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Клеточная терапия ревматических и мышечных заболеваний.

Значительная часть пациентов, у которых диагностированы ревматологические и мускулоскелетные заболевания (РМ), демонстрируют устойчивость к традиционной терапии или испытывают повторяющиеся симптомы. Эти заболевания, к которым относятся аутоиммунные расстройства, такие, как множественный склероз, ревматоидный артрит и системный волшебный эритематос, характеризуются наличием автоматически реактивных клеток B, играющих решающую роль в их патогенезе. Стойкость этих самореактивных клеток В в лимфатических органах и воспаленных тканях снижает эффективность таких моноклонных антител, как ритуксимаб,

Принудительный Дулаглутид в реплапсинге-излучающем многократном склерозе: Randomized Open-Lable Treaty-Of-Cost-Tribune.

ВВЕДЕНИЕ: Множественный склероз (MS) является иммунопосредованным воспалительным и нейродегенеративным заболеванием центральной нервной системы (СНС), которое приводит к демиелинации, аксоновым травмам и постепенной инвалидности. Глукагон-подобный пестиду 1 рецепторные агонисты (GLP-1RAs) была предложена в качестве адъюнктурной терапии с потенциальными нейрозащитными свойствами. Мы провели оценку воздействия GLP-1RA - обработка метаболических параметров, функциональных характеристик и биомаркеров нейродегенерации в релапсирующих MS (RRMS).МЕТОДЫ: В этом перспективном, произвольном, открытом, е

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… For context, the minimal clinically important difference (MCID) for T25FW is generally considered to be approximately 20% change from baseline [ 20 ]; the median baseline T25FW in the active group was 5.3 s, and the observed improvement of approximately 0.35 s represents approximately 6.6%, which is …

Therapeutic plasma exchange across multiple organ systems in an Egyptian tertiary center: A seven-year real-world cohort study.

BACKGROUND: Real-world evidence on therapeutic plasma exchange (TPE) from low- and middle-income countries remains limited. Egyptian data across multiple organ systems are scarce. This study aimed to evaluate the indications, safety, efficacy, and predictors of outcomes in patients undergoing TPE at a tertiary center in Egypt over 7 years. METHODS AND FINDINGS: This retrospective cohort study included 221 consecutive patients who underwent TPE (2016-2022) at Zagazig University Hospitals, Egypt. Patients were stratified into renal, neurologic, hematologic, and metabolic groups. Primary outcome

Стратегии лечения множественной миеломы, основанные на наномедицине.

Множественная миелома (ММ) принадлежит к гематологическим маньякам, и общее число случаев заболевания MM растет во всем мире. В течение последних нескольких десятилетий повышенное внимание уделялось развитию и патогенезу MM. Существенные изменения произошли также в парадигме лечения MM, включая протеаозные ингибиторы, иммуномодуляторы и анти CD38 моноклонные антитела, которые значительно улучшили выживание пациентов. Уделение все большего внимания наномедицине обусловлено ее способностью улучшить лечение MM за счет уменьшения системных побочных эффектов и создания возможностей для более точног

Reframing disease burden: validation of DALY-per-case as a per-diagnosis severity metric.

BACKGROUND: Population-weighted metrics (incidence, mortality, disability-adjusted life years (DALYs), mortality to incidence ratio (MIR) can obscure per-case severity for less prevalent but high-impact conditions. This paper introduces DALY per case, total DALYs divided by incident cases, as a standardized estimate of healthy life-years lost per new diagnosis, integrating years of life lost (YLL) and years lived with disability (YLD). Validated using cancers and applied across diverse diseases, the metric enables prevalence-independent severity comparisons. METHODS: Using GBD 2021, we comput

Lumbar Sympathicolysis Attenuates Refractory Chemotherapy-Induced Peripheral Neuropathy in the Lower Extremities: A Prospective, Real-World Study.

PurposeCurrently, there are limited effective treatment strategies available for refractory chemotherapy-induced peripheral neuropathy (CIPN). Lumbar sympathicolysis is a minimally invasive therapy and may offer an option for CIPN. This single-center, prospective, observational study aimed to evaluate the efficacy and safety of CT-guided lumbar sympathicolysis in alleviating multiple symptoms of refractory CIPN in the lower extremities.MethodsThis single-arm study conducted at Henan Cancer Hospital from September 2022 to July 2024,twenty-five patients with refractory CIPN in both lower extremi

Acute radiotoxicity studies and safety assessment of 166Ho-EDTMP and 166Ho-DOTMP for the palliative treatment of bone metastases.

