Carboxy Methyl Lysine [KLH]

Objective: Unusual clinical course Background: Chronic myeloid leukemia (CML) is usually a tri-phasic myeloproliferative neoplasm, characterized by the presence of the BCR-ABL1 fusion gene, derived from a balanced translocation, t(9;22)(q34;q11). BCR-ABL tyrosine kinase inhibitors (TKI) are used to treat patients with CML. The addition of pegylated interferon-alpha 2b to imatinib or dasatinib results in promising deep molecular responses. Because imatinib shows poor penetration into the central nervous system (CNS), the CNS may become a sanctuary site in patients on prolonged imatinib therapy for CML. It is extremely rare for the blast phase in patients with chronic phase CML to affect the CNS without concomitant bone marrow involvement. Case Report: This report describes a 57-year-old woman who was diagnosed with accelerated phase (AP) CML and failed high dose imatinib therapy. Despite achieving an excellent molecular response to dasatinib in 6 months, she developed recurrent isolated CNS blast crisis. Survival was prolonged after treatment with intrathecal chemotherapy and whole-brain radiation therapy combined with dasatinib. After achieving long and deep molecular remission with dasatinib and a few months of pegylated interferon-alpha 2a, she lived for 18 months in treatment-free-remission (TFR). At age 65 years, she died of progressive rectal carcinoma with septic shock, cancer-related venous thromboembolism, and a possible autoimmune disorder. Conclusions: This patient with accelerated phase CML and 2 isolated CNS blast crises died in TFR 8.5 years after her initial diagnosis and 7.5 years after her first isolated CNS blast crisis. Survival resulted from tailoring of therapies around her comorbidities.

With the rapid development of plastic runways in China, incidents of toxic runways that are detrimental to human health frequently occurred. This phenomenon has resulted in public concern on the safety and cleanliness of plastic runways. To improve the sustainability of these runways, the environmental performance of the produced plastic runways should be evaluated. The critical hotspots for plastic runway studies should be determined, and a cleaner optimization path of critical materials should be explored. In this study, a cradle-to-gate life cycle assessment (LCA) on the air-permeable plastic runway was conducted. The green factory formula was identified, and the environmental impacts of the production process were quantitatively analyzed. Detailed life cycle inventory data were obtained from the on-site survey of typical plastic runway manufacturer enterprises in China. Environmental impacts were calculated using the CML 2001 method built into the GaBi 8.0 software. Results indicated that the 1: 7 ratio of polyurethane adhesive to ethylene-propylene-diene monomer rubber particles was the greenest formula with the least environmental impact. The environmental hotspots were from the front-end of raw material production during the mixing phase and the biomass steam input during the curing phase. The characteristic pollutants generated from mixing phase were CO2, methane, NOx, and VOCs, whereas those from the curing phase were CO2, NOx, SO2, freon, HCl, and NH3. Moreover, methylene diisocyanate (MDI) was the cleaner raw material for air-permeable plastic runway production, because the environmental impact of producing an equal mass of MDI was 39%-89% of that by toluene diisocyanate. Thus, this LCA study presents a strategy for the sustainable improvement of air-permeable plastic runway production and also proposes policy recommendations for decision makers. (C) 2020 Elsevier B.V. All rights reserved.