The prognostic impact of reduced variant burden in elderly patients with acute myeloid leukemia treated with decitabine

Background/Aims@#We evaluated the role of next-generation sequencing (NGS)-based disease monitoring for elderly patients diagnosed with acute myeloid leukemia (AML) who received decitabine therapy. @*Methods@#A total of 123 patients aged > 65 years with AML who received decitabine were eligible. We analyzed the dynamics of variant allele frequency (VAF) in 49 available follow-up samples after the fourth cycle of decitabine. The 58.6% VAF clearance (Δ, [VAF at diagnosis − VAF at follow-up] × 100 / VAF at diagnosis) was the optimal cut-off for predicting overall survival (OS). @*Results@#The overall response rate was 34.1% (eight patients with complete remission [CR], six of CR with incomplete hematologic recovery, 22 with partial responses, and six with morphologic leukemia-free status). Responders (n = 42) had significantly better OS compared with non-responders (n = 42) (median, 15.3 months vs. 6.5 months; p < 0.001). Of the 49 patients available for follow-up targeted NGS analysis, 44 had trackable gene mutations. The median OS of patients with ΔVAF ≥ 58.6% (n=24) was significantly better than that of patients with ΔVAF < 58.6% (n = 19) (20.5 months vs. 9.8 months, p = 0.010). Moreover, responders with ΔVAF ≥ 58.6% (n = 20) had a significantly longer median OS compared with responders with VAF < 58.6% (n = 11) (22.5 months vs. 9.8 months, p = 0.004). @*Conclusions@#This study suggested that combining ΔVAF ≥ 58.6%, a molecular response, with morphologic and hematologic responses can more accurately predict OS in elderly AML patients after decitabine therapy.

Development and Effectiveness of Non-Suicidal Self-Injury Prevention Program for Adolescents Using Brief Dialectical Behavioral Therapy Skills Training (DBT-ST) / 신경정신의학

Objectives@#The purpose of this study was to develop a non-suicidal self-injury (NSSI) prevention program for adolescents and confirm its effectiveness in primary prevention by applying dialectical behavior therapy skills training (DBT-ST). @*Methods@#From September to December 2021, 217 first-year students in three middle schools in the Chungcheong Province were tested for changes from before and after the program using the Responses to Depressed Mood Questionnaire and Difficulties in Emotion Regulation Scale-16 using paired t-tests. McNemar’s test was conducted to confirm the changes in the perception and attitude scale of NSSI for each question. @*Results@#A comparison of the changes from before and after the program revealed that the response to depressed mood (t=7.93, p<0.001), ruminant response (t=5.18, p<0.001), and distractive response (t=6.07, p<0.001) which are subfactors of the response to depressive moods, were significantly affected. There was a significant decrease in the difficulty in performing goaloriented behavior (t=3.34, p=0.01) and lack of emotional clarity (t=2.52, p=0.012), which are subfactors of emotional regulation difficulties. Also, in the comparison of the perception and attitude towards NSSI, statistically significant changes were confirmed in 7 out of a total of 9 questions (p<0.001). @*Conclusion@#It was confirmed that this program developed by applying DBT-ST was effective in the primary prevention of NSSI for adolescents.

Clinical Significance of bZIP In-Frame CEBPA-Mutated Normal Karyotype Acute Myeloid Leukemia / Journal of the Korean Cancer Association, 대한암학회지

