Successful Treatment of Pure Red Cell Aplasia with Rituximab in Patients after ABO-Compatible Allogeneic Hematopoietic Stem Cell Transplantation

Pure red cell aplasia (PRCA) following allogeneic hematopoietic stem cell transplantation (HSCT) has been mostly reported in situations involving major ABO incompatibility between donor and recipient. Conventional treatments such as plasma exchange, erythropoietin, and steroid are often unsatisfactory. Rituximab has been reported to be highly effective for PRCA following major ABO-incompatible allogeneic HSCT. A 49-year-old woman with PRCA following ABO-matched allogeneic HSCT for acute lymphoblastic leukemia, refractory to erythropoietin treatment, received 4 doses of rituximab 375 mg/m2 weekly. After the 3rd dose of rituximab, she exhibited a striking rise in her reticulocyte count with an increase in her hemoglobin level. To our knowledge, this is the first case of PRCA following major ABO-compatible allogeneic HSCT resolving completely after rituximab treatment

Ectopic overexpression of the aluminum-induced protein gene from Panax ginseng enhances heavy metal tolerance in transgenic Arabidopsis

Aluminum (Al), one of the most abundant metals in agricultural soils, significantly limits crop growth and productivity in acidic soil by inhibiting root elongation. Al ions, especially Al3+, have a toxic effect on both plant and animal cells under low-pH conditions. We first isolated and characterized aluminum-induced protein (AIP) cDNA from a 4-year-old root of Panax ginseng Meyer. This cDNA encodes an open reading frame of 711 bp with a deduced amino acid sequence of 236 residues. The calculated molecular mass of the mature protein is approximately 58.9 kDa with a predicated isoelectric point of 5.13. The Panax ginsengAIP (PgAIP) contains a domain also present in wheat aluminum-induced protein 7 (Wali7) and shares homology with the AIPs of other species, including Codonopis and Arabidopsis. The PgAIP gene was abundantly expressed in the plant’s leaves and was up-regulated by Al exposure. The functional role of PgAIP in Al tolerance was further validated through its overexpression in Arabidopsis. Transgenic Arabidopsis plants overexpressing the PgAIP gene showed enhanced Al tolerance in terms of root growth when compared to wild-type plants, suggesting PgAIP is important in plant defense against Al toxicity. Confocal analysis of CFP-tagging PgAIP in Arabidopsis showed subcellular localization in the plasma membrane. Our results suggest that PgAIP in the plasma membrane plays an important role in the protection of plant cells against heavy metal exposure

Functional characterization of the pathogenesis-related protein family 10 gene, PgPR10-4, from Panax ginseng in response to environmental stresses

Pathogenesis-related proteins (PRs) are known to function in higher plants as a protein-based defensive system against abiotic and biotic stress, particularly pathogen infections. A full-length cDNA sequence of PR BetV1 was isolated and characterized from a 14-year-old ginseng expressed sequence tags library and we named this as PgPR10-4, because of similar identities with previous isolated PgPR10s sequences. The PgPR10-4 gene encodes a 477 bp open reading frame and its deduced protein contains 158 amino acids with a 53 % identity with that of the Actinidia chinensis BetV1 allergen. The expression of PgPR10-4 gene was abundant in leaves and its transcripts showed differentially up-regulated patterns against several ginseng pathogens and abiotic stimuli such as high light and salinity. In addition, PgPR10-4 expression was strongly responsive towards the stress signaling molecules H2O2 and jasmonic acid (JA), while weekly responsive to salicylic acid and abscisic acid. A functional role of PgPR10-4 in environmental stress tolerance was further validated through its overexpression in Arabidopsis. An analysis of T2 transgenic Arabidopsis plants overexpressing the PgPR10-4 gene showed an enhanced tolerance to bacterial and fungal infection, but not to salt stress. When we tagged with cyan fluorescent protein fusion protein, the PgPR10-4-was found to localize to the cytoplasm. The enhanced antifungal activity observed from the Arabidopsis transgenic lines suggests the possible involvement of PgPR10-4 in a defense-related mechanism via the JA signaling pathway

A Case of Disseminated and Fulminant Plasmacytomas That Developed during Bortezomib Treatment

Multiple myeloma is an incurable and slow growing plasma cell neoplasm. The introduction of new drugs has increased the number of treatment options. Bortezomib, the first-in-class proteasome inhibitor, has been shown to have a significant antitumor activity in the treatment of relapse/refractory patients with multiple myeloma. Additionally, plasmacytomas have shown significant response to bortezomib. In this case report, we describe a patient who developed disseminated and fulminant extramedullary plasmacytomas during combination chemotherapy treatment with bortezomib within a short period, after having shown clinical improvement

