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Simple Summary: Autologous hematopoietic cell transplantation (auto-HCT) can be used to salvage at least a proportion of plasma cell myeloma patients who relapse after a previous auto-HCT. It may, however, occur that there is either no or an insufficient stem cell dose in storage to proceed to transplantation. Remobilization to procure new cells is then required. There are very limited data in the literature concerning the efficacy of stem cell remobilization after previous auto-HCT. In our previous report, we showed that remobilization with cytarabine was associated with a lower risk of remobilization failure in comparison to etoposide or cyclophosphamide. In the current study, we analyze the efficacy and safety of different doses of cytarabine (800, 1600, and 2400 mg/m2), showing that all doses are efficacious but that the dose of 2400 mg/m2 is associated with the most toxicity. Therefore, lower doses of cytarabine seem to be preferable, with plerixafor rescue when needed. Salvage autologous hematopoietic cell transplantation (auto-HCT) may be used to treat relapse of plasma cell myeloma occurring after previous auto-HCT. When an insufficient number of hematopoietic stem cells have been stored from the initial harvest, remobilization is necessary. Here, we aimed to analyze the efficacy and safety of different doses of cytarabine (total 800 vs. 1600 vs. 2400 mg/m2) for remobilization. Sixty-five patients, 55% male, with a median age at remobilization 63 years, were included. Remobilization was performed with cytarabine_800 in 7, cytarabine_1600 in 36, and cytarabine_2400 in 22 patients. Plerixafor rescue was used in 25% of patients receiving cytarabine_1600 and 27% of those receiving cytarabine_2400. Patients administered cytarabine_800 were not rescued with plerixafor. Remobilization was successful in 80% of patients (57% cytarabine_800; 86% cytarabine_1600; 77% cytarabine_2400; p = 0.199). The yield of collected CD34+ cells did not differ between the different cytarabine doses (p = 0.495). Patients receiving cytarabine_2400 were at the highest risk of developing severe cytopenias, requiring blood product support, or having blood-stream infections. One patient died of septic shock after cytarabine_2400. In summary, remobilization with cytarabine is feasible in most patients. All doses of cytarabine allow for successful remobilization. Cytarabine_2400 is associated with higher toxicity; therefore, lower doses (800 or 1600 mg/m2) seem to be preferable. [ABSTRACT FROM AUTHOR]

Obesity is a significant clinical problem worldwide, posing an increasing challenge for both physicians and patients each year. Its complications affect physical and mental health, as well as social and economic consequences. The disease exhibits remarkable heterogeneity, leading to diverse pathogenesis among individuals. Despite a growing selection of weight -reducing medications and increased awareness of the importance of a healthy lifestyle, the effectiveness of obesity therapy often remains insufficient. This raises the question of whether tailoring obesity pharmacotherapy to specific phenotypes and individual patient characteristics results in improved treatment outcomes. Objective: To review literature on the effectiveness of obesity treatment based on the personalization of pharmacotherapy according to its underlying causes. Current Knowledge: Currently, the early outcome of weight loss is closely linked to the long-term effectiveness of obesity pharmacotherapy. However, due to the diversity of obesity pathogenesis, it is not helpful in selecting therapy at the initiation of treatment. Specific characteristics are sought to indicate the appropriate drug during therapy planning. In a U.S. study (Acosta et al., 2021), four obesity phenotypes were identified through relevant tests: "brain hunger," "intestinal hunger," "emotional hunger," and "slow burning." Subsequently, treatments were matched accordingly: phentermine with topiramate or lorcaserin, liraglutide, bupropion with naltrexone, and monotherapy with phentermine. The analysis results showed that phenotype-guided obesity pharmacotherapy resulted in clinically significant absolute weight loss of >10%, >15%, and >20% in 79%, 43%, and 30% of patients, respectively, after one year, compared to 35%, 17%, and 8% in the non-phenotyped group. Other studies demonstrated that for very rare types of obesity dependent on specific genetic mutations, targeted treatment addressing these defects yielded the best therapeutic outcomes (recombinant human leptin therapy for patients with leptin gene mutation - Farooqi et al., 2002; setmelanotide therapy for individuals with proopiomelanocortin deficiency - Clément et al., 2020). The impact of specific gene variants on therapeutic response should also be considered, leading to variability in treatment effects for different patients using the same drug. Conclusion: The concept of basing therapy on obesity phenotypes may currently serve as a guide for treatment selection, although it still requires confirmation in randomized clinical trials. Individualizing the choice of pharmacotherapy must primarily be based on the comprehensive patient picture: their preferences, contraindications, or coexisting conditions, with consideration of depression and the influence of antidepressant medications on body weight. [ABSTRACT FROM AUTHOR]