Purpose@#We evaluated the characteristics of CCAAT/enhancer-binding protein α (CEBPA) mutations and the significance of a basic leucine zipper in-frame mutation (bZIPin-f) of CEBPA in patients with acute myeloid leukemia with a normal karyotype. @*Materials and Methods@#Based on updated knowledge of CEBPA mutations, we conducted next-generation sequencing analyses in a previously established real-world cohort. @*Results@#Among 78 of a total of 395 patients (19.7%), 50 had bZIPin-f CEBPA, and 28 had non-bZIPin-f CEBPA. In the multivariate analysis, patients with NPM1mut, those with bZIPin-f CEBPA, and those who underwent allogeneic hematopoietic cell transplantation (allo-HCT) had favorable overall survival (OS), but FLT3-ITDmut was a poor prognostic indicator. For relapse-free survival (RFS) and cumulative incidence of relapse, bZIPin-f CEBPA, and allo-HCT were associated with favorable outcomes; FLT3-ITDpos was associated with worse outcomes. In the CEBPA double-mutated group (CEBPAdm), bZIPin-f CEBPA was associated with superior outcomes in terms of OS (p=0.007) and RFS (p=0.007) compared with non-bZIPin-f CEBPA. Of 50 patients with bZIPin-f CEBPA, 36 patients had at least one mutation. When grouped by the presence of mutations in chromatic/DNA modifiers (C), cohesion complex (C), and splicing genes (S) (CCS mutations), CCS-mutated bZIPin-f CEBPA was associated with poor OS (p=0.044; hazard ratio [HR], 2.419) and a trend in inferior RFS (p=0.186; HR, 1.838). @*Conclusion@#Only bZIPin-f CEBPA was associated with favorable outcomes in patients with CEBPAdm. However, some mutations accompanying bZIPin-f CEBPA showed inferior OS; thus, further studies with larger numbers of patients are required for clear conclusions of the significance of bZIPin-f CEBPA.

Diagnostic Accuracy and Prognostic Relevance of Immunoglobulin Heavy Chain Rearrangement and 18F-FDGPET/CT Compared With Unilateral Bone Marrow Trephination for Detecting Bone Marrow Involvement in Patients With Diffuse Large B-Cell Lymphoma

Background@#In diffuse large B-cell lymphoma (DLBCL), bone marrow involvement (BMI) has an important clinical implication as a component of staging and International Prognostic Index. This study aimed to determine whether molecular analysis of immunoglobulin heavy chain (IgH) genes and positron emission tomography-computed tomography (PET/CT) could overcome the limitation of defining morphologic BMI by trephination biopsy and could increase the diagnostic accuracy or prognostic prediction. @*Methods@#A total of 94 de novo patients with DLBCL underwent PET/CT, polymerase chain reaction (PCR) test for detection of IgH gene rearrangement, and unilateral bone marrow (BM) trephination at diagnosis. @*Results@#A total of 9 patients (9.6%) were confirmed to present morphologic BMI (mBMI) based on trephination biopsy. On the other hand, 21 patients (22.3%) were confirmed to have IgH clonality (IgH BMI), while 16 (17.0%) were classified with BMI based on the assessment of PET/CT (PET BMI). Each IgH rearrangement PCR and PET/CT showed the high negative predictive value of detecting the BMI. However, the combined assessment of IgH rearrangement and PET/CT could increase the diagnostic accuracy and specificity with 87.2% and 97.0%, respectively. The survival outcome of patients with double positive PET BMI and IgH BMI was significantly worse than that with either single positive PET BMI or IgH BMI, and even less than patients with neither PET BMI nor IgH BMI (3-year PFS: 50.0% vs. 75.4% vs. 97.9%, P = 0.007, 3-year OS: 50.0% vs. 75.6% vs. 80.1%, P = 0.035, respectively). @*Conclusion@#This study suggests that the combined evaluation of PET/CT and IgH rearrangement could give additional information for predicting therapeutic outcomes in patients with negative morphologic BMI as an important part of the prognosis.

