To investigate the extracted process of gossypol acetic acid (G‐AA) from cottonseed soapstock and explore the improvement of its yield and purity, a novel ultrasound‐assisted extraction and crystallization method was introduced to this process. Under the optimized conditions, preliminary G‐AA with the yield of 1300 mg and the purity of 95.9% could be obtained from 100 g of fresh soapstock by ultrasound‐assisted extraction. In addition, UV, IR, and NMR spectrum further confirmed the detailed chemical structure of G‐AA. Assay of inhibiting human prostate tumor cell line PC‐3 and human breast cancer cell line MDA‐MB‐231 revealed its biological activity, the values of IC50 are 9.096 μmol/L and 14.37 μmol/L respectively. In comparison with the conventional solvent extraction, this novel process increases the content of G‐AA over 90%, reduces the time of crystallization by 75%, and retains the anticancer activity of gossypol. © 2009 American Institute of Chemical Engineers AIChE J, 2009

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A 47-year-old woman sought medical attention after 1 week of progressive fatigue, scleral icterus, and dark urine. She had no fever, cough, or shortness of breath. She had no history of HIV, cancer, autoimmune disease, recent infection, diarrhea, or new medication/supplements. In addition, she had no history of out-of-state travel. On examination at the time of admission, she had mild scleral icterus, normal spleen size, no evidence of petechiae or purpura, and a normal neurological examination. Laboratory tests revealed a white blood cell count of 4.8 K/µL, hemoglobin level of 11.5 g/dL, and platelet count of 8 K/µL. She was admitted and tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by nasopharyngeal swab via reverse transcription polymerase chain reaction (RT-PCR). Additional laboratory values were as follows: total bilirubin, 1.7 mg/dL; creatinine, 0.87 mg/dL; lactate dehydrogenase (LDH), 708 U/L; reticulocytes, 1.22%; haptoglobin, <9 mg/dL; prothrombin time, 13.1; and partial thromboplastin time (PTT), 26.6. mg/dL; fibrinogen, 389 mg/dL; and C-reactive protein, 0.1 mg/dL. D-dimer was elevated at 3.9 µg/mL. Normal values for test results are given in Table 1. A direct antiglobulin test (DAT) was negative. The results of a urine pregnancy test were negative. She had extensive negative workup for nonimmune

Allogeneic hematopoietic cell transplantation (HCT) has been shown to be curative in a group of patients with aggressive non-Hodgkin lymphoma (NHL). A previous study has demonstrated equivalent outcomes with a conditioning regimen based on total body irradiation and another not based on total body irradiation with preparative therapy using cyclophosphamide, carmustine, and etoposide (CBV) in autologous HCT. We investigated the safety and efficacy of using CBV in an allogeneic setting. Patients were required to have relapsed or be at high risk for subsequent relapse of NHL. All patients had a fully HLA-matched sibling donor. Patients received carmustine (15 mg/kg), etoposide (60 mg/kg), and cyclophosphamide (100 mg/kg) on days -6, -4, and -2, respectively, followed by allogeneic HCT. All patients were treated with cyclosporine and methylprednisolone as prophylaxis for graft-versus-host disease (GVHD). Thirty-one patients (median age, 46 years) who were felt to be inappropriate candidates for autologous transplantation were enrolled. Each subject had a median of 3 previous chemotherapy regimens. All patients engrafted. Fifteen of 31 patients are alive. Median follow-up time was 11.5 months (range, .4-126). There were 8 deaths due to relapse. Nonrelapse mortality (n = 8) included infection (n = 3), GVHD (n = 2), diffuse alveolar hemorrhage (n = 1), veno-occlusive disease in the setting of concurrent acute GVHD of the liver (n = 1), and leukoencephalopathy (n = 1). Probabilities of event-free survival and overall survival were, respectively, 44% (95% confidence interval, 26%-62%) and 51% (33%-69%) at 1 year and 44% (26%-62%) and 47% (29%-65%) at 5 years. Probability of relapse was 33% (15%-51%) at 1 year and 5 years. Probability of nonrelapse mortality was 31% (13%-49%) at 1 year and 5 years. Incidences were 29% for acute GVHD and 39% for chronic GVHD. None of the 12 patients who developed chronic GVHD has disease recurrence. Patients who had required >3 previous chemotherapy regimens before HCT had an increased probability of relapse. CBV is an effective preparative regimen for patients with aggressive NHL who undergo allogeneic HCT.

Tipifarnib (R115777) inhibits farnesylation of key proteins that modulate signaling pathways implicated in cell growth and proliferation, including members of the Ras and Rho families. It has broad-spectrum antiproliferative activity in vitro and in vivo. Clinical trials employing a continuous administration schedule have demonstrated dose-limiting neurotoxicity and myelosuppression. Preclinical studies have shown that intermittent oral administration can suppress tumor growth comparable to continuous administration. We conducted a National Cancer Institute-sponsored phase I trial to determine the feasibility of an intermittent dosing schedule of R115777 given orally twice daily on weeks 1 and 3 of a 28-day cycle in patients with malignant solid tumors. Starting dose was 300 mg twice daily (b.i.d.) with escalation by 300 mg b.i.d. increments over six dose levels to a maximum of 1800 mg b.i.d. Dose-limiting toxicity (DLT) was defined as any grade 3 or 4 non-hematologic toxicity, grade 4 thrombocytopenia, grade 4 neutropenia (ANC) with fever (38.3 degrees C or above) or a documented infection. Twenty-one patients with advanced solid tumors, all of whom had prior systemic therapy, were accrued. Grade 3 fatigue was dose limiting for two of three patients at the 900 mg b.i.d. dose level. Although no responses were seen, four of six patients with stable disease remained on study for at least a year (16, 17, 13 and 12 months) before developing progressive disease. Three of these prolonged stable disease patients had non-small cell lung cancer. We conclude that intermittent dosing of R115777 is feasible and tolerable. The recommended phase II dose is 600 mg orally b.i.d. on alternate weeks.

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Filgrastim (granulocyte colony-stimulating factor) has recently been reported to successfully treat patients with leukemic relapse after allogeneic peripheral stem cell transplantation (PSCT). However, the majority of the patients who responded also developed graft-versus-host disease (GVHD). Polyserositis as a manifestation of GVHD is a rare phenomenon. We report the first case of polyserositis following the use of filgrastim to treat a patient with acute myelogenous leukemia (M7), who had relapsed after an initially successful allogeneic PSCT. The polyserositis manifested with effusions and was initially controlled with high doses of steroids and pericardial stripping; however, after a quiescent period the patient eventually developed bronchiolitis obliterans with organizing pneumonia that required additional immunosuppressive therapy. We review the literature on GVHD-associated polyserositis and offer potential explanations for its pathogenesis.