Acute lymphoblastic leukemia (ALL) is the most common malignancy among children. The trial Chinese Children Leukemia Group (CCLG)‐ALL 2008 was a prospective clinical trial designed to improve ...treatment outcome of childhood ALL through the first nation‐wide collaborative study in China. Totally 2231 patients were recruited from ten tertiary hospitals in eight cities. The patients were stratified according to clinical‐biological characteristics and early treatment response. Standard risk (SR) and intermediate risk (IR) groups were treated with a modified BFM based protocol, and there was 25%‐50% dose reduction during intensification phases in the SR group. Patients in high risk (HR) group received a more intensive maintenance treatment. Minimal residual disease (MRD) monitoring with treatment adjustment was performed in two hospitals (the MRD group). Complete remission (CR) was achieved in 2100 patients (94.1%). At five years, the estimate for overall survival (OS) and event‐free survival (EFS) of the whole group was 85.3% and 79.9%, respectively. The cumulative incidence of relapse (CIR) was 15.3% at five years. The OS, EFS and CIR for the SR group were 91.5%, 87.9%, and 9.7%, respectively. The outcome of the MRD group is better than the non‐MRD group (5y‐EFS: 82.4% vs 78.3%, P = .038; 5y‐CIR: 10.7% vs 18.0%, P < .001). Our results demonstrated that the large‐scale multicenter trial for pediatric ALL was feasible in China. Dose reduction in the SR group could achieve high EFS. MRD‐based risk stratification might improve the treatment outcome for childhood ALL.
Summary
We explored the prognostic factors for children with very high‐risk (VHR) Philadelphia chromosome (Ph) negative B‐cell acute lymphoblastic leukaemia (B‐ALL) and compared the therapeutic ...effects of intensive chemotherapy and unmanipulated haploidentical haematopoietic stem cell transplantation (haplo‐HSCT) as post‐remission treatment in these patients undergoing first complete remission (CR1). A total of 104 paediatric patients with VHR B‐ALL in CR1 were retrospectively enrolled in this study, including 42 receiving unmanipulated haplo‐HSCT (Group A) and 62 receiving ongoing chemotherapy (Group B). Estimated 3‐year overall survival (OS), disease‐free survival (DFS) and cumulative incidence of relapse (CIR) at 36·2 months median follow‐up were 69·5 ± 4·7%, 63·5 ± 4·8% and 32·4 ± 4·7%, respectively. Maintenance of persistent positive or conversion from negative to positive of measurable residual disease (MRD) and chemotherapy were independent risk factors associated with inferior long‐term survival and higher CIR. OS, DFS, and CIR differed significantly between the groups in patients with persistent positive or negative‐to‐positive MRD. Haplo‐HSCT may be an option for children with VHR Ph‐negative B‐ALL in CR1, especially for patients with persistent positive or negative‐to‐positive MRD, and could achieve better survival than intensive chemotherapy as post‐remission treatment.
Direct detection of circularly polarized light (CPL) is a challenging task due to limited materials and ambiguous structure–property relationships that lead to low distinguishability of the light ...helicities. Perovskite ferroelectric semiconductors incorporating chirality provide new opportunities in dealing with this issue. Herein, a pair of 2D chiral perovskite ferroelectrics is reported, which have enhanced CPL detection performance due to interplays among lattice, photon, charge, spin, and orbit. The chirality‐transfer‐induced chiral&polar ferroelectric phase enhances the asymmetric nature of the photoactive sublattice and achieves a switchable self‐powered detection via the bulk photovoltaic effect. The single‐crystal‐based device exhibits a CPL‐sensitive detection performance under 430 nm with an asymmetric factor of 0.20 for left‐ and right‐CPL differentiation, about two times that of the pure chiral counterparts. The enhanced CPL detection performance is ascribed to the Rashba–Dresselhaus effect that originates from the bulk inversion asymmetry and strong spin–orbit coupling, shown with a large Rashba coefficient, which is demonstrated by density functional theory calculation and circularly polarized light excited photoluminescence measurement. These results provide new perspectives on chiral Rashba ferroelectric semiconductors for direct CPL detection and ferroelectrics‐based chiroptics and spintronics.
A pair of 2D chiral perovskite Rashba ferroelectric semiconductors is reported. The fabricated single‐crystal device responds to circularly polarized light (CPL) under 430 nm with an anisotropy factor of 0.20 for the left‐ and right‐CPL differentiation, about two times of reported pure chiral counterparts. The enhanced performance is ascribed to the Rashba–Dresselhaus effect with a large Rashba coefficient of 0.93 eV Å.
