No abstract

DHS skin tests to Old tuberculin, mumps, and Candida have been performed on diagnosis and 1 and 6 months later in 31 consecutive male cases of bronchial carcinoma. Length of survival was directly correlated with the strength of skin test response on diagnosis. All long‐term survivors were positive to both Candida and Old tuberculin. Correlation between general condition and strength of skin test response was present on diagnosis but not in patients alive and tested 6 months later. The results suggest that both symptom pattern before diagnosis (primary, systemic, metastatic) and general condition on diagnosis are dependent on the immune status as demonstrated by the skin tests.

Background Advances in allogeneic hematopoietic stem cell transplant (HSCT) have increased patient survival, although substantial treatment-related toxicity remains, including chronic kidney disease (CKD). We assessed the association between CKD, and survival and transplant-specific outcomes in HSCT recipients. Methods We conducted a retrospective study of all 408 adult patients with allogenic HSCT at Princess Margaret Cancer Centre (Toronto, Canada, 2015-2018). We used logistic regression to identify risk factors for CKD at 1-year post-transplant. Associations between CKD at 1-year and overall survival, relapse-free survival, graft-versus-host-disease (GVHD)-free/relapse-free survival, relapse and transplant-related mortality were examined using extended time-varying Cox models. In a sensitivity analysis, we restricted the cohort to survivors at 1-year, using standard Cox proportional hazard models to examine associations between CKD and overall survival, relapse-free survival and GVHD-free/relapse-free survival, and Fine and Gray's competing risk models to determine associations between CKD and relapse/transplant-related mortality. Results The prevalence of CKD at 1-year was 19% (46 patients) with median follow-up of 23 months. Multivariable regression identified age at transplant (adjusted OR 1.09, 95%CI = 1.05-1.14, p < 0.0001), female gender (aOR 2.83, 95%CI = 1.34-5.97, p = 0.006) and acute kidney injury during the first 100 days (aOR 3.86, 95%CI = 1.70-8.73, p = 0.001) as risk factors for CKD at 1-year. Patients with CKD at 1-year had significantly poorer overall survival than those without CKD, when adjusted for relevant covariates (adjusted HR 1.93, 95%CI = 1.02-3.66, p = 0.04 in the time-varying Cox model and aHR 2.06, 95%CI = 1.04-4.07, p = 0.04 using standard Cox model). CKD at 1-year was also associated with worse GVHD-free/relapse-free survival (aHR 1.65, 95%CI = 1.04-2.61, p = 0.03). Conclusions CKD adversely affects the long-term prognosis for allogeneic HSCT recipients, with increased mortality risk and worse GVHD-free/relapse-free survival.