Clinical characteristics,molecular profile and outcomes of myeloid sarcoma: a single institution experience over 13 years

Background: Myeloid sarcoma (MS) is characterized by extramedullary infiltration by immature myeloid cells. Owing to rarity of this disease, the clinical features and overall outcomes are yet to be clarified.

Objective: To define clinical characteristics, epidemiology, pathologic findings, treatment options and outcomes in MS.

Methods: We conducted a retrospective review of 23 patients diagnosed with MS at our institute over a period of 13 years (2002–2015).

Results: MS presented mostly as a manifestation of relapsed acute myeloid leukemia, seen in 39% of patients. Skin and subcutaneous soft tissues were the most common sites of anatomic involvement (69.5%). Ninety five percent (n?=?19) were positive for classical myeloid markers with either cytochemical staining (chloracetate-esterase, MPO), flow-cytometry (CD33, CD34, CD13 and CD117), or immunohistochemistry (CD34, CD43, CD68 and lysozyme). Of these, 52% were positive for CD33 (n?=?12), 35% for CD68 (n?=?8), 30% for CD34 (n?=?7), and 26% for lysozyme (n?=?6). Cytogenetic abnormalities were seen in 63% (n?=?12/19) patients on bone-marrow aspirate, with five patients displaying a complex (n?=?3) or monosomal (n?=?2) karyotype. Twenty seven percent patients with a normal karyotype had presence of deleterious mutations (FLT3, ASXL, STAG and JAK2) on further testing with myeloid mutation panel. The Median overall survival (OS) of the entire cohort was 15.9 months (95% CI, 7.4–24.4 months). The OS was significantly better for patients <65 years (24.6 vs. 3.4 months, p?=?0.009) of age, and for those attaining a complete remission (CR) to induction therapy (25.7 vs. 0.8 months, p?Conclusion: Failure to achieve CR with induction therapy, and age >65 years are associated with poor outcomes in MS. Allogeneic stem-cell transplant in first remission appears to be the most effective modality for achieving long-term remissions.     

Biosimilars: what the dermatologist should know

Biosimilars are highly similar versions of approved branded biologics. In contrast to generics, which are identical copies of the originator medicines, biosimilars are considered unique but related molecules that differ from the originator reference product as well as from each other. Owing to the complexity of biologic medicines, such as therapeutic monoclonal antibodies, minor differences between biosimilars and the reference products are acceptable provided these differences do not result in any clinically meaningful differences in safety or efficacy. In addition, minor changes in structure and function may occur over time in originator biologic products as a result of alterations in production materials (e.g. cell lines), processes or conditions. The developmental process for biosimilars focuses on a ‘totality of evidence’ approach that emphasizes a stepwise investigational process, including comprehensive structural, functional, pharmacologic and clinical assessment for similarity. The goal of the phase 3 clinical development programme for a biosimilar is not to establish efficacy, per se, but to demonstrate that there are no clinically meaningful differences between the proposed biosimilar and the reference product. The requirement to show clinical similarity informs biosimilar study design, including the selection of the patient population, disease state (indication), study endpoints and statistical methods. Based on the clinical trial results in a representative patient population, results may be extrapolated to other indications provided scientific justification is demonstrated based on, among other things, similar mechanism of action in the extrapolated indications. This review presents the current state of knowledge with respect to biosimilars. We aim to provide the practising clinician with a working knowledge of biosimilars as well as provide some practical guidance on their use and potential benefits in treating dermatologic diseases.     

Temperature Dependent Adsorption–Desorption Behaviour of Pendimethalin in Punjab Soils

Bulletin of Environmental Contamination and Toxicology - This study shows the effect of soil type and temperature on the adsorption and desorption behaviour of pendimethalin using a batch...     

Adjuvant radiotherapy for atypical and malignant meningiomas: a systematic review

Atypical meningiomas (AMs) and malignant meningiomas (MMs) are tumors with a lower incidence and poorer prognosis than benign meningiomas. The role of radiotherapy as an adjuvant to surgical resection, especially for AMs, is incompletely defined. In this study, the English-language literature was systematically reviewed for studies that reported tumor characteristics, treatment parameters, and clinical outcomes after adjuvant radiotherapy for AM and MM, including overall survival, progression-free survival, and/or time to recurrence or mortality. Clinical outcomes were further assessed in the context of resection status, timing of administration, and radiation dose. Outcomes after stereotactic radiosurgery were also examined. Treatment toxicity and other potential prognostic or confounding factors were appraised. Ten and 11 studies for AM and MM, respectively, met the inclusion criteria. The median 5-year progression-free survival and overall survival after adjuvant radiotherapy were 54.2% and 67.5%, respectively, for AM and 48% and 55.6% for MM. The complication rates were 11.1% for AM and 5.1% for MM. Incomplete resection and radiation dose <50 Gy conferred significantly poorer 5-year progression-free survival. Most studies were unable to demonstrate a statistically significant prognostic benefit for adjuvant radiotherapy in AM. In conclusion, adjuvant radiotherapy significantly improved local control of AMs and MMs, especially after subtotal resection. Study limitations, including inadequate statistical power, may underlie the studies'' inability to demonstrate a statistically significant benefit for adjuvant radiotherapy in AM. Because these tumors preferentially recur within 5 years of surgical resection, future studies should define whether early adjuvant therapy should become part of the standard treatment paradigm for completely excised tumors.     

