Transient CDK4/6 inhibition protects hematopoietic stem cells from chemotherapy-induced exhaustion

Conventional cytotoxic chemotherapy is highly effective in certain cancers, but causes dose-limiting damage to normal proliferating cells, especially hematopoietic stem and progenitor cells (HSPCs). Serial exposure to cytotoxics causes a long-term hematopoietic compromise (‘exhaustion’), which limits the use of chemotherapy and success of cancer therapy. Here, we show that the co-administration of G1T28 (trilaciclib), a small-molecule inhibitor of cyclin-dependent kinases 4 and 6 (CDK4/6), contemporaneously with cytotoxic chemotherapy protects murine hematopoietic stem cells (HSCs) from chemotherapy-induced exhaustion in a serial 5-fluorouracil (5FU) treatment model. Consistent with a cell intrinsic effect, we show directly preserved HSC function resulting in a more rapid recovery of peripheral blood counts, enhanced serial transplantation capacity and reduced myeloid skewing. When administered to healthy human volunteers, G1T28 demonstrated excellent in vivo pharmacology and transiently inhibited bone marrow (BM) HSPC proliferation. These findings suggest that the combination of CDK4/6 inhibitors (CDK4/6i) with cytotoxic chemotherapy should provide a means to attenuate therapy-induced BM exhaustion in patients with cancer

A phase 1/2 trial of HQK-1001, an oral fetal globin inducer, in sickle cell disease

Therapeutics which reduce the pathology in sickle cell syndromes are needed, particularly non-cytotoxic therapeutics. Fetal hemoglobin (HbF, α2γ2) is established as a major regulator of disease severity; increased HbF levels correlate with milder clinical courses and improved survival. Accordingly, sodium dimethylbutyrate (HQK-1001), an orally-bioavailable, promoter-targeted fetal globin gene-inducing agent, was evaluated in a randomized, blinded, dose-ranging Phase I/II trial in 24 adult patients with HbSS or S/β thalassemia, to determine safety and tolerability of three escalating dose levels. The study therapeutic was administered once daily for two 6-week cycles, with a 2-week interim dose holiday. Twenty-one patients completed the study. Five patients received study drug at 10 or 20 mg/kg doses, seven patients received study drug at 30 mg/kg/dose, and 4 patients received placebo. HQK-1001 was well-tolerated with no unexpected drug-related adverse events; a dose-limiting toxicity was not identified. Plasma drug levels were sustained above targeted levels for 24 hours. Increases in HbF above baseline were observed particularly with 30 mg/kg/day doses; in five of seven treated patients, a mean absolute increase in HbF of 0.2 g/dl and a mean increase in total hemoglobin (Hgb) of 0.83 g/dl above baseline were observed, whereas no increases occurred in placebo-treated controls. These findings of favorable PK profiles, tolerability, early rises in HbF and total Hgb indicate that trials of longer duration appear warranted to more definitively evaluate the therapeutic potential of HQK-1001 in sickle cell disease

Costing Out Nursing Service : A Review of the Literature

A review of literature examined the state of the art of costing out nursing service. The purpose pf this review was to determine the current status of knowledge relating to this function. Examination of various methodologies revealed systems ranging from the logical and simplified methods of assessing costs to complex billing systems requiring mammoth amounts of bookwork. Nurse administrators are becoming cognizant of the complexity of factors involved in determining the price of health care as related to the cost of nursing. Recommendations for future studies in this area were made based on the need for a uniform and valid pricing methodology

Presence of sulphur bacteria and a quality of groundwater in water intake Osowa

Microorganisms that live in groundwater should be considered not only from the sanitary-hygienic point of view but also in terms of adverse changes in groundwater chemistry in the aquifer layer and its negative influence on the installed devices. For these reasons, it is important to correct approach to the problem of bacterial contamination of groundwater. The paper presents selected results of physicochemical and bacteriological parameters of raw water and treated water (after building a water treatment plant). The aim of the study is evaluatoin of groundwater quality on water intake Osowa taking into account the presence of sulfur bacteria, as well as to determine the causes of the appearance of hydrogen sulfide smell in these waters

A Bibliography for Selected Pharmacokinetic Topics

A bibliography for selected topics in pharmacokinetics has been assembled in order to aid in rapidly gathering original scientific papers which illustrate fundamental pharmacokinetic principles important to pharmacists, pharmacy students, pharmacy residents, pharmaceutical science graduate students, and several other health professionals. Portions of this bibliography have comprised part of the syllabus for basic and clinical pharmacokinetics graduate-level courses and for independent study projects. </jats:p