[Successful treatment of cutaneous leishmaniasis with simulated daylight photodynamic therapy]. / Erfolgreiche Therapie der kutanen Leishmaniose mit simulierter Tageslicht-photodynamischer Therapie.

A 5-year-old Syrian boy , presented with a complex cutaneous leishmaniasis (CL) of the right ankle caused by Leishmania (L.) tropica. The patient received photodynamic therapy (PDT; 6 cycles with application of 5­aminolevulinic acid and foil occlusion for 3 h). Due to pain during exposure to red light, exposure was continued with simulated daylight (sDL-PDT). The lesion healed with an atrophic scar. Due to fewer side effects and less pain, sDL-PDT seems to be a good therapeutic strategy for CL caused by L. tropica.

Impact of comorbidities on overall survival in patients with chronic myeloid leukemia: results of the randomized CML study IV.

We studied the influence of comorbidities on remission rate and overall survival (OS) in patients with chronic myeloid leukemia (CML). Participants of the CML Study IV, a randomized 5-arm trial designed to optimize imatinib therapy, were analyzed for comorbidities at diagnosis using the Charlson Comorbidity Index (CCI); 511 indexed comorbidities were reported in 1519 CML patients. Age was an additional risk factor in 863 patients. Resulting CCI scores were as follows: CCI 2, n = 589; CCI 3 or 4, n = 599; CCI 5 or 6, n = 229; and CCI ≥ 7, n = 102. No differences in cumulative incidences of accelerated phase, blast crisis, or remission rates were observed between patients in the different CCI groups. Higher CCI was significantly associated with lower OS probabilities. The 8-year OS probabilities were 93.6%, 89.4%, 77.6%, and 46.4% for patients with CCI 2, 3 to 4, 5 to 6, and ≥7, respectively. In multivariate analysis, CCI was the most powerful predictor of OS, which was still valid after removal of its age-related components. Comorbidities have no impact on treatment success but do have a negative effect on OS, indicating that survival of patients with CML is determined more by comorbidities than by CML itself. OS may therefore be inappropriate as an outcome measure for specific CML treatments. The trial was registered at www.clinicaltrials.gov as #NCT00055874.