Clinical Characteristics of Adolescents Hospitalized Through Emergency Room for Intentional Self-Harm or Suicide Attempts

Objectives@#This study aimed to investigate the clinical characteristics of adolescents hospitalized through the emergency room for intentional self-harm or suicide attempts. @*Methods@#This retrospective study used data from the Korean National Hospital Discharge In-depth Injury Survey conducted between 2006 and 2018 for individuals aged 10–24 years. The clinical characteristics of the patients were analyzed and compared across sex and age groups using the Rao-Scott chi-square tests and multiple logistic regression analysis for complex survey data. @*Results@#The most common psychiatric diagnosis was mood disorder (22.0%), and more female patients were diagnosed with it than male patients (p=0.010). The 19–24 years age group was diagnosed with mood disorder the most compared to other younger groups (p=0.012). Male patients used lethal methods more than female patients (p=0.008), and the 19–24 years age group used more drug poisoning and cutting or piercing (p<0.001) for intentional self-harm or suicide attempts than younger groups. @*Conclusion@#Adolescents hospitalized for intentional self-harm or suicide attempts showed significant differences in clinical characteristics across sex and age groups. These findings suggest that measures for preventing self-harm or suicide attempts need to be differentiated according to the sex and age of adolescents.

Real-world evidence of levofloxacin prophylaxis in elderly patients with newly diagnosed multiple myeloma who received bortezomib, melphalan, and prednisone regimen

Background@#Although survival outcomes of multiple myeloma (MM) have improved with the development of new and effective agents, infection remains the major cause of morbidity and mortality. Here, we evaluated the efficacy of levofloxacin prophylaxis (in a real-world setting) during bortezomib, melphalan, and prednisone (VMP) therapy in elderly patients with newly diagnosed MM. @*Methods@#This study retrospectively analyzed the records of patients with newly diagnosed MM treated with the VMP regimen between February 2011 and September 2020 at three institutes of the Republic of Korea. @*Results@#Of a total of 258 patients, 204 (79.1%) received levofloxacin prophylaxis during VMP therapy. The median number of levofloxacin prophylaxis cycles was 4 (range, 1‒9), but 10 patients did not complete the planned prophylaxis because of side effects. Sixty-six patients (25.5%) experienced severe infections during VMP therapy, most of which (74.7%) occurred within the first four cycles of VMP therapy regardless of levofloxacin prophylaxis status. Early severe infection was significantly associated with poor survival.In multivariate analysis, levofloxacin prophylaxis was significantly associated with a lower risk in early severe infection. @*Conclusion@#Our findings suggest that levofloxacin prophylaxis should be considered at least during the first four cycles of VMP therapy in elderly patients with newly diagnosed MM.

Update on primary plasma cell leukemia

Plasma cell leukemia (PCL) is a rare and highly aggressive plasma cell neoplasm developing in 0.5‒4% of patients with multiple myeloma (MM). The diagnostic criteria were recently revised from 20% to ≥5% of circulating plasma cells in peripheral blood smears. PCL is classified as primary or secondary; primary PCL is when it presents in patients with no MM. Primary PCL shows clinical and laboratory features at presentation that differ from MM and exhibits a dismal prognosis even with the use of effective agents against MM. Therefore, intensive chemotherapy should be initiated immediately after diagnosis, and autologous stem cell transplantation is recommended for transplant-eligible patients. Maintenance therapy after transplantation may reduce the rate of early relapses. We reviewed the definitions of PCL, revised diagnostic criteria, clinical features, and appropriate initial treatments for primary PCL.

Effects of School Bullying Prevention Camp on the Adolescent Perpetrators of School Violence

Objectives@#The purpose of this study was to evaluate the effects of a school bullying prevention camp for adolescent perpetrators of school violence. @*Methods@#A total of 95 adolescents (boys=73, girls=22) were included in this study. The changes after the program were evaluated using several self-rating scales for the assessment of the degree of depression, loneliness, impulsivity, self-esteem, and interpersonal reactivity compared with the baseline scales. @*Results@#The school bullying prevention camp significantly reduced the degree of depression severity (z=-5.874, p<0.001) and impulsivity scale (z=-3.861, p<0.001), while increasing self-esteem (z=-2.091, p=0.037). The degree of depression severity (z=-4.635, p<0.001), loneliness (z=-2.168, p=0.030), and impulsivity (z=-2.987, p=0.003) significantly reduced, whereas self-esteem significantly increased (z=-2.221, p=0.026) for male students who had no history of child abuse. However, there were no significant changes after the program for the degree of depression, loneliness, impulsivity, self-esteem, and interpersonal reactivity among female students with a history of child abuse. @*Conclusion@#The results of our study suggest that the development of diverse standardized guidance programs is necessary for teenagers with different characteristics and backgrounds. Such programs are expected to be more effective in preventing school violence.

