Non-Hodgkin lymphoma (NHL) disproportionately affects older patients, who do not often undergo allogeneic hematopoietic cell transplantation (HCT). We analyzed Center for International Blood and ...Marrow Transplant Research data on 1248 patients age >= 40 years receiving reduced-intensity conditioning (RIC) or nonmyeloablative (NMA) conditioning HCT for aggressive (n = 668) or indolent (n = 580) NHL Aggressive lymphoma was more frequent in the oldest cohort 49% for age 40 to 54 versus 57% for age 55 to 64 versus 67% for age >= 65; P = .0008). Fewer patients aged >= 65 had previous autografting (26% versus 24% versus 9%; P = .002). Rates of relapse, acute and chronic GVHD, and nonrelapse mortality (NRM) at 1 year post-HCT were similar in the 3 age cohorts (22% 95% confidence interval (CI), 19% to 26% for age 40 to 54, 27% 95% CI, 23% to 31% for age 55 to 64, and 34% 95% CI, 24% to 44% for age >= 65. Progression-free survival (PFS) and overall survival (OS) at 3 years was slightly lower in the older cohorts (OS: 54% 95% CI, 50% to 58% for age 40 to 54; 40% 95% CI, 36% to 44% for age 55 to 64, and 39% 95% CI, 28% to 50% for age >= 65; P < .0001). Multivariate analysis revealed no significant effect of age on the incidence of acute or chronic GVHD or relapse. Age >= 55 years, Karnofsky Performance Status <80, and HLA mismatch adversely affected NRM, PFS, and OS. Disease status at HCT, but not histological subtype, was associated with worse NRM, relapse, PFS, and OS. Even for patients age >= 55 years, OS still approached 40% at 3 years, suggesting that HCT affects long-term remission and remains underused in qualified older patients with NHL.
The survival of relapsed acute myeloid leukemia (AML) after autologous hematopoietic stem cell transplantation (Autologous HCT) is very poor. We studied the outcomes of 302 patients who underwent ...secondary allogeneic hematopoietic cell transplantation (Allo-HCT) from an unrelated donor (URD) using either myeloablative (n=242) or reduced-intensity conditioning regimens (RIC, n=60) reported to CIBMTR. After a median follow-up of 58 months (range 2–160), the probability of treatment-related mortality (TRM) was 44% (95%CI 38–50) at 1-year. The 5-year incidence of relapse and overall survival (OS) was 32% (95%CI 27–38) and 22% (95%CI 18–27), respectively. In multivariate analysis significantly better OS was observed with RIC regimens (Hazard Ratio (HR) 0.51, 95%CI 0.35–0.75, p<0.001), with Karnofsky performance status (KPS) ≥90% (HR 0.62, 95%CI 0.47–0.82, p=0.001) and in CMV-negative recipients (HR 0.64, 95%CI 0.44–0.94, p=0.022). Longer interval (>18 months) from Autologous HCT to URD Allo-HCT was associated with significantly lower Relapse risk (HR 0.19, 95%CI 0.09–0.38, p<0.001) and improved LFS (HR 0.53, 95%CI 0.34–0.84, p=0.006). URD Allo-HCT after Autologous HCT relapse results in 20% long-term leukemia-free survival, with best results with longer interval to secondary URD transplantation, KPS ≥90%, in complete remission, and using RIC regimens. Further efforts to reduce TRM and relapse are still needed.
Studies suggest that patients who live in rural areas may have worse clinical outcomes compared with patients living in urban areas. We studied whether place of residence (rural vs. urban) is ...associated with clinical outcomes of patients with leukemia or myelodysplastic syndrome who received an unrelated donor hematopoietic-cell transplantation (HCT). Patients’ residential ZIP code at the time of transplant was used to determine rural or urban designation based on the Rural Urban Commuting Codes. The study included 6140 patients reported to the Center for International Blood and Marrow Transplant Research from 121 US HCT centers: 1179 (19%) came from rural areas while 4961 (81%) came from urban areas. Rural and urban patients were similar in patient-, disease- and transplant-related characteristics aside from household income and distance travelled to HCT center. After adjusting for income and other significant patient, disease and transplant-related variables, the risk of overall mortality between patients residing in rural and urban areas were not statistically significant (relative risk 1.01, 95% confidence intervals 0.93–1.10, p=0.74). Similar outcomes were noted for transplant-related mortality, disease-free survival and relapse. Patient’s income, derived from US Census and based on their residential ZIP code, was independently associated with outcomes. In summary, our study showed no differences in the clinical outcomes of patients from rural or urban areas after unrelated donor HCT.
The purpose of this study was to evaluate how participating in the Habitat for Humanity house-building process influenced participants’ purpose well-being, social well-being, community well-being, ...physical and mental well-being, and financial well-being, and how effective Habitat for Humanity is in aiding neighborhood revitalization within the Greater Lafayette area. The research project resulted in a presentation of quantitative data and a testimonial video that highlighted the stories of families that had worked with Habitat for Humanity. Quantitative data was gathered through a survey that addressed respondents’ levels of satisfaction within the various categories of well-being mentioned above. Testimonial information was gathered from interviews with respondents to gain a more personal insight into their stories. The majority of respondents indicated their satisfaction with the overall Habitat for Humanity process and noticeable positive impacts on all aspects of their well-being. Responses were more varied to questions regarding a sense of community within their neighborhoods and a sense of safety. Respondents also indicated occasional dissatisfaction with the inadequate level of homeowner-related education provided through the Habitat for Humanity house-building process. Habitat for Humanity might consider focusing more attention on neighborhood revitalization initiatives including a focus on a general sense of community, overall safety, and periodic check-ins with those who have previously participated in the house-building project.
Quantum Error Mitigation (QEM) presents a promising near-term approach to reduce error when estimating expectation values in quantum computing. Here, we introduce QEM techniques tailored for quantum ...annealing, using Zero-Noise Extrapolation (ZNE). We implement ZNE through zero-temperature extrapolation as well as energy-time rescaling. We conduct experimental investigations into the quantum critical dynamics of a transverse-field Ising spin chain, demonstrating the successful mitigation of thermal noise through both of these techniques. Moreover, we show that energy-time rescaling effectively mitigates control errors in the coherent regime where the effect of thermal noise is minimal. Our ZNE results agree with exact calculations of the coherent evolution over a range of annealing times that exceeds the coherent annealing range by almost an order of magnitude.
Quantum computers hold the promise of solving certain problems that lie beyond the reach of conventional computers. Establishing this capability, especially for impactful and meaningful problems, ...remains a central challenge. One such problem is the simulation of nonequilibrium dynamics of a magnetic spin system quenched through a quantum phase transition. State-of-the-art classical simulations demand resources that grow exponentially with system size. Here we show that superconducting quantum annealing processors can rapidly generate samples in close agreement with solutions of the Schr\"odinger equation. We demonstrate area-law scaling of entanglement in the model quench in two-, three- and infinite-dimensional spin glasses, supporting the observed stretched-exponential scaling of effort for classical approaches. We assess approximate methods based on tensor networks and neural networks and conclude that no known approach can achieve the same accuracy as the quantum annealer within a reasonable timeframe. Thus quantum annealers can answer questions of practical importance that classical computers cannot.
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