Mast cell leukemia with prolonged survival on PKC412/midostaurin

Mast cell leukemia (MCL) is a rare and aggressive form of systemic mastocytosis. There are approximately 50 reported cases since 1950s. MCL is refractory to cytoreduction chemotherapy and the average survival is only six months. We report a MCL case in a 71 year-old woman with high tumor load at the initial presentation in 2005, who did not respond to either interleukin-2 or dasatinib therapy. After enrolled in a clinical trial of PKC412 (or Midostaurin) with a daily dose of 100 mg, the patient responded well to PKC412 and became transfusion independent in three months. Since then, her disease had been stably controlled. This is the first report of a high-tumor-load MCL case which achieved prolonged survival (101 months) by PKC 412. The 101-month overall survival is the longest among reported MCL cases in the English literature

Cutting edge: acute lung allograft rejection is independent of secondary lymphoid organs

It is the prevailing view that adaptive immune responses are initiated in secondary lymphoid organs. Studies using alymphoplastic mice have shown that secondary lymphoid organs are essential to initiate allograft rejection of skin, heart, and small bowel. The high immunogenicity of lungs is well recognized and allograft rejection remains a major contributing factor to poor outcomes after lung transplantation. We show in this study that alloreactive T cells are initially primed within lung allografts and not in secondary lymphoid organs following transplantation. In contrast to other organs, lungs are acutely rejected in the absence of secondary lymphoid organs. Two-photon microscopy revealed that recipient T cells cluster predominantly around lung-resident, donor-derived CD11c+ cells early after engraftment. These findings demonstrate for the first time that alloimmune responses following lung transplantation are initiated in the graft itself and therefore identify a novel, potentially clinically relevant mechanism of lung allograft rejection

"You have to take it that way." A study of the subjective experience of the corona pandemic by older people in need of help and care living at home

Nikelski A, Trompetter E, Feldmann S, et al. „Das muss man so nehmen.“ Eine Studie zum subjektiven Erleben der Coronapandemie älterer hilfe- und pflegebedürftiger Menschen in der Häuslichkeit. Zeitschrift für Gerontologie und Geriatrie. 2021;54:359–364.Background As older people are at increased risk of severe and fatal courses of SARS-CoV-2 infection, they receive special attention, which, however, often refers one-sidedly to their need for protection. What is needed is a discussion that considers the subjective reality and resources as well as risks. Objective The study focused on the perspectives of older people. The aim was to shed light on their subjective experience of the corona pandemic. The questions were how they experienced the pandemic, the risks, consequences and protective measures, to what extent these affected their everyday life and how they dealt with it. Material and methods A total of 12 guideline-based telephone interviews were conducted in May and June 2020 with 9 women and 3 men between 77 and 91 years of age, who lived in their own homes, had impaired health and needed help and care. The data were evaluated by structuring content analysis. Results The respondents were generally concerned about the corona pandemic but considered their own risk to be low. They saw themselves as hardly affected by the immediate consequences of the crisis or severely restricted in their everyday lives. They experienced insecurity in social life and fear of loneliness was central. Overall, they considered the protective measures to be appropriate but criticized early cancelling, family contact restrictions and dealing with the dying. Conclusion A moderate degree of direct personal involvement, acceptance and adaptability characterized the experience and handling of the corona pandemic. Resources and skills in dealing with the crisis become visible