Effects of School Bullying Prevention Camp on the Adolescent Perpetrators of School Violence

Objectives@#The purpose of this study was to evaluate the effects of a school bullying prevention camp for adolescent perpetrators of school violence. @*Methods@#A total of 95 adolescents (boys=73, girls=22) were included in this study. The changes after the program were evaluated using several self-rating scales for the assessment of the degree of depression, loneliness, impulsivity, self-esteem, and interpersonal reactivity compared with the baseline scales. @*Results@#The school bullying prevention camp significantly reduced the degree of depression severity (z=-5.874, p<0.001) and impulsivity scale (z=-3.861, p<0.001), while increasing self-esteem (z=-2.091, p=0.037). The degree of depression severity (z=-4.635, p<0.001), loneliness (z=-2.168, p=0.030), and impulsivity (z=-2.987, p=0.003) significantly reduced, whereas self-esteem significantly increased (z=-2.221, p=0.026) for male students who had no history of child abuse. However, there were no significant changes after the program for the degree of depression, loneliness, impulsivity, self-esteem, and interpersonal reactivity among female students with a history of child abuse. @*Conclusion@#The results of our study suggest that the development of diverse standardized guidance programs is necessary for teenagers with different characteristics and backgrounds. Such programs are expected to be more effective in preventing school violence.

Screening Tests for Early Diagnosis of Multiple Myeloma and Related Plasma Cell Disorders / 대한내과학회지

Monoclonal gammopathy (MG) encompasses a diverse group of disorders characterized by the secretion of monoclonal immunoglobulins or their light-chain components. The incidence of multiple myeloma (MM) in South Korea is rapidly increasing, and it is important to be aware of its initial clinical presentations and the most efficient laboratory algorithms for early detection. Serum protein electrophoresis (SPE) and urine protein electrophoresis (UPE) are the primary screening tests for patients with clinically suspected MM or amyloid light-chain amyloidosis; these tests are reimbursed in South Korea. We reviewed clinical studies that applied national and international guidelines to evaluate test panels for early detection of MGs, including MM. The serum free light chain (sFLC) with SPE panel is recommended for the initial work up for diagnosis of MGs. In the case of a normal SPE, sFLC should be measured subsequently, so as not to miss the presence of M-protein. Use of this screening panel avoids medical expenses related to delayed diagnosis. Guidelines and recommendations suggest that no single method (SPE, serum immunofixation electrophoresis, sFLC, or UPE) should be used to exclude a diagnosis of MM. We believe that a screening test panel comprising SPE plus sFLC will increase the rate of early and accurate diagnosis of MM and related disorders.

Frontline therapy for newly diagnosed patients with multiple myeloma

Since the introduction of an alkylator to the treatment of multiple myeloma (MM), new effective agents have been developed, such as immunomodulatory drugs including thalidomide, lenalidomide, and pomalidomide; proteasome inhibitors including bortezomib, carfilzomib, and ixazomib; monoclonal antibodies including daratumumab and elotuzumab; and deacetylase inhibitors including panobinostat. Numerous regimens with these new agents have been developed and they have contributed in improving survival outcomes in MM patients. In addition, the recommended therapies for newly diagnosed MM change every year based on the results of clinical trials. This review will discusses the appropriate induction therapies based on recent clinical trials for patients with newly diagnosed MM.

