173 research outputs found
The Phase-Contrast Imaging Instrument at the Matter in Extreme Conditions Endstation at LCLS
We describe the Phase-Contrast Imaging instrument at the Matter in Extreme
Conditions (MEC) endstation of the Linac Coherent Light Source. The instrument
can image phenomena with a spatial resolution of a few hundreds of nanometers
and at the same time reveal the atomic structure through X-ray diffraction,
with a temporal resolution better than 100 femtosecond. It was specifically
designed for studies relevant to High-Energy-Density Science and can monitor,
e.g., shock fronts, phase transitions, or void collapses. This versatile
instrument was commissioned last year and is now available to the MEC user
community
an ALWP-EBMT study
Background Allogeneic stem cell transplantation is the only curative option
for patients with acute myeloid leukemia (AML) experiencing relapse. Either
matched sibling donor (MSD) or unrelated donor (UD) is indicated. Methods We
analyzed 1554 adults with AML transplanted from MSD (n = 961) or UD (n = 593,
HLA-matched 10/10, n = 481; 9/10, n = 112). Compared to MSD, UD recipients
were older (49 vs 52 years, p = 0.001), transplanted more recently (2009 vs
2006, p = 0.001), and with a longer interval to transplant (10 vs 9 months, p
= 0.001). Conditioning regimen was more frequently myeloablative for patients
transplanted with a MSD (61 vs 46 %, p = 0.001). Median follow-up was 28
(range 3–157) months. Results Cumulative incidence (CI) of neutrophil
engraftment (p = 0.07), grades II–IV acute GVHD (p = 0.11), chronic GVHD (p =
0.9), and non-relapse mortality (NRM, p = 0.24) was not different according to
the type of donor. At 2 years, CI of relapse (relapse incidence (RI)) was 57
vs 49 % (p = 0.001). Leukemia-free survival (LFS) at 2 years was 21 vs 26 % (p
= 0.001), and overall survival (OS) was 26 vs 33 % (p = 0.004) for MSD vs UD,
respectively. Chronic GVHD as time-dependent variable was associated with
lower RI (HR 0.78, p = 0.05), higher NRM (HR 1.71, p = 0.001), and higher OS
(HR 0.69, p = 0.001). According to HLA match, RI was 57 vs 50 vs 45 %, (p =
0.001) NRM was 23 vs 23 vs 29 % (p = 0.26), and LFS at 2 years was 21 vs 27 vs
25 % (p = 0.003) for MSD, 10/10, and 9/10 UD, respectively. In multivariate
analysis adjusted for differences between the two groups, UD was associated
with lower RI (HR 0.76, p = 0.001) and higher LFS (HR 0.83, p = 0.001)
compared to MSD. Interval between diagnosis and transplant was the other
factor associated with better outcomes (RI (HR 0.62, p < 0.001) and LFS (HR
0.67, p < 0.001)). Conclusions Transplantation using UD was associated with
better LFS and lower RI compared to MSD for high-risk patients with AML
transplanted in first relapse
What is the outcome of patients with acute leukemia who survive severe acute graft-versus-host disease?
