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Muacevic A, Adler JR, Altshuler E, Seifert RP, Al-Mansour ZA. Pericardial Effusion: A Novel Presentation of Aplastic Anemia. Cureus 2023; 15:e33276. [PMID: 36741642 PMCID: PMC9894639 DOI: 10.7759/cureus.33276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/02/2023] [Indexed: 01/04/2023] Open
Abstract
Pericardial effusion is defined as the accumulation of fluid between the visceral and parietal pericardium. The underlying etiology varies as any pathology that causes pericarditis or involves the pericardium can cause effusion. In practice, the majority of pericarditis cases are idiopathic, although these are assumed to be secondary to occult viral infection or inflammatory phenomena. Malignancy, particularly the metastatic spread of noncardiac primary tumors, has been implicated as a differential in the diagnosis of pericardial effusion. Though commonly seen in solid malignancies, effusion has been reported in hematologic malignancies such as myelodysplastic syndrome (MDS), acute leukemia, and lymphoma. Nonetheless, pericardial effusions associated with hematologic conditions are extremely rare with only one case report published describing pericardial effusion secondary to immune thrombocytopenia (ITP). We herein report the first documented case, to our knowledge, of pericardial effusion as an initial clinical manifestation of aplastic anemia in a middle-aged male presenting with pancytopenia.
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Førde JL, Reiten IN, Fladmark KE, Kittang AO, Herfindal L. A new software tool for computer assisted in vivo high-content analysis of transplanted fluorescent cells in intact zebrafish larvae. Biol Open 2022; 11:281291. [PMID: 36355409 PMCID: PMC9770244 DOI: 10.1242/bio.059530] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 11/02/2022] [Indexed: 11/12/2022] Open
Abstract
Acute myeloid leukemia and myelodysplastic syndromes are cancers of the bone marrow with poor prognosis in frail and older patients. To investigate cancer pathophysiology and therapies, confocal imaging of fluorescent cancer cells and their response to treatments in zebrafish larvae yields valuable information. While zebrafish larvae are well suited for confocal imaging, the lack of efficient processing of large datasets remains a severe bottleneck. To alleviate this problem, we present a software tool that segments cells from confocal images and track characteristics such as volume, location in the larva and fluorescent intensity on a single-cell basis. Using this software tool, we were able to characterise the responses of the cancer cell lines Molm-13 and MDS-L to established treatments. By utilizing the computer-assisted processing of confocal images as presented here, more information can be obtained while being less time-consuming and reducing the demand of manual data handling, when compared to a manual approach, thereby accelerating the pursuit of novel anti-cancer treatments. The presented software tool is available as an ImageJ java-plugin at https://zenodo.org/10.5281/zenodo.7383160 and the source code at https://github.com/Jfo004/ConfocalCellSegmentation.
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Affiliation(s)
- Jan-Lukas Førde
- Centre for Pharmacy, Department of Clinical Science, University of Bergen, 5021 Bergen, Norway,Department of Internal Medicine, Haukeland University Hospital, 5021 Bergen, Norway
| | - Ingeborg Nerbø Reiten
- Centre for Pharmacy, Department of Clinical Science, University of Bergen, 5021 Bergen, Norway
| | | | - Astrid Olsnes Kittang
- Centre for Pharmacy, Department of Clinical Science, University of Bergen, 5021 Bergen, Norway,Department of Clinical Science, University of Bergen, 5021 Bergen, Norway
| | - Lars Herfindal
- Centre for Pharmacy, Department of Clinical Science, University of Bergen, 5021 Bergen, Norway,Author for correspondence ()
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Takahashi H, Yoshimatsu G, Faustman DL. The Roles of TNFR2 Signaling in Cancer Cells and the Tumor Microenvironment and the Potency of TNFR2 Targeted Therapy. Cells 2022; 11:1952. [PMID: 35741080 DOI: 10.3390/cells11121952pubmedhttps:/www.ncbi.nlm.nih.gov/pubmed/35741080pubmed] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 06/08/2022] [Accepted: 06/14/2022] [Indexed: 08/02/2024] Open
Abstract
The appreciation that cancer growth is promoted by a dynamic tumor microenvironment (TME) has spawned novel approaches to cancer treatment. New therapies include agents that activate quiescent T effector cells and agents that interfere with abnormal neovascularity. Although promising, many experimental therapies targeted at the TME have systemic toxicity. Another approach is to target the TME with greater specificity by taking aim at the tumor necrosis factor receptor 2 (TNFR2) signaling pathway. TNFR2 is an attractive molecular target because it is rarely expressed in normal tissues (thus, has low potential for systemic toxicity) and because it is overexpressed on many types of cancer cells as well as on associated TME components, such as T regulatory cells (Tregs), tumor-associated macrophages, and other cells that facilitate tumor progression and spread. Novel therapies that block TNFR2 signaling show promise in cell culture studies, animal models, and human studies. Novel antibodies have been developed that expressly kill only rapidly proliferating cells expressing newly synthesized TNFR2 protein. This review traces the origins of our understanding of TNFR2's multifaceted roles in the TME and discusses the therapeutic potential of agents designed to block TNFR2 as the cornerstone of a TME-specific strategy.
