Evaluation of ferroelectricity in a distorted wurtzite-type structure of Sc-doped LiGaO2.

Since the discovery of ferroelectricity in a wurtzite-type structure, this structural type has gathered much attention as a next-generation ferroelectric material due to its high polarization value combined with its high breakdown strength. However, the main targets of wurtzite-type ferroelectrics have been limited thus far to simple nitride/oxide compounds. The investigation of new ferroelectric materials with wurtzite-type structures is important for understanding ferroelectricity in such structures. We therefore focus on ß-LiGaO2 in this study. Although AlN and ZnO possess well-known wurtzite-type structures (P63mc), ß-LiGaO2 has a distorted wurtzite-type structure (Pna21), and there are no reports of ferroelectricity in LiGaO2. In this study, we have revealed that LiGaO2 exhibits relatively high barrier height energy for polarization switching, however, Sc doping effectively reduces that energy. Then, we conducted thin film preparation and evaluation for Sc-doped LiGaO2 to observe its ferroelectric properties. We successfully observed ferroelectric behavior by using piezoresponse force microscopy measurements for LiGa0.8Sc0.2O2/SrRuO3/(111)SrTiO3.

Mild Acute Graft-Versus-Host Disease Improves Outcomes After HLA-Haploidentical-Related Donor Transplantation Using Posttransplant Cyclophosphamide and Cord Blood Transplantation.

Haploidentical-related donor transplantation using posttransplant cyclophosphamide (PTCy-haplo) and cord blood transplantation (CBT) are valid alternatives for patients with hematological malignancies when HLA-matched donor transplantation (MDT) is unavailable. However, the effects of graft-versus-host disease (GVHD) on outcomes after these transplants have not been fully elucidated. Therefore, we evaluated the effects of acute and chronic GVHD on transplant outcomes after PTCy-haplo transplants and compared them with CBT and MDT. We included a total of 914 adult patients with hematological malignancies in the Kyoto Stem Cell Transplantation Group registry who received PTCy-haplo (N = 120), CBT (N = 402), and MDT (N = 392), and achieved neutrophil engraftment. A multivariate analysis revealed that grade I-II acute GVHD improved of overall survival (OS) after PTCy-haplo [hazard ratio (HR) = 0.39, P = 0.018] and CBT (HR = 0.48, P < 0.001), but not after MDT (HR = 0.80, P = 0.267) compared with patients without acute GVHD. Grade I-II acute GVHD had a trend toward reducing the risk of nonrelapse mortality (NRM) after PTCy-haplo (HR = 0.13, P = 0.060) and this positive effect was significant after CBT (HR = 0.39, P = 0.003). A negative impact of grade III-IV acute GVHD on NRM was observed after CBT and MDT, but not after PTCy-haplo. Limited chronic GVHD had a positive impact on OS after CBT and MDT, but not after PTCy-haplo. In conclusion, mild acute GVHD improved outcomes after PTCy-haplo and CBT, and limited chronic GVHD improved outcomes after CBT and MDT. These data indicated that the effects of GVHD on transplant outcomes depended on transplant platforms.

Effects of combined test dose and therapeutic drug monitoring strategy in exposure-directed busulfan.

