Acute kidney injury (AKI) is a complex disorder for which currently there is no accepted definition. Having a uniform standard for diagnosing and classifying AKI would enhance our ability to manage these patients. Future clinical and translational research in AKI will require collaborative networks of investigators drawn from various disciplines, dissemination of information via multidisciplinary joint conferences and publications, and improved translation of knowledge from pre-clinical research. We describe an initiative to develop uniform standards for defining and classifying AKI and to establish a forum for multidisciplinary interaction to improve care for patients with or at risk for AKI. Members representing key societies in critical care and nephrology along with additional experts in adult and pediatric AKI participated in a two day conference in Amsterdam, The Netherlands, in September 2005 and were assigned to one of three workgroups. Each group's discussions formed the basis for draft recommendations that were later refined and improved during discussion with the larger group. Dissenting opinions were also noted. The final draft recommendations were circulated to all participants and subsequently agreed upon as the consensus recommendations for this report. Participating societies endorsed the recommendations and agreed to help disseminate the results. The term AKI is proposed to represent the entire spectrum of acute renal failure. Diagnostic criteria for AKI are proposed based on acute alterations in serum creatinine or urine output. A staging system for AKI which reflects quantitative changes in serum creatinine and urine output has been developed. We describe the formation of a multidisciplinary collaborative network focused on AKI. We have proposed uniform standards for diagnosing and classifying AKI which will need to be validated in future studies. The Acute Kidney Injury Network offers a mechanism for proceeding with efforts to improve patient outcomes.

Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury

Liposomal drug delivery systems: from concept to clinical applications.

Background Imatinib, a selective inhibitor of the BCR-ABL tyrosine kinase, produces high response rates in patients with chronic-phase chronic myeloid leukemia (CML) who have had no response to interferon alfa. We compared the efficacy of imatinib with that of interferon alfa combined with low-dose cytarabine in newly diagnosed chronic-phase CML. Methods We randomly assigned 1106 patients to receive imatinib (553 patients) or interferon alfa plus low-dose cytarabine (553 patients). Crossover to the alternative group was allowed if stringent criteria defining treatment failure or intolerance were met. Patients were evaluated for hematologic and cytogenetic responses, toxic effects, and rates of progression. Results After a median follow-up of 19 months, the estimated rate of a major cytogenetic response (0 to 35 percent of cells in metaphase positive for the Philadelphia chromosome) at 18 months was 87.1 percent (95 percent confidence interval, 84.1 to 90.0) in the imatinib group and 34.7 percent (95 perce...

https://www.nejm.org/doi/pdf/10.1056/NEJMoa022457

Imatinib compared with interferon and low-dose cytarabine for newly diagnosed chronic-phase chronic myeloid leukemia

BackgroundIn a phase 1 trial, axicabtagene ciloleucel (axi-cel), an autologous anti-CD19 chimeric antigen receptor (CAR) T-cell therapy, showed efficacy in patients with refractory large B-cell lymphoma after the failure of conventional therapy. MethodsIn this multicenter, phase 2 trial, we enrolled 111 patients with diffuse large B-cell lymphoma, primary mediastinal B-cell lymphoma, or transformed follicular lymphoma who had refractory disease despite undergoing recommended prior therapy. Patients received a target dose of 2×106 anti-CD19 CAR T cells per kilogram of body weight after receiving a conditioning regimen of low-dose cyclophosphamide and fludarabine. The primary end point was the rate of objective response (calculated as the combined rates of complete response and partial response). Secondary end points included overall survival, safety, and biomarker assessments. ResultsAmong the 111 patients who were enrolled, axi-cel was successfully manufactured for 110 (99%) and administered to 101 (91%)....

/pdf/axicabtagene-ciloleucel-car-t-cell-therapy-in-refractory-5dcmuep4o0.pdf

Axicabtagene Ciloleucel CAR T-Cell Therapy in Refractory Large B-Cell Lymphoma

BACKGROUND: The cause of chronic myeloid leukemia (CML) is a constitutively active BCR-ABL tyrosine kinase. Imatinib inhibits this kinase, and in a short-term study was superior to interferon alfa ...

/pdf/five-year-follow-up-of-patients-receiving-imatinib-for-2ejt1h30j2.pdf

Five-year follow-up of patients receiving imatinib for chronic myeloid leukemia

High-Dose Chemotherapy Followed by Autologous Stem Cell Transplantation (auto-SCT) Versus CHOP Regimen in Patients with Untreated Aggressive Non-Hodgkin’s Lymphoma: An Update of the GOELAMS 072 Trial with a Median Follow-up of 9.8 Years

Cytokines in human multiple myeloma , Cytokines in human multiple myeloma , کتابخانه مرکزی دانشگاه علوم پزشکی تهران

Cytokines in Human Multiple Myeloma

8020 Background: Elotuzumab is a humanized antibody against CS1, a cell surface glycoprotein, which is highly expressed in multiple myeloma (MM). In mouse xenograft MM model, elotuzumab demonstrated significantly enhanced anti-tumor activity when combined with lenalidomide (len) compared to len alone. The study objectives were to evaluate the MTD, safety, PK and efficacy of elotuzumab in combination with len and low dose dexamethasone (dex). Methods: Len (25 mg PO) was given on Days 1-21 of a 28-day cycle. Elotuzumab (IV infusion) in 3 escalating dose cohorts (5, 10 and 20 mg/kg) was given weekly for the first two cycles and then every other week of subsequent cycles. Dex was given weekly at 40 mg PO. First 5 patients were treated for 6 months before a protocol amendment to continue treatment until progression. Results: A total of 29 patients (pts) with a median age of 60 years were enrolled; 28 pts received study drug. Pts had a median of 3 prior MM treatments including thalidomide (59%), bortezomib (69%...

Elotuzumab in Combination With Lenalidomide and Low-Dose Dexamethasone in Relapsed or Refractory Multiple Myeloma: A Phase 1/2 Study

Daratumumab in transplant regimens for myeloma

A total of 91 patients with acute monoblastic leukemia (AML) were treated following two induction regimens (ARA-C + RBZ, with of without CPA), and a unique maintenance therapy (CNS prophylaxis and reinductions every 6 weeks, for 36 months). Complete remission (CR) was obtained in 84% of patients. The only prognostic factor significantly influencing the CR rate was age, with 92% for the less than 40 years group and 75% for the greater than or equal to 40 years group. CR was not influenced by sex, tumoral syndrome, leukocytosis, cytological subclassification (M5A, M5B), or induction regimen with or without CPA. The duration of CR in these forms which have a traditionally poor prognosis, was no different from other forms of AML (21 months), and the disease-free survival at 50 months was 45%. These results, pertaining to the largest published series treated by the same protocol, are the best reported in literature and confirm the role of induction and maintenance therapy in CR.

Jean Luc Harousseau

Papers

High-Dose Chemotherapy Followed by Autologous Stem Cell Transplantation (auto-SCT) Versus CHOP Regimen in Patients with Untreated Aggressive Non-Hodgkin’s Lymphoma: An Update of the GOELAMS 072 Trial with a Median Follow-up of 9.8 Years

Cytokines in Human Multiple Myeloma

Elotuzumab in Combination With Lenalidomide and Low-Dose Dexamethasone in Relapsed or Refractory Multiple Myeloma: A Phase 1/2 Study

Daratumumab in transplant regimens for myeloma

[Improved results in the treatment of acute monoblastic leukemia: analysis of 91 patients treated in the 01 AM 81 protocol].