Advancements in cancer immunotherapies targeting CD20: from pioneering monoclonal antibodies to chimeric antigen receptor-modified T cells

CD20 located predominantly on the B cells plays a crucial role in their development, differentiation, and activation, and serves as a key therapeutic target for the treatment of B-cell malignancies. The breakthrough of monoclonal antibodies directed against CD20, notably exemplified by rituximab, revolutionized the prognosis of B-cell malignancies. Rituximab, approved across various hematological malignancies, marked a paradigm shift in cancer treatment. In the current landscape, immunotherapies targeting CD20 continue to evolve rapidly. Beyond traditional mAbs, advancements include antibody-drug conjugates (ADCs), bispecific antibodies (BsAbs), and chimeric antigen receptor-modified (CAR) T cells. ADCs combine the precision of antibodies with the cytotoxic potential of drugs, presenting a promising avenue for enhanced therapeutic efficacy. BsAbs, particularly CD20xCD3 constructs, redirect cytotoxic T cells to eliminate cancer cells, thereby enhancing both precision and potency in their therapeutic action. CAR-T cells stand as a promising strategy for combatting hematological malignancies, representing one of the truly personalized therapeutic interventions. Many new therapies are currently being evaluated in clinical trials. This review serves as a comprehensive summary of CD20-targeted therapies, highlighting the progress and challenges that persist. Despite significant advancements, adverse events associated with these therapies and the development of resistance remain critical issues. Understanding and mitigating these challenges is paramount for the continued success of CD20-targeted immunotherapies.

Concomitant inhibition of the thioredoxin system and nonhomologous DNA repair potently sensitizes Philadelphia-positive lymphoid leukemia to tyrosine kinase inhibitors

Breakpoint cluster region-Abelson (BCR::ABL1) gene fusion is an essential oncogene in both chronic myeloid leukemia (CML) and Philadelphia-positive (Ph+) B-cell acute lymphoblastic leukemia (B-ALL). While tyrosine kinase inhibitors (TKIs) are effective in up to 95% of CML patients, 50% of Ph+ B-ALL cases do not respond to treatment or relapse. This calls for new therapeutic approaches for Ph+ B-ALL. Previous studies have shown that inhibitors of the thioredoxin (TXN) system exert antileukemic activity against B-ALL cells, particularly in combination with other drugs. Here, we present that peroxiredoxin-1 (PRDX1), one of the enzymes of the TXN system, is upregulated in Ph+ lymphoid as compared to Ph+ myeloid cells. PRDX1 knockout negatively affects the viability of Ph+ B-ALL cells and sensitizes them to TKIs. Analysis of global gene expression changes in imatinib-treated, PRDX1-deficient cells revealed that the nonhomologous end-joining (NHEJ) DNA repair is a novel vulnerability of Ph+ B-ALL cells. Accordingly, PRDX1-deficient Ph+ B-ALL cells were susceptible to NHEJ inhibitors. Finally, we demonstrated the potent efficacy of a novel combination of TKIs, TXN inhibitors, and NHEJ inhibitors against Ph+ B-ALL cell lines and primary cells, which can be further investigated as a potential therapeutic approach for the treatment of Ph+ B-ALL.

[Expectations towards forensic professionals conducting external examinations of dead bodies on the crime scene--results of a questionnaire distributed among public prosecutors in the Mazovian Voivodeship]

The purpose of this study was to determine expectations of public prosecutors towards forensic professionals participating in external examinations of dead bodies performed at the site of finding the corpses. The presence of forensic physicians on the crime scene was recognized as advantageous by all prosecutors; however, expectations associated with corpse inspection did not correspond to capabilities of modern medicine or necessitated repeating activities performed during autopsies. Homicides (99%), deaths of children (86%) and "media" deaths (73%) were indicated as cases when the presence of forensic professional was especially important. Definition of injuries with indication of the causative object made by forensic physicians on the crime scene was the advantage most often chosen by respondents (82%). Almost one third of respondents expected forensic physicians to evaluate the length and direction of wound tracts, more than half of them--to provide a detailed description of injuries, one fifth wanted physicians to determine the exact time of death. Description of post mortem changes was not indicated as the most important benefit by any prosecutor.

CONCLUSIONS

Public prosecutors recognized the presence of forensic professionals on the crime scene as advantageous, but their expectations associated with dead body examinations did not correspond to capabilities of forensic medicine or forced physicians to perform activities normally made during autopsy. An algorithm of dead body examination on the crime scene including aims and advantages of such a examination should be developed jointly by prosecutors and forensic medicine specialists.

