The 2010 and 2017 editions of the European LeukemiaNet (ELN) recommendations for diagnosis and management of acute myeloid leukemia (AML) in adults are widely recognized among physicians and ...investigators. There have been major advances in our understanding of AML, including new knowledge about the molecular pathogenesis of AML, leading to an update of the disease classification, technological progress in genomic diagnostics and assessment of measurable residual disease, and the successful development of new therapeutic agents, such as FLT3, IDH1, IDH2, and BCL2 inhibitors. These advances have prompted this update that includes a revised ELN genetic risk classification, revised response criteria, and treatment recommendations.
The first edition of the European LeukemiaNet (ELN) recommendations for diagnosis and management of acute myeloid leukemia (AML) in adults, published in 2010, has found broad acceptance by physicians ...and investigators caring for patients with AML. Recent advances, for example, in the discovery of the genomic landscape of the disease, in the development of assays for genetic testing and for detecting minimal residual disease (MRD), as well as in the development of novel antileukemic agents, prompted an international panel to provide updated evidence- and expert opinion-based recommendations. The recommendations include a revised version of the ELN genetic categories, a proposal for a response category based on MRD status, and criteria for progressive disease.
Because of the collapse of landfill sites, reduction and recycling of municipal solid wastes is a crucial concern in the small island states of the Caribbean region. This study is part of a project ...promoted by the General Council of Guadeloupe about home composting of household biodegradable wastes, and concerned 60 volunteer households from 10 municipalities with different pedoclimatic conditions. The aim was to examine the problems observed during home composting, and to assess compost quality. Only 32% of households experienced at least one problem during composting, including the presence of cockroaches and scolopendra (23%), rodents (12%), bad smells and excess leachate (8%). Despite these problems no one stopped composting. Most of these difficulties were not severe and slight changes in the composting procedure should be sufficient to solve them; e.g. to wear gloves when handling composts, to control harmful animals outside the composter, and to increase the stable to labile waste ratio. Neither Escherichia coli nor Salmonella sp. were present in the composts. Organic matter (OM, mean 46%), nitrogen (N, 2.2%), potassium (K, 2.1%), and lignin (20%) contents were much greater than those observed for industrial compost produced in Guadeloupe. Temperature inside the composters during the thermophilic phase (∼43 °C) was lower than that currently reported for industrial composting, which reduced OM decomposition and favoured the conservation of the more stable organic compounds such as lignin. Also, nutrient leaching was lower in the closed home composting system, which favoured the conservation of N and K. Differences between municipalities concerned the contents of calcium (greatest for the municipalities with calcareous soils) and OM (lowest for the warmer municipalities). These results indicated that home composts may be helpful to improve OM content and nutrient availability in infertile tropical soils. This study highlighted that home composting may be a suitable alternative to help local authorities to achieve targets to divert wastes from landfill.
•Home composting may be a sustainable alternative to divert wastes from landfill.•This study assessed end compost quality and problems observed during home composting.•Most of difficulties found by households were not severe and can be easily solved.•Composts were of suitable quality to be used in private gardens.•The selected households might become community leaders to promote home composting.
Symbiotic dinitrogen fixation by legume trees represents a substantial N input in agroforestry systems, which may benefit the associated crops. Applying ¹⁵N labelling, we studied N transfer via ...common mycelial networks (CMN) and root exudation from the legume tree Gliricidia sepium to the associated fodder grass Dichantium aristatum. The plants were grown in greenhouse in shared pots in full interaction (treatment FI) or with their root systems separated with a fine mesh that allowed N transfer via CMN only (treatment MY). Tree root exudation was measured separately with hydroponics. Nitrogen transfer estimates were based on the isotopic signature of N (δ¹⁵N) transferred from the donor. We obtained a range for estimates by calculating transfer with δ¹⁵N of tree roots and exudates. Nitrogen transfer was 3.7-14.0 and 0.7-2.5% of grass total N in treatments FI and MY, respectively. Root δ¹⁵N gave the lower and exudate δ¹⁵N the higher estimates. Transfer in FI probably occurred mainly via root exudation. Transfer in MY correlated negatively with grass root N concentration, implying that it was driven by source-sink relationships between the plants. The range of transfer estimates, depending on source δ¹⁵N applied, indicates the need of understanding the transfer mechanisms as a basis for reliable estimates.
The market for insulation material is playing a crucial role in Europe's energy transformation, due to its influence on energy consumption in buildings. The introduction of renewable materials for ...thermal insulation is recent, and little is known so far about its environmental implications. This study analyses the environmental performance of a cork insulation board, made of agglomerated cork from forestry cork wastes, by means of cradle-to-gate Life Cycle Assessment methodology. The results indicate that the use of natural insulation materials does not necessarily imply a reduction of environmental impacts due to manufacturing processes with a low technological development. In this case, the most influential stage is the manufacturing stage, in which the board agglomeration and the cork trituration have the highest impacts. The most influential inputs are both the transport used during the life cycle and the large quantities of electricity and diesel in the manufacturing stage. Some strategies have been identified to reduce the environmental impact, such as promote the acquisition of local raw cork to reduce transportation from the manufacturer, improve the efficiency and productivity of manufacturing processes and improve the product design to help increase its market share. Moreover, the inclusion of biogenic carbon contained in forest-based building materials affects the Global Warming Potential results considerably. However, it is very important to consider how this biogenic carbon is calculated and how the product is managed after its lifetime.
