Daratumumab for relapsed or refractory AL amyloidosis with high plasma cell burden.

Daratumumab, an anti-CD38 antibody, is effective in AL amyloidosis with low tumor burden. Data of daratumumab treatment in patients with AL amyloidosis but high tumor burden (≥10% bone marrow plasma cells) are limited. We report retrospective data of 10 consecutive patients with high tumor burden treated with daratumumab for relapsed/refractory AL amyloidosis.

Updated recommendations for diagnosis and treatment of plasma cell myeloma in Switzerland.

This update on plasma cell myeloma has been elaborated by a Swiss expert panel as a result of the plethora of new data on the treatment of plasma cell myeloma reported recently. It adds new insights to the more extensive review that was published 3 years ago and may help clinicians on decision making for their patients. The new recommendations for distinguishing plasma cell myeloma from smouldering myeloma are briefly presented, including a section on contemporary imaging studies with this respect.

Melphalan dose in myeloma patients ≥65 years of age undergoing high-dose therapy and autologous stem cell transplantation: a multicentric observational registry study.

The optimal melphalan dose prior to autologous stem cell transplantation (ASCT) is not known for elderly multiple myeloma (MM) patients. We analyzed data of all MM patients ≥65 years (n = 388) enrolled in the observational Swiss Blood Stem Cell Transplantation Registry. The median age was 67 years (65-77).

Y -Ibritumomab tiuxetan (Y -IT) and high-dose melphalan as conditioning regimen before autologous stem cell transplantation for elderly patients with lymphoma in relapse or resistant to chemotherapy: a feasibility trial (SAKK 37/05).

Standard conditioning regimens for autologous stem cell transplantation (ASCT) are often not tolerated by elderly patients, on one hand. Single high-dose melphalan, on the other hand, has been shown to be safe and active as a pretransplant preparative regimen in elderly patients. Y -Ibritumomab tiuxetan (Y -IT) is well tolerated and feasible in the transplantation setting.

Current status and updated recommendations for diagnosis and treatment of plasma cell myeloma in Switzerland.

The availability of drugs such as thalidomide, bortezomib and lenalidomide changed the landscape in myeloma treatment and has extended the median survival up to 10 years with a substantial improvement in quality of life. This development prompted a Swiss expert panel to re-evaluate the current status and formulate updated clinical recommendations for the diagnosis and treatment of plasma cell myeloma. These recommendations should help clinicians in their decision making to achieve the best outcome based on currently available data.

Two-dimensional infrared spectroscopy reveals the structure of an Evans auxiliary derivative and its SnCl4 Lewis acid complex.

Determining the structure of reactive intermediates is the key to understanding reaction mechanisms. To access these structures, a method combining structural sensitivity and high time resolution is required. Here ultrafast polarization-dependent two-dimensional infrared (P2D-IR) spectroscopy is shown to be an excellent complement to commonly used methods such as one-dimensional IR and multidimensional NMR spectroscopy for investigating intermediates.

Autotransplant for Hodgkin lymphoma after failure of upfront BEACOPP escalated (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine and prednisone).

BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine and prednisone) escalated is the preferred upfront Hodgkin lymphoma (HL) treatment in a number of countries. Upon failure, high-dose chemotherapy with autologous stem cell support (HDT/ASCT) is performed, but its effectiveness has not been verified in this setting. We analyzed all Swiss cases of chemosensitive HL autografted after failure of BEACOPP escalated (n = 22) and compared outcomes with 22 cases of HDT/ASCT following frontline ABVD (doxorubicin, bleomycin, vinblastine and dacarbazine) failure.

A case of lenalidomide-induced hypersensitivity pneumonitis.

Background: Lenalidomide is a new immunomodulatory drug, FDA-approved for the treatment of the 5q-myelodysplastic syndrome and refractory or relapsed multiple myeloma (MM). Regarding the treatment of MM, there have been published cases of acute pulmonary toxicity for the proteasome inhibitor bortezomib and the immunomodulatory drug thalidomide; only 1 case of lenalidomide-induced pulmonary toxicity has been described in the literature.

Case Report: In our manuscript, we describe the clinical course and diagnostic workup of a 66-year-old male patient with MM on lenalidomide with signs of acute pulmonary toxicity.

Integrating novel agents into multiple myeloma treatment - current status in Switzerland and treatment recommendations.

The treatment of multiple myeloma has undergone significant changes in the recent past. The arrival of novel agents, especially thalidomide, bortezomib and lenalidomide, has expanded treatment options and patient outcomes are improving significantly. This article summarises the discussions of an expert meeting which was held to debate current treatment practices for multiple myeloma in Switzerland concerning the role of the novel agents and to provide recommendations for their use in different treatment stages based on currently available clinical data.

Prognosis of acute myeloid leukemia in the general population: data from southern Switzerland.

Aims And Background: To evaluate the outcome of adult patients with de novo acute myeloid leukemia in the Italian-speaking part of Switzerland and to identify prognostic factors, time to progression and overall survival.

Methods And Study Design: Data of all adult patients diagnosed with acute myeloid leukemia from January 1984 to December 2003 were collected retrospectively. Univariate and multivariate analysis for time to progression and overall survival were performed.

A phase I-II study to determine the maximum tolerated infusion rate of rituximab with special emphasis on monitoring the effect of rituximab on cardiac function.

Purpose: This phase I infusion rate escalation trial was undertaken to evaluate the maximum applicable infusion rate for rituximab without steroid premedication in patients having received one previous rituximab infusion.

Experimental Design: Cohorts of at least three patients were assigned to rituximab with or without concomitant chemotherapy. The initial infusion rate was 200 mg/h in the first cohort, and was increased by 100 mg/h in each subsequent cohort to a maximum of 700 mg/h.