Although exposure-directed busulfan (BU) dosing can improve allogeneic hematopoietic stem cell transplantation outcomes, there is still large variability in BU exposure with test dose alone due to changes in BU clearance caused by drug interactions. We conducted a single-arm phase II trial using the combined test dose and therapeutic drug monitoring strategy (PK-guided group) and compared the outcomes with an external historical cohort receiving a fixed-dose (fixed-dose group). The first eight and second eight doses were adjusted based on the area under the blood concentration-time curve (AUC) of the test and first doses, respectively, targeting a total AUC of 82.1 mg·h/L. All patients received either BU and cyclophosphamide conditioning (BU/CY) or fludarabine (FLU)-containing conditioning. The BU clearance at the first dose decreased more in patients receiving FLU than in those receiving BU/CY; however, BU clearance also declined over time in patients who received BU/CY. The simulated total AUC (sAUC) with test dose only was significantly higher in patients who received FLU than in those who received BU/CY, but sAUC with the combined strategy was comparable. The 100-day progression-free survival was 85.5% (95% confidence interval [CI]: 71.9-92.8%), and was not inferior to that in the fixed-dose group. For the FLU-containing regimens, the PK-guided group showed decreased relapse (0.0% vs. 26.9%, p = 0.03), and favorable overall survival (75.1% vs. 57.0%, p = 0.07) at 1 year. The combined strategy effectively controlled the BU exposure close to the target levels, potentially improving efficacy, especially in patients receiving the FLU-containing regimen. Clinical evaluation of efficacy of dose-modified intravenous busulfan in allogeneic hematopoietic stem cell transplantation for hematological malignancy (#UMIN000014077, June 15th, 2014).

Epitope Mismatch at HLA-DRB1 Associates with Reduced Relapse Risk in Cord Blood Transplantation for Standard-Risk Hematologic Malignancy.

Cord blood transplantation (CBT) is an attractive therapeutic option for patients with hematologic malignancies. CBT tolerates HLA mismatches between donors and recipients, but the HLA mismatches that generate graft-versus-tumor (GVT) effects remain unknown. Given that HLA molecules contain epitopes comprising polymorphic amino acids that determine their immunogenicity, we investigated associations between epitope-level HLA mismatches and relapse following single-unit CBT. A total of 492 patients with hematologic malignancies who underwent single-unit, T cell-replete CBT were included in this multicenter retrospective study. HLA epitope mismatches (EMs) were quantified using HLA matchmaker software from donor and recipient HLA-A, -B, -C, and -DRB1 allele data. Patients were dichotomized by median EM value and divided into 2 groups: patients who underwent transplantation in complete/partial remission (standard stage: 62.4%) and others (advanced stage: 37.6%). The median number of EMs in the graft-versus-host direction (GVH-EM) was 3 (range, 0 to 16) at HLA class I and 1 (range, 0 to 7) at HLA-DRB1. Higher HLA class I GVH-EM was associated with increased nonrelapse mortality (NRM) in the advanced stage group (adjusted hazard ratio [HR], 2.12; P = .021), with no significant advantage for relapse in either stage. In contrast, higher HLA-DRB1 GVH-EM was associated with better disease-free survival in the standard stage group (adjusted HR, .63; P = .020), which was attributed to lower relapse risk (adjusted HR, .46; P = .014). These associations also were observed even within HLA-DRB1 allele-mismatched transplantations in the standard stage group, indicating that EM might have an impact on relapse risk independent of allele mismatch. High HLA-DRB1 GVH-EM did not increase NRM in either stage. High HLA-DRB1 GVH-EM may lead to potent GVT effects and a favorable prognosis following CBT, especially in patients who underwent transplantation at the standard stage. This approach may facilitate appropriate unit selection and improve the overall prognosis of patients with hematologic malignancies who undergo CBT.

Advantages of Higher Busulfan Dose Intensity in Fludarabine-Combined Conditioning for Patients with Acute Myeloid Leukemia Undergoing Cord Blood Transplantation.

The alkylating agent busulfan is commonly used as conditioning in allogeneic hematopoietic stem cell transplantation for acute myeloid leukemia (AML). However, a consensus has not yet been reached regarding the optimal busulfan dose in cord blood transplantation (CBT). Therefore, we conducted this large nationwide cohort study to retrospectively analyze the outcomes of CBT in patients with AML receiving busulfan at intermediate (6.4 mg/kg i.v.; BU2) or higher (12.8 mg/kg i.v.; BU4) doses within a fludarabine/i.v. busulfan (FLU/BU) regimen. Among 475 patients who underwent their first CBT following FLU/BU conditioning between 2007 and 2018, 162 received BU2 and 313 received BU4. Multivariate analysis identified BU4 as a significant factor for longer disease-free survival (hazard ratio [HR], .85; 95% confidence interval [CI], .75 to .97; P = .014) and a lower relapse rate (HR, .84; 95% CI, .72 to .98; P = .030). No significant differences were observed in non-relapse mortality between BU4 and BU2 (HR, 1.05; 95% CI, .88-1.26; P = .57). Subgroup analyses showed that BU4 provided significant benefits for patients who underwent transplantation while not in complete remission (CR) and those age <60 years. Our present results suggest that higher busulfan doses are preferable in patients undergoing CBT, particularly those not in CR and younger patients.

