Allogeneic matched-sibling hematopoietic cell transplantation for AML: comparable outcomes between Eastern Mediterranean (EMBMT) and European (EBMT) centers.

Allogeneic hematopoietic cell transplantation (HCT) activity significantly increased in the Eastern Mediterranean area over the past decade. However, comparative outcomes with longer established centers, especially European Blood and Marrow Transplantation (EBMT) centers, have not been reported. We compared outcomes of matched-sibling allogeneic HCT between East Mediterranean Blood and Marrow Transplantation (EMBMT) and EBMT centers for adult patients with AML in first CR using myeloablative conditioning. We matched 431 patients from EMBMT with 431 patients from EBMT centers according to patient, disease and transplant characteristics. EMBMT recipients and donors were more likely to be CMV seropositive. There were no significant differences in the incidence of acute or chronic GVHD, or the 3-year cumulative incidence of non-relapse mortality (NRM) and relapse incidence (RI) between the two groups (NRM: EMBMT=16% vs EBMT=11), (RI: EMBMT=13% vs EBMT=19%). Notably, the 3-year leukemia-free survival (LFS) and OS were similar between the groups (LFS: EMBMT=70±2% vs EBMT=69±3%), (OS: EMBMT=74±2% vs EBMT=73±2%). Despite differences in socioeconomics, health resources and transplant experience, matched-sibling allogeneic HCT outcomes in emerging centers in the EMBMT region appear similar to EBMT centers.

Surgical complications related to hematopoietic stem cell transplantation.

BACKGROUND: Surgical complications in recipients of hematopoietic stem cell transplantation (HSCT) are common. However, this issue is infrequently reported in the literature. METHODS: The records of 165 patients who underwent hematopoietic stem cell transplantation at King Hussein Cancer Center between January 2007 and December 2008 were retrospectively reviewed. All surgical complications were included and were classified into gastrointestinal (GI), catheter-related, ear, nose and throat (ENT), peri anal, musculoskeletal, neurological and urological complications. RESULTS: There were 279 surgical complications in the studied patients. Gastrointestinal (n = 122) and catheter-related (n = 78) complications were the most frequent. The frequency and the percentage of patients needing surgical intervention for the 5 most common complications were as follows: Gastrointestinal (n = 122, 4.5% needed surgical intervention), catheter-related (n = 78, 46.2%), ear, nose and throat (n = 31, 9.7%), perianal disease (n = 21, 19%) and urinary complications (n = 17, 5.9%). Surgical consultation was sought for 116 surgical complications. Surgical interventions were necessary for 55 patients. All the patients who underwent surgery did not have an intervention-related mortality except for one patient who died from surgical intervention post-gastrointestinal complication. CONCLUSION: The majority of surgical complications after HSCT do not require surgical intervention. However, these conditions may overlap with the more common reasons for surgical consultation and must be identifiable by the surgeon. Extra vigilance is necessary when dealing with both GI and catheter-related complications as they are the most frequent. The early involvement of surgeons and proper timing of surgical management may circumvent detrimental outcomes.

No improvement of survival with reduced- versus high-intensity conditioning for allogeneic stem cell transplants in Ewing tumor patients.

BACKGROUND: Outcomes of Ewing tumor (ET) patients treated with allogeneic stem cell transplantation (allo-SCT) were compared regarding the use of reduced-intensity conditioning (RIC) and high-intensity conditioning (HIC) regimens as well as human leukocyte antigen (HLA)-matched and HLA-mismatched grafts. PATIENTS AND METHODS: We retrospectively analyzed data of 87 ET patients from the European Group for Blood and Marrow Transplantation, Pediatric Registry for Stem Cell Transplantations, Asia Pacific Blood and Marrow Transplantation and MetaEICESS registries treated with allo-SCT. Fifty patients received RIC (group A) and 37 patients received HIC (group B). Twenty-four patients received HLA-mismatched grafts and 63 received HLA-matched grafts. RESULTS: Median overall survival was 7.9 months [±1.24, 95% confidence interval (CI) 5.44-10.31] for group A and 4.4 months (±1.06, 95% CI 2.29-6.43) for group B patients (P = 1.3). Death of complications (DOC) occurred in 4 of 50 (0.08) and death of disease (DOD) in 33 of 50 (0.66) group A and in 16 of 37 (0.43) and 17 of 37 (0.46) group B patients, respectively. DOC incidence was decreased (P < 0.01) and DOD/relapse increased (P < 0.01) in group A compared with group B. HLA mismatch was not generally associated with graft-versus-Ewing tumor effect (GvETE). CONCLUSIONS: There was no improvement of survival with RIC compared with HIC due to increased DOD/relapse incidence after RIC despite less DOC incidence. This implicates general absence of a clinically relevant GvETE with current protocols.

