Identifying Future Study Designs and Indicators for Somatic Health Associated with Diets of Cohorts Living in Eco-Regions: Findings from the INSUM Expert Workshop.

Diets, but also overall food environments, comprise a variety of significant factors with direct and indirect impacts on human health. Eco-Regions are geographical areas with a territorial approach to rural development, utilizing organic food and farming practices, and principles and promoting sustainable communities and food systems. However, so far, little attention has been given to quantifying aspects of the health of citizens living in these sustainable transition territories. The project "Indicators for Assessment of Health Effects of Consumption of Sustainable, Organic School Meals in Eco-Regions" (INSUM) aims to identify and discuss research approaches and indicators that could be applied to effectively measure the somatic, mental, and social health dimensions of citizens in Eco-Regions, linked to the intake of organic foods in their diets. In this paper, we focus on the somatic (physical) health dimension. A two-day workshop was held to discuss suitable methodology with an interdisciplinary, international group of experts. The results showed the limitations of commonly used tools for measuring dietary intake (e.g., relying on the memory of participants), and nutritional biomarkers (e.g., variations in correlations with specific intakes) for research understanding dietary intake and the health effects of diets. To investigate the complexity of this issue, the most suitable approach seems to be the combination of traditional markers of physical and mental health alongside emerging indicators such as the microbiome, nutrigenomics, metabolomics, or inflammatory biomarkers. Using new, digital, non-invasive, and wearable technologies to monitor indicators could complement future research. We conclude that future studies should adopt systemic, multidisciplinary approaches by combining not only indicators of somatic and mental health and social wellbeing (MHSW) but also considering the potential benefits of organic diets for health as well as aspects of sustainability connected to food environments.

Organic Food in Athletes Diet-Narrative Review of Alternative Products in Sports Nutrition.

Athletes are characterized by special nutritional needs. Meeting their dietary needs associated with intensive exercise is a prerequisite for effective training and success in sports competitions. Hence, it is important to supply key performance nutrients, such as macronutrients, antioxidants, calcium, vitamin D, or iron, in adequate quantities. The increased need for these nutrients makes it necessary to look for food products on the market that more fully cover these needs. Such products may include organic foods. According to research, they have unique properties and are richer in selected nutrients, such as antioxidants. Hence, the aim of this review was to analyze the available literature as to whether organic foods have the potential to more fully cover the increased nutritional requirements of athletes for selected nutrients compared to conventionally produced foods. A narrative review of current literature was carried out. As the analysis showed, organic foods are characterized by a higher content of antioxidant bioactive compounds, a higher content of n-3 fatty acids, a better n:3/n:6 ratio, and a more optimal amino acid composition, which may result in an appropriate dietary ration design for athletes. In conclusion, organic food appears to be an interesting alternative to meet the special nutritional needs of professional and amateur athletes.

Dietary intake of polish organic and conventional fruit growers and their life partners - a pilot study.

Diet is one of the elements that contribute to health and quality of life. There are significant discrepancies between the diets of people living in different regions, with different beliefs, or with different approaches to sustainability and ecology. There is a lack of research on dietary intake among organic and conventional fruit growers. The aim of our study was to examine the diets of orchardists and their immediate life partners in terms of meeting energy requirements, nutrient intake and fulfillment of dietary recommendations in this group. Fifty-three participants (28 in the organic group and 25 in the conventional group) took part in the study. Dietary data were obtained using the 3-day dietary record. Body mass and height were measured and BMI was calculated. Physical activity was estimated using a questionnaire method. The study group was aged 44 ± 8 years, with a body weight of 84 ± 16 kg and a height of 172 ± 9 cm. The mean BMI was 28 ± 4 kg/m2. Mean energy intake with diet was 2170 ± 606 kcal/day with needs of 3002 (1991-5144) kcal/day. A significant proportion of the study group did not fulfill their calcium and vitamin D requirements. In addition, a significant proportion of the conventional fruit growers did not cover their needs for potassium, magnesium and vitamins: E, C, and folate. Both groups had too high an intake of cholesterol and saturated fatty acids, and too low an intake of polyunsaturated fatty acids. In conclusion, the orchardists' diets mostly provided adequate amounts of nutrients, with inadequate intakes of calcium, vitamin D, cholesterol, and fatty acids. The diets of organic fruit growers were significantly richer in selected nutrients.

