Post-Irradiation Hyperamylasemia Is a Prognostic Marker for Allogeneic Hematopoietic Stem Cell Transplantation Outcomes in Pediatric Population: A Retrospective Single-Centre Cohort Analysis.

BACKGROUND: Total body irradiation (TBI) is a mandatory step for patients with acute lymphoblastic leukemia (ALL), undergoing allogeneic hematopoietic stem cell transplantation (HSCT). In the past, amylases have been reported to be a possible sign of TBI toxicity. We investigated the relationship between total amylases (TA) and transplant-related outcomes in pediatric recipients. METHODS: We retrospectively analyzed the medical records of all the patients who underwent allogeneic HSCT between January 2000 and November 2019. The inclusion criteria were the following: recipient's age between 2 and 18, diagnosis of ALL, no previous transplantation, and use of TBI-based conditioning. The serum total amylase and pancreatic amylase were evaluated before, during, and after transplantation. Cytokines and chemokines assays were retrospectively performed. RESULTS: 78 patients fulfilled the inclusion criteria. Fifty-seven patients were treated with fractionated TBI, and 21 with a single-dose regimen. The overall survival (OS) was 62.8%. Elevated values of TA were detected in 71 patients (91%). The TA were excellent in predicting the OS (AUC = 0.773; 95% CI = 0.66-0.86; p < 0.001). TA values below 374 U/L were correlated with a higher OS. The highest mean TA values (673 U/L) were associated with a high disease-progression mortality rate. The TA showed a high predictive performance for disease progression-related death (AUC = 0.865; 95% CI = 0.77-0.93; p < 0.0001). Elevated TA values were also connected with significantly higher levels of proinflammatory cytokines, such as TNF-α, IL-6, and RANTES (p < 0.001). CONCLUSIONS: this study shows that TA is a valuable predictor of post-transplant OS and increased risk of leukemia relapse.

Neutron and photon out-of-field doses at cardiac implantable electronic device (CIED) depths.

The accuracy of an out-of-field dose from an Elekta Synergy accelerator calculated using the X-ray Voxel Monte Carlo (XVMC) dose algorithm in the Monaco treatment planning system (TPS) for both low-energy (6 MV) and high-energy (15 MV) photons at cardiac implantable electronic device (CIED) depths was investigated through a comparison between MCNPX simulated out-of-field doses and measured out-of-field doses using three high spatial and sensitive active detectors. In addition, total neutron equivalent dose and fluence at CIED depths of a 15-MV dose from an Elekta Synergy accelerator were calculated, and the corresponding CIED relative neutron damage was quantified. The results showed that for 6-MV photons, the XVMC dose algorithm in Monaco underestimated out-of-field doses in all off-axis distances (average errors: -17% at distances X < 10 cm from the field edge and -31% at distances between 10 < X ≤ 16 cm from the field edge), with an increasing magnitude of underestimation for high-energy (15 MV) photons (up to 11%). According to the results, an out-of-field photon dose at a shallower CIED depth of 1 cm was associated with greater statistical uncertainty in the dose estimate compared to a CIED depth of 2 cm and clinical depth of 10 cm. Our results showed that the relative neutron damage at a CIED depth range for 15 MV photon is 36% less than that reported for 18 MV photon in the literature.

Medium-term feasibility of the management of the invasive crayfish Procambarus clarkii with the sterile males release technique.

BACKGROUND: The sterile male release technique (SMRT) is a useful method applied for controlling invasive and pest species. However, the use of X-rays can lead to negative effects on the survival and health conditions of sterilized males. RESULTS: This study was set up to evaluate the functional integrity of physiological, morphological and behavioural responses in males of the red swamp crayfish, Procambarus clarkii (Girard, 1852), exposed to a dose of 40 Gy of ionizing radiation. Concerning physiological responses, the results showed that the irradiation dose, tested at 5, 12, 28, 35, 65, 99, 132 and 193 days after treatment, has no effects on glycaemic and plasmatic total protein levels measured as biomarkers for general stress indexes. Nevertheless, the significant reduction of circulating haemocytes and the basal levels of phenoloxidase (PO) activities recorded in 40-Gy irradiated crayfishes indicate that the exposure shrinks their capability to mount a rapid nonspecific response, and higher levels of plasmatic total PO activity indicate the ability to compensate and maintain an inducible response. Histological analyses performed at the end of the experiment showed no morphological damage in the testicular acini of irradiated males. Moreover, behavioural responses to two different water stimuli (vaporization and jet), measured at 15 and 45 days after the irradiation, were not modified in exposed crayfishes compared to the control group. CONCLUSIONS: These results confirm the validity of SMRT on young males when the breeding season is less than 4 months but exposure to X-ray should be repeated at mid-breeding season when temperatures allow a longer breeding season. © 2021 Society of Chemical Industry.