Early switch to nilotinib in a case of non-optimal response to imatinib

We report a case of excellent response to nilotinib in a 22 years old man with chronic myeloid leukemia in suboptimal response to imatinib. After diagnosis he started cytoreductive therapy with cytarabine and hydroxyurea, then he begun therapy with imatinib 400 mg/day. After 3 months of treatment, he obtained a complete hematologic response (CHR) and a minor cytogenetic response (minor CyR). At 6 months CHR was confirmed, but bone marrow analysis showed increasing number of Ph+ cells (minimal CyR) and non significant reduction of BCR-ABL levels. According to ELN (European LeukemiaNet) guidelines, this is considered a suboptimal response. Clonal evolution, kinase domain mutations and reduced drug intake were excluded, thus we decided to early switch to nilotinib at 400 mg/BID. After 3 months of treatment we obtained a complete cytogenetic response (CCyR) and a strong reduction of BCR-ABL transcript, almost reaching a major molecular response (MMR)

Early switch to nilotinib in a case of non-optimal response to imatinib

We report a case of excellent response to nilotinib in a 22 years old man with chronic myeloid leukemia in suboptimal response to imatinib. After diagnosis he started cytoreductive therapy with cytarabine and hydroxyurea, then he begun therapy with imatinib 400 mg/day. After 3 months of treatment, he obtained a complete hematologic response (CHR) and a minor cytogenetic response (minor CyR). At 6 months CHR was confirmed, but bone marrow analysis showed increasing number of Ph+ cells (minimal CyR) and non significant reduction of BCR-ABL levels. According to ELN (European LeukemiaNet) guidelines, this is considered a suboptimal response. Clonal evolution, kinase domain mutations and reduced drug intake were excluded, thus we decided to early switch to nilotinib at 400 mg/BID. After 3 months of treatment we obtained a complete cytogenetic response (CCyR) and a strong reduction of BCR-ABL transcript, almost reaching a major molecular response (MMR)

An Automated Platform for Phytoplankton Ecology and Aquatic Ecosystem Monitoring

High quality monitoring data are vital for tracking and understanding the causes of ecosystem change. We present a potentially powerful approach for phytoplankton and aquatic ecosystem monitoring, based on integration of scanning flow-cytometry for the characterization and counting of algal cells with multiparametric vertical water profiling. This approach affords high-frequency data on phytoplankton abundance, functional traits and diversity, coupled with the characterization of environmental conditions for growth over the vertical structure of a deep water body. Data from a pilot study revealed effects of an environmental disturbance event on the phytoplankton community in Lake Lugano (Switzerland), characterized by a reduction in cytometry-based functional diversity and by a period of cyanobacterial dominance. These changes were missed by traditional limnological methods, employed in parallel to high-frequency monitoring. Modeling of phytoplankton functional diversity revealed the importance of integrated spatiotemporal data, including circadian time-lags and variability over the water column, to understand the drivers of diversity and dynamic processes. The approach described represents progress toward an automated and trait-based analysis of phytoplankton natural communities. Streamlining of high-frequency measurements may represent a resource for understanding, modeling and managing aquatic ecosystems under impact of environmental change, yielding insight into processes governing phytoplankton community resistance and resilience

Exploring the Remediation of Behavioral Disturbances of Spatial Cognition in Community-Dwelling Senior Citizens with Mild Cognitive Impairment via Innovative Technological Apparatus (BDSC-MCI Project): Protocol for a Prospective, Multi-Center Observational Study

Spatial navigation (SN) has been reported to be one of the first cognitive domains to be affected in Alzheimer’s disease (AD), which occurs as a result of progressive neuropathology involving specific brain areas. Moreover, the epsilon 4 isoform of apolipoprotein-E (APOE-ε4) has been associated with both sporadic and familial late-onset AD, and patients with mild cognitive impairment (MCI) due to AD are more likely to progressively deteriorate. Spatial navigation performance will be examined on a sample of 76 community-dwelling senior citizens (25 healthy controls; 25 individuals with subjective cognitive decline (SCD); and 26 patients with MCI due to AD) via a virtual computer-based task (i.e., the AppleGame) and a naturalistic task (i.e., the Detour Navigation Test—modified version) for which a wearable device with sensors will be used for recording gait data and revealing physiological parameters that may be associated with spatial disorientation. We expect that patients with MCI due to AD and APOE-ε4 carriers will show altered SN performances compared to individuals with SCD and healthy controls in the experimental tasks, and that VR testing may predict ecological performance. Impaired SN performances in people at increased risk of developing AD may inform future cognitive rehabilitation protocols for counteracting spatial disorientation that may occur during elders’ traveling to unfamiliar locations. The research protocol has been approved by the Ethics Committee of the Istituto Auxologico Italiano. Findings will be published in peer-reviewed medical journals and discussed in national and international congresses