The Real-World Evidence on the Fragility and Its Impact on the Choice of Treatment Regimen in Newly Diagnosed Patients with Multiple Myeloma over 75 Years of Age.

Fragility scales are intended to help in therapeutic decisions. Here, we asked if the fragility assessment in MM patients ≥ 75 years old qualified for treatment by the local physician correlates with the choice of treatment: a two- or three-drug regimens. Between 7/2018 and 12/2019, we prospectively enrolled 197 MM patients at the start of treatment from the 13 Polish Myeloma Group centers. The data to assess fragility were prospectively collected, but centrally assessed fragility was not disclosed to the local center. The activity of daily living (ADL) could be assessed in 192 (97.5%) and was independent in 158 (80.2%), moderately impaired in 23 (11.7%), and 11 (5.6%) in completely dependent. Patients with more than three comorbidities made up 26.9% (53 patients). Thus, according to the Palumbo calculator, 43 patients were in the intermediate fitness group (21.8%), and the rest belonged to the frailty group (153, 77.7%). Overall, 79.7% of patients (157) received three-drug regimens and 20.3% (40) received two-drug regimens. In each ECOG group, more than three out of four patients received three-drug regimens. According to the ADL scale, 82.3% of the independent 65.2% of moderately impaired, and 81.8% of the dependent received three-drug regimens. Out of 53 patients with at least four comorbidities, 71.7% received three-drug regimens, and the rest received two-drug regimens. Thirty-four patients from the intermediate fit group (79.0%), and 123 (79.9%) from the frail group received three-drug regimens. Early mortality occurred in 25 patients (12.7%). No one discontinued treatment due to toxicity. To conclude, MM patients over 75 are mainly treated with triple-drug regimens, not only in reduced doses, regardless of their frailty scores. However, the absence of prospective fragility assessment did not negatively affect early mortality and the number of treatment discontinuations, which brings into question the clinical utility of current fragility scales in everyday practice.

Biological Activity of Extracts from Differently Produced Blueberry Fruits in Inhibiting Proliferation and Inducing Apoptosis of HT-29 Cells.

For several decades, people have been searching for natural substances of plant origin that, when introduced into the diet, could strengthen immunity, have anticancer properties, and support conventional therapy. The development of agriculture with the implementation of various plant cultivation systems, apart from the economic aspect, results in the search for such cultivation conditions that would contribute to obtaining the most beneficial product for health. Therefore, the aim of our research is as follows: (a) to compare the antiproliferative activity and the ability to induce apoptosis of HT-29 cells by extracts from blueberry fruits deriving from different types of cultivation systems (conventional, organic, and biodynamic); (b) to examine whether the interaction of extracts with anticancer drugs used in the treatment of colorectal cancer is influenced by the type of cultivation, and (c) to investigate whether extracts obtained from fruits from subsequent years of cultivation retain the same biological activity. The results of our study are promising but inconclusive. A statistically significant difference occurred in only one of the two years of the study. The greatest inhibition of proliferation is observed for biodynamic cultivation compared to organic cultivation, while the highest levels of apoptosis and necrosis of HT-29 cells are induced by blueberry fruit extracts obtained from organic cultivation. The complementary effect of the extracts on the inhibition of HT-29 cell proliferation by anticancer drugs (5-FU and Erbitux) is not demonstrated. The induction of apoptosis by 5-FU is not enhanced by blueberry extracts, in contrast to necrosis. The level of apoptosis and necrosis induced by Erbitux is potentiated, but no dependence on crop type is shown. Blueberry fruit extracts from two consecutive years of cultivation did not maintain the same activity. A plausible reason for the variability in the composition and biological activity of fruit extracts obtained from two years of cultivation is the varying environmental conditions.

Profile of Selected Secondary Metabolites and Antioxidant Activity of Valerian and Lovage Grown in Organic and Low-Input Conventional System.

