CDMA, OFDM, MC-CDMA, quel choix pour une voie descendante ?

Cet article propose une démarche comparative de différentes formes d'onde candidates pour une voie descendante de radiocommunications. Partant d'un formalisme général pour le DS-CDMA, l'OFDM et le MC-CDMA, les comportements de ces formes d'onde vis à vis d'erreurs de fréquence ou de bruit de phase sont analysés

OFDM and CDMA, unified approach and channel-matched spreading codes generation algorithm

In this paper TDMA, CDMA, MC-CDMA and OFDM are presented through an unified formalism. The cyclic prefix insertion is extended to all approaches presented and not only restricted to OFDM. Many fundamental results are highlighted. It is for example shown that if we are looking for a family of orthogonal spreading sequences being yet orthogonal after a one chip delay then we have not another choice than OFDM. Different kind of receivers, involving a same « channel » matrix, are presented : OFDM receiver, Rake receiver and MMSE receiver. All these receivers involve a same channel matrix representing the effect of the propagation channel, the cyclic prefix insertion and its suppression. Finally an algorithm for generating spreading sequences matched to a given propagation channel is introduced. Spreading sequences generated having unequal transmission properties, a power and modulation allocation algorithm is introduced for them. Performances obtained are then very close to those obtained through the OFDM approach.Cet article s'appuie sur un formalisme matriciel qui permet de présenter les approches TDMA, CDMA, MC-CDMA et OFDM de manière unifiée. La formalisation généralise l'emploi du préfixe cyclique, initialement réservé à l'OFDM, à toutes ces approches. Elle permet de mettre en lumière plusieurs résultats fondamentaux de manière très rapide. On montre ainsi que si l'on cherche des séquences d'étalement CDMA qui sont orthogonales et dont l'orthogonalité résiste à une imprécision temporelle d'un élément de la séquence alors, obligatoirement, ces séquences sont les sinusoïdes complexes utilisées en OFDM. On développe ensuite les différentes formes possibles des récepteurs. Le récepteur MMSE, le récepteur RAKE et le récepteur classiquement utilisé dans le cas de l'OFDM sont exprimés en faisant intervenir une même matrice « canal » qui intègre à elle seule l'insertion du préfixe cyclique, la convolution par la réponse impulsionnelle du canal et la suppression du préfixe cyclique. Enfin, dans le cas d'un canal connu, on introduit une méthode de conception de séquences d'étalement adaptées au canal. Les séquences de cette famille affichant des performances de transmission inégales, on propose alors de leur appliquer, comme on le fait pour l'OFDM, un algorithme d'allocation de puissances d'émission et de schémas de modulation. On montre alors que les performances de transmission obtenues sont comparables à celles de l'OFDM

Antithymocyte globulins and chronic graft-vs-host disease after myeloablative allogeneic stem cell transplantation from HLA-matched unrelated donors: a report from the Sociéte Française de Greffe de Moelle et de Thérapie Cellulaire.

International audienceThis retrospective report assessed the impact of rabbit antithymocyte globulins (ATG), incorporated within a standard myeloablative conditioning regimen prior to allogeneic stem cell transplantation (allo-SCT) using human leukocyte antigen-matched unrelated donors (HLA-MUD), on the incidence of acute and chronic graft-vs-host disease (GVHD). In this series of leukemia patients, 120 patients (70%) did not receive ATG ('no-ATG' group), whereas 51 patients received ATG ('ATG' group). With a median follow-up of 30.3 months, the cumulative incidence of grade 3-4 acute GVHD was 36% in the no-ATG group and 20% in the ATG group (P = 0.11). The cumulative incidence of extensive chronic GVHD was significantly lower in the ATG group as compared to the no-ATG group (4 vs 32%, respectively; P = 0.0017). In multivariate analysis, the absence of use of ATG was the strongest parameter associated with an increased risk of extensive chronic GVHD (relative risk) = 7.14, 95% CI: 1.7-33.3, P = 0.008). At 2 years, the probability of nonrelapse mortality, relapse, overall and leukemia-free survivals was not significantly different between the no-ATG and ATG groups. We conclude that the addition of ATG to GVHD prophylaxis resulted in decreased incidence of extensive chronic GVHD without an increase in relapse or nonrelapse mortality, and without compromising survival after myeloablative allo-SCT from HLA-MUD

