Sustained Progression-Free Survival Benefit of Rituximab Maintenance in Patients With Follicular Lymphoma : Long-Term Results of the PRIMA Study

PURPOSE The PRIMA study (ClinicalTrials.gov identifier: NCT00140582) established that 2 years of rituximab maintenance after first-line immunochemotherapy significantly improved progression-free survival (PFS) in patients with follicular lymphoma compared with observation. Here, we report the final PFS and overall survival (OS) results from the PRIMA study after 9 years of follow-up and provide a final overview of safety. METHODS Patients (> 18 years of age) with previously untreated high-tumor-burden follicular lymphoma were nonrandomly assigned to receive one of three immunochemotherapy induction regimens. Responding patients were randomly assigned (stratified by induction regimen, response to induction treatment, treatment center, and geographic region) 1:1 to receive 2 years of rituximab maintenance (375 mg/m(2), once every 8 weeks), starting 8 weeks after the last induction treatment, or observation (no additional treatment). All patients in the extended follow-up provided their written informed consent (data cutoff: December 31, 2016). RESULTS In total, 1,018 patients completed induction treatment and were randomly assigned to rituximab maintenance (n = 505) or observation (n = 513). Consent for the extended follow-up was provided by 607 patients (59.6%) of 1,018 (rituximab maintenance, n = 309; observation, n = 298). After data cutoff, median PFS was 10.5 years in the rituximab maintenance arm compared with 4.1 years in the observation arm (hazard ratio, 0.61; 95% CI, 0.52 to 0.73; P <.001). No OS difference was seen in patients randomly assigned to rituximab maintenance or observation (hazard ratio, 1.04; 95% CI, 0.77 to 1.40; P = .7948); 10-year OS estimates were approximately 80% in both study arms. No new safety signals were observed. CONCLUSION Rituximab maintenance after induction immunochemotherapy provides a significant long-term PFS, but not OS, benefit over observation.Peer reviewe

Mussel incubation method for monitoring organochlorine compounds in freshwater recipients of pulp and paper industry

A biological method based on bioaccumulation and using incubated lake mussels (Anodonta piscinalis) was developed and applied for monitoring organic chlorocompounds originating especially from pulp and paper industry and occurring in the water in very small and fluctuating concentrations. By this method the spreading of the severe PCB-pollution in Lake Kernaalanjärvi was specified, and the limits of the PCB-leakage in the Äänekoski area were defined. Of the other chlorohydrocarbons lindane as well as DDE were detected everywhere in small concentrations. DDT was, on the contrary, very rarely found. Hexachlorobenzene occurred also very commonly, and the highest concentrations were detected in the immediate recipients of pulp mills. Some local pollution cases caused by chlorophenols used in wood preservatives were detected. Airborne chlorophenolics were found everywhere. 2, 4, 6- Trichlorophenol was found to be the main chlorophenolic in the recipient of the sulphite pulp mill. It was possible to clear up the occurrence and transformation of bleaching remnants (S2PCP-group). In addition, there was proof of the transformation of chlorophenols and chloroguaiacols into chloroanisoles and chloroveratroles in the watercourse. Analysis of the S2PCP-group from incubated mussels seems to be very suitable for the monitoring of organochlorine compounds originating from pulp and paper industry. The introduction of biological effluent treatment caused a significant decrease of chlorophenolic compounds. Chlorinated dibenzo-p-dioxins and dibenzofurans were also found with the help of incubated mussels in areas worst polluted by pulping effluents, although in very small concentrations. It was also found that biological treatment of waste water decreases these compounds considerably and that the components occurring after the purification process were clearly less toxic furans. Practical guidelines of the mussel incubation method are presented

Refractory organic pollutants and toxicity in pulp and paper mill wastewaters

This review describes medium and high molecular weight organic material found in wastewaters from pulp and paper industry. The aim is to review the versatile pollutants and the analysis methods for their determination. Among other pollutants, biocides, extractives, and lignin-derived compounds are major contributors to harmful effects, such as toxicity, of industrial wastewaters. Toxicity of wastewaters from pulp and paper mills is briefly evaluated including the methods for toxicity analyses. Traditionally, wastewater purification includes mechanical treatment followed by chemical and/or biological treatment processes. A variety of methods are available for the purification of industrial wastewaters, including aerobic and anaerobic processes. However, some fractions of organic material, such as lignin and its derivatives, are difficult to degrade. Therefore, novel chemical methods, including electrochemical and oxidation processes, have been developed for separate use or in combination with biological treatment processes.peerReviewe

Analysis of Trace Pharmaceuticals and Related Compounds in Municipal Wastewaters by Preconcentration, Chromatography, Derivatization, and Separation Methods

A significant portion of pharmaceuticals and other organic chemicals consumed by people and animals are released into municipal wastewater treatment plants. Most of them are degraded during the wastewater treatment processes, but some of them degrade only partially and may be widely transported and dispersed into the aquatic environment. This is why efficient and fast analytical methods are needed for detection of organic compounds in wastewaters at trace levels. Because wastewaters often consist of complex matrices and high-molecular mass materials, e.g., lignocellulosic biomass, which may bring challenges to the sample preparation procedures, efficient pre-concentration methods such as solid phase extraction (SPE) solid phase microextraction (SPME), or single drop microextraction (SDME) are needed. The most common analysis methods are gas chromatography (GC) and liquid chromatography (LC) coupled with tandem mass spectrometry (MS/MS). The aim of this review is to give an overview of chromatographic and spectroscopic methods when characterizing low- and medium-molecular weight organic pollutants, mainly focusing on pharmaceuticals, biocides, and personal care products in environmental matrices