In the present study, the roots of valerian (Valeriana officinalis L.) and lovage (Levisticum officinale Koch.) from the organic and low-input conventional cultivation systems were subjected to the analysis of selected groups of phenolic compounds (phenolic acids, flavonoids) and antioxidant activity. Plants were grown in two consecutive vegetation seasons in the experimental plots located in western Poland. Phenolic acids and flavonoids were determined by high performance liquid chromatography (HPLC/UV-Vis), while the antioxidant activity of the samples was measured with the use of DPPH radical scavenging activity assay. The concentrations of phenolic acids (sum) and flavonoids (sum) were found to be higher in the conventional lovage roots, as compared to the organically grown lovage roots, while in the case of valerian, no significant effects of the cultivation system on the levels of the sums of these analyzed compounds were found. Furthermore, no significant effect of the cultivation system on the antioxidant activity of herbs was observed. Additional efforts could be invested in enhancing the potential of organic medicinal plants to consistently present the expected high concentrations of health-promoting antioxidants, which could be effectively brought through their post-harvest handling, storage and processing, and thus meet consumers' expectations at the stage when they reach the market.

Are Organic Certified Carrots Richer in Health-Promoting Phenolics and Carotenoids than the Conventionally Grown Ones?

The aim of the present study was to determine the concentrations of polyphenols and carotenoids by means of HPLC/UV-Vis in certified organic and non-organic carrots (Daucus carota L.) of two cultivars (Flacoro and Nantejska). The analyzed carrot root samples contained, on average, 4.29 ± 0.83 mg/100g f.w. of carotenoids (mainly ß-carotene) and 9.09 ± 2.97 mg/100g f.w. of polyphenols, including 4.44 ± 1.42 mg/100g f.w. of phenolic acids and 4.65 ± 1.96 mg/100g f.w. of flavonoids. Significant effects of the production system on the carotenoids (total) and ß-carotene concentration were found, with higher concentrations of these compounds generally identified in conventionally cultivated roots (4.67 ± 0.88 mg/100g f.w.) vs. organically grown ones (4.08 ± 0.74 mg/100g f.w.). There was a noticeable inter-sample (inter-farm) variation in the concentration of polyphenols in carrot roots. Despite a general trend towards higher concentrations of these compounds in the organic carrots (9.33 ± 3.17 mg/100g f.w.) vs. conventional carrots (8.64 ± 2.58 mg/100g f.w.), and in those of Nantejska (9.60 ± 2.87 mg/100g f.w.) vs. Flacoro (8.46 ± 3.02 mg/100g f.w.) cultivar, no consistent, statistically significant impact of the production system and/or cultivar on the level of these bioactive compounds was identified. More efforts should be encouraged to ensure that organic crops reaching the market consistently contain the expected high levels of health-promoting bioactive compounds, which could be brought through their shelf-life and all processing steps, in order to meet consumers' expectations and provide the expected health benefits.

Evaluation of Pesticide Residues Occurrence in Random Samples of Organic Fruits and Vegetables Marketed in Poland.

In recent years, organic food, produced with the use of natural means and production methods, has been gaining more and more popularity among consumers. This is due, inter alia, to their belief that it is more abundant in health-promoting bioactive compounds and safer than conventional food. Consumers are increasingly aware of the harmfulness of plant protection products used in intensive agriculture, which are not allowed in organic production. At the same time, it is reported that a certain share of organic products on the EU market are contaminated with pesticide residues, which may raise consumer concerns and lead to a loss of trust in organic food. The aim of the present study was to investigate the problem of pesticide residues occurrence in random samples of organically produced fruits and vegetables (apples, potatoes, carrots, and beetroots) commonly used in the Polish households, and which are available directly from the organic producers in open markets in Poland. For simultaneous analysis of 375 pesticides, an LC-MS/MS system consisting of an Eksigent expert ultraLC 100-XL coupled to a triple quadrupole mass spectrometer QTRAP 6500 and GC Agilent 6890 N equipped with ECD/NPD system were used. Among the 96 vegetable and fruit samples studied, 89 samples (92.7%) were free from detectable pesticide residues, 7 samples (7.3%) of carrot (5) and potato (2) were contaminated, and in 1 of them (1.0%) the detected residues exceeded the maximum residue limit (MRL). None of the tested apple and beetroot samples were found to contain detectable residues. These findings are important for Polish consumers who look for high-quality organic food. However, the presence of detectable residues in a small proportion of the organic samples indicates a need to strengthen the monitoring of pesticides in organic crops, to educate farmers and to raise their awareness regarding the risks of unauthorized use of pesticides banned in organic farming, which can damage the reputation of the whole organic sector.

