Bone marrow failure syndromes and refractory cytopenia of childhood

__Abstract__ Hematopoiesis, or blood cell production, is sustained through hematopoietic stem cells, which are self-renewing cells that reside in the bone marrow, and that are capable of producing daughter cells that proliferate and mature to provide all adult blood effector cells, including erythrocytes or red blood cells, leukocytes or white blood cells, and thrombocytes or platelets. Erythrocytes are the most numerous cell types in the blood, and have as main task to transport oxygen through the lungs to peripheral tissues; leukocytes are responsible for elimination of bacteria and viruses, and thrombocytes for blood clotting. Hematopoiesis can be subdivided into myelopoiesis and lymphopoiesis. Myelopoiesis comprises the generation of granulocytes, monocytes, mast cells, mega- karyocytes (the precursors of thrombocytes), and erythrocytes. Lymphopoiesis encompasses the generation of B cells, T cells, and NK cells; collectively referred to as lymphocytes. Although recent insights suggest that cell fate determination during hematopoiesis is more plastic than previously thought, the classic, hierarchical model of determination of hematopoietic cell lineages is depicted in Figure 1 (adapted from Orkin and Zon

Prognostic Implications of Lateral Lymph Nodes in Rectal Cancer:A Population-Based Cross-sectional Study with Standardized Radiological Evaluation after Dedicated Training

BACKGROUND: There is an ongoing discussion regarding the prognostic implications of the presence, short-axis diameter, and location of lateral lymph nodes. OBJECTIVE: To analyze lateral lymph node characteristics, the role of downsizing on restaging MRI, and associated local recurrence rates for patients with cT3-4 rectal cancer after MRI re-review and training. DESIGN: Retrospective population-based cross-sectional study. SETTINGS: This collaborative project was led by local investigators from surgery and radiology departments in 60 Dutch hospitals. PATIENTS: A total of 3057 patients underwent rectal cancer surgery in 2016: 1109 had a cT3-4 tumor located ≤8 cm from the anorectal junction, of whom 891 received neoadjuvant therapy. MAIN OUTCOME MEASURES: Local recurrence and (ipsi) lateral local recurrence rates. RESULTS: Re-review identified 314 patients (35%) with visible lateral lymph nodes. Of these, 30 patients had either only long-stretched obturator (n = 13) or external iliac (n = 17) nodes, and both did not lead to any lateral local recurrences. The presence of internal iliac/obturator lateral lymph nodes (n = 284) resulted in 4-year local recurrence and lateral local recurrence rates of 16.4% and 8.8%, respectively. Enlarged (≥7 mm) lateral lymph nodes (n = 122) resulted in higher 4-year local recurrence (20.8%, 13.1%, 0%; p &lt;.001) and lateral local recurrence (14.7%, 4.4%, 0%; p &lt; 0.001) rates compared to smaller and no lateral lymph nodes, respectively. Visible lateral lymph nodes (HR 1.8 [1.1-2.8]) and enlarged lateral lymph nodes (HR 1.9 [1.1-3.5]) were independently associated with local recurrence in multivariable analysis. Enlarged lateral lymph nodes with malignant features had higher 4-year lateral local recurrence rates of 17.0%. Downsizing had no impact on lateral local recurrence rates. Enlarged lateral lymph nodes were found to be associated with higher univariate 4-year distant metastasis rates (36.4% vs 24.4%; p = 0.021), but this was not significant in multivariable analyses (HR 1.3 [0.9-1.]) and did not worsen overall survival. LIMITATIONS: This study was limited by the retrospective design and total number of patients with lateral lymph nodes. CONCLUSIONS: The risk of lateral local recurrence due to (enlarged) lateral lymph nodes was confirmed, but without the prognostic impact of downsizing after neoadjuvant therapy. These results point toward the incorporation of primary lateral lymph node size into treatment planning. See Video Abstract.</p

The beneficial local and abscopal effect of splenic irradiation in frail patients with chronic lymphocytic leukaemia

Biological, physical and clinical aspects of cancer treatment with ionising radiatio

Incubation lighting schedules and their interaction with matched or mismatched post hatch lighting schedules : Effects on broiler bone development and leg health at slaughter age

The incidence of leg pathologies in broiler chickens with a developmental origin may be decreased by stimulating embryonic bone development through lighting schedules during incubation, but this may depend on post hatch lighting conditions. Aim was to investigate how lighting schedules during incubation and their interactions with matched or mismatched lighting schedules post hatch affected bone development and leg health at slaughter age. In a 3 × 2 factorial designed experiment, eggs were incubated under continuous cool white LED light (Inc24L), 16 h of light, 8 h of darkness (Inc16L:8D), or continuous darkness (Inc24D) from set till hatch. After hatch, broilers were housed under continuous light (PH24L, to match Inc24L and Inc24D) or 16 h of light, 8 h of darkness (PH16L:8D, to match Inc16L:8D). Gait scores were determined on D21, D28, and D34. After slaughter on D35, legs were scored for varus-valgus deformities, rotated tibia, tibial dyschondroplasia, bacterial chondronecrosis with osteomyelitis (BCO), epiphyseolysis, and epiphyseal plate abnormalities from 1 = absent to 4 = severe. Femur and tibia dimensions and mineral density were determined. Inc24L led to more epiphyseal plate abnormalities than Inc16L:8D or Inc24D. Inc24D led to more BCO than Inc16L:8D. Gait scores on D21, D28, and D34, and bone dimensions did not differ between treatments. Inc24L led to higher femur mineral density than Inc24D with Inc16L:8D intermediate. Providing a chicken with a matched post hatch lighting schedule did not affect most measurements of bone development and health. It can be concluded that a circadian incubation lighting schedule may improve leg health in broilers

Incubation lighting schedules and their interaction with matched or mismatched post hatch lighting schedules : Effects on broiler bone development and leg health at slaughter age

The incidence of leg pathologies in broiler chickens with a developmental origin may be decreased by stimulating embryonic bone development through lighting schedules during incubation, but this may depend on post hatch lighting conditions. Aim was to investigate how lighting schedules during incubation and their interactions with matched or mismatched lighting schedules post hatch affected bone development and leg health at slaughter age. In a 3 × 2 factorial designed experiment, eggs were incubated under continuous cool white LED light (Inc24L), 16 h of light, 8 h of darkness (Inc16L:8D), or continuous darkness (Inc24D) from set till hatch. After hatch, broilers were housed under continuous light (PH24L, to match Inc24L and Inc24D) or 16 h of light, 8 h of darkness (PH16L:8D, to match Inc16L:8D). Gait scores were determined on D21, D28, and D34. After slaughter on D35, legs were scored for varus-valgus deformities, rotated tibia, tibial dyschondroplasia, bacterial chondronecrosis with osteomyelitis (BCO), epiphyseolysis, and epiphyseal plate abnormalities from 1 = absent to 4 = severe. Femur and tibia dimensions and mineral density were determined. Inc24L led to more epiphyseal plate abnormalities than Inc16L:8D or Inc24D. Inc24D led to more BCO than Inc16L:8D. Gait scores on D21, D28, and D34, and bone dimensions did not differ between treatments. Inc24L led to higher femur mineral density than Inc24D with Inc16L:8D intermediate. Providing a chicken with a matched post hatch lighting schedule did not affect most measurements of bone development and health. It can be concluded that a circadian incubation lighting schedule may improve leg health in broilers