Response to Therapy, Treatment Intolerance and Tyrosine Kinase Inhibitor Cessation Eligibility in a Real-World Cohort of Chronic Myeloid Leukaemia Patients.

Tyrosine kinase inhibitor (TKI) therapy has revolutionised chronic myeloid leukaemia (CML) management, it is however associated with significant side effects and economic burden. Recent studies have demonstrated that treatment free remission is possible in certain patients. The aim of this study was to characterise a real-world population in terms of response to therapy, treatment intolerance and potential eligibility for stopping treatment. Included were 105 CML patients diagnosed in Northern Ireland from March 2009-February 2018. Response to treatment was defined as per the 2009 and 2013 European Leukaemia Net guidelines. Potential for treatment cessation was assessed as per the 2017 UK Interim Expert Opinion on Discontinuing Tyrosine Kinase Inhibitor Treatment in Clinical Practice for Treatment-Free Remission in Chronic Myeloid Leukaemia. Our cytogenetic data cohort had a 12-month complete cytogenetic response rate of 66% and the molecular data cohort had a 12-month major molecular response rate of 38%. Of those commenced on 2nd line TKI therapy 81% achieved an optimal response at 12 months. Twenty-two patients developed intolerance and required a change in TKI therapy. The commonest side effects were gastro-intestinal upset (18%), transaminitis (16%) and fluid retention (16%). In our cohort, 20% were considered eligible to stop TKI therapy. The commonest reason for ineligibility was insufficient duration of therapy (25%). We observed that 1st and 2nd line TKI therapy are effective but problems with failure and intolerance persist. Additionally, this study identifies a cohort of patients who may attempt TKI cessation using the UK Interim Expert Opinion report on TKI therapy discontinuation.

Structural, optical and vibrational properties of self-assembled Pbn+1(Ti1-x Fex)nO(3n+1)-δ Ruddlesden-Popper superstructures.

Bulk crystals and thin films of PbTi(1-x)FexO3(-δ) (PTFO) are multiferroic, exhibiting ferroelectricity and ferromagnetism at room temperature. Here we report that the Ruddlesden-Popper phase Pbn+1(Ti(1-x)Fex)nO3(n+1)-δ forms spontaneously during pulsed laser deposition of PTFO on LaAlO3 substrates. High-resolution transmission electron microscopy, x-ray diffraction and x-ray photoemission spectroscopy were utilised to perform a structural and compositional analysis, demonstrating that n ≃ 8 and x ≃ 0.5. The complex dielectric function of the films was determined from far-infrared to ultraviolet energies using a combination of terahertz time-domain spectroscopy, Fourier transform spectroscopy, and spectroscopic ellipsometry. The simultaneous Raman and infrared activity of phonon modes and the observation of second harmonic generation establishes a non-centrosymmetric point group for Pbn+1(Ti0.5Fe0.5)nO3(n+1)-δ, a prerequisite for (but not proof of) ferroelectricity. No evidence of macroscopic ferromagnetism was found in SQUID magnetometry. The ultrafast optical response exhibited coherent magnon oscillations compatible with local magnetic order, and additionally was used to study photocarrier cooling on picosecond timescales. An optical gap smaller than that of BiFeO3 and long photocarrier lifetimes may make this system interesting as a ferroelectric photovoltaic.

Gene expression profiling identifies different sub-types of retinoblastoma.

BACKGROUND: Mutation of the RB1 gene is necessary but not sufficient for the development of retinoblastoma. The nature of events occurring subsequent to RB1 mutation is unclear, as is the retinal cell-of-origin of this tumour. METHODS: Gene expression profiling of 21 retinoblastomas was carried out to identify genetic events that contribute to tumorigenesis and to obtain information about tumour histogenesis. RESULTS: Expression analysis showed a clear separation of retinoblastomas into two groups. Group 1 retinoblastomas express genes associated with a range of different retinal cell types, suggesting derivation from a retinal progenitor cell type. Recurrent chromosomal alterations typical of retinoblastoma, for example, chromosome 1q and 6p gain and 16q loss were also a feature of this group, and clinically they were characterised by an invasive pattern of tumour growth. In contrast, group 2 retinoblastomas were found to retain many characteristics of cone photoreceptor cells and appear to exploit the high metabolic capacity of this cell type in order to promote tumour proliferation. CONCLUSION: Retinoblastoma is a heterogeneous tumour with variable biology and clinical characteristics.

