ABSTRACT
These last 20 years, several techniques have been developed for quantifying DNA methylation, the most studied epigenetic marks in eukaryotes, including the gold standard method, whole-genome bisulphite sequencing (WGBS). WGBS quantifies genome-wide DNA methylation but has several inconveniences rendering it less suitable for population-scale epigenetic studies. The high cost of deep sequencing and the large amounts of data generated prompted us to seek an alternative approach. Restricting studies to parts of the genome would be a satisfactory alternative had there not been a major limitation: the need to select upstream targets corresponding to differentially methylated regions (DMRs) as targets. Given the need to study large numbers of samples, we propose a strategy for investigating DNA methylation variation in natural populations, considering the structural complexity of the genomes with their size and their content in unique as coding regions versus repeated regions as transposable elements. We first identified regions of highly variable DNA methylation in a representative subset of genotypes representative of the biological diversity in the population by WGBS. We then analysed the variations of DNA methylation in these targeted regions at the population level by Sequencing Capture Bisulphite (SeqCapBis). The entire strategy was then validated by applying it to another species. Our strategy was developed as a proof of concept on natural populations of two forest species: Populus nigra and Quercus petraea.
ABSTRACT
Two different TiO2/SiO2 compounds containing TiO2 nanodomains dispersed over SiO2 were investigated applying the AEIR method at the adsorption equilibrium of NH3 and H2O from 300 to 723 K, particularly for the measurement of the individual heats of adsorption of the different species on Lewis acidic sites (LAS) and Brønsted acidic sites (BAS) as evaluation of the strength of the sites. It revealed two types of NH3 adsorption sites: the first ones could correspond either to NH3 species H-bonded to free OH groups or to coordinated weak LAS (named L1). The second ones (L2) were attributed to strongest LAS similar to those present at the surface of TiO2 nanocrystallites. They also correspond to the stronger adsorption sites of H2O. Two types of Brønsted acid sites (BAS) were additionally evidenced by the AEIR method and proposed to be specifically located on the Si-O-Ti bridging bonds at the TiO2/SiO2 interface. The heats of adsorption of the different adsorbed species provided by the AEIR method were consistent with literature data on average values of the heats of adsorption of NH3 and H2O from microcalorimetry measurements. The surface acidity of the two compounds in the presence of H2O was determined using NH3-H2O coadsorption. At T ≥ 473 K, the NH3 species on the L2 sites were not significantly displaced from the surface whatever the partial pressure of H2O studied in agreement with the Temkin competitive model using the individual heats of adsorption of the NH3 and H2O species. This model also revealed the presence of a small amount of H2O species adsorbed on L2 sites allowing H2O dissociation or/and hydrolysis of SiOTi or TiOTi bridges, leading to the formation of a much higher amount of BAS. Therefore, this original work combining the AEIR method and the Temkin competitive model provided new insights for understanding water effects on acidic oxide catalysts.
ABSTRACT
After autologous hematopoietic cell transplantation (HCT) in the first complete remission (CR1), patients with acute myeloid leukemia (AML) may relapse and undergo allogeneic HCT in the second complete remission (CR2). The aim of this study was to analyze the outcome of allogeneic HCT performed in CR2 comparing patients with prior consolidation by autologous HCT versus patients with chemotherapy consolidation. Included were 2619 adults with allogeneic HCT in CR2 from 2000 to 2017 with (n = 417) or without (n = 2202) prior autologous HCT. Patient groups were not entirely comparable; patients with prior autologous HCT were younger, had less often a favorable cytogenetic profile, had more commonly donors other than matched siblings, and more often received reduced-intensity conditioning. In multivariate analysis, nonrelapse mortality risks in patients with prior autologous HCT were 1.34 (1.07 to 1.67; P = .01) after adjustment for age, cytogenetic risk, transplant year, donor, conditioning intensity, sex matching, interval diagnosis-relapse, and relapse-allogeneic HCT as compared with chemotherapy consolidation. Similarly, risks of events in leukemia-free survival and graft-versus-host disease, relapse-free survival were higher with prior autologous HCT, 1.17 (1.01 to 1.35), P = .03 and 1.18 (1.03 to 1.35), P = .02, respectively. Risk of death was also higher, 1.13 (0.97 to 1.32), P = .1, but this was not significant. Postremission consolidation with autologous HCT for AML in CR1 increases toxicity of subsequent allogeneic HCT in CR2.
