ALBERT

Description: Starting from the results regarding a nonvacuum technique to fabricate CIGS thin films for solar cells by means of single-step electrodeposition, we focus on the methodological problems of modeling at cell structure and photovoltaic module levels. As a matter of fact, electrodeposition is known as a practical alternative to costly vacuum-based technologies for semiconductor processing in the photovoltaic device sector, but it can lead to quite different structural and electrical properties. For this reason, a greater effort is required to ensure that the perspectives of the electrical engineer and the material scientist are given an opportunity for a closer comparison and a common language. Derived parameters from ongoing experiments have been used for simulation with the different approaches, in order to develop a set of tools which can be used to put together modeling both at single cell structure and complete module levels.

Description: Biomass is one of the most promising renewable energy sources. Abundantly, the potential as an alternative source to meet the world energy demand has been widely acknowledged. Gasification is one of the most efficient processes concerning thermochemical conversion, having as objective the production of a gas with useful energy power, known as producer gas. In order to optimize thermochemical processes such as the combustion of gases and subsequent gas mixture, computer modeling is becoming an important tool. Aiming to improve the performance of a combustion chamber, previously coupled to a downdraft gasifier, a thermofluidynamic model was elaborated and validated, using the concepts of computational fluid dynamics (CFD). It was reported that temperature, pressure, and velocity distributions of the computational model showed good consistency with experimental data, which allows using this model to predict the performance of this type of combustion chambers.

Description: Biomass is one of the most promising renewable energy sources. Abundantly, the potential as an alternative source to meet the world energy demand has been widely acknowledged. Gasification is one of the most efficient processes concerning thermochemical conversion, having as objective the production of a gas with useful energy power, known as producer gas. In order to optimize thermochemical processes such as the combustion of gases and subsequent gas mixture, computer modeling is becoming an important tool. Aiming to improve the performance of a combustion chamber, previously coupled to a downdraft gasifier, a thermofluidynamic model was elaborated and validated, using the concepts of computational fluid dynamics (CFD). It was reported that temperature, pressure, and velocity distributions of the computational model showed good consistency with experimental data, which allows using this model to predict the performance of this type of combustion chambers.

Description: Key Points The mechanism of bone marrow failure (BMF) in PNH is not known. Novel CD1d-restricted, GPI-specific T cells are present in PNH patients and might be responsible for BMF.

Description: Introduction Primary immune thrombocytopenia (ITP) is an acquired autoimmune disorder with a very variable outcome. Bleeding manifestations and platelets count are considered the main criteria to start treatment in these patients. The initial recommended therapy are corticosteroids and intravenous immunoglobulin (IgsIV). The aim of our study is the description of efficacy and safety of high-dose dexamethasone (Dx) used as frontline therapy in newly diagnosed ITP patients. Methods A series of patients diagnosed in our centre from March 2009 to August 2012 has been studied. They have received first-line treatment with Dx (40 mg/d four consecutive days every 2 or 4 weeks) for 1 to 6 courses. Sex, age, cardiovascular risk factors, reasons to treat, response, courses of treatment, complications and relapse rate were recorded and analyzed. Results Our series of twenty-nine patients, 18 women (62%) and 11 men (38%), had a median age of 54 years (range 16-92 years). Twenty-five patients (86%) were treated after low platelet counts (30x 10e9 / L) with or without clinical bleeding, whereas the other four patients were treated as a surgery preparation. One patient received a reduced dose of Dx (20 mg/d x 4 days) because of comorbidities and high risk of infection. In thirteen patients, IgsIV were added to Dx in the first course (1g/kg/d x 2 days), because of high bleeding risk or more severe bleeding at diagnosis. Platelets count at baseline was 15x109/ L (range 1-29 x109/ L). Ninety-three percent of patients responded after the first course of Dx (69% complete response CR, 24% partial response PR), and 45% of the patients did not require additional Dx treatment. The median time to reach a response was 5 days since the first day of treatment (range 2-60). The sixteen patients who need more than one course received a median of 4 (range 2-10), all of them without IgsIV. After a median follow-up of 14 months (range 2-45), 69% of these patients maintained the response without further treatment. Therefore, the overall response of the series reaches 83%. After 6 courses of treatment, 5 subjects did not achieved response and were classify as corticosteroid dependent. Of these, one patient was splenectomized and at present he remains at CR after 30 months of follow up. Another patient is waiting for splenectomy, and other three received thrombopoietin analogs, remaining all them in CR under treatment. Thirteen patients received a combination of Igs and Dx in the first course due to high risk of bleeding (platelets less than 20 x 10e9/L and hemorrhagic manifestations). Eleven of them (81%) achieved response (4 PR, 7CR) at a median time of 4 days (range 2–60). After the first course of treatment, 61% (8 of 13) of patients receiving both IgsIV and Dx responded, vs 35% (5 of 16) of those treated only with Dx. This difference was not statistically significant, probably because of the small number of patients in our series. All patients treated with IgsIV and Dx in the first course got the best response after 4 cycles of dexamethasone, compared to 75% of subjects treated with Dx for 4 to 6 courses. Dx was usually well tolerated, since only 13% of the patients experienced side effects: one case of hypertension, another patient developed hyperglycemia associated to corticosteroids and other two presented mild transient steroid psychosis episodes. Infectious events were not observed. Conclusions Treatment with high-dose dexamethasone as first-line treatment for ITP is a good alternative to prednisone because it shows a high efficacy and a good safety profile. In our experience, the association of IgsIV and Dx in the first course may improve the response rate and decrease the total dose of steroids needed to achieve a similar response. Disclosures: No relevant conflicts of interest to declare.