Copyright of General Medicine & Health Sciences / Medycyna Ogólna i Nauki o Zdrowiu is the property of Witold Chodzki Institute of Rural Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Salvage autologous hematopoietic stem cell transplantation (auto-HSCT) constitutes a therapeutic option for a group of well-selected patients with relapsed multiple myeloma (MM). However, if an insufficient number of stem cells were harvested and stored before the first auto-HSCT, stem cells need to be remobilized. Patients diagnosed with MM who following relapse after auto-HSCT, had remobilization and afterward, auto-HSCT with remobilized cells were included in this retrospective analysis. Thirty-three patients, 61% males, the median age 61 years, were included. With a median follow-up of 1.8 years, 2-year progression-free survival was 56.2%, non-relapse mortality 4.8%. The 2-year cumulative incidence of t-MDS was 4.9%. Factors important for the outcome were: the quality of response, previous radiotherapy, the time between the first and salvage auto-HSCT. To conclude, salvage auto-HSCT performed with cells procured after the previous auto-HSCT can be efficacious in relapsed MM, especially if a sufficiently long response had been obtained to the first auto-HSCT(s). [ABSTRACT FROM AUTHOR]

Background: Salvage autologous hematopoietic stem cell transplantation (autoHSCT) may be used to treat relapse of multiple myeloma occurring after previous autoHSCT. When insufficient number of hematopoietic stem cells was stored from the initial harvest, remobilization of stem cells is necessary. Purpose: The analysis of stem cell remobilization after previous autoHSCT. Patients and Methods: Fifty‐eight patients, 60% males, median 59 years, were included. Median time interval between autoHSCT and remobilization was 42 months. The first remobilization was performed mostly after chemotherapy: cyclophosphamide (33%), cytarabine (43%), and etoposide (19%). Results: The first remobilization was successful in 67% patients. About 19% patients required plerixafor rescue, among whom it allowed for successful harvesting in 14%. Use of cyclophosphamide, cytarabine, and etoposide allowed for successful remobilization in 53%, 84%, and 55% patients, respectively. Patients treated with cytarabine had the highest yield of CD34+ cells (median 7.5 × 106/kg vs 5.8 and 2.4 for etoposide and cyclophosphamide, P =.001). Higher percentage of patients was able to collect ≥2 × 106 CD34+ cells/kg during one leukapheresis after cytarabine (76% vs 21% for cyclophosphamide vs 36% for etoposide, P =.001). Cytarabine use was associated with lower risk of remobilization failure OR = 0.217, P =.02. Toxicity comprised mostly hematological toxicity (thrombocytopenia and neutropenia). One patient succumbed to septic shock. Conclusion: Remobilization after previous autoHSCT is feasible only in a proportion of patients. Cytarabine is associated with the highest rate of successful mobilization and the highest yield of mobilized CD34+ cells. The toxicity requires careful surveillance of these patients. [ABSTRACT FROM AUTHOR]

Introduction: Salvage autologous hematopoietic cell transplantation (auto-HCT) constitutes a therapeutic option for multiple myeloma patients who experience relapse after a previous auto-HCT. When insufficient number of hematopoietic stem cells was stored from the initial harvest, remobilization of stem cells is necessary. The data on the efficacy and safety of different remobilization protocols are scarce, including the data on cytarabine dosing. Material i methods: A retrospective analysis of multiple myeloma patients who experienced relapse after a previous auto-HCT and afterwards underwent remobilization with cytarabine. Results: Sixty-five patients, 55% males, median age at remobilization 63 (37-71) years, were included. 80% patients did have a single, 20% a tandem auto-HCT before remobilization. The median time between the most recent auto-HCT and remobilization was 42 (8-239) months. The total cytarabine dose administered for remobilization was 2400 mg/m² in 29%, 2000 mg/m² in 2%, 1600 mg/m² in 58%, and 800 mg/m² in 11% patients. Plerixafor rescue was used in 23% patients (29% from the group 1600 mg/m², 20% ― 2000-2400 mg/m²). Successful remobilization (>2 × 106 CD34+ cells//kg) was possible in 82% patients; 80% in a group 2000-2400 mg/m², 87% 1600 mg/m², and 57% 800 mg/m². The total yield of CD34+ cells (× 106/kg) after the first remobilization for patients for whom any collection was possible was: 8.22 (0.65-18.49) for cytarabine 2400 mg/m², 4.87 (0.98-33.6%) 1600 mg/m², and 5.36 (1.52-9.07) 800 mg/m². Toxicity was mostly hematological. Remobilization was associated with one death due to septic shock. Conclusion: Remobilization with cytarabine after previous auto-HCT was feasible only in a proportion of patients. Cytarabine dose of 800 mg/m² was associated with the lowest rate of successful remobilization, the group was however small and not rescued with plerixafor. Future research is needed to elucidate whether the 800 mg/m² is similarly efficient to higher doses. [ABSTRACT FROM AUTHOR]

