Benefits and risks of clofarabine in adult acute lymphoblastic leukemia investigated in depth by multi-state modeling

Background: We recently reported results of the prospective, open-label HOVON-100 trial in 334 adult patients with acute lymphoblastic leukemia (ALL) randomized to first-line treatment with or without clofarabine (CLO). No improvement of event-free survival (EFS) was observed, while a higher proportion of patients receiving CLO obtained minimal residual disease (MRD) negativity. Aim: In order to investigate the effects of CLO in more depth, two multi-state models were developed to identify why CLO did not show a long-term survival benefit despite more MRD-negativity. Methods: The first model evaluated the effect of CLO on going off-protocol (not due to refractory disease/relapse, completion or death) as a proxy of severe treatment-related toxicity, while the second model evaluated the effect of CLO on obtaining MRD negativity. The subsequent impact of these intermediate events on death or relapsed/refractory disease was assessed in both models. Results: Overall, patients receiving CLO went off-protocol more frequently than control patients (35/168 [21%] vs. 18/166 [11%], p = 0.019; HR 2.00 [1.13–3.52], p = 0.02), especially during maintenance (13/44 [30%] vs. 6/56 [11%]; HR 2.85 [95%CI 1.08–7.50], p = 0.035). Going off-protocol was, however, not associated with more relapse or death. Patients in the CLO arm showed a trend towards an increased rate of MRD-negativity compared with control patients (HR MRD-negativity: 1.35 [0.95–1.91], p = 0.10), which did not translate into a significant survival benefit. Conclusion: We conclude that the intermediate states, i.e., going off-protocol and MRD-negativity, were affected by adding CLO, but these transitions were not associated with subsequent survival estimates, suggesting relatively modest antileukemic activity in ALL.</p

Molecular characterization of mutant TP53 acute myeloid leukemia and high-risk myelodysplastic syndrome

Substantial heterogeneity within mutant TP53 acute myeloid leukemia (AML) and myelodysplastic syndrome with excess of blast (MDS-EB) precludes the exact assessment of prognostic impact for individual patients. We performed in-depth clinical and molecular analysis of mutant TP53 AML and MDS-EB to dissect the molecular characteristics in detail and determine its impact on survival. We performed next-generation sequencing on 2200 AML/MDS-EB specimens and assessed the TP53 mutant allelic status (mono- or bi-allelic), the number of TP53 mutations, mutant TP53 clone size, concurrent mutations, cytogenetics, and mutant TP53 molecular minimal residual disease and studied the associations of these characteristics with overall survival. TP53 mutations were detected in 230 (10.5%) patients with AML/MDS-EB with a median variant allele frequency of 47%. Bi-allelic mutant TP53 status was observed in 174 (76%) patients. Multiple TP53 mutations were found in 49 (21%) patients. Concurrent mutations were detected in 113 (49%) patients. No significant difference in any of the aforementioned molecular characteristics of mutant TP53 was detected between AML and MDS-EB. Patients with mutant TP53 have a poor outcome (2-year overall survival, 12.8%); however, no survival difference between AML and MDS-EB was observed. Importantly, none of the molecular characteristics were significantly associated with survival in mutant TP53 AML/MDS-EB. In most patients, TP53 mutations remained detectable in complete remission by deep sequencing (73%). Detection of residual mutant TP53 was not associated with survival. Mutant TP53 AML and MDS-EB do not differ with respect to molecular characteristics and survival. Therefore, mutant TP53 AML/MDS-EB should be considered a distinct molecular disease entity

Impulsive Fermi magnon-phonon resonance in antiferromagnetic CoF2CoF_{2}

Understanding spin-lattice interactions in antiferromagnets is one of the most fundamental issues at the core of the recently emerging and booming fields of antiferromagnetic spintronics and magnonics. Recently, coherent nonlinear spin-lattice coupling was discovered in an antiferromagnet which opened the possibility to control the nonlinear coupling strength and thus showing a novel pathway to coherently control magnon-phonon dynamics. Here, utilizing intense narrow band terahertz (THz) pulses and tunable magnetic fields up to 7 T, we experimentally realize the conditions of the Fermi magnon-phonon resonance in antiferromagnetic $CoF_{2}$. These conditions imply that both the spin and the lattice anharmonicities harvest energy transfer between the subsystems, if the magnon eigenfrequency $f_{m}$ is twice lower than the frequency of the phonon $2f_{m}=f_{ph}$. Performing THz pump-infrared probe spectroscopy in conjunction with simulations, we explore the coupled magnon-phonon dynamics in the vicinity of the Fermi-resonance and reveal the corresponding fingerprints of an impulsive THz-induced response. This study focuses on the role of nonlinearity in spin-lattice interactions, providing insights into the control of coherent magnon-phonon energy exchange

Regional disparities in the use of intensive chemotherapy for AML in the Netherlands: Does it influence survival?

