Ramathibodi Hospital

Background Symptomatic dermographism (SD) is the most common subtype of chronic inducible urticaria, yet its prevalence and clinical relevance in pediatric urticaria remain incompletely characterized. Objective assessment of SD and its relationship with disease activity in children is limited. Methods In this prospective observational study, children aged 1–18 years with acute or chronic urticaria were enrolled at a tertiary care center. Dermographometer testing using FricTest® 4.0 was performed at baseline and repeated after 6 weeks. SD was defined as a wheal diameter ≥3 mm with pruritus at 10 min after provocation. Disease activity and control were assessed using the Urticaria Activity Score over 7 days (UAS7) and the Urticaria Control Test (UCT). Results A total of 144 children (median age 9 years; 49.3% male) were included, of whom 79.2% had chronic urticaria. SD was identified in 24.3% of patients, with similar prevalence between acute and chronic urticaria. Children with SD were older and more frequently reported skin stroking or scratching as a trigger (p < 0.001). Dermographometer wheal diameter correlated with UAS7 (r = 0.33, p < 0.001). Lower dermographometer thresholds and more positive FricTest pins were associated with greater disease activity. At 6-week follow-up, children with SD showed improved dermographometer responses but were less likely to achieve well-controlled disease. SD at presentation was more frequent among children who progressed to chronic urticaria. Conclusion SD is common in pediatric urticaria and is associated with higher disease activity and poorer short-term disease control. Dermographometer-based provocation testing may complement patient-reported outcome measures.

Cytomegalovirus (CMV) infection is a major concern in CMV-seropositive kidney transplant recipients receiving anti-thymocyte globulin (ATG). Although valganciclovir prophylaxis is recommended, cost and toxicity limit its use. A hybrid strategy—initial prophylaxis followed by preemptive therapy—is used in our setting, but its effectiveness in this high-risk group remains unclear.Kaplan-Meier plot for cumulative incidence of clinically significant CMV infection within 6 months post-KT in CMV-seropositive recipients receiving ATG induction therapy by hybrid strategy and prophylaxis strategy. We conducted a retrospective cohort study (2018–2024) at Ramathibodi Hospital, Thailand. The hybrid group received IV ganciclovir after transplant surgery during hospitalization, followed by outpatient CMV DNA monitoring every 2–4 weeks until three months post-transplant. The prophylaxis group received oral valganciclovir for three months. Outcomes included CMV infection within six months, which was further classified into asymptomatic CMV infection, clinically significant CMV infection (CsCMVi), and CMV disease, as well as adverse events. Risk factors for CsCMVi were analyzed using a Cox proportional hazards model. A total of 111 CMV-seropositive KT recipients were included (75 in the hybrid group, 36 in the prophylaxis group). CMV infection occurred in 70.7% of the hybrid group compared to 16.7% in the prophylaxis group (p < 0.001). CsCMVi rates were 33.3% vs. 5.6%, respectively (p = 0.001) (Figure 1). Allograft dysfunction was also more frequent in the hybrid group (45.3% vs. 16.7%, p = 0.01). Rates of neutropenia, leukopenia, and lymphopenia were similar between groups (all p = NS). In multivariate analysis, independent risk factors for CsCMVi included the hybrid strategy (HR, 6.06; 95% CI, 1.04–35.36; p = 0.045), panel-reactive antibody (PRA) percentage (HR, 1.02; 95% CI, 1.00–1.04; p = 0.019), and a >40% decline in eGFR at discharge (HR, 48.09; 95% CI, 4.39–527.20; p = 0.002). However, underlying hypertension was identified as a protective factor against CsCMVi (HR, 0.12; 95% CI, 0.04–0.80; p = 0.024). Universal prophylaxis may offer improved protection—both direct (against CMV infection) and indirect (against allograft dysfunction)—compared to the hybrid strategy in CMV-seropositive KT recipients receiving ATG induction therapy, without increasing bone marrow toxicity. Improved access to CMV prophylaxis is needed for this high-risk population. All Authors: No reported disclosures

Abstract Background: Endometrial cancer affects more than 420,000 women worldwide, with approximately 40% of cases occurring in Asia. Recently, endometrial cancer is now more precisely categorized through molecular subtyping, which has improved prognostic assessment and guided treatment strategies. In this study, we identified molecular subtypes of endometrial cancer in Asian patients using comprehensive genomic profiling of liquid biopsy samples, circulating tumor DNA (ctDNA). Methods: This is an Asian multicenter prospective observational study conducted by five institutions in Japan, Malaysia, Philippines, Taiwan, and Thailand (NCT05099978, ClinicalTrials.gov). Eligible patients had histological diagnosis of endometrial cancer with metastatic or recurrent disease. Genomic profiling was conducted by AmpliSeq HD custom panel (Thermo Fisher Scientific), targeting 23 genes (752 amplicons), designed using AmpliSeq Designer to cover on genes and hotspot mutation regions associated with endometrial cancer. This panel can identify (1) full-length in following genes: ARID1A, ARID1B, B2M, CCNE1, CTCF, JAK1, PIK3R1, PTEN, RB1, RPL22, SMARCB1, SMARCA4 and TP53, (2) hotspot mutation or region in following genes: AKT1, BRAF, CTNNB1, ERBB2, KRAS, MET, MYC, PIK3CA, POLE and PPP2R1A. Results: From August 2022 to March 2024, a total of 60 patients with advanced endometrial cancer were enrolled, including 44 from Japan, 10 from Taiwan, 3 from Malaysia, 2 from Philippines, and 1 from Thailand. The median age was 59 (range, 31 to 79) years. Most cases were at relapse (36; 60.0%) at liquid biopsy. In terms of therapy, 10 (16.7%) of the subjects had received radiation prior to the liquid biopsy, and 33 (55%) of the patients had received chemotherapy prior to the liquid biopsy. Genomic alterations were detected in 75.0% (45/60), with a median number of 2 genomic abnormality per case (range, 0-12). The most frequently altered genes were PTEN (n=20, 33.3%), TP53 (n=19, 31.7%), PIK3CA (n=19, 31.7%) and CTNNB1 (n=14, 23.3%). CNV analysis excluded 18 samples with both low coverage depth and low uniformity, or low uniformity alone, resulting in a total of 42 cases analyzed. CNVs were detected in eight patients: 2 with ERBB2 amplification, 2 with PIK3CA amplification, 2 with MYC amplification, and 2 with CCNE1 amplification. Conclusion: The comprehensive genomic profiling of liquid-based samples prior to treatment initiation may help guide personalized therapeutic strategies for Asian patients with advanced or recurrent endometrial cancer. Citation Format: Hiroki Tamura, Yuki Kojima, Kazuki Sudo, Wan Zamaniah Wan Ishak, Marcelo S. Imasa, Arb-aroon Lertkhachonsuk, Ryoka Miki, Hiroshi Yoshida, Shinji Kohsaka, Yukari Nagasaka, Ryunosuke Machida, Tetsuya Sasaki, Tomomi Hata, Kenichi Nakamura, Kan Yonemori. Genomic profiling of circulating tumor DNA in endometrial cancer in Asia: A-TRAIN study [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2026; Part 1 (Regular Abstracts); 2026 Apr 17-22; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2026;86(7 Suppl):Abstract nr 3853.