Description: Introduction Acute promyelocytic leukemia (APL) of the WHO classification is genetically characterized by the t(15;17)(q22;q21) chromosomal translocation involving the retinoic acid receptor alpha (RARA) located on band 17q21 and the promyelocytic leukemia gene (PML) on band 15q24 , leading to the PML/RARA fusion transcript, and by sensitivity of blast cells to all-trans retinoic acid or arsenic trioxide (ATO) targeted therapy. Although the vast majority of APL cases present with t(15;17)(q24;q21), formerly (q22;q21), a few patients have either simple or complex variants of this translocation involving chromosome 15, 17 and one or more other chromosomes. Analysis of these variant translocations is of great interest because they may mask a cryptic t(15;17) leading to misdiagnose a true APL as non APL-AML with other translocations involving RARA but not PML do exist, as mentioned in the WHO classification, and generally these cases do not respond to ATRA or ATO therapy and require more intensive chemotherapy. In these cases, the PML/RARA fusion gene can be identified by molecular analyses such as reverse transcriptase-polymerase chain reaction (RT-PCR) and fluorescence in situ hybridization (FISH). Case report 29-year-old man presented with dizziness and tiredness. Physical examination: organomegaly was not observed. Peripheral blood: hemoglobin concentration, 71 g/L; platelet count, 10x109/L white blood cell count (WBC) 0.5x109/L. Bone marrow aspirate showed 56% blast cells with Auer rods. Coagulation tests were normal. Leukemic cells were CD13+, CD33+, CD34-, CD117+ and HLA-DR-. Cytogenetic analysis by G-banding performed in bone marrow metaphase cells afforded the following karyotype: 46,XY, t(15;17)(q11;q21) with derivative (der) (15) shorter and der(17) longer than in classical t(15;17)(q24;q21). PCR analysis of the PML/RAR fusion gene according to standard protocols disclosed the presence of the L isoform. FISH studies using dual color dual fusion probes (Vysis) covering the entire PML and RARA genes , showed a classical 2F1G1R (2 fusion, 1 green, 1 red) signal pattern on nuclei. However , on metaphases, we detected a normal PML (red) and RARA (green) signals on normal chromosome 15 and 17 respectively , but the two fusion signals were located on der(17). The patient was treated with IC-APL protocols (all-trans retinoic acid plus daunorubicin) and complete remission was achieved after induction therapy. Discussion To explain the origin of the observed karyotype and molecular results, especially the double fusion signal on der(17), we propose two hypotheses: a classical t(15;17)(q24;q21) initially occurred leading to one fusion gene located on each derivative accompanied or followed either by a second translocation event implicating both derivative chromosomes with breakpoints located centromeric to the former breakpoint on der(15) and telomeric to the former breakpoint on der(17), or by an insertion of part of the der(15) containing the PML/RARA fusion gene into the der(17). Results obtained through FISH analysis support our first hypotheses. No differences in the clinical outcome between APL cases with classical t(15;17) and those with variant translocations leading to PML-RARA fusion gene have been reported. These results highlight the utility of combined cytogenetic, FISH and RT-PCR analyses to unveil the cases with variant or cryptic t(15;17). To our knowledge, this is the first report of an APL patient showing a variant t(15;17) involving only chromosomes 15 and 17 with two fusion signals on der(17). Disclosures: No relevant conflicts of interest to declare.

