31 research outputs found

    Inter- and Intra-specific variability in functional traits of seedlings planted in successional tropical dry forest

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    The dry tropical forests are among the most threatened ecosystems in the world; they have been degraded and removed due to commercial values and cattle ranges. Restoration projects have gained global importance, including in Costa Rica where large restoration efforts have been started since 1970s. However, previous restoration projects have scored limited success in several areas due to species mismatch with the prevailing site conditions. Thus, trait-based approach has been emerged as a way to identify candidate species for restoration. A trait is a morphological, anatomical, biochemical, physiological and/or phenological feature measurable at the individual level; whereas a functional trait is any trait which impacts fitness indirectly by its effects on growth, reproduction and survival. The aims of the study were to examine variation in traits within (intra-specific) and between (inter-specific) species in relation to above- (light) and below-ground (nutrient and water) resources; and if functional traits are good predictors of survival and growth of planted seedlings of four tree species, Astronium graveolens (RonRon), Dalbergia retusa (Cocobolo), Hymenaea courbaril (Guapinol), and Thouinidium decandrum (Sardino). For this purpose, a factorial experiment involving two levels of forest type (old versus young) and trenching (with versus without) was established in the forest experimental station, Horizontes, a part of Conservation area of Guanacaste. There were four plots in each forest type, and four seedlings of each species were planted in May 2013 in each sub-plot. Leaf- and stem functional traits and survival rate were assessed two years post-planting while root collar diameter and height of seedlings were recorded for two consecutive years post-planting. Two-way analysis of variance (ANOVA) was performed to determine significant differences in intra-specific trait variabilities while three-way ANOVA was performed to determine differences in traits and seedling performance among species and treatments. To examine whether traits can predict field performance of planted seedlings, correlation analyses were performed between traits and seedling growth variables. The results showed that intra-specific leaf and stem traits did not vary significantly between forest types and trenching treatment for all the studied species, except A. graveolens for which specific leaf area was significantly higher (p = 0.015) for seedlings planted under old- than young forest. Three-way ANOVA showed highly significant differences in leaf- and stem traits among species (p < 0.01), except stem dry matter content (p = 0.209). Leaf thickness, leaf dry matter content and specific leaf area did also significantly vary between forest types (p < 0.05) but not between trenching treatments and interactions between species, forest type and trenching treatments. The mean stem specific density, leaf dry matter content and leaf density were lower while specific leaf area was higher for D. retusa than other species. H. courbaril had higher leaf thickness than the rest of the species. For A. graveolens and T. decandrum, stem specific density, specific leaf area, leaf dry matter content and leaf density did not differ significantly. Among the traits analysed, leaf thickness and leaf dry matter content were significantly higher for seedlings planted in young- than old forest; whereas specific leaf area was significantly lower for seedlings planted in young- than old forest. The trenching treatment (with versus without) had no effect on inter-specific traits. The correlation between inter-specific traits and seedling growth was significant for most of the traits analysed. Seedling height and root collar diameter during the first two years post-planting significantly and positively correlated with leaf thickness and negatively with specific leaf area. The current annual increment in height (CAIH) and root collar diameter (CAID) were positively correlated with leaf density and leaf dry matter content but negatively correlated with specific leaf area. Correlation analysis between intra-specific traits and seedling growth was also performed; and significant correlation was found between leaf thickness and stem dry matter content with seedling growth in three out of four species; especially leaf thickness was correlated with both diameter and height growth of two out of four species. In conclusion, this study highlights the importance of functional traits when looking on survival and growth of different species in different environmental conditions. This new trait-based approach is shown to predict survival and growth and thereby can be used as a possible guide for future restoration projects in similar climatic- and environmental conditions. As sample sizes were few in the present study, I recommend further research using larger