Infections with the 2009 H1N1 influenza virus among hematopoietic SCT recipients: a single center experience.

We retrospectively reviewed medical records of 39 hematopoietic SCT (HSCT) recipients who presented at our hospital between 1 October 2009 and 31 January 2010 with the 2009 H1N1 influenza infection. The median age at presentation was 13.8 years (range: 3.3-56.9), infections developed at a median of 585 days (range: 0-2316) post transplant, the majority (n=27, 69%) occurred in allogeneic HSCT recipients, 12 (31%) patients were on immunosuppressive therapy and 12 (31%) had GVHD. Lower airway disease was present in 8 patients (21%). In total, 15 patients (39%) were hospitalized with a median duration of 4.5 days (range: 3-27 days) and 3 (8%) required mechanical ventilation; 2 of whom died.

Bone marrow and stem cell transplantation at King Hussein cancer center.

Bone marrow and stem cell transplantation in Jordan has been performed since the 1990s, but the first comprehensive program was established at King Hussein Cancer Center (KHCC) in March 2003. The program, in addition to other health care institutions in Amman, serves approximately 5.6 million Jordanians. Also, we treat several patients per year from neighboring Arab countries. The program at KHCC performs an average of 80 transplants per year. During the past 4 years 320 patients received transplants at KHCC; 26% of them received an autologous graft and 74% allogeneic grafts. Of the allogeneic grafts 91% were taken from matched family members, 6.7% were haploidentical from one of the parents, and 2.3% were from an unrelated donor or umbilical cord blood. The actuarial overall survival among all patients has been around 65%. The most common indication for transplantation at KHCC was leukemia/MDS followed by benign nonmalignant hematological/immune deficiency/metabolic disorders, with thalassemia major being the most common among this group. The cost of SCT is variable and depends on many factors including the type of transplant and the attending post-transplant complications. The average charge for autologous transplant (both adults and pediatrics) is 24,695 JD (one JD equals 1.42 USD), and the average charge for allogeneic transplant (both adults and pediatrics) excluding haploidentical transplant is 46,787 JD. We have not noticed any peculiar patterns of complications following BMT; however, we have seen a high incidence of chronic GVHD following minitransplant with fludarabine and single-dose TBI (Seattle protocol). At the inception of the program, invasive fungal infection mainly related to building construction, and central line complications were significant. Measures implemented to control such complications were successful to a large extent. We report our results to the EBMT group and we are accredited as an unrelated transplantation center. Although from a young program, our group has presented abstracts to international conferences.

Cancer chemoprevention drug targets.

Cancer chemoprevention is a new approach in the management of cancer. Traditional cytotoxic chemotherapeutic approaches cannot cure most advanced solid malignancies. Chemoprevention can be defined as the use of non-cytotoxic drugs and natural agents to block the progression to invasive cancer. Chemoprevention can either prevent DNA damage that initiates the neoplastic transformation process or reverses the progression of pre-invasive lesions. Epidemiological observations, experimental evidence from animal carcinogenesis models, knock-out models, cancer cell lines and clinical trials have shown the efficacy of this approach. Recent advances in our understanding of carcinogenesis have led to the synthesis of new drugs that target specific receptors. Non-steroidal anti-inflammatory drugs target the prostaglandin pathway. The identification of the role of cyclooxygenase-2 in epithelial carcinogenesis led to the synthesis of selective cyclooxygenase-2 inhibitors (Celecoxib). Celecoxib was subsequently approved for the prevention of colon polyps in familial adenomatous polyposis after the completion of a randomized clinical trial. The large chemoprevention clinical trial with the selective estrogen receptor modulator, tamoxifen, showed the benefit of tamoxifen in the prevention of breast cancer in high-risk women. Retinoids and rexinoids target the retinoid receptors and have a role in chemoprevention of aerodigestive, hepatic and cervical neoplasia. Selenium, an inhibitor of the glutathione peroxidase system, is being tested in the chemoprevention of prostate cancer and lung cancer. The different isoforms of vitamin E (tocopherols) may be chemopreventive. Recent evidence indicates that gamma-tocopherol may be a more powerful chemopreventive than the alpha-tocopherol. The review details the rationale, experimental and clinical evidence and the drug targets of the chemopreventive agents that are currently in various phases of clinical development.

