• Atypical CD4(+)/CD8(+) Lymphocytosis and Prolonged Pancytopenia Associated With Human Herpesvirus 6 Reactivation After Autologous Peripheral Blood Stem Cell Transplantation

      Russell, Samantha J; Duran, Juanita; Fuchs, Deborah; Yeager, Andrew M; Univ Arizona, Coll Med Tucson, Dept Med; Univ Arizona, Coll Med Tucson, Dept Pathol; Univ Arizona, Canc Ctr (CIG MEDIA GROUP, LP, 2019-08-01)
    • Clinical and Molecular Characteristics and Burden of Kidney Cancer Among Hispanics and Native Americans: Steps Toward Precision Medicine

      Batai, Ken; Bergersen, Andrew; Price, Elinora; Hynes, Kieran; Ellis, Nathan A.; Lee, Benjamin R.; Univ Arizona, Dept Surg, Div Urol; Univ Arizona, Dept Cellular & Mol Med (CIG MEDIA GROUP, LP, 2018-06)
      Cancer disparities in Native Americans (NAs) and Hispanic Americans (HAs) vary significantly in terms of cancer incidence and mortality rates across geographic regions. This review reports that kidney and renal pelvis cancers are unevenly affecting HAs and NAs compared to European Americans of non-Hispanic origin, and that currently there is significant need for improved data and reporting to be able to advance toward genomic-based precision medicine for the assessment of such cancers in these medically underserved populations. More specifically, in states along the US-Mexico border, HAs and NAs have higher kidney cancer incidence rates as well as a higher prevalence of kidney cancer risk factors, including obesity and chronic kidney disease. They are also more likely to receive suboptimal care compared to European Americans. Furthermore, they are underrepresented in epidemiologic, clinical, and molecular genomic studies of kidney cancer. Therefore, we maintain that progress in precision medicine for kidney cancer care requires an understanding of various factors among HAs and NAs, including the real kidney cancer burden, variations in clinical care, issues related to access to care, and specific clinical and molecular characteristics.(C) 2018 Elsevier Inc. All rights reserved.
    • Racial and Ethnic Disparities in Renal Cell Carcinoma: An Analysis of Clinical Characteristics

      Batai, Ken; Harb-De la Rosa, Alfredo; Lwin, Aye; Chaus, Fahad; Gachupin, Francine C; Price, Elinora; Lee, Benjamin R; Univ Arizona, Dept Surg, Div Urol; Univ Arizona, Dept Family & Community Med; Univ Arizona, Dept Surg (CIG MEDIA GROUP, LP, 2019-02-01)
      Racial/ethnic minority groups, including Hispanic Americans (HAs) and Native Americans (NAs), have a heavier burden of kidney cancer than European Americans (EAs). We investigated variations in clinical characteristics of HA and NA patients with renal cell carcinoma (RCC) who were previously underrepresented. Clinical records of 294 patients with RCC (151 EAs, 95 HAs, 22 NAs, and 26 others) without prior diagnosis of cancer were reviewed. Logistic regression analysis was performed to understand patients' clinical characteristics. HAs had about 5 years younger average age at diagnosis than EAs (55.8 vs. 60.5 years) and an almost 3-fold increased odds of diagnosis before age 50 years (odds ratio [OR], 2.77; 95% confidence interval [CI], 1.39-5.54). The mean age of diagnosis among NAs was 49.7 years, and NAs had an over 6-fold higher odds of diagnosis at a younger age (OR, 6.23; 95% CI, 2.00-19.46). Clear-cell RCC (ccRCC) was more common in HAs and NAs than EAs. Over 90% of HA patients had ccRCC, whereas only 78.8% of EA patients had ccRCC. HAs had increased odds of diagnosis with ccRCC compared with EAs (OR, 2.79; 95% CI, 1.15-6.80). Among HAs, older patients and patients who spoke Spanish as their primary language were more likely to have advanced stage RCC at diagnosis (OR, 10.48; 95% CI, 1.69-64.89 and OR, 4.61; 95% CI, 1.38-15.40). HA and NA patients with RCC had different clinical characteristics than EA patients. It is necessary to better understand the clinical characteristics of these underserved HA and NA populations with high kidney cancer burden.
    • Urothelial Carcinoma of the Renal Pelvis and Ureter: Does Location Make a Difference?

      Lwin, Aye A; Hsu, Chiu-Hsieh; Chipollini, Juan; Univ Arizona, Dept Urol; Univ Arizona, Dept Epidemiol & Biostat (CIG MEDIA GROUP, LP, 2020-02)
      There has been a scarcity of data on outcomes of upper tract urothelial carcinoma. We queried a large cancer registry and found a strong association between survival and location of tumor. Patients with ureteral urothelial carcinoma were found to be treated with less radical surgery and to have worse survival than those with renal pelvis urothelial carcinoma. These patients may suffer from poor initial staging and suboptimal treatments. Background: There is a paucity of data on outcomes of upper tract urothelial carcinoma (UTUC) arising from the renal pelvis (RPUC) versus UTUC arising from the ureter (UUC). The published literature is conflicting, and there is no consensus on patient prognosis based on disease location. The aim of this study is to compare clinical and survival outcomes based on location of primary tumor using a large national registry. Materials and Methods: The National Cancer Database was queried from 2010 to 2016 for patients with localized (cN0M0) UTUC. Patients were stratified based on location of tumor. Survival analysis was performed using Cox proportional hazard regression and inverse probability of treatment weighting (IPTW)-adjusted Kaplan-Meier curves. We also performed exploratory analyses based on tumor stage. Results: We identified 11,922 patients who underwent surgical treatment. The median follow-up was 32.1 months. Patients with RPUC presented with higher tumor stage and grade. Patients with UUC were treated with less radical nephroureterectomy (56.4% vs. 84.3%; P < .01). IPTW-adjusted Kaplan-Meier curves demonstrated higher median overall survival for RPUC versus UUC (71.1 vs. 66.8 months, respectively; P = .01). This benefit was consistent across tumor stage subgroups, reaching statistical significance in patients with T1 disease. On multivariable analysis, ureteral location of tumor was a predictor of worse survival. Conclusion: Patients with UUC were found to be treated with less radical surgery and to have worse survival than those with RPUC. These patients may suffer from poor initial staging and suboptimal treatments. Further studies are needed to evaluate potential biological differences of UTUC based on tumor location. (C) 2019 Elsevier Inc. All rights reserved.