Objective Acute myeloid leukaemia (AML) prognosis is enhanced with intensive remission induction chemotherapy (ICT) in eligible patients. However, ICT eligibility perceptions may differ among healthcare professionals. This nationwide, population-based study aimed to explore regional variation in ICT application and its relation with overall survival (OS). Methods and analysis We compared nine Dutch regional networks using data from the Netherlands Cancer Registry. Regional variance was assessed for the entire population and age subgroups (ie, ≤60 years and >60 years) using multivariable mixed effects logistic and Cox proportional hazard regression analyses, expressed via median OR (MOR) and median HR (MHR). Results Including all adult AML patients from 2014 to 2018 (N=4060 patients; 58% males; median age, 70 years), 1761 (43%) received ICT. ICT application varied from 36% to 57% (MOR 1.36 (95% CI 1.11 to 1.58)) across regions, with minor variations for patients aged ≤60 years (MOR 1.16 (95% CI 1.00 to 1.40)) and more extensive differences for those aged >60 years (MOR 1.43 (95% CI 1.16 to 1.63)). Median OS spanned 4.9-8.4 months across regions (MHR 1.11 (95% CI 1.00 to 1.15)), with pronounced differences in older patients (MHR 1.12 (95% CI 1.08 to 1.20)) but negligible differences in the younger group (MHR 1.02 (95% CI 1.00 to 1.14)). Survival differences for the total population and the older patients decreased to respectively, MHR 1.09 (95% CI 1.00 to 1.13) and 1.10 (95% CI 1.04 to 1.18), after additional adjustment for the probability of receiving ICT within a region, indicating approximately 10% unexplained differences. Conclusion Regional disparities in ICT application and survival exist, especially in older AML patients. However, ICT application differences partially explain survival disparities, indicating the need for more standardised ICT eligibility criteria and a better understanding of underlying causes of outcome disparities

Ten millennia of hepatitis B virus evolution

Hepatitis B virus (HBV) has been infecting humans for millennia and remains a global health problem, but its past diversity and dispersal routes are largely unknown. We generated HBV genomic data from 137 Eurasians and Native Americans dated between ~10,500 and ~400 years ago. We date the most recent common ancestor of all HBV lineages to between ~20,000 and 12,000 years ago, with the virus present in European and South American hunter-gatherers during the early Holocene. After the European Neolithic transition, Mesolithic HBV strains were replaced by a lineage likely disseminated by early farmers that prevailed throughout western Eurasia for ~4000 years, declining around the end of the 2nd millennium BCE. The only remnant of this prehistoric HBV diversity is the rare genotype G, which appears to have reemerged during the HIV pandemic

Spectroscopic insights into cobalt-catalyzed Fischer-Tropsch synthesis:a review of the carbon monoxide interaction with single crystalline surfaces of cobalt

\u3cp\u3eThe present article summarizes experimental findings of the interaction of CO with single crystal surfaces of cobalt. We first provide a quantitative study of non-dissociative CO adsorption on Co(0001) and establish a quantitative correlation between θ\u3csub\u3eCO\u3c/sub\u3e and adsorption site occupation. In light of these findings we revisit the structure of previously reported ordered CO/Co(0001) adsorbate layers. Measurements of the CO coverage at equilibrium conditions are used to derive a phase diagram for CO on Co(0001). For low temperature Fischer-Tropsch synthesis conditions the CO coverage is predicted to be ≈0.5 ML, a value that hardly changes with p\u3csub\u3eCO\u3c/sub\u3e. The CO desorption temperature found in temperature programmed desorption is practically structure-independent, despite structure-dependent heats of adsorption reported in the literature. This mismatch is attributed to a structure-dependent pre-exponential factor for desorption. IR spectra reported throughout this study provide a reference point for IR studies on cobalt catalysts. Results for CO adsorbed on flat and defect-rich Co surfaces as well as particular, CO adsorbed on top sites, and in addition affect the distribution of CO\u3csub\u3ead\u3c/sub\u3e over the various possible adsorption sites.\u3c/p\u3

Adsorption and decomposition of ethene and propene on Co(0001):the surface chemistry of fischer-tropsch chain growth intermediates

