Introduction: Emerging treatments in dermatology are often introduced into clinical practice due to the hype and publicity they carry. Dermatologists are often tempted to introduce these treatments which lack clinical evidence pertaining to safety and efficacy. This consensus position statement is presented to make dermatologists aware of the efficacy and safety, recommending the present status of six emerging treatments in dermatology, namely exosomes, polydeoxyribonucleotides (PDRNs), autologous micrograft transplant using Rigenera Activa ™ device, nanofat and stromal vascular fraction (SVF) for androgenetic alopecia, intravenous (IV) therapy, and thread lifts. It has been conducted by the Task Force of the Association of Cutaneous Surgeons of India (ACSI). Background and Aim: Emerging treatments in dermatology gain immense traction due to their prominence on social media and peer usage. Most of these treatments are unregulated, unapproved, with unknown long term-safety data. Many also have questionable efficacy with no standard protocols for use. This study consensus was thus conceived to find current clinical evidence, identify gaps, and provide a guideline to dermatologists while using these treatments. Material and Methods: Sixteen dermatologists of the Task Force of ACSI divided into groups of two and three, researched evidence for efficacy, guidelines for use, and safety from published literature. Six emerging treatments in dermatology, namely exosomes, PDRN, autologous micrograft transplant using Rigenera Activa TM device, nanofat and stromal vascular fraction (SVF) for androgenetic alopecia, IV therapy, and thread lifts were included. The expert panel developed a consensus statement deducing the level of evidence, strength of recommendation grade, and safety of the six treatments, using a modified Delphi consensus method. The final consensus was arrived at if >90% fully agreed to the recommendations. Less than a 90% consensus on a particular treatment was deliberated upon in a second round, asking the concerned expert to provide a reasoning and a re-evaluation was done. Results: Out of the 14 dermatologists, over 90% fully agreed to the strengths of recommendation, levels of evidence, and safety recommendations of all the six emerging treatments. The final consensus was thus arrived at.

Newly diagnosed mantle cell lymphoma (MCL) is commonly treated with rituximab (R) combined with anthracycline-based chemotherapy, with or without autologous stem-cell transplantation (ASCT). While rituximab maintenance (RM) in clinical trials has been shown to prolong overall survival (OS), its impact at population level remains largely unknown. This study evaluates the effect of RM on outcome of patients with MCL. Patients aged ≥18 years diagnosed with MCL between 1989-2020 were identified using the Netherlands Cancer Registry, and categorized into periods reflecting R and RM implementation (1989-2000, 2001-2014, 2015-2020). Treatment strategies were categorized as R-CHOP, R-CHOP followed by high-dose cytarabine (intensive) and ASCT, and other. The primary endpoint was 5-year OS. Multivariable analysis (MVA) was performed using Cox regression. Among 4,751 patients, 5-year relative survival (RS) improved from 38% (1989-2000) to 47% (2001-2014) and 60% (2015-2020) (p<0.01), irrespective of age (≤65 years: 32% and >65 years: 20% increase over time. Patients with progression (POD) within 12 months had 2-year OS of 25%. Since 2014, RM implementation reached 80% in younger and 50% in older patients. RM was associated with improved OS especially for patients in partial remission (PR), after induction treatment with R-CHOP. In MVA patients with R-CHOP, RM was independently associated with reduced mortality (hazard ratio 0.69; 95% CI, 0.53 - 0.90). Relative survival in MCL improved by more than 20% over the past 30 years. Early disease progression remains associated with poor outcome. RM was associated with improved survival, especially for patients achieving PR following R-CHOP.