sample size for each treatment (sub-plot) and more species to be able to identify the best predictive traits.Den tropiska torrskogen Àr en av de mest hotade ekosystemen i vÀrlden. De har degraderats och arealen minskar pÄ grund av skogarnas kommersiella vÀrden, ökad odling av jordbruksgrödor och boskapsskötsel. Restaureringsprojekt har fÄtt global betydelse, dÀribland i Costa Rica dÀr stora restaureringsinsatser inleddes pÄ 1970-talet. Emellertid har restaureringsprojekten visat begrÀnsad framgÄng inom flera omrÄden pÄ grund av att anvÀnda arter varit i obalans med rÄdande förhÄllanden pÄ platsen. SÄlunda har ett egenskaps-baserat tillvÀgagÄngssÀtt vuxit fram som ett sÀtt att identifiera kandidatarter för restaurering. Egenskaper av betydelse i sammanhanget kan vara morfologiska, anatomiska, biokemiska, fysiologiska och fenologiska, mÀtbara pÄ individnivÄ. En funktionell egenskap Àr en egenskap som pÄverkar lÀmpligheten indirekt genom dess effekter pÄ tillvÀxt, reproduktion och överlevnad. Syftet med studien var att undersöka variationer i egenskaper inom arten (intra-specifik) och mellan arter (inter-specifika) i förhÄllande till ovanjordiska- (ljus) och underjordiska (nÀringsÀmnen och vatten) resurser, samt om de funktionella egenskaperna Àr goda prediktorer för överlevnad och tillvÀxt av planterade plantor av fyra trÀdslag, Astronium graveolens (Ronron), Dalbergia retusa (Cocobolo), Hymenaea courbaril (Guapinol), och Thouinidium decandrum (Sardino). För detta ÀndamÄl lades ett faktorsexperiment ut i tvÄ skogstyper (gammal eller ung), med eller utan rotisolering (diken) i försöksskogar i Horizontes, en del av ett naturvÄrdsomrÄde i Guanacaste, Costa Rica. PÄ fyra ytor i varje skogstyp planterades fyra plantor av varje art i maj 2013. Blad- och stamfunktionella egenskaper och överlevnad mÀttes tvÄ Är efter plantering och rothalsdiameter och höjd mÀttes varje Är under tvÄ Är efter plantering. TvÄ-vÀgs variansanalys (ANOVA) anvÀndes för att berÀkna skillnader i variation i inomartsspecifika egenskaper, och trevÀgs ANOVA anvÀndes för att berÀkna skillnader i variation i egenskaper mellan arter och behandlingar. För att undersöka om egenskaper kan förutsÀga överlevnad och tillvÀxt i fÀlt för planterade plantor utfördes korrelationsanalyser mellan egenskaper och tillvÀxtvariabler. Resultaten visar att inomartsspecifika blad- och stamegenskaper inte varierar signifikant mellan skogstyper och dikningsbehandlingar för alla studerade arter, förutom för A. graveolens för vilken den specifika bladytan var signifikant högre (p = 0,015) för plantor planterade i den Àldre skogstypen Àn i ungskog. TrevÀgs ANOVA visade starka signifikanta skillnader i blad- och stamegenskaper mellan arter (p <0,01), förutom stamtorrsubstanshalt (p = 0,209). Bladtjocklek, bladtorrsubstanshalt och specifik bladyta varierade signifikant mellan skogstyper (p <0,05), men inte mellan dikningsbehandlingar och interaktioner mellan arter, skogstyp och dikningsbehandlingar. MedelvÀrdet för stamspecifik densitet, bladtorrsubstanshalt och bladdensitet var lÀgre medan specifika bladytan var högre för D. retusa jÀmfört med de andra arterna. H. courbaril hade högre bladtjocklek Àn övriga arter. Stamspecifik densitet, specifik bladyta, bladtorrsubstanshalt och bladtÀthet skilde sig inte signifikant mellan A. graveolens och T. decandrum. Bland de egenskaper som analyserades, var bladtjocklek och bladtorrsubstanshalt betydligt högre för plantor planterade i ung skog Àn i gammal skog, emedan specifik bladyta var signifikant lÀgre för plantor planterade i ung 5 skog jÀmfört med gammal skog. Rotisoleringsbehandling (med eller utan dike) hade ingen effekt pÄ mellanarts-specifika egenskaper. Korrelationen mellan inter-specifika egenskaper och planttillvÀxt var signifikant för de flesta av egenskaperna som analyserades. Planthöjd och rothalsdiameter under de tvÄ första Ären efter plantering var signifikant- och positivt korrelerat med bladtjocklek och negativt med specifik bladyta. Den nuvarande Ärliga tillvÀxten i höjd (CAIH) och rothalsdiameter (CAID) var positivt korrelerad med bladdensitet och bladtorrsubstanshalt men negativt korrelerad med specifik bladyta. Korrelationsanalys mellan intra-specifika egenskaper och planttillvÀxt utfördes ocksÄ och visar pÄ signifikant korrelation mellan bladtjocklek och stamtorrsubstanshalt med planttillvÀxt i tre av fyra arter, sÀrskilt var bladtjocklek korrelerad med bÄde diameter och höjdtillvÀxt av tvÄ av fyra arter. Sammanfattningsvis belyser denna studie vikten av funktionella egenskaper vid analys av överlevnad och tillvÀxt av olika arter under olika miljöförhÄllanden. Detta nya egenskapsbaserade tillvÀgagÄngssÀtt kan förutsÀga överlevnad och tillvÀxt och dÀrmed anvÀndas som vÀgledning för framtida restaureringsprojekt under liknande klimat- och miljöförhÄllanden. Eftersom storleken pÄ den aktuella studien var i minsta laget, rekommenderar jag ytterligare forskning med större prov-storlekar för varje behandling samt flera arter för att pÄ sÄ sÀtt kunna identifiera de bÀsta prediktiva egenskaperna