Red Horse Chestnut and Horse Chestnut Flowers and Leaves: A Potential and Powerful Source of Polyphenols with High Antioxidant Capacity.

Aesculus flowers and leaves are an excellent source of bioactive compounds, including flavanols, phenolic acids, and anthocyanins, and the leaves also contain antioxidant carotenoids and chlorophylls. The aim of this study was to analyse and compare the amounts of bioactive compounds present in Aesculus hippocastanum and Aesculus × carnea flowers and leaves over two years. These two species from six independent locations (parks and green areas) located in Warsaw were assessed in this study. The dry matter by the scale method and polyphenol, carotenoid, and chlorophyll content by the HPLC method of the flowers and leaves was evaluated. Red horse chestnut flowers contained significantly more total carotenoids (40.6 µg/g FW) and chlorophylls (36.9 µg/g FW) than horse chestnut flowers, and red horse chestnut flowers contained higher levels of anthocyanins (5.41 µg/g FW) than other species. We observed that horse chestnut flowers were characterized by a higher total polyphenols concentration (9.45 µg/g FW) compared to red horse chestnut flowers. In addition, the analysis of leaves showed that all quality parameters were higher in red horse chestnut species. Five individual anthocyanins were identified in both species' flowers, but a higher concentration was found in red horse chestnut flowers, and pelargonidin-3-O-glucoside was the predominant form among a pool of total anthocyanins. In both experimental years, leaves (109.25 mMol/100 g FW and 112.0 mMol/100 g FW) were characterized by a higher antioxidant activity than flowers (27.0 mMol/100 g FW and 27.5 mMol/100 g FW).

Identifying Future Study Designs for Mental Health and Social Wellbeing Associated with Diets of a Cohort Living in Eco-Regions: Findings from the INSUM Expert Workshop.

Diets influence our mental health and social wellbeing (MHSW) in multiple ways. A rising community concept, Eco-Regions, has gained interest. The research project "Indicators for assessment of health effects of consumption of sustainable, organic school meals in Ecoregions" (INSUM) aims to develop future-oriented research approaches to measure the potential health effects of more sustainable and healthy diets. This first part of the project focuses on MHSW with the goal to identify suitable study designs and indicators. The methodology is based on a 2-day workshop with an interdisciplinary group of experts. This paper describes commonly applied research methods on the nexus between diet and MHSW as presented by the experts and summarises key points from the discussions. The results show that the dominating tool to investigate MSHW is questionnaires. Questionnaires vary largely depending on the research design, such as participants or distribution channels. Cohort studies addressing families and including in-depth interventional and/or experimental studies may be suitable for an Eco-Region investigation. Those MHSW studies can be conducted and combined with measurements of somatic health effects. We conclude that indicators should be seen as complementary rather than independent. Explorative research designs are required to investigate complex Eco-Regions.

Bioactive Compounds, Sugars, and Sensory Attributes of Organic and Conventionally Produced Courgette (Cucurbita pepo).

Organic agriculture is considered one of the elements of sustainable food production and consumption, mainly due to its limited impact on the natural environment. At the same time, the quality features of organically produced foods, especially sensory attributes and health promoting values, are important factors determining consumers' interest, and therefore play a key role in the organic sector's development. The aim of this study was to investigate the sensory characteristics and concentrations of sugars and selected health-promoting bioactive compounds of organic courgette compared to conventionally grown courgette. In addition, untargeted metabolomic analysis of the courgette fruits was performed. The results of this study did not show a significant effect of the horticultural system (organic vs. conventional) on the concentrations of vitamin C, carotenoids, and chlorophylls in the courgette fruits. However, the fruits from the organic systems were significantly richer in sugars when compared to the conventionally cultivated ones (p = 0.038). Moreover, the organic fruits fertilized with manure contained significantly higher amounts of polyphenols, including gallic acid (p = 0.016), chlorogenic acid (p = 0.012), ferulic acid (p = 0.019), and quercetin-3-O-rutinoside (p = 0.020) compared to the conventional fruits. The untargeted analysis detected features significantly differentiating courgette fruits depending on the cultivar and horticultural system. Some significant differences in sensory values were also identified between fruits representing the two cultivars and coming from the horticultural systems compared in the study. Conventional courgettes were characterized by the most intensive peel color and aquosity, but at the same time were the least hard and firm compared to the fruits from the two organic systems. There was also a trend towards higher overall quality of the organically grown fruits. The presented study shows that the organic and conventional courgette fruits differ in a number of quality features which can influence consumers' health and purchasing choices.