Autologous stem-cell transplantation is a fundamental therapy for multiple myeloma. Although inpatient chemo-based stem-cell mobilization (SCM) is standard care in Germany, outpatient approaches could ease healthcare constraints. We analyzed 109 myeloma patients undergoing SCM and collection at the University Medical Center Göttingen for safety. We then trained machine learning models to predict adverse events (AEs) requiring hospitalization and to forecast AE onset timing for optimized ward management. In our cohort, 97% achieved successful collection, but 69% experienced severe AEs necessitating hospitalization. Simulations suggest a risk-stratified outpatient protocol could cut bed usage by at least one third without compromising safety. Classification models accurately predicted some AE types (e.g., elevated creatinine, ROC-AUC 1.0), though neutropenic fever remained challenging (ROC-AUC 0.67). Regression models forecast AE onset with a mean error of just over one day. These results outline a data-driven roadmap for safely adopting outpatient SCM and optimizing resource allocation in clinical practice.

The February 2026 Foot &amp; Ankle Roundup 360 looks at: Percutaneous distal metatarsal osteotomy with Akin offers better early soft-tissue recovery and equivalent one-year outcomes to open chevron Akin; Is autologous osteoperiosteal transplantation a good option for osteochondral lesions of the talus?; Os vesalianum pedis is uncommon and found in around 0.6% of feet, but important to recognize in lateral foot pain; Neuroma width an important factor in success of Morton’s treatment; Lateral metatarsosesamoid suspensory ligament release is unnecessary for moderate hallux valgus but adds correction in severe deformity; Unimalleolar fractures generally do well in the long term, but trimalleolar injuries carry a substantial risk of persistent impairment; Altered gait biomechanics after peroneus longus tendon harvest for anterior cruciate ligament reconstruction: truth or myth?; Early clinical benefit with the TARIC total ankle prosthesis but a high incidence of early radiological abnormalities warrants vigilance.

Compared to total body irradiation or chemotherapy, antibody-drug conjugates (ADCs) offer a more targeted and potentially less toxic method for transplant conditioning. CD45-ADC targets a pan-leukocyte antigen expressed on HSPCs and immune cells, offering a promising strategy for gene therapy or allogeneic transplantation. We evaluated reconstitution, clonal dynamics, immune tolerance, and toxicity following conditioning with a DGN549-C-conjugated CD45-ADC followed by autologous transplantation in rhesus macaques. Two doses (0.2 and 0.3 mg/kg) were tested, with HSPC infusion 10 days post-conditioning. All animals received barcoded, CopGFP-expressing lentivirally transduced HSPCs. Both doses resulted in profound depletion of HSPCs and expected cytopenias, with incomplete lymphocyte depletion. With 0.2 mg/kg CD45-ADC conditioning, two animals showed robust multilineage engraftment with gene-modified cells and high clonal diversity, comparable to TBI. However, CopGFP+ cell levels and clonal diversity declined at 4-8 months, accompanied by development of anti-CopGFP antibodies, suggesting immune rejection. Incomplete T-cell depletion may have contributed. Notably, this rejection was slower and less complete than following busulfan conditioning, suggesting partial immune tolerance. Dexamethasone treatment in one animal reversed rejection and stabilized CopGFP+ levels for over 2 years. At 0.3mg/kg CD45-ADC, two animals developed severe respiratory distress 4-6 days post-transplantation, requiring humane euthanasia, accompanied by elevated inflammatory cytokines. This severe syndrome was not seen in 9 additional animals conditioned with CD45-ADC. These findings highlight the importance of pre-clinical evaluation of experimental therapeutics. Combining lower-dose CD45-ADC with immune suppression may enable durable engraftment in settings of alloantigen or neoantigen expression.

Lymphomas are the third most common childhood cancer in Brazil. Management is predicated on precise diagnosis and staging through clinical, pathological, molecular, and radiological evaluation. Although the prognosis for pediatric non-Hodgkin and Hodgkin lymphoma has improved markedly, relapsed or refractory cases remain a clinical challenge. For these patients, aggressive chemotherapy followed by autologous or allogeneic hematopoietic cell transplantation serves as a vital salvage strategy. The Pediatric Group of the Brazilian Society of Bone Marrow Transplantation and Cellular Therapy has revised its current consensus, providing updated recommendations for indications and conditioning protocols. This revision also includes the assessment of new therapeutic strategies, including immunotherapy and CAR-T cell therapy, for eligible patients.

