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2022 ◽  
Vol 45 (2) ◽  
pp. 41-45
Author(s):  
Abdul-Rahman Zaher ◽  
Falah M AL-Rekabi ◽  
Saad Akram Hatif

The aim of present study was to evaluate the possibility of teratogenicity in rats when exposed to zinc chloride (ZnCl2) pre and post pregnancy. To achieve this goal, a total of 40 mature Albino Wistar female rats were divided equally into four groups as follows: T1, dosed 0.7 mg/day ZnCl2 for two months before mating and till to the day 5th of pregnancy, the females of this group were mated with males dosed 0.7 mg/day ZnCl2 for two weeks before mating; T2, dosed 0.7 mg/day ZnCl2 for two months before mating and till to the day 16th of pregnancy and then were mated with control males (not exposed to any level of ZnCl2); T3, dosed 0.7mg/day ZnCl2 for two months before mating and till the end of pregnancy and were mated with control males; Control, dosed with water free from ZnCl2 along the period of experiment and were mated with control males. At the end of each pregnancy phase, results revealed that alpha fetoprotein serum levels were significantly (P<0.05) higher in all treatment groups compared to the control group, and the most prominent increase was observed in the T3 group. All treatment groups showed a significant (P<0.05) decrease in gestation, viability, and lactation indices when compared to the control group, with the T3 group showing the most significant decrease. Additionally, on days 1, 4, 7, 14, and 21 of lactation period, there was a significant (P<0.05) decrease in mean pup body weights in treated groups compared to the control group, with T3 group having the most prominent body weight decrease. The findings of this study revealed that ZnCl2 at a daily dose of 0.7 mg may cause teratogenic defects in rats at various stages of pregnancy, particularly at the third stage. As high-risk groups, pregnant women and children should use Zn supplementation carefully, whether as a food additive or for self-medication. Simultaneously, evaluating effect of low-dose Zn supplementation over a longer duration is required.


Author(s):  
Mohsen Sheykhhasan ◽  
Hamed Manoochehri ◽  
Paola Dama

AbstractAcute lymphoblastic leukemia (ALL) is a cancer-specific lymphoid cell. Induction and consolidation chemotherapy alone or in combination with different therapeutic approaches remain the main treatment. Although complete or partial remission of the disease can be achieved, the risk of relapse or refractory leukemia is still high. More effective and safe therapy options are yet unmet needs. In recent years’ new therapeutic approaches have been widely used. Hematopoietic Stem Cell Transplantation (HSCT) presents significant limitations and the outcome of the consolidation treatment is patient dependent. Side effects such as Graft versus Host Disease (GvHD) in allogeneic hematopoietic stem cell transplantation are extremely common, therefore, using alternative methods to address these challenges for treatment seems crucial. In the last decade, T cells genetically engineered with Chimeric Antigen Receptor (CAR) treatment for the ALL are largely studied and represent the new era of strategy. According to the Phase I/II clinical trials, this technology results seem very promising and can be used in the next future as an effective and safe treatment for ALL treatment. In this review different generations, challenges, and clinical studies related to chimeric antigen receptor (CAR) T-cells for ALL treatment are discussed.


Author(s):  
A. O. Olayanju ◽  
N. I. Kyesmen ◽  
R. B. Jacob ◽  
T. D. Adeniyi ◽  
S. S. Enitan ◽  
...  