Studies on the efficacy of combined immunostimulant-antibiotic therapy against experimental Mycoplasma gallisepticum infection in chickens.

Josamycin is an antibiotic known to become selectively concentrated intracellularly and in respiratory organs, the habitate of Mycoplasma gallisepticum. The aim of this present work was to evaluate the efficacy of josamycin when given alone or combined with an immunostimulant Cornebacterium cutis ultralysate. Groups of chickens were given josamycin alone or Corynebacterium ultralysate alone or both agents or nothing immediately before induction of Mycoplasma gallisepticum infection. Birds were subjected to pathological examination to evaluate the incidence and severity of air-sacculitis, bacteriological examination for re-isolation of Mycoplasma gallisepticum and for immunological examination to evaluate the humoral immune response to the infection (haemagglutination inhibiting titre determination). The effect of treatments used in this study was to decrease the incidence and severity of air sacculitis. The magnitude of rise in haemagglutination inhibiting titres were greater and faster in birds given Corynebacterium ultralysate. Treatments failed to achieve complete elimination of Mycoplasma. No special advantage was obtained from the use of josamycin, its effects were rather similar to previously used chemotherapy.

Binding of aluminum to human serum transferrin, human serum albumin and rat serum proteins.

Human serum transferrin (HSTF), human serum albumin (HSA) and rat serum were compared for their interaction with AlCl3, in a Tris-HCl buffer solutions (pH 7.4). The AlCl3 was tested in series of concentrations in the range of 50 microM up to 500 microM. HSTF, HSA and their 1:1 mixture and rat serum were incubated at 37 degrees C with series of AlCl3 concentrations. The protein profile of the incubated solutions were compared to control using SDS-PAGE and FPLC tests. The results indicated that HSTF was more specifically responsive to AlCl3 showing a characteristic increase in its UV absorption, peak and area dimensions. Simultaneously, HSA was less affected, but it showed a significant shift with an increase in molecular weight accompanied with a change in its profile. The respective bands of transferrin and albumin in rat serum behaved similarly. The SDS-PAGE and FPLC data coincided and confirmed the preferential affinity of HSTF to bind with Al3+. These results support the suggestion of using HSTF for monitoring levels of Al3+ in human blood samples of exposed population. The importance of further developing such a biomarker is the increased demand for early detection of the hazardous levels of Al3+ in relation to its long term neurotoxic adverse effects.

Gamma aminobutyric acid radioreceptor-assay a possible biomarker for human exposure to certain agrochemicals.

Cyclodiene insecticides, hexachlorocyclohexanes, pyrethroids, bicyclophosphates, the bicycloorthocarboxylate insecticides and some of their metabolites and environmental degradation products are central nervous system toxicants with high specific binding affinity to the chloride channel of the gamma-aminobutyric acid (GABA)A receptor-ionophore sites. [35S] tertiary-butylbicyclophosphorothionate (TBPS) with specific activity higher than 60 Ci/mmole has a high binding affinity to the same sites and is now commercially available and can be used to label the GABAA receptor for the development of a radioreceptor assay technique. The GABA receptor was prepared by ultra centrifugation and dialysis of brain homogenates of either cow, goat, rat or catfish. The receptor was then labeled with [35S] TBPS and the assay was conducted by measuring the displacement of radioactivity following incubation with samples containing the analytes. A radioreceptor assay protocol was developed to measure the amount of the alpha-endosulfan in blood samples. The assay was extremely sensitive, and can detect 0.2 nM of endosulfan at a level equivalent to 0.08 ppb or 8 x 10(-11) gm of endosulfan in each ml of the blood samples.

New species of Rhabdochona Railliet, 1916 (Nemata: Rhabdochonidae) from Rainbow Trout in California Streams.

Three new species of Rhabdochona Railliet, 1916 are described and illustrated from Salmo gairdneri Richardson (rainbow trout) in freshwater streams in California: Rhabdochona californiemis n. sp., R. paxmani n. sp., and R. satmonis n. sp. Rhabdochona californiensis n. sp. is characterized by 14 anteriorly directed teeth in the prostome, egg devoid of filaments or floats, male and female tail terminus with a single mucro, left (long) spicule slender with a moderate distended podoid terminal end, spicular ratio 1:3.8. Rhabdochona paxmani n. sp. is characterized by 10 teeth in the prostome, eggs with polar floats, left (long) spicule slender with podoid terminus distended and having a minute subterminal spine; right spicule with prominent gorgeret (barb), spicular ratio 1:4.3, male and female tail terminus with a cuticular conical rounded short projection. Rhabdochona salmoni, n. sp. is characterized by 10 teeth anteriorly directed in the prostome, eggs with polar floats, left spicule slender with a distended podoid terminus; right spicule with a sharply indented gorgeret, spicular ratio 1:4.3, male and female tail terminus with a conical or rounded tip.

