Rationale and Design of a Prospective, Multicentre, Stop Tyrosine Kinase Inhibitor Trial of Paediatric Patients with Chronic Myeloid Leukaemia with Sustained Complete Molecular Response (STKI-14)

Chronic myeloid leukaemia (CML) is a relatively rare disease in children, accounting for 2–3% of all paediatric leukaemia cases. Generally, children with CML can avoid hematopoietic stem cell transplantation and achieve molecular responses with tyrosine kinase inhibitors (TKI). However, CML stem cells are thought to survive in many patients, even after TKI treatment. Many aspects of the toxic effects of prolonged exposure to TKIs during childhood remain unclear, particularly those regarding growth impairment. This lack of clarity underscores the importance of the present clinical trial, which aims to clarify the feasibility of treatment-free remission (TFR) in children following TKI treatment. We aim to examine the long-term out-comes and complications of TKIs before and after cessation to better understand the unknown complications that could arise in adulthood. This trial targets patients who were diagnosed with CML at an age younger than 20 years, were in the chronic or accelerated phase at initial diagnosis and remained in complete molecular remission for at least 2 years after TKI administration. We will examine the utility of TKI cessation and assess the treatment results of patients who resumed TKI therapy after losing a major molecular response. We will also investigate factors related to the feasibility of a TFR after TKI cessation

Salmonella in healthy pigs: prevalence, serotype diversity and antimicrobial resistance observed during 1998–1999 and 2004–2005 in Japan

To determine prevalence, serotype diversity and antimicrobial resistance of Salmonella in healthy pigs, faecal samples from 6771 pigs on 73 farms collected during 1998–1999 and 2004–2005 were examined. Salmonella isolates were serotyped and tested for susceptibility to 22 antimicrobials: benzylpenicillin, ampicillin, amoxicillin, cefazolin, cephaloridine, gentamicin, kanamycin, streptomycin, fradiomycin, colistin, tetracycline, chlortetracycline, oxytetracycline, chloramphenicol, thiamphenicol, sulfadimethoxine, sulfamethoxazole, sulfamethoxypyridazine, trimethoprim, sulfamethoxazole/trimethoprim, norfloxacin and ofloxacin. Farm-level and pig-level Salmonella prevalences were 35·5% and 2·2% in 1998–1999, and 35·7% and 3·3% in 2004–2005. Prevalence by growth stage was 2·4% for sows, 3·3% for weaned pigs, 2·7% for fattening pigs and 3·8% for finishing pigs. The predominant serotypes identified were Agona (28·4%), Typhimurium (17·9%) and Infantis (16·4%) in 1998–1999, and Typhimurium (32·5%), Anatum (24·6%) and Infantis (13·5%) in 2004–2005. Compared with the 1998–1999 isolates, the 2004–2005 isolates showed significantly higher rates of resistance to all the antimicrobials except tetracyclines (P<0·01 to P<0·05) and resistance to ⩾2 antimicrobials [19·4% (13/67) vs. 39·7% (50/126), P<0·01]. This study provides national estimates of Salmonella prevalence in healthy pigs of different growth stages in Japan