Spatial Transcriptomics Analysis Reveals that CCL17 and CCL22 are Robust Indicators of a Suppressive Immune Environment in Angioimmunoblastic T Cell Lymphoma (AITL).

BACKGROUND: T cell lymphoma is a complex and highly aggressive clinicopathological entity with a poor outcome. The angioimmunoblastic T-cell lymphoma (AITL) tumor immune microenvironment is poorly investigated. METHODS: Here, to the best of our knowledge, spatial transcriptomics was applied for the first time to study AITL. RESULTS: Using this method, we observed that AITL was surrounded by cells bearing immune-suppressive markers. CCL17 and CCL22, the dominant ligands for CCR4, were up-regulated, while the expression of natural killer (NK) cell and CD8+ cytotoxic T lymphocyte (CTL) markers decreased. Colocalization of Treg cells with the CD4+ TFH-GC region was also deduced from the bioinformatic analysis. The results obtained with spatial transcriptomics confirm that AITL has a suppressive immune environment. Chemotherapy based on the CHOP regimen (cyclophosphamide, doxorubicin, vincristine plus prednisone) induced complete remission (CR) in this AITL patient. However, the duration of remission (DoR) remains a concern. CONCLUSIONS: This study demonstrates that AITL has an immune suppressive environment and suggests that anti-CCR4 therapy could be a promising treatment for this lethal disease.

CXCL1 Clone Evolution Induced by the HDAC Inhibitor Belinostat Might Be a Favorable Prognostic Indicator in Triple-Negative Breast Cancer.

Triple-negative breast cancer (TNBC) is the most lethal subtype of breast cancer due to its lack of treatment options. Patients with TNBC frequently develop resistance to chemotherapy. As epigenetic-based antineoplastic drugs, histone deacetylase inhibitors (HDACis) have achieved particular efficacy in lymphoma but are less efficacious in solid tumors, and the resistance mechanism remains poorly understood. In this study, the GSE129944 microarray dataset from the Gene Expression Omnibus database was downloaded, and fold changes at the transcriptome level of a TNBC line (MDA-MB-231) after treatment with belinostat were identified. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were used to identify the critical biological processes. Construction and analysis of the protein-protein interaction (PPI) network were performed to screen candidate genes related to cancer prognosis. A total of 465 DEGs were identified, including 240 downregulated and 225 upregulated genes. The cytokine-cytokine receptor pathway was identified as being significantly changed. Furthermore, the expression of CXCL1 was implicated as a favorable factor in the overall survival of breast cancer patients. With in vitro approaches, we also showed that belinostat could induce the expression of CXCL1 in another 2 TNBC cell lines (BT-549 and HCC-1937). We speculate that belinostat-induced CXCL1 expression could be one of the results of the stress clone evolution of cells after HDACi treatment. These findings provide new insights into clone evolution during HDACi treatment, which might guide us to a novel perspective that various mutation-targeted treatments should be implemented during the whole treatment cycle.

Effects of a Clinically Indicated Peripheral Intravenous Replacement on Indwelling Time and Complications of Peripheral Intravenous Catheters in Pediatric Patients: A Randomized Controlled Trial.

Peripheral intravenous catheters (PVCs) are common treatment modalities for pediatric patients, and may cause infection, infiltration, occlusion, and phlebitis. The purpose of this study was to evaluate the effect of a clinically indicated peripheral intravenous replacement (CIPIR) on PVC indwelling time and complication rates in pediatric patients. This study used a randomized, pre- and post-repeated measures design. A total of 283 participants were randomly assigned to an experimental group (n = 140) and a control group (n = 143). The experimental group received CIPIR and the control group received usual care with routine PVC replacement every three days. The insert sites of PVC were assessed every day until the signs of infiltration, occlusion, or phlebitis were presented. Patients in the experimental group had significantly longer PVC indwelling times compared to those in the control group (t = -18.447, p < 0.001). No significant differences were noted between groups in infiltration (χ2 = 2.193, p = 0.139), occlusion (χ2 = 0.498, p = 0.481), or phlebitis (χ2 = 3.865, p = 0.050). CIPIR can prolong the PVC indwelling time in pediatric patients with no increase in the rate of adverse events.

Reduction in nausea and vomiting in children undergoing cancer chemotherapy by either appropriate or sham auricular acupuncture points with standard care.

BACKGROUND: Over 40% of children with cancer have reported that chemotherapy-induced nausea and vomiting (CINV) are the two most distressing side-effects of treatment even when antiemetic drugs have been used. OBJECTIVES: The purpose of this article is to report the findings from a feasibility and pilot study using auricular point acupressure point for CINV in a small group of children in Taiwan. METHODS: This was a crossover randomized design study. CINV symptoms were assessed on 10 patients just prior to and for 7 days following each of three rounds of chemotherapy drugs (CTX). They received standard care (SC) and were not entered into a test treatment group until they completed the baseline assessment, which was conducted during their first round of chemotherapy after entering the study. Just prior to receiving the second round of CTX, patients were randomized into one of two treatment conditions: auricular acupressure intervention, in addition to standard care (AAP) or auricular acupressure using sham auricular points (SAP) in addition to standard care. For the third round of CTX, they were switched to the other treatment group. RESULTS: The enrollment rate for this study was 77% of the children invited to participate and of those, 88% provided completed data sets for all three treatment conditions. Patients in the AAP group reported significantly lower occurrence and severity of nausea and vomiting than patients in the SC group (p<0.05). There were no significant differences of nausea and vomiting for patients between the AAP and SAP groups. All of the patients took antiemetic medication on the day they received CTX, and 80% of patients reported that the antiemetics did not help to treat CINV. CONCLUSIONS: These preliminary findings did show evidence that AAP is acceptable to the children and their parents to prevent/treat CINV. However, there were no statistically significant differences between the AAP and SAP groups in the prevention/treatment of CINV. There were clinical trend differences between the groups, which may due to the small sample size. In a larger study, it would be important to determine whether the effects of the AAP and SAP treatment are independent of any psychologic effects, such as the researcher's increased presence in both treatment groups.

[The experiences of caregivers caring for children with cord blood transplantation].

BACKGROUND: Advancing technology has greatly increased cord blood transplantation (CBT) success rates. However, transplant patient caregivers may encounter a great deal of stress related to knowledge deficits with regard to post-transplant care and lack of relevant care experience. Existing studies for CBT primarily focus on investigating the transplant process and survival rate. Studies on the experience of caregivers caring for CBT children are extremely scarce. It is important for future studies to explore the care experiences of CBT caregivers. PURPOSE: This study explored the experiences of primary caregivers responsible to care for pediatric patients after CBT. METHODS: Researchers conducted a phenomenological study of lived experiences using qualitative interviews that were in-depth, face-to-face, and semi-structured. RESULTS: Colaizzi analysis identified three themes, as follows: (1) emotional transition; (2) bearing indescribable of stress; (3) searching for management in meaningful resolutions. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: Study results can provide valuable insights and information to healthcare providers developing preparatory educational programs for caregivers of discharged CBT patients. Findings can help alleviate care stress and anxiety in caregivers and nurses.