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| ID | Type | Description | Link |
|---|---|---|---|
| IRBMED 2003-0590 and HUM 46747 | Other Identifier | University of Michigan Medical IRB |
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The purpose of this study is to determine the effectiveness of etanercept in the treatment of patients with sub-acute lung injury following a bone marrow transplant. This study will also examine the toxicity of treatment with etanercept as well as whether there is an improved quality of life in these patients.
Lung or breathing problems can develop several months to years following a bone marrow transplant. In some cases, these breathing problems develop without any signs of germs or infection in the lungs. The name for this type of breathing problem is called "Sub-Acute Lung Injury". Sub-acute lung injury often develops many months, even years following a bone marrow transplant. It is often characterized by shortness of breath, cough, wheezing and fatigue.
Sub-acute lung injury can either lead to the formation of scar tissue in the lungs (making it difficult to take deep breaths), or it can cause the lungs to get weak (making people feel out of breath easily). Approximately 25 - 50% of patients with sub-acute lung injury may eventually die from the damage in their lungs. Typically, such patients die from infections that develop inside the damaged lungs.
In this study, treatment with an experimental drug called Etanercept will be used. (Enbrel). The physicians feel there is the possibility that Etanercept may help improve breathing. Breathing ability will be assessed prior to treatment as well as during and after treatment so that comparisons can be made.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| etanercept treatment | Experimental | Etanercept for lung injury |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Etanercept | Drug | Etanercept will be given on an open label, single arm basis to patients with non-infectious, sub-acute lung injury. 0.4 mg/kg/dose to a maximum of 25 mg, subcutaneously, twice weekly, for a total of 24 dosages. |
| Measure | Description | Time Frame |
|---|---|---|
| Percent of Patients With a Greater Than or Equal to 10% Improvement in FEV1, or FVC, and DLCO | Response was defined as a greater than or equal to 10% improvement in the absolute value for FEV1 (for obstructive defects) or FVC (for restrictive defects), and DLCO (Diffusing Capacity of the Lungs for Carbon Monoxide) . | week 12 post therapy |
| Measure | Description | Time Frame |
|---|---|---|
| Percentage of Participants That Experience Grade 3 to 4 Adverse Events | To evaluate the toxicity of etanercept therapy in patients with sub-acute lung injury > 100 days post transplant, the percent incidence of grade 3 to 4 adverse events among evaluable patients was calculated. | continuously (and week 4, week 8 and week 12, week 20) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Gregory A Yanik, MD | The University of Michigan Comprehensive Cancer Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| The University of Michigan Cancer Center | Ann Arbor | Michigan | 48109 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 22155140 | Result | Yanik GA, Mineishi S, Levine JE, Kitko CL, White ES, Vander Lugt MT, Harris AC, Braun T, Cooke KR. Soluble tumor necrosis factor receptor: enbrel (etanercept) for subacute pulmonary dysfunction following allogeneic stem cell transplantation. Biol Blood Marrow Transplant. 2012 Jul;18(7):1044-54. doi: 10.1016/j.bbmt.2011.11.031. Epub 2011 Dec 10. |
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Study subjects were recruited from the Blood and Marrow Stem Cell Program at the University of Michigan Medical Center between 2001 and 2008, all subjects having received an allogeneic Stem Cell Transplant (SCT) at least 100 days before study entry.
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| ID | Title | Description |
|---|---|---|
| FG000 | Etanercept Treatment | Etanercept for lung injury Etanercept: Etanercept will be given on an open label, single arm basis to patients with non-infectious, sub-acute lung injury. 0.4 mg/kg/dose to a maximum of 25 mg, subcutaneously, twice weekly, for a total of 24 dosages. |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
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| COMPLETED |
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| NOT COMPLETED |
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All patients enrolled that received at least one scheduled dose.
