Allogeneic Hematopoietic Cell Transplantation in Patients Aged 50Years or Older with Severe Aplastic Anemia

We report on 499 patients with severe aplastic anemia aged ≥ 50years who underwent hematopoietic cell transplantation (HCT) from HLA-matched sibling (n = 275, 55%) or HLA-matched (8/8) unrelated donors (n = 187, 37%) between 2005 and 2016. The median age at HCT was 57.8 years; 16% of patients were 65 to 77years old. Multivariable analysis confirmed higher mortality risks for patients with performance score less than 90% (hazard ratio [HR], 1.41; 95% confidence interval [CI], 1.03 to 1.92; P = .03) and after unrelated donor transplantation (HR, 1.47; 95% CI, 1 to 2.16; P = .05). The 3-year probabilities of survival for patients with performance scores of 90 to 100 and less than 90 after HLA-matched sibling transplant were 66% (range, 57% to 75%) and 57% (range, 47% to 76%), respectively. The corresponding probabilities after HLA-matched unrelated donor transplantation were 57% (range, 48% to 67%) and 48% (range, 36% to 59%). Age at transplantation was not associated with survival, but grades II to IV acute graft-versus-host disease (GVHD) risks were higher for patients aged 65years or older (subdistribution HR [sHR], 1.7; 95% confidence interval, 1.07 to 2.72; P = .026). Chronic GVHD was lower with the GVHD prophylaxis regimens calcineurin inhibitor (CNI) + methotrexate (sHR, .52; 95% CI, .33 to .81; P = .004) and CNI alone or with other agents (sHR, .27; 95% CI, .14 to .53; P < .001) compared with CNI + mycophenolate. Although donor availability is modifiable only to a limited extent, choice of GVHD prophylaxis and selection of patients with good performance scores are key for improved outcomes.

Transaminase and alkaline phosphatase activity in the serum of burn patients treated with highly purified tannic acid

The effects of local treatment with highly purified tannic acid (HPTA) on serum transaminase and alkaline phosphatase activity in burn patients were studied, retrospectively. Temporary elevations in the activity of gamma-glutamyl transferase (GGT), aspartate aminotransferase (ASAT), alanine aminotransferase (ALAT) and alkaline phosphatase (AP) were observed in both HPTA-treated patients and their matched controls. No statistically significant difference was found between the two patient-groups with respect to the mean enzyme activities, calculated as the areas under the curve between 5 and 15 days post-burn (PBD). These results seem to indicate that HPTA does not cause hepatotoxicity, at least when applied to a burned area corresponding to approximately 10% of the total body surface. This is in agreement with the widespread and frequent use of HPTA in the food, cosmetic and pharmaceutical industries.

A novel class of aromatic vitamin D analogs

Vitamin D analogs in which the triene moiety is replaced by an aromatic ring have been synthesized and their ability to bind to the vitamin D receptor investigated.