Quality of life assessment in multiple myeloma patients undergoing dose-reduced tandem autologous stem cell transplantation.

Few studies exist that consider health-related quality of life (HR-QoL) in patients with multiple myeloma (MM) undergoing tandem autologous stem cell transplantation (TASCT). Eighteen patients with advanced MM who underwent dose-modified TASCT were enrolled in this study between March 2006 and March 2008. Patients <60 year old (10) received conditioning with melphalan 140 mg/m(2) and patients who were ≥60 years (8) received 100 mg/m(2). The median age was 57.5 years (range 35-69). We conducted the European Organization of Research and Treatment of Cancer (EORTC) QLQ-C30 and the QLQ-MY24 questionnaires via interviews at presentation, after each ASCT and thereafter every 3 months for 24 months. Mean global health measure improved from 3.44 before transplant to 4.50 (1=very poor, 7=excellent) at the second and subsequent follow-up visits (P<0.001) and the mean global quality of life score improved from 3.61 to 4.71 (P<0.001). Pain symptoms were reduced (P=0.001), and physical functioning improved (P<0.001) throughout the period of post-transplant follow-up. Our study showed that dose-reduced TASCT is well tolerated with low toxicity albeit the transient reduction in QoL during both transplants. Post-transplant follow-up showed significant improvement in overall HR-QoL that reflects positively on the overall disease-outcome. Furthermore, a sole focus on patient-survival does not adequately provide indication regarding the tolerability and effectiveness of a proposed treatment on the patient's perceived quality of life. As clinicians, our primary concern should be toward patient-welfare as well as survival. Therefore, we should employ the tools of QoL in conjunction with overall survival in order to deliver the best possible patient outcomes. The EORTC-QLQ-MY24 is a practical tool in measuring QoL in myeloma patients.

Induction of early and bioeffective antibody response in rodents with the luteinizing hormone-releasing hormone vaccine given as a single dose in biodegradable microspheres along with alum.

BACKGROUND: Previous studies in animals and phase I/phase II clinical trials in humans have shown the suppressive effect of immunization with the luteinizing hormone-releasing hormone (LHRH) vaccine on prostatic hypertrophy and hyperplasia. A drawback of this vaccine was a delay of about 8 weeks in buildup of antibody titers to efficacy level and the requirement of three injections of the vaccine given at monthly interval for full primary immunization. METHODS: LHRH vaccine was encapsulated in poly-lactic-co-glycolic acid (PLGA) 50:50 copolymer microspheres of reproducible physicochemical characteristics. Immunogenicity studies were carried out in rodents and prostate weights were determined at various antibody titers. RESULTS: The vaccine entrapped in biodegradable microspheres generated high antibody response in rats, persisting for 5-7 months following a single immunization. One hundred micrograms was the optimum dose, and the intramuscular route was more immunogenic than the subcutaneous. It was further observed that coadministration of 75% of the vaccine entrapped in microspheres with 25% adsorbed on alum generated higher antibody response in rodents, exceeding the bioeffective threshold as early as day 15 postimmunization. CONCLUSIONS: Coadministration of the LHRH vaccine in biodegradable PLGA microspheres with a quarter of the dose adsorbed on alum generates high antibody titers within 15 days, which are effective in causing atrophy of the prostate.

Effect of volatiles from neem and other natural products on gonotrophic cycle and oviposition of Anopheles stephensi and An. culicifacies (Diptera: Culicidae).

The gonotrophic cycle of female Anopheles was impaired by exposure to volatiles of neem, (Azadirachta indica), reetha, (Sapindus mukorossi), and garlic, (Allium sativum), but not to castor seeds and cotton seed oil. A brief exposure to contact or volatile extracts from neem suppressed rather than inhibited oviposition. Complete inhibition of oviposition was observed by exposure of mosquitoes to neem oil and 1 fraction containing volatile components. Vitellogenesis was impaired irreversably by long-term exposure to neem odor and some extracts. The effect of volatiles on oviposition seems to be regulated by absorption through the cuticle, although passage through the spiracles could not be excluded.