COULD NEUTROPHIL EXTRACELLULAR TRAPS BE THE NEW PROGNOSTIC MARKERS OF CANCER?

Neutrophil extracellular traps (NETs) were described more than one decade ago, but recently, the interest in these structures has increased due to their involvement in cancer progression, cancer-related thrombosis, and development of metastasis. This protumoral role of NETs strengthens their potential as new prognostic markers of cancer.

Malignancies after renal transplantation: experience of a Mexican referral center

OBJECTIVE

To report the incidence of cancer after renal transplantation at a referral center in a developing country.

MATERIALS AND METHODS

Consecutive patients receiving renal transplantations during a 48-year period at Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran were analyzed. The standardized incidence ratio (SIR) was calculated based on data from GLOBOCAN 2012.

RESULTS

From 1257 patients, 98 (8%) developed 143 malignancies. The SIR of all the cohort was 4.1 (95% CI 3.2-5.1). The relative risks of male and female transplant recipients were 4.6 and 3.5 times greater than the risk of cancer of the general population, respectively. The most common malignancy was non-melanoma skin cancer (52%). The malignancy that associated with the greater relative risk was Kaposi sarcoma (SIR: 200), followed by lymphomas (SIR: 30). A multivariate analysis comparing patients with cancer and controls confirmed that receiving a three-drug regimen as final treatment, prolonged immunosuppression, and patients undergoing a second renal transplantation were factors associated with increased cancer development.

CONCLUSION

To date, there is paucity of data from developing countries. We reported the results from a National Health Institute in Mexico including a large cohort with a long follow-up, demonstrating differences within frequencies and risks compared to other regions of the world.

Correlation of T Cell Subsets and Hypercholesterolemia of the Donor and Its Association with Acute Graft-versus-Host Disease

Background: Acute graft-versus-host disease (aGVHD) is an important cause of death following allogeneic hematopoietic stem cell transplantation (allo-HSCT). The association between cholesterol and aGVHD was previously described potentially, resulting from pro-inflammatory responses associated with hypercholesterolemia. The aim of this study was to correlate T cell subsets in donor bone marrow (BM) samples with their levels of cholesterol and associate these results with recipients who developed aGVHD and those who did not. Materials and Methods: A prospective study was performed in 39 donor samples. T cell subsets were analyzed by flow cytometry. Results: Eleven (28%) donors had hypercholesterolemia. Donor samples with hypercholesterolemia had less Tregs compared to donors with normal levels of cholesterol (22.69 (IQR=30.6) cells/µL vs 52.62 (IQR=44.68) cells/µL, p=0.04). Among all individuals in the cohort, aGVHD was observed in 21%: 36% from donors with hypercholesterolemia versus 14% from donors with normal levels of cholesterol. Conclusion: As we described the association between hypercholesterolemia and diminished Tregs, our results might suggest that normalizing the levels of total cholesterol in the donor, prior performing allo-HSCT, might be an effective approach to diminish the risk of the receptor to develop aGVHD.

Correlation of T Cell Subsets and Hypercholesterolemia of the Donor and Its Association with Acute Graft-versus-Host Disease

Background: Acute graft-versus-host disease (aGVHD) is an important cause of death following allogeneic hematopoietic stem cell transplantation (allo-HSCT). The association between cholesterol and aGVHD was previously described potentially resulting from pro-inflammatory responses associated with hypercholesterolemia. The aim of this study was to correlate T-cell subsets in donor bone marrow (BM) samples with their levels of cholesterol and associate these results with recipients who developed aGVHD and those who did not. Materials and Methods: A prospective study was performed in 39 donor samples. T-cell subsets were analyzed by flow cytometry. Results: Eleven (28%) donors had hypercholesterolemia. Donor samples with hypercholesterolemia had less Tregs compared to donors with normal levels of cholesterol (22.69 (IQR=30.6) cells/µL vs 52.62 (IQR=44.68) cells/µL, p=0.04). Among all individuals in the cohort, aGVHD was observed in 21%: 36% from donors with hypercholesterolemia versus 14% from donors with normal levels of cholesterol. Conclusion: As we described the association between hypercholesterolemia and diminished Tregs, our results might suggest that normalizing the levels of total cholesterol in the donor, prior performing allo-HSCT, might be an effective approach to diminish the risk of the receptor to develop aGVHD.

Clinical effects of hydration, supplementary vitamins, and trace elements during end-of-life care for cancer patients

INTRODUCTION

current data regarding the decision on rehydration of patients with terminal-stage cancer remain controversial.

OBJECTIVE

the present study was to evaluate the effect of intravenous hydration and supplementary vitamins and trace elements on clinical symptoms and biochemical parameters in palliative cancer patients.

METHODS

a randomized clinical trial including 72 palliative cancer patients aged 18 years and older was performed at the National Cancer Institute in Mexico. Patients were divided into two groups: intervention and control, both receiving intravenous saline solution weekly for 4 weeks, but the former was also supplemented with vitamins and trace elements. Symptoms were assessed at baseline and 4 weeks after with the Edmonton Symptom Assessment Scale. Same measurements applied to biochemical parameters.

RESULTS

the mean age of the patients was 58.75 years. The most frequent cancer diagnoses were gastrointestinal (32 %). In the between-groups analysis significant improvements were found for the intervention group in anorexia (p = 0.024), pain (p = 0.030), chloride (p = 0.043), phosphorus (p = 0.001), potassium (p = 0.006), and total proteins (< 0.0001).

CONCLUSION

we highlight the improvement in the control of most symptoms and some biochemical parameters in the intervention group receiving vitamins and oligoelements along with intravenous hydration. Further studies are needed.