No abstract

Key Points Vitamin D deficiency is a predictor for poor overall survival in patients with multiple myeloma, even after adjusting for age and stage. This difference is only observed in white patients, not African Americans, even under a lower threshold for deficiency.

Phragmanthera capitata was reported to possess many biological properties making it a good candidate for the formulation of a phytomedicine with multiple effects. In this work, we studied some factors likely to modify these therapeutic properties with the aim to contribute to its standardization as an improved traditional medicine. P. capitata parasitizing Persea americana, Psidium guajava, and Podocarpus mannii were harvested at three phenological stages (vegetative, flowering, and fruiting stages). The extracts were prepared by maceration in n-hexane, ethyl acetate, ethanol, methanol, and distilled water. The total phenolic, flavonoid, flavonol, and tannin contents were measured using appropriate methods. The antioxidant potential of extracts was investigated using TAC, DPPH scavenging, and FRAP methods. The α-amylase and α-glucosidase inhibitory activities of extracts were determined using enzymatic methods. The ethyl acetate extracts with the best phenolic content were subjected to HPLC analysis. The extraction yields were higher with methanol. The ethyl acetate extract of P. capitata harvested from P. guajava showed a stable HPLC profile during the development of the plant, while extracts from the plant collected from P. americana and P. mannii showed both qualitative and quantitative variations according to phonological stages of the plant. The inhibition of α-amylase was more pronounced for P. capitata harvested from P. guajava, decreasing during flowering and fruiting, while inhibition of α-glucosidase was not influenced by the phenological stage and the host of the plant. The α-amylase inhibitors were better extracted by ethyl acetate and those of α-glucosidase by ethanol or methanol. The phenolic contents and antioxidant properties of the extracts were influenced by the phenological stage of P. capitata and its hosts. These results suggest that it is preferable to harvest P. capitata during flowering or during fruiting stages on any host. None of the used solvents permitted an optimal extraction of active principles form P. capitata, suggesting that the mixture of solvents must be considered in further studies.

Multiple myeloma (MM) is a heterogeneous disease featured by an increased incidence in African Americans (AA). We have previously observed that with equal access to healthcare, younger AA (age <65 years) patients have superior overall survival (OS) than white patients. As MM prognosis is influenced by presence of del17p, we investigated racial differences in its occurrence and impact in a large cohort of MM patients from the Veterans Affairs (VA) system. Among 2243 VA patients with MM for whom del17p data was available, del17p was present in 8.83% of all patients, with significantly lower prevalence in AA (5.56%) compared to white (10.52%, p<0.001). The difference was even more pronounced among younger (<65 years) AA (4.34%) versus white (9.8%, p=0.004). However, we observed no significant difference in survival between AA and white patients with del17p regardless of age category, suggesting that del17p carries a poor prognosis across race and age. Interestingly, among patients without del17p, we still noted a significantly superior OS in younger AA as compared to white (7.75 vs. 5.10 years, p=0.042). Our study shows a lower incidence of del17p in AA but suggests that the survival advantage for younger AA is primarily due to factors other than del17p.