Ninety-one children and adolescents 18 years or younger after allogeneic hematopoietic stem cell transplantation (HSCT) for relapsed or refractory Hodgkin lymphoma (HL) were analyzed. Fifty-one patients received reduced intensity conditioning (RIC); 40 patients received myeloablative conditioning (MAC). Nonrelapse mortality (NRM) at 1 year was 21% (؎ 4%), with comparable results after RIC or MAC. Probabilities of relapse at 2 and 5 years were 36% (؎ 5%) and 44% (؎ 6%), respectively. RIC was associated with an increased relapse risk compared with MAC; most apparent beginning 9 months after HSCT (P ؍ .01). Progressionfree survival (PFS) was 40% (؎ 6%) and 30% (؎ 6%) and overall survival (OS) was 54% (؎ 6%) and 45% (؎ 6%) at 2 and 5 years, respectively. Disease status at HSCT was predictive of PFS in multivariate analysis (P < .001). Beyond 9 months, PFS after RIC was lower compared with MAC (P ؍ .02). Graft-versus-host disease did not affect relapse rate and PFS. In conclusion, children and adolescents with recurring HL show reasonable results with allogeneic HSCT. Especially patients allografted in recent years with good performance status and chemosensitive disease show highly encouraging results (PFS: 60% ؎ 27%, OS: 83% ؎ 15% at 3 years). Because relapse remains the major cause of treatment failure, additional efforts to improve disease control are
We have developed SF films with biological properties that supported the growth of rabbit and human CECs, which showed normal morphology and characteristic markers; and with mechanical properties that allowed its use in a DMEK surgery, proving its in vivo functionality in a rabbit model of endothelial dysfunction.
Multiple myeloma is a very heterogeneous disease with variable survival. Despite recent progress and the widespread use of new agents, patients with relapsed and refractory disease have a poor outcome. Immunomodulatory drugs play a key role in both the front-line and the relapsed/refractory setting. The combination of pomalidomide (POM) and dexamethasone is safe and effective in relapsed and refractory patients, even in those with high-risk cytogenetic features. Furthermore, it can be used in most patients without the need to adjust according to the degree of renal failure. In order to further improve the results, POM-based triplet therapies are currently used. This article highlights the most relevant issues of POM and POM-based combinations in the relapsed/refractory multiple myeloma setting, from a pharmacological and clinical point of view.
Corneal keratoplasty (penetrating or lamellar) using cadaveric human tissue, is nowadays the main treatment for corneal endotelial dysfunctions. However, there is a worldwide shortage of donor corneas available for transplantation and about 53% of the world’s population have no access to corneal transplantation. Generating a complete cornea by tissue engineering is still a tough goal, but an endothelial lamellar graft might be an easier task. In this study, we developed a tissue engineered corneal endothelium by culturing human corneal endothelial cells on a human purified type I collagen membrane. Human corneal endothelial cells were cultured from corneal rims after corneal penetrating keratoplasty and type I collagen was isolated from remnant cancellous bone chips. Isolated type I collagen was analyzed by western blot, liquid chromatography -mass spectrometry and quantified using the exponentially modified protein abundance index. Later on, collagen solution was casted at room temperature obtaining an optically transparent and mechanically manageable membrane that supports the growth of human and rabbit corneal endothelial cells which expressed characteristic markers of corneal endothelium: zonula ocluddens-1 and Na+/K+ ATPase. To evaluate the therapeutic efficiency of our artificial endothelial grafts, human purified type I collagen membranes cultured with rabbit corneal endothelial cells were transplanted in New Zealand white rabbits that were kept under a minimal immunosuppression regimen. Transplanted corneas maintained transparency for as long as 6 weeks without obvious edema or immune rejection and maintaining the same endothelial markers that in a healthy cornea. In conclusion, it is possible to develop an artificial human corneal endothelial graft using remnant tissues that are not employed in transplant procedures. This artificial endothelial graft can restore the integrality of corneal endothelium in an experimental model of endothelial dysfunction. This strategy could supply extra endothelial tissue and compensate the deficit of cadaveric grafts for corneal endothelial transplantation.
The invasive macroalga Rugulopteryx okamurae represents an unprecedented case of bioinvasion by marine macroalgae facing the European coasts. Since the first apparition of the species in the Strait of Gibraltar in 2015, its fast dispersion along the introduced habitats constitutes a real challenge to develop monitoring strategies that ahead of its impacts. The present study uses three different approaches to address impacts on the benthic ecosystems, at the same time offers relevant data for future management actions in El Estrecho Natural Park (PNE). Information obtained by monitoring permanent sentinel stations revealed a significant loss in resident species coverage after the moment of maximum growth in 2017. Thus, despite coverage of R. okamurae did not strongly varied in the latter years, impacts generated remain high in the habitats studied. Estimations of the invasive species coverage by combining cartographic image analysis and in situ data predicted a major occupation (over 85% coverage) between 10 and 30 m, coinciding with the maximum rocky surface areas (m2) mapped on the PNE. Furthermore, a Citizen Science research collaboration evidenced impacts on the benthic seascape through an ad hoc exploration of images that allowed a “before” and “after” comparison of the invasion process in the same geographic locations. This has made it possible to graphically demonstrate severe changes in the underwater seascape and, therefore, the general impact of this new biological invasion. The spatial colonization estimations combined with the impacts reported by both scientific [Sessile Bioindicators in Permanent Quadrats (SBPQ) sentinel stations] and civilian (Citizen Science) monitoring methodologies claim the urgent development of further studies that allow the design of monitoring strategies against R. okamurae expansion across the Mediterranean and Atlantic waters.
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