Incidence and Prognostic Significance of High-Risk Cytogenetically Abnormalities in Multiple Myeloma Patients in Colombia.

INTRODUCTION: Multiple Myeloma (MM) is the second most common hematological cancer, several cytogenetics abnormalities such as t(4;14), del (17p), and t(14;16) were identified as a high-risk for survival, in Latin America, we have very little data on cytogenetic alterations in MM. This study describes the incidence of high-risk cytogenetically abnormalities in a Colombian population and prognostic significance. METHODS: In a retrospective cohort of new diagnostic Multiple Myeloma between 2016 and 2020, we identified a high-risk cytogenetically abnormalities t(4;14), t(14;16), and 17p deletions by FISH techniques and described incidence. We followed patients until progression or death and comparing progression free survival (PFS) and overall survival (OS), according with high- risk cytogenetically features. RESULTS: We included 135 newly diagnosed MM patients, the incidence of high-risk cytogenetically abnormalities were 30.3%, with 17.1% of 17p deletions, 14.1% of t(4;14) and 2.25% of t(14;16). According to the high risk cytogenetically abnormalities, the median PFS for the group of no abnormalities were 50.2 months 95% CI [25.2-62.4] and for the group of high-risk cytogenetic abnormalities 33.9 months 95% CI [23.6-NA] (P = .2). For OS the median were 76.9 months, 95% CI [67.5-NA] and 42.7 months 95% CI [33.3-NA], respectively (P = .009). CONCLUSION: High-risk cytogenetically abnormalities were independent risk factor for OS but not PFS in this cohort of patients, and the incidence of del (17p) was slightly higher than the literature reports.  MICROABSTRACT: Prognostic significance of high-risk cytogenetic abnormalities in Multiple Myeloma in Colombia is unknown. In a retrospective cohort study of 135 newly, diagnostic Multiple Myeloma we found incidence of high-risk cytogenetic abnormalities was 30.3%. The hazard ratio (HR) for disease progression or death compared high-risk cytogenetic group vs. control was 1.22, (95% CI, 0.73-2.05) (P = .2), and The HR for death for the group of high-risk cytogenetic abnormalities was 2.17, (95% CI, 1.19-3.97). In the group of high-risk cytogenetic abnormalities, if the patient received VRD as induction treatment the median PFS were 41.2 months 95% CI [13.3-NA] and 33.9 months 95% CI [24.9-NA] for patients with different induction treatment (P = .56).

Measurable Residual Disease Assessment and Allogeneic Transplantation as Consolidation Therapy in Adult Acute Lymphoblastic Leukemia in Colombia.

INTRODUCTION: Detectable minimal residual disease (MRD) after therapy for acute lymphoblastic leukemia (ALL) is the strongest predictor of hematologic relapse. The objective of the study was to assess disease-free survival (DFS) and overall survival (OS) of patients with ALL according with MRD status at the end of induction therapy in a Colombian population. PATIENTS AND METHODS: We assessed a retrospective cohort to compare DFS and OS in adults with de novo ALL according to MRD status at the end of induction chemotherapy, and the type of postinduction consolidation strategy used. RESULTS: A total of 165 adults with ALL were included in the MRD part of the study, 73 patients in the MRD-negative group and 92 in the MRD-positive group. Median DFS for the MRD-positive group was 11 months (95% confidence interval, 11.7-22.2) and was not reached for the MRD-negative group (P < .001). At 3 years, DFS was 18% and 55%, respectively (P < .001). The median OS for MRD-positive patients was 16 months (95% confidence interval, 8.8-23.15) and was not reached in the MRD-negative group. At 3 years, OS was 26% and 51% for the former and latter group, respectively. Among subjects who did not receive a transplant, median DFS was 21 months for MRD-negative patients and 9 months for MRD-positive patients (P < .001). The median DFS was not reached in either group, whereas 3-year DFS was 64% for MRD-negative and 70% for MRD-positive patients who underwent transplantation in first remission (P = .861). CONCLUSION: MRD status at the end of induction is an independent prognostic factor for DFS and OS in adult ALL. Allogeneic transplantation in first remission could overcome the adverse prognostic impact of MRD.

