Increased fibrinogen levels at diagnosis are associated with adverse outcome in patients with acute myeloid leukemia

Increased plasma fibrinogen levels are associated with shortened overall survival (OS) in some solid tumor types. In contrast, the prognostic significance of varying fibrinogen levels in acute myeloid leukemia (AML) at diagnosis is unknown. In this study, we assessed the prognostic significance of fibrinogen levels in AML patients. In a comprehensive retrospective single-center study, we determined the survival rates of 375 consecutive AML patients undergoing at least one cycle of intensive chemotherapy induction treatment. Patients were dichotomized between low (<4.1 g/L) and high fibrinogen levels (≥4.1 g/L) at diagnosis of AML before initiation of treatment. Subsequently, quartile ranges were applied to analyze the association of varying fibrinogen levels on survival. We observed that the rates of complete remission, early death, and admission to intensive care unit were equal in the low versus high fibrinogen group. However, OS was significantly better in the low fibrinogen group (27.3 vs 13.5 months; p = 0.0009) as well as progression-free survival (12.3 vs 7.8 months; p = 0.0076). This survival difference remained significant in the multivariate analysis (p = 0.003). Assessing quartiles of fibrinogen values, we further confirmed this observation. Our data suggest that high fibrinogen levels at diagnosis of AML are associated with unfavorable OS and progression-free survival but not with increased mortality during induction treatment.

(Tables 1,2) Site characteristics and phenotypic attributes of King Penguins (Aptenodytes patagonicus) on Possession Island

In colonial species, it is often assumed that locations in the center of the colony are of highest quality and provide highest breeding success. We tested this prediction, known as the "central-periphery model," in a King Penguin colony in the subantarctic Crozet Archipelago. Breeding activity and survival of 150 penguins, fitted with transponder tags, were monitored over an entire breeding season. Among these 150 birds, 50 bred on the slope at the upper periphery of the colony, where the rates of predation and parasitism by ticks were high. Fifty birds bred in the center of the colony, where rates of predation and tick parasitism were low, and 50 bred at the lower end of the colony, where the rate of tick parasitism was low but predation and flooding were important risks. We predicted that the center of the colony should provide the safest breeding place and consequently be characterized by the highest breeding success and be used by the highest-quality individuals. Yet we found that penguins breeding in the center of the colony had the same breeding success as those at both peripheral locations. In addition, penguins breeding on the upper slope had a higher survival rate than penguins breeding at the center or bottom of the slope and were likely of higher quality. Our study does not support the central-periphery model and emphasizes the complexity behind the relationships among breeding site, breeding success, and individual quality.

A comprehensive policy to ameliorate adverse effects of transportation facilities. Appendix.

Transportation Department, Office of the Assistant Secretary for Environment, Safety, and Consumer Affairs, Washington, D.C.

More needs to be done to reduce the number and adverse impact of illegal aliens in the United States, Immigration and Naturalization Service, Department of Justice;

"B-125051."

A catalogue of pictures by British artists, in the possession of Sir John Fleming Leicester, bart., with etchings from the whole collection. Including the pictures in his gallery at Tabley House, Cheshire; executed by permission of the proprietor; and accompanied with historical and biographical notices.

Mode of access: Internet.

Improved visibility for school buses during adverse weather - summary report. Final report.

National Highway Traffic Safety Administration, Washington, D.C.

Improved visibility for school buses during adverse weather - volume I. Final report.

National Highway Traffic Safety Administration, Washington, D.C.

Improved visibility for school buses during adverse weather - volume II: appendixes. Final report.

National Highway Traffic Safety Administration, Washington, D.C.

The ordinances of the Clothworkers' Company together with those of the ancient guilds or fraternities of the fullers & shearmen of the city of Lon don, transcribed from the originals in the possession of the Company.

Includes index.

New York city in Indian possession /

Mode of access: Internet.

"This is gonna hurt me more than it hurts you!" : a manager's guide to taking adverse actions /

Mode of access: Internet.

Airborne ultrasound : measurement and possible adverse effects /

Mode of access: Internet.