Some plants used in the management of sickle cell disease (SCD) have been shown to increase gelling time of sickle cell blood and inhibits sickling in vitro, reversal of sickling, inhibiting osmotically induced haemolysis of erythrocytes, membrane stabilization. Plants such as Sorghum bicolar, Phyllanthus amarus, U. afzelii, Securidaca longipedunculata, Momordica charantia, Dalium guineense have been found to exhibit anti-sickling properties. The polyherbal combination of these drugs was used in this study for the investigation of the effects of anti-sickling polyherbal mixture on haematological indices in rabbits. Sixty (60) New Zealand rabbits weighing 1200g ±200g, conducted in duplicate and designated experiment X (normal rabbits) and Y (anaemia induced using Cadmium 2mg/kg +10 mg/Kg body weight phenylhydrazine for 15 days). Both groups were further subdivided into four groups (A-D) with 5 animals each, administered saline substitute, different grades of polyherbal mixtures for 8 weeks. Blood sample (2mls) was collected into Ethylene Diamine Tetra Acetic Acid (EDTA) bottles for full blood count. The results in the experiment (X) showed significant increase in WBC (103/μl) count across the groups (B=8.15±0.33; C=9.3±0.74; D=9.8±0.59) compared to the control group (A=7.25±0.44) (p<0.05). RBC (106/μl) count showed insignificant increase in group B (5.1±0.20) and C (5.6±0.450), decrease level in D (4.4±0.26) compared to control A (4.8±0.29) (p<0.05). Hb(g/dl) and HCT (%) showed similar pattern with insignificant increased levels across all treatment groups (B=14.8±0.59, 43.4±1.74; C=15.5±0.78, 45.8±3.; D=14.2±0.85, 43.7±2.62) compared to control A (13.6±0.68; 41.5±2.49) respectively. Platelets showed significant increase in group B and C (286±17.16 and 286±17.16) compared to control A (244±9.76) with significant decrease in group D (226±18.08) (p<0.05). In experiment (Y), WBC count showed significant increase across all treatment groups (B= 6.4±0.26 C= 6.8±0.54 D =10.6±0.64) compared to control (A= 4±0.24) (p<0.05). RBC (106/μl) count in control A gave (2.5±0.15), insignificant increase in B (3.1±0.12) with significant increase in group C (3.5±0.28) and insignificant decrease in D (2.2±0.13) (p<0.05). Higher level of Hb (g/dL) was seen in group B and C (B= 8.4±0.34; C= 9.1±0.46), while D (7.7±0.46) had a slightly elevated value compared to the control A (7.1±0.36) (p<0.05). HCT (%) showed significant increase across the groups (B=26±1.04; C=28±2.24; D=24±1.44) (p<0.05) compared to control A (18±1.08). Red cell indices showed some degree of derangement across the study groups. Findings in this study suggest that polyherbal mixture have a positive effect on the haemoglobin, red blood cells, packed cell volume and white blood cell count of the rabbits in a dose dependent manner.


2021 ◽  
Vol 11 (12) ◽  
pp. 48-52
Author(s):  
Sayyed Adnan Mohammad ◽  
Mujassam M

Osteoarthritis is the commonest of all joint diseases. It results due to breakdown and destruction of joint tissues. The clinical picture of osteoarthritis strongly resembles with Waja-ul-Mafasil which has been elaborated in detail by Unani physicians. Considering the high prevalence, side effects of modern pharmacological treatment and high cost of surgical interventions with equivocal effectiveness of all treatment modalities, there is need for safe, economic and effective treatment in Unani Medicine for osteoarthritis. Unani System of Medicine has Ilaj Bit Tadbeer (Regimenal Therapy) as one of the modes of treatment. The Regimenal Therapy works on the principle of modifying or modulating the six essential factors (Asbaab-e-sittah zarooriya) for maintenance of health and prevention from diseases. Nowadays Regimenal Therapy holds an important place in Unani Medicine particularly for musculoskeletal and nervous disorders. The focus of this paper is to discuss and summarize the role of Ilaj bit Tadbeer in the management of Waja-ul-Mafasil. Key words: Osteoarthritis, Waja-ul-Mafasil, Unani System of Medicine, Ilaj Bit Tadbeer, Regimenal Therapy.


Plants ◽  
2021 ◽  
Vol 10 (12) ◽  
pp. 2584
Author(s):  
Laura Gaile ◽  
Una Andersone-Ozola ◽  
Ineta Samsone ◽  
Didzis Elferts ◽  
Gederts Ievinsh

