Salvage treatment for refractory or relapsed acute myeloid leukemia: a 10-year single-center experience

OBJECTIVES: The outcomes of refractory and relapsed acute myeloid leukemia (AML) patients in developing countries are underreported, even though the similar classic regimens are widely used. METHODS: We conducted a retrospective comparison of ‘‘MEC’’ (mitoxantrone, etoposide, and cytarabine) and ‘‘FLAG-IDA’’ (fludarabine, cytarabine, idarubicin, and filgrastim) in adults with first relapse or refractory AML. RESULTS: In total, 60 patients were included, of which 28 patients received MEC and 32 received FLAG-IDA. A complete response (CR) rate of 48.3% was observed. Of the included patients, 16 (27%) died before undergoing bone marrow assessment. No statiscally significant difference in CR rate was found between the two protocols (p=0.447). The median survival in the total cohort was 4 months, with a 3-year overall survival (OS) rate of 9.7%. In a multivariable model including age, fms-like tyrosine kinase 3 (FLT3) status, and stem-cell transplantation (SCT), only the last two indicators remained significant: FLT3-ITD mutation (hazard ratio [HR] =4.6, po0.001) and SCT (HR=0.43, p=0.01). CONCLUSION: In our analysis, there were no significant differences between the chosen regimens. High rates of early toxicity were found, emphasizing the role of supportive care and judicious selection of patients who are eligible for intensive salvage therapy in this setting. The FLT3-ITD mutation and SCT remained significant factors for survival in our study, in line with the results of previous studies

Descrição morfológica dos ovários do peixe Melanotaenia boesemani em atividade reprodutiva

Resumo: Estudou-se o tecido germinativo ovariano do peixe Melanotaenia boesemani. Por meio de análises morfológicas das gônadas, realizadas após a confecção de lâminas histológicas elaboradas em parafina e coradas com hematoxilina-eosina, foram descritos os tipos celulares encontrados e realizada a classificação do estádio de maturidade dos peixes. Macroscopicamente, foi identificado que a referida espécie possui ovário único, arredondado e, na fase observada, amarelado, localizado na parte látero-anterior da cavidade celomática. As fêmeas analisadas foram classificadas na escala de desenvolvimento gonadal como maduro/em reprodução. A presença de folículos vazios e marcas de desova nas lamelas ovulígeras mostrou-se evidente. Nos ovócitos vitelogênicos deste peixe, foi constatada a presença de filamentos de adesão ovocitária ancorados à zona pelúcida. Os ovários apresentaram aspecto morfológico geral semelhante ao de outros peixes teleósteos. Seu tipo de desova foi classificado como intermitente e o padrão de desenvolvimento de ovócitos, como assincrônico

Identification of genetic elements in metabolism by high-throughput mouse phenotyping

Metabolic diseases are a worldwide problem but the underlying genetic factors and their relevance to metabolic disease remain incompletely understood. Genome-wide research is needed to characterize so-far unannotated mammalian metabolic genes. Here, we generate and analyze metabolic phenotypic data of 2016 knockout mouse strains under the aegis of the International Mouse Phenotyping Consortium (IMPC) and find 974 gene knockouts with strong metabolic phenotypes. 429 of those had no previous link to metabolism and 51 genes remain functionally completely unannotated. We compared human orthologues of these uncharacterized genes in five GWAS consortia and indeed 23 candidate genes are associated with metabolic disease. We further identify common regulatory elements in promoters of candidate genes. As each regulatory element is composed of several transcription factor binding sites, our data reveal an extensive metabolic phenotype-associated network of co-regulated genes. Our systematic mouse phenotype analysis thus paves the way for full functional annotation of the genome