    How do different site factors affect the survival of planted tree species in a secondary rainforest on Borneo?

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    De tropiska regnskogarna Àr nÄgra av de mest komplexa och artrikaste ekosystemen i VÀrlden. Stora delar av de naturliga Dipterocarpa regnskogarna har under de senaste decennierna försvunnit helt p.g.a. Àndrad markanvÀndning (oftast jordbruk), eller degraderats till sekundÀra regnskogar p.g.a. torka, brÀnder och selektiva avverkningar. Det finns dÀrför behov av rehabilitering för att fÄ tillbaka artrikedomen i skogarna. Syftet med det hÀr kandidatarbetet Àr att titta pÄ hur överlevnaden hos plantor i ett rehabiliteringsprojekt i en sekundÀr regnskog pÄverkas av olika stÄndortsfaktorer. Min hypotes var att överlevnaden hos plantorna skulle pÄverkas beroende pÄ var man planterade plantorna och att överlevnaden skulle vara beroende av vegetationstÀthet, ljustillgÄng och topografi. Jag anvÀnde mig av material frÄn ett artdemonstrationsprojekt i INIKEAs rehabiliteringsprojektomrÄde i Sabah, Borneo, som samlats in under maj-juni 2012. Det bestod av 34 arter som slumpmÀssigt planterats ut i 34 linjer med 20 planteringspunkter i varje linje. Materialet delades in i olika grupper: Total, Shorea, Parashorea, Light hardwood och Medium och Heavy hardwood. Materialet analyserades i MINITAB 16 Statistical Software och Microsoft Excel. Jag begrÀnsade arbetet genom att titta pÄ en stÄndortsfaktor Ät gÄngen mot överlevanden. Resultatet av min studie visade att stÄndortsfaktorerna placering, lutning, vegetationstyp, krontÀckningsgrad och mark signifikant pÄverkade överlevnaden hos trÀdplantor i demoprojektet. Sannolikheten för överlevnad var lÄg i de mest lutande partierna, övre sluttningar, ungskogar och vattenleder vilket indikerar att topografin och ljustillgÄngen har pÄverkan pÄ överlevnaden. Sannolikheten för överlevnad var hög dÀr omgivande vegetation var tÀt, vilket indikerar pÄ att vegetationstÀtheten pÄverkar överlevnaden.The tropical rainforests are among the most complex and diverse ecosystems in the world. Large parts of the natural Dipterocarp rainforests have in recent decades disappeared due to land use change, or been degraded to secondary rainforests due to droughts, fires and selective logging. Therefore there is a need of rehabilitation to bring back the diversity of the forests. The aim of this bachelor thesis is to look at how the survival of seedlings in a rehabilitation project in a secondary rainforest is affected by some different site factors. My hypothesis was that the survival of the plants would be affected depending on where you planted the seedlings and that survival would be dependent on vegetation density, light availability and topography. I used material from a species demonstration project in the INIKEA rehabilitation project area in Sabah, Borneo, collected during May-June 2012. It consisted of 34 species that was randomly planted in 34 lines with 20 planting spots in each line. The material was divided into different groups: General, Shorea, Parashorea, Light hardwood and Medium- and Heavy hardwood. The material was analyzed in MINITAB 16 Statistical Software and Microsoft Excel. I limited the work by analyzing one site factor at a time against the survivor. The results of my study showed that the site factors Location, Slope, Canopy cover, Intensity and Soil significantly affected the survival of tree seedlings in the demonstration project. The probability of survival was low in sloping sections, upper edges, juvenile forests and waterways, which indicates that the topography and light availability have an impact on survival. The probability of survival was high when the surrounding vegetation was dense, indicating that vegetation density affects survival

