Rituximab as immunotherapy following autologous stem cell transplantation (ASCT) in a 17-year-old boy with diffuse large B cell lymphoma – a case report

SummaryRituximab is a human-mouse chimeric monoclonal antibody with specifity for the CD20 antigen expressed on B-lineage cells.We are reporting a 17-year old boy diagnosed with diffuse large B cell lymphoma, CD20(+). He was treated by standard chemotherapy and megachemotherapy with ASCT. The boy relapsed in the mediastinum and lungs one year after the treatment was completed. He underwent secondary treatment: surgical procedure, chemotherapy and immunotherapy with rituximab, second ASCT and again immunotherapy in the post-transplantation period. No severe complications during the treatment with rituximab were observed except for leukopenia and central venous catheter infection.The CT scans performed one year after the therapy was completed showed regression of changes previously observed

67. Radical radiotherapy of muscle-invading bladder cancer (BC): a retrospective analysis of 49 patients

Growing interest in the use of combined modality approaches for bladder-sparing procedures force radiation oncologists to optimise methods of radical radiotherapy. Since treatment policies have changed considerably over the last years, in this retrospective study we analysed feasibility of radical radiotherapy and outcomes of patients treated in our institution between 1992 and 2000. Study group comprised 49 consecutive BC patients aged 43 to 80 years (median 71), including three cases with clinically involved pelvic lymph nodes. There were 45 urothelial, and four other types of cancer (grade 1- four, 2 – 21, 3-nine, and unknown -14 cases). Six patients were referred for radiotherapy after nonradical operation. Treatment was delivered with the use of 60Co or LA five days a week, without planned interruptions. Thirty-two patients received elective irradiation of the pelvic lymph nodes to the dose 40 to 48 Gy, followed by the boost to the bladder to the total dose 60 to 66 Gy. Seventeen patients received total dose of 58 to 62 Gy to the bladder and perivesical tissue. Fraction doses ranged from 1.8 to 2.0 Gy. Treatment was prematurely stopped due to disease progression (PD), patient refusal, uraemia, in one case each, and intractable diarrhoea in six cases. After a median follow-up of 14 months (range 1 – 102) 23 patients died of PD. Median survival in the entire group is 159 months. Results of this study confirm relative efficacy of radiotherapy in BC. Further refinement of radiotherapy techniques is warranted to improve the outcome

Plausible role of estrogens in pathogenesis, progression and therapy of lung cancer

Malignant neoplasms are among the most common diseases and are responsible for the majority of deaths in the developed world. In contrast to men, available data show a clear upward trend in the incidence of lung cancer in women, making it almost as prevalent as breast cancer. Women might be more susceptible to the carcinogenic effect of tobacco smoke than men. Furthermore, available data indicate a much more frequent mutation of the tumor suppressor genep53 in non-small cell lung cancer (NSCLC) female patients compared to males. Another important factor, however, might lie in the female sex hormones, whose mitogenic or carcinogenic effect is well known. Epidemiologic data show a correlation between hormone replacement therapy (HRT) or oral contraceptives (OCs), and increased mortality rates due to the increased incidence of malignant tumors, including lung cancer. Interestingly, two types of estrogen receptors have been detected in lung cancer cells: ERα and ERβ. The presence of ERα has been detected in tissues and non-small-cell lung carcinoma (NSCLC) cell lines. In contrast, overexpression of ERβ is a prognostic marker in NSCLC. Herein, we summarize the current knowledge on the role of estrogens in the etiopathogenesis of lung cancer, as well as biological, hormonal and genetic sex-related differences in this neoplasm

Monkeypox Transmission and Pathogenesis in Prairie Dogs

During May and June 2003, the first cluster of human monkeypox cases in the United States was reported. Most patients with this febrile vesicular rash illness presumably acquired the infection from prairie dogs. Monkeypox virus was demonstrated by using polymerase chain reaction in two prairie dogs in which pathologic studies showed necrotizing bronchopneumonia, conjunctivitis, and tongue ulceration. Immunohistochemical assays for orthopoxviruses demonstrated abundant viral antigens in surface epithelial cells of lesions in conjunctiva and tongue, with less amounts in adjacent macrophages, fibroblasts, and connective tissues. Viral antigens in the lung were abundant in bronchial epithelial cells, macrophages, and fibroblasts. Virus isolation and electron microscopy demonstrated active viral replication in lungs and tongue. These findings indicate that both respiratory and direct mucocutaneous exposures are potentially important routes of transmission of monkeypox virus between rodents and to humans. Prairie dogs offer insights into transmission, pathogenesis, and new vaccine and treatment trials because they are susceptible to severe monkeypox infection

Quantitative RT-PCR profiling of the Rabbit Immune Response: Assessment of Acute Shigella flexneri Infection

Quantitative reverse transcription PCR analysis is an important tool to monitor changes in gene expression in animal models. The rabbit is a widely accepted and commonly used animal model in the study of human diseases and infections by viral, fungal, bacterial and protozoan pathogens. Only a limited number of rabbit genes have, however, been analyzed by this method as the rabbit genome sequence remains unfinished. Recently, increasing coverage of the genome has permitted the prediction of a growing number of genes that are relevant in the context of the immune response. We hereby report the design of twenty-four quantitative PCR primer pairs covering common cytokines, chemoattractants, antimicrobials and enzymes for a rapid, sensitive and quantitative analysis of the rabbit immune response. Importantly, all primer pairs were designed to be used under identical experimental conditions, thereby enabling the simultaneous analysis of all genes in a high-throughput format. This tool was used to analyze the rabbit innate immune response to infection with the human gastrointestinal pathogen Shigella flexneri. Beyond the known inflammatory mediators, we identified IL-22, IL-17A and IL-17F as highly upregulated cytokines and as first responders to infection during the innate phase of the host immune response. This set of qPCR primers also provides a convenient tool for monitoring the rabbit immune response during infection with other pathogens and other inflammatory conditions

Age-dependent determinants of infectious complications profile in children and adults after hematopoietic cell transplantation : lesson from the nationwide study

Incidence and outcome of microbiologically documented bacterial/viral infections and invasive fungal disease (IFD) in children and adults after hematopoietic cell transplantation (HCT) were compared in 650 children and 3200 adults in multicenter cross-sectional nationwide study. Infections were diagnosed in 60.8% children and 35.0% adults, including respectively 69.1% and 63.5% allo-HCT, and 33.1% and 20.8% auto-HCT patients. The incidence of bacterial infections was higher in children (36.0% vs 27.6%; p  21 days were risk factors for death from infection. In conclusion, pediatric patients have 2.9-fold higher incidence and 2.5-fold better outcome of infections than adults after HCT