Allogeneic hematopoietic stem cell transplantation for secondary acute myeloid leukemia: a report from the Acute Leukemia Working Party of the EBMT
Secondary AML is an independent risk factor for outcome after SCT in First complete remission: a registry-based comparison to de novo AML on behalf of the EBMT acute leukemia working party
Allogeneic stem cell transplantation using HLA-matched donors for acute myeloid leukemia with deletion 5q or monosomy 5 : a study from the Acute Leukemia Working Party of the EBMT
Deletion 5q or monosomy 5 (-5/5q-) in acute myeloid leukemia (AML) is a common high-risk feature that is referred to allogeneic stem cell transplantation. However, -5/5q- is frequently associated with other high-risk cytogenetic aberrations such as complex karyotype, monosomal karyotype, monosomy 7 (-7), or 17p abnormalities (abn (17p)), the significance of which is unknown. In order to address this question, we studied adult patients with AML harboring -5/5q- having their first allogeneic transplantation between 2000 and 2015. Five hundred and one patients with -5/5q- have been analyzed. Three hundred and thirty-eight patients (67%) were in first remission and 142 (28%) had an active disease at time of allogeneic transplantation. The 2-year probabilities of overall survival and leukemia-free survival were 27% and 20%, respectively. The 2-year probability of treatment-related mortality was 20%. We identified four different cytogenetic groups according to additional abnormalities with prognostic impact: -5/5q- without complex karyotype, monosomal karyotype or abn(17p), -5/5q- within a complex karyotype, -5/5q- within a monosomal karyotype and the combination of -5/5q- with abn(17p). In multivariate analysis, factors associated with worse overall survival and leukemia-free survival across the four groups were active disease, age, monosomal karyotype, and abn(17p). The presence of -5/5q- without monosomal karyotype or abn(17p) was associated with a significantly better survival rate while -5/5q- in conjunction with monosomal karyotype or abn(17p) translated into a worse outcome. The patients harboring the combination of -5/5q- with abn(17p) showed very limited benefit from allogeneic transplantation.Peer reviewe
Inferior outcome of allogeneic stem cell transplantation for secondary acute myeloid leukemia in first complete remission as compared to de novo acute myeloid leukemia
Following chemotherapy, secondary acute myeloid leukemia (sAML), occurring after antecedent hematologic diseases, previous chemotherapy or radiation, has an inferior prognosis compared with de novo AML. To define the outcome of sAML in the context of allogeneic stem cell transplantation (alloSCT), a retrospective, registry-based comparison was performed, including 11,439 patients with de novo and 1325 with sAML. Among transplants in first complete remission (CR1) (n = 8,600), the 3-year cumulative incidence of relapse (RI) and non-relapse mortality (NRM) was 28.5% and 16.4% for de novo, and 35% and 23.4% for sAML. Three-year overall survival (OS), leukemia-free survival (LFS) and Graft-versus-Host Disease/relapse-free survival (GRFS) was 60.8%, 55.1%, and 38.6% for de novo, and 46.7%, 41.6%, and 28.4% for sAML, respectively. In multivariate analysis, sAML was associated with a lower OS (HR = 1.33 [95% CI = 1.21-1.48]; p <10(-5)), LFS (HR = 1.32 [95% CI = 1.19-1.45]; p <10(-5)) and GRFS (HR = 1.2 [95% CI = 1.1-1.31]; p <10(-4)) and higher NRM (HR = 1.37 [95% CI = 1.17-1.59]; p <10(-4)) and RI (HR = 1.27 [95% CI = 1.12-1.44]; p <10(-3)). Results of the Cox model were confirmed in a matched-pair analysis. In contrast, results did not differ between de novo and sAML after alloSCT in induction failure or relapse. Hence, this analysis identified sAML as an independent risk factor for outcome after alloSCT in CR1.Peer reviewe
The impact of concomitant cytogenetic abnormalities on acute myeloid leukemia with monosomy 7 or deletion 7q after HLA-matched allogeneic stem cell transplantation
Monosomy 7 or deletion 7q (-7/7q-) is the most frequent adverse cytogenetic features reported in acute myeloid leukemia (AML), and is a common indication for allogeneic stem cell transplantation (SCT). Nevertheless, -7/7q- occurs frequently with other high-risk cytogenetic abnormalities such as complex karyotype (CK), monosomal karyotype (MK), monosomy 5 or deletion 5q (-5/5q-), 17p abnormalities (abn(17p)) or inversion of chromosome 3 (inv(3)), the presence of which may influence the outcomes after SCT. A total of 1109 patients were allocated to this study. Two-year probability of leukemia-free survival (LFS) and overall survival (OS) were 30% and 36%, respectively. Two-year probability of non-relapse mortality (NRM) was 20%. We defined five different cytogenetic subgroups: the "-7/7q- +/- CK group- designated group1," the "MK group-designated group 2," the "-5/5q- group- designated group 3," the "abn(17p) group- designated group 4" and the "inv(3) group- designated group 5." The 2-year probability of LFS in first remission was 48% for group 1, 36.4% for group 2, 28.4% for group 3, 19.1% for group 4 and 17.3% for group 5, respectively (P <.001). Multivariate analysis confirmed those significant differences across groups. Note, SCT in -7/7q- AML provides durable responses in one third of the patients. The presence of -7/7q- with or without CK in the absence of MK, abn(17p) or inv (3) is associated with a better survival after SCT. On the contrary, addition of MK, -5/5q-, abn(17p) or inv(3) identifies a sub-group of patients with poor prognosis even after SCT.Peer reviewe
- …