Efficacy of high-dose therapy and hematopoietic stem cell transplantation for mantle cell lymphoma

Conventional treatment of mantle cell lymphoma (MCL) yields modest responses and short remissions. We report 30 hematopoietic stem cell transplants (HSCT) for MCL: 13 autologous, 10 allogeneic myeloablative, and 7 nonablative. After a median 1.2 years from diagnosis (range 0.5 to 4.7) and a median of 2 pre-HSCT chemotherapeutic regimens (range 1 to 5), their median age at HSCT was 52 years (range 37 to 67). Eleven patients (41%) were in first remission, 11 (41%) were in second remission, and 7 (25%) had resistant disease. Four died early. Nineteen achieved CR (83%) and 4 PR (17%). With median 2.7 years of follow-up, 5-year overall survival (OS) was 42% (95% CI 11-73%) after autologous versus allogeneic at 49% (95% CI 22-76%). Five-year progression-free survival (PFS) was 31% (95% CI 3-59%) and 50% (95% CI 24-76%) for autologous and allogeneic HSCT, respectively. Fourteen died: 3 from sepsis, 1 acute GVHD, 10 MCL. No autologous transplant-related deaths occurred. Allogeneic transplant-related mortality was 29% (95% CI 6-52%) at 1 and 5 years. HSCT for MCL can yield extended disease control and long-term survival.     

Sexual Behavior, Psychosocial and Knowledge Differences between Consistent, Inconsistent and Non-Users of Condoms: A Study of Female Bar and Hotel Workers in Moshi, Tanzania

Understanding psychosocial, sexual behavior and knowledge differences between never, inconsistent and consistent condom users can improve interventions to increase condom use in resource-poor countries, but they have not been adequately studied. We examined these differences in a cohort of 961 female hotel and bar workers in Moshi, Tanzania. Forty-nine percent of women reported no condom use; 39% reported inconsistent use, and 12% reported consistent use. Women with multiple sexual partners in the past five years were less likely to be consistent rather than inconsistent users as were women who had ever exchanged sex for gifts or money. Inconsistent users had higher condom knowledge and higher perceived acceptability of condom use than did never users, but they did not differ from consistent users by these factors. There are important differences between women by level of condom use. These findings can help inform interventions to increase condom use.     

Candidemia in patients with hematologic malignancies: analysis of 7 years' experience in a single center

We report 45 incidents of candidemia in 45 patients diagnosed with hematologic malignancies between 1997 and 2004. A large majority of species isolated were non-albicans and there was an unexpectedly high incidence of Candida tropicalis. The attributable mortality (15%) was interestingly low in this population of severely immunocompromised patients.     

Resistance of disposable drapes to bacterial penetration

PURPOSE: To test the bacterial penetrability of disposable non-woven drapes used specifically for total hip arthroplasty. METHODS: 12 round agar plates were inoculated with 107 colony-forming units/ml of coagulase-negative staphylococci (CNS) and incubated in air at 37 degrees Celsius for 18 hours to obtain a semi-confluent growth of organisms. Six brands of disposable drapes were tested; each was assigned to 2 plates. Each disposable drape was placed between a round agar plate and an inverted square agar plate filled with blood agar. After 30 and 90 minutes, the square agar plates were removed and incubated for 48 hours and inspected for growth of CNS. RESULTS: Bacterial penetration was time dependant. Certain brands of drapes were more impenetrable than others; none was impenetrable at all time points, but most remained so or allowed passage of fewer than 100 colony-forming units at 90 minutes. CONCLUSION: It is recommended that drapes be rigorously tested with regard to their resistance to bacterial penetration.     

Venlafaxine-mirtazapine combination in the treatment of persistent depressive illness

The combination of mirtazapine and venlafaxine has been suggested as a treatment option for difficult to treat depressive illness. We describe 32 patients with persistent depressive illness (44% male; mean age 42 years; mean 2.5 previous antidepressant trials) that received mirtazapine and venlafaxine in combination at some point over the 3 year period between 2002 and 2005. Clinical response rates (CGI-improvement score of two or less) were 44% at 4 weeks and 50% at 8 weeks. At 6 month review, 18 patients (56% of the original cohort and 75% of those still receiving treatment) had significantly responded. Clinical response typically occurred at moderate and high dose treatment with both agents. A total of 44% experienced some adverse effects with sedation (19%) and weight gain (19%) most frequent. Five patients discontinued treatment due to these effects. No serious adverse effects were linked to the combination treatment. We discuss the implications of these findings for the use of venlafaxine and mirtazapine in combination in more difficult to treat patients with depression.     

Cone photoreceptor mosaic disruption associated with Cys203Arg mutation in the M-cone opsin

Missense mutations in the cone opsins have been identified as a relatively common cause of red/green color vision defects, with the most frequent mutation being the substitution of arginine for cysteine at position 203 (C203R). When the corresponding cysteine is mutated in rhodopsin, it disrupts proper folding of the pigment, causing severe, early onset retinitis pigmentosa. While the C203R mutation has been associated with loss of cone function in color vision deficiency, it is not known what happens to cones expressing this mutant opsin. Here, we used high-resolution retinal imaging to examine the cone mosaic in two individuals with genes encoding a middle-wavelength sensitive (M) pigment with the C203R mutation. We found a significant reduction in cone density compared to normal and color-deficient controls, accompanying disruption in the cone mosaic in both individuals, and thinning of the outer nuclear layer. The C203R mosaics were different from that produced by another mutation (LIAVA) previously shown to disrupt the cone mosaic. Comparison of these mosaics provides insight into the timing and degree of cone disruption and has implications for the prospects for restoration of vision loss associated with various cone opsin mutations.     

Pretreatment angiogenic cytokines predict response to chemoimmunotherapy in patients with chronic lymphocytic leukaemia

Serum levels of pro-[vascular endothelial growth factor (VEGF)] and anti-[thrombospondin-1 (TSP)] angiogenic cytokines were prospectively measured in a phase II trial of chemoimmunotherapy (CIT) for chronic lymphocytic leukaemia (CLL) patients ( n  = 56). Pretreatment VEGF levels were lower among patients who achieved complete remission (CR) or nodular partial remission (nPR) relative to those with partial remission (PR) or stable/progressive disease (median 122·0 pg/ml vs. 246·8 pg/ml; P  = 0·03). VEGF:TSP ratio was lower (anti-angiogenic phenotype) among patients who achieved CR/nPR. The pretreatment VEGF:TSP ratio also correlated with overall survival ( P  = 0·008). A pro-angiogenic profile appears associated with diminished response and inferior survival in CLL patients receiving CIT.     

Using social network analysis to evaluate community capacity building of a regional Community Cancer Network

The Tampa Bay Community Cancer Network (TBCCN) is one of 25 Community Network Programs funded by the National Cancer Institute's (NCI's) Center to Reduce Cancer Health Disparities with the objectives to create a collaborative infrastructure of academic and community based organizations and to develop effective and sustainable interventions to reduce cancer health disparities. In order to describe the network characteristics of the TBCCN as part of our ongoing evaluation efforts, we conducted social network analysis surveys with our community partners in 2007 and 2008. One key finding showed that the mean trust value for the 20 community partners in the study increased from 1.8 to 2.1 (p<0.01), suggesting a trend toward increased trust in the network. These preliminary results suggest that TBCCN has led to greater collaboration among the community partners that were formed through its capacity‐building and evidence‐based dissemination activities for impacting cancer health disparities at the community level. © 2010 Wiley Periodicals, Inc.