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| ID | Title | Description |
|---|---|---|
| BG000 | Etanercept Treatment | Etanercept for lung injury Etanercept: Etanercept will be given on an open label, single arm basis to patients with non-infectious, sub-acute lung injury. 0.4 mg/kg/dose to a maximum of 25 mg, subcutaneously, twice weekly, for a total of 24 dosages. |
| Units | Counts |
|---|---|
| Participants |
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| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean | Full Range | years |
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| Sex: Female, Male | Count of Participants | Participants |
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| Diagnosis | Number | participants |
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| Human Leukocyte Antigen (HLA) Match | Number | participants |
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| Cell Source | Cell source for transplant. | Number | participants |
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| Donor Type | Number | participants |
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| Chronic Graft Versus Host Disease (GVHD) Present | Number | participants |
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| Lung Injury Pattern | Number | participants |
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| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Percent of Patients With a Greater Than or Equal to 10% Improvement in FEV1, or FVC, and DLCO | Response was defined as a greater than or equal to 10% improvement in the absolute value for FEV1 (for obstructive defects) or FVC (for restrictive defects), and DLCO (Diffusing Capacity of the Lungs for Carbon Monoxide) . | 34 subjects were enrolled. Thirty-one of 34 subjects were evaluable for response, with three subjects completing <50% of scheduled dosing. | Posted | Number | percent evaluable participants | week 12 post therapy |
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| Secondary | Percentage of Participants That Experience Grade 3 to 4 Adverse Events | To evaluate the toxicity of etanercept therapy in patients with sub-acute lung injury > 100 days post transplant, the percent incidence of grade 3 to 4 adverse events among evaluable patients was calculated. | 34 subjects were enrolled and evaluated for adverse events. | Posted | Number | percentage of participants | continuously (and week 4, week 8 and week 12, week 20) |
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Adverse Events (AEs) were collected for each patient from time of administration of the first dose of drug up to 28 days after the final dose of study drug.
Serious Adverse Events (SAEs) are defined as Grade 4 or 5 (Adverse events will use the descriptions and grading scales found in the revised National Cancer Institute (NCI) Common Toxicity Criteria (CTC), version 2.0.) non-pulmonary toxicities.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Etanercept Treatment | Etanercept for lung injury Etanercept: Etanercept will be given on an open label, single arm basis to patients with non-infectious, sub-acute lung injury. 0.4 mg/kg/dose to a maximum of 25 mg, subcutaneously, twice weekly, for a total of 24 dosages. | 5 | 34 | 21 | 34 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Hyperglycemia | Metabolism and nutrition disorders | CTCAE (2.0) |
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| Hypophosphatemia | Metabolism and nutrition disorders | CTCAE (2.0) |
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| Dyspnea | Respiratory, thoracic and mediastinal disorders | CTCAE (2.0) |
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| Bacteremia/Infection | Infections and infestations | CTCAE (2.0) |
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| AML Relapse | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | CTCAE (2.0) |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Anemia | Blood and lymphatic system disorders | CTCAE (2.0) |
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| anorexia | Metabolism and nutrition disorders | CTCAE (2.0) |
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| blisters | Skin and subcutaneous tissue disorders | CTCAE (2.0) |
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| chills | General disorders | CTCAE (2.0) |
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| constipation | Gastrointestinal disorders | CTCAE (2.0) |
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| bronchoalveolar lavage - positive for bacteria | Respiratory, thoracic and mediastinal disorders | CTCAE (2.0) |
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| cushingoid appearance | Endocrine disorders | CTCAE (2.0) |
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| diarrhea | Gastrointestinal disorders | CTCAE (2.0) |
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| dizzyness | Nervous system disorders | CTCAE (2.0) |
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| dry skin | Skin and subcutaneous tissue disorders | CTCAE (2.0) |
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| DVT | Vascular disorders | CTCAE (2.0) |
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| dysphagia | Gastrointestinal disorders | CTCAE (2.0) |
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| dyspnea | Respiratory, thoracic and mediastinal disorders | CTCAE (2.0) |
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| dysuria | Renal and urinary disorders | CTCAE (2.0) |
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| Ecchymosis | Vascular disorders | CTCAE (2.0) |
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| elevated Alkaline Phoshpatase | Investigations | CTCAE (2.0) |
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| elevated ALT | Investigations | CTCAE (2.0) |
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| elevated AST | Investigations | CTCAE (2.0) |
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| elevated Creatinine | Investigations | CTCAE (2.0) |
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| elevated T-bili | Investigations | CTCAE (2.0) |
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| epistaxis | Respiratory, thoracic and mediastinal disorders | CTCAE (2.0) |
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| fatigue | General disorders | CTCAE (2.0) |
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| fever | General disorders | CTCAE (2.0) |
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| gastroenteritis | Gastrointestinal disorders | CTCAE (2.0) |
