Predictive factors for the outcome of allogeneic transplantation in patients with MDS stratified according to the revised IPSS-R.

Approximately one-third of patients with myelodysplastic syndrome (MDS) receiving allogeneic hematopoietic stem cell transplantation (HSCT) are cured by this treatment. Treatment failure may be due to transplant complications or relapse. To identify predictive factors for transplantation outcome, we studied 519 patients with MDS or oligoblastic acute myeloid leukemia (AML, <30% marrow blasts) who received an allogeneic HSCT and were reported to the Gruppo Italiano Trapianto di Midollo Osseo registry between 2000 and 2011. Univariate and multivariate survival analyses were performed using Cox proportional hazards regression. High-risk category, as defined by the revised International Prognostic Scoring System (IPSS-R), and monosomal karyotype were independently associated with relapse and lower overall survival after transplantation. On the other hand, older recipient age and high hematopoietic cell transplantation-comorbidity index (HCT-CI) were independent predictors of nonrelapse mortality. Accounting for various combinations of patient's age, IPSS-R category, monosomal karyotype, and HCT-CI, the 5-year probability of survival after allogeneic HSCT ranged from 0% to 94%. This study indicates that IPSS-R risk category and monosomal karyotype are important factors predicting transplantation failure both in MDS and oligoblastic AML. In addition, it reinforces the concept that allogeneic HSCT offers optimal eradication of myelodysplastic hematopoiesis when the procedure is performed before MDS patients progress to advanced disease stages.

Reconstitution of Human Cytomegalovirus-Specific CD4+ T Cells is Critical for Control of Virus Reactivation in Hematopoietic Stem Cell Transplant Recipients but Does Not Prevent Organ Infection.

The relative contribution of human cytomegalovirus (HMCV)-specific CD4(+) and CD8(+) T cells to the control of HCMV infection in hematopoietic stem cell transplant (HSCT) recipients is still controversial. HCMV reactivation and HCMV-specific CD4(+) and CD8(+) T cell reconstitution were monitored for 1 year in 63 HCMV-seropositive patients receiving HSCT. HCMV reactivation was detected in all but 2 patients. In 20 of 63 (31.7%) patients (group 1) HCMV infection resolved spontaneously, whereas 32 of 63 (50.8%) patients (group 2) controlled the infection after a single short-course of pre-emptive therapy and the remaining 9 (14.3%) patients (group 3) suffered from relapsing episodes of HCMV infection, requiring multiple courses of antiviral therapy. The kinetics and magnitude of HCMV-specific CD8(+) T cell reconstitution were comparable among the 3 groups, but HCMV-specific CD4(+) T cells were lower in number in patients requiring antiviral treatment. HCMV-seronegative donors, as well as unrelated donors (receiving antithymocyte globulin) and acute graft-versus-host disease (GVHD) were associated with both delayed HCMV-specific CD4(+) T cell reconstitution and severity of infection. Conversely, these risk factors had no impact on HCMV-specific CD8(+) T cells. Eight patients with previous GVHD suffered from HCMV gastrointestinal disease, although in the presence of HCMV-specific CD4(+) and CD8(+) systemic immunity and undetectable HCMV DNA in blood. Reconstitution of systemic HCMV-specific CD4(+) T cell immunity is required for control of HCMV reactivation in adult HSCT recipients, but it may not be sufficient to prevent late-onset organ localization in patients with GVHD. HCMV-specific CD8(+) T cells contribute to control of HCMV infection, but only after HCMV-specific CD4(+) T cell reconstitution.

PBSC mobilization in lymphoma patients: analysis of risk factors for collection failure and development of a predictive score based on the kinetics of circulating CD34+ cells and WBC after chemotherapy and G-CSF mobilization.

Autologous stem cell transplantation (ASCT) is a potentially curative treatment of lymphoma, but peripheral blood stem cell (PBSC) mobilization fails in some patients. PBSC mobilizing agents have recently been proved to improve the PBSC yield after a prior mobilization failure. Predictive parameters of mobilization failure allowing for a preemptive, more cost-effective use of such agents during the first mobilization attempt are still poorly defined, particularly during mobilization with chemotherapy + granulocyte colony-stimulating factor (G-CSF). We performed a retrospective analysis of a series of lymphoma patients who were candidates for ASCT, to identify factors influencing PBSC mobilization outcome. Premobilization parameters-age, histology, disease status, mobilizing protocol, and previous treatments-as well as white blood cell (WBC) and PBSC kinetics, markers potentially able to predict failure during the ongoing mobilization attempt, were analyzed in 415 consecutive mobilization procedures in 388 patients. We used chemotherapy + G-CSF in 411 (99%) of mobilization attempts and PBSC collection failed (<2 × 10(6) CD34+ PBSC/kg) in 13%. Multivariable analysis showed that only a low CD34+ PBSC count and CD34+ PBSC/WBC ratio, together with the use of nonplatinum-containing chemotherapy, independently predicted mobilization failure. Using these three parameters, we established a scoring system to predict risk of failure during mobilization ranging from 2 to 90%, thus allowing a selective use of a preemptive mobilization policy.

Optimal timing of allogeneic hematopoietic stem cell transplantation in patients with myelodysplastic syndrome.

