Immune Reactions following Cord Blood Transplantations in Adults

Cord blood transplantation (CBT) is an attractive alternative therapy in adult patients with advanced hematological malignancies in whom matched donors are unavailable. However, the risk of complications, especially infections, post-CBT increases the mortality rates in these patients. Although the incidence of acute and chronic graft versus host disease (GVHD) post-CBT is lower than that following bone marrow transplantation and peripheral blood stem cell transplantation (SCT), the additional immunosuppressive therapy required to treat it could increase the mortality in these patients. Further, chronic GVHD following CBT is milder and responds better to treatment than that occurring after bone marrow transplants. Unlike bone marrow transplantation, the onset of GVHD is a positive prognostic indicator of overall survival in patients receiving CBT, due to the graft versus malignancy (GVM) effect. This paper focuses on the immune reactions following CBT and aims to elucidate a management strategy for acute and chronic GVHD

Gene–Environment Interactions in Preventive Medicine: Current Status and Expectations for the Future

The progression of many common disorders involves a complex interplay of multiple factors, including numerous different genes and environmental factors. Gene–environmental cohort studies focus on the identification of risk factors that cannot be discovered by conventional epidemiological methodologies. Such epidemiological methodologies preclude precise predictions, because the exact risk factors can be revealed only after detailed analyses of the interactions among multiple factors, that is, between genes and environmental factors. To date, these cohort studies have reported some promising results. However, the findings do not yet have sufficient clinical significance for the development of precise, personalized preventive medicine. Especially, some promising preliminary studies have been conducted in terms of the prevention of obesity. Large-scale validation studies of those preliminary studies, using a prospective cohort design and long follow-ups, will produce useful and practical evidence for the development of preventive medicine in the future

Prediction of Female Breast Cancer Incidence among the Aging Society in Kanagawa, Japan

<div><p>Owing to the increasing number of elderly “baby boomers” in Japan, the number of cancer patients is also expected to increase. Approximately 2 million baby boomers from nearby local areas are residing in metropolitan areas; hence, the geographical distribution of cancer patients will probably markedly change. We assessed the expected number of breast cancer (BC) patients in different regions (urban, outer city, town, rural) using estimates of the nation’s population and Kanagawa Cancer Registry data. To estimate future BC incidence for each region, we multiplied the 2010 rate by the predicted female population for each region according to age group. The incidence cases of BC in those aged ≥65 years is expected to increase in all areas; in particular, compared to rates in 2010, the BC incidence in urban areas was predicted to increase by 82.6% in 2035 and 102.2% in 2040. Although the incidence in all BC cases in urban areas showed an increasing trend, until peaking in 2040 (increasing 31.2% from 2010), the number of BC patients would continue to decrease in other areas. The number of BC patients per capita BC specialist was 64.3 patients in 2010; this value would increase from 59.3 in 2010 to 77.7 in 2040 in urban areas, but would decrease in other areas. Our findings suggest that the number of elderly BC patients is expected to increase rapidly in urban areas and that the demand for BC treatment would increase in the elderly population in urban areas.</p></div

Nutritional Approach to Cancer Cachexia: A Proposal for Dietitians

Cachexia is one of the most common, related factors of malnutrition in cancer patients. Cancer cachexia is a multifactorial syndrome characterized by persistent loss of skeletal muscle mass and fat mass, resulting in irreversible and progressive functional impairment. The skeletal muscle loss cannot be reversed by conventional nutritional support, and a combination of anti-inflammatory agents and other nutrients is recommended. In this review, we reviewed the effects of nutrients that are expected to combat muscle loss caused by cancer cachexia (eicosapentaenoic acid, &beta;-hydroxy-&beta;-methylbutyrate, creatine, and carnitine) to propose nutritional approaches that can be taken at present. Current evidence is based on the intake of nutrients as supplements; however, the long-term and continuous intake of nutrients as food has the potential to be useful for the body. Therefore, in addition to conventional nutritional support, we believe that it is important for the dietitian to work with the clinical team to first fully assess the patient&rsquo;s condition and then to safely incorporate nutrients that are expected to have specific functions for cancer cachexia from foods and supplements

Trends and Projections of the Breast Cancer Incidence Cases (/year) using Nordpred in Kanagawa (All Age Groups).

<p>Incidence cases projections for all age groups using the projection from the Nordpred package.</p

Geographical Features of Secondary Medical Regions.

<p>Geographical Features of Secondary Medical Regions.</p