\u3cp\u3e(Graph Presented) Experiments that provide insight into the elementary reaction steps of C\u3csub\u3ex\u3c/sub\u3eH\u3csub\u3ey\u3c/sub\u3e adsorbates are of crucial importance to better understand the chemistry of chain growth in Fischer-Tropsch synthesis (FTS). In the present study we use a combination of experimental and theoretical tools to explore the reactivity of C\u3csub\u3e2\u3c/sub\u3eH\u3csub\u3ex\u3c/sub\u3e and C\u3csub\u3e3\u3c/sub\u3eH\u3csub\u3ex\u3c/sub\u3e adsorbates derived from ethene and propene on the close-packed surface of cobalt. Adsorption studies show that both alkenes adsorb with a high sticking coefficient. Surface hydrogen does not affect the sticking coefficient but reduces the adsorption capacity of both ethene and propene by 50% and suppresses decomposition. On the other hand, even subsaturation quantities of CO\u3csub\u3ead\u3c/sub\u3e strongly suppress alkene adsorption. Partial alkene dehydrogenation occurs at low surface temperature and predominantly yields acetylene and propyne. Ethylidyne and propylidyne can be formed as well, but only when the adsorbate coverage is high. Translated to FTS, the stable, hydrogen-lean adsorbates such as alkynes and alkylidynes will have long residence times on the surface and are therefore feasible intermediates for chain growth. The comparatively lower desorption barrier for propene relative to ethene can to a large extent be attributed to the higher stability of the molecule in the gas phase, where hyperconjugation of the double bond with σ bonds in the adjacent methyl group provides additional stability to propene. The higher desorption barrier for ethene can potentially contribute to the anomalously low C\u3csub\u3e2\u3c/sub\u3eH\u3csub\u3ex\u3c/sub\u3e production rate that is typically observed in cobalt-catalyzed FTS.\u3c/p\u3

The formation and influence of carbon on cobalt-based Fischer-Tropsch synthesis catalysts: An integrated review

The existing open and patent literature on the topic of carbon deposition was integrated with current work to provide a clearer understanding on the role of carbon as a deactivation mechanism of cobalt catalysts in the Fischer-Tropsch synthesis (FTS). Although the FTS did occur in the presence of active surface carbon and various hydrocarbon products, there may be a gradual transformation into inactive more stable forms of carbon in extended runs. This carbon could be possibly detrimental for catalyst activity. A deactivating polymeric carbon build-up may occur on Co/Pt/Al2O3 FTS catalysts, taken from a 100-bpd slurry bubble column reactor operated at commercially relevant FTS conditions. This polymeric carbon is located both on the support and on cobalt. This is an abstract of a paper presented at the 236th ACS National Meeting (Philadelphia, PA 8/17-21/2008)

SiO2-supported Fe & FeMn colloids—Fischer-Tropsch synthesis on 3D model catalysts

A well-defined model catalyst constituting a compromise between high surface area, porous, industrial catalysts and a planar model catalyst has been developed. It allows for measurements of catalytic activity in micro reactors, where diffusion problems are kept at a minimum, while characterization both by surface science techniques and by bulk techniques can be applied. Monodisperse, non-porous SiO 2 microspheres with diameter 875 ± 25 nm have been synthesized, serving as the large area model support. These where then impregnated with pre-formed, monodisperse, colloidal Fe and FeMn nanoparticles resulting in a three-dimensional equivalent of a flat, Fe(-Mn)/SiO 2 model catalysts. Characterization with electron microscopy (SEM and TEM), X-ray photoelectron spectroscopy (XPS) and X-ray diffraction (XRD), before and after catalytic testing was performed. It was shown that the model catalysts can be used in Fischer-Tropsch synthesis experiments under industrially relevant conditions. The FTS experiments reveal that compared to the pure Fe catalyst, FeMn shows more stable activity, higher selectivity towards olefins and lower selectivity toward CH 4 and CO 2. Significant amounts of hydrocarbons on the catalyst surfaces and some minor indications of sintering were detected after the reaction. Formation of FeC x was detected for the Fe catalyst while no significant amounts could be seen on the Mn-promoted catalyst

Quantification of T-cell-mediated apoptosis in heterogeneous leukemia populations using four-color multiparameter flow cytometry

Background: The unique capacity of dendritic cells to present antigens to naive T cells is being increasingly utilized in cancer therapy. The efficacy of cell-based immunotherapy can be analyzed by determination of cytotoxic activity of T cells toward tumor cells in vitro. This study supplies a flow cytometric method to analyze T-cell-mediated cytotoxic activity toward heterogeneous leukemic cell populations at a single-cell level. Methods: The fluorescent probe SYTO16 and the dead-cell dye 7-aminoactinomycine-D (7-AAD) were used to identify early and late stages of apoptosis in combination with leukemia cell-identifying markers. Determination of viable, apoptotic, and necrotic cells was performed by inclusion of fluorescent beads. Results: In nine acute myeloid leukemia samples and three leukemic cell lines the use of SYTO16 next to the dead-cell marker 7-AAD significantly increased (P = 0.001) the sensitivity of the cytotoxicity assay as compared with single use of 7-AAD. Analysis of several effector-to-target ratios revealed the ability to determine dose-response effects. Enumeration of absolute numbers resulted in coefficients of variation of 4.1% and 8.4% for cell lines and leukemic samples, respectively. Conclusion: The presented flow cytometric cytotoxicity assay enables the study of T-cell-mediated apoptosis in a heterogenous leukemia population