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| headache | Nervous system disorders | CTCAE (2.0) |
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| hematuria | Renal and urinary disorders | CTCAE (2.0) |
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| hypercalcemia | Metabolism and nutrition disorders | CTCAE (2.0) |
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| hyperglycemia | Metabolism and nutrition disorders | CTCAE (2.0) |
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| hyperkalemia | Metabolism and nutrition disorders | CTCAE (2.0) |
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| hyperphosphatemia | Metabolism and nutrition disorders | CTCAE (2.0) |
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| hypertension | Vascular disorders | CTCAE (2.0) |
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| hypertriglyceridemia | Metabolism and nutrition disorders | CTCAE (2.0) |
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| hypoalbuminemia | Metabolism and nutrition disorders | CTCAE (2.0) |
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| hypocalcemia | Metabolism and nutrition disorders | CTCAE (2.0) |
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| hypoglycemia | Metabolism and nutrition disorders | CTCAE (2.0) |
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| hypokalemia | Metabolism and nutrition disorders | CTCAE (2.0) |
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| hypomagnesemia | Metabolism and nutrition disorders | CTCAE (2.0) |
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| hyponatremia | Metabolism and nutrition disorders | CTCAE (2.0) |
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| hypophosphatemia | Metabolism and nutrition disorders | CTCAE (2.0) |
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| hypotension | Vascular disorders | CTCAE (2.0) |
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| hypoxia | Respiratory, thoracic and mediastinal disorders | CTCAE (2.0) |
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| insomnia | Psychiatric disorders | CTCAE (2.0) |
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| irregular heart beat | Cardiac disorders | CTCAE (2.0) |
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| pruitis | Skin and subcutaneous tissue disorders | CTCAE (2.0) |
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| leg edema | General disorders | CTCAE (2.0) |
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| leukopenia | Blood and lymphatic system disorders | CTCAE (2.0) |
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| lower extremity soreness | General disorders | CTCAE (2.0) |
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| lymphopenia | Blood and lymphatic system disorders | CTCAE (2.0) |
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| muscle cramps | Musculoskeletal and connective tissue disorders | CTCAE (2.0) |
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| musculoskeletal range of motion | Musculoskeletal and connective tissue disorders | CTCAE (2.0) |
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| nasal congestion | Respiratory, thoracic and mediastinal disorders | CTCAE (2.0) |
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| nausea | Gastrointestinal disorders | CTCAE (2.0) |
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| nocturia | Renal and urinary disorders | CTCAE (2.0) |
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| pleural effusion | Respiratory, thoracic and mediastinal disorders | CTCAE (2.0) |
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| rash | Skin and subcutaneous tissue disorders | CTCAE (2.0) |
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| rhinorrhea | Respiratory, thoracic and mediastinal disorders | CTCAE (2.0) |
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| thrombocytopenia | Blood and lymphatic system disorders | CTCAE (2.0) |
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| tremors | General disorders | CTCAE (2.0) |
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| upper respiratory infection | Respiratory, thoracic and mediastinal disorders | CTCAE (2.0) |
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| vomiting | Gastrointestinal disorders | CTCAE (2.0) |
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| weakness | General disorders | CTCAE (2.0) |
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| weight gain | Investigations | CTCAE (2.0) |
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| weight loss | Investigations | CTCAE (2.0) |
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| infection | Infections and infestations | CTCAE (2.0) |
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| UTI | Infections and infestations | CTCAE (2.0) |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Gregory Yanik, M.D. | University of Michgan Comprehensive Cancer Center | 734-936-8785 | gyanik@umich.edu |
| ID | Term |
|---|---|
| D055371 | Acute Lung Injury |
| D012128 | Respiratory Distress Syndrome |
| D001989 | Bronchiolitis Obliterans |
| D055370 | Lung Injury |
| ID | Term |
|---|---|
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D012120 | Respiration Disorders |
| D001988 | Bronchiolitis |
| D001991 | Bronchitis |
| D001982 | Bronchial Diseases |
| D008173 | Lung Diseases, Obstructive |
| D013898 | Thoracic Injuries |
| D014947 | Wounds and Injuries |
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| ID | Term |
|---|---|
| D000068800 | Etanercept |
| ID | Term |
|---|---|
| D007141 | Immunoglobulin Fc Fragments |
| D007128 | Immunoglobulin Fragments |
| D010446 | Peptide Fragments |
| D010455 | Peptides |
| D000602 | Amino Acids, Peptides, and Proteins |
| D007127 | Immunoglobulin Constant Regions |
| D007136 | Immunoglobulins |
| D007162 | Immunoproteins |
| D001798 | Blood Proteins |
| D011506 | Proteins |
| D012712 | Serum Globulins |
| D005916 | Globulins |
| D018124 | Receptors, Tumor Necrosis Factor |
| D018121 | Receptors, Cytokine |
| D011971 | Receptors, Immunologic |
| D011956 | Receptors, Cell Surface |
| D008565 | Membrane Proteins |
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| Chronic Mylogenous Leukemia (CML) |
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| NHL/CLL |
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| Myeloma |
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| Nonmalignant |
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