Predicting Survival after Allogeneic Hematopoietic Cell Transplantation in Myelofibrosis : Performance of the Myelofibrosis Transplant Scoring System (MTSS) and Development of a New Prognostic Model

Accurate prognostic tools are crucial to assess the risk/benefit ratio of allogeneic hematopoietic cell transplantation (allo-HCT) in patients with myelofibrosis (MF). We aimed to evaluate the performance of the Myelofibrosis Transplant Scoring System (MTSS) and identify risk factors for survival in a multicenter series of 197 patients with MF undergoing allo-HCT. After a median follow-up of 3.1 years, 47% of patients had died, and the estimated 5-year survival rate was 51%. Projected 5-year risk of nonrelapse mortality and relapse incidence was 30% and 20%, respectively. Factors independently associated with increased mortality were a hematopoietic cell transplantation-specific comorbidity index (HCT-CI) ≥3 and receiving a graft from an HLA-mismatched unrelated donor or cord blood, whereas post-transplant cyclophosphamide (PT-Cy) was associated with improved survival. Donor type was the only parameter included in the MTSS model with independent prognostic value for survival. According to the MTSS, 3-year survival was 62%, 66%, 37%, and 17% for low-, intermediate-, high-, and very high-risk groups, respectively. By pooling together the low- and intermediate-risk groups, as well as the high- and very high-risk groups, we pinpointed 2 categories: standard risk and high risk (25% of the series). Three-year survival was 62% in standard-risk and 25% in high-risk categories (P <.001). We derived a risk score based on the 3 independent risk factors for survival in our series (donor type, HCT-CI, and PT-Cy). The corresponding 5-year survival for the low-, intermediate-, and high-risk categories was 79%, 55%, and 32%, respectively (P <.001). In conclusion, the MTSS model failed to clearly delineate 4 prognostic groups in our series but may still be useful to identify a subset of patients with poor outcome. We provide a simple prognostic scoring system for risk/benefit considerations before transplantation in patients with MF

Role of age and comorbidities in mortality of patients with infective endocarditis

Purpose: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. Methods: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015. Patients were stratified into three age groups:<65 years, 65 to 80 years, and = 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. Results: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 = 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients =80 years who underwent surgery were significantly lower compared with other age groups (14.3%, 65 years; 20.5%, 65-79 years; 31.3%, =80 years). In-hospital mortality was lower in the <65-year group (20.3%, <65 years;30.1%, 65-79 years;34.7%, =80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%, =80 years; p = 0.003).Independent predictors of mortality were age = 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI = 3 (HR:1.62; 95% CI:1.39–1.88), and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared, the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. Conclusion: There were no differences in the clinical presentation of IE between the groups. Age = 80 years, high comorbidity (measured by CCI), and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group

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Separation of Oxygen and Nitrogen by Porous Cyanometallates

The adsorption-based separation in porous solids takes place through steric, kinetic, or equilibrium effect selectivity. In this contribution the oxygen-nitrogen separation by four porous frameworks representative of cyanometallates was studied by inverse gas chromatography. The following materials were considered: Cd3[Co(CN)6]2 (cubic), Zn3[Co(CN)6]2 (rhombohedral), Zn3K2 [Fe(CN)6]2 (rhombohedral) and Co[Fe(CN)5NO] (cubic). Chromatographic separation profiles from gases mixtures using columns of these materials were recorded. For columns prepared from rhombohedral zinc hexacyanocolbaltate(III) excellent separation of O2 and N2 was observed. Such behavior was attributed to a kinetic-based selectivity related to the size and shape for the pore windows of this material. The porous framework of this zinc phase is formed by ellipsoidal cavities (12.5 9 8A˚ ) communicated by elliptical windows of 5A˚ . For Cd3[Co(CN)6]2 and Co[Fe(CN)5 NO] also kinetic-based selectivity was observed while for Zn3K2[Fe(CN)6]2 the Kþ ion located close to the cavity windows hinders the porous windows accessibility for nitrogen and oxygen molecules. All the samples to be studied were characterized from X-ray diffraction, infrared spectroscopy, termogravimetric and adsorption data

A new felsic cone-sheet swarm in the Central Atlantic Islands: The cone-sheet swarm of Boa Vista (Cape Verde)

The island of Boa Vista is one of the oceanic islands with the largest amount of felsic rocks reported in the world (50% of the total outcropping igneous rocks of Boa Vista). The felsic rocks are trachytes and phonolites generated within the second main stage of the volcanic activity that lasted about four million years. Three consecutive felsic episodes are distinguished: the first occurred between 14.5Ma and 13.5Ma, the second between 13.6 Ma and 12.0 Ma, and the third and last between 12.0 Ma and 10.4Ma. Their geochemical composition reveals the presence of crystal fractionation processeswith participation of feldspars andamphibole aswell as different accessory phases involved in each episode. The Boa Vista felsic cone-sheet swarm, the youngest third episode, is formed by several hundreds of peralkaline ne-phonolitic sheets distributedwithin a circular surface about 11 kmin radius. The cone-sheets conforma single general pattern characterized by a decreasing dip outward the structure, together with a constant dip of each individual sheet. The average inclination of sheets is around 40° in the sectors next to the centre of the structure whereas it is only about 30° next to its periphery. The magmatic focus of the sheets is located over 3 km deep almost coinciding with the convergence centre of a contemporary basic radial dike swarm