König, Sarah T1 - Students’ perception of three-dimensionally printed teeth in endodontic training JF - European Journal of Dental Education N2 - Introduction In endodontic education, there is a need for thorough training prior to students embarking on clinical treatment. The aim of this study was to use three-dimensional printing technology to create a new model and to compare its suitability for training purposes with resin blocks and extracted teeth. Materials and Methods Multi-jet-modelling (MJM) produced the 3D model replicating a common difficulty in root-canal morphology. An evaluation study comprising 88 students was run in the sixth semester (summer 2018 and winter 2018/2019). A new questionnaire assessed students’ perception of training models and educational environment. Welch's t-test analysed significant differences. Results The most pronounced differences between models were noted when rating material hardness, radiopacity, root-canal configuration and suitability for practising. Students estimated their learning outcome as greater with 3D-printed teeth compared to resin blocks. Three-dimensionally printed teeth received significantly lower ratings with regard to enthusiasm, the learning of fine motor skills and spatial awareness, when compared to human teeth (p ≤ .001). However, 3D-printed teeth were appreciated for additional benefits, such as their cleanliness, availability and standardisation of training opportunities with complex root-canal configurations. Conclusion Students preferred extracted human teeth to 3D-printed teeth with respect to their physical characteristics and training experience. However, educational advantages may compensate for the shortcomings. The new questionnaire proved both adequate and accurate to assess the models and educational environment in endodontic training. The new 3D-printed teeth enhanced the learning opportunities. KW - 3D-printed tooth KW - three-dimensional printing KW - teaching materials KW - root-canal treatment KW - endodontics KW - dental education Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-318676 VL - 26 IS - 4 SP - 653 EP - 661 ER - TY - JOUR A1 - Saussele, Susanne A1 - Hehlmann, Ruediger A1 - Fabarius, Alice A1 - Jeromin, Sabine A1 - Proetel, Ulrike A1 - Rinaldetti, Sebastien A1 - Kohlbrenner, Katharina A1 - Einsele, Hermann A1 - Falge, Christine A1 - Kanz, Lothar A1 - Neubauer, Andreas A1 - Kneba, Michael A1 - Stegelmann, Frank A1 - Pfreundschuh, Michael A1 - Waller, Cornelius F. A1 - Oppliger Leibundgut, Elisabeth A1 - Heim, Dominik A1 - Krause, Stefan W. A1 - Hofmann, Wolf-Karsten A1 - Hasford, Joerg A1 - Pfirrmann, Markus A1 - Müller, Martin C. A1 - Hochhaus, Andreas A1 - Lauseker, Michael T1 - Defining therapy goals for major molecular remission in chronic myeloid leukemia: results of the randomized CML Study IV JF - Leukemia N2 - Major molecular remission (MMR) is an important therapy goal in chronic myeloid leukemia (CML). So far, MMR is not a failure criterion according to ELN management recommendation leading to uncertainties when to change therapy in CML patients not reaching MMR after 12 months. At monthly landmarks, for different molecular remission status Hazard ratios (HR) were estimated for patients registered to CML study IV who were divided in a learning and a validation sample. The minimum HR for MMR was found at 2.5 years with 0.28 (compared to patients without remission). In the validation sample, a significant advantage for progression-free survival (PFS) for patients in MMR could be detected (p-value 0.007). The optimal time to predict PFS in patients with MMR could be validated in an independent sample at 2.5 years. With our model we provide a suggestion when to define lack of MMR as therapy failure and thus treatment change should be considered. The optimal response time for 1% BCR-ABL at about 12-15 months was confirmed and for deep molecular remission no specific time point was detected. Nevertheless, it was demonstrated that the earlier the MMR is achieved the higher is the chance to attain deep molecular response later. KW - Chronic myeloid leukaemia KW - Molecularly targeted therapy KW - Risk factors KW - Risk factors KW - Translational research Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-227528 VL - 32 IS - 5 ER - TY - JOUR A1 - Rinaldetti, Sébastien A1 - Pfirrmann, Markus A1 - Manz, Kirsi A1 - Guilhot, Joelle A1 - Dietz, Christian A1 - Panagiotidis, Panayiotidis A1 - Spiess, Birgit A1 - Seifarth, Wolfgang A1 - Fabarius, Alice A1 - Müller, Martin A1 - Pagoni, Maria A1 - Dimou, Maria A1 - Dengler, Jolanta A1 - Waller, Cornelius F. A1 - Brümmendorf, Tim H. A1 - Herbst, Regina A1 - Burchert, Andreas A1 - Janßen, Carsten A1 - Goebeler, Maria Elisabeth A1 - Jost, Philipp J. A1 - Hanzel, Stefan A1 - Schafhausen, Philippe A1 - Prange-Krex, Gabriele A1 - Illmer, Thomas A1 - Janzen, Viktor A1 - Klausmann, Martine A1 - Eckert, Robert A1 - Büschel, Gerd A1 - Kiani, Alexander A1 - Hofmann, Wolf-Karsten A1 - Mahon, François-Xavier A1 - Saussele, Susanne T1 - Effect of ABCG2, OCT1, and ABCB1 (MDR1) Gene Expression on Treatment-Free Remission in a EURO-SKI Subtrial JF - Clinical Lymphoma, Myeloma & Leukemia N2 - Within the EURO-SKI trial, 132 chronic phase CML patients discontinued imatinib treatment. RNA was isolated from peripheral blood in order to analyze the expression of MDR1, ABCG2 and OCT1. ABCG2 was predictive for treatment-free remission in Cox regression analysis. High transcript levels of the ABCG2 efflux transporter (>4.5 parts per thousand) were associated with a twofold higher risk of relapse. Introduction: Tyrosine kinase inhibitors (TKIs) can safely be discontinued in chronic myeloid leukemia (CML) patients with sustained deep molecular response. ABCG2 (breast cancer resistance protein), OCT1 (organic cation transporter 1), and ABCB1 (multidrug resistance protein 1) gene products are known to play a crucial role in acquired pharmacogenetic TKI resistance. Their influence on treatment-free remission (TFR) has not yet been investigated. Materials and Methods: RNA was isolated on the last day of TKI intake from peripheral blood leukocytes of 132 chronic phase CML patients who discontinued TKI treatment within the European Stop Tyrosine Kinase Inhibitor Study trial. Plasmid standards were designed including subgenic inserts of OCT1, ABCG2, and ABCB1 together with GUSB as reference gene. For expression analyses, quantitative real-time polymerase chain reaction was used. Multiple Cox regression analysis was performed. In addition, gene expression cutoffs for patient risk stratification were investigated. Results: The TFR rate of 132 patients, 12 months after TKI discontinuation, was 54% (95% confidence interval [CI], 46%-62%). ABCG2 expression (parts per thousand) was retained as the only significant variable (P=.02; hazard ratio, 1.04; 95% CI, 1.01-1.07) in multiple Cox regression analysis. Only for the ABCG2 efflux transporter, a significant cutoff was found (P=.04). Patients with an ABCG2/GUSB transcript level >4.5 parts per thousand (n=93) showed a 12-month TFR rate of 47% (95% CI, 37%-57%), whereas patients with low ABCG2 expression (<= 4.5 parts per thousand; n=39) had a 12-month TFR rate of 72% (95% CI, 55%-82%). Conclusion: In this study, we investigated the effect of pharmacogenetics in the context of a CML treatment discontinuation trial. The transcript levels of the efflux transporter ABCG2 predicted TFR after TKI discontinuation. (C) 2018 The Authors. Published by Elsevier Inc. KW - ABCG2 KW - Biomarker KW - CML KW - Imatinib KW - Prediction Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-226281 VL - 18 IS - 4 ER - TY - JOUR A1 - Boch, Tobias A1 - Spiess, Birgit A1 - Heinz, Werner A1 - Cornely, Oliver A. A1 - Schwerdtfeger, Rainer A1 - Hahn, Joachim A1 - Krause, Stefan W. A1 - Duerken, Matthias A1 - Bertz, Hartmut A1 - Reuter, Stefan A1 - Kiehl, Michael A1 - Claus, Bernd A1 - Deckert, Peter Markus A1 - Hofmann, Wolf‐Karsten A1 - Buchheidt, Dieter A1 - Reinwald, Mark T1 - Aspergillus specific nested PCR from the site of infection is superior to testing concurrent blood samples in immunocompromised patients with suspected invasive aspergillosis JF - Mycoses N2 - Invasive aspergillosis (IA) is a severe complication in immunocompromised patients. Early diagnosis is crucial to decrease its high mortality, yet the diagnostic gold standard (histopathology and culture) is time‐consuming and cannot offer early confirmation of IA. Detection of IA by polymerase chain reaction (PCR) shows promising potential. Various studies have analysed its diagnostic performance in different clinical settings, especially addressing optimal specimen selection. However, direct comparison of different types of specimens in individual patients though essential, is rarely reported. We systematically assessed the diagnostic performance of an Aspergillus‐specific nested PCR by investigating specimens from the site of infection and comparing it with concurrent blood samples in individual patients (pts) with IA. In a retrospective multicenter analysis PCR was performed on clinical specimens (n = 138) of immunocompromised high‐risk pts (n = 133) from the site of infection together with concurrent blood samples. 38 pts were classified as proven/probable, 67 as possible and 28 as no IA according to 2008 European Organization for Research and Treatment of Cancer/Mycoses Study Group consensus definitions. A considerably superior performance of PCR from the site of infection was observed particularly in pts during antifungal prophylaxis (AFP)/antifungal therapy (AFT). Besides a specificity of 85%, sensitivity varied markedly in BAL (64%), CSF (100%), tissue samples (67%) as opposed to concurrent blood samples (8%). Our results further emphasise the need for investigating clinical samples from the site of infection in case of suspected IA to further establish or rule out the diagnosis. KW - antifungal KW - aspergillosis KW - BAL KW - blood KW - cerebrospinal fluid KW - comparison KW - PCR KW - Aspergillus Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-214065 VL - 62 IS - 11 SP - 1035 EP - 1042 ER -