    Critical, Engaged and Change-oriented Scholarship in Environmental Communication. Six Methodological Dilemmas to Think With

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    While calls for critical, engaged and change-oriented scholarship in environmental communication (EC) abound, few articles discuss what this may practically entail. With this article, we aim to contribute to a discussion in EC about the methodological implications of such scholarship. Based on our combined experience in EC research and drawing from a variety of academic fields, we describe six methodological dilemmas that we encounter in our research practice and that we believe are inherent to such scholarship. These dilemmas are (1) grasping communication; (2) representing others; (3) involving people in research; (4) co-producing knowledge; (5) engaging critically; and (6) relating to conflict. This article does not offer solutions to these complex dilemmas. Rather, our dilemma descriptions are meant to help researchers think through methodological issues in critical, engaged and change-oriented EC research. The article also helps to translate the dilemmas to the reality of research projects through a set of questions, aimed to support a sensitivity to, and understanding of, the dilemmas in context. critical, engaged, change-oriented, methodology, dillemmaspublishedVersio

    Long-term tolerability and efficacy after initial PegIFN-alpha addition to dasatinib in CML-CP : Five-year follow-up of the NordCML007 study

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    Objectives Treatment-free remission (TFR) has emerged as a treatment goal in chronic myeloid leukemia in the chronic phase (CML-CP). Attempts to increase proportion of patients achieving TFR include combination of tyrosine kinase inhibitors (TKI) and other drugs. Interferon-alpha in addition to TKI has shown promising efficacy but with dose-dependent toxicity and discontinuations. NordCML007 was initiated to study the efficacy and safety of low dose pegylated IFN-alpha (PegIFN-alpha) in combination with dasatinib (DAS) in CML-CP. Methods Forty patients with newly diagnosed CML-CP were given DAS upfront. After month 3 (M3) 15 mu g/wk of PegIFN-alpha was added and increased to 25 mu g/wk from M7 until M15. DAS treatment was continued and adverse events and BCR-ABL1 qRT-PCR values were reported yearly after M24. Results from M1 to M18 have previously been published, and here we present long-term data. Results After 5 years of follow-up, there were no suspected unexpected serious adverse reactions, no increase in serosal effusions, no disease progressions and no CML-related deaths. Rates of MR3.0 (MMR), MR4.0 and MR4.5 were 84.6%, 64.1% and 51.3% respectively at M60, and 95% of patients reached MMR at some point during the study. Conclusion Initial addition of PegIFN-alpha to DAS shows good long-term efficacy without increased toxicity.Peer reviewe

    IFN-α with dasatinib broadens the immune repertoire in patients with chronic-phase chronic myeloid leukemia

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    In chronic myeloid leukemia (CML), combination therapies with tyrosine kinase inhibitors (TKIs) aim to improve the achievement of deep molecular remission that would allow therapy discontinuation. IFN-alpha is one promising candidate, as it has long-lasting effects on both malignant and immune cells. In connection with a multicenter clinical trial combining dasatinib with IFN-alpha in 40 patients with chronic-phase CML (NordCML007, NCT01725204), we performed immune monitoring with single-cell RNA and T cell receptor (TCR) sequencing (n = 4, 12 samples), bulk TCR beta sequencing (n = 13, 26 samples), flow cytometry (n = 40, 106 samples), cytokine analyses (n = 17, 80 samples), and ex vivo functional studies (n = 39, 80 samples). Dasatinib drove the immune repertoire toward terminally differentiated NK and CD8+ T cells with dampened functional capabilities. Patients with dasatinib-associated pleural effusions had increased numbers of CD8(+) recently activated effector memory T (Temra) cells. In vitro, dasatinib prevented CD3-induced cell death by blocking TCR signaling. The addition of IFN-alpha reversed the terminally differentiated phenotypes and increased the number of costimulatory intercellular interactions and the number of unique putative epitope-specific TCR clusters. In vitro IFN-alpha had costimulatory effects on TCR signaling. Our work supports the combination of IFN-alpha with TKI therapy, as IFN-alpha broadens the immune repertoire and restores immunological function.Peer reviewe