Giant reduction of InN surface electron accumulation: compensation of surface donors by Mg dopants.

Extreme electron accumulation with sheet density greater than 10(13) cm(-2) is almost universally present at the surface of indium nitride (InN). Here, x-ray photoemission spectroscopy and secondary ion mass spectrometry are used to show that the surface Fermi level decreases as the Mg concentration increases, with the sheet electron density falling to below 10(8) cm(-2). Surface space-charge calculations indicate that the lowering of the surface Fermi level increases the density of unoccupied donor-type surface states and that these are largely compensated by Mg acceptors in the near-surface hole depletion region rather than by accumulated electrons. This is a significant step towards the realization of InN-based optoelectronic devices.

Thickness dependence of the strain, band gap and transport properties of epitaxial In2O3 thin films grown on Y-stabilised ZrO2(111).

Epitaxial films of In(2)O(3) have been grown on Y-stabilised ZrO(2)(111) substrates by molecular beam epitaxy over a range of thicknesses between 35 and 420 nm. The thinnest films are strained, but display a 'cross-hatch' morphology associated with a network of misfit dislocations which allow partial accommodation of the lattice mismatch. With increasing thickness a 'dewetting' process occurs and the films break up into micron sized mesas, which coalesce into continuous films at the highest coverages. The changes in morphology are accompanied by a progressive release of strain and an increase in carrier mobility to a maximum value of 73 cm(2) V(-1) s(-1). The optical band gap in strained ultrathin films is found to be smaller than for thicker films. Modelling of the system, using a combination of classical pair-wise potentials and ab initio density functional theory, provides a microscopic description of the elastic contributions to the strained epitaxial growth, as well as the electronic effects that give rise to the observed band gap changes. The band gap increase induced by the uniaxial compression is offset by the band gap reduction associated with the epitaxial tensile strain.

Surface band-gap narrowing in quantized electron accumulation layers.

An energy gap between the valence and the conduction band is the defining property of a semiconductor, and the gap size plays a crucial role in the design of semiconductor devices. We show that the presence of a two-dimensional electron gas near to the surface of a semiconductor can significantly alter the size of its band gap through many-body effects caused by its high electron density, resulting in a surface band gap that is much smaller than that in the bulk. Apart from reconciling a number of disparate previous experimental findings, the results suggest an entirely new route to spatially inhomogeneous band-gap engineering.

Accurate ultra-low-energy secondary ion mass spectrometry analysis of wide bandgap GaN/In(x)Ga(1-x)N structures using optical conductivity enhancement.

Ultra-low-energy secondary ion mass spectrometry has been used to undertake a structural analysis of GaN-In(x)Ga(1-x)N (x approximately 0.25) quantum wells used in optoelectronic devices. The high resistivity of intrinsic GaN-In(x)Ga(1-x)N restricts the necessary electrical path between the analyzed area and the instrument ground potential resulting in surface charge accumulation. Consequently, unstable and unrepresentative depth profiles tend to be produced. A technique known as optical conductivity enhancement (OCE) has been used during depth profiling to reduce the material resistivity. This creates an electrical path between the sample and holder, eliminating charge build up and resulting in accurate depth profiles.

The donor nature of muonium in undoped, heavily n-type and p-type InAs.

The charge state of muonium has been investigated in p-type doped, nominally undoped (low n-type) and heavily n-type doped InAs. The donor Mu(+) state is shown to be the dominant defect in all cases. Consequently, muonium does not simply counteract the prevailing conductivity in this material. This is consistent with the charge neutrality level lying above the conduction band minimum in InAs.

Unintentional conductivity of indium nitride: transport modelling and microscopic origins.

A three-region model for the high n-type conductivity in InN, including contributions from the bulk, surface and buffer layer interface of the sample, is considered. In particular, a parallel conduction analysis is used to show that this model can account for the carrier concentration and mobility variation with film thickness that has previously been determined from single-field Hall effect measurements. Microscopic origins for the donors in each region are considered, and the overriding tendency towards n-type conductivity is discussed in terms of the bulk band structure of InN.

Surface electron accumulation and the charge neutrality level in In2O3.

