Summary:chronic myeloid leukemia (CML) relapsed after allogeneic bone marrow transplantation (BMT). [1][2][3][4][5] Chimerism studies in patients who relapsed following an Recent observations of chimerism in patients relapsed following an allotransplant suggest the persistence of allotransplant suggest the persistence of immunotolerance thus offering a biologic rationale for the use of DLT. 6 Sevimmunotolerance, thus offering a biologic rationale for the use of donor lymphocyte transfusion (DLT). In this eral methods with different sensitivities are useful to evaluate the chimerism status in transplanted patients. These study, we have analyzed by PCR amplification of several VNTR regions, sequential bone marrow and peripheral include cytogenetics, Y body detection, protein polymorphism, and red cell phenotyping. 7-9 More recently, DNAblood DNA samples in four patients who received DLT for CML relapse after bone marrow transplantation.based methodology has provided more sensitive techniques. In particular, polymerase chain reaction (PCR) amplifiPrior to DLT, all patients showed mixed chimerism in peripheral blood cells while two had mixed chimerism cation of individual specific genetic loci, such as the variable tandem repeats (VNTR) and the short tandem repeats and two no chimerism in the BM. None of these four patients showed evidence of chimerism at the cyto-(STR), have increased the sensitivity of the analysis up to 1-0.1% and 0.1-0.01%, respectively. 10,11 Using these genetic level (all had 100% +ve metaphases). After DLT, a complete hematologic and molecular remission (ie disassays, a condition of mixed chimerism (MC) has been shown in 80% of CML patients receiving T cell-depleted appearance of the BCR/ABL fusion transcript) was obtained in the two patients who had bone marrow allografts. 11 With regard to CML patients treated with DLT for mixed chimerism prior to DLT. The two patients without evidence of marrow chimerism prior to DLT conrelapse after BMT, Mackinnon et al 12 have analyzed the chimerism status of T lymphocytes by PCR and shown that verted to a pattern of mixed chimerism after DLT, but both developed a severe bone marrow aplasia occurring a MC was present in almost every patient prior to DLT. While this observation encourages the use of adoptive at day 56 and 36, respectively. With regard to the sequential analysis of bone marrow chimerism after immunotherapy in these patients, it provides no prognostic information on the post-DLT clinical outcome. DLT we observed that: (1) the disappearance of BCR/ABL +ve cells paralleled the conversion to a patIn this study, we have analyzed by PCR amplification of several VNTR regions sequential bone marrow and periphtern of full donor chimerism; and (2) the time interval to achieve CR was inversely correlated with the percenteral blood DNA samples in four patients who received DLT for CML relapse after BMT. We show that bone marrow age of donor DNA in bone marrow. In conclusion, we have shown here that the assessment of bone marrow chimerism pre-DLT is pr...
Recent advances in materials and fabrication techniques provided portable, performant, sensing optical spectrometers readily operated by user-friendly cabled or wireless systems. Such systems allow rapid, non-invasive, and not destructive quantitative analysis of human tissues. This proof-of-principle investigation tested whether infrared spectroscopy techniques, currently utilized in a variety of areas, could be applied in living humans to categorize muscles. Using an ASD FieldSpec® 4 Standard-Res Spectroradiometer with a spectral sampling capability of 1.4 nm at 350–1000 nm and 1.1 nm at 1001–2500 nm, we acquired reflectance spectra in visible short-wave infra-red regions (350–2500 nm) from the upper limb muscles (flexors and extensors) of 20 healthy subjects (age 25–89 years, 9 women). Spectra off-line analysis included preliminary preprocessing, Principal Component Analysis, and Partial Least-Squares Discriminant Analysis. Near-infrared (NIR) spectroscopy proved valuable for noninvasive assessment of tissue optical properties in vivo . In addition to the non-invasive detection of tissue oxygenation, NIR spectroscopy provided the spectral signatures (ie, “fingerprints”) of upper limb flexors and extensors, which represent specific, accurate, and reproducible measures of the overall biological status of these muscles. Thus, non-invasive NIR spectroscopy enables more thorough evaluation of the muscular system and optimal monitoring of the effectiveness of therapeutic or rehabilitative interventions.
Recent advances in materials and fabrication techniques provided portable, performant, sensing optical spectrometers readily operated by user-friendly cabled or wireless systems. such systems allow rapid, non-invasive, and not destructive quantitative analysis of human tissues. This proof-ofprinciple investigation tested whether infrared spectroscopy techniques, currently utilized in a variety of areas, could be applied in living humans to categorize muscles. Using an ASD FieldSpec® 4 Standard-Res Spectroradiometer with a spectral sampling capability of 1.4 nm at 350-1000 nm and 1.1 nm at 1001-2500 nm, we acquired reflectance spectra in visible shortwave infra-red regions (350-2500 nm) from the upper limb muscles (flexors and extensors) of 20 healthy subjects (age 25-89 years, 9 women). Spectra off-line analysis included preliminary preprocessing, Principal Component Analysis, and Partial Least-Squares Discriminant Analysis. Near-infrared (NIR) spectroscopy proved valuable for noninvasive assessment of tissue optical properties in vivo. In addition to the non-invasive detection of tissue oxygenation, NIR spectroscopy provided the spectral signatures (ie, "fingerprints") of upper limb flexors and extensors, which represent specific, accurate, and reproducible measures of the overall biological status of these muscles. Thus, non-invasive NIR spectroscopy enables more thorough evaluation of the muscular system and optimal monitoring of the effectiveness of therapeutic or rehabilitative interventions.
No abstract
Background Sleep disorders are common in patients with multiple sclerosis and have a bidirectional interplay with fatigue and depression. Objective To evaluate the effect of treatment with oral dimethyl fumarate on the quality of sleep in relapsing-remitting multiple sclerosis. Methods This was a multicentre observational study with 223 relapsing-remitting multiple sclerosis subjects starting treatment with dimethyl fumarate ( n=177) or beta interferon ( n=46). All patients underwent subjective (Pittsburgh Sleep Quality Index) and objective (wearable tracker) measurements of quality of sleep. Fatigue, depression, and quality of life were also investigated and physical activity was monitored. Results Patients treated with dimethyl fumarate had significant improvement in the quality of sleep as measured with the Pittsburgh Sleep Quality Index ( p<0.001). At all-time points, no significant changes in Pittsburgh Sleep Quality Index score were observed in the interferon group. Total and deep sleep measured by wearable tracker decreased at week 12 with both treatments, then remained stable for the total study duration. Depression significantly improved in patients treated with dimethyl fumarate. No significant changes were observed in mobility, fatigue and quality of life. Conclusion In patients with relapsing-remitting multiple sclerosis, the treatment with dimethyl fumarate was associated with improvements in patient-reported quality of sleep. Further randomised clinical trials are needed to confirm the benefits of long-term treatment with dimethyl fumarate.
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