Imatinib, a selective BCR-ABL tyrosine kinase inhibitor (TKI), was introduced after allogeneic hematopoietic stem cell transplantation (allo-HSCT) for patients with chronic myeloid leukemia (CML). However, the long-term effects of allo-HSCT in chronic phase CML patients are mostly unknown. We retrospectively analyzed the outcomes of 204 patients with sibling donors who received peripheral stem cells and underwent allo-HSCT of chronic phase I (CP1) in the pre- and post-TKI era at Shariati Hospital in Tehran, Iran, from 1998 to 2017 and followed up till the end of 2021. The median follow-up time for all patients was 8.7 (SD = 0.54) years. Fifteen-year overall survival (OS), disease-free survival (DFS), graft-versus-host disease-free relapse-free survival (GRFS), relapse, and non-relapse mortality (NRM) incidence were 65.70%, 57.83%, 17.56%, 13.17%, and 28.98%, respectively. Using multivariable analyses, the only risk factor increasing the hazard of death was the time between diagnosis to allo-HSCT greater than 1 year compared to this time less than 1 year by 74% [hazard ratio (HR) = 1.74, P = 0.039]. Also, age is a significant risk factor for DFS (HR = 1.03, P = 0.031). Our findings suggested that allo-HSCT is still an important treatment option for CP1 patients, especially those resistant to TKI treatment. TKI consumption can have a desirable effect on NRM after allo-HSCT for CP1 CML.
Purpose: The coronavirus disease 2019 (COVID-19) is surrounded the world and is associated with multiorgan damage. Olfactory dysfunction is a common manifestation in COVID-19 patients, and in some cases, presents before the coryza signs. We conducted this umbrella review to provide a practical guide on managing, imaging findings, and follow-up of COVID-19 patients with olfactory dysfunction (OD). Methods: A comprehensive search was performed in PubMed, Embase, Scopus, and Web of Science databases from December 2019 until the end of July 2022. Systematic reviews and meta-analyses addressing management and imaging findings of the olfactory manifestations of COVID-19 were included in the study. The quality assessment of included articles was carried out using the Assessment of Multiple Systematic Reviews-2 (AMSTAR-2) tool. Results: A total of 23 systematic reviews were reviewed in this umbrella review. The number of included studies varied between 2 to 155 articles. Several demographic variables were not adequately reported across all the included systematic reviews, including age, gender, preexisting comorbidities, or whether participants had been hospitalized or admitted to the intensive care unit (ICU) due to COVID‐19. Conclusion: It seems that the coronavirus can infect olfactory system structures that play roles in the transmission and interpretation of smell sense. Based on studies, a large proportion of patients experienced OD following COVID-19 infection, and the majority of OD was resolved spontaneously. The possibility of long-lasting OD was higher in young adults with moderate clinical manifestation. Olfactory training (OT) was the most effective therapy. Intranasal corticosteroids (ICS) are also recommended.
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