Showing papers by "Otto Visser published in 2013"

Survival of European patients diagnosed with myeloid malignancies: a HAEMACARE study

Abstract: Population-based information on the survival of patients with myeloid malignancies is rare mainly because some entities were not recognized as malignant until the publication of the third revision of the International Classification of Diseases for Oncology and World Health Organization classification in 2000. In this study we report the survival of patients with myeloid malignancies, classified by updated criteria, in Europe. We analyzed 58,800 cases incident between 1995 to 2002 in 48 population-based cancer registries from 20 European countries, classified into HAEMACARE myeloid malignancy groupings. The period approach was used to estimate 5-year relative survival in 2000-2002. The relative overall survival rate was 37%, but varied significantly between the major groups: being 17% for acute myeloid leukemia, 20% for myelodysplastic/myeloproliferative neoplasms, 31% for myelodysplastic syndromes and 63% for myeloproliferative neoplasms. Survival of patients with individual disease entities ranged from 90% for those with essential thrombocythemia to 4% for those with acute myeloid leukemia with multilineage dysplasia. Regional European variations in survival were conspicuous for myeloproliferative neoplasms, with survival rates being lowest in Eastern Europe. This is the first paper to present large-scale, European survival data for patients with myeloid malignancies using prognosis-based groupings of entities defined by the third revision of the International Classification of Diseases for Oncology/World Health Organization classifications. Poor survival in some parts of Europe, particularly for treatable diseases such as chronic myeloid leukemia, is of concern for hematologists and public health authorities.

Nutritional support in patients with GVHD of the digestive tract: state of the art

Abstract: An important complication of allo-SCT is GVHD, which commonly affects the skin, liver and digestive tract. Clinical symptoms of GVHD of the digestive tract (GVHD-DT) include excessive diarrhoea, abdominal pain and cramps, nausea and vomiting, gastrointestinal bleeding, dysphagia, and weight loss. Treatment is complicated and regarding nutritional support, only a few guidelines are available. Our aim was to critically appraise the literature on nutritional assessment, nutritional status and nutritional support for patients with GVHD-DT. Evidence shows that GVHD-DT is often associated with malnutrition, protein losing enteropathy, magnesium derangements, and deficiencies of zinc, vitamin B12 and vitamin D. Limited evidence exists on derangements of magnesium, resting energy expenditure, bone mineral density and pancreatic function, and some beneficial effects of n-3 polyunsaturated fatty acids and pancreatic enzyme replacement therapy. Expert opinions recommend adequate amounts of energy, at least 1.5 g protein/kg body weight, supplied by total parenteral nutrition in cases of severe diarrhoea. When diarrhoea is <500 mL a day, a stepwise oral upgrade diet can be followed. No studies exist on probiotics, prebiotics, dietary fibre and immunonutrition in GVHD-DT patients. Future research should focus on absorption capacity, vitamin and mineral status, and nutritional support strategies.

Clinical validation of dried blood spot sampling in therapeutic drug monitoring of ciclosporin A in allogeneic stem cell transplant recipients: direct comparison between capillary and venous sampling.

Abstract: Background:The immunosuppressive drug ciclosporin A has a narrow therapeutic window and a large inter- and intraindividual pharmacokinetic variability. Therapeutic drug monitoring of ciclosporin is usually performed in ethylenediaminetetraacetic acid blood, obtained by venous sampling. Dried blood s

Increasing incidence and survival of a rare skin cancer in the Netherlands. A population-based study of 2,220 cases of skin adnexal carcinoma

Abstract: Backgrounds and Objectives The aim of this study was to describe the epidemiology and treatment of skin adnexal carcinoma (SAC) in the Netherlands and to identify prognostic factors for survival in patients with SAC. Methods We used population-based nationwide data from the Netherlands Cancer Registry with cases diagnosed during 1989–2010 and followed up to February 1st, 2012. Results A total of 2,220 SACs were diagnosed during 1989–2010 (age-standardized incidence rate 5.3 per million). Incidence increased by 2.7% and 1.7% annually in males and females, respectively. Fifteen different morphological types were registered. The 5-year relative survival rate increased from 80% in 1989–1994 to 91% in 2006–2010. The majority of all patients (91%) received surgery. Adjuvant radiotherapy and/or lymph node dissection was performed in only a minority of cases. The risk of death was significantly higher in patients who did not receive surgery. Conclusions The rising incidence of SAC together with the predilection for the head and neck region suggests a role for UV radiation in the carcinogenesis of SAC. Furthermore, we found an improved survival of SAC in the Netherlands between 1989 and 2010. In view of the low proportion of patients receiving adjuvant therapy there may be further room for improving survival. J. Surg. Oncol. 2013;107:822–827. © 2013 Wiley Periodicals, Inc.

