Frontline blinatumomab combined with chemotherapy has resulted in improved outcomes in both pediatric and adult patients with acute lymphoblastic leukemia and is considered the new cornerstone of acute lymphoblastic leukemia treatment. The role of asparaginase in this new landscape of acute lymphoblastic leukemia treatment was extensively discussed by an expert panel of hemato-oncologists to reach a consensus on the safety and efficacy of asparaginase in diverse settings with and without blinatumomab. Herein, the following consensus topics are presented: (1) optimal dosing of asparaginase and therapeutic drug monitoring; (2) prevention of asparaginase hypersensitivity reactions and inactivation; (3) integration of frontline blinatumomab, asparaginase, and antimetabolites; and (4) special issues of asparaginase formulations and adaptations for resource-limited settings.

The Pediatric Hodgkin Consortium (PHC) hypothesized that increasing chemotherapeutic dose-density for Hodgkin lymphoma (HL) they could increase the complete response rate among favorable risk patients with HL after 8 weeks of Stanford V compared to 8 weeks of VAMP. This would translate to a decrease in patients who required radiation therapy (RT) to achieve a cure. HOD08 (NCT00846742) was a phase II multicenter investigator-initiated single- arm trial for patients ≤ 21 years of age with previously untreated stage IA or IIA HL without mediastinal bulk or extranodal disease extension and fewer than three sites of disease. Treatment consisted of a modified 8-week Stanford V regimen (vinblastine, doxorubicin, vincristine, bleomycin, mechlorethamine, etoposide and prednisone). Modified tailored field RT was administered only to disease sites achieving less than a CR. The primary objective was to increase CR rate after 8 weeks of chemotherapy by at least 20% (from an estimated 44% to 64%) compared to patients treated on a previous trial (HOD99). HOD08 enrolled 85 patients with HL and 72 were evaluable for the primary objective of whom 55 (76.4%) achieved a CR at all sites and did not receive RT. The 5-year event-free survival (EFS) and overall survival (OS) rates for the entire cohort were 87.4% (95% confidence interval (CI) 80.4%-95.0%) and 98.7% (95% CI 96.2%-100%), respectively. A dose-dense modified Stanford V regimen reduced the proportion of low-risk pediatric patients with HL who received RT while maintaining excellent outcomes. NCT00846742

Objectives: We aimed to determine whether the occurrence of early-onset toxicities due to 5-fluorouracil (5-FU) in treatment-naive patients undergoing their first cycle of FOLFOX/FOLFIRINOX was associated with decreased overall survival, increased risk of treatment cessation, and hospitalization. Methods: This was a retrospective cohort study using patient information from community oncology practices. Patients who received their first dose of 5-FU from 1 January 2015 through 1 August 2023 were included. The occurrence of an early-onset 5-FU-related toxicity (during 5-FU infusion or up to 96 h after infusion completion) in the first cycle of FOLFOX/FOLFIRINOX was the explanatory variable. The primary endpoint was overall survival (OS); secondary endpoints included early treatment cessation and early hospital admission. Results: In total, 3988 patients were included; the median age was 62.9 years and 57.5% were male. Early-onset toxicities were observed in 19.1%, with vomiting, thrombocytopenia, and diarrhea being most common. Patients with early-onset toxicities had a median OS of 2.5 years [95% CI 2.2 to 2.9] compared with 5.3 years [95% CI 4.7 to 5.8] in patients without early-onset toxicities (p < 0.001). The occurrence of early-onset toxicities was associated with an adjusted hazard ratio of 1.61 [95% CI 1.44 to 1.80] and was also significantly associated with early treatment cessation (odds ratio [OR] 1.53, 95% CI 1.30 to 1.80) and early hospital admission (OR 8.69, 95% CI 3.45 to 24.18). Conclusions: Early-onset toxicities related to 5-FU during the first cycle of FOLFOX/FOLFIRINOX treatment were associated with poor outcomes. Early recognition and prompt intervention are pertinent to improve outcomes in patients receiving fluoropyrimidine chemotherapy.