Clinical Outcomes and Prognostic Factors of Up-Front Autologous Stem Cell Transplantation in Patients with Extranodal Natural Killer/T Cell Lymphoma

AbstractLimited data exist on up-front autologous stem cell transplantation (ASCT) in extranodal natural killer/T cell lymphoma (ENKTL). Sixty-two patients (43 men and 19 women) with newly diagnosed ENKTL who underwent up-front ASCT after primary therapy were identified. Poor-risk characteristics included advanced stage (50%), high-intermediate to high-risk International Prognostic Index (25.8%), and group 3 to 4 of NK/T Cell Lymphoma Prognostic Index (NKPI, 67.7%). Pretransplant responses included complete remission in 61.3% and partial remission in 38.7% of patients, and final post-transplantation response included complete remission in 78.3%. Early progression occurred in 12.9%. At a median follow-up of 43.3 months (range, 3.7 to 114.6), 3-year progression-free survival (PFS) was 52.4% and 3-year overall survival (OS) was 60.0%. Patients with limited disease had significantly better 3-year PFS (64.5% versus 40.1%, P = .017) and OS (67.6% versus 52.3%, P = .048) than those with advanced disease. Multivariate analysis showed NKPI and pretransplant response were independent prognostic factors influencing survival, particularly NKPI in limited disease and pretransplant response in advanced disease. Radiotherapy was an independent factor for reduced progression and survival in patients with limited disease, but anthracycline-based chemotherapy was a poor prognostic factor for progression in patients with advanced disease. Up-front ASCT is an active treatment in ENKTL patients responding to primary therapy

Prognostic Factors and Clinical Outcomes of High-Dose Chemotherapy followed by Autologous Stem Cell Transplantation in Patients with Peripheral T Cell Lymphoma, Unspecified: Complete Remission at Transplantation and the Prognostic Index of Peripheral T Cell Lymphoma Are the Major Factors Predictive of Outcome

AbstractHigh-dose chemotherapy followed by autologous stem cell transplantation (HDT/ASCT) offers a rescue option for T cell lymphoma patients with poor prognosis. However, the effectiveness of HDT/ASCT in patients with various peripheral T cell subtypes, optimal transplant timing, and the prognostic factors that predict better outcomes, have not been identified. We retrospectively investigated the clinical outcomes and prognostic factors for HDT/ASCT in 64 Korean patients with peripheral T cell lymphoma, unspecified (PTCL-U) between March 1995 and February 2007. The median age at transplantation was 44 years (range: 15-63 years). According to the age-adjusted International Prognostic Index (a-IPI) and the prognostic index of PTCL (PIT), 8 patients (12.5%) were in the high-risk group and 16 (26.6%) had the 2-3 PIT factors, respectively. After a median follow-up of 29.7 months, the 3-year overall survival (OS) and progression-free survival (PFS) rates were 53.0% ± 7.5% and 44.3% ± 7.0%, respectively. Univariate analysis showed that poor performance status, high lactate dehydrogenase (LDH) levels, high a-IPI score, high PIT classes, failure to achieve complete response (CR) at transplantation, and nonfrontline transplantation were associated with poor OS. Multivariate analysis showed that failure to achieve CR at transplantation (hazard ratio [HR] 2.23; 95% confidence interval [CI] 1.78-7.93) and 2-3 PIT factors (HR 3.76; 95% CI 1.02-5.42) were independent prognostic factors for OS. Failure to achieve CR at transplantation and high PIT are negative predictable factors for survival following HDT/ASCT in patients with PTCL-U

Bi-weekly Chemotherapy of Paclitaxel and Cisplatin in Patients with Metastatic or Recurrent Esophageal Cancer

Although various combinations of chemotherapy regimens have been tried for patients with esophageal cancer, their duration of survival is extremely poor. In this study, we investigated the safety and clinical efficacy of paclitaxel and cisplatin chemotherapy in metastatic or recurrent esophageal cancer. 32 patients enrolled in this study and the median age was 60 yr. Of all the 32, 28 patients (88%) had been treated previously, 22 of them with chemotherapy or radiation therapy. All patients in the study received biweekly paclitaxel (90 mg/m2) followed by cisplatin (50 mg/m2). One patient (3%) responded completely, and 12 patients (38%) showed a partial response; in 9 patients (28%) the disease remained stable, and in 10 patients (31%) it progressed. The objective response rate was 41%. The median duration of response was 4.8 months, and the median overall survival in all patients was 7 months. The 1-yr and 2-yr survival rates were 28.1% and 7.1%, respectively. Grade 3 or 4 of neutropenia and anemia were observed in 6 (19%) and 5 (16%) patients, respectively. The major non-hematologic toxicity was fatigue, but most of them could manageable. In conclusion, biweekly paclitaxel and cisplatin is effective in patients with metastatic or recurrent esophageal cancer