Serum Proinflammatory Mediators at Different Periods of Therapy in Patients With Multiple Myeloma

Multiple myeloma (MM) is a malignant disease characterized by the clonal proliferation of plasma cells within the bone marrow. Several cytokines have been demonstrated to be involved in the control of growth, progression, and dissemination of MM. We determined serum levels of interleukin-1β (IL-1β), soluble interleukin-2 receptor (sIL-2R), interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor-α (TNF-α), and C-reactive protein (CRP) in 14 newly diagnosed MM patients. The median age of the patients was 63.4 ± 10.8 years and all of the patients were stage III (classified according to the Durie-Salmon classification). The same parameters were measured in 15 healthy controls. In addition, we also examined the effects of vincristine-adriamycin-dexamethasone (VAD) therapy on the same parameters and mediators as well as the relationship among the parameters in the same patient groups. The serum concentrations of TNF-α, IL-1β, sIL-2R, IL-6, IL-8, and CRP (18.6 ± 3.7 pg/mL, 10.1 ± 2.8 pg/mL, 730 ± 220 U/mL, 11.4 ± 3.3 pg/mL, 23.9 ± 8.3 pg/mL, and 49.9 ± 19.5 mg/dL, resp) were significantly higher in newly diagnosed MM patients than in healthy controls (P < .0001). All of the parameters were found to be significantly reduced after chemotherapy. In conclusion, we found that after the VAD therapy, the level of these cytokines which are thought to play an important role in the pathogenesis of MM was significantly suppressed. This is the first study demonstrating strong impact of VAD treatment on circulating mediators of sIL-2R and IL-8 levels parameters

Clinical Features and Treatment Strategies of Primary Central Nervous System Lymphoma: a Multicenter Retrospective Study

DergiPark: 379015tmsjAims: Primary central nervous system lymphoma is a rare, highly malignant disease with poor prognosis. Thecurrent knowledge about the disease is mostly gathered from prospective clinical trials and the optimal treatment modality is still a matter of debate. In this study it is aimed to acquire more information about the clinical features of the disease and the responses to different treatment modalities.Methods: The archives in Trakya University Hospital, İnönü University Turgut Özal Medical Center, PamukkaleUniversity Hospital and Erciyes University Hospital researched retrospectively. Demographic, treatment and survival data were retrieved and their statistical analysis was performed. As descriptive statistics number and percentages, arithmetic mean ± standard deviation, median (maximum-minimum) were used. Survival analysis was performed using Kaplan- Meier method.Results: Median age of patients at diagnosis was 53 and out of 28 patients 15 (53.6 %) of them were male. As the symptoms of the disease 18 (66.7%) patients presented headache, 15 (53.8%) presented focal deficit. As initial treatment 26 (92.9%) patients received chemotherapy, while 19 (67.9%) patients were treated with surgical resection and the median overall survival time was 7 months. Conclusion: Achieving complete remission as response to the initial treatment is associated with an improvedoverall survival. Other survival analysis to compare the impact of all initial treatment methods on overall survival resulted statistically insignifican

Evaluation of Ferric and Ferrous Iron Therapies in Women with Iron Deficiency Anaemia

Introduction. Different ferric and ferrous iron preparations can be used as oral iron supplements. Our aim was to compare the effects of oral ferric and ferrous iron therapies in women with iron deficiency anaemia. Methods. The present study included 104 women diagnosed with iron deficiency anaemia after evaluation. In the evaluations performed to detect the aetiology underlying the iron deficiency anaemia, it was found and treated. After the detection of the iron deficiency anaemia aetiology and treatment of the underlying aetiology, the ferric group consisted of 30 patients treated with oral ferric protein succinylate tablets (2 × 40 mg elemental iron/day), and the second group consisted of 34 patients treated with oral ferrous glycine sulphate tablets (2 × 40 mg elemental iron/day) for three months. In all patients, the following laboratory evaluations were performed before beginning treatment and after treatment. Results. The mean haemoglobin and haematocrit increases were 0.95 g/dL and 2.62% in the ferric group, while they were 2.25 g/dL and 5.91% in the ferrous group, respectively. A significant difference was found between the groups regarding the increase in haemoglobin and haematocrit values (P<0.05). Conclusion. Data are submitted on the good tolerability, higher efficacy, and lower cost of the ferrous preparation used in our study

Nodular melanoma presenting with rapid progression and widespread metastases: a case report