[The effect of alcohol consumption on the severity of injuries, prognosis and mortality--a review of literature]

The paper is a review of the most current academic literature published in the English language and addressing the effect of alcohol consumption on the severity of injuries, prognosis and mortality with special emphasis placed on the consultative usefulness of such publications. The report was inspired by repeated questions asked in association with expert opinions on the effects of injuries and addressing a possible effect of alcohol consumption by the victims on the severity of injuries and prognosis. In case of such questions, a valuable supplement to an opinion based on on the expert's professional experience may be found in an analysis of publications focusing on the subject. The present review was based on two databases "Web of science" and "Medline" (2000-2011). Initially, 372 abstracts were taken into account. Subsequently, 42 articles were thoroughly studied. The analyzed material represented both experimental and research approaches to the problem. The experimental approach was based on tests carried out on animals in laboratories, whereas the research approach was based on the observations of patients admitted to hospitals with injuries. The literature overview indicates a neuroprotective feature of alcohol and an improved prognosis in intoxicated people suffering from isolated head injuries, even though the severity of their injuries is much higher than in the cases of sober people. In cases of polytrauma injuries, the influence of alcohol is explicitly negative, but does not increase mortality.

The anatomy of the fundic branches of the stomach: preliminary results

The fundic branches of the stomach can be defined as a group of vessels that can arise either directly or indirectly from the following source arteries: the left inferior phrenic artery, the accessory left hepatic artery, the left gastric artery, the left middle suprarenal artery, the main trunk of the splenic artery, the posterior gastric artery, the superior polar artery, the gastrosplenic artery, the left gastroepiploic artery and the splenic artery with its inferior and superior terminal branches. It is worth mentioning that the fundic branches of the left gastroepiploic artery and the superior and inferior terminal branches of the splenic artery, like other vessels arising from these three source arteries and supplying the stomach, are defined as short gastric arteries. The anatomy of these fundic branches, particularly relevant to some surgical procedures, is not sufficiently described, and the current literature suffers from lack of publications on this particular topic. We therefore decided to explore in detail the arterial vascularisation of the gastric fundus. The research was carried out on material consisting of 15 human stomach specimens. The anatomical analysis comprised the following: the number of occurrences of fundic branches in each of the source arteries defined above, the distance between the origins of the source artery and its arising fundic branch, the way in which the fundic branches arose, the length, diameter at point of origin and morphology of the fundic branches, as well as the exact point of perforation of each fundic branch on the fundus. The highest incidence of the direct-branching pattern of fundic branches was in the left middle suprarenal artery, the gastrosplenic artery and the left gastrosplenic artery. The accessory left hepatic artery, the left gastric artery and the main trunk of the splenic artery were the most frequent site of the indirectly arising pattern of fundic branch. The highest median value of fundic branch length was 63.05 mm, found in the accessory left hepatic artery group. The largest median diameter value of the vessel was encountered among those originating in the left middle suprarenal artery and reached 2.17 mm. The posterolateral quadrant of the fundus received the largest number of fundic branches, amounting to 46.5% of all the fundic branches studied.

[Atypical form of the Simon's symptom in the case of accidental hanging of an 11-year-old boy]

The repot describes a case of death of an 11-year old boy who died due to fatal accidental hanging from a noose at the attic floor.

[Death of a 57-year old male with previously undiagnosed displacement of the abdominal organs to the chest]

The report describes a death of a 57-year old male who died due to exacerbated cardiac and pulmonary insufficiency caused by the displacement of the abdominal organs to the chest through a previously undiagnosed diaphragmatic hernia.

[Fatal ethanol poisoning of the alcohol abusers]

The examined cohort consisted of 137 alcohol abusers, who died suddenly because of the acute ethanol poisoning. Among them there were 109 men and 28 women from 25 to 73 (mean 46.3 +/- 9.22) years old. Autopsy examinations performed in Department of the Forensic Medicine revealed no traumas or diseases explaining the sudden death, but showed the increased blood ethanol concentration from 3.6 to 8.8 (mean 4.67 +/- 0.74) g/l and urine ethanol concentration from 2.0 to 7.3 (mean 4.88 +/- 0.87) g/l. In the period 1996-1999 in Gdańsk Province there was twofold decrease in the number of sudden death caused by the acute ethanol poisoning in the alcohol abusers.