High-resolution x-ray photoemission spectroscopy, infrared reflectivity and Hall effect measurements, combined with surface space-charge calculations, are used to show that electron accumulation occurs at the surface of undoped single-crystalline In2O3. From a combination of measurements performed on undoped and heavily Sn-doped samples, the charge neutrality level is shown to lie approximately 0.4 eV above the conduction band minimum in In2O3, explaining the electron accumulation at the surface of undoped material, the propensity for n-type conductivity, and the ease of n-type doping in In2O3, and hence its use as a transparent conducting oxide material.

Quantized electron accumulation states in indium nitride studied by angle-resolved photoemission spectroscopy.

Electron accumulation states in InN have been measured using high resolution angle-resolved photoemission spectroscopy (ARPES). The electrons in the accumulation layer have been discovered to reside in quantum well states. ARPES was also used to measure the Fermi surface of these quantum well states, as well as their constant binding energy contours below the Fermi level E(F). The energy of the Fermi level and the size of the Fermi surface for these quantum well states could be controlled by varying the method of surface preparation. This is the first unambiguous observation that electrons in the InN accumulation layer are quantized and the first time the Fermi surface associated with such states has been measured.

Positive and negative mood in the elderly: the ZENITH study.

OBJECTIVE: To assess the quality of positive and negative affect (mood) in an ageing European sample. BACKGROUND: Mood quality has important implications for both physical and mental wellbeing. Poor quality moods are associated with deficits in the diverse areas of cognitive function, health, and social relationships. The ageing process presents a number of potential challenges to successful mood regulation that could have wider implications. DESIGN AND PARTICIPANTS: The current study examines the quality of positive and negative affect in 387 healthy participants from three European countries. Moods were measured four times a day for 4-7 d with the Positive and Negative Affect Schedule (PANAS) mood scales. Measures of zinc (Zn) status were taken also. SETTING: Two centres concentrated on 55-70 yr olds (Coleraine, N.Ireland, n = 93 and Clermont-Ferrand, France, n = 95), and two centres concentrated on 70-87 yr olds (Rome, Italy, n = 108, and Grenoble, France, n = 91). RESULTS: Positive affect scores for the centre in Rome were significantly (P < 0.01) lower than for the other three centres, and the Grenoble centre had significantly (P < 0.05) higher scores on negative affect than the other three centres. Mood was not related to measures of zinc status (all Ps > 0.05). CONCLUSIONS: The two centres with the oldest participants showed deficits in mood quality that may have implications for broader well-being.

Cognitive function in healthy older European adults: the ZENITH study.

OBJECTIVE: Baseline data are reported from a study of the effects of zinc supplementation on cognitive function in older adults as assessed by the CANTAB computerised test battery. DESIGN: This is a multicentre prospective intervention study employing a randomised double-blind design. SETTING: European community-based study. PARTICIPANTS: There are 387 healthy adults aged 55-87 y from centres in France, Italy and Northern Ireland. INTERVENTIONS: Measures of visual memory, working memory and attention were obtained at baseline (prior to supplementation). RESULTS: Younger adults (<70 y) performed significantly better than older adults (>70 y) on all tests, with minimal differences between centres. In addition, men outperformed women on tests of spatial span, pattern recognition memory and reaction times, although these gender differences varied somewhat between centres. CONCLUSIONS: The results are generally consistent with previous age- and gender-related effects on cognitive functioning.

Negative band gaps in dilute InNxSb1-x alloys.

A thin layer of InNSb has been fabricated by low energy nitrogen implantation in the near-surface region of InSb. X-ray photoelectron spectroscopy indicates that nitrogen occupies approximately 6% of the anion lattice sites. High-resolution electron-energy-loss spectroscopy of the conduction band electron plasma reveals the absence of a depletion layer for this alloy, thus indicating that the Fermi level is located below the valence band maximum (VBM). The plasma frequency for this alloy combined with the semiconductor statistics indicates that the Fermi level is located above the conduction band minimum (CBM). Consequently, the CBM is located below the VBM, indicating a negative band gap material has been formed. These measurements are consistent with k.p calculations for InN0.06Sb0.94 that predict a semimetallic band structure.

Intrinsic electron accumulation at clean InN surfaces.

