المؤلفون: Wei Mu, Meilan Zhang, Guang Hu, Yunfeng Han, Xia Mao, Caixia Chen, Kefeng Shen, Zhenyu Dai, Xiaojian Zhu, Xiaoxi Zhou, Liang Huang, Qilin Ao, Min Xiao

المصدر: Frontiers in Immunology, Vol 14 (2023)

مصطلحات موضوعية: ALK-positive anaplastic large cell lymphoma, cell therapy, chimeric antigen receptor T cells, CD5 antigen, laboratory based differential diagnosis, Immunologic diseases. Allergy, RC581-607

الوصف: BackgroundAnaplastic Large Cell Lymphoma (ALCL) is one of the most common subtypes of T-cell lymphoma. Among these, refractory and relapsed (r/r) ALK positive ALCL lacks effective therapies. The chimeric antigen receptor-modified T (CAR-T) cell therapy holds great promise as a therapeutic strategy for this disease. However, it is not known yet whether anti-CD5 CAR-T cells are sufficient for the definitive treatment of relapsed ALK+ ALCL, nor the role of accurate laboratory-based diagnoses during CAR-T treatment.Case presentationThe adolescent patient received autologous T cells containing sequences encoding VH domains specific to CD5. Following the infusion, there was an increase in both the copy number and proportion of CAR-T cells in peripheral blood. IL-6 and ferritin levels in the patient exhibited significant fluctuations, with increases of 13 and 70 folds respectively, compared to baseline after the treatment. Additionally, adverse effects were observed, including grade 4 rash, grade 1 headache, nausea, and neck-pain. Surprisingly, a relapsed disease phenotype was identified based on the results of PET/CT and histopathological analysis of the inguinal lymph node biopsy. After conducting a thorough diagnostic assessment, which included flow cytometry, next-generation sequencing (NGS), examination of immune-related gene rearrangements, and analysis of the immune repertoire of T-cell receptors (TCR), we conclusively determined that the hyperplastic T cells identified in the lymph node were the result of an expansion of CAR-T cells. Ultimately, the patient has attained complete remission (CR) and has sustained a disease-free survival state for 815 days as of the cutoff date on August 30, 2023.ConclusionTaken together, the results demonstrate that anti-CD5 CAR-T cells can induce a clinical response in r/r ALK+ ALCL patient. Furthermore, this case underscores the importance of utilizing advanced technologies with high sensitivity and accuracy for biological detection in clinical laboratory diagnosis and prognosis in CAR-T cell treatment.Trial registration numberNCT04767308.

وصف الملف: electronic resource

العلاقة: https://www.frontiersin.org/articles/10.3389/fimmu.2023.1280007/fullTest; https://doaj.org/toc/1664-3224Test

الوصول الحر: https://doaj.org/article/09949907a8e54c0f90b2fdb13acd94d8Test

المؤلفون: Wanzhong Yuan, Ran Huo, Kaiming Ma, Yunfeng Han, Xiaoliang Yin, Jun Yang, Xihai Zhao, Tao Wang

المصدر: Frontiers in Neurology, Vol 13 (2022)

مصطلحات موضوعية: carotid endarterectomy, severe carotid artery stenosis, contralateral carotid artery occlusion, shunt, carotid clamp time, Neurology. Diseases of the nervous system, RC346-429

الوصف: ObjectiveTo analyze the risk factors associated with adverse events after carotid endarterectomy (CEA) in patients with unilateral severe carotid stenosis and contralateral occlusion.MethodsPatients were recruited for CEA between August 2014 and February 2020. CEA was performed under general anesthesia. The carotid clamp time (CCT; long CCT: >20 min) is defined as the period between clamp-on and clamp-off for the stenotic carotid artery. The perioperative factors and postoperative adverse events were recorded. All patients were followed up for 1 year after CEA.ResultsSixty subjects (65.8 ± 7.2 years; 54 males) were included. Patients with adverse events had significantly longer CCT than those without adverse events (60% vs. 40%, P = 0.013). Univariate logistic regression analysis showed that a history of diabetes was significantly associated with adverse events (OR, 0.190; 95% CI, 0.045–0.814; P = 0.025); long CCT was significantly associated with adverse events (OR, 8.500; 95% CI, 1.617–44.682; P = 0.011). After adjusting for confounding factors, including age, sex, BMI, diabetes, PSV, long CCT, non–use of shunt, and history of stroke or TIA, the associations between diabetes and adverse events (OR, 0.113; 95% CI, 0.013–0.959; P = 0.046) were statistically significant; the associations between long CCT and adverse events (OR, 1.301; 95% CI, 1.049–1.613; P = 0.017) were statistically significant.ConclusionsA longer carotid clamp time (>20 min) and a history of diabetes may increase the risk of adverse events in patients with unilateral severe carotid stenosis and contralateral occlusion after CEA. With good preoperative evaluation and intraoperative monitoring, the use of shunts may not be needed intraoperatively in patients with unilateral severe carotid stenosis and contralateral occlusion.

وصف الملف: electronic resource

العلاقة: https://www.frontiersin.org/articles/10.3389/fneur.2022.971673/fullTest; https://doaj.org/toc/1664-2295Test

الوصول الحر: https://doaj.org/article/72a9633d1fd346c5820c42055915780fTest

المؤلفون: Jiali Li, Yang Xun, Cong Li, Yunfeng Han, Yaqi Shen, Xuemei Hu, Daoyu Hu, Zheng Liu, Shaogang Wang, Zhen Li

المصدر: Frontiers in Medicine, Vol 7 (2020)

مصطلحات موضوعية: unenhanced CT, differential renal function, residual parenchymal volume, CT texture analysis, upper urinary tract stones, Medicine (General), R5-920

الوصف: Objectives: The aim of this study was to determine whether unenhanced computed tomography (CT) imaging can estimate differential renal function (DRF) in patients with chronic unilateral obstructive upper urinary tract stones.Materials and Methods: This was a single-center retrospective study of 76 patients. All the patients underwent unenhanced CT and nuclear renography (RG) at an interval of 4 to 6 weeks due to chronic unilateral obstructive urinary stones. Renal CT measurements (RCMs), including residual parenchymal volume (RPV) and volumetric CT texture analysis parameters, were obtained through a semiautomatic method. Percent RCMs were calculated and compared with renal function determined by RG.Results: The strongest Pearson coefficient between percent RCM and DRF was reflected by RPV (r = 0.957, P < 0.001). Combinations of RPV and other parameters did not significantly improve the correlation compared with RPV alone (r = 0.957 vs. r = 0.957, 0.957, 0.887, 0.815, and 0.956 for combination with Hounsfield unit, parenchymal voxel, skewness, kurtosis, and entropy, respectively; all P < 0.001). Percent RPV was subsequently introduced into linear regression, and the equation y = −2.66 + 1.07* × (P < 0.001) was derived to calculate predicted DRF. No statistically difference was found between predicted DRF using the equation and observed DRF according to RG (P = 0.959).Conclusion: Unenhanced CT imaging can estimate DRF in patients with chronic unilateral obstructive upper urinary tract stones, and RG might not be necessary as a conventional method in clinical.

وصف الملف: electronic resource

العلاقة: https://www.frontiersin.org/article/10.3389/fmed.2020.00309/fullTest; https://doaj.org/toc/2296-858XTest

الوصول الحر: https://doaj.org/article/c13ef9264d574390b0bfc19c3490d6fdTest