Study of Optimum Time Span for Distinguishing Rumex spinosus in Wheat Crop Through Spectral Reflectance Characteristics

Using the inherent spatial and temporal variability within a field to manage farm operations is called precision agriculture. This is a site-specific approach which can reduce input costs and results in higher crop productivity, profitability and lesser environmental pollution. Remote sensing provides a means for the development of weed maps by detecting the location of weeds within an agricultural field, so that site-specific/need based herbicide can be applied. Reductions in herbicide use as a result of this practice reduce management costs for farmers and promote environmental friendliness. The results revealed a decreasing trend in the number of tillers, effective tillers, number of grains per ear, 1,000-grain weight and grain yield of wheat with increasing population densities of Rumex spinosus (from 3 to 12 plants m^?2). Highest grain yield of wheat (5.75 tonnes ha^?1) was recorded under solid stand of wheat and lowest grain yield was recorded in treatments having 12 plants of R. spinosus. Higher radiance ratio and NDVI values were recorded in solid stand or pure wheat treatment and minimum under solid weed plots. It was observed that by using radiance ratio and NDVI, pure wheat can be distinguished from pure populations of R. spinosus after 30 DAS. It remains distinguished upto 120 DAS. Different levels of Rumex populations can be discriminated amongst themselves from 60 DAS onwards.     

Quality of life after orbito-facial trauma

In the wake of high incidence of orbito-facial trauma, there has been a growing need to assess not only the visual outcome, but also the psychological impact of the traumatic event. This is a single questionnaire based evaluation of 100 consecutive patients with orbito-facial trauma (blow-out and Le fort type II and III fractures) at six months of trauma. 84% of the patients had a NEI VFQ- 25 score of less than 50, with 49% having a score less than 25, reflecting the grim impact the trauma has on the quality of life. The three parameters of the questionnaire - general health, difficulty with activities and response to vision problems were significantly positively correlated. Quality of life is considerably affected following orbito-facial trauma, disturbing physical, mental and social health. Poor vision is positively correlated with poor general health. Psycho-social impact of trauma needs to be recognized as an important sphere in the management of orbito-facial trauma.     

Systematic Investigation of Parameters Affecting the Performance of an Agitated Filter-Dryer

A systematic experimental investigation of contact drying operation was carried out in an agitated Charles Thompson filter-dryer. In this study, the effect of process parameters (wall temperature, impeller speed, fill level) on the drying performance in the filter-dryer is quantified as a function of bed temperature and solvent concentration. In addition, the impact of drying conditions on the particle size distribution was also examined. It was found that in the range of parameters investigated, drying rate increased with wall temperature and reduced bed depth. The effect of impeller speed was variable where favorable drying conditions were strongly dependent on the particle properties. Moreover, decrease in the particle size was evident with an increase in impeller speed and decrease in the bed depth due to increased collision frequency and reduction in the fill volume both leading to particle attrition respectively. Besides, the average wall to solid heat transfer coefficient is also estimated for variable operating conditions. © 2013 Wiley Periodicals, Inc. and the American Pharmacists Association J Pharm Sci 102:2198–2213, 2013     

Autologous Therapies in Dermatology

Autologous therapy is a therapeutic intervention that uses an individual’s cells or tissues, which are processed outside the body, and reintroduced into the donor. This emerging field presently represents a mere tip of the iceberg with much knowledge and applications yet to be discovered. It, being free from risks of hypersensitivity reactions and transmission of infectious agents, has been explored in various fields, such as plastic surgery, orthopedics, and dermatology. This review article focuses on various forms of autologous therapies used in dermatology along with their applications and mechanisms of action.Autologous therapy is a novel therapeutic intervention that uses an individual’s cells or tissues, which are processed outside the body and reintroduced into the donor. Currently, this form of therapy has broad applications in modern medicine, orthopedics, and therapeutic and cosmetic dermatology.