Minimal residual disease (MRD) detection with translocations and T-cell receptor and immunoglobulin gene rearrangements in adult acute lymphoblastic leukemia patients: a pilot study

Objective: Monitoring minimal residual disease has become increasingly important in clinical practice of ALL management. Break-point fusion regions of leukaemia related chromosomal aberrations and rearranged immunoglobulin (Ig) and T cell-receptor (TCR) genes are used as leukaemia specific markers in genetic studies of MRD.Material and Methods: A total of 31 consecutive patients with newly diagnosed ALL were screened for eligibility criteria. Of those 26 were included in the study. One patient with partial response following induction therapy and four patients who were lost to follow-up after induction were excluded from the study; thus 21 patients were evaluated for MRD by using polymerase chain reaction (PCR), heteroduplex analysis, sequencing and quantitative real time PCR techniques. Results: Chromosomal aberrations were detected in 5 (24%) of the patients and were used for MRD monitoring. Three patients had t(9;22) translocation, the other 2 had t(4;11) and t(1;19). MRD-based risk stratification of the16 patients analysed for Ig/TCR rearrangements revealed 3 low-risk, 11 intermediate-risk and 2 high-risk patients.Conclusion: MRD monitoring is progressively getting to be a more important predictive factor in adult ALL patients. As reported by others confirmed by our limited data there is a good correlation between MRD status and clinical outcome in patients receiving chemotherapy. The pilot-study presented here is the first that systematically and consecutively performs a molecular MRD monitoring of ALL patients in Turkey

Anti-neuronal antibodies associated with headache with neurological deficits and cerebrospinal fluid lymphocytosis

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CO<inf>2</inf> absorption using diethanolamine-water solutions in a rotating spiral contactor

Results for mass transfer in a rotating spiral device are presented here for absorption of carbon dioxide from nitrogen carrier gas using mixtures of diethanolamine (DEA) and water. The ability of the device to examine the full range of flow rate ratio for the two phases while controlling the relative thicknesses of the phase layers is applied to surveying absorption performance over a wide range of DEA concentration at 312 K and 1.8 bara. Comparisons are made for a fixed 86 μm liquid layer thickness, which is shown to fix also the fraction of the liquid accessible by diffusion, while maintaining 90% removal of CO2 from a gas stream of 10% (mole) CO2 in nitrogen. The increasing liquid viscosity with DEA fraction is countered by reducing the liquid flow rate to maintain constant liquid layer thickness and diffusion depth. The allowed gas throughput, while meeting 90% removal, increases with DEA concentration until the increasing viscosity gives sufficient reduction in liquid flow rate to offset the increasing CO2 capacity of the liquid. The maximum gas flow rate has a broad peak centred at a DEA mole fraction of about 0.072 (31% by mass). Utilisation of the amine is increased as DEA concentration increases, apparently as a result of the longer residence time, suggesting an effect of chemical time scales on the order of seconds. For a fixed concentration, full utilisation of the amine is achieved by decreasing the liquid flow rate, which reduces layer thickness and increases diffusion time. The work highlights the use of the rotating spiral for rapid and accurate testing to determine optimum liquid composition of absorbent formulations

Terminating Sequential Delphi Survey Data Collection

The Delphi survey technique is an iterative mail or electronic (e-mail or web-based) survey method used to obtain agreement or consensus among a group of experts in a specific field on a particular issue through a well-designed and systematic multiple sequential rounds of survey administrations. Each of the multiple rounds of the Delphi survey administration is augmented with continuous summary feedback of aggregated responses from the same group of experts. Statistical methods to analyze data from the Delphi surveys to make decisions for terminating subsequent Delphi data collection are needed to ensure that (a) stability of the responses of the panel of experts is reached; and (b) termination of the rounds of the Delphi survey administration is based on sound statistical results. The present study presents an overview of the parametric and nonparametric statistical methods that can be used to analyze the structured Delphi survey data to make decisions about terminating the sequential Delphi survey data collection. Accessed 9,961 times on https://pareonline.net from January 23, 2012 to December 31, 2019. For downloads from January 1, 2020 forward, please click on the PlumX Metrics link to the right

Intensity-modulated radiation therapy (IMRT) with couch rotation in right unilateral breast cancer

Background: In this study, intensity-modulated radiation therapy plans were made with and without couch rotation in patients with right unilateral breast cancer, and a dosimetry analysis was carried out to compare the radiation doses received by target and normal tissues. Materials and Methods: The radiotherapy planning tomography sets of 10 patients who underwent right unilateral mastectomies were retrospectively selected. Target volumes and normal at-risk organs were recontoured, two radiotherapy plans were created for each patient, and these plans were compared by dosimetry analyses. Results: Doses in the target volume (D2%, D98, D50, HI, VRI, and T -PTV-V95) were similar between the plans. In terms of organs at-risk doses, the maximum doses in the contralateral breast were similar between the plans, while the differences in all other organs at-risk dose parameters between the plans were statistically significant. All dosimetry parameters of the heart were significantly lower in the plans with couch rotation. Ipsilateral lung doses were higher in the plans with couch rotation. Contralateral lung and mean breast doses were significantly lower in the plans with couch rotation. Conclusion: In this study, organs at-risk doses were reduced, especially for the heart and the contralateral breast, in patients who were subjected to postmastectomy radiotherapy with right thoracic wall and regional nodal irradiation without compromising radiotherapy dose coverage for the target volumes by rotating the treatment couch by 270°

Sensitive Detection of Plasmodium vivax Using a High-Throughput, Colourimetric Loop Mediated Isothermal Amplification (HtLAMP) Platform: A Potential Novel Tool for Malaria Elimination.

INTRODUCTION: Plasmodium vivax malaria has a wide geographic distribution and poses challenges to malaria elimination that are likely to be greater than those of P. falciparum. Diagnostic tools for P. vivax infection in non-reference laboratory settings are limited to microscopy and rapid diagnostic tests but these are unreliable at low parasitemia. The development and validation of a high-throughput and sensitive assay for P. vivax is a priority. METHODS: A high-throughput LAMP assay targeting a P. vivax mitochondrial gene and deploying colorimetric detection in a 96-well plate format was developed and evaluated in the laboratory. Diagnostic accuracy was compared against microscopy, antigen detection tests and PCR and validated in samples from malaria patients and community controls in a district hospital setting in Sabah, Malaysia. RESULTS: The high throughput LAMP-P. vivax assay (HtLAMP-Pv) performed with an estimated limit of detection of 1.4 parasites/ μL. Assay primers demonstrated cross-reactivity with P. knowlesi but not with other Plasmodium spp. Field testing of HtLAMP-Pv was conducted using 149 samples from symptomatic malaria patients (64 P. vivax, 17 P. falciparum, 56 P. knowlesi, 7 P. malariae, 1 mixed P. knowlesi/P. vivax, with 4 excluded). When compared against multiplex PCR, HtLAMP-Pv demonstrated a sensitivity for P. vivax of 95% (95% CI 87-99%); 61/64), and specificity of 100% (95% CI 86-100%); 25/25) when P. knowlesi samples were excluded. HtLAMP-Pv testing of 112 samples from asymptomatic community controls, 7 of which had submicroscopic P. vivax infections by PCR, showed a sensitivity of 71% (95% CI 29-96%; 5/7) and specificity of 93% (95% CI87-97%; 98/105). CONCLUSION: This novel HtLAMP-P. vivax assay has the potential to be a useful field applicable molecular diagnostic test for P. vivax infection in elimination settings