<p>Abstract</p> <p>Introduction</p> <p>Melanoma is responsible for 1% to 2% of all cancer deaths around the world. Nodular melanoma often carries a poor prognosis because of no prodromal radial growth phase, early distant metastasis and significant tumor volume.</p> <p>Case presentation</p> <p>We present a case of progressive melanoma. A 51-year-old man was admitted to our hospital with dyspnea and skin lesions. These were multiple, dark colored, firm, and nodular and varied in size. He was diagnosed with melanoma. Temozolomide was administered, but he died of respiratory failure within a week after diagnosis.</p> <p>Conclusion</p> <p>Nodular melanoma tends to spread rapidly and eventually metastasize to vital organs. It may be fatal within months of recognition.</p

The Experience of Ibrutinib in Chronic Graft-Versus-Host Disease in Patients Undergoing Allogeneic Hematopoietic Stem Cell Transplantation: Single Center Experience

Introduction:Chronic graft-versus host disease (GVHD) is a serious complication that develops in 35-50% of patients in the late period after allogeneic hematopoetic stem cell transplantation. About half of the patients are resistant to corticosteroids, which is the first-line treatment of chronic GVHD, and therefore new treatment options that can be effective in chronic GVHD are needed. In the present study, we aimed to share our experience with the use of ibrutinib therapy in patients with steroid-resistant chronic GVHD who have previously received multiple lines of systemic therapy.Methods:The characteristics and clinical outcomes of steroid-resistant chronic patients with GVHD receiving ibrutinib were retrospectively reviewed.Results:A total of 10 steroid resi-stant chronic patients with GVHD who received ibrutinib was included. While 50% of the patients had more than one organ involvement, 50% had a single organ involvement. The most commonly affected organs were the skin and liver. The patients received a median of three lines of systemic therapy before ibrutinib. After a median of 210 days of ibrutinib usage, the complete response rate of patients was 40% and the partial response rate was 40%. Corticosteroids were completely discontinued in 30% of patients after ibrutinib were initiated. Before ibrutinib, patients were given a median of 0.3 mg/kg methylprednisolone. The median methylprednisolone dose after ibrutinib was 0.03 mg/kg.Conclusion:Ibrutinib therapy causes a quite high overall response in steroid resistant chronic patients with GVHD and appears to be a good option in these patients

“The Lolelaplap (Marshall Islands) in Us: Sailing West to East (Ralik→Ratak) to These Our Atolls (Aelon Kein Ad) Ad Jolet Jen Anij (Our Blessed Inheritance from God)”

This paper discusses the expansion of Oceania through a Marshallese indigenous lens as a focal point. It explains that decolonizing methodologies allows reclaiming of space for mental liberation and reassurement of constitutional rights. It highlights similar occurrences of decolonization practices meeting resistance in the 21st century all while strengthening the human right argument that no human deserves any less than their fellow human brothers and sisters. It argues that an indigenous imagery can only be viewed through an indigenous lens where the researches’ level of purity is retained and unfiltered. It nevertheless argues that Marshallese ethnolinguistics reveal the same cultural practices in America, Judeo-Christianity, and Oceania thus dictating the reality that “we are the same not withstanding one stays here and one there (Bedbedjin Bedbedjen, Bedbedjinma wot Kwe)”. It further explains the importance in these similarities and how Marshallese spirituality predates introduced American Judeo-Christianity despite the latter attempting to marginalize the former. It concludes by stating that Marshallese contributions on the global stage are rooted in that culture of love (IaKwe) which is echoed by the custom(s) revealing the significance of Marshallese validation academically, spiritually, economically, & socially to prevent institutionalized discrimination. This paper ends stating that the agency to know one’s self and how one should fit in the world, is a human right in itself and Marshallese are entitled to this sense of self worth through knowing thy self by thy self where real thinking takes place in one’s own mind as we all live our own lives

Value of holotranscobalamin II measured by RIA in the diagnosis of megaloblastic anemia in comparison with other diagnostic parameters

