ABSTRACT
Introduction: Chimeric antigen receptor T-cell (CAR-T) therapy is a modern breakthrough technology used in the treatment of B-lineage lymphoid malignancies. These malignancies include acute lymphoblastic leukemia, non-Hodgkin lymphoma, and plasma cell disorders. CAR-T therapy combines cellular therapy, gene therapy, and individualized therapy. The objective of this paper was to review the latest clinical knowledge, and summarize the reported data pertaining to vaccinations in patients after CAR-T therapy. Material and methods: We carried out a review of published original studies as indexed in PubMed, and a review of s presented during major hematology meetings. Results: Overall, 22 original studies were reviewed and considered suitable for analysis regarding the efficacy of vaccinations for patients who had received CAR-T therapy. Data was divided into three groupings: the efficacy of vaccination against coronavirus disease 2019 (COVID-19)/severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2);the efficacy of vaccination against influenza;and the efficacy of post-CAR-T immunization persistence of vaccination performed before CAR-T therapy. Humoral and cellular response to SARS-CoV-2 vaccination was positive for 36.5% and 72.2% of patients, respectively. The positive response to the influenza vaccine was 40% when administered prior to CAR-T therapy, as opposed to 31% after. Seroprotection for vaccine-preventable infections within 3-6 months after CAR-T was comparable to that of the general population, although it was determined to be less effective against specific pathogens (S. pneumoniae, B. pertussis, H. influenzae) in most patients. Conclusions: In cases of incomplete immune reconstitution, there is a high likelihood of a limited response to vaccination. Regarding the SARS-CoV-2/COVID-19 vaccine, T-cell-induced protection is relatively significant. Therefore, B-cell aplasia is not a contraindication for vaccination in CAR-T patients. The consensus of European Society of Blood and Marrow Transplantation/European Hematology Association experts is that vaccination after CAR-T therapy is beneficial in order to reduce the rates of infection, and eventually to improve clinical course. Copyright © 2022 The Polish Society of Haematologists and Transfusiologists, Insitute of Haematology and Transfusion Medicine. All rights reserved
ABSTRACT
Health risks associated with dietary supplements for athletes A properly designed and balanced diet is an essential element of any training plan. Breaking down barriers and overcoming the limits of human endurance are at the heart of sports activity. Ever since high-performance sports, people have tried to gain an advantage over a competitor, i.e., by consuming various substances. The pursuit of being more agile, faster, stronger, and more enduring has given rise to a multi-billion dollar dietary supplements market. Athletes’ dietary supplements can be divided into sports food, vitamin and minerals, and ergogenic supplements. Despite the centuries-old history of doping, the problem of substances that improve performance is still the most discussed topic in modern all types of sport, regardless of discipline or popularity. Dietary supplements are considered safe products, but their concentrated form may expose consumers to the risk of overdosing. Sports supplements are dangerous because they often have higher doses of active substances than over-the-counter medicinal products. Taking many dietary supplements, often with prescribed medications, increases your risk of harmful interactions. Another problem related to dietary supplements is the lack of uniform legal regulations, and hence the high probability of adulteration with substances prohibited in sport or substances hazardous to health. During the COVID-19 pandemic and over the isolation, the number of people exercising at home increased. In problematic contact with primary health care, social media became the main information source about athletes’ dietary supplements, their effectiveness, and safety. Not only nutritionists but also pharmacists and doctors should participate in assessing athletes’ needs and health problems. The increase in health awareness and knowledge about dietary supplements for athletes should be permanently included in the map of health services of the integrated health care model. The decision to take a dietary supplement should be consulted as part of pharmaceutical care or a visit to the doctor. On the other hand, the selection of a specific preparation should be made based on certified brands that verify, authenticate labels, test for the presence of contaminants and substances prohibited in sports. In healthcare, system solutions are needed that focus on strict control and official certification of dietary supplements, as is the case in the pharmaceutical industry. Creating a state certification system for dietary supplements seems essential as a reliable source of verified information for medical professionals. © 2021 National Museum. All rights reserved.