Epidemiology, Diagnosis, and Treatment of HIV-Associated Non-Hodgkin Lymphoma in Resource-Limited Settings

Lymphoma was a common complication of HIV infection in the pre-antiretroviral era, and the incidence of HIV-associated lymphoma has dropped dramatically since the introduction of combination antiretroviral therapy (cART) in resource-rich regions. Conversely, lymphoma is an increasingly common complication of HIV infection in resource-limited settings where the prevalence of HIV infection is high. Relatively little is known, however, about the true incidence and optimal treatment regimens for HIV-associated lymphoma in resource-poor regions. We review the epidemiology, diagnosis, and treatment of HIV-associated non-Hodgkin lymphoma in developing nations and highlight areas for further research that may benefit care in both settings. Examples include risk modification and dose modification of chemotherapy based on HIV risk factors, improving our understanding of the current burden of disease through national cancer registries, and developing cost-effective hematopathological diagnostic strategies to optimize care delivery and maximize use of available chemotherapy

Selection of plasma facing materials for ITER

ITER will be the first tokamak having long pulse operation using deuterium-tritium fuel. The problem of designing heat removal structures for steady state in a neutron environment is a major technical goal for the ITER Engineering Design Activity (EDA). The steady state heat flux specified for divertor components is 5 MW/m{sup 2} for normal operation with transients to 15 MW/m{sup 2} for up to 10 s. The selection of materials for plasma facing components is one of the major research activities. Three materials are being considered for the divertor; carbon fiber composites, beryllium, and tungsten. This paper discusses the relative advantages and disadvantages of these materials. The final section of plasma facing materials for the ITER divertor will not be made until the end of the EDA

Development of a full-size divertor cassette prototype for ITER

Production of a full-size divertor cassette involves eight major components. All of the components are mounted on the cassette body. Inner divertor channel components for the vertical target design are being provided by the Japan Home Team. Outer divertor channel components for the vertical target design are being provided by the European and United States Home Teams. Gas box liners are being provided by the Russian Home Team. The full-size components manufactured by the four parties will be shipped to the US Home Team for assembly into a full size divertor cassette. The techniques for assembly and maintenance of the cassette will be demonstrated during this process. The assembled cassette will be tested for proper flow distribution and proof of the filling and draining procedures. The testing will include vacuum leak tightness at full temperature and pressure, cyclic heating to 150 {degrees}C, verification of dimensional accuracy of the assembled components, and application of thermal gradients to measure dimensional stability. The development of the divertor for the International Thermonuclear Experimental Reactor (ITER) depends on successful R&D efforts on materials, joining, and plasma materials interactions. Results of the development program are presented. The scale-up of the processes developed in the basic research and development tasks is accomplished by producing and high-heat-flux testing medium and full-scale mock- ups. The design of the mock-ups is discussed

Proceedings of US/Japan workshop, Q219 on high heat flux components and plasma surface interactions for next fusion devices

This report contains the viewgraphs from the proceedings of US/Japan Workshop on High Heat Flux Components and Plasma Surface Interactions for Next Fusion Devices. Some of the general topics covered by this report are: PFC/PSI in tokamak and helical devices; development of high heat flux components; PSIS and plasma facing materials;tritium; and material damage

PLT neutral injector performance

The experience with respect to beamline operation on PLT and on the Princeton test stand is reviewed. We discuss the performance of the injectors, beam energy distributions as measured by two techniques, beam-associated impurities, control of gas evolution in the drift duct by titanium evaporation, reionization in the drift duct, and the computer archiving and control system currently under development

Three-Year Follow-Up Analysis of Axicabtagene Ciloleucel in Relapsed/Refractory Indolent Non-Hodgkin Lymphoma (Zuma-5)

Axicabtagene ciloleucel (axi-cel) is an autologous anti-CD19 chimeric antigen receptor (CAR) T-cell therapy approved for relapsed/refractory (R/R) follicular lymphoma (FL). Approval was supported by the phase 2, multicenter, single-arm ZUMA-5 study of axi-cel for patients with R/R indolent non-Hodgkin lymphoma (iNHL; N = 104), including FL and marginal zone lymphoma (MZL). In the primary analysis (median follow-up, 17.5 months), the overall response rate (ORR) was 92% (complete response rate, 74%). Here, we report long-term outcomes from ZUMA-5. Eligible patients with R/R iNHL after ≥2 lines of therapy underwent leukapheresis, followed by lymphodepleting chemotherapy and axi-cel infusion (2 × 106 CAR T cells per kg). The primary end point was ORR, assessed in this analysis by investigators in all enrolled patients (intent-to-treat). After median follow-up of 41.7 months in FL (n = 127) and 31.8 months in MZL (n = 31), ORR was comparable with that of the primary analysis (FL, 94%; MZL, 77%). Median progression-free survival was 40.2 months in FL and not reached in MZL. Medians of overall survival were not reached in either disease type. Grade ≥3 adverse events of interest that occurred after the prior analyses were largely in recently treated patients. Clinical and pharmacokinetic outcomes correlated negatively with recent exposure to bendamustine and high metabolic tumor volume. After 3 years of follow-up in ZUMA-5, axi-cel demonstrated continued durable responses, with very few relapses beyond 2 years, and manageable safety in patients with R/R iNHL. The ZUMA-5 study was registered at www.clinicaltrials.gov as #NCT03105336