To describe an unusual case of cytomegalovirus (CMV) retinitis presenting with significant vitreous inflammation in a lymphoma patient following combined autologous transplantation and chimeric antigen receptor (CAR) T cell therapy. This is a retrospective case report. The case was evaluated with multimodal ophthalmic imaging, and the diagnosis was established based on cytological and virological tests. A 54-year-old male with primary diffuse large B cell lymphoma of the cervical lymph nodes experienced monocular visual loss one month after combined autologous hematopoietic stem cell transplantation and CAR-T cell therapy. Initial examination revealed significant vitreous inflammation, mimicking intraocular lymphoma relapse. After the removal of dusty vitreous in the subsequent diagnostic vitrectomy, extensive retinal vascular occlusion emerged as the key feature with minimal retinal lesions. Cytological and virological studies of the vitreous sample excluded intraocular lymphoma and confirmed CMV retinitis. This case highlights prominent vitritis as an atypical presentation of CMV retinitis. This report broadens the recognized clinical spectrum of CMV retinitis, underscoring the necessity of considering CMV retinitis in the differential diagnosis of vitreous inflammation, particularly in lymphoma patients with complex immune statuses.

Background/Objectives: Large osteochondral lesions of the talus (OLT) pose a major challenge because their size and depth often exceed the indications for bone marrow stimulation, and durable biological repair remains difficult to achieve. However, evidence for autologous osteochondral transplantation (AOT) in extensive talar defects is still limited. Methods: In this retrospective cohort, 40 consecutive patients ≥ 14 years with ICRS grade III–IV lesions of the talar dome were treated with AOT at a tertiary referral center. One to three overlapping cylindrical osteochondral grafts (mean diameter 0.9 cm) were harvested from non-weight-bearing regions of the ipsilateral patellofemoral groove using a water-cooled diamond trephine system and implanted press-fit into the talar dome. Donor sites were refilled with autologous iliac crest bone cylinders and hydroxyapatite substitute. Pain (Numeric Rating Scale, NRS) and function (AOFAS Ankle–Hindfoot Score) were recorded preoperatively and at 3, 6, 9, and 12 months, and changes over time were analyzed using generalized estimating equations. Results: Mean defect size was 137.4 ± 31.9 mm2, and 82.5% of lesions were ICRS grade III. NRS pain improved from 5.69 ± 2.52 preoperatively to 0.53 ± 0.98 at 12 months (p < 0.001). AOFAS score increased from 63.79 ± 2.55 to 97.36 ± 2.49 (p < 0.001). Age and graft location significantly influenced postoperative pain, whereas graft size and sex did not. No infections, graft failures, conversions to arthrodesis or arthroplasty, or clinically relevant donor-site symptoms occurred. Conclusions: Multi-plug AOT using a diamond trephine system provides substantial and durable pain relief and functional improvement in patients with large OLT, with low complication and donor-site morbidity rates. These findings support AOT as a joint-preserving option for extensive talar defects and justify further prospective, comparative studies with long-term follow-up.

The repair of facial organ injuries is a complex field in plastic surgery that involves both functional recovery and morphological reconstruction. The therapeutic goal has evolved from traditional wound closure to the harmonious integration of form and function. To achieve this new objective, surgical plans need to combine various flap techniques, autologous and allogeneic tissue transplantation approaches, and incorporate emerging methods such as digital design and biomaterials. Although the repair outcomes of facial organ injuries have improved compared to the past, challenges remain, including insufficient nerve function reconstruction, limited scar management, donor site damage, and immune rejection in allogeneic transplantation. This article systematically reviews the mainstream repair methods and advancements in domestic and international research on key facial structures, including the nose, eyelids, lips, and ears, focusing on their defect characteristics and repair difficulties. It emphasizes how to achieve both three-dimensional structural reconstruction and dynamic functional restoration while maintaining aesthetic reconstruction. In the future, the integration of technologies such as tissue engineering, three-dimensional bioprinting, supermicrosurgery, and artificial intelligence will drive the development of facial organ injury repair and reconstruction towards precision, personalization, and minimally invasive approaches, ultimately achieving comprehensive rehabilitation of patients' physical, psychological, and social roles.

