Acute myeloid leukemia with paraneoplastic pemphigus successfully treated with a personalized antileukemic and immunosuppressive strategy.

Bullous pemphigoid (BP) is a rare blistering disease often considered a primary sign of a paraneoplastic syndrome. Retrospective studies have established its link with hematological malignancies, particularly lymphoproliferative disorders. Here, we present what we believe to be the inaugural case of successful simultaneous management of BP and de novo acute myeloid leukemia (AML) in a 28-year-old male patient. Given the rarity and severity of both conditions, our treatment strategy aimed to maximize efficacy by combining immunosuppressive therapy (initially plasmapheresis with high-dose corticosteroids, followed by anti-CD20 monoclonal antibody and intravenous immunoglobulins 2 g/m2) with lymphodepleting antileukemic chemotherapy utilizing Fludarabine (FLAG-IDA induction regimen). Following diagnosis, considering the patient's youth and the concurrent presence of two rare and potentially life-threatening diseases, we opted for an aggressive treatment. Upon achieving complete morphological remission of AML with measurable residual disease (MRD) negativity, despite incomplete resolution of BP, we proceeded with high-dose cytarabine consolidation followed by peripheral stem cell harvest and autologous stem cell transplantation (ASCT). Our conditioning regimen for ASCT involved Bu-Cy with the addition of anti-thymocyte globulins. At day + 100 post-ASCT, bone marrow evaluation confirmed morphological remission and MRD negativity. Meanwhile, BP had completely resolved with normalization of BP180 antibody levels.

High temporal resolution records of outdoor and indoor airborne microplastics.

There is increasing concern regarding airborne microplastics, but to date, studies have typically used coarse interval sampling (a day or longer) to generate deposition and concentration estimates. In this proof-of-concept study, we used a Burkard volumetric spore trap (intake 10 L min-1; recording airborne particulates onto an adhesive-coated tape moving at 2 mm hr-1) to assess whether this approach has potential to record airborne microplastics at an hourly resolution, thereby providing detailed diurnal patterns. Simultaneous sampling at outdoor and indoor locations at rural and urban sites showed clear daily and weekly patterns in microplastic concentrations which may be related to people and vehicle movement. Indoor residential concentrations of suspected microplastics were the highest (reaching hourly concentrations of 40-50 m-3), whilst rural outdoor concentrations were very low (typically 1-2 m-3 h-1). Whilst the approach shows great potential for high resolution data generation, further development is required for spectroscopic analysis and hence chemical confirmation of visual microplastic identification.