-
Alternative Therapies in Health and... May 2024Autologous hematopoietic stem cell transplantation (AHSCT) is a standard treatment for lymphoma, yet it is associated with psychological distress. Omaha System-based...
BACKGROUND
Autologous hematopoietic stem cell transplantation (AHSCT) is a standard treatment for lymphoma, yet it is associated with psychological distress. Omaha System-based care offers a structured approach to address the unique needs of patients undergoing AHSCT.
OBJECTIVE
This study aims to evaluate the efficacy and utility of Omaha System-based care in patients undergoing autologous hematopoietic stem cell transplantation (AHSCT) for lymphoma (LY), focusing particularly on its impact on psychological well-being.
METHODS
The study adopted an observational design and included 80 LY patients undergoing AHSCT at our hospital between January 2022 and December 2022. Of these, 46 patients received Omaha System-based care (observation group), while 34 patients received conventional care (control group). Pre- and post-intervention assessments comprised the Self-rating Anxiety/Depression Scale (SAS/SDS), Pittsburgh Sleep Quality Index (PSQI), and Functional Assessment of Cancer Therapy-Bone Marrow Transplant (FACT-BMT). Additionally, the duration of stay in the laminar airflow bio-clean room (LAFR), total hospital stays, hospitalization expenses, and incidence of adverse reactions were recorded. Nursing satisfaction was also evaluated.
RESULTS
Post-intervention, the observation group exhibited significantly lower SAS, SDS, and PSQI scores compared to the control group (P < .05), indicating improved psychological well-being. Moreover, the observation group demonstrated a shorter hospital stay (P < .05), reduced healthcare expenditures, lower incidence of adverse reactions, and higher nursing satisfaction (P < .05).
CONCLUSIONS
Omaha System-based care demonstrates promising outcomes in enhancing the safety and psychological well-being of LY patients undergoing AHSCT. The findings underscore its potential as an effective intervention to optimize patient care in this population. Further research is warranted to validate these results and facilitate their broader adoption in clinical practice.
PubMed: 38758141
DOI: No ID Found -
International Journal of Tryptophan... 2024Aryl hydrocarbon receptor (AhR), a ligand-activated transcription factor, is crucial in maintaining the skeletal system. Our study focuses on encapsulating the role of... (Review)
Review
Aryl hydrocarbon receptor (AhR), a ligand-activated transcription factor, is crucial in maintaining the skeletal system. Our study focuses on encapsulating the role of AhR in bone biology and identifying novel signaling pathways in musculoskeletal pathologies using the GEO dataset. The GEO2R analysis identified 8 genes (CYP1C1, SULT6B1, CYB5A, EDN1, CXCR4B, CTGFA, TIPARP, and CXXC5A) involved in the AhR pathway, which play a pivotal role in bone remodeling. The AhR knockout in hematopoietic stem cells showed alteration in several novel bone-related transcriptomes (eg, Defb14, ZNF 51, and Chrm5). Gene Ontology Enrichment Analysis demonstrated 54 different biological processes associated with bone homeostasis. Mainly, these processes include bone morphogenesis, bone development, bone trabeculae formation, bone resorption, bone maturation, bone mineralization, and bone marrow development. Employing Functional Annotation and Clustering through DAVID, we further uncovered the involvement of the xenobiotic metabolic process, p450 pathway, oxidation-reduction, and nitric oxide biosynthesis process in the AhR signaling pathway. The conflicting evidence of current research of AhR signaling on bone (positive and negative effects) homeostasis may be due to variations in ligand binding affinity, binding sites, half-life, chemical structure, and other unknown factors. In summary, our study provides a comprehensive understanding of the underlying mechanisms of the AhR pathway in bone biology.
PubMed: 38757095
DOI: 10.1177/11786469241246674 -
Frontiers in Oncology 2024Chronic myelomonocytic leukemia (CMML) is a rare hematological disorder characterized by variable risk of evolution to acute myeloid leukemia; to date, allogeneic stem...
