Chemomobilization with Etoposide is Highly Effective in Patients with Multiple Myeloma and Overcomes the Effects of Age and Prior Therapy.

The optimal mobilization strategy prior to autologous stem cell transplantation for patients with multiple myeloma remains unclear. Mobilization with cytokines alone appears to yield suboptimal results in older patients as well as patients who have received prior lenalidomide. To avoid the marked cytopenias and risks of hemorrhagic cystitis associated with the administration of cyclophosphamide, we investigated the efficacy and safety of chemomobilization with an intermediate dose etoposide (VP-16; 375 mg/m(2) on days +1 and +2) and granulocyte-colony stimulating factor (G-CSF) (5 µg/kg twice daily from day +3 through the final day of collection). We reviewed our institutional experience with 152 myeloma patients mobilized with this regimen. The addition of VP-16 to G-CSF resulted in successful mobilization in 100% of patients, including 143 (94%) who collected successfully in a single day. A total of 99% of patients, including those with prior XRT and/or prior lenalidomide or thalidomide therapy, collected at least 5 × 10(6) cells/kg in 1 or 2 days of apheresis, and the median total number of CD34(+) cells collected in the entire population was 12 × 10(6) cells/kg. Collection was predictable, with 61% of patients collecting on day +11, and the rest between days +7 and +13. There were no variables, including age, prior imid exposure, radiation therapy, or total amount of prior therapy that were associated with suboptimal mobilization. Adverse effects of the regimen included supportive transfusions required in 31 (20%) patients, and fevers requiring hospitalization or intravenous antibiotics in 26 (17%) patients. VP-16 and G-CSF appears to be a safe and effective mobilization regimen for patients with multiple myeloma undergoing autologous stem cell transplantation, producing excellent stem cell yield with the majority of patients requiring 1 day of apheresis.

Usefulness of the hematopoietic cell transplantation-specific comorbidity index (HCT-CI) in predicting outcomes for adolescents and young adults with hematologic malignancies undergoing allogeneic stem cell transplant.

BACKGROUND: The HCT-CI helps to predict non-relapse mortality (NRM) and overall survival (OS) in allogeneic hematopoietic cell transplantation (HCT) recipients. The usefulness of this index in a younger, adolescent and young adult (AYA) population is unclear. PROCEDURE: We tested the validity of the HCT-CI as a predictor of mortality in a retrospective cohort of 56 AYA recipients between the ages of 16 and 39, using chart abstraction followed by univariable and multivariate analysis. RESULTS: Only pulmonary dysfunction (46%), hepatic dysfunction (27%), infection (20%), and psychiatric disturbance (11%) had frequencies greater than 5% in this population. HCT-CI scores of 0-2 were present in 54%, and scores of >3 in 46%. The cumulative incidence of NRM at 2 years was 32%, with an OS of 46%; the NRM and OS for patients with an HCT-CI of 0-2 were 24% and 62%, whereas the NRM and OS for patients with an HCT-CI >3 were 38% and 28%. Patients with pulmonary dysfunction prior to transplant had a 29% OS at 2 years, compared to a 61% OS among patients without (P = 0.001). There was no statistically significant difference for patients and a worse NRM (P = 0.08). In multivariable analysis, both an HCT-CI score of >3 and any pulmonary dysfunction remained associated with OS (P = 0.01, P = 0.03), but neither with NRM. CONCLUSIONS: The HCT-CI appears useful in predicting OS in AYAs, though higher scores may reflect prior treatment, with pulmonary dysfunction particularly prevalent. Prospective studies to further validate and explain these findings are warranted.

Material Analysis and Molecular Dynamics Simulation for Cavitation Erosion and Corrosion Suppression in Water Hydraulic Valves.

In the milestone of straggling to make water hydraulics more advantageous, the choice of coating polymer for water hydraulics valves plays an essential role in alleviating the impact of cavitation erosion and corrosion, and this is a critical task for designers. Fulfilling the appropriate selection, we conflicted properties that are vital for erosion and corrosion inhibitors, as well as the tribology in the sense of coefficient of friction. This article aimed to choose the best alternative polymer for coating on the selected substrate, that is, Cr2O3, Al2O3, Ti2O3. By applying PROMETHEE (Preference Ranking Organization Method for Enrichment Evaluations), the best polymer obtained with an analyzed performance attribute is Polytetrafluoroethylene (PTFE) that comes up with higher outranking (0.5932052). A Molecular Dynamics (MD) simulation was conducted to identify the stronger bonding with the regards of the better cleave plane between Polytetrafluoroethylene (PTFE) and the selected substrate. Polytetrafluoroethylene (PTFE)/Al2O3 cleaved in (010) plane was observed to be the strongest bond in terms of binding energy (3188 kJ/mol) suitable for further studies.