Is FLT3 internal tandem duplication an unfavorable risk factor for high risk children with acute myeloid leukemia? : Polish experience

According to the AML-BFM 2004 Interim, a treatment protocol used in Poland since 2005, presence of FLT3 internal tandem duplication (FLT3/ITD) qualifies a patient with acute myeloid leukemia (AML) to a high-risk group (HRG). The present study was aimed to identify the prevalence of FLT3/ITD in children with AML in Poland and to evaluate its prognostic significance in the HRG patients. Out of 291 children with de novo AML treated in 14 Polish centers between January 2006 and December 2012, samples from 174 patients were available for FLT3/ITD analysis. Among study patients 108 children (61.7%) were qualified to HRG. Genomic DNA samples from bone marrow were tested for identification of FLT3/ITD mutation by PCR amplification of exon 14 and 15 of FLT3 gene. Clinical features and treatment outcome in patients with and without FLT3/ITD were analyzed in the study. The FLT3/ITD was found in 14 (12.9%) of 108 HRG children. There were no significant differences between children with and without FLT3/ITD in age and FAB distribution. The white blood cells count in peripheral blood at diagnosis was significantly higher (p <0.01) in the children with FLT3/ITD. Over 5-year overall survival rate for FLT3/ITD positive children was worse (42.4%) comparing to FLT3/ITD negative children (58.9%), but the statistical difference was not significant. However, over 5-year survivals free from treatment failures were similar. The FLT3/ITD rate (12.9%) observed in the study corresponded to the published data. There was no significant impact of FLT3/ITD mutation on survival rates, although further studies are needed on this subject

Glomerular filtration rate and prevalence of chronic kidney disease in Wilms’ tumour survivors

Glomerular filtration rate (GFR) was evaluated in 32 Wilms’ tumour survivors (WTs) in a cross-sectional study using 99 Tc-diethylene triamine pentaacetic acid (99 Tc-DTPA) clearance, the Schwartz formula, the new Schwartz equation for chronic kidney disease (CKD), cystatin C serum concentration and the Filler formula. Kidney damage was established by beta-2-microglobulin (B-2-M) and albumin urine excretion, urine sediment and ultrasound examination. Blood pressure was measured. No differences were found between the mean GFR in 99 Tc-DTPA and the new Schwartz equation for CKD (91.8 ± 11.3 vs. 94.3 ± 10.2 ml/min/1.73 m2 [p = 0.55] respectively). No differences were observed between estimated glomerular filtration rate (eGFR) using the Schwartz formula and the Filler formula either (122.3 ± 19.9 vs. 129.8 ± 23.9 ml/min/1.73 m2 [p = 0.28] respectively). Increased urine albumin and B-2-M excretion, which are signs of kidney damage, were found in 7 (22%) and 3 (9.4%) WTs respectively. Ultrasound signs of kidney damage were found in 14 patients (43%). Five patients (15.6%) had more than one sign of kidney damage. Eighteen individuals (56.25%) had CKD stage I (10 with signs of kidney damage; 8 without). Fourteen individuals (43.75%) had CKD stage II (6 with signs of kidney damage; 8 without). The new Schwartz equation for CKD better estimated GFR in comparison to the Schwartz formula and the Filler formula. Furthermore, the WT survivors had signs of kidney damage despite the fact that GFR was not decreased below 90 ml/min/1.73 m2 with 99 Tc- DTPA

Paired opposing leukocyte receptors recognizing rapidly evolving ligands are subject to homogenization of their ligand binding domains

Some leukocyte receptors come in groups of two or more where the partners share ligand(s) but transmit opposite signals. Some of the ligands, such as MHC class I, are fast evolving, raising the problem of how paired opposing receptors manage to change in step with respect to ligand binding properties and at the same time conserve opposite signaling functions. An example is the KLRC (NKG2) family, where opposing variants have been conserved in both rodents and primates. Phylogenetic analyses of the KLRC receptors within and between the two orders show that the opposing partners have been subject to post-speciation gene homogenization restricted mainly to the parts of the genes that encode the ligand binding domains. Concerted evolution similarly restricted is demonstrated also for the KLRI, KLRB (NKR-P1), KLRA (Ly49), and PIR receptor families. We propose the term merohomogenization for this phenomenon and discuss its significance for the evolution of immune receptors

Urban public transport and regional railways in the service of small cities on the example of Lebork

W artykule przedstawiono problematykę funkcjonowania miejskiego transportu zbiorowego oraz kolei regionalnej w obsłudze małych miast. Tematykę tę omówiono na przykładzie Lęborka, który ze względu na swoją lokalizację w środkowej części województwa pomorskiego jest silnie powiązany z najważniejszymi ośrodkami miejskimi na jego obszarze: Trójmiastem oraz w mniejszym stopniu ze Słupskiem. Funkcjonowanie transportu zbiorowego w małych miastach zazwyczaj opiera się na transporcie autobusowym z wykorzystaniem pojazdów ściśle dostosowanych do występującego popytu. Relatywnie niewielkie rozmiary rynku powodują, że w mniejszych ośrodkach miejskich operator transportu zbiorowego pełni jednocześnie funkcję jego organizatora. System transportu zbiorowego w Lęborku składa się z 3 głównych linii podstawowych, obejmujących swoim zasięgiem najważniejsze relacje wewnątrzmiejskie oraz podmiejskie. Dodatkowo funkcjonują 3 linie o charakterze uzupełniającym oraz 2, które ze względu na swoją specyfikę, obsługują potrzeby określonych grup pasażerów. Cechą niemal wszystkich linii jest bardzo szeroki zakres wariantowania przebiegu tras. Cztery z ośmiu linii, poza Lęborkiem, obejmują swoim zasięgiem także obszar sąsiedniej gminy Nowa Wieś Lęborska, co powoduje relatywnie duży udział podróży podmiejskich w ogóle podróży realizowanych miejskim transportem zbiorowym. Ważną rolę w obsłudze Lęborka odgrywa kolej regionalna, funkcjonująca również częściowo w układzie aglomeracyjnym. Zapewnia ona wysoką dostępność do głównych ośrodków miejskich województwa, w tym przede wszystkim Trójmiasta i zlokalizowanych na jego obszarze miejsc pracy i nauki.The article presents the problems of the functioning of urban public transport and regional railways in the service of small towns. This topic is discussed on the example of Lębork, which due to its location in the central part of the pomeranian voivodeship is strongly connected with its most important urban centers: the Tri-City and, to a lesser extent, Słupsk. The functioning of public transport in small towns is usually based on bus transport and use of vehicles strictly adapted to the demand. The relatively small size of the market causes that in small towns the operator of mass transport is also its organizer. The mass transport system in Lębork consists of three main baselines covering the most important intra-city and suburban relations. In addition, there are three complementary lines and two that, due to their specificity, serves the needs of certain groups of passengers. The feature of almost all lines is also a very wide range of route variations. Four of the eight lines also cover the area of the neighboring Nowa Wieś Lęborska com- mune, which results in a relatively large share of suburban journeys in general of journeys made by urban public transport. An important role in the operation of Lębork is played by the regional railway, also functioning partly in the agglomeration system. It ensures high accessibility to the main urban centers of the voivodship, including particularly the Tri-City and its places of work and study