Chronic myelomonocytic leukemia (CMML) is a rare hematological disorder characterized by variable risk of evolution to acute myeloid leukemia; to date, allogeneic stem cell transplantation is the only curative treatment. We report a case of choroidal involvement in a woman affected by CMML and presenting only with visual impairment. The patient was initially evaluated for an intensive therapeutic approach, but after biopsy the ocular lesion spontaneously regressed. Thus a "watch and wait" strategy was preferred. One year and a half after initial diagnosis, the patient is alive, with stable hematological disease and without any ocular involvement. Therefore, a close, not invasive follow up could be useful to tailor treatment for patients affected by single ocular lesions in CMML.
PubMed: 38756666
DOI: 10.3389/fonc.2024.1399894 -
Frontiers in Pharmacology 2024The classical medicinal formula Huangqi Gancao Decoction (HQGCD), originating from the medical book" ". Up to now, the studies focusing on the immunoenhancement effects...
BACKGROUND
The classical medicinal formula Huangqi Gancao Decoction (HQGCD), originating from the medical book" ". Up to now, the studies focusing on the immunoenhancement effects of HQGCD are few, and the actionpathway is not yet clear.
METHOD
In this study, SPF male KM mice were utilized as a model for immunosuppression. Comprehensive observations were made regarding the general behavior and condition of the mice, in addition to monitoring fluctuations in body weight and food intake. The blood routine index was measured, and morphological changes in the ileum and colon tissues were examined. The level of secretory immunoglobulin A (sIgA), superoxide dismutase (SOD), and malondialdehyde (MDA) in ileum and colon tissues were quantified. Additionally, the bone marrow total DNA index was assessed. Flow cytometry analyzed the proportions of CD3⁺, CD4⁺, CD8⁺, and CD4CD8 double-positive (DP) T lymphocytes in small intestinal intraepithelial lymphocytes (IELs). Lastly, the composition and diversity of the cecal microbiota were evaluated using 16S rDNA sequencing technology.
RESULTS
After HQGCD intervention, there were no significant changes in the mice's feed intake and body weight. However, the tissue structures of the ileum and colon showed recovery. In the blood routine index, there was an increase in the total white blood cell count, lymphocyte count, red blood cell count, hematocrit, and hemoglobin content. Additionally, the bone marrow total DNA index was elevated. Level of SOD and sIgA in ileum and colon tissues increased, while the level of MDA decreased. The proportions of CD3⁺ and CD4⁺ T lymphocytes within IELs increased, along with an increase in DP T lymphocytes in IELs (DP IELs), whereas the proportion of CD8⁺ T lymphocytes decreased. The cecal microbiota underwent changes, with an increase in the variety and number of beneficial microbiota.
CONCLUSION
HQGCD could restore the intestinal immune function of immunocompromised mice, and had a certain positive effect on cecal microbiota.
PubMed: 38756377
DOI: 10.3389/fphar.2024.1390170 -
JPGN Reports May 2024Shwachman-Diamond syndrome (SDS) is a genetic disorder caused by mutations in the Shwachman-Bodian-Diamond syndrome (SBDS) gene. The syndrome is characterized by...
Shwachman-Diamond syndrome (SDS) is a genetic disorder caused by mutations in the Shwachman-Bodian-Diamond syndrome (SBDS) gene. The syndrome is characterized by multiorgan dysfunction primarily involving the bone marrow and exocrine pancreas. Frequently overlooked is the hepatic dysfunction seen in early childhood which tends to improve by adulthood. Here, we report a child who initially presented with failure to thrive and elevated transaminases, and was ultimately diagnosed with SDS. A liver biopsy electron micrograph revealed hepatocytes crowded with numerous small mitochondria, resembling the hepatic architecture from patients with inborn errors of metabolism, including mitochondrial diseases. To our knowledge, this is the first report of the mitochondrial phenotype in an SDS patient. These findings are compelling given the recent cellular and molecular research studies which have identified SBDS as an essential regulator of mitochondrial function and have also implicated SBDS in the maintenance of mitochondrial DNA.
