Chronic Myelomonocytic Leukaemia

The classification, pathobiology and clinical management of chronic myelomonocytic leukaemia (CMML) are reviewed. Three important issues are identified: (1) CMML should be recognised as a unique clinical entity and as distinct from myelodysplastic syndromes (MDSs). Somatic mutations of a restricted set of genes are frequent in CMML. (2) Risk stratification for CMML patients should utilise new CMML‐specific prognostic scoring systems. (3) Until randomised clinical trials have defined the role of new drugs (especially of the hypomethylating agents), treatment must focus on the main symptoms and aim at quality‐of‐life improvement

The PAX5 oncogene is expressed in N-type neuroblastoma cells and increases tumorigenicity of a S-type cell line

Neuroblastoma is a neural crest-derived neoplasm of infancy with poor outcome in patients with advanced disease. The oncogenic transcription factor PAX5 is an important developmental regulator and is implicated in the pathogenesis of several malignancies. Screening of neuroblastoma cell lines revealed PAX5 expression in a malignant subset of neuroblastoma cells, so-called ‘N-type' cells, but not in the more benign ‘S-type' neuroblastoma cells. PAX5 expression was also detected in small cell lung cancer, an aggressive tumor of neural crest origin. Based on this observation we hypothesized that there could be a relationship between PAX5 expression and the more malignant phenotype of N-type cells. Stable PAX5 expression was established in several clones of the S-type cell line CA-2E. A noticeable difference in morphology of these transfectants was observed and there was also a significant increase in the proliferation rate. Moreover, PAX5 expressing clones gained the ability to form colonies in a soft agar assay, a marker of tumorigenicity. Down-regulation of PAX5 in several N-type cell lines and one small cell lung cancer cell line utilizing small interfering RNA resulted in a significant decrease in growth rate. Taken together we propose PAX5 as an important factor for the maintenance of the proliferative and tumorigenic phenotype of neuroblastoma. Our data, together with a recent study on the role of PAX genes in cancer suggest that PAX5 and other PAX transcription factors might be valuable targets for cancer therap

Crystalline silicate dust around evolved stars I. The sample stars

This is the first paper in a series of three where we present the first comprehensive inventory of solid state emission bands observed in a sample of 17 oxygen-rich circumstellar dust shells surrounding evolved stars. The data were taken with the Short and Long Wavelength Spectrographs on board of the Infrared Space Observatory (ISO) and cover the 2.4 to 195 micron wavelength range. The spectra show the presence of broad 10 and 18 micron bands that can be attributed to amorphous silicates. In addition, at least 49 narrow bands are found whose position and width indicate they can be attributed to crystalline silicates. Almost all of these bands were not known before ISO. We have measured the peak positions, widths and strengths of the individual, continuum subtracted bands. Based on these measurements, we were able to order the spectra in sequence of decreasing crystalline silicate band strength. We found that the strength of the emission bands correlates with the geometry of the circumstellar shell, as derived from direct imaging or inferred from the shape of the spectral energy distribution. This naturally divides the sample into objects that show a disk-like geometry (strong crystalline silicate bands), and objects whose dust shell is characteristic of an outflow (weak crystalline silicate bands). All stars with the 33.6 micron forsterite band stronger than 20 percent over continuum are disk sources. We define spectral regions (called complexes) where a concentration of emission bands is evident, at 10, 18, 23, 28, 33, 40 and 60 micron. We derive average shapes for these complexes and compare these to the individual band shapes of the programme stars.Comment: 41 pages, 20 figures, accepted by A&A. Tables 4 to 20 are only available in electronic form at the CDS via anonymous ftp to cdsarc.u-strasbg.fr (130.79.128.5) or via http://cdsweb.u-strasbg.fr/cgi-bin/qcat?J/A+A

The VEXAS Syndrome: Uncontrolled Inflammation and Macrocytic Anaemia in a 77-Year-Old Male Patient

The VEXAS (vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic) syndrome is a recently described X-linked autoinflammatory condition caused by a somatic mutation of the UBA1 gene and characterized by an evolving phenotype. This includes inflammatory processes such as recurrent fever, Sweet’s syndrome of the skin, pulmonary fibrosis, relapsing polychondritis and venous thromboembolism. An important feature, present in almost all cases, is the development of a macrocytic anaemia with vacuolization of myeloid and erythroid precursors. Usually, these patients require high doses of steroids to control symptoms and respond poorly to disease-modifying drugs. We describe a new case of the VEXAS syndrome presenting with Sweet’s syndrome which has now been followed for 6 years. Andreas Himmelmann1, Rolf Brücker