Coexistence of HLA and KIR ligand mismatches as a risk factor for viral infection early after cord blood transplantation.

Viral infection is one of the lethal adverse events after cord blood transplantation (CBT). Human leukocyte antigen (HLA) and killer immunoglobulin-like receptor (KIR) ligand divergences can increase the risk of viral infection due to conflicting interactions between virus-infected cells and immune cells. However, the relationship between these disparities and the frequency of viral infection after CBT remains to be evaluated. Herein, we have conducted a retrospective multicenter study to assess the effect of HLA and KIR ligand mismatches on viral infections after CBT. The study included 429 patients, among which 126 viral infections occurred before day 100. Viral infection was significantly associated with poorer overall survival (OS; hazard ratio [HR] 1.74, p < 0.01). Patients harboring ≥3 mismatches in the HLA allele and inhibitory KIR ligand mismatches (HLA & KIR mismatches) had a significantly greater prevalence of viral infection (HR 1.66, p = 0.04). Thus, patients with HLA & KIR mismatches had poorer outcomes in terms of non-relapse mortality (HR 1.61, p = 0.05). Our study demonstrates the unfavorable impacts of HLA & KIR mismatches on viral infections and non-relapse mortality after CBT. Evaluating the viral infection risk and performance of an appropriate and early intervention in high-risk patients and optimizing the graft selection algorithm could improve the outcome of CBTs.

Bortezomib-cyclophosphamide-dexamethasone induction/consolidation and bortezomib maintenance for transplant-eligible newly diagnosed multiple myeloma: phase 2 multicenter trial.

OBJECTIVES: We conducted a phase II trial to prospectively evaluate the efficacy and safety of bortezomib-cyclophosphamide-dexamethasone (VCD) induction, autologous stem cell transplantation (ASCT), VCD consolidation, and bortezomib maintenance in transplant-eligible newly diagnosed multiple myeloma (NDMM) patients in Japan (UMIN000010542). METHODS: From 2013 to 2016, 42 patients with a median age of 58 (range 42-65) years with NDMM were enrolled in 15 centers. The primary endpoint was the complete response (CR) /stringent CR (sCR) rate after transplantation, and overall/progression-free survival rates were also evaluated. RESULTS: Following induction therapy, the overall response rate was obtained in 71% of patients, including a CR/sCR of 10% and a very good partial response (VGPR) of 26%. Twenty-six of the 42 patients completed ASCT following the protocol and CR/sCR and VGPR rate 100 days after ASCT was 26% and 17%, respectively. During consolidation therapy, 3 of the 24 patients achieved deeper responses. Eight of the 18 patients completed 2-year bortezomib maintenance without disease progression and grade 3/4 toxicities. Five patients were VGPR or partial response after ASCT but maintained response with 2-year bortezomib maintenance. Two-year overall and progression-free survival rates were 92.5% (95% confidence interval [CI]: 78.5%-97.5%) and 62.6% (95% CI: 45.8%-75.5%), respectively. Grade 3/4 toxicities (≥ 10%) included neutropenia (19%) and anemia (17%) in induction, and thrombocytopenia (29%) in consolidation. CONCLUSION: VCD induction/consolidation and bortezomib maintenance with ASCT for NDMM resulted in a high CR/sCR rate and provided good overall/progression-free survival in Japan.

Chemical design of a new displacive-type ferroelectric.