The Characteristics of Students Who Had Attempted Self-Injury or Suicide in Chungcheongdo ‘Professional School Visits Outreach Project’ / 신경정신의학

OBJECTIVES: This study examined the characteristics of students who participated in the ‘Professional School Visits Outreach Project’ and evaluated the factors affecting self-injury or suicidal attempts.METHODS: In a cross-sectional study, psychiatrists or mental health professionals conducted a semi-structured interview with 296 students, families, and teachers in Chungcheong province and recorded the socioeconomic status (SES), past psychiatric history, current clinical symptoms, and mental status exams. Logistic regression analysis was performed on the variables with differences between the students who had attempted self-harm or suicide and those who had not.RESULTS: The subjects of this study belonged to a relatively low SES. In addition, their provisional diagnosis was mainly attention-deficit/hyperactivity disorder (38.5%) or depression (29.1%). Approximately 18.2% of students had attempted self-injury or suicide. The variables with differences between students who had attempted self-harm or suicide and those who had not, were female [odds ratio (OR) 2.878, p=0.002], provisional diagnosis of depression (OR 3.045, p=0.001), and a history of bullying victim (OR 1.927, p=0.048). Although the risks of self-injury or suicidal attempts were not increased by child abuse alone, it was increased in girls who experienced both childhood abuse and bullying victim (OR 4.222, p=0.002).CONCLUSION: The ‘Professional School Visits Outreach Project’ provides therapeutic opportunities for low SES and high-risk adolescents with multiple difficulties, such as child abuse, bullying victim, and suicidal behaviors. In addition, the recurrent experience of trauma in girls appears to increase the risk of adolescent self-injury or suicidal attempts.

Efficacy and Safety of Melphalan, Cyclophosphamide and Dexamethasone (MCD) as a Salvage Treatment for Patients with Relapsed/Refractory Multiple Myeloma / 전남의대학술지

This study investigated the efficacy and safety of melphalan, cyclophosphamide, and dexamethasone (MCD) as a salvage regimen for heavily treated relapsed or refractory multiple myeloma patients. We retrospectively analyzed a total of 27 patients who received the MCD regimen between April 2011 and November 2013. The MCD regimen consisted of oral melphalan 6.75 mg/m² on days 1–4, once-weekly dose of oral cyclophosphamide 300 mg/m2 and dexamethasone 20 mg/m² on days 1–4 and days 15–18. Each cycle was repeated every 28 days. The median age of the patients was 66 years and the MCD regimen was initiated at a median 37.7 months from diagnosis. Patients received a median of five regimens including autologous stem cell transplantation. The overall response rate was 25.9% (very good partial response 3.7%, partial response 22.2%) and 8 (29.6%) patients achieved a minor response. Median progression-free survival was 5.6 months (95% confidence interval [CI], 4.2–8.5) ; overall survival 11.7 months (95% CI, 5.4–16.6). Grade 3 or 4 neutropenia and thrombocytopenia were observed in 51.8% and 33.3%, respectively. Although the overall response rate is relatively low, the MCD regimen may have a role as a bridge to a novel regimen in heavily pretreated patients with MM.

Cellular immunotherapy in multiple myeloma

In multiple myeloma (MM), the impaired function of several types of immune cells favors the tumor’s escape from immune surveillance and, therefore, its growth and survival. Tremendous improvements have been made in the treatment of MM over the past decade but cellular immunotherapy using dendritic cells, natural killer cells, and genetically engineered T-cells represent a new therapeutic era. The application of these treatments is growing rapidly, based on their capacity to eradicate MM. In this review, we summarize recent progress in cellular immunotherapy for MM and its future prospects.

STAT3 expression is associated with poor survival in non-elderly adult patients with newly diagnosed multiple myeloma

