Notes

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6), overall survival and disease-free survival are 56.3% and 47.2%. A better diseasefree survival was observed in patients who obtained a molecular response at day +85 compared to cases who did not. The presence of additional copy number aberrations - IKZF1 plus CDKN2A/B and/or PAX5 deletions - was the most important unfavorable prognostic factor on overall and disease-free survival (p=0.005 and p=0.0008). This study shows that in adult Ph+ ALL long-term survivals can be achieved with a total-therapy strategy based on a chemo-free induction and, in complete molecular responders, also without further systemic chemotherapy. Finally, the screening of additional copy number aberrations should be included in the diagnostic work-up. EudraCT 2010-019119-39.Pathogen reduction (PR) technologies for blood components have been established to reduce the residual risk of known and emerging infectious agents. THERAFLEX UVPlatelets, a novel UVC light-based PR technology for platelet concentrates, works without photoactive substances. This randomized, controlled, double-blind, multicenter, noninferiority trial was designed to compare the efficacy and safety of UVC-treated platelets to that of untreated platelets in thrombocytopenic patients with hematologic-oncologic diseases. Primary objective was to determine non-inferiority of UVC-treated platelets, assessed by the 1-hour corrected count increment (CCI) in up to eight per-protocol platelet transfusion episodes. Analysis of the 171 eligible patients showed that the defined non-inferiority margin of 30% of UVC-treated platelets was narrowly missed as the mean differences in 1-hour CCI between standard platelets versus UVC-treated platelets for intention-to-treat and perprotocol analyses were 18.2% (95% confidence interval [CI] 6.4%; 30.1) and 18.7% (95% CI 6.3%; 31.1%), respectively. In comparison to the control, the UVC group had a 19.2% lower mean 24-hour CCI and was treated with an about 25% higher number of platelet units, but the average number of days to next platelet transfusion did not differ significantly between both treatment groups. The frequency of low-grade adverse events was slightly higher in the UVC group and the frequencies of refractoriness to platelet transfusion, platelet alloimmunization, severe bleeding events, and red blood cell transfusions were comparable between groups. Our study suggests that transfusion of pathogen-reduced platelets produced with the UVC technology is safe but non-inferiority was not demonstrated. (The German Clinical Trials Register number DRKS00011156).We have developed a personalized vaccine whereby patient derived leukemia cells are fused to autologous dendritic cells, evoking a polyclonal T cell response against shared and neo-antigens. We postulated that the dendritic cell (DC)/AML fusion vaccine would demonstrate synergy with checkpoint blockade by expanding tumor antigen specific lymphocytes that would provide a critical substrate for checkpoint blockade mediated activation. Using an immunocompetent murine leukemia model, we examined the immunologic response and therapeutic efficacy of vaccination in conjunction with checkpoint blockade with respect to leukemia engraftment, disease burden, survival and the induction of tumor specific immunity. Mice treated with checkpoint blockade alone had rapid leukemia progression and demonstrated only a modest extension of survival. Vaccination with DC/AML fusions resulted in the expansion of tumor specific lymphocytes and disease eradication in a subset of animals, while the combination of vaccination and checkpoint blockade induced a fully protective tumor specific immune response in all treated animals. click here Vaccination followed by checkpoint blockade resulted in upregulation of genes regulating activation and proliferation in memory and effector T cells. Long term survivors exhibited increased T cell clonal diversity and were resistant to subsequent tumor challenge. The combined DC/AML fusion vaccine and checkpoint blockade treatment offers unique synergy inducing the durable activation of leukemia specific immunity, protection from lethal tumor challenge and the selective expansion of tumor reactive clones.Intubation is a frequent procedure in the intensive care unit, often performed in an emergency. Because of patients' clinical condition with little physiological reserve, intubation in the critically ill patients is associated with increased risk of complications. A systematic patient's assessment and a codified and rigorous preparation of the team and equipment significantly reduce the risks of intubation. The purpose of this article is to summarize the different strategies that allow maximizing safety of intubation in the critically ill.Global warming is a major contemporary issue which is the subject of considerable interest and questioning in the scientific community. Today, what do we really know about environmental degradation, the impact on human health and the implications for health equity ? This article invites us to reflect on this by introducing some of the concepts that are currently being developed.Climate change and forced migration are two major global health concerns. They are closely related, with climate change causing an increasing number of forced migrants. Natural disasters, sea-level rising or land aridification are examples of consequences of climate change that have an impact on forced migration. Moreover, the health of forced migrants can be directly affected by climate change, during the migration process or in the host country. The absence of a legal status of « climate refugee » can be an important barrier of access to health care. These vulnerable populations are among the first to be affected, which is an important health equity issue.Climate change and global warming present major clinical challenges. We focus on cardiovascular and renal clinical consequences. The physiological adaptations and physiopathological effects are described, especially in vulnerable populations. The clinical consequences during heat waves, are mainly cardiovascular with stroke, acute ischemic heart disease and sudden death increased by up to 40%. Likewise, episodes of acute renal failure, electrolyte disturbances and kidney stones disease increase. The chronic consequences should not be overlooked, as the risk of heart failure also increases in high ambient temperature regions and there is also some evidence of an increase in chronic kidney disease in tropical zones. Physicians must be aware of these consequences as they will be involved in their management in the future.
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