Description: Introduction Myelodysplastic Syndromes (MDS) are a heterogeneous group of clonal myeloid stem cells disorders with high prevalence in the elderly characterized by inefficient hematopoiesis, peripheral blood (PB) cytopenias, and an increased risk of transformation to acute myeloid leukemia (AML). The karyotype is the clinical parameter with the strongest prognostic impact according the IPSS-R (Greenberg et al., 2012). The most frequent cytogenetic alteration is the chromosome 5q deletion (del[5q]) which as a single anomaly, confers a good prognosis and predicts an excellent response to lenalidomide. Whether other genetic abnormalities routinely cooperate with del(5q) is not known. Whole-exome sequencing (WES) is a powerful tool to identify somatic mutations in protein coding genes that might cooperate with del(5q). In order to better understand the genetic basis of MDS with del(5q), we performed whole-exome sequencing (assessing 334,378 exons) of tumor-normal paired samples from 21 MDS patients. Herein we describe the preliminary findings. The analysis is ongoing and the complete results will be presented in the meeting. Methods A total of 21 patients with MDS (16 with del(5q) as a sole abnormality, 3 with del(5q) and additional alterations and 2 with normal karyotype) were included in our study. We examined a total of 25 tumor samples (21 diagnostic bone marrow (BM) samples with matched CD3+ cells as a controls, additional BM samples from 3 patients during lenalidomide treatment and 1 bone marrow sample from a del(5q) patient after AML progression). DNA was extracted from BM samples and from isolated peripheral blood CD3+ cells (magnetic-activated cell sorting (MACS), MiltenyiBiotec GmbH, Germany). The purity of CD3+ cells was assessed by FC 500 flow cytometer (Beckman Coulter, Hialeah, Fl, USA). Only DNA that fulfilled quality controls required by WES were submitted. For each diagnostic sample, we performed Conventional G-banding cytogenetics and fluorescence in situ hybridization (FISH, to confirm or dismiss 5q deletions). Whole-exome targeted capture was carried out on 3 μg of genomic DNA, using the SureSelect Human Exome Kit 51Mb version 4 (Agilent Technologies, Inc., Santa Clara, CA, USA). The captured and amplified exome library was sequenced with 100 bp paired-end reads on an Illumina HiSeq2000. Whole-exome sequencing data were analyzed using an in-house bioinformatics pipeline as previously reported. Somatic mutations identified as alterations present in tumor but not in the matched CD3+ sample were validated by Sanger sequencing. Results In our preliminary analysis of WES from 12 patients (10 patients with 5q- and 2 patients with normal karyotype), a total of 249 non-silent somatic variant candidates were identified, of which 146 were confirmed as somatic mutations. Recurrent mutations were observed in three genes (ASXL1, NBPF10 and SF3B1) in 3 different patients. Seven genes (HRNR, JAK2, POTEG, MUC5B, PHLDA, TTN, ZNF717) were mutated in two patients. Mutations in several genes known to be mutated in MDS (ASXL1, JAK2, RUNX1, SF3B1, SRSF2 and TET2) were also identified. Patients with the 5q deletion had an average of 11 mutations whereas patients with normal karyotype had a higher mean (14.5). Mutated genes identified in both groups were HRNR, JAK2, MUC5B, NBPF10 and SF3B1. No mutations in TP53 were detected in this subset. Pathway analysis of the complete list of somatically mutated genes will be carried out once all 21 patients are analyzed. The four in-treatment samples will be examined from their matched diagnostic samples. Conclusions Whole-exome sequencing of largely del(5q) MDS patient samples identified both known and previously unreported somatic mutations. Analysis of additional samples will allow a more complete description of the genes and pathways that may cooperate with del(5q) in the development and progression of MDS. Acknowledgments Financial support: This work has been supported (in part) by a grant from Instituto de Salud Carlos III, Ministerio de Sanidad y Consumo, Spain (PI 11/02010); by Red Temática de Investigación Cooperativa en Cáncer (RTICC, FEDER) (RD07/0020/2004; RD12/0036/0044); Acción COST BM0801: European Genomics and Epigenomics Study on MDS and AML; Sociedad Española de Hematología y Hemoterapia (SEHH) and MDS Celgene. Footnotes Rafael Bejar and Francesc Sole contributed equally. Disclosures: Díez-Campelo: Novartis and Celgene: Honoraria, Research Funding. Cañizo:Celgene Jansen-Cilag Arry Novartis: Membership on an entity’s Board of Directors or advisory committees, Research Funding. Sanchez:Celgene: Honoraria, Research Funding. Bejar:Genoptix: Consultancy, Honoraria, Membership on an entity’s Board of Directors or advisory committees; Celgene: Consultancy, Membership on an entity’s Board of Directors or advisory committees. Solé:Celgene: Consultancy, Membership on an entity’s Board of Directors or advisory committees, Research Funding.