Subject(s)
Graft vs Host Disease , Hematopoietic Stem Cell Transplantation , Leukemia, Myeloid, Acute , Adult , Bone Marrow , Graft vs Host Disease/etiology , Humans , Leukemia, Myeloid, Acute/therapy , Remission Induction , Retrospective Studies , Transplantation Conditioning , Transplantation, HomologousABSTRACT
BACKGROUND: Few data are available on long-term fatigue (LTF) and quality of life (QoL) among epithelial ovarian cancer survivors (EOCS). In this case-control study, we compared LTF, symptoms and several QoL domains in EOCS relapse-free ≥3 years after first-line treatment and age-matched healthy women. PATIENTS AND METHODS: EOCS were recruited from 25 cooperative GINECO centers in France. Controls were randomly selected from the electoral rolls. All participants completed validated self-reported questionnaires: fatigue (FACIT-F), QoL (FACT-G/O), neurotoxicity (FACT-Ntx), anxiety/depression (HADS), sleep disturbance (ISI), and physical activity (IPAQ). Severe LTF (SLTF) was defined as a FACIT-F score <37/52. Univariate and multivariate logistic regressions were conducted to analyze SLTF and its influencing factors in EOCS. RESULTS: A total of 318 EOCS and 318 controls were included. EOCS were 63-year-old on average, with FIGO stage I/II (50%), III/IV (48%); 99% had received platinum and taxane chemotherapy, with an average 6-year follow-up. There were no differences between the two groups in socio-demographic characteristics and global QoL. EOCS had poorer FACIT-F scores (40 versus 45, P < 0.0001), lower functional well-being scores (18 versus 20, P = 0.0002), poorer FACT-O scores (31 versus 34 P < 0.0001), and poorer FACT-Ntx scores (35 versus 39, P < 0.0001). They also reported more SLTF (26% versus 13%, P = 0.0004), poorer sleep quality (63% versus 47%, P = 0.0003), and more depression (22% versus 13%, P = 0.01). Fewer than 20% of EOCS and controls exercised regularly. In multivariate analyses, EOCS with high levels of depression, neurotoxicity, and sleep disturbance had an increased risk of developing SLTF (P < 0.01). CONCLUSION: Compared with controls, EOCS presented similar QoL but persistent LTF, EOC-related symptoms, neurotoxicity, depression, and sleep disturbance. Depression, neuropathy, and sleep disturbance are the main conditions associated with severe LTF.
Subject(s)
Cancer Survivors/statistics & numerical data , Carcinoma, Ovarian Epithelial/epidemiology , Fatigue/epidemiology , Ovarian Neoplasms/epidemiology , Quality of Life/psychology , Adult , Aged , Aged, 80 and over , Anxiety/epidemiology , Anxiety/etiology , Carcinoma, Ovarian Epithelial/physiopathology , Carcinoma, Ovarian Epithelial/psychology , Carcinoma, Ovarian Epithelial/therapy , Case-Control Studies , Combined Modality Therapy , Cross-Sectional Studies , Depression/epidemiology , Depression/etiology , Fatigue/etiology , Female , France/epidemiology , Humans , Middle Aged , Ovarian Neoplasms/physiopathology , Ovarian Neoplasms/psychology , Ovarian Neoplasms/therapy , Surveys and Questionnaires , Young AdultABSTRACT
In situ transmission electron microscopy (TEM) of samples in a controlled gas environment allows for the real time study of the dynamical changes in nanomaterials at high temperatures and pressures up to the ambient pressure (105 Pa) with a spatial resolution close to the atomic scale. In the field of catalysis, the implementation and quantitative use of in situ procedures are fundamental for a better understanding of the behaviour of catalysts in their environments and operating conditions. By using a microelectromechanical systems (MEMS)-based atmospheric gas cell, we have studied the thermal stability and the reactivity of crystalline cobalt nanostructures with initial 'urchin-like' morphologies sustained by native surface ligands that result from their synthesis reaction. We have evidenced various behaviors of the Co nanostructures that depend on the environment used during the observations. At high temperature under vacuum or in an inert atmosphere, the migration of Co atoms towards the core of the particles is activated and leads to the formation of carbon nanostructures using as a template the initial multipods morphology. In the case of reactive environments, for example, pure oxygen, our investigation allowed to directly monitor the voids formation through the Kirkendall effect. Once the nanostructures were oxidised, it was possible to reduce them back to the metallic phase using a dihydrogen flux. Under a pure hydrogen atmosphere, the sintering of the whole structure occurred, which illustrates the high reactivity of such structures as well as the fundamental role of the present ligands as morphology stabilisers. The last type of environmental study under pure CO and syngas (i.e. a mixture of H2 :CO = 2:1) revealed the metal particles carburisation at high temperature.