Since the discovery of the ferroelectric perovskite-type oxide BaTiO3 in 1943, numerous materials have been surveyed as candidates for new ferroelectrics. Perovskite-type materials have played a leading role in basic research and applications of ferroelectric materials since the last century. Experimentalists and theoreticians have developed a new materials design stream for post-perovskite materials. In this stream, we have mainly focused on the role of covalency in the evolution of ferroelectricity for displacive-type ferroelectrics in oxides. This perspective surveys the following topics: (1) crossover from quantum paraelectric to ferroelectric through a ferroelectric quantum critical point, (2) the role of cation-oxygen covalency in ferroelectricity and the crossover to quantum paraelectric in perovskite-type compounds, (3) off-center-induced ferroelectricity in perovskites, (4) second-order Jahn-Teller effect enhancement of ferroelectricity in lithium-niobate-type oxides, (5) the presence of four ferroelectric phases and structural transitions of phases of AFeO3 with decreasing radius of A (A = La-Al), (6) tetrahedral ferroelectrics of perovskite-related Bi2SiO5 and wurtzites, (7) a rare type of polarization switching system in which the coordination number of ions in κ-Al2O3 systems changes between 4 and 6, and (8) lone-pair-electron-induced ferroelectrics in langasite-type compounds.

Establishment of a predictive model for GVHD-free, relapse-free survival after allogeneic HSCT using ensemble learning.

Graft-versus-host disease-free, relapse-free survival (GRFS) is a useful composite end point that measures survival without relapse or significant morbidity after allogeneic hematopoietic stem cell transplantation (allo-HSCT). We aimed to develop a novel analytical method that appropriately handles right-censored data and competing risks to understand the risk for GRFS and each component of GRFS. This study was a retrospective data-mining study on a cohort of 2207 adult patients who underwent their first allo-HSCT within the Kyoto Stem Cell Transplantation Group, a multi-institutional joint research group of 17 transplantation centers in Japan. The primary end point was GRFS. A stacked ensemble of Cox Proportional Hazard (Cox-PH) regression and 7 machine-learning algorithms was applied to develop a prediction model. The median age for the patients was 48 years. For GRFS, the stacked ensemble model achieved better predictive accuracy evaluated by C-index than other state-of-the-art competing risk models (ensemble model: 0.670; Cox-PH: 0.668; Random Survival Forest: 0.660; Dynamic DeepHit: 0.646). The probability of GRFS after 2 years was 30.54% for the high-risk group and 40.69% for the low-risk group (hazard ratio compared with the low-risk group: 2.127; 95% CI, 1.19-3.80). We developed a novel predictive model for survival analysis that showed superior risk stratification to existing methods using a stacked ensemble of multiple machine-learning algorithms.

Single Cord Blood Transplantation Versus HLA-Haploidentical-related Donor Transplantation Using Posttransplant Cyclophosphamide in Patients With Hematological Malignancies.

BACKGROUND: Unrelated cord blood (UCB) and haploidentical related donor transplantation using posttransplant cyclophosphamide (PTCy-haplo) have become alternative options to treat patients with hematological malignancies without a HLA-matched donor. METHODS: We conducted a retrospective study using registry data from the Kyoto Stem Cell Transplantation Group for patients with hematological malignancies who received their first allogeneic hematopoietic cell transplantation using a single UCB unit (n = 460) or PTCy-haplo (N = 57) between 2013 and 2019. RESULTS: We found that overall survival in the UCB group was comparable to that in the PTCy-haplo group (hazard ratio, 1.00; 95% confidence interval, 0.66-1.52), although neutrophil and platelet engraftment were significantly delayed. Nonrelapse mortality risk and the incidence of graft-versus-host disease in the UCB group were also comparable to those in the PTCy-haplo group. Although the relapse risk was similar between the UCB group and the PTCy-haplo group regardless of the disease risk, acute myeloid leukemia patients benefit from UCB transplant with a significantly lower relapse rate (hazard ratio, 0.38; 95% confidence interval, 0.18-0.76). CONCLUSIONS: UCB transplant gives outcomes comparable to PTCy-haplo transplant, and both UCB and PTCy-haplo units are suitable as alternative donor sources for patients without an HLA-matched sibling or unrelated donor.

