Clinical practice guidelines for the prevention and treatment of EGFR inhibitor-associated dermatologic toxicities

Background Epidermal growth factor receptor inhibitors (EGFRI) produce various dermatologic side effects in the majority of patients, and guidelines are crucial for the prevention and treatment of these untoward events. The purpose of this panel was to develop evidence-based recommendations for EGFRI-associated dermatologic toxicities. Methods A multinational, interdisciplinary panel of experts in supportive care in cancer reviewed pertinent studies using established criteria in order to develop first-generation recommendations for EGFRI-associated dermatologic toxicities. Results Prophylactic and reactive recommendations for papulopustular (acneiform) rash, hair changes, radiation dermatitis, pruritus, mucositis, xerosis/fissures, and paronychia are presented, as well as general dermatologic recommendations when possible. Conclusion Prevention and management of EGFRI-related dermatologic toxicities is critical to maintain patients’ health-related quality of life and dose intensity of antineoplastic regimens. More rigorous investigation of these toxicities is warranted to improve preventive and treatment strategies

Dynamic changes of regulatory T cell and dendritic cell subsets in stable kidney transplant patients a prospective analysis

Introduction. We aimed to identify immune status of the stable kidney allografts from the point of some cellular changes that may occur after transplantation. Materials and Methods. This study considered 57 patients with no rejection during the 6 months after transplantation. Flow cytometric frequencies of circulatory CD4+CD25+FoxP3+ and CD8+CD28- regulatory T cells (Treg) as well as myeloid dendritic cells type 1 (MDC1) and type 2 (MDC2) and plasmacytoid dendritic cells (PDC) were measured before transplantation and 2 weeks and 1, 3, and 6 months after transplantation. Using adjusted model of repeated measure analysis, we assessed the influence of different parameters on different cell subsets. Results. The mean number of Tregs and PDCs decreased 2 weeks after transplantation and then increased as they reached their values before transplantation within a few months after transplantation. The mean MDC1s increased during 2 weeks and then decreased to its before-transplantation values within 6 months. The frequency of Tregs (r = 0.90) and MDC1s (r = 0.75) at month 3 could strongly predict their frequencies at month 6. Different variables including family relationship between donor and recipient, glomerular filtration rate, and human leukocyte antigen antibody mismatch did not change the frequency of different cell subsets during the time. Conclusions. The dynamism and circulatory changes in the frequency of Tregs and PDCs are opposite to MDCs after kidney transplantation. We describe these changes in a group of patients with stable graft; however, our study does not render any idea in patients with unstable or rejecting grafts

The frequency of HHV-8 Infection in otherwise healthy blood donors as well as renal allograft recipients living in Iran

Background: Different reports from Middle East countries demonstrated Kaposi's sarcoma (KS) in transplant population. This vascular malignancy occurs mostly among immunocompromised individuals. Human herpesvirus 8 (HHV-8) appears to be the causative factor for the development of this neoplasm. Transplant programs are concerned about the frequencies of HHV-8 infection either in general population or transplant patients. Methods: The current study was conducted in two phases. Firstly, we detected antibodies against HHV-8 in 790 otherwise healthy blood donors. Secondly, a total of 125 kidney allograft recipients evaluated as being seropositive for HHV-8. We utilized enzyme immunoassay (EIA) for serologic studies. Results: Among blood donors, the male to female ratio was 1.05 (405 vs. 385) while the mean age was 38.9 ± 11.7 years. The serostatus of none of these blood donors were positive for HHV-8. Among kidney recipients, the male to female ratio was 1.9 (82 vs. 43). The mean age was 39.01 ± 14.77 years. Two (1.6) patients were seropositive for HHV-8. Conclusion: The prevalence of HHV-8 infection among Iranians is likely to be low. Yet, owing to the evidence of this infection among kidney allograft recipients and its probable role in developing post- transplantation KS (PT-KS), further studies appear to be required to keep the various aspects of this infection under close surveillance