Sezary Syndrome presenting with leonine facies and treated with low-dose subcutaneous alemtuzumab

Abstract Cutaneous T-cell lymphomas (CTCL) comprise a group of diseases characterized by the accumulation of malignant T cells within the skin. Sezary syndrome represents an aggressive form of CTCL, in which the skin is diffusely affected and the peripheral blood is involved. It is characterized by the triad of generalized erythroderma, lymphadenopathy, and neoplastic T cells (Sezary cells) in the skin, lymph nodes, and peripheral blood. Leonine facies is rare and corresponds to the morphologic manifestation of diffuse dermal infiltration of the face. It can occur in cutaneous T-cell lymphomas that progress during years without therapy. We present the case of a 54-year-old man with Sezary syndrome presenting with leonine facies, unresponsive to conventional therapies; he exhibited a promising response to subcutaneous low-dose alemtuzumab. A 54-year-old male was observed in our department because of a four-year history of generalized pruritus and cutaneous lesions on the face. On physical examination he showed generalized erythroderma, lichenification, diffuse alopecia, madarosis, and diffuse infiltration of facial skin, particularly on the eyebrows and ears, giving the appearance of a leonine facies The full blood count revealed 18.59x10 9 /L leukocytes, 7.81 x10 9 /L neutrophils, 1.39 x10 9 /L lymphocytes, hemoglobin 15.2 g/dL, and platelets 395 x10 9 /L, with 45.5 percent of atypical lymphocytes. Biochemistry studies were relevant for high LDH (430 UI/L) and high β2-microglobulin (2341 ng/mL) levels. Thoracic, abdominal and pelvic CT scans were unremarkable and the bone marrow biopsy revealed invasion of atypical lymphocytic cells. Flow cytometry and molecular biology studies confirmed the presence of the phenotypically abnormal monoclonal CD4+ T cells in the peripheral blood and bone marrow. The diagnosis of Sezary syndrome (SS) (T4NxM0B2) was made. The patient started combined systemic chemotherapy with CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) accomplishing four cycles with no response. A regimen of low dose subcutaneous (sc) alemtuzumab was then introduced, beginning with 3 mg in the first day, followed by 10 mg three times a week for twelve weeks. There was a transient interruption of the treatment at the fourth week, with a duration of six weeks, for asymptomatic reactivation of cytomegalovirus. We observed a marked reduction o

COFFEE: A HEALTH FUEL-BLOT POPULAR DRINKING

Now, the days begin with cups of coffee worldwide. Caffeine is the main component of coffee, which is vastly consumed as a psychoactive agent, and in varieties of dietary supplements. Day by day coffee and caffeinated-consumption areas are expanding. Only a single cup of coffee contains thousands of biochemical. Otherwise, during roasting, some of which turn to convert other chemicals moieties. Thus, the coffee is an interesting item to the drug scientists. Upon this jackpot, a number of researches have been done on coffee and its chemical components; in which many postulations are still in contentious and some are unclear to the coffee users. Upon going through the stand-point, this study has been snapshot to sketch a complete overview on coffee and its components. Our finding depicts constituents of coffee to have antioxidant, anti-inflammatory, anti-Alzheimer's disease, anti-Parkinson's disease, and cardioprotective activities. But the anti-cancerous effect of coffee components is not clear yet. In conclusion, coffee, and its constituents are in important in phytopharmacological research.Keywords: Coffee, Coffee components, Health-effect

CANAL DISH (CD), THE NEW ANTIMICROBIAL TESTING APPARATUS

Objective: This writing aims to introduce new antimicrobial test apparatus called Canal Dish (CD), theoretically.Methods: We have designed two types of CD such as Circular CD (CCD) and Square CD (SCD). Internally, the CCD is a 80 mm diameter circular while the SCD is a 80×80 mm square CD plate. Both of them contain 2(40×2) mm parallel travelling canals from the each CD-centre having radius of 3 mm. Canals are 6 mm in depth.Results: The features of CCD and SCD indicate possible allowance of various size, low media consuming, the inclusion of multiple microorganisms and/or test samples/doses, ease of handling; therefore, understanding, rapidity, and economy.Conclusion: CD may replace currently used Petri dishes due to its cost-effectiveness, rapidity, ease of handling and a wider range of applicability.Keywords: Antimicrobial assay, Canal dish, Circular, Square, New apparatu

MACERATION-VORTEX-TECHNIQUE (MVT), A RAPID AND NEW EXTRACTION METHOD IN PHYTO-PHARMACOLOGICAL SCREENING

Extraction is a process of preparation of extracts from biological materials (plant/animal/microorganism) in the essence of drug discovery and development scienticism. This writing is aimed at proposing a new, rapid, economical and easy extraction method, Maceration-Vortex-Technique (MVT). For this 2-5 g of powdered materials is sucked into 5-10 ml of solvent recommended for extraction. A cleaned, small amber-colored glass bottle of 20-25 ml capacity is needed for this purpose. Powdered materials are mixed with the solvent, then followed by shaking vigorously; shaken for 1.5-2 h and vortexed for 5 min. The extract is collected by immediate filtration through filter paper (Whatmann no. 1) and allowed for concentration and/or solvent partitioning. The MVT allows a 3 h extraction of plant materials. A small amount of extraction material is needed along with a small quantity of solvent which is a marker for the economy of this extraction process. In conclusion, rapidity in the extraction process is the rapidity in the screening process of biological materials. The MVT may be one of the speediest and most economical extraction processes.Keywords: Extraction, Maceration-Vortex-Technique, New method, Phyto-pharmacological screenin

Possible oxidative effects of isotretinoin and modulatory effects of vitamins A and C in Saccharomyces cerevisiae

Isotretinoin (ITN), chemically known as 13-cis-retinoic acid, is a part of the broad group of compounds related to vitamin A. It is particularly employed in the treatment of nodular cystic acne and as an inhibitor of proliferation of neoplastic cells, by exerting a regulatory effect on the cell differentiation. This study aimed at investigating the possible oxidative effects of ITN and modulatory effects of vitamins A and C in mutant and non-mutant Saccharomyces cerevisiae strains. In addition, to reconfirm the oxidative effects, five in vitro antioxidant assays were also prepared taking the alpha-tocopherol analogue, trolox as a standard. In vivo study conducted on S. cerevisiae cells was carried out with ITN 20 μg/ml taking hydrogen peroxide (H2O2) as stressor (STR), whereas ITN 5 to 50 μg/ml was considered for in vitro assays taking similar dose of trolox (TRO). Results show ITN to have oxidative effect in both in vitro and in vivo tests. In conclusion, ITN produced oxidative effects and there may be an hypervitaminosis effect with vitamins A and C, thus insinuation to genetic material.Key words: Assay, isotretinoin, vitamin A, vitamin C, oxidative stress