Analysis of the clinical impact of NPM1 mutant allele burden in a large cohort of younger adult patients with acute myeloid leukaemia

Although an NPM1 mutation is generally considered to be a good prognostic marker in acute myeloid leukaemia, it has recently been suggested that a higher level of NPM1 mutant (NPM1MUT) alleles relative to wild‐type alleles is associated with poor clinical outcome. We therefore sought to confirm this finding in a larger study of 876 NPM1MUT cases entered into UK national trials. In univariate analysis, the higher NPM1MUT allele burden was associated with a lower complete remission (CR) rate, higher relapse rate and reduced overall survival, but this was largely attributable to the association of the higher NPM1MUT allele burden with other known poor risk factors, particularly the presence of a concomitant FLT3 internal tandem duplication. In multivariate analysis, there was no significant impact of the NPM1MUT allele burden on CR rates, and the impact on relapse and overall survival, whilst still significant, was greatly reduced. This impact was similar in patients who did or did not receive an allogeneic transplant in first CR. We conclude that the binary presence or absence of an NPM1 mutation, combined with minimal residual disease levels following induction therapy, should continue to be used in therapeutic management rather than stratification according to the NPM1MUT level

Therapy for isocitrate dehydrogenase 2 (IDH2)(R172)-mutant acute myeloid leukaemia

Although we earlier reported a very poor outcome for younger adult patients with isocitrate dehydrogenase 2 (IDH2)R172-mutated acute myeloid leukaemia (AML) entered into UK trials compared to IDH2WT and IDH2R140-mutated patients, this was not corroborated by a study from the German-Austrian AML Study Group. We have therefore investigated a later cohort of IDH2-mutated patients to identify any changes in outcome and whether this could inform the optimal treatment for IDH2R172 AML. We found an improved outcome for IDH2R172-mutated AML in the later trials and the data suggests that this may be due to the increased use of allogeneic transplantation to consolidate first remission

Additional impact of mutational genotype on prognostic determination in resistant and relapsed acute myeloid leukaemia

Outcome after failure of initial therapy in younger adult patients with acute myeloid leukaemia (AML) is highly variable. Cytogenetics, length of first remission (CR1) before relapse, and allogeneic transplantation are known prognostic factors, but the contribution of leukaemic genotype is less clear, particularly in resistant disease. Of 5,651 younger adult patients entered into UK MRC/NCRI AML trials between 1988 and 2014 with available FLT3ITD and NPM1 genotype, 326 (6%) had resistant disease and 2338 (41 %) relapsed after achieving CR1. Overall survival (OS) was significantly higher in relapsed compared to resistant disease (p = 0·03). Independent favourable prognostic factors for OS in resistant disease included lower blast cell percentage after two courses of induction therapy (p = 0.0006) and NPM1 mutant (NPM1MUT) (p = 0.04). In relapsed disease, longer CR1 was a favourable independent factor for attainment of CR2 (p < 0.0001) and OS from time of relapse (p < 0.0001), but CR2 rate and OS from relapse were significantly worse in those who had received an allograft in CR1 (respectively p < 0.05, p < 0·002). NPM1MUT was marginally beneficial for OS (p = 0.04). FLT3ITD and DNMT3AMUT were adverse factors for OS (respectively p < 0.0001, p = 0.02). Mutational analysis adds additional independent prognostic information to demographic features and previous therapy in patients with resistant and relapsed disease

NADH Regeneration : A Case Study of Pt-catalyzed NAD+ Reduction with H2

ACKNOWLEDGMENTS: This work was supported by The Royal Society (ICA\R1\180317).Peer reviewedPostprin

Accurate Parameter Extraction From Liquids Measured Using On-chip Terahertz Spectroscopy

We introduce a method for estimating the permittivity of liquid samples measured using integrated microfluidic/planar Goubau line terahertz waveguides, in which simulation results are incorporated with measurement data to enable accurate frequency-dependent analysis

On-chip Terahertz Spectroscopy of Liquid Mixtures

We demonstrate 'through-substrate' sensing of fluids for application in the terahertz spectroscopy of biological materials. This technique employs planar Goubau lines with integrated photoconductive material, formed on a flexible, thin polyimide substrate, and bonded to a microfluidic channel. Few-picosecond pulses are used to probe liquid samples confined within the channel, over a total interaction length of 4 mm, overcoming water-absorption limitations of free-space terahertz transmission measurements

Cofactor NAD(P)H regeneration:how selective are the reactions?

The regeneration of NAD(P)H can be achieved via catalysis, but the unequivocal determination of the species involved has not yet been fully realized. The current analytical methods of reactant/product analysis based on UV-vis spectroscopy, enzymatic assays, NMR spectroscopy, and HPLC are critically examined here with suggestions for future development

A cluster randomized controlled trial of a modified vaccination clinical reminder for primary care providers

Objective: Adult vaccination rates in the United States fall short of national goals, and rates are particularly low for Black Americans. We tested a provider-focused vaccination uptake intervention: a modified electronic health record clinical reminder that bundled together three adult vaccination reminders, presented patient vaccination history, and included talking points for providers to address vaccine hesitancy. Method: Primary care teams at the Atlanta Veterans Affairs Medical Center, who saw 28,941 patients during this period, were randomly assigned to receive either the modified clinical reminder (N = 44 teams) or the status quo (N = 40 teams). Results: Uptake of influenza and other adult vaccinations was 1.6 percentage points higher in the intervention group, which was not statistically significant (CI = [-1.3, 4.4], p = 0.28). The intervention had similar effects on Black and White patients and did not reduce the disparity in vaccination rates between these groups. Conclusion: Provider-focused interventions are a promising way to address vaccine hesitancy, but they may need to be more intensive than a modified clinical reminder to have appreciable effects on vaccination uptake

Analytical Models for Valence Fermions in Isotropic Traps

For isotropic confining Ioffe-Pritchard or TOP potentials, a valence fermion trapped with a closed core of other fermions can be described by an analytical effective one-particle model with a physical eigenspectrum. Related constructions exist for Paul and Penning traps. The analytical models arise from quantum-mechanical supersymmetry.Comment: accepted for publication in Physics Letters

In situ XAFS of acid-resilient iridate pyrochlore oxygen evolution electrocatalysts under operating conditions

Pyrochlore iridates (Na,Ca)2-xIr2O6?H2O are acid-stable electrocatalysts that are candidates for use in electrolysers and fuel cells. Ir LIII-edge X-ray absorption fine structure spectroscopy in 1 M H2SO4 at oxygen evolution conditions suggests the involvement of the electrons from the conduction band of the metallic particles, rather than just surface iridium reacting