BACKGROUND: Signal transducer and activator of transcription 3 (STAT3) is not only a key signaling molecule in the regulation of growth but is also involved in malignant transformation. We investigated the prognostic significance of STAT3 expression in 94 non-elderly adult patients (aged 38 to 65 yr) with newly diagnosed multiple myeloma (MM). METHODS: Tumor cell-specific phosphotyrosine-STAT3 (PY-STAT3) expression at the time of diagnosis was evaluated with dual immunohistochemical (IHC) staining for PY-STAT3 and CD138. RESULTS: PY-STAT3 positivity was detected in 10 patients (10.6%), including three who showed strong expression. PY-STAT3-positive patients had higher serum C-reactive protein and calcium levels at diagnosis than did PY-STAT3-negative patients. PY-STAT3 positivity had predictive value for poor progression-free survival (PFS; P=0.001) and overall survival (OS; P=0.003). Among the 60 patients who received frontline autologous stem cell transplantation, PY-STAT3-positive patients had poorer PFS than did PY-STAT3-negative patients (4.2 vs. 19.2 mo, respectively; P=0.013). Multivariate analysis identified PY-STAT3 expression as an independent prognostic factor for PFS (relative risk [RR]=2.706, P=0.014) and OS (RR=3.091, P=0.044). CONCLUSION: These data show that PY-STAT3 positivity, as determined using dual IHC, is a marker of poor prognosis in non-elderly adult patients with MM.

Psychopathology Associated with Participant Role among Bullying Situation / 신경정신의학

OBJECTIVES: In recent years, school violence has been increasing and this situation is complicated by various factors. The objective of this study is to explore the distribution of the participants' roles and to examine the psychopathology associated with these roles among middle school students. METHODS: In a cross-sectional study, 490 middle school students completed the Participant Role Questionnaire (PRQ) for classifying the participants' roles in a bullying situation. The Korean-Youth Self Report (K-YSR), Revised Children's Manifest Anxiety Scale (RCMAS), Rosenberg Self-Esteem Scale (RSE) and Parent Adolescent Communication Inventory (PACI) were also included to evaluate the psychopathology of the students. RESULTS: The distribution rates of the bully, assistant, reinforcer, defender and outsider groups were 4.1%, 3.1%, 5.3%, 53.7%, and 32.0%, respectively. Among the syndrome scales of K-YSR, almost each items' and the total scores (p=0.049), RCMAS (p=0.000), PACI (p=0.000), and RSE (p=0.000) were significantly different among all group. The average scores on the K-YSR and RCMAS were the highest in the assistant and reinforcer groups. CONCLUSION: The assistant and reinforcer groups showed more severe psychopathologies. This means that they suffered from more difficulties than the other groups. Therefore, they need more intensive therapeutic interventions. Except for the defender group, who prevented bullying, the outsider group was the largest group. Therefore, a comprehensive approach that can change outsiders to defenders should be employed for the prevention of bullying in adolescents.

Bendamustine in heavily pre-treated multiple myeloma patients: Results of a retrospective analysis from the Korean Multiple Myeloma Working Party

BACKGROUND: Bendamustine may be a potential treatment option for patients with myeloma, but little is known about the utility of bendamustine as a salvage treatment, especially in Asian patients. METHODS: We performed a multicenter retrospective study of patients with relapsed or refractory myeloma who received bendamustine and prednisone. RESULTS: The records of 65 heavily pre-treated patients, who had undergone bortezomib and lenalidomide treatment (median number of previous treatments: 5), were analyzed. The median time from diagnosis to bendamustine treatment was 3.8 years, and the median patient age was 63 years (range, 38‒77 yr). The responses to the last treatment before bendamustine were refractory disease (N=52, 80%) or disease progression from partial response (N=13, 20%). Twenty-three patients responded to the treatment, with an overall response rate of 35% (23/65), and the median number of bendamustine treatment cycles was two (range, 1‒5 cycles). The median overall survival after bendamustine treatment was 5.5 months and the overall survival rate in responders to bendamustine was significantly better than that in non-responders (P=0.036). CONCLUSION: Bendamustine may be a potential salvage treatment to extend survival in a select group of heavily pre-treated patients with relapsed or refractory myeloma.

