Comparable efficacy and lower cost of PBSC mobilization with intermediate-dose cyclophosphamide and G-CSF compared with plerixafor and G-CSF in patients with multiple myeloma treated with novel therapies.

Studies comparing the efficacy and cost of stem cell mobilization with intermediate-dose CY (ID-CY) and G-CSF against plerixafor and G-CSF, specifically in multiple myeloma (MM) patients treated in the novel therapy era, are not available. Eighty-eight consecutive patients undergoing mobilization with ID-CY (3-4 g/m(2)) and G-CSF (n=55) were compared with patients receiving plerixafor and G-CSF (n=33). Compared with plerixafor, ID-CY use was associated with higher median peak peripheral blood CD34+ cell count (68 vs 160 cells/µL, P<0.001), and CD34+ cell yield on day 1 of collection (6.9 × 10(6) vs 11.7 × 10(6) cells/kg, P<0.001). Total CD34+ cell yield was significantly higher in the ID-CY patients (median collection 16.6 × 10(6) vs 11.6 × 10(6) cells/kg; P<0.001). ID-CY use was associated with significantly more frequent episodes of febrile neutropenia (16.3% vs 0%; P=0.02), intravenous antibiotic use (16.3% vs 3%; P=0.03) and hospitalizations (P=0.02). The average total cost of mobilization in the plerixafor group was significantly higher compared with the ID-CY group ($28 980 vs $22 504.8; P=0.001). Our data indicate robust stem cell mobilization in MM patients treated with novel agents, with G-CSF and either ID-CY or plerixafor. When compared with plerixafor, ID-CY-containing mobilization was associated with significantly lower average total mobilization costs.

Power-frequency electromagnetic fields and the capacitative calcium entry system in SV40-transformed Swiss 3T3 cells.

The present study was designed to test the hypothesis that a 60 Hz electromagnetic field could affect the influx of calcium ions across the plasma membrane through the so-called capacitative calcium entry system. Recordings of cytosolic calcium-ion concentrations in SV40-transformed Swiss 3T3 cells were obtained in real time during exposure to magnetic fields ranging from 0.3-50 mT or to sham conditions using the calcium-sensitive photoprotein aequorin. This was done for cell populations whose capacitative entry system was activated by either bradykinin or thapsigargin under a variety of experimental conditions. No effects of the magnetic field were observed on bradykinin-induced calcium transients and, with the exception of a small but statistically significant increase observed in experiments performed at 50 mT, no effects of the fields were observed on baseline calcium levels prior to or after such transients. The magnetic fields also had no effects on the size or kinetics of any of the thapsigargin-induced calcium transients. Overall, the data fail to support the hypothesis tested in this work.

Intracranial chemical-shift artifacts on MR images of the brain: observations and relation to sampling bandwidth.

The purpose of this study was to evaluate the presence of chemical-shift artifacts on cranial MR and to illustrate the interrelationship among chemical-shift artifacts, variable acquisition parameters, and field strength. Measurements of chemical-shift artifacts were performed on scans obtained from a volunteer imaged in a 1.5-T General Electric system at bandwidths of 8, 16, and 32 kHz, using a 24-cm field of view and an 8-kHz bandwidth with a 48-cm field of view. Chemical-shift displacements at 8 kHz were 6.6 and 14.2 mm at the respective fields of view. Retrospective review was also performed in 77 cases of cranial MR performed on a 1.4-T Technicare unit for the presence and source of chemical-shift artifact on spin-density and T2-weighted images. Most data reviewed showed no significant interference of chemical-shift artifacts on cranial images. An artifactual subdural fluid collection was a common artifact (n = 30/77). When present, this was due to shift of fat signal from subcutaneous tissues onto the brain in patients younger than 10 years old (n = 4/10) and correlated with the distance between brain and subcutaneous fat of less than the linear value of the chemical shift. When this artifact was present in adults (n = 25/67), it was due to shift of the medullary fat signal across the inner table of the skull. The latter also occurred in one child under 10. Apparent location shifts, consistent with the displacement expected from the chemical-shift artifact, were noted in five of five cases of intracranial lipoma. In one of these, the chemical-shift artifact disguised the presence of a large associated vessel. The method of calculating the linear displacement of chemical-shift artifact is reviewed, and the interrelationship of machine parameters and chemical-shift artifact is illustrated. Chemical-shift artifact increases proportionally with field strength and field of view. Increasing the bandwidth to decrease chemical-shift artifact has a resultant penalty in signal to noise but allows a lower time to echo. A lower time to echo can also be accomplished without increasing the bandwidth if asymmetric sampling is used. Awareness of the relationships among chemical-shift artifacts, acquisition parameters, and field strengths can result in a more tailored examination when the chemical-shift artifact is going to be a significant factor. In addition, interpreter error can be avoided by awareness of these relationships when reviewing images from outside institutions.