Comprehensive studies on the acute toxicity and safety profiles of therapeutic doses of 166Ho-EDTMP and 166Ho-DOTMP in the bone tissue and bone marrow of animals are limited, particularly when 166Ho produced in low-power reactors is used. These bone-specific complexes were synthesized through the coordination of 166Ho3+ ions in a neutral buffer. Acute toxicity studies were conducted at a dose of 1850 MBq/kg over 14 days, whereas safety assessments were performed at therapeutic doses of 18.5, 37, and 74 MBq/kg over 30 days in ICR mice. Hematological, biochemical, and histopathological toxicitie

Advances in Imaging for Metastatic Epidural Spinal Cord Compression: A Comprehensive Review of Detection, Diagnosis, and Treatment Planning.

Metastatic epidural spinal cord compression (MESCC) is a critical oncologic emergency caused by the invasion of metastatic tumors into the spinal epidural space, leading to compression of the spinal cord. If not promptly diagnosed and treated, MESCC can result in irreversible neurological deficits, including paralysis, significantly impacting the patient's quality of life. Early detection and timely intervention are crucial to prevent permanent damage. Imaging modalities play a pivotal role in the diagnosis, assessment of disease extent, and treatment planning for MESCC. Magnetic resonance ima

Risk and response adapted therapy following autologous stem cell transplant in patients with newly diagnosed multiple myeloma (RADAR (UK-MRA Myeloma XV Trial): study protocol for a phase II/III randomised controlled trial.

IntroductionMultiple myeloma is a plasma cell malignancy that accounts for 1%-2% of newly diagnosed cancers.At diagnosis, approximately 20% of patients can be identified, using cytogenetics, to have inferior survival (high-risk). Additionally, standard-risk patients, with detectable disease (minimal residual disease (MRD)-positive) postautologus stem cell transplant (ASCT), fare worse compared with those who do not (MRD-negative). Research is required to determine whether a risk-adapted approach post-ASCT could further improve patient outcomes.MethodsRADAR is a UK, multicentre, risk-adapted, r

Outcomes in dogs undergoing surgical stabilization and non-stereotactic radiation therapy for axial and appendicular bone tumors.

BackgroundInformation on dogs that undergo radiation therapy (RT) with non-stereotactic protocols in addition to surgical stabilization with implant placement for treatment of bone tumors is limited.ObjectiveOur primary objectives were to describe the clinical characteristics as well as short- and long-term outcomes, including complications, function, and disease progression, in dogs that underwent both surgical stabilization with implant placement and non-stereotactic RT for local treatment of a bone tumor.MethodsA bi-institutional retrospective case series was performed.AnimalsEight client-o

History of hematopoietic cell transplantation: challenges and progress.

After more than 60 years of research in allogeneic hematopoietic cell transplantation (HCT), this therapy has advanced from one that was declared dead in the 1960s to a standard treatment of otherwise fatal malignant and non-malignant blood diseases. To date, close to 1.5 million hematopoietic cell transplants have been performed in more than 1,500 transplantation centers worldwide. This review will highlight the enormous efforts by numerous investigators throughout the world who have brought the experimental field of HCT to clinical reality, examine ongoing challenges, and provide insights fo

Intraoperative radiotherapy combined with spinal stabilization surgery-a novel treatment strategy for spinal metastases based on a first single-center experiences.

INTRODUCTION: Current treatment of spinal metastases (SM) aims on preserving spinal stability, neurological status, and functional status as well as achieving local control. It consists of spinal surgery followed by radiotherapy and/or systemic treatment. Adjuvant therapy usually starts with a delay of a few weeks to prevent wound healing issues. Intraoperative radiotherapy (IORT) has previously been successfully applied during brain tumor, breast and colorectal carcinoma surgery but not in SM, including unstable one, to date. In our case series, we describe the feasibility, morbidity and mort

Local Recurrence and Development of Spinal Cord Syndrome during Follow-Up after Surgical Treatment of Metastatic Spine Disease.

BackgroundSurgical decompression (SD), with or without posterior stabilization followed by radiotherapy, is an established treatment for patients with metastatic spinal disease with epidural spinal cord compression (ESCC). This study aims to identify risk factors for occurrence of neurological compromise resulting from local recurrence.MethodsAll patients who received surgical treatment for metastatic spinal disease at our center between 2011 and 2022 were included in this study. Cases were evaluated for tumor entity, surgical technique for decompression (decompression, hemilaminectomy, lamine

Broad application prospects of bone turnover markers in pediatrics.

