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A substantial proportion of patients requiring allogeneic stem cell transplantation (alloSCT) do not have a human leukocyte antigen-matched sibling donor and need an alternative donor. In this multicenter retrospective study, we compared the outcomes of 176 patients with myelodysplastic syndrome and acute leukemia undergoing alloSCT from haploidentical ( n  = 121) and international ( n  = 55) donors between 2002 and 2016. For recipients of haploidentical and international donors, the 2-year overall survival rates were 33.4% and 35.3%, respectively ( P  = 0.347), and relapse-free survival rates were 31.7% and 34.4% ( P  = 0.264), respectively. In addition, there were no significant differences in the cumulative incidences of acute and chronic graft versus host disease or incidences of infection within 30 days (all P >  0.05). Similarly, there were no significant differences in these measures for acute leukemia patients ( n  = 143; all P >  0.05). A multivariate analysis revealed that the donor type was not an independent prognostic or predictive factor. These data suggest that both haploidentical and international donors are feasible alternative sources for alloSCT when a matched donor is not available domestically. [ABSTRACT FROM AUTHOR]

• Rapidity of response was associated with genetic alterations in immune cells. • Genes associated with NK-cell showed significant differences according to the response. • Innate immune system at diagnosis had an important role in treatment response in CML. Genetic differences may be associated with the response to tyrosine kinase inhibitor (TKI) in patients with chronic myeloid leukemia (CML). In this study, we identified genetic alterations between rapid and slow responders (BCR/ABL1 International Scale at 6 months: ≤0.1 % vs. > 0.1 %) of TKI treatment in chronic phase CML patients. Our analyses involved single nucleotide polymorphism (SNP), a Genome Wide Association Study and a Network-wide Association Study (NetWAS). Seventy-two patients from 16 institutions were enrolled and treated with a TKI, nilotinib. Gene Set Analysis identified genetic alterations in pathways related to the differentiation, proliferation, and activity of various innate immune cells. The NetWAS analysis found that genes associated with natural killer (NK) cells (PTPRCAP, BLNK, HCK, ARHGEF11, GPR183, TRPV2, SHKBP1, CD2) showed significant differences between rapid and slow responders of nilotinib. However, we found no significantly different genetic alterations according to the response in the SNP analysis. In conclusion, we found that rapidity of response to TKI was associated with pathway-associated genetic alterations in immune cells, particularly with respect to NK cell activity. These results suggested that the innate immune system at initial diagnosis had an important role in treatment response in patients with CML. [ABSTRACT FROM AUTHOR]

• Ultra-deep sequencing is a sensitive method for genetic-based treatment decisions. • Specific mutations could have a prognostic application in predicting response. • Based on mutational analyses, nilotinib is a promising option for Korean patients. Ultra-deep sequencing detects low-frequency genetic mutations with high sensitivity. We used this approach to prospectively examine mutations in the BCR/ABL1 tyrosine kinase from patients with newly diagnosed, chronic-phase chronic myeloid leukemia (CML) treated with the tyrosine kinase inhibitor nilotinib. Between May 2013 and November 2014, 50 patients from 18 institutions were enrolled in the study. We screened 103 somatic mutations and found that mutations in the P-loop domain were the most frequent (173/454 mutations in the P-loop) and noted the presence of the V299 L mutation (dasatinib-resistant/nilotinib-sensitive) in 98 % of patients (49/50). No patients had Y253H, E255 V, or F359 V/C/I mutations, which would recommend dasatinib rather than nilotinib treatment. The S417Y mutation was associated with lower achievement of a major molecular response (MMR) at 6 months, and the V371A mutation was associated with reduced MMR and MR4.5 durations (MMR for 2 years: 100 % for no mutation vs. 75 % for mutation, P= 0.039; MR4.5 for 15 months: 94.1 % vs. 25 %, P= 0.002). Patients with known nilotinib-resistant mutations had lower rates of MR4.5 achievement. In conclusion, ultra-deep sequencing is a sensitive method for genetic-based treatment decisions. Based on the results of these mutational analyses, nilotinib treatment is a promising option for Korean patients with CML. [ABSTRACT FROM AUTHOR]

Radiation-induced cavernous malformations (RICMs) are most commonly reported in young patients who have previously received radiotherapy. Here, we report a case of a patient with a germ cell tumor who was treated with whole brain radiotherapy (WBRT) and then incidentally found to have numerous RICMs. A 31-year-old male visited the hospital for a testicular mass. On examination, he was diagnosed with a mixed germ cell tumor with lung/brain metastases. The patient underwent a left orchiectomy and received 4 cycles of chemotherapy. He was then treated with WBRT for residual lesions in the brain and a wedge resection for the lung metastasis. Four years later, approximately 250-300 RICMs were incidentally observed in a follow-up brain image. Because the patient had not noticed any symptoms and the RICMs were small in size, he was not treated. To our knowledge, this is the first reported case of numerous (approximately 250-300) RICMs in a germ cell tumor patient after WBRT. Herein, we report details of this case and discuss the typical clinical features of RICM. [ABSTRACT FROM AUTHOR]

Herbal plants have long been used as traditional medicines to treat diseases caused by microbial pathogens. The hepatitis A virus (HAV) causes acute liver infection through the fecal–oral route. Although the antimicrobial activities of herbal extracts against bacterial and some viral pathogens have been extensively studied, their antiviral properties against HAV have not been investigated thus far. This study was designed to investigate the inhibitory effect of 16 herbal extracts against HAV. Significant inhibition of HAV was observed only when HAV was co-treated with extracts. Ten out of the 16 herbal extracts demonstrated significant virucidal activity against HAV. Alnus japonica extract at a concentration of 50 μg/mL reduced HAV titer by 3.43 ± 0.24 logs. Artemisia annua, Allium sativum, Allium fistulosum, and Agrimonia pilosa extracts showed 2.33 ± 0.43, 2.10 ± 0.41, 2.07 ± 0.60, and 2.03 ± 0.26-log reductions, respectively. Pleuropterus multiflorus, Eleutherococcus senticosus, Coriandrum sativum, Ginkgo biloba, and Torilis japonica extracts reduced HAV titer by 1.02 ± 0.21 to 1.90 ± 0.33 logs. Among the 10 herbal extracts, Alnus japonica extract was the most potent in inhibiting HAV without exhibiting cytotoxicity. [ABSTRACT FROM AUTHOR]