Genetic Differentiation in Anthocyanin Content among Berry Fruits.

Anthocyanins are widely distributed secondary metabolites that play an essential role in skin pigmentation of many plant organs and microorganisms. Anthocyanins have been associated with a wide range of biological and pharmacological properties. They are also effective agents in the prevention and treatment of many chronic diseases. Berries are particularly abundant in these compounds; therefore, their dietary intake has health-promoting effects. The aim of this study was to identify and determine the anthocyanin content in selected species and cultivars of berry fruits, such as raspberry, blackberry, red currant, blackcurrant, and highbush blueberry, widely consumed by Europeans. The concentrations of anthocyanins were determined by HPLC, identifying individual compounds: cyanidin-3-O-glucoside, pelargonidin-3-O-glucoside, delphinidin-3-O-glucoside, delphinidin-3-O-rutinoside, cyanidin-3-O-rutinoside, delphinidin-3-O-galactoside, cyanidin-3-O-galactoside, and malvidin-3-O-galactoside. The experimental data showed that the selected species and cultivars of berry fruits differ significantly in the contents of anthocyanins. Among all species tested, blackberry and blackcurrant were characterized significantly by the highest content of anthocyanins (sum), while the lowest content was found in red currant fruits. Additionally, the content of individual anthocyanin compounds in particular species and cultivars was also different. Considering the high content of anthocyanins and their potential positive impact on human health and protection against disease, berries should be part of healthy nutrition.

Biologically Active Compounds in Selected Organic and Conventionally Produced Dried Fruits.

A growing demand for organic foods is driven by consumers' perception that they are more nutritious. However, while there is a number of scientific studies showing some superior qualities of organically grown fruit and vegetables, including, i.e., higher content of phenolics, some vitamins and antioxidant activity, scientific research looking into the quality of processed organic products is very limited. At the same time the consumption of processed, convenient foods, with a long shelf-life, is rapidly increasing all over the world. Among the processed fruit-based products, dried fruits are recognized by consumers as one of the best snacks, highly nutritious and containing a large amount of fibre. In the presented experiment, four types of organic and conventionally produced dried fruits were examined: Apricots, apple rings, cranberries, and prunes. The concentrations of polyphenols (in all products) and carotenoids (in apricots) were measured using high performance liquid chromatography (HPLC). The study confirms that dry fruits can be undoubtedly considered as a rich source of polyphenols, however, a large variation in the concentrations of these compounds among different brands of products was also pointed: 219.03 ± 3.90-296.96 ± 2.86 mg 100 g-1 in dried apricots, 95.24 ± 15.12-627.71 ± 48.64 mg 100 g-1 in dried apple rings, 14.64 ± 0.43-203.09 ± 7.96 mg 100 g-1 in dried cranberries, and 134.65 ± 12.27-422.44 ± 9.00 mg 100 g-1 in prunes. Carotenoids concentrations in dried apricots ranged from 2.72 ± 0.31 to 17.49 ± 0.17 µg g-1. Among the tested dried fruits, only in the case of apricots organic products were characterized by the higher contents of phenolics and carotenoids compared to the conventional brands. In the case of other products there was either no consistent significant production system effect, or the concentrations of the analyzed phenolic compounds were higher in conventional products.

The Profile of Selected Antioxidants in Two Courgette Varieties from Organic and Conventional Production.

Courgette is considered as a low-calorie vegetable with health-promoting properties. However, scientific publications focused on the profile and content of bioactive compounds in courgette, as well as the potential fruit quality modulating factors, are rare. Due to the high adaptability of courgette to weather and agronomic conditions, it is produced on a global scale. The aim of this study was to analyse the impact of organic versus conventional agronomic practices on the concentration of selected antioxidants in courgette fruits. Fruits of two courgette varieties (Astra Polka and Nimba) produced in an organic and conventional system were tested by high performance liquid chromatography (HPLC) to determine the content of polyphenols (flavonoids and phenolic acids), carotenoids, chlorophylls, and vitamin C. Organic courgette fruits were characterised by their significantly higher content of phenolic acids and flavonoids when compared to the conventionally grown fruit. The organic cultivation might be a good method to increase concentration of bioactive compounds with antioxidant properties in courgette fruits. Nevertheless, the identified trends should be further confirmed, with attention paid to other courgette varieties, as well as to the potential interactions between the plant genotype, agronomic system and the location-specific growing conditions.