3D bioprinted composite scaffold incorporating microfluidics-derived chondrocyte microspheroids promotes auricular cartilage regeneration

Freiberg's disease is a condition characterized by progressive flattening and eventual collapse of a metatarsal head. Core decompression, metatarsophalangeal joint (MTPJ) debridement, metatarsal osteotomies, autologous osteochondral transplantation (AOT), interpositional arthroplasties, and synthetic implant hemiarthroplasties comprise the surgical management options for patients with Freiberg's disease. Although autografts harvested from the iliac crest have been utilized for the treatment of various osteochondral pathologies of the lower extremity, their use for Freiberg's disease has not been reported to date. We present the case of a novel technique of metatarsal osteoperiostic grafting from the iliac crest (MetOPIC) to the second metatarsal head with injection of concentrated bone marrow aspirate (cBMA) in a 28-year-old former collegiate cheerleader with a longstanding history of chronic pain due to Freiberg's disease. The patient was able to return to her normal activities and participate in sporting activity 8 weeks following the operation. To the authors' knowledge, this is the first report of the use of the MetOPIC procedure to surgically correct Freiberg's disease.Levels of Evidence: V, Case report.

Cryopreservation of peripheral-blood-derived hematopoietic stem and progenitor cells (PBSCs) has been used for decades, primarily for autologous transplantation. Now, in the era of new cellular therapies, the cryopreservation of allogeneic PBSCs may also become relevant. While the defining quality-control parameters are assessed before cryopreservation, in thawed cryopreserved samples the viability of total nucleated cells is often the only parameter analyzed. We therefore evaluated the recovery rates of total and viable CD45+ and CD34+ cells after cryopreservation. Thirty-nine samples of allogeneic PBSC products were analyzed before and after cryopreservation. Post-thaw viability was assessed using trypan blue exclusion. To investigate the influence of different preanalytical preparation methods, PBSCs were resuspended in phosphate-buffered saline (PBS) or human serum albumin (HSA), and the cells suspended in HSA were tested without incubation or following incubation at 37°C for 1 h or 2 h. The number and viability of CD45+ and CD34+ cells were evaluated by flow cytometry and compared with pre-thaw values. After cryopreservation, we observed significant decreases in both total and viable CD45+ cell numbers. In contrast, the difference in total CD34+ cell numbers was rather small, whereas the median recovery rate of viable CD34+ cells after resuspension in PBS was 70.1%. Relevant differences between the preanalytical treatment groups could not be observed. The viability values as determined by trypan blue viability staining and flow cytometry were not correlated. Determination of the CD34+ cell recovery rate after thawing is feasible and may be used as an additional parameter for quality control for cryopreserved allogeneic PBSCs. However, the results of currently used viability assays vary considerably, making comparisons between different cell processing units and cryopreservation protocols difficult. Therefore, available protocols should be carefully evaluated based on "good-manufacturing-practice" (GMP) regulations before implementation.