BACKGROUND: Bone turnover markers (BTMs) have been studied for application in clinical medicine. However, BTMs in children are challenging, and few studies explore these BTMs in children. The application of BTMs is complicated mainly due to pre-analytical factors, variable reference intervals of age- and sex-related BTMs for adolescents and children in different regions and laboratories. Therefore, laboratory testing of BTMs is critical for understanding pediatric bone development and metabolism, which provides additional information about bone development and diseases. METHODS: Literature se

Психометрические свойства сообщаемых пациентами итоговых показателей качества жизни, связанных со здоровьем, в множестве миелом: систематический обзор на основе руководящих принципов КОСМИН.

ЦЕЛЬ: На систематической основе выявлять сообщаемые пациентами итоговые показатели (ПРОМ), используемые для оценки связанных со здоровьем качества жизни (HRQOL), симптомов и бремени заболеваний у пациентов с множественной миеломой (MM), и оценивать их измерительные свойства с использованием методологии КОСМИН. МЕТОДЫ: Был проведен систематический обзор в соответствии с руководящими принципами КОСМИН в отношении пересмотра ПМР. В соответствующих исследованиях сообщалось о разработке PROM, проверке содержания, адаптации к различным культурам или one или более измерительных свойств ПМР, используе

A biobehavioral intervention to enhance recovery following hematopoietic cell transplantation: Protocol for a feasibility and acceptability randomized control trial.

BackgroundInsomnia, fatigue, and depression are among the most persistent and distressing concerns for hematologic cancer patients recovering from hematopoietic cell transplantation (HCT). This study will evaluate a novel behavioral intervention, Restoring Sleep and Energy after Transplant (ReSET), designed to alleviate insomnia, fatigue, and depression by improving rest-activity patterns. Evidence-based behavioral strategies to improve nighttime sleep and increase non-sedentary daytime activity will be combined to optimize 24-h rest-activity patterns.MethodsThe protocol herein evaluates the f

Using Dose-Escalation and -Expansion Cohort Study as Pivotal Trial for Targeted Anticancer Drug Approval.

Early-phase clinical trials (EPCTs) have been increasingly adopted as the pivotal trial to support US Food and Drug Administration (FDA) approval of novel anticancer drugs. Among EPCT designs, dose-escalation and -expansion cohort (DEEC) substantially reduces the time and resources that are required in the traditional three-phase paradigm. DEEC facilitates expedited approvals of investigational drugs, particularly those targeting novel mechanisms, helping to address the pressing needs of patients with cancer. From 2012 to 2023, DEECs provided pivotal trial evidence that supported the FDA appro

Membrane-to-Patient Optimization: Individualized Dialyzer Selection for Extracorporeal Dialysis.

Extracorporeal dialysis for uremic toxin removal and fluid regulation relies on specialized dialyzers whose membranes differ markedly in polymer chemistry, pore architecture, adsorption capacity, surface bioactivity, and convective performance. These structural and material distinctions result in wide variation in the clearance of chemically diverse uremic solutes. Despite the expanding range of dialyzer options, membrane selection in clinical practice remains largely non-individualized. In this review, we propose a phenotype-based model for dialyzer membrane selection. We outline how distinct

T-cell-engaging antibodies for the treatment of solid tumors: challenges and opportunities.

Purpose of reviewT-cell-engaging antibodies or T-cell engagers (TCEs) can connect a patient's cytotoxic T cells with cancer cells, leading to potent redirected lysis. Until very recently, only one TCE was approved, the CD19/CD3-bispecific blinatumomab. Many new TCEs in late-stage clinical development target various hematopoietic lineage markers like CD20, BCMA, or CD123. Although very compelling single-agent activity of TCEs was observed with various blood-borne cancers, therapy of solid tumor indications has thus far been less successful.Recent findingsThe approval in 2022 of the gp100 peptid

Beyond αβ T cells: NK, iNKT, and γδT cell biology in leukemic patients and potential for off-the-shelf adoptive cell therapies for AML.

Acute myeloid leukemia (AML) remains an elusive disease to treat, let alone cure, even after highly intensive therapies such as stem cell transplants. Adoptive cell therapeutic strategies based on conventional alpha beta (αβ)T cells are an active area of research in myeloid neoplasms given their remarkable success in other hematologic malignancies, particularly B-cell-derived acute lymphoid leukemia, myeloma, and lymphomas. Several limitations have hindered clinical application of adoptive cell therapies in AML including lack of leukemia-specific antigens, on-target-off-leukemic toxicity, immu