Safety and Efficacy of Axicabtagene Ciloleucel versus Standard of Care in Patients 65 Years of Age or Older with Relapsed/Refractory Large B-Cell Lymphoma

Purpose: Older patients with relapsed/refractory (R/R) large B-cell lymphoma (LBCL) may be considered ineligible for curative-intent therapy including high-dose chemotherapy with autologous stem-cell transplantation (HDT-ASCT). Here, we report outcomes of a preplanned subgroup analysis of patients >= 65 years in ZUMA-7. Patients and Methods: Patients with LBCL refractory to or relapsed = 65 years were random-ized to axi-cel and SOC, respectively. Median EFS was greater with axi-cel versus SOC (21.5 vs. 2.5 months; median follow-up: 24.3 months; HR, 0.276; descriptive P = 3 adverse events occurred in 94% of axi-cel and 82% of SOC patients. No grade 5 cytokine release syndrome or neurologic events occurred. In the quality-of-life analysis, the mean change in PRO scores from baseline at days 100 and 150 favored axi-cel for EORTC QLQ-C30 Global Health, Physical Functioning, and EQ-5D-5L visual analog scale (descriptive P = 65 and = 65 years with R/R LBCL

Plasma Performance Improvements with Liquid Lithium Limiters in CDX-U

The use of flowing liquid lithium as a first wall for a reactor has potentially attractive physics and engineering features. The Current Drive experiment-Upgrade (CDX-U) at the Princeton Plasma Physics Laboratory has begun experiments with a fully toroidal liquid lithium limiter. CDX-U is a compact [R = 34 cm, a = 22 cm, Btoroidal = 2 kG, IP =100 kA, T(subscript)e(0) {approx} 100 eV, n(subscript)e(0) {approx} 5 x 10{sup 19} m-3] short-pulse (<25 msec) spherical tokamak with extensive diagnostics. The limiter, which consists of a shallow circular stainless steel tray of radius 34 cm and width 10 cm, can be filled with lithium to a depth of a few millimeters, and forms the lower limiting surface for the discharge. Heating elements beneath the tray are used to liquefy the lithium prior to the experiment. The total area of the tray is approximately 2000 cm{sup 2}. The tokamak edge plasma, when operated in contact with the lithium-filled tray, shows evidence of reduced impurities and recycling. The reduction in re cycling and impurities is largest when the lithium is liquefied by heating to 250 degrees Celsius. Discharges which are limited by the liquid lithium tray show evidence of performance enhancement. Radiated power is reduced and there is spectroscopic evidence for increases in the core electron temperature. Furthermore, the use of a liquid lithium limiter reduces the need for conditioning discharges prior to high current operation. The future development path for liquid lithium limiter systems in CDX-U is also discussed

Outcomes of Medicare-age eligible NHL patients receiving RIC allogeneic transplantation: a CIBMTR analysis

The application of allogeneic hematopoietic cell transplantation (allo-HCT) in non-Hodgkin lymphoma (NHL) patients ≥65 years in the United States is limited by lack of Medicare coverage for this indication. Using the Center for International Blood and Marrow Transplant Research (CIBMTR) database, we report allo-HCT outcomes of NHL patients aged ≥65 years (older cohort; n = 446) compared with a cohort of younger NHL patients aged 55-64 years (n = 1183). We identified 1629 NHL patients undergoing a first reduced-intensity conditioning (RIC) or nonmyeloablative conditioning allo-HCT from 2008 to 2015 in the United States. Cord blood or haploidentical transplants were excluded. The median age was 68 years (range 65-77) for the older cohort vs 60 years (range 55-64) in the younger cohort. The 4-year adjusted probabilities of nonrelapse mortality (NRM), relapse/progression (R/P), progression-free survival (PFS), and overall survival (OS) of the younger and older groups were 24% vs 30% (P = .03), 41% vs 42% (P = .82), 37% vs 31% (P = .03), and 51% vs 46% (P = .07), respectively. Using multivariate analysis, compared with the younger group, the older cohort was associated with increased NRM, but there was no difference between the 2 cohorts in terms of R/P, PFS, or OS. The most common cause of death was disease relapse in both groups. In NHL patients eligible for allo-HCT, there was no difference in OS between the 2 cohorts. Age alone should not determine allo-HCT eligibility in NHL, and Medicare should expand allo-HCT coverage to older adults