•Environmental impacts of cork insulation board have been assessed.•The majority of environmental burdens are concentrated at the manufacturing stage.•Transport and energy consumption are the most influential factors in the life cycle.•Great potential for environmental improvement throughout the manufacturing of cork board.
In 2003, an international working group last reported on recommendations for diagnosis, response assessment, and treatment outcomes in acute myeloid leukemia (AML). Since that time, considerable ...progress has been made in elucidating the molecular pathogenesis of the disease that has resulted in the identification of new diagnostic and prognostic markers. Furthermore, therapies are now being developed that target disease-associated molecular defects. Recent developments prompted an international expert panel to provide updated evidence- and expert opinion–based recommendations for the diagnosis and management of AML, that contain both minimal requirements for general practice as well as standards for clinical trials. A new standardized reporting system for correlation of cytogenetic and molecular genetic data with clinical data is proposed.
Patients with acute myeloid leukemia (AML) and FLT3/internal tandem duplication (FLT3/ITD) have poor prognosis if treated with chemotherapy only. Whether this alteration also affects outcome after ...allogeneic hematopoietic stem-cell transplantation (HSCT) remains uncertain.
We analyzed 206 patients who underwent HLA-identical sibling and matched unrelated HSCTs reported to the European Group for Blood and Marrow Transplantation with a diagnosis of AML with normal cytogenetics and data on FLT3/ITD (present: n = 120, 58%; absent: n = 86, 42%). Transplantations were performed in first complete remission (CR) after myeloablative conditioning.
Compared with FLT3/ITD-negative patients, FLT3/ITD-positive patients had higher median leukocyte count at diagnosis (59 v 21 × 10(9)/L; P < .001) and shorter interval from CR to transplantation (87 v 99 days; P = .04). Other characteristics were similar in the two groups. At 2 years, relapse incidence (RI; ± standard deviation) was higher (30% ± 5% v 16% ± 5%; P = .006) and leukemia-free survival (LFS) lower (58% ± 5% v 71% ± 6%; P = .04) in FLT3/ITD-positive compared with FLT3/ITD-negative patients. In multivariate analyses, FLT3/ITD led to increased RI (hazard ratio HR, 3.4; 95% CI, 1.46 to 7.94; P = .005), as did older age, female sex, shorter interval between CR and transplantation, and higher number of chemotherapy courses before achieving CR. FLT3/ITD positivity was associated with decreased LFS (HR, 0.37; 95% CI, 0.19 to 0.73; P = .002), along with older age and higher number of chemotherapy courses before achieving CR.
FLT3/ITD adversely affected the outcome of HSCT in the same direction it does after chemotherapy; despite this, more than half of the patients harboring this mutation who received transplants were alive and leukemia free at 2 years. To further improve the results, use of FLT3 inhibitors before or after HSCT deserves investigation.
Editorial: Stress, anxiety, and the synapse Gosselink, Kristin L; Fonseca, Jorge A Sierra; Jezova, Daniela
Frontiers in behavioral neuroscience,
11/2022, Volume:
16
Journal Article
Peer reviewed
Open access
Bertholomey et al. confirm that control adult female rats display less anxiety-like behavior than males in an elevated plus maze. Chronic corticosterone (Cort) exposure, which partially mimics a ...chronic stress condition, had no impact on anxiety measures but increased immobility in the forced swim test, a behavioral marker of depression, in an age- and sex-specific manner. Collectively, the articles in this Research Topic give a wide view of chronic stress models, their impact on excitability in the brain, and their potential contribution to the development of increased anxiety or other conditions of impaired mental health.
PURPOSE Acute myelogenous leukemia (AML) and myelodysplastic syndrome (MDS) primarily afflict older individuals. Hematopoietic cell transplantation (HCT) is generally not offered because of concerns ...of excess morbidity and mortality. Reduced-intensity conditioning (RIC) regimens allow increased use of allogeneic HCT for older patients. To define prognostic factors impacting long-term outcomes of RIC regimens in patients older than age 40 years with AML in first complete remission or MDS and to determine the impact of age, we analyzed data from the Center for International Blood and Marrow Transplant Research (CIBMTR). PATIENTS AND METHODS We reviewed data reported to the CIBMTR (1995 to 2005) on 1,080 patients undergoing RIC HCT. Outcomes analyzed included neutrophil recovery, incidence of acute or chronic graft-versus-host disease (GVHD), nonrelapse mortality (NRM), relapse, disease-free survival (DFS), and overall survival (OS). RESULTS Univariate analyses demonstrated no age group differences in NRM, grade 2 to 4 acute GVHD, chronic GVHD, or relapse. Patients age 40 to 54, 55 to 59, 60 to 64, and > or = 65 years had 2-year survival rates as follows: 44% (95% CI, 37% to 52%), 50% (95% CI, 41% to 59%), 34% (95% CI, 25% to 43%), and 36% (95% CI, 24% to 49%), respectively, for patients with AML (P = .06); and 42% (95% CI, 35% to 49%), 35% (95% CI, 27% to 43%), 45% (95% CI, 36% to 54%), and 38% (95% CI, 25% to 51%), respectively, for patients with MDS (P = .37). Multivariate analysis revealed no significant impact of age on NRM, relapse, DFS, or OS (all P > .3). Greater HLA disparity adversely affected 2-year NRM, DFS, and OS. Unfavorable cytogenetics adversely impacted relapse, DFS, and OS. Better pre-HCT performance status predicted improved 2-year OS. CONCLUSION With these similar outcomes observed in older patients, we conclude that older age alone should not be considered a contraindication to HCT.
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