The e1a3 BCR-ABL1 Fusion Transcript in Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia

Stephen E. Langabeer 대한진단검사의학회 2015 Annals of Laboratory Medicine Vol.35 No.5

“JAK2 V617F Mutation in Cervical Cancer Related to HPV & STIs” - Letter

Stephen E. Langabeer 대한암예방학회 2019 Journal of cancer prevention Vol.24 No.1

In a recent issue of the Journal of Cancer Prevention, Abdolmaleki and Sohrabi investigated the frequency of the JAK2 V617F mutation in patients with cervical cancer, proposing that polymorphisms in genes encoding elements of the intracellular JAK-STAT signalling pathway may contribute to oncogenesis through an immunomodulatory effect [1]. Several aspects of this study require extensive explanation and clarification. Firstly, the authors have selected the JAK2 p.V617F (c.1849G>T; reference sequence NM_004972.3) which is not a polymorphism as continually stated, but the most common somatic, driver mutation of the classical myeloproliferative neoplasms (MPN) of polycythemia vera, essential thrombocythemia and primary myelofibrosis. This acquired mutation, located in exon 14 (not exon 12) of the JAK2 gene, causes constitutive activation of JAK-STAT signalling mediated by hematopoietic growth factors resulting in proliferation of various myeloid cell lineages [2]. Selection of this acquired molecular marker to correlate with cervical cancer therefore appears highly erroneous and requires justification. Secondly, in order to detect the JAK2 V617F, the authors use a restriction fragment length polymorphism (RFLP) technique that detects the presence of the G>T transversion. This technique has been demonstrated to be highly inefficient due to incomplete restriction enzyme cleavage, particularly at low JAK2 V617F levels and therefore, assigning positivity and subsequent mutation zygosity would be extremely challenging [3]. Numerous real-time PCR approaches exist for the detection of the JAK2 V617F and given the availability of this methodology to the authors, the selection of an RFLP approach appears somewhat confounding [4]. Furthermore, the authors report the presence of a heterozygous JAK2 V617F in 68 (34.9%) of all study participants in Table 2, a strikingly disproportionate high number, lending further evidence for a largely false-positive identification of this mutation. Finally, if these study participants truly harbor the JAK2 V617F, did any possess other clinical, hematological or laboratory evidence of a co-existing MPN in addition to cervical cancer? If so, further information needs to be provided. While polymorphisms in immune mediators, including those of JAK2 such as rs10815144 and rs12349785, have been previously associated with the risk of cervical cancer [5], the rationale for examining the MPN-associated JAK2 V617F with such a problematic methodology in cervical cancer pathogenesis appears unconvincing.

Molecular screening for an underlying myeloproliferative neoplasm in patients with stroke: who and how?

Stephen E. Langabeer 대한혈액학회 2020 Blood Research Vol.55 No.1

Polycythemia vera emerging eighteen years after acute myeloid leukemia diagnosis

Stephen E. Langabeer,Derick W. O’Flynn,Mary R. Cahill 대한혈액학회 2021 Blood Research Vol.56 No.2

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Determinants of Potentially Unnecessary Cervical Cancer Screenings in American Women

Seo, Munseok,Langabeer, James The Korean Society for Preventive Medicine 2018 예방의학회지 Vol.51 No.4

Objectives: To identify factors responsible for potentially clinically unnecessary cervical cancer screenings in women with prior hysterectomy. Methods: A retrospective cross-sectional study was conducted using the Centers for Disease Control and Prevention's Behavioral Risk Factor Surveillance System (BRFSS). This study targeted adult women and examined whether they received a both a Papanicolaou (Pap) test and undergone a hysterectomy in the last three years. We conducted multivariate analyses, including weighted proportions and odds ratios (ORs), based on the modified BRFSS weighting method (raking). The inclusion criteria were adult women (>18 years old) who reported having received a Pap test within the last 3 years. Results: Of all women (n=252 391), 72 366 had received a Pap test, and 32 935 of those women (45%, or 12.5 million, weighted) had a prior hysterectomy. We found that age, race/ethnicity, marital status, family income, health status, time since last routine checkup, and health insurance coverage were all significant predictors. Black, non-Hispanic women were 2.23 times more likely to receive Pap testing after a hysterectomy than white women (OR, 2.23; 95% confidence interval [CI], 1.99 to 2.50). Similarly, the odds for Hispanic women were 2.34 times higher (OR, 2.34; 95% CI, 1.97 to 2.80). The odds were also higher for those who were married (OR, 1.17; 95% CI, 1.08 to 1.27), healthier (OR, 1.24; 95% CI, 1.14 to 1.35), and had health insurance (OR, 1.54; 95% CI, 1.28 to 1.84), after controlling for confounders. Conclusions: We conclude that women may potentially receive Pap tests even if they are not at risk for cervical cancer, and may not be adequately informed about the need for screenings. We recommend strategies to disseminate recommendations and information to patients, their families, and care providers.