Reduced Relapse Incidence with FLAMSA-RIC Compared with Busulfan/Fludarabine for Acute Myelogenous Leukemia Patients in First or Second Complete Remission: A Study from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation

Busulfan/fludarabine (BuFlu) is a widely used conditioning regimen for patients with myeloid malignancies. The sequential FLAMSA (fludarabine + Ara-C + amsacrine chemotherapy) protocol followed by either cyclophosphamide and total body irradiation (FLAMSA-TBI) or cyclophosphamide and busulfan (FLAMSA-Bu) has shown remarkable activity in high-risk acute myelogenous leukemia (AML) patients. Here we compare the outcomes of AML patients transplanted in first complete remission (CR1) or second complete remission (CR2) after conditioning with BuFlu or FLAMSA. Eligible patients had their first allogeneic stem cell transplantation for AML in CR1 or CR2 between January 2005 and June 2016. Donors were matched related or unrelated with up to 1 mismatch. Conditioning consisted of either BuFlu or FLAMSA. Propensity score matching was applied and comparisons were performed using weighted Cox regression. BuFlu conditioning was used in 1197 patients, whereas FLAMSA-TBI and FLAMSA-Bu were used in 258 and 141 patients, respectively. Median follow-up of survivors was 24.72 months. In univariate analysis, relapse incidence (RI) was 30.3%, 21.9%, and 23.1% in the BuFlu, FLAMSA-TBI, and FLAMSA-Bu groups, respectively (P < .01), and nonrelapse mortality at 2 years was 16.1%, 16.4%, and 26.7%, respectively (P < .01). Leukemia-free survival (LFS) at 2 years was 53.6%, 61.6%, and 50.1%, respectively (P = .03). Weighted Cox regression revealed that FLAMSA-TBI compared with BuFlu was associated with lower RI (hazard ratio [HR], .64; 95% confidence interval [CI], .42 to .98; P = .04) and a trend for better LFS (HR, .72; 95% CI, .49 to 1.06; P = .09). These results suggest that compared with BuFlu, conditioning with FLAMSA-TBI leads to reduced RI at 2 years in AML patients transplanted in CR1 or CR2. (C) 2018 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved

L’ajout de la lomustine bénéficie aux leucémies myéloïdes aiguës du sujet âgé avec cytogénétique non-défavorable et d’un profil moléculaire à haut risque de l’European Leukemia Net 2017

# 07-03International audienc

Nilotinib with or without cytarabine for Philadelphia-positive acute lymphoblastic leukemia.

We previously demonstrated that a reduced-intensity chemotherapy schedule can safely replace hyper-CVAD (cyclophosphamide-vincristine-doxorubicin [Adriamycin]-dexamethasone) cycle 1 when combined with imatinib in adults with Philadelphia-positive acute lymphoblastic leukemia. In the present randomized GRAAPH-2014 trial, we used nilotinib and addressed the omission of cytarabine (Ara-C) in consolidation. The primary objective was the major molecular response (MMR) rate measured by BCR::ABL1 quantification after cycle 4 (end of consolidation). All patients were eligible for allogeneic stem cell transplant (SCT), whereas those in MMR could receive autologous SCT, followed by 2-year imatinib maintenance in both cases. After the enrollment of 156 of 265 planed patients, the data and safety monitoring board decided to hold the randomization because of an excess of relapse in the investigational arm. Among the 155 evaluable patients, 76 received Ara-C during consolidation (arm A) and 79 did not (arm B). Overall, 133 patients (85%) underwent SCT, 93 allogeneic and 40 autologous. The noninferiority end point regarding MMR was reached with 71.1% (arm A) and 77.2% (arm B) of patients reaching MMR. However, the 4-year cumulative incidence of relapse was higher in arm B compared with arm A (31.3% [95% confidence interval {CI}, 21.1%-41.9%] vs 13.2% [95% CI, 6.7%-21.9%]; P = .017), which translated to a lower relapse-free survival. With a median follow-up of 3.8 years, 4-year overall survival was 79.0% (95% CI, 70.6%-89.3%) in arm A vs 73.4% (95% CI, 63.9%-84.4%) in arm B (P = .35). Despite a noninferior rate of MMR, more relapses were observed when ARA-C was omitted without impact on survival. ClinicalTrials.gov ID, NCT02611492