Abstract
The contribution of microRNAs (miR) to the pathogenesis of mantle cell lymphoma (MCL) is not well known. We investigated the expression of 86 mature miRs mapped to frequently altered genomic regions in MCL in CD5(+)/CD5(-) normal B cells, reactive lymph nodes, and purified tumor cells of 17 leukemic MCL, 12 nodal MCL, and 8 MCL cell lines. Genomic alterations of the tumors were studied by single nucleotide polymorphism arrays and comparative genomic hybridization. Leukemic and nodal tumors showed a high number of differentially expressed miRs compared with purified normal B cells, but only some of them were commonly deregulated in both tumor types. An unsupervised analysis of miR expression profile in purified leukemic MCL cells revealed two clusters of tumors characterized by different mutational status of the immunoglobulin genes, proliferation signature, and number of genomic alterations. The expression of most miRs was not related to copy number changes in their respective chromosomal loci. Only the levels of miRs included in the miR-17-92 cluster were significantly related to genetic alterations at 13q31. Moreover, overexpression of miR-17-5p/miR-20a from this cluster was associated with high MYC mRNA levels in tumors with a more aggressive behavior. In conclusion, the miR expression pattern of MCL is deregulated in comparison with normal lymphoid cells and distinguishes two subgroups of tumors with different biological features.
Highlights
Much may be learned from contemporary service provision when considering applicable future palliative care models for those with frailty
Following the successful resuscitation of a 42-year-old patient with locally advanced pancreatic cancer after an in hospice cardiac arrest, using basic life support with automatic external defibrillation (AED), the case was brought to the monthly Significant Event Meeting (SEM)
Our data suggests that the SPICT cannot be applied retrospectively or electronically to identify patients in the acute setting who would benefit from specialist palliative care input
Summary
The aim of this study was to explore the views of experts on the use of big data (BD) advanced analytics (i.e: machine learning, deep learning or artificial intelligence techniques) on the identification of frail older patients with nonmalignant diseases who could benefit from early palliative care (PC). We performed a retrospective service evaluation of patient outcome following critical care outreach review in patients deemed unsuitable for critical care admission and evaluated appropriateness of referral to the Specialist Palliative Care Team (SPCT) Conclusions CCOTs identify patients who are inappropriate for higher-level care Most of these patients are unlikely to survive their hospital admission and the vast majority would benefit from SPCT review for appropriate symptom management and Advanced Care Planning (ACP). Method Following the successful resuscitation of a 42-year-old patient with locally advanced pancreatic cancer after an in hospice cardiac arrest, using basic life support with automatic external defibrillation (AED), the case was brought to the monthly Significant Event Meeting (SEM) This proved a controversial case, overall we agreed CPR was appropriate for this patient. We investigated whether the SPICT could identify these patients during an acute attendance to the ED
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