Evaluation of the Potential Allergenicity of Strawberries in Response to Different Farming Practices.

Fruit allergies are a large problem today. Many consumers suffer from food allergies or intolerances. The method of food production has a major impact on its quality. In fruit and vegetable production, three different farming systems are mainly found: conventional, integrated pest management and organic production. The latter is considered the best in terms of fruits and vegetables safety and high quality. The present experiment was performed to demonstrate the effect of the strawberry production method on its allergenic properties and flavonoid content. The strawberry 'Honeoye' cv. was used for the study. Fruits from the three cultivation systems, organic, conventional and integrated, were tested for their content of biologically active compounds and their potential allergenicity. The results obtained indicate that the strawberries from the organic system were the safest because they contained the lowest levels of Bet v1 and profilin in comparison with the fruits from the integrated and conventional systems.

Outcome of a Real-Life Population of Patients With Acute Promyelocytic Leukemia Treated According to the PETHEMA Guidelines: The Polish Adult Leukemia Group (PALG) Experience.

BACKGROUND: Acute promyelocytic leukemia (APL) has a favorable prognosis. However, results of randomized studies do not necessarily reflect the outcomes of a real-life population. PATIENTS AND METHODS: We analyzed 283 unselected APL patients treated in 20 Polish hospitals between 2005 and 2017. All patients were intended to be treated with PETHEMA (Programa Español para el Tratamiento de las Hemopatías Malignas) protocols based on all-trans retinoic acid plus chemotherapy. RESULTS: The probability of overall survival at 4 years was 67%, while event-free survival was 64%. The early death (ED) rate was 20.1% (n = 57), while 3.5% (n = 10) patients died before induction therapy was started. The main causes of ED included hemorrhage (45.6%), infections (17.5%), and differentiation syndrome (14.5%). Of 273 treated patients, 214 (78.4%) experienced hematologic morphologic remission, 2 (0.7%) were found to have resistant disease, 47 (17.2%) could not be evaluated for response because of ED, and in 6 (3.7%) no data concerning the response were available. Multivariate analyses showed that predictors of ED and overall survival were Eastern Cooperative Oncology Group performance status > 2, age > 60 years, and all types of bleeding episodes that occurred before starting therapy, while an additional predictor of event-free survival was high white blood cell count (> 10 109/L). CONCLUSION: ED remains a major problem in APL patients, especially in a real-life population. Shortening of the time between the initial contact with a health care professional, and all-trans retinoic acid administration and the use of appropriate supportive care could improve the outcome of unselected APL population, mainly by reducing the ED rate.

Mucormycosis in a patient with acute myeloblastic leukemia following liver transplantation for Wilson's disease.

A case is presented of mucormycosis in a patient with acute myeloblastic leukemia following liver transplantation for Wilson's disease. A 58-year-old female was admitted to the Department of Haematology with deterioration of her general condition, loss of appetite, tiredness and difficulty with mental contact for a few days. Blood and urine cultures for bacteria and fungus, galactomannan antigen were negative. Whole body computed tomography demonstrated bilateral hilar lymphadenopathy with necrotic lesions: splenomegaly with a hypodensive lesion 13 × 20 × 19 mm and lower pulmonary infiltrates suggested fungal etiology. Magnetic resonance imaging of the brain showed thickened meninges. Finally, mucormycosis was diagnosed. Treatment with amphotericin B lipid complex was started, resulting in an partial improvement of the general condition and decreased level of inflammatory markers. However, the patient's condition continued to deteriorate, with sepsis etiology Escherichia coli, and despite the intensive managements she eventually died.

Predictive Model for Infection Risk in Myelodysplastic Syndromes, Acute Myeloid Leukemia, and Chronic Myelomonocytic Leukemia Patients Treated With Azacitidine; Azacitidine Infection Risk Model: The Polish Adult Leukemia Group Study.