BackgroundEarly initiation of broad-spectrum antibiotics reduces morbidity and mortality for hematopoietic cell transplant (HCT) recipients with neutropenic fever, but prolonged antibiotic exposure increases risks of Clostridioides difficile infection, graft-vs-host disease, and antibiotic resistance. We compared the safety and effectiveness of short versus extended antibiotic therapy for HCT recipients with neutropenic fever in the immediate post-transplant period.MethodsWe performed a retrospective, single-center cohort study of adult HCT recipients with febrile neutropenia admitted between January 2019 and May 2024 to compare outcomes treated short (≤7 days) versus extended ( >7 days) antibiotic course. Primary composite endpoints were (1) clinical failure (30-day all-cause mortality or ICU admission), and (2) adverse events (Clostridioides difficile infection or acute kidney injury [AKI]). Multivariable logistic regression was used to adjust for confounding factors.ResultsOverall, 103 patients (55 short-, 48 extended duration) were included. Most (61.2%) underwent autologous transplantation, most frequently for non-Hodgkin lymphoma (29.1%) and multiple myeloma (25.2%), with 58.3% having moderate comorbidity burden (HCT-CI score 2-4). Mean antibiotic duration was 3.6 vs.11.9 days in short and extended groups, respectively. Adjusted for age, gender, transplant type, infection type, and underlying malignancy, there was no difference in clinical failure between groups (OR [95% CI]: 3.36 [0.49, 27.66]; p = 0.229). While composite adverse events were more common in the extended group, the difference was not significant (OR [95% CI]: 3.78 [0.95, 16.7], p = 0.066). AKI, however, was significantly higher in the extended antibiotic group (OR [95% CI]: 5.33 [2.09,15.06], p = 0.048). Recurrent fever was uncommon, and extended antibiotics were associated with longer hospital stays (OR, 84.66; 95% CI, 2.7 – 40475; p = 0.047).ConclusionShorter antibiotic therapy was associated with similar rates of clinical failure compared to extended courses in HCT patients with neutropenic fever. Shorter antibiotic duration was also associated with lower odds of AKI and reduced hospital stays.DisclosuresAll Authors: No reported disclosures

Focal cartilage lesions of the knee joint frequently cause chronic symptoms and therefore require early treatment. Concomitant pathologies such as malalignment, ligamentous instability, or meniscal deficiency have a decisive impact on the outcome of cartilage regenerative procedures and must therefore be addressed concomitantly. Small chondral defects up to approximately 2cm2 are commonly treated primarily by bone marrow stimulation (BMS), preferably using microdrilling techniques. For defects of approximately 1-4cm2, matrix-augmented bone marrow stimulation (m-BMS) is considered the standard of care, providing superior mid-term outcomes. Larger defects exceeding approximately 2cm2 are preferentially treated with matrix-associated autologous chondrocyte transplantation (m-ACT), which has demonstrated stable long-term results. Osteochondral lesions require a combined treatment approach addressing both cartilage and subchondral bone. Overall, treatment follows a clearly defined stepwise concept based on epidemiological factors, defect morphology, concomitant pathologies, and structured rehabilitation.

This systematic review and meta-analysis assessed long-term outcomes following total pancreatectomy with islet autotransplantation (TPIAT). Seventeen studies including 1332 patients were analyzed. The pooled insulin independence rate was 34%, with higher rates for non-chronic pancreatitis indications (68%) versus chronic pancreatitis (33%). TPIAT is effective in preserving endocrine function. Further studies are needed to validate outcomes across extended indications and to standardize reporting, incorporating metabolic markers and patient-reported quality-of-life endpoints over long-term follow-up.

