Deferasirox reduces oxidative DNA damage in bone marrow cells from myelodysplastic patients and improves their differentiation capacity.

Patients with low-risk myelodysplastic syndromes (MDS) usually develop iron overload. This leads to a high level of oxidative stress in the bone marrow (BM) and increases haematopoietic cell dysfunction. Our objective was to analyse whether chelation with deferasirox (DFX) alleviates the consequences of oxidative stress and improves BM cell functionality. We analysed 13 iron-overloaded MDS patients' samples before and 4-10 months after treatment with DFX. Using multiparametric flow cytometry analysis, we measured intracellular reactive oxygen species (ROS), DNA oxidation and double strand breaks. Haematopoietic differentiation capacity was analysed by colony-forming unit (CFU) assays. Compared to healthy donors, MDS showed a higher level of intracellular ROS and DNA oxidative damage in BM cells. DNA oxidative damage decreased following DFX treatment. Furthermore, the clonogenic assays carried out before treatment suggest an impaired haematopoietic differentiation. DFX seems to improve this capacity, as illustrated by a decreased cluster/CFU ratio, which reached values similar to controls. We conclude that BM cells from MDS are subject to higher oxidative stress conditions and show an impaired haematopoietic differentiation. These adverse features seem to be partially rectified after DFX treatment.

Unclassifiable CD20-negative Testicular Diffuse Large B-cell Lymphoma.

CD20-negative diffuse large B-cell lymphoma (DLBCL) is a very uncommon neoplasm, and very rare unclassifiable cases that did not meet the criteria for well-established subtypes of CD20-negative DLBCLs have been reported. CD20-negative DLBCLs often present an aggressive clinical course with important chemoresistance and poor prognosis. Here, we report a case of CD20-negative DLBCL presented as a testicular mass. To the best of our knowledge, this is one of the first reported cases of testicular unclassifiable CD20-negative DLBCL.

Outpatient Microureteroscopy for Distal Ureteral Stone-A True Minimally Invasive Procedure.

INTRODUCTION: To describe microureteroscopy, a novel minimally invasive approach for treating distal ureteral lithiasis. TECHNICAL CONSIDERATIONS: Seven female patients with distal ureteral stones ≤ 10 mm were operated by microureteroscopy. The microureteroscope consist on a 4.85 Fr (16-gauge) sheath, a 0.9 mm diameter flexible optic system, and a 3-arm Luer-lock adapter to connect the sheath and insert the optics. Patients are placed in lithotomy position. Under sedative anesthesia and antimicrobial coverage, we performed microureteroscopy in patients with distal ureteral stones, describing key steps and perioperative and postoperative outcomes. Stone clearance was assessed using X-ray plain abdominal film of KUB at 15 days. Mean patients age was 54.5 years, and mean stone size was 7.98 mm. Stone-free rate was 100%. Patients were discharged 2-4 hours after the procedure without intraoperative or major perioperative complications. CONCLUSION: Microureteroscopy was developed to reduce dilation and ureteral wall damage and, thus, to decrease postoperative stenting and hospital stay.