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Increased cell proliferation is a hallmark of acute lymphoblastic leukemia (ALL), and genetic alterations driving clonal proliferation have been identified as prognostic factors. To evaluate replicative history and its potential prognostic value, we determined telomere length (TL) in lymphoblasts, B-, and T-lymphocytes, and measured telomerase activity (TA) in leukocytes of patients with ALL. In addition, we evaluated the potential to suppress the in vitro growth of B-ALL cells by the telomerase inhibitor imetelstat. We found a significantly lower TL in lymphoblasts (4.3 kb in pediatric and 2.3 kb in adult patients with ALL) compared to B- and T-lymphocytes (8.0 kb and 8.2 kb in pediatric, and 6.4 kb and 5.5 kb in adult patients with ALL). TA in leukocytes was 3.2 TA/C for pediatric and 0.7 TA/C for adult patients. Notably, patients with high-risk pediatric ALL had a significantly higher TA of 6.6 TA/C compared to non-high-risk patients with 2.2 TA/C. The inhibition of telomerase with imetelstat ex vivo led to significant dose-dependent apoptosis of B-ALL cells. These results suggest that TL reflects clonal expansion and indicate that elevated TA correlates with high-risk pediatric ALL. In addition, telomerase inhibition induces apoptosis of B-ALL cells cultured in vitro. TL and TA might complement established markers for the identification of patients with high-risk ALL. Moreover, TA seems to be an effective therapeutic target; hence, telomerase inhibitors, such as imetelstat, may augment standard ALL treatment.

Autologous hematopoietic stem cell transplantation (autoHSCT) is a standard of care for patients with hemato-oncologic diseases. This procedure is highly regulated, and a quality assurance system needs to be in place. Deviations from defined processes and outcomes are reported as adverse events (AEs: any untoward medical occurrence temporally associated with an intervention that may or may not have a causal relationship), including adverse reactions (ARs: a response to a medicinal product which is noxious and unintended). Only a few reports on AEs cover the procedure of autoHSCT from collection until infusion. Our aim was to investigate the occurrence and severity of AEs in a large data set of patients who were treated by autoHSCT. In this retrospective, observational, single-center study on 449 adult patients during the years 2016–2019, AEs occurred in 19.6% of the patients. However, only 6.0% of patients had ARs, which is a low rate compared to the percentages (13.5–56.9%) found in other studies; 25.8% of the AEs were serious and 57.5% were potentially serious. Larger leukapheresis volumes, lower numbers of collected CD34+ cells and larger transplant volumes significantly correlated with the occurrence and number of AEs. Importantly, we found more AEs in patients >60 years (see graphical abstract). By preventing potentially serious AEs of quality and procedural issues, AEs could be reduced by 36.7%. Our results provide a broad view on AEs and point out steps and parameters for the potential optimization of the autoHSCT procedure, especially in elderly patients.

Introduction: The living lab approach allows citizens to be directly involved in projects in integrated healthcare to ensure that the development of topics is tailored to their needs and priorities and that their values are respected all throughout ideation and development. Be it through providing insights to researchers, participating in the collection and analysis of information on their health and well-being, or initiating and co-constructing the protocols of a project, citizens can be involved in many ways. They are the experts of their own lives! Aims & methods: While setting up a community living lab, the development of a large-scale panel of citizens is an intensive, but necessary action. This community forms a large-scale co-creation and test environment of individuals willing to contribute to the development of new concepts, services, or products. A user panel fulfills two core functions: Firstly, the panel is needed as a recruitment (data)base for the various experiments/research projects that will run within the living lab (as well as facilitating scalability). The panel must be well profiled and easily accessible, so it can be quickly activated.  Secondly, this test panel aims to act as a benchmark for the living lab. It is the breeding ground from which specific needs and requirements, but also certain trends, can be identified bottom-up. This information can serve as a basis for defining new projects. In this presentation, we will highlight:  What the requirements are for a representative reference group to run projects How different profiles and organisations can be approached and attracted The importance of network building How a panel database can be built and managed Which techniques can be used to profile panel members How to keep panel members interested and motivated to contribute to projects on a regular basis Key findings: LiCalab has over 10 years of experience in working with citizens in innovation projects. It takes time to build a test panel and it will always remain a work in progress. The main learnings from this journey are that you need to be a trusted partner for both citizens and intermediaries as well as care organisations. An ethical approach, committed and inclusive communication, and an attractive story are key. Conclusions: Citizens are motivated partners in designing future-proof and inclusive healthcare. A well profiled database and a close one-on-one connection with members is an intensive but rewarding approach for all parties that want to build new solutions together with end users. Implications: Local authorities, care organisations and companies increasingly acknowledge the importance of citizen involvement to design better solutions corresponding to the needs of end users.