Ibrutinib in the Treatment of Refractory Chronic Lymphocytic Leukemia

Background & Aims. This paper presents the results of the observational study of ibrutinib in patients with chronic lymphocytic leukemia (CLL), conducted in SP Botkin Municipal Clinical Hospital. The main objective was the analysis of complications of ibrutinib and identification of factors, influencing the dosage regimen; the secondary objective was the estimation of the total response to treatment, event-free and overall survival. Materials & Methods. The study included 96 patients with CLL with indications for ibrutinib therapy. The median age was 64,9 years (range 32–91 years), the study population consisted of 69 (72 %) men and 27 (28 %) women. The condition of 25 (26 %) patients according to the ECOG scale was of > 3 points. The disease of stage C were diagnosed in 36 (37 %) patients . Deletion of 17p/TP53 mutations were detected in 29 (33 %) of 87 patients. Seventy patients had refractory CLL. The median of the number of the lines of the previous therapy was 3 (range 1–9). Adverse events were assessed in accordance with the CTCAE criteria, version 4.0; the bleeding severity was evaluated using ITP-specific bleeding score; hematological complications were classified according to the recommendations of IWCLL-2008. Results. Ibrutinib was administered at a dosage of 420 mg per day daily until progression or intolerable toxicity. The median duration of ibrutinib therapy was 10.3 months. Ibrutinib was shown to have moderate toxicity, mostly of grade I or II. The bleeding was the most frequent complication. Of the hematological complications, thrombocytopenia was the most common (35 %); neutropenia grade III) developed in 26 % of patients. The treatment response was assessed in 92 patients. The overall response to treatment was 89 %. Complete remission, partial remission and partial remission with lymphocytosis were achieved in 4 (4 %), 57 (62 %), and 21 (23 %) patients, respectively. The event-free survival and overall survival by the month 10 was 90 % and 91 %, respectively. For this observation period, ECOG status and the number of the lines of therapy prior to ibrutinib had the prognostic value. Conclusion. Ibrutinib was shown to have high efficiency in relapsed/refractory forms of CLL. The nature of the ibrutinib toxicity is fundamentally different from that of the conventional chemotherapy. The frequency of ibrutinib therapy complications and patients’ non-compliance depends on the intensity of the previous treatment of CLL. Despite a short observation period, it can be concluded that ibrutinib had the greatest impact on the patient’s quality of life when administered for the first relapse. The low toxicity of ibrutinib is likely to allow the combination with other antitumor agents

Biological function in the twilight zone of sequence conservation

Abstract Strong DNA conservation among divergent species is an indicator of enduring functionality. With weaker sequence conservation we enter a vast ‘twilight zone’ in which sequence subject to transient or lower constraint cannot be distinguished easily from neutrally evolving, non-functional sequence. Twilight zone functional sequence is illuminated instead by principles of selective constraint and positive selection using genomic data acquired from within a species’ population. Application of these principles reveals that despite being biochemically active, most twilight zone sequence is not functional

Eight-month-old infants’ behavioural responses to peers’ emotions as related to the asymmetric frontal cortex activity

Infants are sensitive to and converge emotionally with peers’ distress. It is unclear whether these responses extend to positive affect and whether observing peer emotions motivates infants’ behaviors. This study investigates 8-month-olds’ asymmetric frontal EEG during peers’ cry and laughter, and its relation to approach and withdrawal behaviors. Participants observed videos of infant crying or laughing during two separate sessions. Frontal EEG alpha power was recorded during the first, while infants’ behaviors and emotional expressions were recorded during the second session. Facial and vocal expressions of affect suggest that infants converge emotionally with their peers’ distress, and, to a certain extent, with their happiness. At group level, the crying peer elicited right lateralized frontal activity. However, those infants with reduced right and increased left frontal activity in this situation, were more likely to approach their peer. Overall, 8-month-olds did not show asymmetric frontal activity in response to peer laughter. But, those infants who tended to look longer at their happy peer were more likely to respond with left lateralized frontal activity. The link between variations in left frontal activity and simple approach behaviors indicates the presence of a motivational dimension to infants’ responses to distressed peers

Moisture sorption in developing cotton fibers

The moisture sorption behavior of developing cotton fibers is studied by dynamic vapor sorption. Mature fibers show a typical sigmoidal isotherm, IUPAC type II, describing the adsorption on macroporous and non-porous adsorbents with a typical hysteresis. This is different from the type III isotherms exhibited by elongating fibers explained by the weak adsorbate-adsorbent interactions. The maximum sorption capacity clearly decreases throughout the cotton fiber development. This decrease is very rapid during the elongation phase of the fibers, but declines beyond 25 days post anthesis (DPA). This transition corresponds to the time point where the secondary cell wall becomes dominant over the primary cell wall, as confirmed with FT-IR. Also only little moisture hysteresis appeared during the elongation phase whereas from 25 DPA onwards a distinct hysteresis is observed that remains almost constant until maturation of the fiber. The study clearly elucidates the sorption mechanism during the elongation phase of the fiber to be different from the one during the secondary cell wall synthesis. This improved understanding of the cotton sorption behavior is important for optimal application of cotton fiber in novel materials