Hirschmanniella pomponiensis n. sp. (Nemata: Pratylenchidae), Parasitic on Bulrush, Scirpus robustus Pursh.

A new species of Hirschmanniella was found in bulrush roots; LM and SEM morphological studies revealed that it is distinct from other species in the genus. Therefore, it is designated Hirschmanniella pomponiensis n. sp. Six lips are fused to form a hexagonal labial plate, six inner sensilla encircle the stoma opening, and four cephalic sensilla open in the corners of subdorsal and subventral lips. Cephalic lip region consists of six or seven annuli. The female has incomplete areolation in the lateral field, the intestine overlaps the rectum, the tail tip is pointed and without annulation.

Meloidogyne californiensis n. sp. (Nemata: Meloidogyninae), Parasitic On Bulrush, Scirpus robustus Pursh.

Meloidogyne californiensis n. sp. is described and illustrated from bulrush Scirpus robustus in California. LM and SEM studies revealed that this species differs from other known species in the genus Meloidogyne especially by the prominent posterior cuticular protuberances in the female, the distinct shape of the perineal pattern which is marked by one prominent stria in the perineum, indistinct lateral lines, many broken discontinuous striae on both sides of the arch, and the excretory pore being located posterior to stylet base. Second-stage juveniles 448-628 mum long, stylet length 11-13 mum, styler delicate, with small knobs sloping posteriorly, cephalic region with 2 or 3 annuli, and inflated rectum. Males vary greatly in size (712-1,952 mum), stylet length 18-28 mum (mean 22 mum), cephalic region slightly set off the body with two or three annuli, spear heavy with massive rounded knobs, lateral field marked by four areolated incisures as seen by SEM.

Isolation and structure determination of new nematicidal triglyceride fromArgemone mexicana.

The petroleum ether extract ofArgemone mexicana seeds was found to possess nematicidal activity against the plant parasitic nematodeMeloidogyne incognita. The active nematicidal compound has been isolated from the crude extract by column Chromatographic techniques and purified by TLC. Chemical structure has been determined by chemical and spectro-scopic methods to be that of a triglyceride, sn-glycerol-1-eicosa-9, 12-dien-oate-2-palmitoleate-3-linoleate.

Serodiagnosis of Toxoplasma gondii in habitually aborting women and other adults from North Jordan.

The prevalence of anti-Toxoplasma gondii antibodies in serum samples of 55 habitually aborting women, 46 women with normal pregnancies, 92 outpatient adults, and 150 University students from North Jordan was studied using the enzyme linked immunosorbent assay (ELISA). Sera from the habitually aborting group were also tested by the indirect immunofluorescent (IIF) test. No significant difference was found between the overall prevalence rates in University students, outpatient adults and women with normal pregnancies (25.3%, 22.8% and 26.1% respectively). The prevalence in habitually aborting women exceeded two times that in women with normal pregnancies or in outpatient females (58.2%, 26.1% and 25.0% respectively), and was approximately three times that in female University students (18.3%). The greatest difference in the prevalence rate between habitually aborting women and those with normal pregnancies or outpatient females was found in groups having the highest antibody level (greater than or equal to 100% of standard positive controls). A positive correlation between the results of the ELISA and those of the IIF test occurred at titres of greater than or equal to 1:40 of the latter test in habitually aborting women.

Bacteriuria following vaginal delivery.

Vaginal delivery may predispose to bacteriuria, as it entails repeated vaginal examination, compression of the bladder and sometimes urethral catheterization. One hundred and forty pregnant women were studied. Three samples of urine were used for cultures; the first at start of labor, the second 24 h after labor, and the third 14 days later. Culture plates were examined for total colony count, which was multiplied by 10 to give an estimate of the number of organisms/ml. Type of organism was identified. Nine of 112 women (8%) developed bacteriuria for the first time after labor. Of these, premature rupture of membranes occurred in four, prolonged labor in two, and cervical and vaginal tears in two others. Detection and treatment of postpartum bacteriuria could decrease the incidence of urinary tract infection.