Guideline for the diagnosis and management of myelofibrosis

The guideline group regarding the diagnosis and management of myelofibrosis was selected to be representative of UK-based medical experts, together with a contribution from a single expert from the USA. MEDLINE and EMBASE were searched systematically for publications in English from 1966 until August 2011 using a variety of key words. The writing group produced the draft guideline, which was subsequently revised by consensus of the members of the General Haematology and Haemato-oncology Task Forces of the British Committee for Standards in Haematology (BCSH). The guideline was then reviewed by a sounding board of UK haematologists, the BCSH and the British Society for Haematology Committee and comments incorporated where appropriate. The criteria used to state levels and grades of evidence are as outlined in the Procedure for Guidelines commissioned by the BCSH; the 'GRADE' system was used to score strength and quality of evidence. The objective of this guideline is to provide healthcare professionals with clear guidance on the investigation and management of primary myelofibrosis, as well as post-polycythaemic myelofibrosis (post-PV MF) and post-thrombocythemic myelofibrosis (post-ET MF) in both adult and paediatric patients.

A randomised, phase II trial of the DNA-hypomethylating agent 5-aza-2'-deoxycytidine (decitabine) in combination with carboplatin vs carboplatin alone in patients with recurrent, partially platinum-sensitive ovarian cancer.

Background: Our previous laboratory and clinical data suggested that one mechanism underlying the development of platinum resistance in ovarian cancer is the acquisition of DNA methylation. We therefore tested the hypothesis that the DNA hypomethylating agent 5-aza-2'-deoxycytodine (decitabine) can reverse resistance to carboplatin in women with relapsed ovarian cancer.

Methods: Patients progressing 6-12 months after previous platinum therapy were randomised to decitabine on day 1 and carboplatin (AUC 6) on day 8, every 28 days or carboplatin alone. The primary objective was response rate in patients with methylated hMLH1 tumour DNA in plasma.

Results: After a pre-defined interim analysis, the study closed due to lack of efficacy and poor treatment deliverability in 15 patients treated with the combination. Responses by GCIG criteria were 9 out of 14 vs 3 out of 15 and by RECIST were 6 out of 13 vs 1 out of 12 for carboplatin and carboplatin/decitabine, respectively. Grade 3/4 neutropenia was more common with the combination (60% vs 15.4%) as was G2/3 carboplatin hypersensitivity (47% vs 21%).

Conclusions: With this schedule, the addition of decitabine appears to reduce rather than increase the efficacy of carboplatin in partially platinum-sensitive ovarian cancer and is difficult to deliver. Patient-selection strategies, different schedules and other demethylating agents should be considered in future combination studies.

An Association of Cancer Physicians' strategy for improving services and outcomes for cancer patients

The Association of Cancer Physicians in the United Kingdom has developed a strategy to improve outcomes for cancer patients and identified the goals and commitments of the Association and its members.

Mes livres, mes dessins, mes autographes [catalogue, par Arthur Meyer]

[Collection Meyer (Arthur)]

Second Welland Canal - Book 1, Survey Map 12 - St. Catharines and Lock 4

Survey map of the Second Welland Canal created by the Welland Canal Company showing the Town of St. Catharines. Identified structures associated with the Canal include Lock 4, Hydraulic Race, floating tow path, and the Canal waterway itself. The surveyors' measurements and notes can be seen in red and black ink and pencil. Local area landmarks are also identified and include streets and roads (ex. Geneva Street, St. Paul Street, Queenston Street, Niagara Street and Mill Street), C. Phelp's Grist Mill and Store House, Stinson's Distillery, and several unnamed bridges. Properties and property owners of note are: Concession 6 Lot 16, J. R. Benson, Calvin Phelps, J. Hudson, David Gray, A. Roberts, Mrs. McDonell, J. S. McDonell, T. B. Wragg, J. Donaldson, W. Barr Jr., C. L. Hall, G. Ward, Ridout Bros and Co., and the St. Catharines Grass Co.

Chemical behaviour of the Wheal Jane bioremediation system

The effectiveness of remediation of the highly acidic and transition metal polluted mine water discharge from the Wheal Jane Mine by the Wheal Jane Passive Treatment Plant is described. The success of the remediation required that all the system components work as predicted. The study shows considerable success in the removal of key toxic metals and clearly demonstrates the potential for natural attenuation of acid mine drainage, particularly iron oxidation, by microbial populations. The Wheal Jane Passive Treatment Plant provides the only experimental facility of its kind. (C) 2004 Elsevier B.V. All rights reserved.