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Affiliation(s)
- Hiroyuki Takahashi
- Department of Gastroenterological Surgery, Fukuoka University Hospital, Fukuoka 814-0180, Japan
- Immunobiology Department, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA 02129, USA
| | - Gumpei Yoshimatsu
- Department of Gastroenterological Surgery, Fukuoka University Hospital, Fukuoka 814-0180, Japan
| | - Denise Louise Faustman
- Immunobiology Department, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA 02129, USA
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Takahashi H, Yoshimatsu G, Faustman DL. The Roles of TNFR2 Signaling in Cancer Cells and the Tumor Microenvironment and the Potency of TNFR2 Targeted Therapy. Cells 2022; 11:cells11121952. [PMID: 35741080 PMCID: PMC9222015 DOI: 10.3390/cells11121952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 06/08/2022] [Accepted: 06/14/2022] [Indexed: 11/16/2022] Open
Abstract
The appreciation that cancer growth is promoted by a dynamic tumor microenvironment (TME) has spawned novel approaches to cancer treatment. New therapies include agents that activate quiescent T effector cells and agents that interfere with abnormal neovascularity. Although promising, many experimental therapies targeted at the TME have systemic toxicity. Another approach is to target the TME with greater specificity by taking aim at the tumor necrosis factor receptor 2 (TNFR2) signaling pathway. TNFR2 is an attractive molecular target because it is rarely expressed in normal tissues (thus, has low potential for systemic toxicity) and because it is overexpressed on many types of cancer cells as well as on associated TME components, such as T regulatory cells (Tregs), tumor-associated macrophages, and other cells that facilitate tumor progression and spread. Novel therapies that block TNFR2 signaling show promise in cell culture studies, animal models, and human studies. Novel antibodies have been developed that expressly kill only rapidly proliferating cells expressing newly synthesized TNFR2 protein. This review traces the origins of our understanding of TNFR2’s multifaceted roles in the TME and discusses the therapeutic potential of agents designed to block TNFR2 as the cornerstone of a TME-specific strategy.
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Affiliation(s)
- Hiroyuki Takahashi
- Department of Gastroenterological Surgery, Fukuoka University Hospital, Fukuoka 814-0180, Japan; (H.T.); (G.Y.)
- Immunobiology Department, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA 02129, USA
| | - Gumpei Yoshimatsu
- Department of Gastroenterological Surgery, Fukuoka University Hospital, Fukuoka 814-0180, Japan; (H.T.); (G.Y.)