Diverging breast and stomach cancer incidence and survival in migrants in The Netherlands, 1996-2009.

Abstract: Background. Migrant populations usually experience a health transition with respect to their cancer risk as a result from environmental changes and acculturation processes. We investigated potentially contrasting experiences with breast and stomach cancer risk and survival in migrants to the Netherlands in a retrospective cohort study. Methods. Invasive breast (n = 96 126) and stomach cancer cases (n = 24 496) diagnosed 1996–2009 were selected from the population-based Netherlands Cancer Registry. Standardized Incidence Ratios (SIRs) were computed as the ratio of observed and expected cancers. Differences in survival were expressed as relative excess risk of mortality (RER). Results. Women from Morocco, Suriname and Turkey exhibited a significantly lower risk for breast cancer than native Dutch women (SIR range 0.5–0.9). Relative excess mortality was significantly increased in Surinamese (RER = 1.2, 95% CI 1.0–1.5) patients. The incidence of non-cardia stomach cancer was significantly elevated in all migrants, except in Indonesians, being highest in Turkish males (SIR = 2.2, 1.9–2.6). Cardia stomach cancer appeared to be less frequent in all migrants, being lowest in Surinamese males (SIR = 0.3, 0.2–0.5). Relative excess mortality was significantly lower in patients from the Antilles (RER = 0.7, 0.5–1.0), Suriname (0.8, 0.6–0.9) and Turkey (0.7, 0.6–0.9). Conclusion. The lower incidence rates of breast and cardia stomach cancer in migrants as well as their higher non-cardia stomach cancer rates reflect most likely early life exposures including pregnancy and/or dietary patterns during life-course. While higher relative excess mortality from breast cancer in migrant women might point toward inadequate access and treatment in this group, lower excess mortality from (especially non-cardia) stomach cancer remains to be explained

Investigating cervical, oesophageal and colon cancer risk and survival among migrants in The Netherlands.

Abstract: Background: Studies on cancer in migrants can shed light on grey areas in cancer aetiology and can help assessing the effectiveness of prevention measures. In this study, we aimed to determine the impact of migration and different ethnic backgrounds on cervical, colon and oesophageal cancer risk and survival. Methods: Cancers diagnosed in 1996–2009 were selected from The Netherlands Cancer Registry. Besides standardized incidence ratios, differences in survival were explored using Cox regression and relative survival analysis. Results: All migrant women had increased risks for cervical cancer when compared with Dutch native women, ranging from standardized incidence ratio = 1.8 (95% confidence interval 1.6–2.2) in Surinamese women to 1.2 (0.9–1.5) in Turkish women. Relative survival was better among Moroccan, Surinamese and Antillean migrants [5-year relative survival rates (RSR) range: 71–73%] compared with that of native Dutch (66%); however, it was poorer in Indonesians (51%). Although oesophageal cancer risk was lower in all migrants with Standardized incidence ratios ranging from 0.1 to 0.6, survival was slightly lower relative to Dutch natives (1-year RSR: 21–32% compared with 37%; Turkish: 42%). Colon cancer was less common among migrants, particularly among Moroccans and Turkish. Five-year RSR from colon cancer was equal or better in all migrants (range: 48% in Indonesians to 62% in Turkish) compared with Dutch natives (48%). Conclusion: Risk of cervical, oesophageal and colon cancer in migrants mainly reflects the risks in their countries of origin. Almost similar cancer survival rates in migrants and native Dutch individuals points towards successful and comprehensive health care in The Netherlands. Primary cancer prevention should target high-risk groups and involve migration-sensitive approaches.

Fertility and sexual function in female Hodgkin lymphoma survivors of reproductive age