ABSTRACT
Unrelated cord blood transplantation (UCBT) after a reduced intensity conditioning regimen (RIC) has extended the use of UCB in elderly patients and those with co-morbidities without an HLA-identical donor, although post-transplant relapse remains a concern in high-risk acute myeloid leukemia (AML) patients. HLA incompatibilities between donor and recipient might enhance the alloreactivity of natural killer (NK) cells after allogeneic hematopoietic stem-cell transplantation (HSCT). We studied the reconstitution of NK cells and KIR-L mismatch in 54 patients who underwent a RIC-UCBT for AML in CR in a prospective phase II clinical trial. After RIC-UCBT, NK cells displayed phenotypic features of both activation and immaturity. Restoration of their polyfunctional capacities depended on the timing of their acquisition of phenotypic markers of maturity. The incidence of treatment-related mortality (TRM) was correlated with low CD16 expression (P=0.043) and high HLA-DR expression (P=0.0008), whereas overall survival was associated with increased frequency of NK-cell degranulation (P=0.001). These features reflect a general impairment of the NK licensing process in HLA-mismatched HSCT and may aid the development of future strategies for selecting optimal UCB units and enhancing immune recovery.
Subject(s)
Cord Blood Stem Cell Transplantation , Killer Cells, Natural/immunology , Leukemia, Myeloid, Acute/immunology , Recovery of Function/immunology , Registries , Transplantation Conditioning , Adult , Allografts , Disease-Free Survival , Female , Humans , Leukemia, Myeloid, Acute/mortality , Leukemia, Myeloid, Acute/therapy , Male , Middle Aged , Prospective Studies , Survival RateABSTRACT
Allogeneic stem cell transplantation (allo-SCT) following a non-myeloablative (NMA) or reduced-intensity conditioning (RIC) is considered a valid approach to treat patients with refractory/relapsed Hodgkin lymphoma (HL). When an HLA-matched donor is lacking a graft from a familial haploidentical (HAPLO) donor, a mismatched unrelated donor (MMUD) or cord blood (CB) might be considered. In this retrospective study, we compared the outcome of patients with HL undergoing a RIC or NMA allo-SCT from HAPLO, MMUD or CB. Ninety-eight patients were included. Median follow-up was 31 months for the whole cohort. All patients in the HAPLO group (N=34) received a T-cell replete allo-SCT after a NMA (FLU-CY-TBI, N=31, 91%) or a RIC (N=3, 9%) followed by post-transplant cyclophosphamide. After adjustment for significant covariates, MMUD and CB were associated with significantly lower GvHD-free relapse-free survival (GRFS; hazard ratio (HR)=2.02, P=0.03 and HR=2.43, P=0.009, respectively) compared with HAPLO donors. In conclusion, higher GRFS was observed in Hodgkin lymphoma patients receiving a RIC or NMA allo-SCT with post-transplant cyclophosphamide from HAPLO donors. Our findings suggest they should be favoured over MMUD and CB in this setting.