Background The presence of mixed-lineage leukaemia rearrangement (MLL-r) in paediatric patients with acute myeloid leukaemia (AML) is a poor prognostic predictor. Whether allogeneic haematopoietic ...stem cell transplantation (allo-HSCT) is beneficial in such cases remains unclear. Methods We evaluated the outcomes and prognostic factors of allo-HSCT in 44 paediatric patients with MLL-r AML in the first complete remission (CR1) between 2014 and 2019 at our institution. Results For all the 44 patients, the 3-year overall survival (OS), event-free survival (EFS), and cumulative incidence of relapse (CIR) were 74.5%, 64.1%, and 29.1%, respectively. Among them, 37 (84.1%) patients received haploidentical (haplo)-HSCT, and the 3-year OS, EFS, and CIR were 73.0%, 65.6%, and 26.4%, respectively. The 100-day cumulative incidence of grade II-IV acute graft-versus-host disease (aGVHD) post-transplantation was 27.3%, and that of grade III-IV aGVHD was 15.9%. The overall 3-year cumulative incidence of chronic graft-versus-host disease (cGVHD) post-transplantation was 40.8%, and that of extensive cGVHD was 16.7%. Minimal residual disease (MRD)-positive (MRD +) status pre-HSCT was significantly associated with lower survival and higher risk of relapse. The 3-year OS, EFS, and CIR differed significantly between patients with MRD + pre-HSCT (n = 15; 48.5%, 34.3% and 59%) and those with MRD-pre-HSCT (n = 29; 89.7%, 81.4% and 11.7%). Pre-HSCT MRD + status was an independent risk factor in multivariate analysis. Conclusions Allo-HSCT (especially haplo-HSCT) can be a viable strategy in these patients, and pre-HSCT MRD status significantly affected the outcomes. Keywords: MLL rearrangement, Paediatric patient, Acute myeloid leukaemia, Haploidentical haematopoietic stem cell transplantation
Although chimeric antigen receptor T-cell (CAR-T) therapy produces a high complete remission rate among patients with relapsed/refractory B-cell acute lymphoblastic leukemia, relapse remains an ...urgent issue. It is uncertain whether consolidative haploidentical-allogeneic hematopoietic stem cell transplantation (haplo-HSCT) is suitable for achieving sustainable remission. Therefore, we aimed to assess the efficacy and safety of bridging CAR-T therapy to haplo-HSCT. Fifty-two patients with relapsed/refractory Philadelphia chromosome-negative B-cell acute lymphoblastic leukemia who underwent haplo-HSCT after CAR-T therapy were analyzed. The median time from CAR-T therapy to haplo-HSCT was 61 days. After a median follow-up of 24.6 months, the 1-year probabilities of event-free survival, overall survival, and cumulative incidence of relapse were 80.1% (95% confidence interval (CI), 69.0-90.9), 92.3% (95% CI, 85.0-99.5), and 14.1% (95% CI, 10.7-17.4), respectively, while the corresponding 2-year probabilities were 76.0% (95% CI, 64.2-87.7), 84.3% (95% CI, 74.3-94.3), and 19.7% (95% CI, 15.3-24.0), respectively. No increased risk of 2-year cumulative incidence of graft-versus-host disease, treatment-related mortality, or infection was observed. A pre-HSCT measurable residual disease-positive status was an independent factor associated with poor overall survival (hazard radio: 4.201, 95% CI: 1.034-17.063; P = 0.045). Haplo-HSCT may be a safe and effective treatment strategy to improve event-free survival and overall survival after CAR-T therapy.
Pediatric acute myeloid leukemia (AML) with t(8;21) (q22;q22) is classified as a low-risk group. However, relapse is still the main factor affecting survival. We aimed to investigate the effect of ...allogeneic hematopoietic stem cell transplantation (allo-HSCT) on reducing recurrence and improving the survival of high-risk pediatric t(8;21) AML based on minimal residual disease (MRD)-guided treatment, and to further explore the prognostic factors to guide risk stratification treatment and identify who will benefit from allo-HSCT.
Overall, 129 newly diagnosed pediatric t(8;21) AML patients were included in this study. Patients were divided into high-risk and low-risk group according to RUNX1-RUNX1T1 transcript levels after 2 cycles of consolidation chemotherapy. High-risk patients were divided into HSCT group and chemotherapy group according to their treatment choices. The characteristics and outcomes of 125 patients were analyzed.
For high-risk patients, allo-HSCT could improve 5-year relapse-free survival (RFS) rate compared to chemotherapy (87.4% vs. 61.9%; P = 0.026). Five-year overall survival (OS) rate in high-risk HSCT group had a trend for better than that in high-risk chemotherapy group (82.8% vs. 71.4%; P = 0.260). The 5-year RFS rate of patients with a c-KIT mutation in high-risk HSCT group had a trend for better than that of patients with a c-KIT mutation in high-risk chemotherapy group (82.9% vs. 75%; P = 0.400). Extramedullary infiltration (EI) at diagnosis was associated with a high cumulative incidence of relapse for high-risk patients (50% vs. 18.4%; P = 0.004); allo-HSCT can improve the RFS (P = 0.009).
allo-HSCT can improve the prognosis of high-risk pediatric t(8;21) AML based on MRD-guided treatment. Patients with a c-KIT mutation may benefit from allo-HSCT. EI is an independent prognostic factor for high-risk patients and allo-HSCT can improve the prognosis.