PubMed: 38756125
DOI: 10.1002/jpr3.12064 -
Nature Communications May 2024Bone marrow plasma cells (BMPC) are the correlate of humoral immunity, consistently releasing antibodies into the bloodstream. It remains unclear if BMPC reflect...
Bone marrow plasma cells (BMPC) are the correlate of humoral immunity, consistently releasing antibodies into the bloodstream. It remains unclear if BMPC reflect different activation environments or maturation of their precursors. Here we define human BMPC heterogeneity and track the recruitment of antibody-secreting cells (ASC) from SARS-CoV-2 vaccine immune reactions to the bone marrow (BM). Trajectories based on single-cell transcriptomes and repertoires of peripheral and BM ASC reveal sequential colonisation of BMPC compartments. In activated B cells, IL-21 suppresses CD19 expression, indicating that CD19-BMPC are derived from follicular, while CD19-BMPC originate from extrafollicular immune reactions. In primary immune reactions, both CD19- and CD19-BMPC compartments are populated. In secondary immune reactions, most BMPC are recruited to CD19-BMPC compartments, reflecting their origin from extrafollicular reactivations of memory B cells. A pattern also observable in vaccinated-convalescent individuals and upon diphtheria/tetanus/pertussis recall-vaccination. Thus, BMPC diversity reflects the evolution of a given humoral immune response.
Topics: Humans; Plasma Cells; Interleukins; Bone Marrow; Antigens, CD19; Immunity, Humoral; COVID-19; SARS-CoV-2; Bone Marrow Cells; Single-Cell Analysis; Adult; B-Lymphocytes; Antibody-Producing Cells; Female; Male; Vaccination; Middle Aged; Diphtheria-Tetanus-Pertussis Vaccine
PubMed: 38755157
DOI: 10.1038/s41467-024-48570-0 -
Nature Communications May 2024The natural history of multiple myeloma is characterized by its localization to the bone marrow and its interaction with bone marrow stromal cells. The bone marrow...
The natural history of multiple myeloma is characterized by its localization to the bone marrow and its interaction with bone marrow stromal cells. The bone marrow stromal cells provide growth and survival signals, thereby promoting the development of drug resistance. Here, we show that the interaction between bone marrow stromal cells and myeloma cells (using human cell lines) induces chromatin remodeling of cis-regulatory elements and is associated with changes in the expression of genes involved in the cell migration and cytokine signaling. The expression of genes involved in these stromal interactions are observed in extramedullary disease in patients with myeloma and provides the rationale for survival of myeloma cells outside of the bone marrow microenvironment. Expression of these stromal interaction genes is also observed in a subset of patients with newly diagnosed myeloma and are akin to the transcriptional program of extramedullary disease. The presence of such adverse stromal interactions in newly diagnosed myeloma is associated with accelerated disease dissemination, predicts the early development of therapeutic resistance, and is of independent prognostic significance. These stromal cell induced transcriptomic and epigenomic changes both predict long-term outcomes and identify therapeutic targets in the tumor microenvironment for the development of novel therapeutic approaches.
Topics: Multiple Myeloma; Humans; Chromatin Assembly and Disassembly; Tumor Microenvironment; Cell Line, Tumor; Mesenchymal Stem Cells; Gene Expression Regulation, Neoplastic; Transcription, Genetic; Bone Marrow Cells; Cell Movement; Stromal Cells; Female; Male
PubMed: 38755155
DOI: 10.1038/s41467-024-47793-5 -
Nature Communications May 2024The regeneration of critical-size bone defects, especially those with irregular shapes, remains a clinical challenge. Various biomaterials have been developed to enhance...
