Hemophagocytic lymphohistiocytosis (HLH) is difficult to diagnose and treat. Highly elevated ferritin is strongly associated with HLH and levels may provide a prognostic marker. A comprehensive review of ferritin data from our patients during treatment was analyzed with respect to mortality. A patient was 17 times more likely to die when percent ferritin decrease was less than 50% as compared to a 96% or greater decrease as indicated with multivariate logistic modeling. Higher maximum ferritin levels in the first 3 weeks also contributed to the odds of death (OR=5.6;90%CI=1.2-24.9). Regular ferritin measurements may be useful predicting outcomes in HLH patients.

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Background First-degree relatives of melanoma survivors have a substantially higher lifetime risk for melanoma than individuals with no family history. Exposure to ultraviolet radiation is the primary modifiable risk factor for the disease. Reducing UV exposure through sun protection may be particularly important for children with a parental history of melanoma. Nonetheless, limited prior research has investigated sun protection practices and sun exposure among these children. Methods The California Cancer Registry was used to identify melanoma survivors eligible to participate in a survey to assess their children's sun protection practices and sun exposure. The survey was administered by mail, telephone, or web to Latino and non-Latino white melanoma survivors with at least one child (0–17 years; N = 324). Results Sun exposure was high and the rate of sunburn was equivalent to or higher than estimates from average risk populations. Use of sun protection was suboptimal. Latino children were less likely to wear sunscreen and hats and more likely to wear sunglasses, although these differences disappeared in adjusted analyses. Increasing age of the child was associated with lower sun protection and higher risk for sunburn whereas higher objective risk for melanoma predicted improved sun protection and a higher risk for sunburns. Perception of high barriers to sun protection was the strongest modifiable correlate of sun protection. Conclusions Interventions to improve sun protection and reduce sun exposure and sunburns in high risk children are needed. Impact Intervening in high risk populations may help reduce the burden of melanoma in the U.S.

CD40L generates immune responses in leukemia-bearing mice, an effect that is potentiated by IL-2. We studied the feasibility, safety, and immunologic efficacy of an IL-2-and CD40L-expressing recipientderived tumor vaccine consisting of leukemic blasts admixed with skin fibroblasts transduced with adenoviral vectors encoding human IL-2 (hIL-2) and hCD40L. Ten patients (including 7 children) with high-risk acute myeloid (n ‫؍‬ 4) or lymphoblastic (n ‫؍‬ 6) leukemia in cytologic remission (after allogeneic stem cell transplantation [n ‫؍‬ 9] or chemotherapy alone

Vascular complications such as bleeding due to gastrointestinal telangiectatic anomalies, pulmonary arteriovenous malformations, hepatopulmonary syndrome, and retinal vessel abnormalities are being reported in patients with telomere biology disorders (TBDs) more frequently than previously described. The international clinical care consortium of telomere-associated ailments and family support group Dyskeratosis Congenita Outreach, Inc. held a workshop on vascular abnormalities in the TBDs at the National Cancer Institute in October 2017. Clinicians and basic scientists reviewed current data on vascular complications, hypotheses for the underlying biology and developed new collaborations to address the etiology and clinical management of vascular complications in TBDs.

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Introducing chemical equilibrium concepts in undergraduate general chemistry promotes improved understanding of chemical reactions. We have developed an engaging laboratory experiment exploring the equilibrium of cobalt complexation in alcohols using UV−vis spectroscopy and successfully implemented in a large general chemistry class of 378 students at Brown University. The octahedral to tetrahedral (pink to blue) cobalt complex transition generates vivid visualizations, increasing students' interest in learning. The equilibrium constants can be measured using UV−vis absorption spectroscopy and the Beer−Lambert law. Vast differences in molar absorptivity coefficients between octahedral and tetrahedral geometries of cobalt complexes prompt discussions on absorptivity, orbital splitting, and color change under the purview of learning Le Chatelier's principle. Additionally, the experimental results regarding the equilibrium constant allowed students to examine possible mechanistic pathways. Student responses to conducting the experiment were positive, most notably because this experiment encouraged them to analyze their experimental results critically and propose possible reaction mechanisms and equilibrium expressions while appreciating the sharp color transition that the complexation equilibrium undergoes.