Pralatrexate in Combination with Bortezomib for Relapsed or Refractory Peripheral T Cell Lymphoma in 5 Elderly Patients

Peripheral T cell lymphoma (PTCL) is a heterogeneous group of aggressive lymphomas with poor prognosis. Elderly (age ≥ 65years) patients generally have impaired bone marrow function, altered drug metabolism, comorbidities, and poor functional status. Thus, treatment of elderly patients with relapsed or refractory PTCL remains a challenge for clinicians. A recent study disclosed that pralatrexate has a synergistic effect in combination with bortezomib. Weekly pralatrexate and bortezomib were administered intravenously for 3 weeks in a 4-week cycle. Of 5 patients, one achieved complete response after 4 cycles which has lasted 12 months until now. Another patient attained partial response after 2 cycles. Only 1 patient experienced grade 3 thrombocytopenia and neutropenia. Two patients suffered from grade 3 mucositis. Combination therapy with pralatrexate and bortezomib may be used as a salvage therapy for relapsed or refractory PTCL in the elderly with a favorable safety profile.

Sarcoplasmic reticulum Ca²⁺ ATPase 2 (SERCA2) reduces the migratory capacity of CCL21-treated monocyte-derived dendritic cells

The migration of dendritic cells (DCs) to secondary lymphoid organs depends on chemoattraction through the interaction of the chemokine receptors with chemokines. However, the mechanism of how lymphoid chemokines attract DCs to lymphoid organs remains unclear. Here, we demonstrate the mechanism of DC migration in response to the lymphoid chemokine CCL21. CCL21-mediated DC migration is controlled by the regulation of sarcoplasmic reticulum Ca²⁺ ATPase 2 (SERCA2) expression rather than through the activation of mitogen-activated protein kinases CCL21-exposed mature DCs (mDCs) exhibited decreased SERCA2 expression but not decreased phospholamban (PLB) or Hax-1 expression, which are known to be SERCA2-interacting proteins. In addition, CCL21 did not affect the mRNA levels of SERCA2 or its interacting protein Hax-1. Interestingly, SERCA2 expression was inversely related to DC migration in response to chemokine stimulation. The migratory capacity of CCL21-treated mDCs was decreased by the phospholipase C inhibitor U73122 and by the protein kinase C inhibitor BAPTA-AM. The migratory capacities of mDCs were increased in response to SERCA2 siRNA expression but were decreased by SERCA2 overexpression. In addition, DCs treated with a SERCA2-specific inhibitor (cyclopiazonic acid) had significantly increased migratory capacities as mDCs regardless of SERCA2 expression. Moreover, SERCA2 expression was dependent on DC maturation induced by cytokines or Toll-like receptor agonists. Therefore, the migratory capacities differed in differentially matured DCs. Taken together, these results suggest that SERCA2 contributes to the migration of CCL21-activated DCs as an important feature of the adaptive immune response and provide novel insights regarding the role of SERCA2 in DC functions.

Predictive Efficacy of Interim Positron Emission Tomography/Computed Tomography (PET/CT) for the Treatment of Aggressive Lymphoma / 전남의대학술지

The prognostic value of whole-body positron emission tomography/computed tomography (PET/CT) with 18F-fluoro-2-deoxy-D-glucose (FDG) shortly after the onset of induction chemotherapy or mid treatment could help to predict long-term clinical outcomes in patients with Hodgkin's or Non-Hodgkin's lymphoma. However, FDG is not a tumor-specific substance, and it may accumulate to the point of being detected in a variety of benign conditions or at physiologic anatomical sites, which may give rise to false-positive interpretation. In an attempt to standardize the reporting criteria for interim PET/CT, the First International Workshop on Interim PET in Lymphoma suggested visual response criteria with the Deauville five-point scale, and the standardized uptake value (SUV) has been investigated in comparison with this visual system. A quantitative approach using the measurement of maximal SUV (SUVmax) or the reduction rate of SUVmax (DeltaSUVmax) might be more appropriate in early-response PET/CT for reducing false-positive rates or for decreasing interobserver variability in interpretation. In this review, the predictive efficacy of PET/CT is discussed for the treatment of aggressive lymphoma, especially in terms of an interim PET/CT-based prognostic model.