| | - Denise Louise Faustman
- Immunobiology Department, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA 02129, USA
- Correspondence: ; Tel.: +1-617-726-4084; Fax: +1-617-726-4095
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Fogaça da Mata M, Vieira Martins M, Rato J, Madeira M, Gonçalves JP, Teixeira A, Anjos R. Azacitidine-induced massive pericardial effusion in a child with myelodysplastic syndrome. J Oncol Pharm Pract 2022; 28:975-978. [PMID: 35037800 DOI: 10.1177/10781552211073884] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Pericardial effusions are rare yet potentially fatal conditions in children. Azacitidine is a DNA-hypomethylating agent used in the treatment of myelodysplastic syndrome. Although seldomly described in adults, no cases of azacitidine-induced pericardial effusion have been reported in children. CASE REPORT A 7-year-old boy with myelodysplastic syndrome presented with a large pericardial effusion with risk for cardiac tamponade after his first azacitidine cycle. MANAGEMENT & OUTCOME The patient was admitted to a pediatric ICU, antibiotic and steroid therapy were initiated. Pericardiocentesis was done due to hemodynamic instability. Serum and pericardial fluid complementary evaluation excluded infectious and malignant causes. The pericardial effusion did not reappear and additional pleural and ascitic slight effusions responded well to diuretics. Follow-up azacitidine cycles were administered by tapering daily dosages and using adjunctive steroid therapy, with no additional adverse events. DISCUSSION We report the first pediatric case of large pericardial effusion secondary to azacitidine therapy in a child with MDS. This adverse reaction has not been described in pediatric patients, in which this therapeutic option has been increasingly used. We seek to raise awareness on the potential life-threatening cardiotoxicity of azacitidine in pediatric patients.
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Affiliation(s)
- Miguel Fogaça da Mata
- Pediatric Cardiology Department, Hospital de Santa Cruz, 70897Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal
| | - Miguel Vieira Martins
- Pediatrics Department, 162181Centro Hospitalar Universitário Cova da Beira, Covilhã, Portugal
| | - João Rato
- Pediatric Cardiology Department, Hospital de Santa Cruz, 70897Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal
| | - Márcio Madeira
- Cardiac Surgery Department, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal
| | - Jean-Pierre Gonçalves
- Pediatrics Department, 37838Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal
| | - Ana Teixeira
- Pediatric Cardiology Department, Hospital de Santa Cruz, 70897Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal
| | - Rui Anjos
- Pediatric Cardiology Department, Hospital de Santa Cruz, 70897Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal
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Grafanaki K, Kourakli A, Skeparnias I, Spiliopoulos T, Koumoundourou D, Bravou V, Alexopoulos A, Symeonidis A, Georgiou S. Rare lobular capillary hemangioma associated with azacitidine in high-risk myelodysplastic syndrome patient. Dermatol Ther 2021; 34:e14884. [PMID: 33594760 DOI: 10.1111/dth.14884] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Accepted: 02/13/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Katerina Grafanaki
- Department of Dermatology, University Hospital of Patras, School of Medicine, University of Patras, Patras, Greece.,Department of Biochemistry, School of Medicine, University of Patras, Patras, Greece
| | - Alexandra Kourakli
- Hematology Division, Department of Internal Medicine, University Hospital of Patras, School of Medicine, Patras, Greece
| | - Ilias Skeparnias
- Department of Biochemistry, School of Medicine, University of Patras, Patras, Greece
| | - Theofanis Spiliopoulos
- Department of Dermatology, University Hospital of Patras, School of Medicine, University of Patras, Patras, Greece
| | - Dimitra Koumoundourou
- Department of Anatomy-Histology-Embryology, School of Medicine, University of Patras, Patras, Greece
| | - Vasiliki Bravou
- Department of Anatomy-Histology-Embryology, School of Medicine, University of Patras, Patras, Greece
| | - Angelos Alexopoulos
- Hematology Division, Department of Internal Medicine, University Hospital of Patras, School of Medicine, Patras, Greece
| | - Argiris Symeonidis
- Hematology Division, Department of Internal Medicine, University Hospital of Patras, School of Medicine, Patras, Greece