Subject(s)
Cyclophosphamide/therapeutic use , Hodgkin Disease/therapy , Stem Cell Transplantation/methods , Transplantation Conditioning/methods , Transplantation, Haploidentical , Adult , Cord Blood Stem Cell Transplantation , Disease-Free Survival , Female , Follow-Up Studies , Graft vs Host Disease , HLA Antigens , Histocompatibility , Hodgkin Disease/mortality , Humans , Male , Retrospective Studies , Stem Cell Transplantation/standards , Transplantation, Homologous , Unrelated Donors/supply & distributionABSTRACT
BACKGROUND: Maintenance strategies beyond response or tumor stabilization with first-line chemotherapy in metastatic breast cancer (MBC) have not been extensively studied. Endocrine therapy combined with continued bevacizumab may be a helpful option for estrogen receptor (ER)-positive MBC. PATIENTS AND METHODS: In this prospective, open-label, phase III study, patients with histologically confirmed ER-positive, HER2-negative MBC and non-progressive disease after 16-24 weeks of taxane plus bevacizumab (T + BEV) were randomized to continuation of T + BEV or maintenance bevacizumab plus exemestane (E + BEV). The primary end point was progression-free survival (PFS) from randomization. To have 80% power to detect an improvement in the 6-month PFS rate (PFS6m) from 50% to 65%, 186 assessable patients were needed for a total of 141 PFS events. An interim analysis was planned after 40% of the required events. RESULTS: The interim analysis with 98 patients showed that the probability of reaching a statistically significant improvement in PFS by the end of the study was only 7%. This led the Independent Data and Monitoring Committee to recommend termination of patient enrollment. After a median of 21-month follow-up of all randomized patients (117 in total), PFS6m from randomization was 67.2% [95% confidence interval (CI) 53.6-77.7] with T + BEV and 55.2% (95% CI 41.5-66.9) with E + BEV [hazard ratio (HR): 1.0, 95% CI 0.7-1.5, P = 0.998]. Median PFS from BEV initiation was 12.5 and 12.3 months in the T + BEV and E + BEV arms, respectively. In the T + BEV arm, taxane was prematurely stopped for the majority of patients (94.9%), mainly due to toxicity (49.2%). Updated data after 35 months' median follow-up showed death rates of 44% and 55% in T + BEV and E + BEV arms, respectively. CONCLUSION: In this trial, maintenance therapy with E + BEV in ER-positive, HER2-negative MBC patients with no evidence of progression after first-line T + BEV did not achieve longer PFS compared with continuation of T + BEV. CLINICALTRIALSGOV: NCT01303679.
Subject(s)
Androstadienes/administration & dosage , Bevacizumab/administration & dosage , Breast Neoplasms/drug therapy , Estrogen Receptor alpha/genetics , Receptor, ErbB-2/genetics , Adult , Aged , Aged, 80 and over , Androstadienes/adverse effects , Bevacizumab/adverse effects , Breast Neoplasms/genetics , Breast Neoplasms/pathology , Disease-Free Survival , Drug-Related Side Effects and Adverse Reactions/genetics , Drug-Related Side Effects and Adverse Reactions/pathology , Female , Humans , Middle Aged , Neoplasm MetastasisABSTRACT
Peripheral T-cell lymphoma carries a poor prognosis. To document a possible graft-versus-lymphoma effect in this setting, we evaluated the impact of immunomodulation in 63 patients with peripheral T-cell lymphoma who relapsed after allogeneic transplant in 27 SFGM-TC centers. Relapse occurred after a median of 2.8 months. Patients were then treated with non-immunologic strategies (chemotherapy, radiotherapy) and/or immune modulation (donor lymphocyte infusions (DLI) and/or discontinuation of immunosuppressive therapy). Median overall survival (OS) after relapse was 6.1 months (DLI group: 23.6 months, non-DLI group: 3.6 months). Among the 14 patients who received DLI, 9 responded and 2 had stable disease. Among the remaining 49 patients, a complete response accompanied by extensive chronic GvHD was achieved in two patients after tapering of immunosuppressive drugs. Thirty patients received radio-chemotherapy, with an overall response rate of 50%. In multivariate analysis, chronic GvHD (odds ratio: 11.25 (2.68-48.21), P=0.0009) and skin relapse (odds ratio: 4.15 (1.04-16.50), P=0.043) were associated with a better response to treatment at relapse. In a time-dependent analysis, the only factor predictive of OS was the time from transplantation to relapse (hazards ratio: 0.33 (0.17-0.640), P=0.0009). This large series provides encouraging evidence of a true GvL effect in this disease.
