Reliability, sensitivity and responsiveness of the Infant Behavioral Assessment in very preterm infants

Aim: The aim of this study is to investigate the reliability, sensitivity and responsiveness of the Infant Behavioral Assessment (IBA) to evaluate neurobehavioural organization in very preterm infants. Methods: Videotaped assessments of very preterm infants participating in a recent trial served to evaluate a standardized IBA observation. Inter‐rater reliability was based on 40 videos scored by two independent observers, using percentage agreement and weighted Kappa’s. Sensitivity was evaluated by comparing the IBA results of 169 infants at 35–38 weeks postmenstrual age, dichotomized according to two developmental risk factors. For responsiveness, the effect size (ES) was calculated between 0 and 6 months corrected age in all intervention and control infants and in subgroups of high‐risk intervention and control infants with oxygen dependency ≥28 days. Results: Inter‐rater agreement was 93% in the total assessment; Kappa agreement was moderate to good in the behavioural categories. Significant differences were found between groups with or without risk factors. Larger differences between ESs in the randomized groups with oxygen dependency ≥28 days than in the total randomized groups reflect the responsiveness of the IBA. Conclusion: In this study, we found satisfactory to good clinimetric characteristics of the IBA in very preterm born infants.     

Dendritic-cell tumor vaccines

Most cancers remain incurable. Introduction of novel therapeutic methods, including new cytostatic regimens and targeted therapies, such as monoclonal antibodies and tyrosine kinase inhibitors, have increased remission rates as well as improved patient survival, but the ability to cure many cancer patients remains elusive. It is thus necessary to further develop alternative strategies to improve patient prognosis. The majority of patients who respond to induction therapy inevitably relapse, mainly because of the proliferation of residual malignant cells that have escaped control by induction chemotherapy. Therefore the eradication of minimal residual disease may be crucial to prevent a relapse and achieve a long-term remission. It seems that an advantageous treatment option may be cellular immunotherapy with dendritic-cell vaccines which might induce long-term specific anticancer responses with immune memory cells, which could contribute to effective and lasting elimination of malignant cells.     

Profilaktyka i leczenie zakażeń u chorych na przewlekłą białaczkę limfocytową

Infections have a significant impact on the clinical course of chronic lymphocytic leukemia and are the leading cause of patients’ death. Severe and recurrent infections are associated with impaired immunity connected with the pathogenesis of the disease, older age of patients and immunosuppressive therapy. The infections caused by encapsulated bacteria (Streptococcus pneumoniae, Haemophilus influenzae) dominate in untreated patients, while in patients under therapy, infections are caused by Staphylococcus aureus and Gram-negative bacteria such as: Pseudomonas aeruginosa, Escherichia coli and Klebsiella pneumoniae, opportunistic infections are also frequent. It is important not only to treat the infections, but also their appropriate prevention. The article discusses various methods for prevention of infections, including vaccinations.     

TLR2 Expression on Leukemic B Cells from Patients with Chronic Lymphocytic Leukemia

Archivum Immunologiae et Therapiae Experimentalis - Antigenic stimulation is considered as a possible trigger of neoplastic transformation in chronic lymphocytic leukemia (CLL). B-cell receptor...     

The frequency of T regulatory cells modulates the survival of multiple myeloma patients: detailed characterisation of immune status in multiple myeloma

Background:

Multiple myeloma (MM) is an immunoproliferative disease characterised by the uncontrolled proliferation of plasma cells, which is accompanied by defects in the immune system.

Methods:

This study aimed to characterise the frequency of T regulatory cells (Tregs), dendritic cells (DCs) as well as sub-populations of T cells bearing regulatory properties like CD4⁺GITR⁺, CD4⁺CD62L⁺, CD3⁺TCRγδ⁺ along with the concentrations of IL-10, TGFβ, IL-6 in 66 patients with MM. Subsequently, the influence of therapy on those components of immune system was assessed.

Results:

The percentage of both myeloid and plasmacytoid DC was lower in MM compared with control group while Treg (CD4⁺CD25^highFOXP3⁺) frequencies were significantly higher in MM patients compared with healthy control (6.16% vs 0.05%, respectively). Also, the percentages of CD4⁺GITR⁺, CD4⁺CD62L⁺ were increased compared with healthy volunteers. We found that patients with higher percentages of Treg live shorter (median overall survival 21 months vs not-reached, P=0.013).

Conclusion:

This study identifies several abnormalities of immune system in MM, which only partly could be normalised after successful therapy. The dysfunction of immune system such as decreased antigen presentation along with increased frequencies of suppressive cells and cytokines might facilitate progression of the disease and infectious complications limiting survival of MM patients.     

The clinical significance of ZAP-70 and CD38 expression in B-cell chronic lymphocytic leukaemia.

BACKGROUND: B-cell chronic lymphocytic leukaemia (B-CLL) is a disease with a highly variable clinical course; some patients never need treatment, while others require intensive treatment early after diagnosis. Recently, some new prognostic factors, such as IgVH mutational status, ZAP-70 and the expression of CD38 in leukaemic cells were introduced to identify attenuated versus progressive types of CLL bearing the potential to facilitate risk-adapted treatment strategies. PATIENTS AND METHODS: To evaluate the clinical value of ZAP-70 and CD38 as predictors of disease progression we assessed the expression of these markers by the flow cytometry method in 156 B-CLL patients. RESULTS AND CONCLUSIONS: Both ZAP-70 and CD38 expression were shown to predict the clinical course of the disease, while ZAP-70 expression appeared to be more predictive than CD38 expression and more relevant in defining the cases of B-CLL responsive or refractory to first line chemotherapy. A simultaneous evaluation of ZAP-70 and CD38 expression allowed distinguishing the patients groups with the most favourable prognosis as well as those with the worst. Taken together we recommend assessing both ZAP-70 and CD38 protein expression for the definition of prognostic subgroups in patients with B-CLL.