Suppression Mechanisms of the Solid-Electrolyte Interface Formation at the Triple-Phase Interfaces in Thin-Film Li-Ion Batteries.

Side reactions of the charge/discharge in Li-ion batteries (LIBs) generate a solid-electrolyte interface (SEI) onto an electrode surface, resulting in the degradation of the lifetime of a cell. The suppression of SEI formations has attracted much attention for achieving longer cyclable LIBs. Our research group has previously reported that few SEI were observed at triple-phase interfaces (TPIs) consisting of BaTiO3, LiCoO2, and electrolyte interfaces in LIBs with excellent cyclability and ultrahigh-speed chargeability. An investigation on the suppression mechanisms of SEI formations at TPIs should yield important information on understanding the undesirable side reactions. Therefore, we have explored the suppression mechanisms of SEI formations by preparing epitaxial thin films and evaluating the surface of the samples after the electrochemical treatment. The results of X-ray photoelectron spectroscopy and scanning electron microscopy with energy-dispersive X-ray analysis measurements suggested that the decomposition of LiPF6 was suppressed at TPIs, implying that the generation of PF5 via the decomposition of LiPF6 contributed to SEI formation.

The Critical Role of Stereochemically Active Lone Pair in Introducing High Temperature Ferroelectricity.

In this paper, a comparative structural, dielectric, and magnetic study of two langasite compounds Ba3TeCo3P2O14 (absence of lone pair) and Pb3TeCo3P2O14 (Pb2+ 6s2 lone pair) have been carried out to precisely explore the development of room temperature spontaneous polarization in the presence of a stereochemically active lone pair. In the case of Pb3TeCo3P2O14, mixing of both Pb 6s with Pb 6p and O 2p helps the lone pair to be stereochemically active. This stereochemically active lone pair brings a large structural distortion within the unit cell and creates a polar geometry, while the Ba3TeCo3P2O14 compound remains in a nonpolar structure due to the absence of any such effect. Consequently, polarization measurement under varying electric fields confirms room temperature ferroelectricity for Pb3TeCo3P2O14, which was not the case for Ba3TeCo3P2O14. A detailed study was carried out to understand the microscopic mechanism of ferroelectricity, which revealed the exciting underlying activity of a polar TeO6 octahedral unit as well as Pb-hexagon.

Sizable Suppression of Thermal Hall Effect upon Isotopic Substitution in SrTiO_{3}.

We report measurements of the thermal Hall effect in single crystals of both pristine and isotopically substituted strontium titanate. We discovered a 2 orders of magnitude difference in the thermal Hall conductivity between SrTi^{16}O_{3} and ^{18}O-enriched SrTi^{18}O_{3} samples. In most temperature ranges, the magnitude of thermal Hall conductivity (κ_{xy}) in SrTi^{18}O_{3} is proportional to the magnitude of the longitudinal thermal conductivity (κ_{xx}), which suggests a phonon-mediated thermal Hall effect. However, they deviate in the temperature of their maxima, and the thermal Hall angle ratio (|κ_{xy}/κ_{xx}|) shows anomalously decreasing behavior below the ferroelectric Curie temperature T_{c}∼25 K. This observation suggests a new underlying mechanism, as the conventional scenario cannot explain such differences within the slight change in phonon spectrum. Notably, the difference in magnitude of thermal Hall conductivity and rapidly decreasing thermal Hall angle ratio in SrTi^{18}O_{3} is correlated with the strength of quantum critical fluctuations in this displacive ferroelectric. This relation points to a link between the quantum critical physics of strontium titanate and its thermal Hall effect, a possible clue to explain this example of an exotic phenomenon in nonmagnetic insulating systems.

Room-Temperature Antiferroelectricity in Multiferroic Hexagonal Rare-Earth Ferrites.