BACKGROUND: Myelodysplastic syndromes (MDS), chronic myelomonocytic leukemia (CMML), and acute myeloid leukemia (AML) patients, including those treated with azacitidine, are at increased risk for serious infections. The aim of our study was to identify patients with higher infectious risk at the beginning of azacitidine treatment. PATIENTS AND METHODS: We performed a retrospective evaluation of 298 MDS/CMML/AML patients and included in the analysis 232 patients who completed the first 3 cycles of azacitidine therapy or developed Grade III/IV infection before completing the third cycle. RESULTS: Overall, 143 patients (62%) experienced serious infection, and in 94 patients (41%) infection occurred within the first 3 cycles. The following variables were found to have the most significant effect on the infectious risk in multivariate analysis: red blood cell transfusion dependency (odds ratio [OR], 2.38; 97.5% confidence interval [CI], 1.21-4.79), neutropenia <0.8 × 109/L (OR, 3.03; 97.5% CI, 1.66-5.55), platelet count <50 × 109/L (OR, 2.63; 97.5% CI, 1.42-4.76), albumin level <35 g/dL (OR, 2.04; 97.5% CI, 1.01-4.16), and Eastern Cooperative Oncology Group performance status ≥2 (OR, 2.19; 97.5% CI, 1.40-3.54). Each of these variables is assigned 1 point, and the combined score represents the proposed Azacitidine Infection Risk Model. The infection rate in the first 3 cycles of therapy in lower-risk (0-2 score) and higher-risk (3-5 score) patients was 25% and 73%, respectively. The overall survival was significantly reduced in higher-risk patients compared with the lower-risk cohort (8 vs. 29 months). CONCLUSION: We selected a subset with high early risk for serious infection and worse clinical outcome among patients treated with azacitidine.

Polyphenols and carotenoids in pickled bell pepper from organic and conventional production.

Sweet bell pepper is a perfect source of flavonoids and carotenoids. Some experiments indicated that fresh organic vegetables contained more of these bioactive compounds in comparison to the conventional ones. It could be expected that pickled organic vegetables also contain more antioxidant compounds. The aim of this study was therefore to analyse and to compare the concentration of bioactive compounds in organic vs. conventional pickled bell pepper. Two cultivars of sweet red pepper (Roberta and Berceo) from organic and conventional cultivation were used in the experiment. The content of dry matter, polyphenols and carotenoids in fruit has been determined. The conventional pickled bell pepper fruits appeared to be richer in phenolic acids, while organic samples contained significantly more flavonoids, including myricetin, quercetin, kaempferol, apigenin, and carotenoids such as beta-carotene, alpha-carotene, capsorubin, cryptoxanthin and cryptoflavin in comparison to the conventional ones.

The efficacy and safety of pomalidomide in relapsed/refractory multiple myeloma in a "real-world" study: Polish Myeloma Group experience.

BACKGROUND: Patients with relapsed/refractory multiple myeloma (RRMM) have poor prognosis. Pomalidomide is an immunomodulatory compound that has demonstrated activity in MM patients with disease refractory to lenalidomide and bortezomib. OBJECTIVES: Participants of clinical trials are highly selected populations; therefore, the aim of this study was to present observations from real practice that might provide important information for practitioners. PATIENTS AND METHODS: We analyzed retrospectively 50 patients treated with pomalidomide in 12 Polish sites between 2014 and 2017. Median age was 63 years, median time since diagnosis 4.5 years and median number of prior regimens 4. RESULTS: The overall response rate was 39.1%. Median progression-free survival (PFS) and overall survival (OS) were 10.0 and 14.0 months, respectively. Previous treatment with immunomodulatory drugs, bortezomib or stem cell transplant had no impact on PFS and OS. Most frequent grade 3/4 treatment-emergent adverse events were hematologic (neutropenia 24.0%, thrombocytopenia 10.0%, anemia 8.0%). Most common grade 3/4 non-hematologic toxicities were respiratory tract infection (14.0%) and neuropathy (4.0%). CONCLUSIONS: This real-world data have confirmed that pomalidomide is an active drug in RRMM and support results of published clinical trials and other real-world studies.