Structured interrogation (SI) is a frequency-domain NIRS technique that adjusts the relative phase between intensity-modulated light sources and generates a various spatial pattern of depth sensitivity. It can be used to extract quantitative information from multi-layered tissues. We apply Cramér-Rao lower bound (CRLB) analysis for phase selection. Then, the selected SI phases are used to resolve the optical properties of a fat/muscle tissue model. We found that CRLB is effective for selecting SI phase shift, and a combination of SI measurements and multi-distance measurements can result in an accurate estimation of optical properties and allow for more compact fd-NIRS probes.

Molecular imaging tools that can image plant metabolism and effects of external agricultural treatments in the micro-environment of plant tissues are significant for further understanding plant biology and optimizing the formulation of new agricultural products. Mass spectrometry, a common tool used by plant biologists, is unable to resolve nano-crystalline active ingredients (AIs) on the leaf surface nor achieve 3D molecular imaging of living plants. To address that, multiphoton microscopy (MPM) and fluorescence lifetime imaging microscopy (FLIM) are combined to achieve sub-cellular, depth-resolved fluorescence lifetime of both AIs and intrinsic proteins/pigments (e.g., chlorophyll and/or cytosolic NADH) after the herbicide treatment application. Here we present a method using a custom-designed, high-speed MPM-FLIM system, "Instant FLIM", to achieve real-time, unlabeled 3D functional molecular imaging of intrinsic proteins and pigments in optically thick and highly scattering plant samples with the application of external treatments. To validate the capability of MPM-FLIM to measure intrinsic proteins and pigments within plant tissues, we present the results of unlabeled bluegrass blades samples. To demonstrate simultaneous imaging of 3D molecular plant tissue and the agricultural AI nano-crystals deposition and formation, we evaluate the performance of the MPM-FLIM by applying commercial herbicide product to gamagrass blade sample. Additionally, to measure the herbicide-induced cellular-level functional responses within living plant tissues, 3D time-resolved molecular MPM-FLIM imaging of hemp dogbane leaf with herbicide is performed. Results demonstrate MPM-FLIM is capable of 3D simultaneous functional imaging of label-free living plant tissues and the quantitative measurements of the location and formation of AI nanocrystals within the plant tissues.

Frequency domain (FD) diffuse optical spectroscopy (DOS) can be used to recover absolute optical properties of biological tissue, providing valuable clinical feedback, including in diagnosis and monitoring of breast tumours. In this study, tomographic (3D) and topographic (2D) techniques for spatially-varying optical parameter recovery are presented, based on a multi-distance, handheld DOS probe. Processing pipelines and reconstruction quality are discussed and quantitatively compared, demonstrating the trade-offs between depth sensitivity, optical contrast, and computational speed. Together, the two techniques provide both depth sensitive real-time feedback, and high-resolution 3D reconstruction from a single set of measurements, enabling faster and more accurate clinical feedback.

We have recently isolated a cDNA (SKv1.1) encoding a Shaker-related K+ channel from the human parasitic trematode Schistosoma mansoni. In order to better understand the functions of SKv1.1 protein, the distribution of SKv1.1 protein in adult S. mansoni was analyzed by immunohistochemistry using a region-specific antibody. SKv1.1 proteins were widely expressed in the nervous and muscular systems. The strongest immunoreactivity (IR) was observed in the nervous system of both male and female. In the nervous system, IR for SKv1.1 proteins was localized in cell bodies and nerve fibers of the anterior ganglia, the central commissure, and the main nerve cords. IR was also observed in the dorsal and the ventral peripheral nerve nets, fine nerve fibers entering into a variety of structures such as the dorsal tubercles, longitudinal and ventral muscle fibers, and oral and ventral suckers. In the muscular system, SKv1.1 proteins were localized to the longitudinal, circular, and ventral muscle fibers of male as well as in isolated muscle fibers where native A-type K+ currents were measured. Moderate IR was also seen in a large number of cell bodies in the parenchyma. These results indicate that SKv1.1 protein may play an important role in the regulation of the excitability of neurons and muscle cells of S. mansoni.

We demonstrate improvements in diffuse optical tomography image quality by using phased sources in frequency domain near-infrared spectroscopy. We developed a framework for modeling interfering photon density waves with varying phase and amplitude.

Children with cancer in low- and middle-income countries (LMIC) succumb to their disease four times more often than those in high-income countries (HIC).[1]