The antiferroelectric (AFE) phase, in which nonpolar and polar states are switchable by an electric field, is a recent discovery in promising multiferroics of hexagonal rare-earth manganites (ferrites), h-RMn(Fe)O3. However, this phase has so far only been observed at 60-160 K, which restricts key investigations into the microstructures and magnetoelectric behaviors. Herein, we report the successful expansion of the AFE temperature range (10-300 K) by preparing h-DyFeO3 films through epitaxial stabilization. Room-temperature scanning transmission electron microscopy reveals that the AFE phase originates from a nanomosaic structure comprising AFE P3̅c1 and ferroelectric P63cm domains with small domain sizes of 1-10 nm. The nanomosaic structure is stabilized by a low c/a ratio derived from the large ionic radius of Dy3+. Furthermore, weak ferromagnetism and magnetocapacitance behaviors are observed. Below 10 K, the film exhibits an M-shaped magnetocapacitance versus magnetic field curve, indicating unusual magnetoelectric coupling in the AFE phase.

Vancomycin Intoxication and Cefepime-induced Encephalopathy Treated by Abdominal Drainage of Massive Ascites in Addition to Online Hemodiafiltration.

A patient with recurrent plasmacytoma with massive ascites exhibited vancomycin intoxication and cefepime-induced encephalopathy due to renal dysfunction. The ascitic accumulation of these drugs was suspected because of the refractory intoxicated state. To remove these drugs that had accumulated in the blood and ascites, abdominal drainage was performed in addition to online hemodiafiltration. If patients with renal dysfunction and massive ascites develop vancomycin intoxication and cefepime-induced encephalopathy that cannot be improved by drug discontinuation, physicians should suspect ascitic accumulation and evaluate the ascitic concentration. Furthermore, if a high accumulation in massive ascites occurs, physicians should perform abdominal drainage along with blood purification.

Large Polarization Switching and High-Temperature Magnetoelectric Coupling in Multiferroic GaFeO3 Systems.

GaFeO3-type iron oxides are promising multiferroics due to the coexistence of large spontaneous magnetization and polarization near room temperature. However, the high leakage current and difficulties associated with synthesizing single crystals make it difficult to achieve two important features in the system: a large ferroelectric polarization switching and magnetoelectric coupling at a high-temperature region. Herein, we report successful achievement of these features by preparing high-quality Sc-doped GaFeO3 single crystals (ScxGa1-x/2Fe1-x/2O3 with x = 0-0.3) using the floating zone method. The x ≥ 0.05 crystals exhibit a leakage current 104 times lower than the x = 0 crystals, highlighting the importance of Sc doping. Because of the reduced leakage current, the Sc-doped crystals exhibit large ferroelectric polarization switching along the c-axis with a remanent polarization of 22-25 µC/cm2, which is close to the theoretically predicted polarization value of 25-28 µC/cm2. In addition, the Sc-doped crystals exhibit ferrimagnetism with magnetic anisotropy along the a-axis. Furthermore, a magnetic-field-induced modulation of polarization is observed in the x = 0.15 crystal even at a relatively high temperature, i.e., 100 K.

Influence of Comorbid Psychiatric Disorders on the Risk of Development of Alcohol Dependence by Genetic Variations of ALDH2 and ADH1B.

