Impact of route and adequacy of nutritional intake on outcomes of allogeneic haematopoietic cell transplantation for haematologic malignancies.

BACKGROUND: Allogeneic haematopoietic cell transplantation (HCT) is often associated with poor oral intake due to painful mucositis and gastrointestinal sequalae that occur following a preparative regimen of intensive chemotherapy and/or total body radiation. Although attractive to assume that optimal nutrition improves HCT outcomes, there are limited data to support this. It is also unclear whether artificial nutrition support should be provided as enteral tube feeding or parenteral nutrition (PN). METHODS: We analysed day-100 non-relapse mortality (NRM), incidence of acute graft-versus-host disease (GvHD), acute gastrointestinal GvHD, 5-year survival and GvHD-free/relapse-free survival (GRFS) according to both route and adequacy of nutritional intake prior to neutrophil engraftment, together with other known prognostic factors, in a retrospective cohort of 484 patients who underwent allogeneic HCT for haematologic malignancy between 2000 and 2014. RESULTS: Multivariate analyses showed increased NRM with inadequate nutrition (hazard ratio (HR) 4.1; 95% confidence interval (CI) 2.2-7.2) and adequate PN (HR 2.9; 95% CI 1.6-5.4) compared to adequate enteral nutrition (EN) both P < .001. There were increased incidences of gastrointestinal GvHD of any stage and all GvHD ≥ grade 2 in patients who received PN (odds ratio (OR) 2.0; 95% CI 1.2-3.3; P = .006, and OR 1.8; 95% CI 1.1-3.0; P = .018, respectively), compared to adequate EN. Patients who received adequate PN and inadequate nutrition also had reduced probabilities of survival and GRFS at 5 years. CONCLUSION: Adequate EN during the early transplantation course is associated with reduced NRM, improved survival and GRFS at 5 years. Furthermore, adequate EN is associated with lower incidence of overall and gut acute GvHD than PN, perhaps because of its ability to maintain mucosal integrity, modulate the immune response to intensive chemo/radiotherapy and support the gastrointestinal tract environment, including gut microflora

Humoral response to mRNA anti–COVID-19 vaccines BNT162b2 and mRNA-1273 in patients with chronic lymphocytic leukemia

International audienceAbstract Immunocompromised individuals such as patients with chronic lymphocytic leukemia (CLL) are at risk of impaired immune responses to vaccination. The objective of our study was to evaluate severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)–specific antibody responses in patients with CLL after the first, second, and third doses of the BNT162b2 or mRNA-1273 vaccines and after a single dose for patients with confirmed previous COVID-19. In all, 530 patients were included in the study. Patients received 2 doses at a 4-week interval and a third dose if they were seronegative after the second dose. Response rate was 27% after dose 1 and 52% after dose 2. Post-dose 2 treatment-naïve patients had the highest response rate (72%) followed by patients previously treated by chemoimmunotherapy (60%). Among patients receiving therapy, those receiving Bruton tyrosine kinase inhibitor alone (22%) or in combination with anti-CD20 monoclonal antibodies or venetoclax (0%) had the poorer response rate whereas patients who received venetoclax monotherapy achieved a significantly higher response rate (52%). A multivariable analysis identified age older than 65 years, ongoing CLL treatment, and gamma globulin ≤6 g/L as independent predictors of the absence of seroconversion. Post-dose 2 seronegative patients had a global response rate of 35% after dose 3. This study provides an argument for the use of a third dose and for prophylactic SARS-CoV-2 neutralizing monoclonal antibodies

Clinical Implications of Novel Genomic Discoveries in Chronic Lymphocytic Leukemia

International audienc

Reservoir fluid characterisation using gas chromatography-mass spectrometry

Summarization: The compositional characterisation of naturally occurring hydrocarbon mixtures is an integral part of routine petroleum laboratory analysis. Currently, the measurements of the gas and liquid phase compositions require separate gas chromatographic set-ups with analysis times of up to 1 h. These analyses may lack important information because several critical components are not sufficiently separated. This work uses a GC-MS with a quadrupole mass analyser to routinely provide classification of the eluted peaks into alkanes, iso-alkanes, naphthenes and aromatics as well as to determine their concentration. The selected set-up uses a single injection point and a single analytical column to analyse sequentially both gas and liquid samples. Specific calibration procedures have been developed to allow for the variation of the Full-size image (<1 K) intensities from run to run and for the conversion of peak areas to concentrations. The new extended compositional analysis throws light on the distribution of the different types of molecules in the reservoir fluid and provides accurate physical properties for each cut, thus improving the understanding of the thermodynamic and rheological behaviour of the petroleum fluids.Presented on: Journal of Petroleum Science and Engineerin

Microdistillation: a method combining gas and liquid chromatography to characterize petroleum liquids

Summarization: A chromatographic method has been developed for the analysis of petroleum liquids to replace the standard distillation which is used by the analytical laboratories to split the sample into light and heavy fractions, thus permitting the detailed characterization of the former. The microdistillation, which uses only a few microlitres of sample, is based on a dynamic accelerated vaporization of the light components assisted by an overlying flow of an inert gas and it achieves a fast and efficient separation between the residue and the distilled product. As the microdistillation unit is physically attached to the gas analyser, it thereby constitutes a closed system with the latter and allows the vaporized fraction to be characterized directly by gas chromatography. The remaining residue is subsequently characterized by liquid chromatography. The accuracy of the method was tested against synthetic mixtures of known composition and against stock tank oils. The microdistillation can be extended to the analysis of all types of multicomponent mixtures with constituents exhibiting a wide boiling point distribution.Presented on: Journal of Chromatography

Hormographiella aspergillata: an emerging basidiomycete in the clinical setting? A case report and literature review

International audienceBackground: Filamentous basidiomycetes are mainly considered to be respiratory tract colonizers but the clinical significance of their isolation in a specimen is debatable. Hormographiella aspergillata was first reported as a human pathogen in 1971. We discuss the role of this mold as a pathogen or colonizer and give an update on diagnostic tools and in vitro antifungal susceptibility. Case presentation: We identified three cases of H. aspergillata with respiratory symptoms in a short period of time. One invasive infection and two colonizations were diagnosed. Culture supernatants showed that H. aspergillata can produce galactomannan and β-D-glucan but not glucuronoxylomannan. For the first time, isavuconazole susceptibility was determined and high minimum inhibitory concentrations (MICs) were found. Liposomal amphotericin B and voriconazole have the lowest MICs. Conclusion: To date, 22 invasive infections involving H. aspergillata have been reported. On isolation of H. aspergillata, its pathogenic potential in clinical settings can be tricky. Molecular identification and antifungal susceptibility testing are essential considering high resistance against several antifungal therapies