Plerixafor in patients with lymphoma and multiple myeloma: effectiveness in cases with very low circulating CD34+ cell levels and preemptive intervention vs remobilization.

This retrospective study presents data from 105 consecutive multiple myeloma and lymphoma patients who had PB CD34+ cell counts <10/µL on day 4 of steady-state G-CSF mobilization for autologous hematopoietic cell transplantation. Our results confirm the capacity of plerixafor to improve mobilization outcomes in this clinical setting. In addition, they show that the effectiveness of plerixafor, compared with G-CSF only, translates to patients with very low (<3.5/µL) circulating CD34+ cell counts: overnight CD34+ cell count expansion (5.3- vs 1.7-fold), overall CD34+ cell yield (2.29 vs 0.15 × 10(6) CD34+ cells per kg) and patients yielding ⩾2 × 10(6) CD34+ cells per kg (63% vs 3%). Furthermore, our data also show that preemptive plerixafor is significantly more effective and more efficient than in remobilization: CD34+ cell yield in the first apheresis (3.28 vs 2.0 × 10(6) CD34+ cells per kg) and overall (3.73 vs 2.44 × 10(6) CD34+ cells per kg), patients yielding ⩾2 × 10(6) CD34+ cells per kg in the first apheresis (85% vs 44%) and overall (92% vs 64%), all this requiring less days and doses of plerixafor treatment (1.08 vs 1.48). These data would advocate using plerixafor as an early preemptive intervention based on day 4 circulating CD34+ counts, including very high-risk patients with very low circulating levels.

Endogenous lipid pneumonia in an African grey parrot (Psittacus erithacus erithacus).

Lipid pneumonia is an unusual, non-infectious, inflammatory lung disease characterized by patchy pneumonic consolidation secondary to accumulation of lipid in macrophages. It can be classified as exogenous or endogenous, depending on whether it is associated with the aspiration of foreign material. Endogenous lipid pneumonia (EnLP) has been reported in many mammal species. In pet birds, EnLP is an incidental and uncommon lesion of unknown pathogenesis. A 35-year-old African grey parrot (Psittacus erithacus erithacus) was presented for depression lasting several months, with marked worsening over the 2 days prior to presentation. The animal died shortly after admission. Necropsy examination showed that the lungs were firm with diffuse grey discolouration. Microscopically, there was EnLP, anthracosis, severe atherosclerosis and hepatic amyloidosis. Although the pathogenesis of EnLP in birds is not clear, it has been associated with concurrent atherosclerosis, hepatic diseases and other lesions of the respiratory tract. This is the first description of EnLP in a bird associated with severe respiratory distress.

Detection of hepatitis C virus antibodies in oral fluid specimens for prevalence studies.

Within the framework of hepatitis C virus (HCV) prevalence monitoring, we evaluated oral fluid (OF), which is richer in IgG than whole saliva, as a possible alternative to serum for the detection of HCV antibodies. Paired OF and serum samples were collected from 90 individuals, including 45 HCV-positives and 45 HCV-negatives. The detection of HCV antibodies in both serum and OF was performed using the Ortho HCV 3.0 SAVe enzyme-linked immunosorbent assay (ELISA) (Ortho-Clinical Diagnostics, Inc., Raritan, NJ), but a modified, more sensitive protocol was used to process OF. The sensitivity and specificity of this assay were 86.67% (95% confidence interval (CI): 72.51-94.46%) and 100% (95% CI: 90.20-99.80%) in OF and 100% in serum. The correlation obtained between both types of clinical specimens was excellent (k: 0.87, 95% CI: 0.66-1.07). However, the negative predictive value (NPV) of the assay in OF decreased with the prevalence of HCV infection in the population studied. Our results suggest that the modified Ortho HCV 3.0 SAVe ELISA is suitable for the detection of HCV antibodies in OF for epidemiological studies. Using this assay, we observed an unadjusted anti-HCV prevalence of 78.6% among a population of intravenous drug users; when adjusted to account for assay sensitivity, this prevalence may be closer to 90%.

Sensitization of naive beagles by intradermal injection of an ascaris antigen: induction of a model of skin allergy.

Ascaris suum-hypersensitive beagles represent a unique model of skin allergy. Despite its suitability, the need to test numerous dogs prior to the selection of natural positive responders causes many complications. We hypothesized that the model could be induced in adult beagles by primary sensitization. Ten dogs were included in an intradermal sensitization program using ascaris antigen and were thereafter tested for cutaneous reaction. After 2 weeks, 60% developed a positive reaction that lasted for months. We therefore present a straightforward method to establish the Ascaris canine model of allergy that will extend its availability for research in cutaneous allergy immunomodulation.

Thrombotic thrombocytopenic purpura and pregnancy: a review of ten cases.

BACKGROUND AND OBJECTIVES: A series of women with pregnancy-associated thrombotic thrombocytopenic purpura, is presented. This study will focus on the relationship between thrombotic thrombocytopenic purpura and pregnancy and on maternal and neonatal outcomes. MATERIALS AND METHODS: Among forty-six consecutive patients with thrombotic thrombocytopenic purpura, nine pregnant patients were identified. RESULTS: Seven patients presented an acute single episode associated with pregnancy and two patients had a chronic relapsing form of the disease. None of these two patients were diagnosed during pregnancy or in the postpartum period. There was one maternal death. Fetal mortality was 33%. CONCLUSIONS: The recurrence is rare in women who had the prior episode related to pregnancy. The risk of death for these patients seems not higher than that of the remaining patients in the series. Preterm delivery and intrauterine fetal death were frequent complications of these pregnancies.