Reduced-intensity conditioning versus myeloablative conditioning allogeneic stem cell transplantation for patients with myelofibrosis

Background@#Allogeneic hematopoietic stem cell transplantation (alloSCT) is the sole curative option for myelofibrosis (MF). However, it is unknown as to which of the two, myeloablative conditioning (MAC) or reduced-intensity conditioning (RIC), is a better preconditioning regimen. @*Methods@#Twenty-five patients with MF were treated with alloSCT, 12 of whom underwent RIC.Baseline characteristics, response to alloSCT, adverse events, including graft-versus-host disease (GVHD), and survival outcomes were reviewed. @*Results@#There was no difference in the neutrophil engraftment rate and time to engraftment between MAC vs. RIC. The time to platelet engraftment was significantly longer in the MAC group (median, 112.8 vs. 28.8 days for MAC vs. RIC, respectively, P =0.049). RIC was more advantageous in terms of achieving complete chimerism (38.5% vs. 83.3%, P =0.041). The incidence of acute GVHD was 84.6% (11 of 13) and 58.3% (7 of 12) in the MAC and RIC groups, respectively. The cumulative incidence of grade III‒IV acute GVHD was significantly higher in the MAC group than in the RIC group (P =0.03). No significant differences were observed in progression-free and overall survival. The 17-month probability of progression-free survival was 38.4% [95% confidence interval (CI), 19.3‒76.5] vs. 47.6% (95% CI, 25.7‒88.2) (P =0.21), and that of overall survival was 53.8% (95% CI, 32.5‒89.1) vs. 48.6% (95% CI, 26.8‒88.3) (P =0.85) for MAC vs. RIC, respectively. @*Conclusion@#RIC offers a significant advantage over MAC, even in younger patients with MF undergoing alloSCT, in terms of cell engraftment, rate of complete chimerism achievement, and incidence of acute GVHD.

Effect of the hedgehog signaling pathway on hair formation-related cells

Alopecia has emerged as one of the biggest interests in modern society. Many studies have focused on the treatment of alopecia, such as transplantation of hair follicles or inhibition of the androgen pathway. Hair growth is achieved through proper proliferation of the components such as keratinocytes and dermal papilla cells (DPCs), movement, and interaction between the two cells. The present study examined the effect of the hedgehog (Hh) signaling pathway, which is an important and fundamental signal in the cell, on the morphology and the viability of human keratinocytes and DPCs. Upregulation of Hh signaling caused a morphological change and an increase in epithelium-mesenchymal transition-related gene expression but reduced the viability of keratinocytes, while the alteration of Hh signaling did not cause any change in DPCs. The results show the possibility that the regulation of Hh signaling can be applied for the treatment of alopecia.

Bleeding after Taking Dual Antiplatelets and NSAID Concurrently

When stenting is applied to treat myocardial infarction, antiplatelet agents are administered to prevent thrombosis, which increases the risk of bleeding. Patients with myocardial infarction are also more likely to have osteoarthritis simultaneously, because both diseases occur frequently in elderly patients. Patients with osteoarthritis often use analgesics, especially nonsteroidal anti-inflammatory drugs (NSAIDs); hence, patients with both diseases use analgesics and antiplatelet agents simultaneously. The risk of bleeding increases with the use of antiplatelet agents and this is further increased when NSAIDs are added. We would like to report a case that reflects this situation. A 60-year-old man underwent stenting after ST-elevation myocardial infarction, and was treated with aspirin and clopidogrel. This patient also received a pelubiprofen prescription from another physician to treat osteoarthritis. After the patient took pelubiprofen twice, he found a bruise on his wrist and reported it to the pharmacist. It is unlikely that this is rare in community pharmacies, so pharmacists should pay careful attention to the concomitant administration of analgesics to patients receiving antiplatelet agents and should provide appropriate education to patients.

Anti-cancer and -Metastatic Effects of Lactobacillus Rhamnosus GG Extract on Human Malignant Melanoma Cells, A375P and A375SM

Human malignant melanoma is an aggressive skin cancer which has been rising at a greater rate than any other cancers. Although various new therapeutic methods have been developed in previous studies, this disease has properties of high proliferation and metastasis rate which remain obstacles that have lead to a poor prognosis in patients. It has been reported that a specific Lactobacillus extract has anti-cancer and –metastasis effect in vitro and in vivo. However, previous research has not specified precisely what effect the Lactobacillus rhamnosus GG (LGG) extract has had on human malignant melanomas. In this study, we showed that the LGG extract has anti-cancer and –metastasis effects on the human malignant melanoma cell lines, A375P and A375SM. At first, it was found that, while the LGG extract affects human neonatal dermal fibroblasts slightly, it induced the dose-dependent anti-cancer effect on A375P and A375SM by a WST-1 proliferation assay. As a result of a real-time PCR analysis, the expression patterns of several genes related to cell cycle, proliferation, and apoptosis were modulating in a manner that inhibited the growth of both malignant melanoma cell lines after the treatment of the LGG extract. Furthermore, genes related to the epithelialmesenchymal transition were down-regulated, and migration rates were also decreased significantly by the LGG extract. Our study showed that the LGG extract could be used as a potential therapeutic source.