Insulina cerebral / Brain insulin

La insulina es una hormona con efectos sobre el metabolismo y crecimiento normal de muchas células del cuerpo. En las últimas décadas se han descubierto, ademas, sus efectos sobre funciones del sistema nervioso central: modulación del ciclo apetito-saciedad, función reproductiva, liberación de neurotransmisores, supervivencia neuronal y plasticidad sinoptica. Las evidencias obtenidas desde modelos animales y hallazgos neuropatológicos han permitido entender parte de los mecanismos que asocian a la señal de la insulina con enfermedades neurodegenerativas como la enfermedad de Alzheimer. En este artículo se revisarán las acciones de la insulina sobre el hipotálamo, la supervivencia neuronal, la plasticidad sinoptica y por último, las implicaciones de estos conocimientos en la comprensión de procesos degenerativos del sistema nervioso central como la enfermedad de Alzheimer.

Insulin acts on metabolisms and normal growth. In the past decades, its effects on central nervous system functions, such as: appetite-satiety cycle modulation, reproductive function, neurotransmitter release, neuronal survival and synaptic plasticity have been discovered. Evidences got from animal models and neuropathologic findings, have elucidated a fraction of the mechanism that associates insulin signal with neurodegenerative syndromes, like Alzheimer disease. Here, insulin action on hypothalamus, neuron survival, synaptic plasticity and implications of this knowledge on understanding degenerative process of central nervous system particularly Alzheimer disease, will be reviewed.

Insulina y enfermedad de Alzheimer: una diabetes tipo 3 / Insulin and Alzheimer disease: type 3 diabetes

La enfermedad de Alzheimer es un trastorno degenerativo del sistema nervioso central cuya incidencia probablemente aumentará en los próximos años. Los resultados de investigaciones recientes relacionan esta enfermedad con trastornos en la señal de la insulina a nivel de las neuronas. ¿Es la Enfermedad de Alzheimer una diabetes tipo 3? En este documento presentamos una reseña breve de las evidencias que se levantan en torno a este modelo de la enfermedad.

Escasa hemoglobina glucosilada y su posible relación con mayor tiempo de almacenamiento eritrocitario en solución aditiva AS-1 / Relationship between glucosilate hemoglobin and storage time of erythrocytes in AS-1 additive solution

La solución aditiva AS-1 permite un almacenamiento eritrocitario mayor que otras soluciones. Su composición hace esperable altos niveles del prooxidante HbA1c. Durante el almacenamiento hay una disminución de la actividad de la G6PD. Este trabajo busca evidencia sobre las ventajas de la solución AS-1 en los mecanismos prooxidantes y/o antioxidantes. Objetivo: Describir el comportamiento de la HbA1c, la actividad de G6PD, FRAP y otros parámetros habituales de lesión de eritrocitos en AS-l. Métodos: En 9 unidades de glóbulos rojos empaquetados en AS-1, fue determinada la HbA1c, la actividad de G6PD y el FRAP del sobrenadante, junto con otras variables indicativas de deterioro. Los datos fueron agrupados por día de muestreo (1,14,28,42) y analizados mediante diferencia sobre medias (ANOVA). Resultados: La concentración promedio de HbA1c fue de 5,37 por ciento en el día uno y de 5,58 por ciento en el 42, sin representar aumento significativo. La actividad de G6PD disminuyó en un 59,42 por ciento durante los 42 días (12,31 Vs 5,0, p<0,05) y un se produjo un aumento significativo del FRAP (320 Vs 556 um p<0.05). Conclusiones: El no aumento de HbA1c representa escaso incremento del daño oxidativo,que sumado al aumento del FRAP permiten una mejor preservación de eritrocitos en AS-l, a pesar de la disminución de la actividad de G6PD. Esto permite suponer que dentro de las ventajas de la solución AS-l, se encuentra el evitar la acumulación de HbA1c y el permitir un aumento de los mecanismos antioxidantes inespecíficos mediante procesos que deberán ser estudiados.