Engraftment after autologous hematopoietic stem cell transplantation in patients mobilized with Plerixafor: A retrospective,multicenter study of a large series of patients

Plerixafor (PLX) appears to effectively enhance hematopoietic stem-cell mobilization prior to autologous hematopoietic stem cell transplantation (auto-HCT). However, the quality of engraftment following auto-HCT has been little explored. Here, engraftment following auto-HCT was assessed in patients mobilized with PLX through a retrospective, multicenter study of 285 consecutive patients. Information on early and 100-day post-transplant engraftment was gathered from the 245 patients that underwent auto-HCT. The median number of PLX days to reach the stem cell collection goal (≥2 × 10⁶ CD34⁺ cells/kg) was 1 (range 1–4) and the median PLX administration time before apheresis was 11 h (range 1–18). The median number of apheresis sessions to achieve the collection goal was 2 (range 1–5) and the mean number of CD34⁺ cells collected was 2.95 × 10⁶/kg (range 0–30.5). PLX administration was safe, with only 2 mild and transient gastrointestinal adverse events reported. The median time to achieve an absolute neutrophil count (ANC) >500/μL was 11 days (range 3–31) and the median time to platelet recovery >20 × 10³/μL was 13 days (range 5–69). At 100 days after auto-HCT, the platelet count was 137 × 10⁹/L (range 7–340), the ANC was 2.3 × 10⁹/L (range 0.1–13.0), and the hemoglobin concentration was 123 g/L (range 79–165). PLX use allowed auto-HCT to be performed in a high percentage of poorly mobilized patients, resulting in optimal medium-term engraftment in the majority of patients in whom mobilization failed, in this case mainly due to suboptimal peripheral blood CD34⁺ cell concentration on day +4 or low CD34⁺ cell yield on apheresis.     

Impairment of pre-mRNA splicing in liver disease:Mechanisms and consequences

Pre-mRNA splicing is an essential step in the process of gene expression in eukaryotes and consists of the removal ofintrons and the linking of exons to generate mature mRNAs. This is a highly regulated mechanism that allows the alternative usage of exons, the retention ofintronic sequences and the generation of exonic sequences of variable length. Most human genes undergo splicing events, and disruptions of this process have been associated with a variety of diseases, including cancer. Hepatocellular carci...     

Tratamiento del carcinoma de cuerpo uterino mediante laparoscopia asistida por robot: nuestros primeros resultados

Objective

To present our experience from October 2009 though December 2011 and to compare outcomes and complications with a large study published in the American Journal of Obstetrics and Gynecology (AJOG) in 2011.

Material and methods

We performed a prospective study of our first 55 corpus uteri carcinomas: 50 endometrioid adenocarcinomas, two papillary serous carcinomas and three Müllerian adenosarcomas, treated with robot-assisted laparoscopy (da Vinci) in the Basurto University Hospital from October 2009 through December 2011.The variables analyzed were age, body mass index, histologic type, stages, treatment, mean operating time, mean of number of lymph nodes retrieved, the mean number and percentage of involved lymph nodes, surgical bleeding and conversion to laparotomy. We also analyzed the number and the percentage of operative, post-operative and total complications.

Results

The mean number of pelvic nodes was 14.44 vs. 13.16. Operating time was 181.1/286.5 minutes vs 196.33 minutes. Conversion to laparotomy was 5.45% vs. 2.9%. The percentage of total complications was 16.36% vs. 6.4%.

Conclusions

1) The number of pelvic nodes retrieved and the operating time were similar to those reported by the AJOG study. 2) Conversion to laparotomy and the percentage of total complications were higher than those reported in the AJOG study, possibly due to the smaller number of cases and the lesser experience (learning curve). 3) Robot-assisted laparoscopy is a viable approach with an excellent future in the treatment and staging of corpus uteri carcinomas.