    Vinter och is

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    Vinter och is – Inledaren: Och vad gör ni pĂ„ vintern dĂ„? av Pia Prost – Vinterupplevelser i skĂ€rgĂ„rdsnatur av Sanna-Mari Kunttu – HĂ„ll i er! av Alice Björklöf – Iskallt men inte dött av Tore Lindholm – Vinterlycka pĂ„ en ö av Nina Söderlund – Vintertankar frĂ„n Nötö av Ida Wulff – En isvinter Ă€r efterlĂ€ngtad av Clara Lindqvist – Med sopsĂ€ckar mot vĂ€der och vind av Nina Söderlund – Vinterfiske i Österbotten av Jessica Sundman – Ett rikt liv under isen pĂ„ Antarktis av Joanna Norkko – Nya idĂ©er i HoutskĂ€r av Ulla Mattsson-WiklĂ©n – Iskarta som kulturminne av Kristin Mattsson – Kreativa Korpo av Micaela Jansson – RĂ„gskĂ€r krigsvintern 1940 av Tuva-Stina LindĂ©n – Vinter i vilda och vackra Varanger av Tiia Kalske – Ett skepp kommer lastat med nya arter – vad sker sen? av Heidi Herlevi – En eftermiddag vid Jungfrusund av Anders Moliis-Mellberg – SkĂ€rgĂ„rdsfotograf Erik Saanila av Pia Prost – SkĂ€rinytt SkĂ€rgĂ„rdsseminarier – Bokhörnan: Aboa Mare 200 Ă„r – Sista bilde

    HyvÀ toimintatapa ryhmÀtoiminnassa - : ryhmÀmuotoisen toimintatavan kehittÀminen osana ikÀÀntyneen hoito ja kuntoutusta, HUS, Hyks vanhuspsykiatriassa

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    KehittÀmistyön tarkoituksena oli kehittÀÀ hyvÀÀ toimintatapaa ryhmÀtoiminnalle HUS, Hyks vanhuspsykiatriassa. Tutkimuksellisen kehittÀmistyön tavoitteena oli tukea iÀkkÀÀn kuntoutujan tai potilaan toimintakykyÀ kehittÀmÀllÀ ryhmÀmuotoista toimintaa. TÀssÀ tutkimuksellisessa kehittÀmistyössÀ tietokÀsitys perustui siihen, ettÀ kÀytÀntö ja teoria yhdessÀ muodostavat uutta tietoa. TÀmÀ tiedontuotantotapa korostaa tiedon kÀyttökelpoisuutta. KehittÀmistyön ensimmÀinen vaihe aloitettiin tutustumalla, teorioihin vanhenemisesta, oppimisesta, kuntoutuksesta ja ryhmÀmuotoisesta toiminnasta. Seuraavaksi perehdyttiin tutkimuksiin ikÀÀntyneiden ryhmÀtoiminnasta. Valittiin neljÀ tieteellistÀ tutkimusta, joiden valinnassa pyrkimyksenÀ oli löytÀÀ luotettavia suomalaisessa sosiaali- ja terveyspalvelujÀrjestelmÀssÀ toteutettuja tieteellisiÀ tutkimuksia, jotka sijoittuvat eri palvelusektoreille ja olivat taustoiltaan erilaisia. Valitut tutkimukset analysoitiin sisÀltölÀhtöisesti, etsien niistÀ yhtÀlÀisyyksiÀ ja eroja. Analysoinnin pohjalta syntyi synteesi, asioista, jotka keskeisesti vaikuttavat ryhmÀmuotoisen toiminnan suunnitteluun ja toteutukseen. KehittÀmistyön toisessa vaiheessa synteesi muodosti teemapohjan ryhmÀhaastatteluille, joita toteutettiin kaksi. RyhmÀhaastatteluun kutsutut olivat henkilökuntaa ja moniammatillisen työryhmÀn jÀseniÀ. HeillÀ oli suoraa tai vÀlillistÀ kokemusta ryhmÀtoiminnan vaikutuksesta hoito ja kuntoutustyössÀ vanhuspsykiatriassa. Haastattelut ÀÀnitettiin ja litteroitiin. Saatu aineisto analysoitiin sisÀllönanalyysiperiaattein. Tuloksena syntyi henkilökunnan kokemukseen perustuva nÀkemys hyvÀstÀ toimintatavasta ryhmÀtoiminnassa vanhuspsykiatriassa. HyvÀ ryhmÀtoimintatapa perustui kahdeksaan suunnittelussa ja toteutuksessa huomioita-vaan asiaan:1. Teorian yhteys kÀytÀnnön työhön. 2. Vaikutuksen arvioinnista kohti vaikut-tavuuden arviointia.3. AsiakaslÀhtöisyyden ja osallisuuden huomioiminen. 4. YmpÀristön merkitys ryhmÀtoiminnan toteuttamisessa.5. RyhmÀtoiminta tukee potilaan toimintakykyÀ. 6. Toimintakyvyn muutosten dynaamisuus. 7. Opittujen asioiden siirtyminen arkipÀivÀÀn. 8. Moniammatilliuuden merkitys. Avainsanat ryhmÀtoiminta, ikÀÀntyminen, toimintakykyThe purpose of this development work was to develop good practices for group activities within the HUS, Helsinki University Central Hospital (HUS, HUCH) geropsychiatric branch. The aim of this development work was to support the functioning of a patient or an aged person in rehabilitation, in a diverse fashion, through developing group-based activities. The epistemological base for this thesis is that knowledge is created through combining practice and theory. This way of creating knowledge emphasizes the practical applicability of knowledge. Theoretical understanding and empirical research results were needed for evaluating and examining knowledge gleaned from working practices. The first phase of this development work was to become familiar with theories on aging, learning, rehabilitation and group-based activities. The next phase was to become ac-quainted with the research on group activities for the aged. Four studies were chosen, based on the desire to find reliable Finnish research conducted within the social and health care systems, within different sectors and from different backgrounds. The studies chosen were analyzed using content analysis, to locate similarities and differences between them. A synthesis was created based on the analysis, incorporating issues central to the planning and carrying out of group activities. In the second phase of the development work, this synthesis was used as the thematic base for two thematic group interviews. The inter-viewees were staff members of a multi-professional working group, with direct or indirect experience of the impact of group activity in geropsychiatric care and rehabilitation. The interviews were recorded and transcribed. The transcribed data was analyzed using content analysis. As a result, a view of good practice for group activity in geropsychiatrics was formed, based on the experience of care staff. Good practice was seen as based on eight aspects to be taken into account in the planning and implementation of group activity: 1. The connection between theory and practice 2. From effect evaluation towards impact evaluation 3. The connection between patient-oriented practices and participative agency 4. The impact of the environment to implement-ing group activities 5. Group activity supports the functioning of the patient 6. The dynamic nature of the changes in the ability to function 7. Transferring the learned content into eve-ryday practice 8. The meaning of multi-professionalism Keywords Group activity, aging, ability of functio