Mantodea is a predatory insect group, its members occupying a diverse array of widely distributed habitats. Praying mantis species utilize hunting strategies including remarkable mimicry and unique ...camouflage for hiding from natural enemies while catching their prey. The emergence of a “cyclopean ear” in mantises is thought to be a morphological innovation of the group, and an “arms race” with echolocating bats is one of the hypotheses put forward to account for the emergence of the mantis ear from a coevolutionary perspective. However, this hypothesis has not been rigorously tested because of a lack of robust higher‐level phylogeny and a detailed chronogram of Mantodea. Previous phylogenetic studies found an incongruence between traditional classification and molecular phylogenetics due to the convergent evolution of various ecomorphic strategies of the lineage. Here, we performed a comprehensive phylogenetic analysis of Mantodea based on data from 61 mitogenomes. Our analyses showed that the monophyly of Acanthopidae, Haaniidae, Nanomantidae, Miomantidae and Mantidea was supported. The newly updated Gonypetidae were paraphyletic, whereas Eremiaphilidae, Deroplatyidae and Toxoderidae were polyphyletic. Our molecular dating analyses inferred that Spinomantodea originated at ca. 149 Ma (Late Jurassic), whereas the origin of hearing mantises (Cernomantodea) was inferred as Early Cretaceous (119 Ma, 95% CI: 110–129 Ma). The molecular dating results indicated that the hearing organ in mantises did not arise in response to bat predation. Our study provides a robust framework for further evolutionary comparative studies of mantises.
The higher‐level phylogeny of Mantodea was elucidated.
An early Cretaceous origin for hearing mantises was estimated and long predates the emergence of echolocating bats.
Molecular dating analyses showed the diversification of angiosperms may have contributed to the radiation of major mantodean lineages.
Copper (I) based halide scintillators have received high attention due to their high light yield. At the same time, researchers are increasingly interested in exploring organic‐inorganic hybrid ...copper(I) based halides, due to the diversity and tunability of structures. Here, we describe high‐efficiency photoluminescence and X‐ray excited luminescence in (DFPD)3Cu2I5 (1) (DFPD=4,4‐difluoro‐bipiperidinium). 1 is comprised of a unique Cu2I53− cluster, which have typical structure allowing high‐transition‐probability self‐trapped exciton emission (one Cu+ ion adopts the tetrahedral coordination geometry, the other trigonal planar coordination geometry, the Cu−Cu distance (2.574 Å) is short). Accordingly, 1 shows efficient yellow‐green photoluminescence with the maximum at 527 nm, a full‐width at half‐maximum of 99.2 nm, a large Stokes shift of 214 nm (1.6 eV) and a quantum yield of 77.15 %. Polycrystalline 1 can also convert high‐energy X‐ray photons into UV‐visible pulsed fluorescence with the light yield of 5000 photons/MeV. This finding plays a valuable role in the development of organic‐inorganic hybrid copper(I) based scintillators.
A hybrid copper (I)‐based metal halide scintillator, (4,4‐difluoro‐bipiperidinium)3Cu2I5, which shows a high‐efficiency photoluminescence with quantum yield of 77.15 % and X‐ray excited luminescence with the optical yield of 5000 photons/MeV, is described.
Increasing attention has been devoted to studying perovskite‐type multifunctional stimuli‐responsive materials with multiple channel physical characteristics. However, it remains challenging to ...simultaneously achieve multifunction and regulate structural phase transition temperature in hybrid perovskites. Here, we report two three‐dimensional organic–inorganic hybrid rare‐earth double perovskite compounds, (HQ)2RbEu(NO3)6 (1, HQ=quinuclidium) and (4FHQ)2RbEu(NO3)6 (2, 4FHQ=4‐fluoro‐quinuclidium), which exhibit ferroelasticity, dielectric switch, and excellent photoluminescence response. The phase transition temperature of 2 increases 169 K compared with 1 through H/F substitution. This result is attributed to the H/F substitution inducing the generation of the Rb‐F coordination bond between cations and anions. Meanwhile, the photoluminescence emission intensity of 2 shows no quench with the increase of temperature, in particular, the emission spectrum achieves fine regulation at high temperatures. This work provides a new solution for the realization of multi‐functions and regulations of the properties based on hybrid perovskite materials with high critical temperatures.
Multifunctional perovskites: Two 3D hybrid rare‐earth double perovskite compounds show multiple stimuli‐responsive properties that ferroelasticity, dielectric switch, and photoluminescence. The photoluminescence response shows that the emission intensity has no quench as the temperature increased. In particular, using the H/F substitution strategy generating an Rb‐F coordinate bond enhanced the interactions between the cations and the anions to realize high Tc ferroelasticity.
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