Subject(s)
Chemoradiotherapy , Hematopoietic Stem Cell Transplantation , Immunosuppressive Agents/administration & dosage , Lymphocyte Transfusion , Lymphoma, T-Cell, Peripheral , Adult , Allografts , Disease-Free Survival , Follow-Up Studies , Humans , Lymphoma, T-Cell, Peripheral/mortality , Lymphoma, T-Cell, Peripheral/therapy , Middle Aged , Retrospective Studies , Survival RateSubject(s)
Leukemia, Myeloid, Acute/therapy , Philadelphia Chromosome , Stem Cell Transplantation , Adolescent , Adult , Aged , Allografts , Bone Marrow Transplantation , Disease-Free Survival , Female , France/epidemiology , Humans , Leukemia, Myeloid, Acute/genetics , Leukemia, Myeloid, Acute/mortality , Male , Middle Aged , Societies, Medical , Survival RateABSTRACT
OBJECTIVES: Although many authors have highlighted similarities between conduct disorder (CD) and alexithymia, little empirical research has actually investigated the contribution of emotion processing to CD. The purpose of this study was to explore the relationships between CD and scores on affect regulation scales among 75 adolescents: a group of 30 adolescents with CD and a group of 45 controls, ranging in age from 13 to 18. METHOD: All participants filled in a socio-demographic questionnaire. CD diagnosis was assessed in regard to DSM-IV criteria using the specific CD section of the Kiddie-Sads. Affect regulation was measured with two self-reports: TAS-20 (Toronto Alexithymia Scale), known as the gold standard for alexithymia measurement, and DERS (Difficulties in Emotion Regulation Scale), a recently validated scale. In addition, since depression may influence the correlations between CD and alexithymia, it was also measured with the BDI. In order to have more information on the CD group, the CTQ was also used. One way analyses of variance adjusting for age were used for mean score comparisons. Partial correlations adjusting for age were used to investigate the link between the CD severity (the severity index was calculated from the Kiddie-Sads) and affect regulation scores. Finally, discriminant analyses were conducted to explore whether affect regulation could correctly categorize controls and adolescents with CD. RESULTS: These results provided some additional data in order to understand the relationship between affect regulation and CD. Controls and adolescents with CD had significantly different emotion regulation scales scores at both scales (TAS-20 and DERS) and in most of their dimensions. Moreover, they also point out the positive correlation between difficulties in affect regulation and CD severity. To our knowledge, this is the first study to have investigated relationships between CD and alexithymia using a severity index of CD. Finally, discriminant analyses showed that the two emotion regulation scales permitted the significant discrimination of both groups. These results are consistent with previous works highlighting the theoretical relationship between deficit in mental elaboration and acting-out. They point to the need to develop therapeutic programs in order to improve emotion regulation of teenagers with CD. Finally, an additional analysis showed a relationship between emotional neglect in childhood (measured with CTQ) and the CD severity. A task for future research would be to study the relationships between attachment, emotional regulation and CD in adolescence.
Subject(s)
Affective Symptoms/diagnosis , Affective Symptoms/psychology , Conduct Disorder/diagnosis , Conduct Disorder/psychology , Emotional Intelligence , Adolescent , Antisocial Personality Disorder/diagnosis , Antisocial Personality Disorder/psychology , Depressive Disorder/diagnosis , Depressive Disorder/psychology , Female , Humans , Male , Surveys and QuestionnairesSubject(s)
Genes, Transgenic, Suicide , Genetic Therapy , Immunotherapy, Adoptive , Lymphocytes/metabolism , Neoplasms/genetics , Neoplasms/therapy , Graft vs Host Disease/etiology , Humans , Immunotherapy, Adoptive/adverse effects , Lymphocyte Depletion , Lymphocytes/immunology , Neoplasms/complications , Neoplasms/immunology , Tissue Donors , Transduction, Genetic , Treatment OutcomeABSTRACT
Previous data suggested that allo-SCT might be an effective therapy in the setting of chemo-refractory/relapsed diseases because of the potent long-term immune-mediated tumor control. This retrospective study aimed to analyze the outcome of adult patients who received allo-SCT in a chemo-refractory/relapsed status. The series included 840 patients with active or progressive disease at the time of transplant. Median age was 50 years. With a median follow-up of 40 months, 3-year OS, disease-free survival (DFS), and non-relapse mortality rates were 29±2, 23±2, and 30±2%, respectively. At the last follow-up, 252 patients (30%) were still alive (of whom 201 were in CR (24%). In a Cox multivariate analysis, the use of a reduced-intensity conditioning (RIC) before allo-SCT and use of an HLA-identical sibling donor remained independently associated with a better OS (hazard ratio (HR)=0.82; 95% confidence interval (CI), 0.69-0.98, P=0.03; and HR=0.79; 95% CI, 0.66-0.93, P=0.006, respectively). Also, a diagnosis of myelodysplastic syndrome/myeloproliferative disorder, Hodgkin lymphoma and non-Hodgkin lymphoma compared with acute leukemia had a favorable impact on OS (HR=0.55; 95% CI, 0.45-0.68, P<0.0001; HR=0.49; 95% CI, 0.31-0.75, P=0.001; and HR=0.47; 95% CI, 0.35-0.63, P<0.0001, respectively). In conclusion, this study suggests that allo-SCT may be of benefit in some subgroups of patients with active or progressive hematological malignancies at the time of allo-SCT.