Abstract: Aims and objectives To assess the perceived fertility status and to determine the association between perceived fertility status and sexual function, as reported by young female Hodgkin lymphoma survivors. Background Young female Hodgkin lymphoma survivors are at risk of infertility and impaired sexual function. However, little is known about their awareness of infertility and its association with sexual functioning. Design A descriptive questionnaire survey. Methods In this cross-sectional study, a survey was completed by female Hodgkin lymphoma survivors (< 40 years). Outcome measures included self-reported fertility status and sexual problems and the internationally validated Female Sexual Function Index. Results In total, 36 survivors were included (mean age 32 years, SD 4). Eighteen women (50%) thought themselves fertile. Eight survivors (22%) who perceived themselves as being infertile were more often treated with alkylator-based chemotherapy, and 63% reported sexual dysfunction. Ten survivors (28%) were not aware as to whether they were fertile or not; seven of these would like to have children. The reported fertility status was related to age and chemotherapy regimen. Regarding sexuality, 14 (39%) of the female Hodgkin lymphoma survivors reported one or more sexual problem and none reported recovery. Female sexual dysfunction according to the Female Sexual Function Index was reported by 11 (31%) survivors. Conclusion Almost 30% of Hodgkin lymphoma survivors do not know whether they are fertile or not. Overall sexual dysfunction is common in Hodgkin lymphoma survivors and comparable to the general population. However, a lack of desire was significantly more often reported in female Hodgkin lymphoma survivors. Relevance to clinical practice To prevent assumed infertility and unintended childlessness by postponing parenthood in young female survivors, awareness of fertility status is needed. There is also a need to routinely assess sexual function and provide adequate interventions to improve arousal and lubrication problems.

Comment on ‘Psychological distress in patients with cancer: is screening the effective solution?’

Abstract: Comment on ‘Psychological distress in patients with cancer: is screening the effective solution?’

Cancer incidence and mortality of Surinamese migrants in the Netherlands: in-between Surinamese and Dutch levels?

Abstract: It has been suggested that the cancer risk of migrants from low-income to high-income countries will converge toward the levels of their host country. However, comparisons with country of origin are mostly lacking. We compared cancer incidence and mortality rates of Surinamese migrants in the Netherlands to both native Dutch and Surinamese levels. Data covering the period 1995–2008 were obtained from Surinamese and Dutch national cancer registries and national cause-of-death registries. Cancer incidence was studied for 21 types of cancer and cancer mortality for nine types. We calculated age-standardized incidence/mortality ratios (SIR/SMR) for the Surinamese migrants and for Suriname, using the native Dutch population as reference. Significantly lower overall cancer incidence (SIR = 0.77, 95 % CI = 0.69–0.84) and mortality rates (SMR = 0.63, 95 % CI = 0.55–0.72) were found for Surinamese migrants compared to native Dutch. Generally, cancer risk was lower for most cancers (e.g., cancer of the breast, colon and rectum, lung), but higher for other cancers (e.g., cancer of the uterine cervix, liver). For most cancers, cancer risk of the Surinamese migrants was in-between Surinamese and native Dutch levels. Importantly, for many cancers, migrants’ incidence and mortality rates had not closely approached native Dutch rates. For skin cancer, incidence levels for Surinamese migrants were lower than both Surinamese and native Dutch levels. The results suggest that cancer incidence and mortality rates of Surinamese migrants generally converge from Surinamese toward Dutch levels, though not for all cancer types. Overall, Surinamese migrants still had a much more favorable cancer profile than the native Dutch population.

Cardiovascular morbidity and mortality in patients treated for ductal carcinoma in situ of the breast.

Abstract: 58 Background: Recent concerns about potential overdiagnosis and overtreatment of ductal carcinoma in situ of the breast (DCIS) render evaluation of late effects of treatment, such as cardiovascula...

Feasibility of Intermittent Fish Oil Infusions in Outpatients with Graft- Versus-Host Disease of the Digestive Tract

Abstract: N-3 polyunsaturated fatty acids from fish oil may have immune-modulating effects in Graft-versus-Host Disease of the digestive tract (GVHD-DT). The objective of this pilot study was to investigate feasibility, safety and effects on fatty acid composition of plasma lipids and white blood cells (WBC), following intermittent fish oil infusion in outpatients with chronic GVHD-DT. Four outpatients received intermittent infusion of a 10% fish oil emulsion (Omegaven) during 4 hours, at day 1 (1.5 mL/kg), 3 (2.25 mL/kg) and 5, 8, 10 and 12 (3 mL/kg). At baseline and consecutive visits, fatty acid composition of plasma triglycerides (TG), plasma phospholipids (PL) and WBC, serum TG concentrations, routine laboratory tests, as well as adverse events were monitored. During the fish oil infusions, serum TG increased, but decreased 2 h after termination of infusion. In 3 patients, the dose of Omegaven® needed to be reduced. EPA was incorporated into plasma PL, plasma TG and WBC as of 2 days after the first infusion; peak levels of EPA were reached at the final infusion, or 2 days after. In conclusion, intermittent fish oil infusions result in incorporation of EPA in plasma and WBC, but can be complicated by a reversible increase in serum triglycerides.