The aim of the present study was to establish an experimental system in controlled conditions to study the physiological effect of abiotic/biotic interaction using a rare wild leguminous plant species from coastal sand dunes, Anthyllis maritima. The particular hypothesis tested was that there is an interaction between sand burial, rhizobial symbiosis and salt treatment at the level of physiological responses. Experiment in controlled conditions included 18 treatment combinations of experimental factors, with two intensities of sand burial, rhizobial inoculation and two types of NaCl treatment (soil irrigation and foliar spray). Shoot biomass was significantly affected both by burial and by inoculation, and by interaction between burial and NaCl in the case of shoot dry mass. For plants sprayed with NaCl, burial had a strong significant positive effect on shoot growth irrespective of inoculation. General effect of inoculation with rhizobia on shoot growth of plants without NaCl treatment was negative except for the plants buried 2 cm with sand, where significant stimulation of shoot dry mass by inoculant was found. The positive effect of burial on shoot growth was mainly associated with an increase in leaf petiole height and number of leaves. Performance index significantly increased in buried plants in all treatment combinations, and leaf chlorophyll concentration increased in buried plants independently on burial depth, and only in plants not treated with NaCl. Inoculation led to significant increase of leaf peroxidase activity in all treatment combinations except NaCl-irrigated plants buried for 2 cm by sand. Sand burial stimulated peroxidase activity, mostly in non-inoculated plants, as inoculation itself led to increased enzyme activity. In conclusion, strong interaction between sand burial and NaCl treatment was evident, as the latter significantly affected the effect of burial on growth and physiological indices. Moreover, rhizobial symbiosis had a significant effect on physiological processes through interaction with both sand burial and NaCl treatment, but the effect was rather controversial; it was positive for photosynthesis-related parameters but negative for growth and tissue integrity indices.


2021 ◽  
Vol 25 (7) ◽  
pp. 1305-1309
Author(s):  
O.A. Iroko ◽  
I.L. Sowunmi ◽  
J.M. Ajekiigbe ◽  
S.O. Rufiai ◽  
W.T. Wahab

Faidherbia albida is an agroforesrty tree that has the potential of promoting agroforestry establishment in Nigeria. The seeds are glossy due to the presence of wax in the seed coat which prevents easy penetration of water. Thus, this study assessed the effect of different pretreatments (biological, mechanical and chemical) on the germination of F. albida seeds. The treatments include; seeds scarified at the helium, soaked in cold water for 24 hours, soaked in hot water for 3 minutes, 5 minutes, 10 minutes, & 15 minutes and soaked in Conc. H2SO4 for 3 minutes, 5 minutes, 10 minutes, and 15 minutes. The result showed that all treatment had uniform germination percentage of 100% but seeds soaked in H2SO4 for 15 min and 10 min had the highest germination value of (65.25) and (65.00) respectively, followed by 15mins soaking in hot water (47.14) while the least germination value was recorded in seeds scarified mechanically (33.31). Analysis of variance revealed that there was no significant difference in the treatments. However, seeds treated with H2SO4 at 15 mins and 10 mins had the best performance in terms of germination value compared with other treatments. Therefore, for optimum and uniform germination, the seed of F. albida seeds should be soak in concentrated H2SO4 for 15 min.


Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 1211-1211
Author(s):  
Elizabeth Yang ◽  
Svetlana Rassulova ◽  
Dhwani Sahjwani ◽  
An Harmanli ◽  
Ryan Fassnacht ◽  
...  