There are limited surgical options to successfully close a refractory macular hole. One promising option is an autologous neurosensory retinal free flap transplantation. An autologous neurosensory retinal free flap transplantation places a graft of peripheral autologous retinal tissue into the macular hole and was developed to improve post-surgical outcomes. Here, clinical instrumentation and a high-resolution adaptive optics system imaged the graft and host tissue of a patient whose refractory macular hole was successfully closed with an autologous neurosensory retinal free flap transplantation. A 71-year-old Hispanic female with bilateral moderate nonproliferative diabetic retinopathy (visual acuity of 20/100 in each eye) underwent an autologous neurosensory retinal free flap transplantation in the right eye only, which successfully closed a large refractory macular hole measuring 4° in diameter. Although somewhat variable, the best-corrected visual acuity improved from 20/100 to 20/70 with a subjective improvement noted by the patient. The eye was examined using (1) fundus photography and (2) clinical optical coherence tomography both presurgery and post surgery and (3) with adaptive optics-optical coherence tomography-scanning laser ophthalmoscopy post surgery. Postsurgical clinical optical coherence tomography imaging revealed restoration of the external limiting membrane within the graft. Adaptive optics-optical coherence tomography imaging provided enhanced lateral and axial resolution and showed a restored inner segment/outer segment junction within the graft. Adaptive optics-optical coherence tomography also revealed the cone outer segment tip layer in the host tissue, highlighting preservation of the microarchitecture and indicating that the host tissue was not negatively impacted by the surgery or the presence of the graft. Further, adaptive optics-scanning laser ophthalmoscopy imaging revealed photoreceptors within the graft and surrounding host tissue, indicating surgical success, graft acceptance and viable host tissue. Although the exact physiological mechanisms that promote macular hole closure and intraretinal cellular changes after an autologous neurosensory retinal free flap transplantation are unknown, imaging supports the procedure as a reasonable surgical option for refractory macular hole closure. The preserved integrity of the host tissue suggests that the graft does not negatively impact the retina following the surgery. Furthermore, the improvement in the inner segment/outer segment junction and external limiting membrane noted over time within the graft are considered favorable as they relate to the structure and function of the retina.

This paper posits that the most significant long-term existential risk to human civilization is not an acute technological or environmental catastrophe, but a chronic, systemic decay driven by the psychological and demographic consequences of a biologically capped lifespan. The entrenched expectation of mortality before 120 years fosters a condition of "temporal myopia," which cultivates cultural short-termism, consumerist nihilism, and demographic apathy. A critical and compounding aspect of this risk is the observed strong negative correlation between high cognitive ability and reproductive rates, leading to a systematic, dysgenic drain on humanity's problem-solving capacity. This creates a recursive threat far greater than any single hazard, as it erodes the intellectual capital necessary to navigate all other complex challenges. To counter this civilizational trajectory, we propose a novel biomedical paradigm: a strategy of continuous personal rejuvenation. This approach is based on utilizing in-vitro gametogenesis to generate autologous gametes, followed by auto-fertilization to create a new embryonic lineage. This protocol enables a comprehensive reset of cellular age, including the critical de novo formation of young centrioles, addressing the Centriolar Theory of Organismal Aging. The resulting young, perfectly matched adult stem cells are proposed for periodic autologous transplantation to maintain the body's regenerative potential indefinitely. We argue that this intervention transcends its medical purpose. By enabling the indefinite maintenance of cognitive and physical vitality, it allows the most capable individuals to remain active contributors for centuries, provides time for wisdom to accumulate, and transforms detrimental demographic structures. Therefore, rejuvenation biotechnology should be framed not as a mere luxury, but as a necessary civilizational safeguard—a strategic imperative to prevent a slow-motion intellectual and demographic collapse and to secure a flourishing long-term future for humanity.

HIV and Monkey Pox virus coinfection after autologous hematopoietic stem-cell transplantation for Hodgkin lymphoma: A case report

Autologous peripheral blood stem cell (PBSC) collection can be challenging in pediatric patients with solid tumors following intensive chemotherapy. Plerixafor, a hematopoietic stem cell mobilizing agent, has been increasingly used in such cases; however, reports from Japan remain limited. We conducted a single-center retrospective observational study to assess the efficacy and safety of plerixafor. Eight pediatric patients with solid tumors (nine mobilization attempts) who received plerixafor at our institution between 2015 and 2024 were included in the analysis. The median CD34-positive cell count collected was 10.8×106/kg. In all cases, the target cell dose required for autologous transplantation was successfully achieved. Adverse events were mild, including transient headache, elevated liver enzymes, and diarrhea. No severe adverse events were observed. Plerixafor was effective and well tolerated in pediatric patients with solid tumors, regardless of disease status (newly diagnosed or relapsed). These findings support its potential as a valuable stem cell mobilization option in pediatric transplant settings in Japan.

Safety and efficacy of G-CSF alone with pre-emptive plerixafor for autologous peripheral blood hematopoietic stem cell mobilization in newly diagnosed multiple myeloma.