Mechanisms and management of CAR T toxicity

Chimeric antigen receptor (CAR) T cell therapies have dramatically improved treatment outcomes for patients with relapsed or refractory B-cell acute lymphoblastic leukemia, large B-cell lymphoma, follicular lymphoma, mantle cell lymphoma, and multiple myeloma. Despite unprecedented efficacy, treatment with CAR T cell therapies can cause a multitude of adverse effects which require monitoring and management at specialized centers and contribute to morbidity and non-relapse mortality. Such toxicities include cytokine release syndrome, immune effector cell-associated neurotoxicity syndrome, neurotoxicity distinct from ICANS, immune effector cell-associated hemophagocytic lymphohistiocytosis-like syndrome, and immune effector cell-associated hematotoxicity that can lead to prolonged cytopenias and infectious complications. This review will discuss the current understanding of the underlying pathophysiologic mechanisms and provide guidelines for the grading and management of such toxicities

Indian Female Non-Business Graduate Students’ Experience: Understanding of Commercial Acumen Skills and Relevance to Employment

Indian female graduate students have to make choices among multiple aspects of their mental and physical abilities as science students and women in a society with different gender norms in the country. However, their experiences have not been well researched within the scholarship on commercial acumen. In this study, using the phenomenological approach, we explored the phenomenon of commercial acumen in the Indian female graduates studying science course meaning non-business course. The participants were diverse in terms of their status as students, current students and alumni. A small number of employers also participated in the study. A survey with open-ended and closed questions was used to evaluate the understanding and relevance of commercial acumen skills in the female graduate students, alumni, and employers. The findings of 127 responses indicated that the female graduate students perceived being on the non-business course as a limited experience of understanding of commercial acumen in the context of employability skills. This study recommends a reflection on the part of the educators to highlight the relevance and definition of commercial acumen during degree programmes

2017年の1月から6月へのデラウェア裁判所のM&A訴訟

This paper presents an overview of some of the most important decisions handed down by theDelaware Supreme Court　and the Delaware Court of Chancery from January 2017 to June 2017 inlawsuits arising out of Merger and Acquisition (M&A) transactions

Multiple myeloma: is it time for biomarker-driven therapy?

Remarkable strides have been made in understanding the molecular mechanisms by which multiple myeloma develops, leading to more sophisticated classification that incorporates not only the traditional diagnostic criteria, but also immunophenotype, genetic, and molecular features. However, even with this added information, considerable heterogeneity in clinical outcomes exists within the identified subtypes. The present paradigm for myeloma treatment is built on the basic step of defining transplant eligibility versus noneligibility, as determined by age, performance status, and cumulative burden of comorbidities. An incredibly complex heterogeneous disease is, therefore, treated in a generalized way with the result that large interpatient variability exists in the outcome. As antimyeloma therapeutics continue to expand it is becoming even more crucial to personalize treatment approaches that provide the most value to a specific patient. Development of biomarkers, either individually or as larger sets or patterns and ranging from analysis of blood or bone marrow to biomedical imaging, is a major focus in the field. Biomarkers such as involved serum free light chain ratio and MRI focal lesions have been implemented in the new definition of multiple myeloma and guide clinicians to initiate treatment in otherwise asymptomatic individuals. Currently, however, there is not enough evidence to support intensifying the treatment for high-risk disease or reducing the treatment for low-risk disease. Minimal residual disease-negative status is an important biomarker that holds promise for monitoring the effectiveness of response-adapted strategies. This article sheds light on the forward landscape and rear-mirror view of biomarkers in myeloma