    Clinical and Immunological Studies in Chronic Myeloid Leukaemia

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    Chronic myeloid leukaemia (CML) is characterised by the constitutively active tyrosine kinase BCR-ABL. Standard treatment with tyrosine kinase inhibitors (TKI) in the chronic phase (CP) of CML conveys excellent long-term prognosis but is associated with side effects and costs. Treatment free remission (TFR) is possible in a proportion of patients discontinuing treatment after obtaining deep treatment responses but it is not fully known how to select the right patients for stopping attempts. Treatment of accelerated phase (AP) and blast crisis (BC) is more complicated and the prognosis more dismal. In this thesis, we have studied factors of importance for outcome in CML patients with focus on immunological factors and clinical management. In a cohort of 32 newly diagnosed CP-CML patients, evidence of active immune escape mechanisms were found. These declined with the course of TKI treatment and at the same time, effector lymphocyte responses were elicited. These anti-leukaemia immune responses might help in the long-term control of CML. Multiple plasma protein markers were also measured with three multiplex platforms in a smaller cohort of patients (n=14). Inflammatory cytokines and other plasma proteins were affected by TKI treatment and multiplexing seems useful for finding potential biomarkers with biologic or prognostic significance in CML. Patients progressing to AP/BC were studied in a population-based material from the Swedish CML register. Approximately 4% of TKI-treated CP-CML patients transformed to AP/BC within 2 years of diagnosis. Monitoring of treatment responses was suboptimal in 1/3 of these patients and the median survival was 1.4 years after diagnosis of AP/BC. Thus, minimising the risk of disease progression through strict adherence to guidelines for monitoring and treatment is essential. In a cohort of patients (n=50) discontinuing TKI treatment within a large European trial, musculoskeletal pain was reported by 30% of patients, starting within 1- 6 weeks of TKI discontinuation and spontaneously resolving over time in most cases. Patients (n=56) were also evaluated with a multiplex platform with a total of 162 inflammation- and cancer-related plasma proteins. No predictive protein biomarkers for successful TKI discontinuation could be found. However, profound effects of TKI-treatment were seen and plasma proteomics could be useful for understanding effects of long-term TKI-treatment
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