Abstract Background Clostridioides difficile infection (CDI) is frequent in pediatric patients with acute lymphoblastic leukemia (ALL). Studies have shown upwards of 20% positivity rate in CDI testing among pediatric oncology patients, and up to several percent in pediatric ALL patients in the first 180 days of diagnosis. Antibiotic usage has been variably linked to CDI positivity in these populations. As CDI testing is usually done in symptomatic patients, the question of C. difficile carriage versus CDI has not been addressed. We and others have shown that microbiome is altered in pediatric ALL patients and survivors. We conducted a longitudinal stool microbiome study in pediatric ALL patients and tested the hypothesis that alteration of the microbiome during ALL treatment promotes C. difficile carriage. Methods Children with ALL were prospectively recruited on a rolling basis and stool samples were collected at diagnosis (Dx) and at the end of induction (EOI), consolidation (EOC), interim maintenance I (IMI), delayed intensification (DI), interim maintenance II (IMII), as well as approximately 3 months and 6 months into maintenance (M3, M6). Stool samples from healthy siblings were used as controls. TaqMan-based quantitative-PCR (qPCR) was performed on DNA extracted from stool samples to detect C. diff 16S rRNA, tcdA, (Toxin A) and tcdB (Toxin B) genes . Samples positive or either tcdA or tcdB, or both, were designated positive for toxigenic C. difficile. 16S rRNA hypervariable region V4 was sequenced and analyzed for microbiome diversity and relative abundance of microbiota. Results 32 ALL patients age 3 months-19 years were included. The diagnoses were 12 standard risk and 14 high risk pre-B ALL, 5 T-ALL, and 1 relapsed pre-B ALL. Stool samples were collected from 18 healthy siblings. The numbers of samples tested at each treatment phase were: 29 Dx, 24 EOI, 23 EOC, 25 IMI, 21 DI, 6 IMII, 14 M3, 7 M6. No patient had symptoms suggestive of CDI, and no patient was clinically tested or treated for CDI. Total number of stool samples tested was 149, of which 43 (29%) were positive for toxigenic C. difficile (Figure 1). At diagnosis, 2/29 (7%) patients were positive, compared to 2/18 (11%) in healthy siblings. At EOI, positivity rate increased to 17%, then up to 40% - 52% at EOC, IMI, and DI. C. difficile positivity were lower around 30% at M3 and M6, although few patients reached maintenance to contribute samples for analysis. Twenty-five patients (78%) were positive at some phase. Longitudinal analysis of individual patients showed that C. difficile positivity was intermittent through treatment phases; only 3 patients remained persistently positive. Seven patients (22%) were never positive. Multivariate analysis showed that EOC, IMI, and DI treatment phases were significant risk factors for C. difficile carriage. Neither the number of antibiotics nor the number of antibiotic courses administered was significant. Leukemia risk stratification (high risk versus standard risk) also did not correlate with C. difficile positivity. Microbiome analysis showed statistically significant differences in relative abundance of certain taxa between C. diff positive and negative samples at the class, order, and family levels (Figure 2). Examples include depletion of the class Verrucomicrobiae, which contains protective Akkermansia, and depletion of the common taxa Bifidobacteriaceae and Ruminococcaceae. Conclusion Longitudinal PCR testing of toxigenic C. difficile in pediatric ALL patients demonstrated increased C. difficile prevalence further into treatment phases. C. difficile carriage correlated significantly with depletion of several bacterial taxa, as microbiome diversity decreased overall with successive treatment phases. Our data lend support to the hypothesis that altered microbiome in ALL treatment allows permissibility for C. difficile carriage. In addition, no C. difficile positive patient had symptoms of CDI, therefore, caution must be taken in clinical testing, as there is a high asymptomatic carriage rate. Further longitudinal testing during maintenance and off-therapy is needed to see if C. difficile carriage rate returns to baseline and correlates with recovery of gut microbiome. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.


Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 4365-4365
Author(s):  
Shringi Sharma ◽  
Xavier Pepin ◽  
Harini Burri ◽  
Lianqing Zheng ◽  
Nataliya Kuptsova-Clarkson ◽  
...  