Allogeneic hematopoietic stem cell transplantation (HSCT) represents the only curative treatment for patients with myelodysplastic syndrome (MDS), but involves non-negligible morbidity and mortality. Registry studies have shown that advanced disease stage at transplantation is associated with inferior overall survival. To define the optimal timing of allogeneic HSCT, we carried out a decision analysis by studying 660 patients who received best supportive care and 449 subjects who underwent transplantation. Risk assessment was based on both the International Prognostic Scoring System (IPSS) and the World Health Organization classification-based Prognostic Scoring System (WPSS). We used a continuous-time multistate Markov model to describe the natural history of disease and evaluate the effect of allogeneic HSCT on survival. This model estimated life expectancy from diagnosis according to treatment policy at different risk stages. Relative to supportive care, estimated life expectancy increased when transplantation was delayed from the initial stages until progression to intermediate-1 IPSS-risk or to intermediate WPSS-risk stage, and then decreased for higher risks. Modeling decision analysis on WPSS versus IPSS allowed better estimation of the optimal timing of transplantation. These observations indicate that allogeneic HSCT offers optimal survival benefits when the procedure is performed before MDS patients progress to advanced disease stages.

Laser-Treated Steel Surfaces Gliding on Snow at Different Temperatures.

With the goal of substituting a hard metallic material for the soft Ultra High Molecular Weight Polyethylene (UHMWPE) presently used to make the bases of skis for alpine skiing, we used two non-thermodynamic equilibrium surface treatments with ultra-short (7-8 ps) laser pulses to modify the surface of square plates (50 × 50 mm2) made of austenitic stainless steel AISI 301H. By irradiating with linearly polarized pulses, we obtained Laser Induced Periodic Surface Structures (LIPSS). By laser machining, we produced a laser engraving on the surface. Both treatments produce a surface pattern parallel to one side of the sample. For both treatments, we measured with a dedicated snow tribometer the friction coefficient µ on compacted snow at different temperatures (-10 °C; -5 °C; -3 °C) for a gliding speed range between 1 and 6.1 ms-1. We compared the obtained µ values with those of untreated AISI 301H plates and of stone grinded, waxed UHMWPE plates. At the highest temperature (-3 °C), near the snow melting point, untreated AISI 301H shows the largest µ value (0.09), much higher than that of UHMWPE (0.04). Laser treatments on AISI 301H gave lower µ values approaching UHMWPE. We studied how the surface pattern disposition, with respect to the gliding direction of the sample on snow, affects the µ trend. For LIPSS with pattern, orientation perpendicular to the gliding direction on snow µ (0.05) is comparable with that of UHMWPE. We performed field tests on snow at high temperature (from -0.5 to 0 °C) using full-size skis equipped with bases made of the same materials used for the laboratory tests. We observed a moderate difference in performance between the untreated and the LIPSS treated bases; both performed worse than UHMWPE. Waxing improved the performance of all bases, especially LIPSS treated.

Data on the flexural vibration of thin plate with elastically restrained edges: Finite element method and wave based method simulations.

The data here reported refer to the numerical examples shown in the research article "Wave based method for flexural vibration of thin plate with general elastically restrained edges" (Liu et al., 2020 [1]). Within the examples, only the datasets regarding the plates with elastic or elastic-damping supports are provided. The datasets contain the raw data directly obtained from the forced vibration simulations. The simulations are carried out using two methods: the finite element method realized in ANSYS Mechanical APDL and the proposed wave based method (Liu et al., 2020 [1]), implemented in a MATLAB code. The data obtained from ANSYS serves as reference for the response of the plate under different boundary conditions. For each frequency, the transverse displacements of the plate at two pre-selected points are listed in the spreadsheet (e.g. MS Excel). When damping is present, they are separated into real part and imaginary part. This part of data can be used as reference when other novel methods are developed. The datasets obtained from MATLAB include the contribution factors as well as the wave functions. Based on them, one can obtain the displacement as a complex number at any point of the plate after a simple postprocessing. Postprocessing codes to obtain the frequency response function for a user-given point and the displacement field at a user-given frequency are also provided. This part of data presents much more information than the previous part as well as the corresponding results in the related research article. It makes it possible to see the responses at other points or other frequencies that are not considered in the research article, without repeating the time-consuming simulations. Moreover, if someone wants to further improve the wave based method, this part of data will be helpful, either for analysing the limitations of the proposed method or for more direct comparisons. Any research related to the flexural vibration of plate can also consider the data provided in this article.

Moving microphone arrays to reduce spatial aliasing in the beamforming technique: theoretical background and numerical investigation.

This paper introduces a measurement technique aimed at reducing or possibly eliminating the spatial aliasing problem in the beamforming technique. Beamforming main disadvantages are a poor spatial resolution, at low frequency, and the spatial aliasing problem, at higher frequency, leading to the identification of false sources. The idea is to move the microphone array during the measurement operation. In this paper, the proposed approach is theoretically and numerically investigated by means of simple sound propagation models, proving its efficiency in reducing the spatial aliasing. A number of different array configurations are numerically investigated together with the most important parameters governing this measurement technique. A set of numerical results concerning the case of a planar rotating array is shown, together with a first experimental validation of the method.

Conjunctival hemorrhagic events associated with imatinib mesylate.

Imatinib mesylate (IM) is used in the targeted therapy of chronic myelogenous leukemia and gastrointestinal stromal tumors. It is well tolerated and leads to no higher incidence of hemorrhagic events than other therapies. Of 87 patients we treated with IM for a minimum of 3 months, 10 patients (11%) developed unilateral or bilateral conjunctival hemorrhage (CH). No other hemorrhagic events were observed during follow-up, except for CH recurrence in 6 cases (7%). Because there was no other obvious reason for such a high incidence of CH, we hypothesize drug hypersensitivity or ocular irritation induced by IM treatment.