Appropriate radiation dose for symptomatic relief and local control in patients with adult T cell leukemia/lymphoma

Adult T-cell leukemia/lymphoma (ATL) is an aggressive peripheral T-cell neoplasm that occurs only in patients with human T-cell leukemia virus type 1. No large study or randomized trial investigating radiotherapy (RT) for ATL has been performed. We retrospectively reviewed 55 courses of RT for 41 consecutive patients with ATL who underwent RT between 2000 and 2016 at our institutions. The results showed that RT for local ATL lesions can achieve symptomatic improvement in 92% of cases. Local remission, either complete remission (CR) or partial response (PR), was achieved in 100% of the patients (CR: 89%, PR: 11%) with ≥40 Gy irradiation. CR or PR was achieved in 71% (CR: 29%, PR: 43%) with 30–39 Gy and in 73% (CR: 6.7%, PR: 67%) with ≤29 Gy irradiation. The mean total radiation dose in the CR and PR groups differed significantly (38 vs 25 Gy, P = 0.0002). The maximum acute toxicity was Grade 0–2 in all patients, except for one patient experienced Grade 3 radiation dermatitis. In-field relapses occurred in 36% of patients, and the frequency of in-field relapses was 11%, 30% and 71% among those who achieved CR, PR and SD, respectively. All 9 patients who received total skin irradiation experienced cutaneous relapses, with a median of 63 days (range, 7–210 days). Almost all (39 of 41) patients with ATL experienced out-of-field progression after RT. In conclusion, RT was confirmed to be effective and safe for palliative treatment of local ATL lesions

Nutraceuticals and regulation of adipocyte life: premises or promises

Obesity is the actual worldwide health threat, that is associated with an increased number of metabolic disorders and diseases. Following the traditional hypothesis stating that in obesity hypertrophic adipocytes trigger the adipose tissue hyperplasia, strategies to treat obesity have increased fat researches of the molecular processes that achieve adipocyte enlargement and formation that finally increase body fat mass. Moreover, a new cell type was recently identified, the "brite" adipocyte that presents a unique gene expression profile of compared to both brown and white adipocytes. Therapies against obesity, targeting these cells and their pathways, would include the induction of lipolysis and apoptosis or the inhibition of differentiation and adipogenesis. However, it should be noted that both the increase of adipocyte size and number take place in association with positive energy balance. According to the adipose tissue expansion hypothesis, adipogenesis could be related with improved metabolic health of obese people, taking back the adipose mass to a traditionally site of lipid storage. Furthermore, new perspectives in fat biology suggest that the conversion of white-to-brown adipocytes and their metabolism could be exploited for the development of therapeutic approaches against obesity-associated diseases and for the regulation of energy balance. Drugs currently available to treat obesity generally have unpleasant side effects. A novel promising approach is the usage of dietary supplements and plant products that could interfere on the life cycle of adipocyte. Here, various dietary bioactive compounds that target different stages of adipocyte life cycle and molecular and metabolic pathways are reviewe