Stark-assisted population control of coherent CS(2) 4f and 5p Rydberg wave packets studied by femtosecond time-resolved photoelectron spectroscopy.

A two-color (3+1(')) pump-probe scheme is employed to investigate Rydberg wave packet dynamics in carbon disulfide (CS(2) (*)). The state superpositions are created within the 4f and 5p Rydberg manifolds by three photons of the 400 nm pump pulse, and their temporal evolution is monitored with femtosecond time-resolved photoelectron spectroscopy using an 800 nm ionizing probe pulse. The coherent behavior of the non-stationary superpositions are observed through wavepacket revivals upon ionization to either the upper (12) or lower (32) spin-orbit components of CS(2) (+).

N-level Li2 multiphoton rotational wave packets: alignment effects in resonant multiphoton coherent excitation.

Using one color ultrafast pump-probe spectroscopy, the authors create N-level multiphoton rotational wave packets via resonant optical pumping between the A((1)Sigma(u) (+)) and E((1)Sigma(g) (+)) electronically bound states of Li(2) from a single optically state-selected rovibrational state |nu(A)=11, j(A)=28>. The authors find that excitation with a single amplitude shaped femtosecond pulse allows the direct observation of up to a six photon absorption, which generates a coherent superposition of 13 rotational states. The multilevel rotational wave packet is theoretically treated with the multipole moment formalism in order to characterize the experimentally observed time-dependent alignment.

BRAF mutations in multiple sebaceous hyperplasias of patients belonging to MYH-associated polyposis pedigrees.

The characteristics of sebaceous gland hyperplasia (SGH) consist of yellowish or skin-colored papules and nodules. Chronic sun exposure and immunosuppressed conditions are the main environmental risk factors, whereas chronological aging regulated by hormones and molecular changes are the intrinsic risk factors. We have evaluated the contribution of BRAF, K-Ras, and N-Ras mutations to the pathogenesis of SGHs in four patients belonging to three MYH-associated polyposis (MAP) pedigrees.

Coherent polyatomic dynamics studied by femtosecond time-resolved photoelectron spectroscopy: dissociation of vibrationally excited CS2 in the 6s and 4d Rydberg states.

The dissociation dynamics of the 6s and 4d Rydberg states of carbon disulfide (CS(2)*) are studied by time-resolved photoelectron spectroscopy. The CS(2) is excited by two photons of 267 nm (pump) to the 6s and 4d Rydberg states and probed by ionization with either 800 or 400 nm. The experiments can distinguish and successfully track the time dynamics of both spin [1/2] (upper) and [3/2] (lower) cores of the excited Rydberg states, which are split by 60 meV, by measuring the outgoing electron kinetic energies.

Thrombotic thrombocytopenic purpura associated with renal failure after autologous transplantation for multiple myeloma successfully treated with rituximab.

Thrombotic thrombocytopenic purpura (TTP) is a haematological syndrome characterised by a dramatic onset requiring an urgent treatment with plasma exchange (PE). However, the prognosis is still dismal for PE related complications, a rate of failure and remarkable frequencies of relapse. TTP post transplantation is largely described as an outstanding, unusual complication of allogenic transplantation, but it is rarely mentioned after autologous transplantation.

Control of Li2 wave packet dynamics by modification of the quantum mechanical amplitude of a single state.

Sequences of pulses with different spectra are used to control rotational wave packet dynamics in Li(2) by exploiting quantum interference phenomena. Wave packet superpositions are excited in a two-step resonant Raman process by two different pulses. Interferences between individual states shared by both wave packets can be used to enhance or destroy specific components of a superposition by varying the time delay between the pulses and/or the relative phase within the pulses.

Can magnesium sulfate reduce the risk of cerebral injury after perinatal asphyxia?

Hypoxia-ischemia produces brain damage by processes that continue for many hours after reoxygenation/reperfusion. This provides a window of opportunity for therapy aimed at preventing further loss of brain cells. Sulfate magnesium can prevent posthypoxic brain injury by blocking glutamate receptors within the calcium (Ca++) ion channel.

Suppression and recovery of adrenal response after short-term, high-dose glucocorticoid treatment.

Background: Suppression of the adrenal response is an unpredictable consequence of glucocorticoid treatment. To investigate the kinetics of the adrenal response after short-term, high-dose glucocorticoid treatment, we measured the adrenal response to the low-dose (1 microg) corticotropin stimulation test.

Methods: We studied 75 patients who received the equivalent of at least 25 mg prednisone daily for between 5 days and 30 days.

Long-term protection after stopping venom immunotherapy: results of re-stings in 200 patients.

Background: Venom immunotherapy (VIT) protects most patients allergic to Hymenoptera stings while booster injections are continued. Few data on long-term protection after discontinuation of treatment are available.

Objective: We sought to investigate protection from re-stings over a prolonged period after stopping VIT.

Clinical and immunological condition of newborns of mothers treated for recurrent spontaneous abortions with paternal lymphocytes immunization.

Objective: The aim of this study was to evaluate the clinical condition at birth and some laboratory parameters in newborns of mothers treated for recurrent spontaneous abortion (RSA) of unknown etiology with paternal lymphocytes immunization.

Study Design: The study comprised 104 newborns delivered by 102 women with RSA, who underwent alloimmunization and 90 randomly chosen control newborns. The following parameters were analysed in two groups of newborns: general condition at birth, physical development, course of adaptation period, values of hematological and immunological (percentage of CD3, CD4, CD8, CD19 and CD3/CD25 lymphocytes, chemiluminescence of neutrophils at rest and stimulated with opsonized zymosane) parameters in umbilical arterial blood.