The aim of the present experiment was to investigate the influence of silver nanoparticles on Fusarium culmorum (W.G. Smith) Sacc. (FC) spores. The silver nanoparticles were produced by the high-voltage arc discharge method. To test the effect of silver nanoparticles on FC spores, 3 parameters were tested. One of these parameters was the vegetative mycelial growth in 2 experiments. The first involved the growth of FC spores on potato dextrose agar (PDA) medium after contact with 0.12-10 ppm of silver nanoparticles, and the second the growth of spores after contact with 0.12-2.5 ppm solutions of silver, but with culturing on 3 types of media (PDA, nutrient-poor PDA, and agar) instead. The next parameter was the formation of spores after the mycelia were cultured. The last parameter was spore germination in a 2.5 ppm solution of silver nanoparticles. A significant reduction in mycelial growth was observed for spores incubated with silver nanoparticles. This relationship was dependent on the incubation time and type of growth medium, but did not depend significantly on the concentration of silver nanoparticles up to 2.5 ppm. The sporulation test showed that, relative to control samples, the number of spores formed by mycelia increased in the culture after contact with silver nanoparticles, especially on the nutrient-poor PDA medium. The 24 h incubation of FC spores with a 2.5 ppm solution of silver nanoparticles greatly reduced the number of germinating fragments and sprout length relative to the control. Le but de ces expériences était d’examiner l’influence de nanoparticules d’argent sur des spores de Fusarium culmorum (W.G. Smith) (FC). Les nanoparticules d’argent ont été produites par la méthode de décharge en arc à haut voltage. Afin de tester l’effet des nanoparticules d’argent sur les spores de FC, 3 paramètres ont été examinés. Un de ces paramètres consistait à mesurer la croissance du mycélium végétatif lors de deux expériences: premièrement, à partir des spores mises en contact avec 0,12 à 10 ppm de nanoparticules d’argent dans du milieu PDA, et deuxièmement, à partir des spores mises en contact avec 0,12 à 10 ppm d’argent en solution, dans trois types de milieux de culture (PDA, PDA appauvri et gélose). Le paramètre suivant consistait à examiner la formation de spores obtenues après la culture du mycélium, et le dernier, à examiner la germination des spores dans une solution contenant 2,5 ppm de particules d’Ag. Une réduction significative de la croissance du mycélium a été observée à partir des spores incubées en présence de nanoparticules d’argent. Cette relation dépendait du temps d’incubation et du type de milieu de croissance, mais ne dépendait pas significativement de la concentration de nanoparticules d’argent jusqu’à 2,5 ppm. Le test de sporulation a montré que le nombre de spores formées par le mycélium en culture augmentait après un contact avec les nanoparticules d’argent comparativement au milieu contrôle, notamment dans le milieu PDA appauvri. L’incubation des spores de FC pendant 24 h dans une solution contenant 2,5 ppm de nanoparticules d’argent réduisait grandement le nombre et la longueur des pousses germinatives, comparativement au contrôle. [ABSTRACT FROM AUTHOR]

Simple Summary: Multiple myeloma (MM) is the second most common haematological malignancy. Despite huge progress associated with the introduction of new antimyeloma drugs, MM remains an incurable disease. In this review, we discuss the role of the innate lymphoid system, its role in the pathogenesis of the disease, and the mechanisms by which innate lymphoid cells (ILC) can theoretically achieve therapeutic benefit in MM treatment. Innate lymphoid cells (ILCs) are a recently identified family of lymphocyte-like cells lacking a specific antigen receptor. They are part of the innate immune system. They play a key role in tissue homeostasis and also control inflammatory and neoplastic processes. In response to environmental stimuli, ILCs change their phenotype and functions, and influence the activity of other cells in the microenvironment. ILC dysfunction can lead to a wide variety of diseases, including cancer. ILC can be divided into three subgroups: ILC Group 1, comprising NK cells and ILC1; Group 2, including ILC2 alone; and Group 3, containing Lymphoid Tissue inducers (LTi) and ILC3 cells. While Group 1 ILCs mainly exert antitumour activity, Group 2 and Group 3 ILCs are protumorigenic in nature. A growing body of preclinical and clinical data support the role of ILCs in the pathogenesis of multiple myeloma (MM). Therefore, targeting ILCs may be of clinical benefit. In this manuscript, we review the available data on the role of ILCs in MM immunology and therapy. [ABSTRACT FROM AUTHOR]

Copyright of Review of Medicine / Przeglad Lekarski is the property of Wydawnictwo Przegld Lekarski / Publisher Medicine Review and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)