Abstract Introduction: Acalabrutinib (Calquence ®), a selective Bruton tyrosine kinase (BTK) inhibitor, is approved for the treatment of mantle cell lymphoma (relapsed/refractory) and chronic lymphocytic leukemia. Patients with hematologic malignancies may require acid-reducing agents (including proton pump inhibitors [PPIs]) for the treatment of gastroesophageal reflux or peptic ulcer disease. The solubility of acalabrutinib is reduced with increasing pH; concomitant administration of acalabrutinib capsules with PPIs reduces acalabrutinib exposure and is currently not recommended. Additionally, many cancer patients are unable to swallow capsules and require alternative methods to deliver acalabrutinib, such as a suspension administered orally or via a nasogastric (NG) tube. To enable the use of acalabrutinib in patients who require co-treatment with PPIs and/or are unable to swallow capsules, a new maleate salt of acalabrutinib, formulated as an immediate-release film-coated tablet (acalabrutinib maleate tablet [AMT]), has been developed which shows fast and complete in vitro release at all physiologic pH. We evaluated the pharmacokinetics (PK), pharmacodynamics (PD), safety, and tolerability of AMT administered orally or via NG tube in the presence or absence of a PPI. In addition, the effect of food on AMT was evaluated to confirm the absence of a clinically relevant impact, consistent with acalabrutinib capsules. Methods: Three Phase 1, open-label, single-dose, cross-over studies were conducted in healthy subjects to establish PK similarity (bioequivalence) between 100-mg AMT and 100-mg acalabrutinib capsules (N=66); evaluate PPI effect by comparing PK of 100-mg AMT administered in the presence vs absence of rabeprazole (PPI; N=14); evaluate food effect by comparing PK of 100-mg AMT administered with a high-fat diet vs fasted (N=16); and assess PK following administration of 100-mg acalabrutinib maleate suspension (in 15 mL water) delivered via NG tube, in the presence vs absence of rabeprazole (N=20). PD was assessed by measuring BTK target occupancy (BTK-TO) in peripheral blood mononuclear cells across all treatment arms and studies. Results: Exposure geometric mean ratios and 90% confidence intervals (CIs) are shown in Table 1 with the PK profiles shown in Figure 1. Systemic exposures (C max and AUC) of acalabrutinib and its major pharmacologically active metabolite, ACP-5862, between AMT and acalabrutinib capsules were bioequivalent (&lt;5% difference in geometric mean exposures, with the 90% CI contained entirely within the pre-defined range of 80.00% and 125.00%). No clinically relevant difference in acalabrutinib/ACP-5862 exposures was observed following administration of AMT with and without PPI; C max was lower (≤~30% difference) and AUC higher (≤~16% difference) with similar BTK-TO (≥95%) across treatment arms. Additionally, no clinically relevant impact of food on acalabrutinib/ACP-5862 exposures was observed; C max was lower (≤~54% difference), with no impact on AUC (≤~3% difference) or BTK-TO (≥95% across treatment arms). Acalabrutinib/ACP-5862 exposures were comparable (≤10% difference) between 100-mg acalabrutinib maleate NG suspension and 100-mg acalabrutinib capsules. In addition, exposures were comparable (≤16% difference) following co-administration of acalabrutinib maleate NG suspension with and without PPI. Overall, the BTK-TO was comparable (≥95%) across all treatment arms. The new AMT formulation showed a well-tolerated safety profile with the majority of observed adverse events (AEs) mild in intensity and no serious AEs reported. No new safety concerns were observed for the AMT. Conclusions: Acalabrutinib maleate, administered as a tablet or suspension, is safe and well tolerated. Based on the PK (and associated variability), BTK-TO, and established exposure-efficacy/safety relationship, AMT clinical effect is expected to be comparable to acalabrutinib capsules at the approved 100-mg BID dosing, regardless of use of PPIs and ingestion of food. Additionally, AMT improves swallowing ability given the film coating and a 50% reduced volume compared with the capsule, and can be easily suspended in a small amount of water to allow dosing in patients unable to swallow tablets. Figure 1 Figure 1. Disclosures Sharma: AstraZeneca: Current Employment, Current equity holder in publicly-traded company, Divested equity in a private or publicly-traded company in the past 24 months. Pepin: AstraZeneca: Current Employment. Burri: AstraZeneca: Current Employment, Divested equity in a private or publicly-traded company in the past 24 months. Zheng: AstraZeneca: Current Employment; Kite Pharma, a Group of Gilead: Ended employment in the past 24 months; Gilead Science Inc., AstraZeneca: Current equity holder in publicly-traded company; Gilead Science Inc.: Divested equity in a private or publicly-traded company in the past 24 months. Kuptsova-Clarkson: AstraZeneca: Current Employment, Current equity holder in publicly-traded company; AbbVie: Current holder of individual stocks in a privately-held company. de Jong: Acerta Pharma B.V. (A Member of the AstraZeneca Group): Current Employment. Yu: AstraZeneca: Current Employment; EMD Serono Research Institute: Ended employment in the past 24 months; AstraZeneca, Johnson and Johnson, AbbVie, Abbott: Current equity holder in publicly-traded company; Merck KGaA: Divested equity in a private or publicly-traded company in the past 24 months. MacArthur: AstraZeneca: Current Employment, Current holder of individual stocks in a privately-held company, Current holder of stock options in a privately-held company. Majewski: AstraZeneca: Current Employment, Current equity holder in publicly-traded company. Ware: AstraZeneca: Current equity holder in publicly-traded company; Denali (DNLI) Therapeutics: Current equity holder in publicly-traded company. Mann: AstraZeneca: Current Employment, Current equity holder in publicly-traded company. Ramies: AstraZeneca: Consultancy. Munugalavadla: AstraZeneca: Current Employment, Current equity holder in publicly-traded company. Sheridan: AstraZeneca: Current Employment, Current equity holder in publicly-traded company. Tomkinson: AstraZeneca: Current Employment, Current equity holder in publicly-traded company. OffLabel Disclosure: New Formulation


Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 4355-4355
Author(s):  
Demi T.C. de Winter ◽  
Jenneke E. van Atteveld ◽  
Jessica G.C.A.M. Buijs-Gladdines ◽  
Rob Pieters ◽  
Sebastian J.C.M.M. Neggers ◽  
...  

Abstract BACKGROUND Osteonecrosis and low bone mineral density (BMD) are serious osteogenic side effects of acute lymphoblastic leukemia (ALL) treatment. Bisphosphonates and recombinant human parathyroid hormone (rPTH) tend to be used to ameliorate osteonecrosis-related symptoms as well as to enhance bone mineral density in children with ALL and severe bone fragility. Only one preclinical study on the safety of bisphosphonates during ALL treatment is available, which raises concerns about their impact on leukemic drug sensitivity. Here, we assessed the influence of various bone-modifying agents (zoledronate, pamidronate and rPTH) on in vitro cytotoxicity of chemotherapeutic agents (vincristine (VCR), daunorubicin (DNR), dexamethasone (DEXA), 6-mercaptopurine (6-MP), PEG-asparaginase (PEG-ASP)) and prednisone (PRED) that are commonly used in ALL treatment. METHODS Potential cytotoxic effects of the bone-modifying agents on leukemia cell viability and on in vitro cytotoxic responses of chemotherapeutic agents were tested in various T-cell and B-cell leukemia cell lines using methyl-thiazol-tetrazolium (MTT) assays. Bone-modifying agents were added at concentrations up to a five-fold of their physiological peak plasma concentration. For each assay, 50th percentile of maximal inhibitory concentration was determined. To quantify the combined effects of the bone-modifying agents on chemotherapeutic agent-induced cytotoxicity, median (interquartile range) combination indexes (CI) were calculated. We considered a median CI of &lt; 0.8 as synergism and &gt; 1.2 as antagonism (based on the method of Chou). RESULTS Zoledronate, pamidronate or rPTH in combination with DNR, 6-MP and PEG-ASP showed median CI values between 0.8 and 1.2. Variable inconclusive results were obtained in combination with VCR. Only the combination of a five-fold peak plasma concentration of zoledronate or pamidronate with DEXA resulted in median CI values of 1.15 (range, 1.08-1.48), and 1.34 (range, 1.07-1.62), respectively. Additional experiments using DEXA as well as PRED in combination with one-, three- or five-fold physiological peak plasma concentrations of zoledronate or pamidronate revealed that median CI values stay within 0.8 and 1.2, except for DEXA exposed leukemia cells in combination with a five-fold physiological peak plasma concentration of pamidronate which repeatedly showed a median CI value above 1.2 (1.34, range 1.04-1.86). CONCLUSIONS Zoledronate, pamidronate or rPTH do not seem to influence drug sensitivity of DNR, 6-MP or PEG-ASP, even at a five-fold physiological peak plasma concentration. Nevertheless, our findings suggest a minimal effect of pamidronate on DEXA-induced leukemia cell death. This suggests that even though zoledronate or pamidronate do not seem to negatively influence DEXA- or PRED- induced toxicity in expected physiological concentrations (one- to three-fold physiological peak plasma concentrations), these bone-modifying agents may only be considered with caution in individual cases, and preferably in clinical trial settings before being applied on a large scale in children with ALL. Disclosures No relevant conflicts of interest to declare.


Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 3012-3012
Author(s):  
Rebecca Crawford ◽  
Verna L Welch ◽  
Richa Shah ◽  
Lynda Doward ◽  
Cheryl Truchan

Abstract Social media (SM) data is emerging as an important source of information on patient disease and treatment experiences. SM data provide researchers access to unsolicited information shared by patients/caregivers (CGs)/healthcare providers (HCPs), without burdens associated with traditional research methods or influence of interviewer bias. SM facilitates open communication on serious illness in an unstructured forum; offering snap shots of information that highlight important issues prioritized by patients/CGs/HCPs. SM data is growing exponentially, manual review of this noisy "Big Data" is time consuming and impractical. Natural language understanding (NLU) provides an optimal approach to extracting structured data elements from unstructured text. This pilot study aimed to use NLU to aggregate, analyze, and better understand various aspects of patients/CGs/HCPs experiences of Acute lymphocytic leukemia (ALL). ALL is a blood and bone marrow cancer with a significant patient symptom burden and detrimental impact on patient/CG health-related quality of life (HRQOL). Publicly available, English-language SM data were indexed from a 25-month period (Jul.2018-Aug.2020). Data were extracted using Sprinklr (Twitter), and Board Reader (boards/blogs/forums/reviews). NLU was applied to capture insights (e.g., emerging patterns/trends/relationships). Advanced analytics identified and analyzed relevant insights, and advanced logic determined user type and post contributor (e.g., patient/CGs/HCP). Posts underwent further manual evaluation using thematic content analysis to explore the experience of ALL shared by users and to support NLU-identified insights. 6,365 ALL-related posts were identified; 289 (4.5%) were contributed by patients, 657 (10.3%) by CGs, 1224 (19.2%) by HCPS and 4,195 (65.9%) by organizations. Topics included expressions of positive support/encouragement for patients/monetary donation requests/treatment type/impact of side effects. NLU identified notable discussion areas: patient/CG commentaries on treatment experiences, decisions, side effects and outcomes, and patient knowledge regarding ALL treatments. 189 patient/CG posts discussed ALL treatments in general, including in-hospital time: missing life events due to intensive treatment regimens and extended hospital stays. 195 patient/CG posts discussed specific ALL treatment experiences: chemotherapy, n=120; bone marrow transplant, n=22; stem cell transplant, n=16; immunotherapy, n=14; Kymriah, n=11; CAR-T, n=8; radiation, n=4. Chemotherapy was mentioned in relation to daily and/or durable short-and long-term effects (e.g., sickness, pain) which had major impacts for patients' and their family's HRQOL. Chemotherapy was associated with unforeseen impacts related to patients compromised immune systems (e.g., restricted social functioning due to increased risk of infection). Fear of infection and impact of treatment notably increased patients' needs to isolate which had a substantial impact on the broader family life. Bone marrow transplant posts described it as 'lifesaving'. Despite uncertainty of treatment success and negative treatment effects, patient/CG posts noted that side effects were an acceptable part of the journey to become cancer free. Posts also illustrated a general shift in patient/CG perception of ALL treatments, specifically that no one treatment works for everyone in the same way, and recent treatment developments mean that ALL is no longer perceived as a death sentence. 66 patient/CG posts commented on the cessation of treatment or lack of treatment due to remission, alternative treatments or end of life. Financial burden due to ALL treatment was an important issue for patients/CGs as it prevented the start of treatment or impaired patients'/CGs' lives. This pilot study shows how NLU can effectively extract SM data expressed by patients/CGs/HCPs relating to ALL. It is important to note that SM data are unregulated, not peer reviewed and inherently reliant on user self-identification. Thus, caution should be used interpreting SM data particularly as the information is not generalizable and/or reflective of the whole ALL patient population. Nevertheless, the pilot demonstrated how user-generated SM data can offer valuable insights on the experience and impact of ALL and its treatments that exist outside of the formal research context. Disclosures Crawford: Pfizer Inc: Consultancy. Welch: Pfizer Inc: Current Employment. Shah: Pfizer Inc: Current Employment. Doward: Pfizer Inc: Consultancy. Truchan: Pfizer Inc: Current Employment.


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