Replacing carmustine by thiotepa and cyclophosphamide for autologous stem cell transplantation in Hodgkin's and non-Hodgkin's B-cell lymphoma

This study aimed to compare the real-life results of TECAM, a thiotepa-based conditioning regimen consisting of thiotepa (40 mg/m² days -5 to -2), etoposide (200 mg/m² days -6 to -3), cytarabine (200 mg/m² days -4 to -1), cyclophosphamide (60 mg/kg day -3), and melphalan (60 mg/m² days -2 to -1) with that of the conventional carmustine-based regimen BEAM. We reviewed 125 consecutive patients who underwent a first autologous transplantation (ASCT) for B-cell lymphomas at a large tertiary transplantation center between 1999 and 2014. TECAM (n=65) and BEAM (n=60) had comparable results (3yPFS 49 vs 62%, P=0.16; 3yOS 64 vs 71%, P=0.44; TRM 1.6 vs 5%, P=0.35) without a difference in toxicity or time to engraftment. Notably, comparable outcomes were observed even though patients treated with TECAM were older (55 vs 44) and had a trend towards more prior lines of therapy (>2 prior lines: 43 vs 27%, P=0.08). In this regard, 23% of TECAM patients were over the age of 65 yet could withstand therapy with similar results to younger patients. We conclude that, replacing carmustine by thiotepa and cyclophosphamide for ASCT conditioning, has comparable efficacy and safety profiles with a possible advantage in older patients.

Antimetastatic effects associated with anticoagulant properties of heparin and chemically modified heparin species in a mouse mammary tumor model

Fibrin deposits surrounding circulating tumor cells may protect them from mechanical trauma and destruction by the host immune system, and may facilitate microvascular entrapment required for metastasis. We report that heparin inhibited the clotting of plasma induced by mouse mammary carcinoma cells in a dose-dependent manner and blocked the production of experimental lung metastasis when administered i.p. at the time of intravenous injection of tumor cells. On the other hand, O/N-desulfated N-acetylated heparin did not exhibit anticoagulant properties and had no effects on metastasis formation. Similarly, reduction of metastasis was not seen with N-desulfated N-acetylated heparin, another chemically modified heparin which does not inhibit blood coagulation but has heparanase inhibitory activity. Our data demonstrate the existence of a strong association between antimetastatic and anticoagulant properties of heparin species in the present experimental system.

Modulation of fibronectin expression and proteolytic activity associated with the invasive and metastatic phenotype in two new murine mammary tumor cell lines

Two cell lines obtained by sequential subcultures from primary cultures of the murine mammary adenocarcinomas M3 and MM3 were characterized. During LM3 cell line evolution an increase in the anchorage-independent growth ability, a displacement towards a triploid level in the chromosomic distribution and a loss of fibronectin (FN) expression were observed. LMM3 cell line showed a tetraploid chromosomic number and was unable to produce FN, behaving in a similar way as its parental tumor MM3. The local invasive ability as well as the spontaneous metastatic capacity of LM3 cells inoculated subcutaneously (s.c.) increased with the passage number and were associated with the progressive loss of FN expression as well as to the appearence of membrane bound uPA. LMM3 cells, which did not express FN, maintained the high spontaneous metastasic capacity already shown by the parental tumor MM3 but acquired a higher local invasive phenotype.

Levels of plasma cysteine-proteinase activity in bladder cancer patients

Plasma activity of a Cathepsin B like (CB) cystine protease was evaluated employing a chromogenic assay in citrated plasma samples of 21 patients with transitional bladder cancer (TBC), and 36 healthy blood donors. The median value of total CB activity was significantly higher in the group of patients bearing bladder carcinoma (103.4 mU/ml) as compared to the control group (77.7 mU/ml). 57% of patients showed high values of total CB while only 25% of the controls showed values over the cut-off levels (97.0 mU/ml). When the proenzyme (pro-CB) was analyzed, the median value was also significantly higher in the TBC patients (42.2 mU/ml) as compared to the control group (20.6 mU/ml). While 62% of TBC group showed values over pro-CB cut-off level (35.0 mU/ml) only 31% of controls did so. Total CB median value from other 29 patients succesfully treated from TBC without evidence of disease at the moment of blood colection was near the cut-off (97.6 mU/ml) while pro-CB median values were lower than the cut-off levels (33.2 mU/ml).

Inhibition of fibrinolysis by a synthetic urokinase inhibitor enhances lung colonization of metastatic murine mammary tumor cells

We have investigated the role of coagulation and fibrinolysis during the metastatic lung colonization of F3II mouse mammary carcinoma cells. The selective synthetic urokinase inhibitor B623 significantly enhanced lung colonization and blocked the antimetastatic effect of heparin when administered i.p. during the first stages of metastasis formation. In B623-treated mice the overall activity of the fibrinolytic system was reduced and circulating urokinase was specifically inhibited by this agent. In vitro studies demonstrated that B623 induces the aggregation of F3II cells in the presence of mouse plasma and facilitates the entrapment of tumor cells in a fibrin gel matrix. Our data suggest that imbalances of fibrin deposition and removal may dramatically influence metastatic lung colonization.

Down modulation of tumor-associated proteolytic activity by n-butanol in cultured murine mammary adenocarcinoma cells

The extractive effects of n-butanol on the cell membrane have been extensively studied. Although shortterm effects of this alcohol were reported, a sustained action on tumor cells has not been described. It was previously shown that M3 mouse mammary adenocarcinoma cells pretreated with n-butanol exhibited a longer latency after subcutaneous inoculation into syngeneic mice. In the present study a short, 5-minute exposure of M3 cells to n-butanol (2.5% v/v) resulted in the complete inhibition of a secreted metalloproteinase activity of 105 kDa and a significant decrease in secreted urokinase (uPA) activity levels (p<0.01) measured in conditioned media after 72 hours of culture. Total cell-associated uPA activity of M3 control monolayers was composed of a membrane-bound (31%) and a cytoplasmic (69%) uPAfraction. In contrast, cell-associated uPA activity of n-butanol pretreated M3 cells was mainly composed of a cytoplasmic uPA fraction and an extremely low membrane-bound uPA fraction (<5%). Further, an impaired uPA receptor binding capacity in these monolayers was also observed (p<0.05). These findings suggest that reduced proteolysis of extracellular matrix components may lead to local changes in tumor stroma composition, resulting in an altered behavior of M3 adenocarcinoma cells when inoculated in vivo.

Establishing the horizontal plane for positioning of the plane of occlusion

The positioning of the teeth according to the proper occlusal plane provides a considerable advantage in fabricating prosthetic appliances and contributes to optimal appearance and function for patients with complete or partial loss of their teeth. A special device simplifies the technique of establishing the horizontal reference for reproducing the occlusal plane.

Management of vertical root fracture in endodontically treated teeth

Vertical root fracture is a common complication during and after endodontic treatment. The condition is often difficult to diagnose and treat. Management of the fracture usually represents a challenging dilemma that requires various techniques.