Testing the Meson Cloud Model in Inclusive Meson Production

We have applied the Meson Cloud Model to calculate inclusive momentum spectra of pions and kaons produced in high energy proton-proton and proton-nucleus collisions. For the first time these data are used to constrain the cloud cut-off parameters. We show that it is possible to obtain a reasonable description of data, especially the large $x_F$ ($x_F \geq 0.2$) part of the spectrum and at the same time describe (partially) the E866 data on $\bar d - \bar u$ and $\bar d / \bar u$. We also discuss the relative strength of the $\pi N$ and $\pi \Delta$ vertices. We find out that the corresponding cut-off parameters should be both soft and should not differ by more than 200 MeV from each other. An additional source (other than the meson cloud) of sea antiquark asymmetry, seems to be necessary to completely explain the data. A first extension of the MCM to proton nucleus collisions is discussed.Comment: 14 pages, Latex, 6 ps figures. Submitted to Phys. Rev.

Pembrolizumab as Consolidation Strategy in Patients with Multiple Myeloma: Results of the GEM-Pembresid Clinical Trial

PD1 expression in CD4+ and CD8+ T cells is increased after treatment in multiple myeloma patients with persistent disease. The GEM-Pembresid trial analyzed the efficacy and safety of pembrolizumab as consolidation in patients achieving at least very good partial response but with persistent measurable disease after first- or second-line treatment. Moreover, the characteristics of the immune system were investigated to identify potential biomarkers of response to pembrolizumab. One out of the 17 evaluable patients showed a decrease in the amount of M-protein, although a potential late effect of high-dose melphalan could not be ruled out. Fourteen adverse events were considered related to pembrolizumab, two of which (G3 diarrhea and G2 pneumonitis) prompted treatment discontinuation and all resolving without sequelae. Interestingly, pembrolizumab induced a decrease in the percentage of NK cells at cycle 3, due to the reduction of the circulating and adaptive subsets (0.615 vs. 0.43, p = 0.007; 1.12 vs. 0.86, p = 0.02). In the early progressors, a significantly lower expression of PD1 in CD8+ effector memory T cells (MFI 1327 vs. 926, p = 0.03) was observed. In conclusion, pembrolizumab used as consolidation monotherapy shows an acceptable toxicity profile but did not improve responses in this MM patient population. The trial was registered at clinicaltrials.gov with identifier NCT02636010 and with EUDRACT number 2015-003359-23.This study was funded by Fundación Ramón Areces (FRA 16/003). T.P. is supported by a grant from the AECC (INVES18043PAIN). This study received financial support from Merck Sharp & Dohme of Spain, a subsidiary of Merck & Co., Inc., Whitehouse Station, New Jersey, USA

Pembrolizumab as consolidation strategy in patients with multiple myeloma: Results of the GEM-Pembresid clinical trial

PD1 expression in CD4+ and CD8+ T cells is increased after treatment in multiple myeloma patients with persistent disease. The GEM-Pembresid trial analyzed the efficacy and safety of pembrolizumab as consolidation in patients achieving at least very good partial response but with persistent measurable disease after first- or second-line treatment. Moreover, the characteristics of the immune system were investigated to identify potential biomarkers of response to pembrolizumab. One out of the 17 evaluable patients showed a decrease in the amount of M-protein, although a potential late effect of high-dose melphalan could not be ruled out. Fourteen adverse events were considered related to pembrolizumab, two of which (G3 diarrhea and G2 pneumonitis) prompted treatment discontinuation and all resolving without sequelae. Interestingly, pembrolizumab induced a decrease in the percentage of NK cells at cycle 3, due to the reduction of the circulating and adaptive subsets (0.615 vs. 0.43, p = 0.007; 1.12 vs. 0.86, p = 0.02). In the early progressors, a significantly lower expression of PD1 in CD8+ effector memory T cells (MFI 1327 vs. 926, p = 0.03) was observed. In conclusion, pembrolizumab used as consolidation monotherapy shows an acceptable toxicity profile but did not improve responses in this MM patient population. The trial was registered at clinicaltrials.gov with identifier NCT02636010 and with EUDRACT number 2015-003359-23

Explorando la celula de origen y los programas transcripcionales patologicos en mieloma multiple (MM) y amiloidosis de cadena ligera (AL) mediante la diseccion del desarrollo de la celula plasmatica (CP) normal

CO-009 MM y AL son las dos gammapatias monoclonales malignas más comunes. Los intentos para identificar las diferencias genéticas entre ambas han tenido poco éxito. Además, se desconoce si MM y AL emergen del mismo compartimento de CPs normales. Nos proponemos definir el atlas trancripcional del desarrollo de la CP normal en sangre periférica (SP) y medula ósea (MO), y compararlo con el programa transcripcional de las CPs clonales de MM y AL. Se estudiaron 93 individuos, en 7 donantes sanos (DS), se aislaron CP de SP según su isotipo de cadena pesada (IgG, IgA and IgM). Adicionalmente, se obtuvieron 5 subpoblaciones de CP de MO basadas en la expresión de CD19, CD39, CD81 y CD56. Las CPs clonales de pacientes con MM (n=38) y AL (n=41) se separaron mediante FACS por fenotipo aberrante especifico de paciente. Para estudiar poblaciones de CP con un reducido numero de células aisladas, empleamos un método de RNAseq de alta sensibilidad (MARS-seq). Se realizaron todas las comparaciones pareadas posibles de expresión diferencial (Deseq2). Se generaron datos de expresión mediante single-cell RNAseq (scRNAseq, 10xGenomics) de un total de 35, 910 PCs de 3 HA, 2 MM and 2 AL, que fueron analizados de manera integrada con el paquete Seurat en R. ..

Flow cytometry for fast screening and automated risk assessment in systemic light-chain amyloidosis

Early diagnosis and risk stratification are key to improve outcomes in light-chain (AL) amyloidosis. Here we used multidimensional-flow-cytometry (MFC) to characterize bone marrow (BM) plasma cells (PCs) from a series of 166 patients including newly-diagnosed AL amyloidosis (N = 94), MGUS (N = 20) and multiple myeloma (MM, N = 52) vs. healthy adults (N = 30). MFC detected clonality in virtually all AL amyloidosis (99%) patients. Furthermore, we developed an automated risk-stratification system based on BMPCs features, with independent prognostic impact on progression-free and overall survival of AL amyloidosis patients (hazard ratio: ≥ 2.9;P ≤ .03). Simultaneous assessment of the clonal PCs immunophenotypic protein expression profile and the BM cellular composition, mapped AL amyloidosis in the crossroad between MGUS and MM; however, lack of homogenously-positive CD56 expression, reduction of B-cell precursors and a predominantly-clonal PC compartment in the absence of an MM-like tumor PC expansion, emerged as hallmarks of AL amyloidosis (ROC-AUC = 0.74;P < .001), and might potentially be used as biomarkers for the identification of MGUS and MM patients, who are candidates for monitoring pre-symptomatic organ damage related to AL amyloidosis. Altogether, this study addressed the need for consensus on how to use flow cytometry in AL amyloidosis, and proposes a standardized MFC-based automated risk classification ready for implementation in clinical practice