Subject(s)
Hematologic Neoplasms/mortality , Hematologic Neoplasms/therapy , Stem Cell Transplantation , Transplantation, Homologous , Adolescent , Adult , Aged , Disease Progression , Disease-Free Survival , Female , France , HLA Antigens/chemistry , Hodgkin Disease/mortality , Hodgkin Disease/therapy , Humans , Lymphoma, Non-Hodgkin/mortality , Lymphoma, Non-Hodgkin/therapy , Male , Middle Aged , Myelodysplastic Syndromes/mortality , Myelodysplastic Syndromes/therapy , Myeloproliferative Disorders/mortality , Myeloproliferative Disorders/therapy , Proportional Hazards Models , Recurrence , Retrospective Studies , Societies, Medical , Treatment Outcome , Young AdultABSTRACT
Despite the advances in the techniques for researching arboreal small mammals, detailed ecological data, such as habitat use patterns, are practically nonexistent for many species. Using 150 live-traps installed on the ground, understory (1.0-5.0m) and canopy (>5.0m) we investigated patterns of arboreal and terrestrial space use by small mammals in an Araucaria Forest in southern Brazil (29°29'08â³S; 50°12'26â³W). We also measured 19 microhabitat variables that could potentially influence the abundance of such mammals on each trap station. The results indicated that Akodon montensis and A. serrensis were mainly terrestrial. Delomys dorsalis was also terrestrial, but it also used understory (17.24% of captures). Juliomys sp. and Gracilinanus microtarsus were the most arboreal small mammals recorded. A. montensis was associated with dense vegetation, while A. serrensis selected positively opened areas. Juliomys sp. and G. microtarsus were associated to microhabitat variables related to the access and movement within the canopy. Moreover, bromeliads on arboreal layer were an important factor for these two arboreal species. This is the first study to report microhabitat associations by Juliomys sp. and A. serrensis, and we demonstrated that vertical stratification and microhabitat use were both synergic mechanisms to determine habitat use by small mammals on the Araucaria Forest of southern Brazil.
ABSTRACT
In the attempt to harmonize clinical practices between different French transplantation centers, the French Society of Bone Marrow Transplantation and Cell Therapy (SFGM-TC) set up the third annual series of workshops which brought together practitioners from all member centers and took place in October 2012 in Lille. Here we report our results and recommendations regarding vaccination post Hematopoietic Stem Cell Transplantation with practical focus on which vaccines to use and when and how to vaccinate?