| | - Sophia Georgiou
- Department of Dermatology, University Hospital of Patras, School of Medicine, University of Patras, Patras, Greece
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Perino J, Mottal N, Bohbot Y, Servant V, Berroneau A, Poustis P, Fenaux P, Laribi K, Charbonnier A, Bilion E, Calmettes C, Bégaud B, Pigneux A, Milpied N, Miremont-Salamé G, Théophile H, Dimicoli-Salazar S. Cardiac failure in patients treated with azacitidine, a pyrimidine analogue: Case reports and disproportionality analyses in Vigibase. Br J Clin Pharmacol 2020; 86:991-998. [PMID: 31912911 DOI: 10.1111/bcp.14211] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 11/25/2019] [Accepted: 12/09/2019] [Indexed: 01/09/2023] Open
Abstract
AIMS Azacitidine (AZA), a pyrimidine analogue, is validated for high-risk myelodysplastic syndrome or low-blast acute myeloid leukaemia in unfit patients for more intensive treatment. This study assessed the putative link between cardiac failure (CF) and AZA exposure. METHODS Cases of CF in patients treated with AZA were retrospectively collected and described from several centres of the Groupe Francophone des Myélodysplasies. A description analysis and a disproportionality analysis using Vigibase, the WHO Global Individual Case Safety Reports (ICSRs) database, were conducted on ICSRs by the Standardized MedDRA Queries (SMQ broad) cardiac failure and by preferred terms cardiac failure and cardiac failure acute. The reported odds ratio (ROR) and its 95% 2-sided confidence interval was computed by comparing the proportion of CF reports with the suspected drug (AZA) and the proportion of reports of the same adverse drug reaction with all other suspected drugs in the database during the same period. RESULTS In the 4 case reports, all patients presented a cardiovascular history. In 1 patient, CF recurred after AZA re-challenge. The pharmacovigilance analysis in Vigibase retrieved 307 ICSRs of CF (SMQ) with AZA. Significant disproportionality signals associated with AZA were identified by using the SMQ cardiac failure (ROR 1.3) and the preferred terms cardiac failure (ROR 5.1) and cardiac failure acute (ROR 23.2). CONCLUSION This study points to the potential role of AZA in the occurrence of CF. Cardiac evaluation before AZA initiation and regular monitoring of cardiac function during AZA treatment should be performed in patients with a history of cardiovascular disease.
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Affiliation(s)
- Justine Perino
- CHU de Bordeaux, Pôle de Santé Publique, Service de pharmacologie médicale, Centre Régional de pharmacovigilance de Bordeaux, Bordeaux, France
| | - Nathan Mottal
- CHU de Bordeaux, Service d'Hématologie Clinique et Thérapie Cellulaire Bordeaux, France
| | - Yohann Bohbot
- CHU d'Amiens, Pôle Cœur-Thorax-Vaisseaux, Département de Cardiologie, Amiens Cedex, France
| | - Vincent Servant
- Pharmacie à Usage Intérieur, CHU de Bordeaux, Pessac, France
| | - Aude Berroneau
- Pharmacie à Usage Intérieur, CHU de Bordeaux, Pessac, France
| | - Pierre Poustis
- Service des soins intensifs cardiologiques Haut-Lévêque (intensive care unit), Pessac, France
| | - Pierre Fenaux
- Service d'Hematologie Seniors, Hôpital Saint Louis, Ass Pub Hôp Paris and Paris 7 Université Paris, France
| | - Kamel Laribi
- Service d'Hematologie, Centre Hospitalier du Mans, Le Mans, France
| | - Aude Charbonnier
- Service d'Hematologie, Institut Paoli Calmettes, Marseille, France
| | - Emilien Bilion
- Service d'Hematologie, Institut Paoli Calmettes, Marseille, France
| | - Claire Calmettes
- CHU de Bordeaux, Service d'Hématologie Clinique et Thérapie Cellulaire Bordeaux, France
| | - Bernard Bégaud
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Centre, team Pharmacoepidemiology, Bordeaux, France
| | - Arnaud Pigneux
- CHU de Bordeaux, Service d'Hématologie Clinique et Thérapie Cellulaire Bordeaux, France
| | - Noël Milpied
- CHU de Bordeaux, Service d'Hématologie Clinique et Thérapie Cellulaire Bordeaux, France
| | - Ghada Miremont-Salamé
- CHU de Bordeaux, Pôle de Santé Publique, Service de pharmacologie médicale, Centre Régional de pharmacovigilance de Bordeaux, Bordeaux, France.,Univ. Bordeaux, Inserm, Bordeaux Population Health Research Centre, team Pharmacoepidemiology, Bordeaux, France
| | - Hélène Théophile
- CHU de Bordeaux, Pôle de Santé Publique, Service de pharmacologie médicale, Centre Régional de pharmacovigilance de Bordeaux, Bordeaux, France
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