Thermal Hydraulic Analysis of Fire Divertor

The Fusion Ignition Research Experiment (FIRE) is being designed as a next step in the US magnetic fusion program. The FIRE tokamak has a major radius of 2 m, a minor radius of 0.525 m, and liquid nitrogen cooled copper coils. The aim is to produce a pulse length of 20 s with a plasma current of 6.6 MA and with alpha dominated heating. The outer divertor and baffle of FIRE are water cooled. The worst thermal condition for the outer divertor and baffle is the baseline D-T operating mode (10 T, 6.6 MA, 20 s) with a plasma exhaust power of 67 MW and a peak heat flux of 20 MW/m{sup 2}. A swirl tape (ST) heat transfer enhancement method is used in the outer divertor cooling channels to increase the heat transfer coefficient and the critical heat flux (CHF). The plasma-facing surface consists of tungsten brush. The finite element (FE) analysis shows that for an inlet water temperature of 30 C, inlet pressure of 1.5 MPa and a flow velocity of 10 m/s, the incident critical heat flux is greater than 30 MW/m{sup 2}. The peak copper temperature is 490 C, peak tungsten temperature is 1560 C, and the pressure drop is less than 0.5 MPa. All these results fulfill the design requirements

H/sub. cap alpha. / studies on TFTR

H/sub ..cap alpha../ emission is a useful indicator of hydrogen ionization since the energy required to excite hydrogen to the n = 3 level is approximately the same as to ionize the hydrogen atom. Other aspects of recycling, such as plasma scrape-off parameters, wall particle fluxes, and wall retention rates can be inferred from spatial distributions of H/sub ..cap alpha../ emission. There are two H/sub ..cap alpha../ diagnostics on TFTF observing the inner limiter: a relatively calibrated wide-angle TV camera, and the absolutely calibrated HAIFA diagnostic, both viewing the inner limiter. H/sub ..cap alpha../ observations by these instruments have been analyzed using the DEGAS neutral transport code. The core recycling rate, and ion and neutral particle limiter fluxes, have been deduced from the calculations. The results are very sensitive to the ion flux distribution, and therefore also provide information on the plasma scrape-off conditions. A survey was made of over 500 TFTR discharges. H/sub ..cap alpha../ emission appears to increase in proportion to /bar n//sub e//sup 2/. The ratio of core ionization to average H/sub ..cap alpha../ emission was calculated to be roughly constant over a large range of discharges. 9 refs., 4 figs., 1 tab

Modeling of Spherical Torus Plasmas for Liquid Lithium Wall Experiments

Liquid metal walls have the potential to solve first-wall problems for fusion reactors, such as heat load and erosion of dry walls, neutron damage and activation, and tritium inventory and breeding. In the near term, such walls can serve as the basis for schemes to stabilize magnetohydrodynamic (MHD) modes. Furthermore, the low recycling characteristics of lithium walls can be used for particle control. Liquid lithium experiments have already begun in the Current Drive eXperiment-Upgrade (CDX-U). Plasmas limited with a toroidally localized limiter have been investigated, and experiments with a fully toroidal lithium limiter are in progress. A liquid surface module (LSM) has been proposed for the National Spherical Torus Experiment (NSTX). In this larger ST, plasma currents are in excess of 1 MA and a typical discharge radius is about 68 cm. The primary motivation for the LSM is particle control, and options for mounting it on the horizontal midplane or in the divertor region are under consideration. A key consideration is the magnitude of the eddy currents at the location of a liquid lithium surface. During plasma start up and disruptions, the force due to such currents and the magnetic field can force a conducting liquid off of the surface behind it. The Tokamak Simulation Code (TSC) has been used to estimate the magnitude of this effect. This program is a two dimensional, time dependent, free boundary simulation code that solves the MHD equations for an axisymmetric toroidal plasma. From calculations that match actual ST equilibria, the eddy current densities can be determined at the locations of the liquid lithium. Initial results have shown that the effects could be significant, and ways of explicitly treating toroidally local structures are under investigation

Experimental observations of the coupling between induced currents and mechanical motion in torsionally supported square loops and plates. Part 1. Experimental analysis

This two-part report describes a series of experiments designed to provide quantitative data on coupled magnetomechanical systems. This first part presents the details of the data analysis, some representative data, the overall results, and conclusions. The Fusion Electromagnetic Induction Experiment (FELIX) facility is described at the Argonne National Laboratory (ANL), where the experiments were performed, and the test fixture which was designed for this investigation. The next section describes the static and dynamic mechanical tests which were performed with the test fixture and summarizes the results. The sixth section presents and summarizes the results of the tests which were made with the dipole field only, which produces no mechanical rotation. The total electric current flowing around a test piece was measured versus time using a Rogowski coil. The seventh section presents and summarizes the results of actual coupled tests which were made with both the dipole field and solenoid field. Both the test piece Rogowski coil and the rotational transducer were employed for these tests

Experimental observations of the coupling between induced currents and mechanical motion in torsionally supported square loops and plates. Part 2. Data inventory

A series of experiments was successfully conducted to investigate the coupling between induced currents and rigid body rotation in square loops and plates. The experiments were performed with the Fusion Electromagnetic Induction Experiment (FELIX) facility at the Argonne National Laboratory. The observed data exhibited the magnetic damping and magnetic stiffness effects ehich arise in coupled systems and agreed very well with previous analytic calculations