The objective of the present study was to measure the total YY3-36 peptide levels in blood sera obtained from the patients presenting with the exogenous constitutional form of obesity and excessive body weight. The secondary objective was to elucidate the influence of YY3-36 peptide on the process of body weight elevation. A significant rise in the serum YY3-36 peptide level was documented in those of the 327 patients included in the study who suffered grade I and II obesity (p<0,05). It was especially high in the patients with grade II obesity (p<0,05). It is concluded that the exogenous constitutional form of obesity is associated with a statistically significant elevation of blood YY3-36 peptide level in patients presenting with grade I and II obesity.
Introduction. Allogeneic haematopoietic stem cell transplantation (allo-HSCT) is the only curative therapy for chronic myeloid leukaemia (CML).Aim. Analysis of allo-HSCT outcomes in CML patients following reduced-intensity conditioning (RIC) regimens.Materials and methods. This retrospective study included 110 CML patients who underwent allo-HSCT in 1995–2019. RIC regimens included busulfan (8–12 mg/kg), fludarabine (180 mg/m2) or melphalan (140 mg/m2), fludarabine (180 mg/m2). The median onset time for treatment with tyrosine kinase inhibitors (TKIs) was 60 days after allo-HSCT (30–835). Post-transplant graft-versus-host-disease (GVHD) prevention with cyclophosphamide (Cy) at high doses (PTCy) of 50 mg/kg in 3–4 days after allo-HSCT (D+3, D+4) was ordered in 61 % (n = 67), with antithymocyte globulin (ATGAM) 60 mg/kg — in 17 % (n = 19), with thymoglobulin 5 mg/kg — in 3 % (n = 3) of the patients.Results. In the study cohort, 50 % (n = 55) of the patients had chronic phase 2 and higher (CP ≥ 2), 25 % (n = 27) — accelerated phase (AP), 9 % (n = 10) — blast crisis (BC) phase of the disease. Among CP ≥ 2 patients, 63 % (n = 58) had a BC in history, and 25 % (n = 23) — 2 or more BCs. One-year non-relapse mortality (NRM) was 21 % (95 % CI 15–31). PTCy prevention of GVHD significantly reduced the NRM risk relative to other schemes: 11 % (95 % CI 5–20) vs. 38 % (95 % CI 23–53) (p = 0.001). Acute GVHD II–IV had a rate of 23 % (95 % CI 15–31), chronic GVHD of moderate to severe degree 15 % (95 % CI 9–22). TKIs were used in 49 % (n = 29) cases for relapse prevention, in 40 % (n = 24) — due to the lack of response to allo-HSCT, in 10 % (n = 6) — in relapse. Donor lymphocyte infusion (DLI) was performed in 37 patients mainly in BCR-ABL positive cases (24 %, n = 9) and relapse (49 %, n = 18). Three-year relapse rate was 36 % (95 % CI 26–46), and five-year relapse-free survival (RFS) was 40 % (95 % CI 29–51). Transplantation in AP or BC phase significantly increased the relapse rate (odds ratio 2.4800 (1.2180–5.050), p = 0.012). Five-year overall survival was 52 % (95 % CI 40–62), a clean BC history and PTCy correlated with a higher 5-year overall survival (odds ratios 1.9990 (1.0700–3.7350), p = 0.029, and 0.3126 (0.1670–0.5851), p = 0.0002, respectively).Conclusion. Reduced-intensity conditioning is advantageous in patients with long-term CML and several lines of TKI therapy in history. Post-transplant complication relief is associated with PTCy prevention. Relapse instances, however, complicate the outcomes of allo-HSCT with RIC. Post-transplant TKI and DLI facilitate response in 54 % of the patients. Success of allo-HSCT largely depends on the disease phase (CP, AP, BC) at the time of transplantation.
The treatment of 36 patients suffering exogenous constitutional obesity (ECO) with sibutramine during 12 weeks resulted in the substantial reduction of body weight, waist circumference (WC), hip circumference (HC), and waist-to-hip ratio (WHR). Simultaneously, the total cholesterol level in the blood decreased. The reduction in the body weight had positive effect on carbohydrate metabolism. Medicamental treatment of obesity caused a drop in systolic arterial pressure and a substantial change in the body composition. Specifically, percentage of both total and visceral fat as well as basal metabolism decreased, water retention in the body increased while the muscular mass remained unaltered. It is concluded that the introduction of Sibutramine into the combined treatment of exogenous constitutional obesity effectively promotes the reduction of the body weight, improvement of the body composition and metabolic characteristics.
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