No abstract

Inflammatory cytokines released by activated lymphocytes and innate cells in the context of cellular therapy can cause fever, vasodilatation, and end-organ damage, collectively known as cytokine release syndrome (CRS). CRS can occur after allogeneic blood or marrow transplantation, but is especially prevalent after HLA-haploidentical (haplo) peripheral blood transplantation (PBT). We reviewed charts of all patients who underwent haplo-PBT between October 1, 2013, and September 1, 2017 and graded CRS in these patients. A total of 146 consecutive patients who underwent related haplo-PBT were analyzed. CRS occurred in 130 patients (89%), with most cases of mild severity (grade 0 to 2). Severe CRS (grade 3 to 5) occurred in 25 patients (17%). In this group with severe CRS, 13 patients had encephalopathy, 12 required hemodialysis, and 11 were intubated. Death from the immediate complications of CRS occurred in 6 patients (24% of the severe CRS group and 4% of the entire haplo-PBT cohort). The cumulative probability of nonrelapse mortality (NRM) was 38% at 6 months for the patients with severe CRS and 8% (121 of 146) in patients without severe CRS. In conclusion, CRS occurs in nearly 90% of haplo-PBTs. Older haplo-PBT recipients (odds ratio [OR], 2.4; 95% confidence interval [CI], .83 to 6.75; P = .11) and those with a history of radiation therapy (OR, 3.85; 95% CI, 1.32 to 11.24; P = .01) are at increased risk of developing severe CRS. Although most recipients of haplo-PBT develop CRS, <20% experience severe complications. The development of severe CRS is associated with a significantly increased risk of NRM.

No abstract

At low concentrations in hard water, the polyphosphates revert to orthophosphate at rates which are not predictable from data obtained at higher concentrations. A reversal in the effect of pH on reversion rate at lower concentrations appears to be due to complex formation between the polyphosphate and the hard water metal ions. A minimum in the rate of reversion of polyphosphate glasses to orthophosphate occurs at an average chain length between about 13 and 40 under the low concentration hard water conditions. Phosphate glasses having an average chain length below 30 show good storage stability but longer-chain glasses undergo a decrease in chain length under normal "dry" storage conditions, with the rate of degradation increasing with increasing chain length.

A simple three scale nomogram is presented to predict lean body mass in men from two anthropometric measurements: height and the circumference of the flexed biceps. The prediction equation used in constructing the nomogram was established from data collected on 198 USAF aircrewmen. Lean body mass was determined on these men by a standard tritium dilution technique. The equation was validated on a total of 65 additional flyers, comparing measurements obtained by tritium dilution (r = 0.91), 40K wholebody counter techniques (r = 0.90), and water-displacement techniques (r = 0.86). A second nomogram demonstrates the flexibility in using this anthropometric-type prediction of body composition to arrive at personalized weight standards.