The regeneration of critical-size bone defects, especially those with irregular shapes, remains a clinical challenge. Various biomaterials have been developed to enhance bone regeneration, but the limitations on the shape-adaptive capacity, the complexity of clinical operation, and the unsatisfied osteogenic bioactivity have greatly restricted their clinical application. In this work, we construct a mechanically robust, tailorable and water-responsive shape-memory silk fibroin/magnesium (SF/MgO) composite scaffold, which is able to quickly match irregular defects by simple trimming, thus leading to good interface integration. We demonstrate that the SF/MgO scaffold exhibits excellent mechanical stability and structure retention during the degradative process with the potential for supporting ability in defective areas. This scaffold further promotes the proliferation, adhesion and migration of osteoblasts and the osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs) in vitro. With suitable MgO content, the scaffold exhibits good histocompatibility, low foreign-body reactions (FBRs), significant ectopic mineralisation and angiogenesis. Skull defect experiments on male rats demonstrate that the cell-free SF/MgO scaffold markedly enhances bone regeneration of cranial defects. Taken together, the mechanically robust, personalised and bioactive scaffold with water-responsive shape-memory may be a promising biomaterial for clinical-size and irregular bone defect regeneration.
Topics: Fibroins; Bone Regeneration; Animals; Tissue Scaffolds; Male; Osteogenesis; Mesenchymal Stem Cells; Rats; Magnesium; Biocompatible Materials; Osteoblasts; Cell Differentiation; Rats, Sprague-Dawley; Water; Cell Proliferation; Tissue Engineering; Skull; Cell Adhesion; Bombyx
PubMed: 38755128
DOI: 10.1038/s41467-024-48417-8 -
Cell Reports. Medicine May 2024Acute myeloid leukemia (AML) is characterized by the accumulation of immature myeloid cells in the bone marrow and the peripheral blood. Nearly half of the AML patients...
Acute myeloid leukemia (AML) is characterized by the accumulation of immature myeloid cells in the bone marrow and the peripheral blood. Nearly half of the AML patients relapse after standard induction therapy, and new forms of therapy are urgently needed. Chimeric antigen receptor (CAR) T therapy has so far not been successful in AML due to lack of efficacy and safety. Indeed, the most attractive antigen targets are stem cell markers such as CD33 or CD123. We demonstrate that CD37, a mature B cell marker, is expressed in AML samples, and its presence correlates with the European LeukemiaNet (ELN) 2017 risk stratification. We repurpose the anti-lymphoma CD37CAR for the treatment of AML and show that CD37CAR T cells specifically kill AML cells, secrete proinflammatory cytokines, and control cancer progression in vivo. Importantly, CD37CAR T cells display no toxicity toward hematopoietic stem cells. Thus, CD37 is a promising and safe CAR T cell AML target.
PubMed: 38754420
DOI: 10.1016/j.xcrm.2024.101572 -
American Society of Clinical Oncology... Jun 2024Although allogeneic hematopoietic cell transplantation (HCT) offers a potential for cure for many patients with advanced hematologic malignancies and bone marrow failure... (Review)
Review
Hematopoietic Stem-Cell Transplantation: Exploring the Latest Advances and Gaps in Disparities, Psychosocial and Symptom Management Interventions, and Chronic Graft-Versus-Host Disease Care.
Although allogeneic hematopoietic cell transplantation (HCT) offers a potential for cure for many patients with advanced hematologic malignancies and bone marrow failure or immunodeficiency syndromes, it is an intensive treatment and accompanied by short- and long-term physical and psychological symptoms requiring specialized care. With substantial advances in therapeutic approaches for HCT and supportive care, HCT survivors experience less morbidity and mortality. However, disparities in both HCT access and outcomes persist, and HCT survivors and their caregivers often lack access to much-needed psychosocial care. Additionally, more medical and psychosocial resources are needed to holistically care for HCT survivors with chronic graft-versus-host disease (GVHD). Hence, this chapter focuses on three areas pertaining to advances and gaps in HCT care: disparities in access to and outcomes of HCT, psychosocial and physical symptom management with supportive care interventions, and GVHD prevention and management.
Topics: Humans; Hematopoietic Stem Cell Transplantation; Graft vs Host Disease; Hematologic Neoplasms; Chronic Disease; Healthcare Disparities; Disease Management; Bronchiolitis Obliterans Syndrome
PubMed: 38754066
DOI: 10.1200/EDBK_432186