Kobalamin eksikliğine bağlı megaloblastik aneminin değişken klinik belirti ve laboratuvar bulgularının olması tanıda zorluklara neden olmaktadır. Serum holotranskobalamin II (holoTC II) düzeyinin azalmasının kobalamin eksikliğinin tanısında erken bir markır olduğu belirtilmekle birlikte, klinik kullanıma uygun bir metot geliştirilmemiştir. Bu çalışmada, kobalamin eksikliğini belirlemede yeni bir ticari test olan holoTC II RIA (Radyoimmüno assay)’nın etkinliği ve diğer laboratuvar bulguları ile karşılaştırılması amaçlandı. Başvuru anında, 20 hastanın 14‘ünde (%70) anemi ve makrositoz, dokuzunda (%45) trombositopeni, yedisinde (%35) nötropeni, 10’unda (%50) serum kobalamin düzeyleri (<100 pg/mL) ve 19’unda (%95) holoTC II düzeyi düşük (<37 pmol/L) bulundu. On gün 1 mg/gün siyanokobalamin tedavisi sonrası hemoglobin, hematokrit, trombosit, serum kobalamin ve serum holoTC II değerlerinde tedavi öncesi ile mukayese edildiğinde istatistiksel olarak anlamlı derecede artış oldu (P<0.05). MCV, LDH ve indirekt bilirübin değerlerinde ise azalma oldu (P<0.05). Plazma holoTC II düzeyinin ölçümünün kobalamin eksikliğini belirlemede daha yüksek özgüllük ve duyarlılığa sahip olduğu bulundu.The presence of variations in the clinical signs and laboratory findings of megaloblastic anemia due to cobalamin deficiency causes diffi culty in the diagnosis. While decreased serum levels of holo-transcobalamin II (holoTC II) is thought to be an early marker in the diagno sis of cobalamin deficiency, no suitable method for clinical use has been developed. In this study, determination of the value of a new commercial test, holoTC II RIA in the diagnosis of cobalamin deficiency, and the comparison of this test with other laboratory markers were aimed. At the admission, anemia and macrocytosis, thrombocytopenia, neutropenia, cobalamin levels <100 pg/mL, and holo tc II levels less than normal (<37 pmol/L) were found in 14 (70%), 9 (45%), 7 (35%), 10 (50%), and 19 (95%) of the 20 patients, respectively. After a 10-day course of 1 mg/day cobalamin treatment, a significant increase occurred in the value of hemoglobin, hematocrite, thrombo cyte, and serum cobalamin and holoTC II when compared to their respective values before the therapy (P<0.05). But, a decrease in the values of MCV, LDH, and unconjugated bilirubin occurred (P<0.05). It was found that the measuring of the plasma levels of holo TC II has a higher sensitivity and specificity in the determination of cobalamin deficiency

Vitamin D and pro-inflammatory cytokine IFN-&#947; and the anti-inflammatory cytokines IL-4 and IL-10 in Peritoneal Dialysis Patients

Several clinical trials in patients with chronic disease have found that active vitamin D usage lowers pro-inflammatory cytokines. The aim of this study was evaluate whether supplementation of cholecalciferol in peritoneal dialysis patients with vitamin D deficiency would lead any chance in the pro-inflammatory cytokine IFN-&#947; and the anti-inflammatory cytokines IL-4 and IL-10, and pentraxin 3 and peripheral blood mononuclear cell subpopulations (CD3, CD4, CD8, CD45)and CD4/CD8 ratio. We analyzed fasting blood samples from 31 continuous peritoneal dialysis patients (14 males, 16 females, mean age 48,6±14,8 yrs) for serum 25-hydroxyvitamin D [25(OH)D)] and specific plasma cytokine concentrations (interferon-gamma [IFN-&#947;], interleukin [IL]-4, and IL-10), pentraxine 3, CD3, CD4, CD8 and CD45 before and after cholecalciferol replacement. Before and after cholecalciferol replacement mean 25 (OH) level was 6,1±2,1 ng/dL and 39,7±10,9 ng/dL respectively (p [Med-Science 2017; 6(3.000): 393-7

Burkitt&apos;s lymphoma presenting with rapidly and multi-organ involvement: A case presentation * Ilhami Berber

ABSTRACT Burkitt lymphoma is an aggressive lymphoma and its clinical, immunologic, chemical features are well-known. Burkitt lymphoma is in highgrade lymphomas and can spread very rapidly. Burkitt lymphoma has been difficult to be cured with conventional chemotherapy for adults. Early autologous bone marrow should be kept in mind in first remission BL. We presented a case of presenting with rapid and multi organ involvement with BL. A 55-year-old male patient responded to the conventional chemotherapy for short-term and died 9 months after diagnosis because of relapse of Burkitt lymphoma