Demographic and Survivorship Disparities in Non-muscle-invasive Bladder Cancer in the United States

Seo, Munseok,Langabeer, James R. II The Korean Society for Preventive Medicine 2018 Journal of Preventive Medicine and Public Health Vol.51 No.5

Objectives: To examine survivorship disparities in demographic factors and risk status for non-muscle-invasive bladder cancer (NMIBC), which accounts for more than 75% of all urinary bladder cancers, but is highly curable with early identification and treatment. Methods: We used the US National Cancer Institute's Surveillance, Epidemiology, and End Results registries over a 19-year period (1988-2006) to examine survivorship disparities in age, sex, race/ethnicity, and marital status of patients and risk status classified by histologic grade, stage, size of tumor, and number of multiple primary tumors among NMIBC patients (n=29 326). We applied Kaplan-Meier (K-M) and Cox proportional hazard methods for survival analysis. Results: Among all urinary bladder cancer patients, the majority of NMIBCs were in male (74.1%), non-Latino white (86.7%), married (67.8%), and low-risk (37.6%) to intermediate-risk (44.8%) patients. The mean age was 68 years. Survivorship (in median life years) was highest for non-Latino white (5.4 years), married (5.4 years), and low-risk (5.7 years) patients (K-M analysis, p<0.001). We found significantly lower survivorship for elderly, male (female hazard ratio [HR], 0.96), Latino (HR, 1.20), and unmarried (married HR, 0.93) patients. Conclusions: Survivorship disparities were ubiquitous across age, sex, race/ethnicity, and marital status groups. Non-white, unmarried, and elderly patients had significantly shorter survivorship. The implications of these findings include the need for a heightened focus on health policy and more organized efforts to improve access to care in order to increase the chances of survival for all patients.

Determinants of Potentially Unnecessary Cervical Cancer Screenings in American Women

서문석,James Langabeer 대한예방의학회 2018 Journal of Preventive Medicine and Public Health Vol.51 No.4

Objectives: To identify factors responsible for potentially clinically unnecessary cervical cancer screenings in women with prior hysterectomy. Methods: A retrospective cross-sectional study was conducted using the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System (BRFSS). This study targeted adult women and examined whether they received a both a Papanicolaou (Pap) test and undergone a hysterectomy in the last three years. We conducted multivariate analyses, including weighted proportions and odds ratios (ORs), based on the modified BRFSS weighting method (raking). The inclusion criteria were adult women (>18 years old) who reported having received a Pap test within the last 3 years. Results: Of all women (n=252 391), 72 366 had received a Pap test, and 32 935 of those women (45%, or 12.5 million, weighted) had a prior hysterectomy. We found that age, race/ethnicity, marital status, family income, health status, time since last routine checkup, and health insurance coverage were all significant predictors. Black, non-Hispanic women were 2.23 times more likely to receive Pap testing after a hysterectomy than white women (OR, 2.23; 95% confidence interval [CI], 1.99 to 2.50). Similarly, the odds for Hispanic women were 2.34 times higher (OR, 2.34; 95% CI, 1.97 to 2.80). The odds were also higher for those who were married (OR, 1.17; 95% CI, 1.08 to 1.27), healthier (OR, 1.24; 95% CI, 1.14 to 1.35), and had health insurance (OR, 1.54; 95% CI, 1.28 to 1.84), after controlling for confounders. Conclusions: We conclude that women may potentially receive Pap tests even if they are not at risk for cervical cancer, and may not be adequately informed about the need for screenings. We recommend strategies to disseminate recommendations and information to patients, their families, and care providers.

Demographic and Survivorship Disparities in Non–muscle-invasive Bladder Cancer in the United States

서문석,James R. Langabeer II 대한예방의학회 2018 Journal of Preventive Medicine and Public Health Vol.51 No.5

Objectives: To examine survivorship disparities in demographic factors and risk status for non–muscle-invasive bladder cancer (NMIBC), which accounts for more than 75% of all urinary bladder cancers, but is highly curable with early identification and treatment. Methods: We used the US National Cancer Institute’s Surveillance, Epidemiology, and End Results registries over a 19-year period (1988-2006) to examine survivorship disparities in age, sex, race/ethnicity, and marital status of patients and risk status classified by histologic grade, stage, size of tumor, and number of multiple primary tumors among NMIBC patients (n=29 326). We applied Kaplan- Meier (K-M) and Cox proportional hazard methods for survival analysis. Results: Among all urinary bladder cancer patients, the majority of NMIBCs were in male (74.1%), non-Latino white (86.7%), married (67.8%), and low-risk (37.6%) to intermediate-risk (44.8%) patients. The mean age was 68 years. Survivorship (in median life years) was highest for non-Latino white (5.4 years), married (5.4 years), and low-risk (5.7 years) patients (K-M analysis, p<0.001). We found significantly lower survivorship for elderly, male (female hazard ratio [HR], 0.96), Latino (HR, 1.20), and unmarried (married HR, 0.93) patients. Conclusions: Survivorship disparities were ubiquitous across age, sex, race/ethnicity, and marital status groups. Non-white, unmarried, and elderly patients had significantly shorter survivorship. The implications of these findings include the need for a heightened focus on health policy and more organized efforts to improve access to care in order to increase the chances of survival for all patients.