Arthritis of large joints shown as a rare clinical feature of cytokine release syndrome after chimeric antigen receptor T cell therapy: A case report
Rationale: Chimeric antigen receptor (CAR)-T cell therapy is a novel type of therapy that is being used in an increasing number of patients with acute lymphoblastic leukemia (ALL). Cytokine release syndrome (CRS) is the most common complication following CAR-T treatment, but the current understanding of the clinical manifestations and pathogenesis of CRS is still limited. Patient concerns: A 34-year-old male patient was diagnosed with ALL in June 2015. Complete remission (CR) was achieved after induction chemotherapy. The patient received 8 cycles of consolidation chemotherapy to maintain CR. In May 2017, the patient had recurrent ALL. Induction chemotherapy was given again, but without remission. In October 2017, CAR-T cell therapy was given. On October 14, the patient was pretreated with an FC regimen (fludarabine phosphate 50 mg qd on days 1–3; cyclophosphamide 0.4 g qd on days 1–3). CAR-T cells were infused on October 19 and October 20, with the number of infused cells at 2 × 105/kg and 1 × 105/kg, respectively. On October 25, the patient had a high fever, swelling, and pain in the large joints of the limbs, and joint effusion. Diagnosis: This patient was diagnosed with relapsed ALL, and he developed CRS after CAR-T therapy. Interventions: Tacilizumab (400 mg) was infused after CRS was diagnosed, and another dose of tacilizumab (240 mg) was given 6 days later. The pain was also treated with an analgesic drug. Methylpredni...
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Conclusions: MSC therapies in the treatment of knee OA are safe and have shown promising results but the available studies are limited. At this time, no definitive recommendations can be made regarding which MSC source to use. Allogeneic MSCs offer theoretical advantages over autologous MSCs, especially in ease of use and consistency of product, but there are concerns regarding cell viability and vitality, as well as the body’s response to nonautologous products. Future clinical trials should focus on randomized head-to-head comparisons of MSC sources as well as the use of multiple injections for patients with knee OA.
Low back pain and neck pain are the first and fourth leading causes, respectively, of years lived with disability. The treatment of intervertebral disk degeneration remains a significant challenge. While there are still many obstacles to overcome, the use of stem cells for the treatment of disk degeneration has emerged as one of the most promising and exciting techniques to restore the structure and function of the degenerated disk. The use of stem cells in treating intervertebral disk disease as well as the obstacles that remain are reviewed here in an evidence-based manner.
Osteosarcoma (OS) is the most common primary bone malignancy and is a leading cause of cancer-related death in children and young adults. Combination chemotherapy developed 3 decades ago significantly improved long-term survival compared to surgery alone. However, despite notable tumor cytoreduction and remission, the 5-year survival rate has remained static at ∼70% since, and the surviving patients have high chemoresistance with sustained risk of recurrent OS that has propensity to metastasize. After metastasis, the 5-year survival rate is abysmally low (∼10% to 20%). Emerging new evidence has revealed that within...
Conclusion. Anxiety and mood are potentially modifiable risk factors that have the greatest impact on pre- and postoperative pain. These results can be used to identify higher-risk patients and develop preoperative therapeutic protocols to improve postoperative outcomes. Level of Evidence: 3
Conclusion. The DASH is a valid and responsive PRO measure to evaluate disabling upper extremity involvement in patients undergoing cervical spine surgery. Level of Evidence: 3
Conclusions. MI TLIF can be safely performed in the obese population despite a higher in-hospital complication rate. Knowledge of common complications will help the treatment team appropriately manage obese patients with degenerative spondylolisthesis. Level of Evidence: 3
CONCLUSIONS: The Naples prognostic score may be a useful prognostic marker in patients with metastatic colorectal cancer receiving systemic chemotherapy. See Video Abstract at http://links.lww.com/DCR/B72. LA PUNTUACIÓN PRONÓSTICA DE NÁPOLES ES UN MARCADOR PRONÓSTICO ÚTIL EN PACIENTES CON CÁNCER COLORRECTAL METASTÁSICO ANTECEDENTES: La inflamación sistémica puede influir en la respuesta a la quimioterapia sistémica o el pronóstico en pacientes con varios tipos de cáncer. La puntuación pronóstica de Nápoles, basada...