The electronic structure of clean InN(0001) surfaces has been investigated by high-resolution electron-energy-loss spectroscopy of the conduction band electron plasmon excitations. An intrinsic surface electron accumulation layer is found to exist and is explained in terms of a particularly low Gamma-point conduction band minimum in wurtzite InN. As a result, surface Fermi level pinning high in the conduction band in the vicinity of the Gamma point, but near the average midgap energy, produces charged donor-type surface states with associated downward band bending. Semiclassical dielectric theory simulations of the energy-loss spectra and charge-profile calculations indicate a surface state density of 2.5 (+/-0.2)x10(13) cm(-2) and a surface Fermi level of 1.64+/-0.10 eV above the valence band maximum.

Molecular analysis of single colonies reveals a diverse origin of initial clonal proliferation in B-precursor acute lymphoblastic leukemia that can precede the t(12;21) translocation.

The pathogenesis of pediatric B-precursor acute lymphoblastic leukemia is largely unknown, and even with nonrandom chromosomal translocations present, the precise order of clonal molecular events is undefined. We developed an in vitro system using cytokines interleukin (IL)-3, IL-7, IL-10, and FMS-like tyrosine kinase 3 ligand with CD40 ligand-expressing fibroblasts to obtain single blast colonies from which clonal immunoglobulin heavy chain (IgH), T-cell receptor delta gene rearrangements, and, in t(12;21)-positive cases, TEL-AML1 fusion transcripts could be simultaneously PCR amplified. The proliferation of early tumor progenitors increased subclone detection enabling us, in seven diagnostic samples, to determine the stage of differentiation at which each leukemia occurred. Four were derived from the stage before initiation of IgH rearrangement, one during recombination of variable, joining, and diversity segments of the heavy chain gene VDJ(H), and two after completion of IgH rearrangement. Furthermore, analysis of a t(12;21)-positive leukemia with unusually late onset, identified both TEL-AML1-positive and -negative colonies carrying a clonal T-cell receptor delta rearrangement, inferring the presence of clonal expansion before the occurrence of the t(12;21). In contrast, in a typical, early onset t(12;21)-positive leukemia, the t(12;21) appeared to be the first clonal event. In both leukemias, the t(12;21) occurred before recombination of variable, joining and diversity segments of the heavy chain gene VDJ.

Molecular cytogenetic characterization of two non-MYCN amplified neuroblastoma cell lines with complex t(11;17).

The pediatric tumor neuroblastoma is characterized by a very variable, and at times unpredictable, pattern of clinical behavior, ranging from a benign localized tumor to an aggressive malignancy with poor prognosis. Standard clinical and pathological assessments do not always differentiate reliably between tumor subtypes and, therefore, genetic markers are now playing an increasingly important role in treatment decisions. MYCN oncogene amplification, for example, provides a useful marker of poor prognosis. However, less than one-half of all patients who present with, or who later develop, metastatic disease show MYCN amplification. Consequently, the identification of characteristic patterns of genetic alteration in the remaining tumors is of importance. In this report, we describe two new cell lines that we have established from metastatic, non-MYCN amplified, advanced stage neuroblastomas. These cell lines show a number of features in common, including unbalanced translocation between 11q and 17q, loss of 3p, 4p and 11q and gain of 17q. Therefore, they provide a valuable resource for the characterization of genetic pathways leading to aggressive tumor growth in non-MYCN amplified neuroblastomas.

Neuroblastomas with chromosome 11q loss and single copy MYCN comprise a biologically distinct group of tumours with adverse prognosis.

Neuroblastoma is a heterogeneous tumour and its effective clinical management is dependent on accurate prognostic evaluation. In approximately 25% of patients amplification of the MYCN oncogene is known to be associated with a poor outcome. In order to identify additional molecular markers with prognostic potential in non-MYCN-amplified neuroblastomas, we looked for a correlation between clinical outcome and loss of heterozygosity (LOH) on four chromosomes that frequently show alteration in neuroblastoma (chromosomes 3, 4, 11 and 14). Chromosome 11q loss (with frequent parallel loss of chromosomes 3p, 4p and/or 14q) was found exclusively in tumours without MYCN amplification and was significantly associated with poor event-free survival. The 2-year event-free survival rate for 11q LOH cases was 30%, compared to 34% for MYCN-amplified cases and 100% for cases without these abnormalities. While 11q LOH was associated predominantly with advanced-stage disease, 2 cases with low-stage disease and 11q LOH both suffered relapses. We conclude that chromosome 11q loss defines a biologically distinct group of tumours without MYCN amplification that appear to have potential for aggressive metastatic growth. Thus this genetic alteration may be an important new prognostic marker in neuroblastoma.