Nutritional Status Is Superior to the ECOG Performance Status in Predicting the Dose-Intensity of the GEMOX Chemotherapy Regimen in Patients with Advanced Cancer

The increasing number of unfit patients calls for better risk assessment prior to initiating anti-tumor treatment. This is a major concern in the prevention and reduction of treatment-related complications. The aim of our study was to evaluate the nutritional status for the risk assessment of patients qualifying to receive the gemcitabine and oxaliplatin (GEMOX) regimen. This single-center, retrospective study examined baseline clinical and biological characteristics in a cohort of 165 unselected, consecutive cancer patients receiving GEMOX. Malnutrition was defined as either body mass index (BMI) <18.5 kg/m², body weight loss >10% over 3 mo, or albuminemia <35 g/L. A total of 165 patients (median age 61 yr, PS 0–1: 71%) were studied. Malnutrition was seen in 43% of PS 0–1 patients, vs. 60% of PS 2 and 66% of PS 3 patients (P > 0.05). Median relative dose-intensity was 0.90 (0.17–1.04). GEMOX dose-intensity correlated negatively with loss of baseline weight (r = ?0.24, P < 0.02). In patients who did not complete more than 2 cycles of chemotherapy, median PS (P < 0.01), mean C-reactive protein (CRP; P < 0.01), and mean albuminemia (P < 0.05) were, respectively, significantly higher, higher, and lower. Malnutrition is associated with a high risk of early discontinuance of treatment. Systematic basal evaluation of the nutritional status, including albuminemia and BMI, is recommended.     

Short exposure to telestereoscope affects the oculomotor system

Under natural viewing conditions, the accommodation and vergence systems adjust the focus and the binocular alignment of the eyes in response to changes in viewing distance. The two responses are linked via cross‐coupling and proceed almost simultaneously. Some optical devices, such as virtual reality or helmet mounted displays, create an oculomotor conflict by modifying demands on both vergence and accommodation. Previous studies extensively investigated the effect of such a conflict on the cross‐coupling between vergence and accommodation, but little is known about the plasticity of the whole oculomotor system. In the present study, an oculomotor conflict was induced by a telestereoscope which magnified the standard inter‐pupillary separation threefold and thus increased the convergence demand while accommodation remained almost unchanged. The effect of a 10 min exposure was assessed via a series of optometric parameters selected on the basis of existing oculomotor models. Associated with subject’s visual complaints, most of the oculomotor parameters tested were modified: there was (1) deterioration of stereoscopic threshold; (2) increase in AC/A ratio; (3) increase in near and far phorias; and (4) shift of the zone of clear and single binocular vision towards convergence. These results showed a change in gain of accommodative vergence and a shift of vergence reserves towards convergence in response to telestereoscopic viewing. The subject’s binocular behaviour tended towards esophoria with convergence excess as confirmed by Sheard’s and Percival’s criteria. Such changes in oculomotor parameters support adaptive behaviour linked with telestereoscopic viewing.     

CD4(+), CD56(+) DC2 acute leukemia is characterized by recurrent clonal chromosomal changes affecting 6 major targets: a study of 21 cases by the Groupe Français de Cytogénétique Hématologique

CD4(+), CD56(+) DC2 malignancies constitute a novel disease entity, which has recently been shown to arise from a transformed lymphoid-related plasmacytoid dendritic cell (DC2). Diagnosis is primarily based on a particular immunophenotype with tumor cells expressing CD4 and CD56 antigens in the absence of common lymphoid or myeloid lineage markers. Little is currently known about the cytogenetic features of this disease entity. In this setting, the Groupe Fran?ais de Cytogénétique Hématologique (GFCH) initiated a cytogenetic study of 18 adults and 3 children with CD4(+), CD56(+) DC2 acute leukemia using conventional and fluorescence in situ hybridization/24-color karyotyping. Clonal, mostly complex chromosome aberrations were found in 14 patients (66%). Six major recurrent chromosomal targets were defined. These were 5q, 12p, 13q, 6q, 15q, and 9, which were involved in 72% (5q), 64% (12p and 13q), 50% (6q), 43% (15q), and 28% (monosomy 9) of cases, respectively. Cytogenetic features can be summarized as follows: (1) gross genomic imbalances (mostly losses) predominate, (2) no single anomaly can be considered as specific, whereas their combination/accumulation is, and (3) both lymphoid and myeloid lineage-associated rearrangements are observed in unusual combinations in the same cell. This is suggestive of complex multistep tumorigenic mechanisms and is supportive of the hypothesis that CD4(+), CD56(+) DC2 acute leukemia may arise from an undifferentiated nonmyeloid nonlymphoid progenitor cell. In conclusion, the present study documents for the first time the existence of a characteristic cytogenetic profile for this novel disease entity.     

Phenolic compounds,carotenoids and antioxidant activity of three tropical fruits

Major compounds (i.e. phenolic compounds and carotenoids) were analysed in the extracts of the edible part of three tropical fruits: the Andean blackberry, the naranjilla and the tree tomato. Ellagitannins and anthocyanins were predominant in blackberries and phenolic composition can be used to differentiate the two species studied. Similar phenolic composition occurred in red and yellow tree tomato except for anthocyanins which were absent in the yellow tree tomato. Phenolic acids were detected in the naranjilla pulp. Carotenoids were analysed in the fruits. The composition in carotenoids was similar in the two varieties of tree tomato and their vitamin A activity was calculated. Carotenol fatty acid esters were predominant. β-Cryptoxanthin esters and β-carotene were the major carotenoids. The carotenoid content was high compared to literature data, providing an important high vitamin A activity. In blackberries and naranjilla, this class of compounds was found only at trace level. Finally, ORAC values were estimated in different solvent extracts and results were compared with published data in common fruits.     

Antiviral therapy is associated with a better survival in patients with hepatitis C virus and B‐cell non‐Hodgkin lymphomas,ANRS HC‐13 lympho‐C study

Hepatitis C virus (HCV) infection increases the risk of B‐cell non‐Hodgkin lymphomas (B‐NHL). Antiviral treatment (AT) can induce hematological responses in patients with marginal zone lymphomas (MZL). The ANRS HC‐13 Lympho‐C study aimed at a better understanding of the impact of AT on HCV associated B‐NHL. This multicentric study enrolled 116 HCV‐positive patients with B‐NHL between 2006 and 2012. Cytological and histological samples were collected for centralized review. At lymphoma diagnosis, median age was 61 years and gender ratio M/F was 1. Cytohistological distribution was marginal zone lymphoma (MZL) n = 45 (39%), diffuse large B‐cell lymphoma (DLBCL) n = 45 (39%), and other types n = 26 (22%). MZL patients had more frequent detection of rheumatoid factor (68% vs. 35%; P = 0.001) and more frequently mixed cryoglobulinemia (74% vs. 44%; P = 0.021) than patients with DLBCL. Among patients receiving AT, a sustained virologic response was achieved in 23 of 38 (61%) patients with MZL and in 9 of 17 (53%) with DLBCL (P = 0.42). Three‐year overall survival (OS) and progression‐free survival were 78% 95%CI [63–88] and 64% [48–76], respectively, without difference between cytohistological groups. Outcome analysis showed a favorable association between OS and AT in all patients (P = 0.05) and in the subgroup of MZL patients only (P = 0.04). Our data support that AT improves the outcomes of HCV‐associated NHLs. The impact of new AT regimen with protease inhibitor needs to be investigated in this setting. [ clinicalTrials.gov Identification number NCT01545544] Am. J. Hematol. 90:197–203, 2015. © 2014 Wiley Periodicals, Inc.