Talimogene laherparepvec (T-VEC) in advanced melanoma: complete response in a heart and kidney transplant patient. A case report.

Talimogene laherparepvec (T-VEC) is a intralesional oncolytic virotherapy, licensed in the European Union for locoregional advanced melanoma of American Joint Committee on Cancer stages IIIB, IIIC and IVM1a. Organ transplant recipients are currently excluded from all clinical trials dealing with immunotherapies due to the risk of transplant rejection. A 58-year-old white man with a history of heart and kidney transplantation in 2014 was diagnosed with melanoma (Breslow thickness 1·6 mm, stage pT2a) on the left arm in September 2015. In March 2016 he developed in transit metastases, and local therapy with a combination of topical imiquimod (5%) and cryotherapy of individual lesions was initiated. However, in November 2016 therapy was stopped following local progression of the metastases. An interdisciplinary decision to treat the patient with T-VEC was taken. After 11 cycles of T-VEC, the patient showed a complete response. As of June 2018, 11 months after the last treatment cycle of T-VEC, the patient continues to be tumour free. The patient tolerated the therapy well with only mild adverse events and did not show any sign of graft rejection or loss of function of the transplanted organs. We conclude that T-VEC can be a potentially effective and safe treatment in patients with a history of organ transplantation. Nevertheless, due to this special situation, the risks and benefits should always be discussed with an interdisciplinary tumour board.

Effect of intravenous immunoglobulin administration on erythrocyte and leucocyte parameters.

BACKGROUND: Intravenous immunoglobulins (IVIG) are an attractive therapeutic tool for therapy of toxic epidermal necrolysis and severe forms of certain autoimmune diseases, including dermatomyositis, autoimmune blistering diseases, systemic vasculitis and lupus erythematodes. OBJECTIVES: Prompted by a case of IVIG-associated haemolytic anaemia, the effects of IVIG administrations on haematological parameters in patients with dermatological conditions were investigated. METHODS: Erythrocyte and leucocyte parameters were retrospectively analysed in 16 patients who had received IVIG at doses from 1 to 3 g/kg bodyweight (n = 35 cycles). The influence of IVIG on leucocyte survival was determined in vitro. RESULTS: Decreased absolute erythrocyte numbers, haemoglobin and haematocrit levels and a case of haemolytic anaemia were linked to transfusion of high-, but not low-dose IVIG. In contrast, leucopenia post-IVIG occurred in the vast majority of the recipients, unrelated to the administered IVIG amounts. In vitro investigations revealed a dose-dependent impairment of cell survival by IVIG in the neutrophil and monocyte, but not in the lymphocyte subpopulations. In several IVIG preparations, substantial amounts of blood group anti-A/anti-B antibodies were detected which could have accounted for the observed changes in the haematological parameters in our study cohort. CONCLUSIONS: IVIG products should be administered strictly according to indications. Commercially available IVIG products can contain blood group-specific antibodies that may induce haemolysis in some recipients. Monitoring of blood counts during applied IVIG therapy, especially when high doses are administered, is recommended.

Role of nitric oxide in physiology and pathology of the gastrointestinal tract.

In this paper the physiological role of NO and isoforms of NOS in the gastrointestinal tract and the involvement of NO in pathological processes of digestive tract as well as the perspective of therapeutic use of NO-donating drugs and selective inhibitors of phosphodiesterase in the treatment of gastric diseases were presented.

[The role of free radicals in inflammatory states, ulceration, and ulcers of the stomach and duodenum]. / Rola wolnych rodników w stanach zapalnych, owrzodzeniu i w chorobie wrzodowej zoladka i dwunastnicy.

The free radicals derived from oxygen have been implicated in damage caused to the gastroduodenal mucosa. The association between the mucosal production of reactive oxygen radicals in the gastric antrum and duodenum, Helicobacter pylori density and duodenal ulcer has been previously described. The role of interleukin IL-8 in the inflammatory process and its relationship with reactive oxygen radicals has also been investigated. These results indicate that oxygen radicals play an important role in the mechanism of ulcer aggravation induced by a variety of different factors.

[Primary gastric non-Hodgkin lymphoma]. / Pierwotne zlosliwe chloniaki zoladka.

Authors discussed etiology, diagnostic and therapeutical problems in the treatment of primary gastric non-Hodgkin lymphoma. The first one was limited to the gastric region and was cured favourably. The second one extended gastric region and affected all alimentary tract. This case was terminated by death of the patient.

[The role of enterochromaffin-like cells in physiology and pathology of stomach and duodenum]. / Rola komórek enterochromafinopodobnych w fizjologii i patologii zoladka i dwunastnicy.

During recent years, gastric ECL cells have attracted much attention, mainly due to the fact that mice and rats were found to develop gastric carcinoids following lifelong treatment with blockers of acid secretion. We present the structure and functions of ECL cells and their influence on physiology and pathology of stomach and duodenum. We describe interactions of enzymes and hormones in histamine-stimulated gastric output.

[Alpha 1-antitrypsin polymorphism]. / Polimorfizm alfa1-antytrypsyny.

Discovery, nomenclature and some genetical and molecular aspect of alpha 1-antitrypsin polymorphism are discussed. Particular attention has been paid to the deficiency variants and their role in human pathology.

Plasms renin acitivity in coarctation of aorta before and after surgery.

Plasma renin acitivity was measured in II cases of coarctation of the aorta before and after operation. The values of plasma renin activity in the recumbent position before operation were significantly lower than in the control group. After surgery plasma renin activity rose to normal levels. There was no correlation between plasma renin activity levels and arterial blood pressure. The renin-angiotensin system seems not to be involved directly in the maintenance of hypertension in patients with aortic coarctation.