Outcomes for patients with severe chronic neutropenia treated with granulocyte colony-stimulating factor

Severe chronic neutropenia (SCN), defined as blood neutrophils \u3c0.5 × 109/L for \u3e3 months, is an uncommon hematological condition associated with recurrent and severe bacterial infections. After short-term clinical trials showed the benefits of granulocyte colony-stimulating factor (G-CSF) treatment for SCN, SCNIR (Severe Chronic Neutropenia International Registry) opened to determine the long-term benefits and safety of this treatment. This report summarizes findings from more than 16 000 patient-years of prospective observations for patients with congenital and acquired SCN. We observed that adverse outcomes depend on the underlying etiology. Myelodysplasia (MDS) and acute myeloid leukemia (AML) occur infrequently and largely in patients with congenital neutropenias. Having cyclic or chronic autoimmune/ idiopathic neutropenia portends a favorable prognosis. A few patients with idiopathic neutropenia evolve to develop lymphoid malignancies, but they do not appear to be at increased risk of myeloid malignancies, even with very long-term G-CSF therapy. Progression to systemic autoimmune diseases, bone marrow (BM) failure, aplastic anemia, or nonmyeloid malignancies are not expected consequences of SCN or treatment with G-CSF

Superoxide dismutase mutations of familial amyotrophic lateral sclerosis and the oxidative inactivation of calcineurin

AbstractApproximately 10% of all familial cases of amyotrophic lateral sclerosis (fALS) are linked to mutations in the SOD1 gene, which encodes the copper/zinc superoxide dismutase (CuZnSOD). Recently, wild-type CuZnSOD was shown to protect calcineurin, a calcium/calmodulin-regulated phosphoprotein phosphatase, from inactivation by reactive oxygen species. We asked whether the protective effect of CuZnSOD on calcineurin is affected by mutations associated with fALS. For this, we monitored calcineurin activity in the presence of mutant and wild-type SOD. We found that the degree of protection against inactivation of calcineurin by different SOD mutants correlates with the severity of the phenotype associated with the different mutations, suggesting a potential role for calcineurin–SOD1 interaction in the etiology of fALS

Long-Term Effects of G-CSF Therapy in Cyclic Neutropenia

Cyclic neutropenia is a rare hematologic disease that is characterized by regular oscillations in blood neutrophil counts from normal levels (absolute neutrophil count [ANC], \u3e1.5×109 per liter) to severe neutropenia (ANC, \u3c0.2×109 per liter), usually with a cycle length of about 21 days.When patients with this disorder have neutropenia, they often have fever and mouth ulcers and are at risk for severe infections. Cyclic neutropenia is usually an autosomal dominant disorder caused by mutations in the gene encoding neutrophil elastase (ELANE)

Playing God? Synthetic biology as a theological and ethical challenge

In the ethical debate over synthetic biology the formula “playing god” is widely used in order to attack this new branch of biotechnology. The article analyses, contextualizes and criticises this usage with respect to the theological concepts of creation, sin and humans as created in the image of God. Against the background of these theological understandings an ethical corridor of how to responsibly cope with the societal challenges of synthetic biology is presented

Exploring Halo Substructure with Giant Stars. VI. Extended Distributions of Giant Stars Around the Carina Dwarf Spheroidal Galaxy -- How Reliable Are They?

The question of the existence of active tidal disruption around various dSph galaxies remains controversial. That debate often centers on the nature (bound vs. unbound) of extended populations of stars. However, the more fundamental issue of the very existence of the extended populations is still contentious. We present an evaluation of the debate centering on one particular dSph, Carina, for which claims both for and against the existence of stars beyond the King radius have been made. Our review includes an examination of all previous studies bearing on the Carina radial profile and shows that the survey method which achieves the highest detected dSph signal-to-background in the outer parts of the galaxy is the Washington M, T2 + DDO51 (MTD) filter approach from Paper II in this series. We then address statistical methods used to evaluate the reliability of MTD surveys in the presence of photometric errors and for which a new, a posteriori statistical analysis methodology is provided. Finally, these statistical methods are tested by new spectroscopy of stars in the MTD-selected Carina candidate sample. Of 74 candidate giants with follow-up spectroscopy, the MTD technique identified 61 new Carina members, including 8 stars outside the King radius. From a sample of 29 stars not initially identified as candidate Carina giants but that lie just outside of our selection criteria, 12 have radial velocities consistent with membership, including 5 extratidal stars. Carina is shown to have an extended population of giant stars extending to a major axis radius of 40' (1.44x the nominal King radius).Comment: 56 pages, 10 figures. Submitted to the Astronomical Journal, 2004 Sep 2

Stable long-term risk of leukaemia in patients with severe congenital neutropenia maintained on G-CSF therapy

In severe congenital neutropenia (SCN), long-term therapy with granulocyte colony-stimulating factor (G-CSF) has reduced mortality from sepsis, revealing an underlying predisposition to myelodysplastic syndrome and acute myeloid leukaemia (MDS/AML). We have reported the early pattern of evolution to MDS/AML, but the long-term risk remains uncertain. We updated a prospective study of 374 SCN patients on long-term G-CSF enrolled in the Severe Chronic Neutropenia International Registry. Long-term, the annual risk of MDS/AML attained a plateau (2·3%/year after 10 years). This risk now appears similar to, rather than higher than, the risk of AML in Fanconi anaemia and dyskeratosis congenita.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/79264/1/j.1365-2141.2010.08216.x.pd

Germany must invest more in its future

Shortly before the parliamentary election in 2013, Germany is riding on a wave of euphoria: hardly any other euro country has weathered the financial and debt crisis so well. Since 2009, GDP has grown by over eight percent and 1.2 million new jobs have been created. Public finances were consolidated and, in 2012, there was a fiscal surplus of 0.2 percent of GDP. An impressive financial position indeed for a country that, only ten years ago, was considered the sick man of Europe. But it is also a deceptive one. If one substitutes these for other comparative figures, then this image is seriously tarnished. Since 1999, Germany has achieved lower economic growth than the rest of the euro area. Real wages have barely increased since 1999 and real consumer spending has grown much more in the euro area on average than in Germany. In addition, German net public assets have contracted significantly. In 1999, net state assets were about 20 percent of GDP and, by 2011, they had declined to 0.5 percent of GDP and are, therefore, no longer available for future generations. In many areas, Germany has not really progressed at all and in some areas it has fallen significantly behind other countries. These arrears have not been balanced out by recent positive developments

Neutrophil elastase mutations and risk of leukaemia in severe congenital neutropenia

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73793/1/j.1365-2141.2007.06897.x.pd