BACKGROUND: Inactive aldehyde dehydrogenase-2 (ALDH2) is a well-known deterrent to the development of alcohol use disorder (AUD), and however, some individuals with inactive ALDH2 do go on to develop AUD. These alcoholics are likely to have strong risk factors for the development of this disorder. Using a model of alcoholics with inactive ALDH2 (the AIA model), we investigated the unique characteristics of alcoholics with inactive ALDH2 in an attempt to identify the risk factors for AUD. In this study, we focused on comorbid psychiatric and personality disorders as potential risk factors for AUD. METHODS: The subjects were 103 male alcoholics with inactive ALDH2 (AIAs), 87 age- and ADH1B genotype-matched alcoholics with active ALDH2 (AAAs) and 200 age-matched healthy men. The alcoholics were divided into 4 subgroups according to their ALDH2 and ADH1B genotypes (inactive ALDH2 vs. active ALDH2, usual ADH1B vs. superactive ADH1B). To assess the participants' comorbid psychiatric disorders, we conducted semi-structured interviews using the Japanese translation of SSAGA version 2. We compared the prevalence of comorbid psychiatric and personality disorders among groups with different combinations of the ALDH2 and ADH1B genotypes. RESULTS: The prevalence of attention-deficit/hyperactivity disorder (ADHD) was significantly higher in the AIAs with usual ADH1B than in the other 3 subgroups of alcoholics. In contrast, the prevalence rates of agoraphobia and panic disorder were significantly lower in the AIAs with superactive ADH1B than in the other 3 subgroups of alcoholics. CONCLUSIONS: This study suggested that (i) ADHD is a risk factor for AUD, consistent with previous reports; (ii) agoraphobia and panic disorder may have deterrent effects against the development of AUD in individuals with inactive ALDH2, probably attributable to the similarity between the symptoms of agoraphobia and panic disorder and the adverse reactions to consumption of alcohol in subjects with inactive ALDH2.

Enhanced Spontaneous Polarization by V4+ Substitution in a Lead-Free Perovskite CaMnTi2O6.

Spontaneous polarization (Ps) of novel order-disorder type lead-free ferroelectric CaMnTi2O6 was successfully enhanced by partial V4+ substitution for Ti4+. A synchrotron X-ray diffraction study revealed that the polar displacement of octahedrally coordinated (Ti, V) in CaMn(Ti1-xVx)2O6 (0 ≤ x ≤ 0.4) increases with V4+ substitution having Jahn-Teller activity owing to the d1 electronic configuration. Our magnetic study suggested the presence of antisite disorder between Ca2+ and square planar coordinated Mn2+ associated with Mn-V intermetallic charge transfer for x ≥ 0.4, resulting in decreases in spontaneous polarization and the ferroelectric-paraelectric transition temperature. This is the first report on the enhanced polarization owing to the Jahn-Teller distortion of V4+ without stereochemical Pb2+ or Bi3+.

Impact of Donor Source on Allogeneic Hematopoietic Stem Cell Transplantation for Mature T Cell and Natural Killer Cell Neoplasms in the Kyoto Stem Cell Transplantation Group.

Although allogeneic hematopoietic stem cell transplantation (allo-HSCT) is the key strategy to cure patients with mature T and natural killer (NK) cell lymphomas/leukemia, especially those with relapsed/refractory diseases, there is no consensus strategy for donor selection. We retrospectively analyzed the outcomes of allo-HSCT in 111 patients in 15 Japanese institutions as a multi-institutional joint research project. Thirty-nine patients received bone marrow or peripheral blood stem cell transplantation from related donors (rBMT/rPBSCT), 37 received BMT/PBSCT from unrelated donors (uBMT/uPBSCT), and 35 received cord blood transplantation (CBT). Overall survival (OS) and progression-free survival (PFS) at 4 years were 42% and 34%, respectively. The cumulative incidences of relapse and nonrelapse mortality were 43% and 25%. In multivariate analysis, CBT showed comparable OS with rBMT/rPBSCT (rBMT/rPBSCT versus CBT: hazard ratio [HR], 1.63; P = .264) and better OS compared with uBMT/uPBSCT (HR, 2.99; P = .010), with a trend toward a lower relapse rate (rBMT/rPBSCT versus CBT: HR, 2.60; P = .010; uBMT/uPBSCT versus CBT: HR, 2.05; P = .082). This superiority of CBT was more definite in on-disease patients (OS: rBMT/rPBSCT versus CBT: HR, 5.52; P = .021; uBMT/uPBSCT versus CBT: HR, 6.80; P = .007). Better disease control was also strongly associated with better OS and PFS with lower relapse rate. In conclusion, allo-HSCT is beneficial for the survival of patients with mature T and NK cell lymphomas/leukemia if performed in a timely fashion. Since CBT showed favorable survival with a lower relapse risk, it could be a preferred alternative, especially in on-disease patients.