Subject(s)
Hematopoietic Stem Cell Transplantation/standards , Immunization Schedule , Vaccination/statistics & numerical data , Vaccines/administration & dosage , Adult , Child , Consensus Development Conferences as Topic , Contraindications , Hematopoietic Stem Cell Transplantation/methods , Humans , Professional Practice/standards , Vaccination/standardsABSTRACT
Both auto-SCT and reduced intensity allo-SCT (RIST) are employed in the treatment of relapsed follicular lymphoma (FL). We have analysed the outcome of these two transplant procedures when used as a first transplant in this setting. We conducted a retrospective comparison of 726 patients who underwent an auto-SCT and 149 who underwent a RIST as a first transplant procedure for relapsed FL as reported to the Lymphoma Working Party of the European Bone Marrow Transplant. The non-relapse mortality (NRM) was significantly worse for patients undergoing a RIST (relative risk (RR) 4.0, P<0.001). The 1-year NRM was 15% for those undergoing a RIST compared with 3% for those undergoing an auto-SCT. Disease relapse or progression were significantly worse for those receiving an auto-SCT (RR 3.1, P<0.001). Patients undergoing a RIST had a 5-year relapse rate of 20% compared with 47% for those undergoing an auto-SCT. The PFS at 5 years was 57% for patients receiving a RIST compared with 48% for those receiving an auto-SCT. There was no significant difference in OS between the two groups. RIST is associated with a higher NRM and lower relapse rate in patients with relapsed FL.
Subject(s)
Hematopoietic Stem Cell Transplantation/methods , Lymphoma, Follicular/therapy , Transplantation Conditioning/methods , Adult , Aged , Disease Progression , Disease-Free Survival , Humans , Lymphoma, Follicular/surgery , Middle Aged , Neoplasm Recurrence, Local , Prospective Studies , Treatment Outcome , Young AdultABSTRACT
Allogeneic hematopoietic SCT (HSCT) from an HLA-identical sibling donor is the recommended upfront therapeutic option for young patients with SAA. The outcome of allogeneic sibling HSCT has remarkably improved during the last decade as a function of improvement in transplantation supportive care. However, there is still much debate concerning the upper age limit for sibling HSCT in SAA, particularly in patients who are refractory to at least one immunosuppressive course. Recent studies suggest that fludarabine-based conditioning may improve HSCT outcome in older patients with SAA. This review discusses available data about the use of fludarabine-based conditioning in transplantation of older patients with SAA. More definitive conclusions are needed from larger studies before the wide adoption of fludarabine-based conditioning as an alternative to the standard CY and ATG-based conditioning.
Subject(s)
Anemia, Aplastic/therapy , HLA Antigens/immunology , Hematopoietic Stem Cell Transplantation/methods , Immunosuppressive Agents/therapeutic use , Transplantation Conditioning/methods , Vidarabine/analogs & derivatives , Adult , Anemia, Aplastic/drug therapy , Anemia, Aplastic/immunology , Anemia, Aplastic/surgery , Humans , Siblings , Tissue Donors , Vidarabine/therapeutic useABSTRACT
Simultaneously to the rapid increase of overweight and obesity a great number of products oriented to weight loss have emerged in the market. The aim of this study was to evaluate the scientific evidence supporting the use of three products designed for weight loss available in Chile: a lipidic emulsion that stimulates ileal brake, a protease inhibitor and an amylase inhibitor. The results indicate that the amylase and protease inhibitors efficiently inhibit the respective enzymatic activities in vitro; however, they do not affect weight control in clinical trials carried out in normal weight as well as in obese subjects. Thus, there is not enough evidence supporting the use of these products for weight control. On the other hand, the results concerning the lipidic emulsion are conflicting and more studies are needed to confirm its possible effect on weight control.
Paralelamente al rápido aumento de la prevalencia de sobrepeso y obesidad han surgido en el mercado múltiples productos que prometen estimular la pérdida de peso sin modificar la dieta y estilo de vida de los individuos. El objetivo de este trabajo es evaluar la evidencia científica que apoye el uso de tres productos disponibles en Chile para el control ponderal y la reducción de sobrepeso y obesidad: una emulsión lipídica que estimula el freno ileal, un inhibidor de proteasa y un inhibidor de amilasa. Los resultados indican que el inhibidor de amilasa y el inhibidor de proteasa, si bien parecen funcionar in vitro, no muestran ningún efecto sobre el control ponderal en los ensayos clínicos realizados tanto en sujetos normopeso como en obesos. El nivel de evidencia que apoya el uso de estos productos para el control ponderal es por lo tanto insuficiente. En caso de la emulsión lipídica, los resultados son conflictivos y más estudios son necesarios para confirmar su eventual efecto sobre el control del peso corporal.