Description: Multiple myeloma (MM) is a heterogeneous disease. Evaluation of prognostic factors and risk stratification at diagnosis is necessary to compare outcome. Attempts have been made to apply a comorbidity score in the clinical sitting, but a standardized general approach is still lacking. We hypothesized that a comprehensive examination of every associated disease in a large cohort of patients could better highlight the prognostic impact of comorbidity in MM. All consecutive patients diagnosed in our institution, from 1993 to 2013, with symptomatic MM according to IMWG criteria were included in our population-based MM registry. Patients with plasma cell leukemia or with palliative management were excluded. Clinical variables analyzed were: age, sex, Durie-Salmon, International Scoring System (ISS), percentage of plasma cell in bone marrow by morphology (PC), serum creatinine (Cr) and estimated glomerular filtration rate according with Modification of Diet in Renal Disease (eGFR-MDRD). The following comorbodities were analysed: hypertension (HTA), diabetes (DM), obesity (OB) (body mass index 〉 30 Kg/m2), hyperlipaemia (HL), prior malignancy (PM), hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), peptic ulcer (PU), thromboembolism (TE), renal transplant (RT), splenectomy (S), cutaneous disease (CD), amyloidosis (AM), heart disease (HD) (arrhythmia, congestive heart failure, coronary artery disease, other), lung disease (LD) (chronic obstructive pulmonary disease, asthma, other), liver disease (HE) (cirrhosis, non-alcoholic fatty liver disease, other), neurological disorder (ND), psychiatric disorder (PD) and rheumatologic disorder (RD). Kaplan-Meier method was used to estimate OS curves. Cox regression was used to determine the prognostic impact of each comorbidity in a univariate and multivariate model. 311 patients were eligible. Median age was 66 years (12-91), 148 men (47.6 %) and 163 women. Percentage of comorbidities was: HTA 45; OB 32.5; DM 20.4; HD 20.4; LD 15.2; PU 10; HL 9.7; ND 8; PM 7.8; PD 6.5; HBV 3.9; HE 3.9; TE 3.6; RD 3,5; AM 2.3; HCV 1.9; CD 1.6; S 1; RT 0.6; HIV 0.3. 63 patients (20.4 %) showed no comorbidities. Univariate analysis (table 1) demonstrated that AM (P=0.022), HCV (0.038), HIV (0.022), PD (0.015) and ND (0.05) were significantly associated with shorter OS. The variables associated with mortality in the multivariate analysis were age (p=0.002), ISS (III vs I: p=0.01), PC (p=0.05) and Cr (p=0.02). Results will be validated in another MM series and presented during the meeting. The overall prognosis of MM depends on a variety of host and disease-related characteristics. We confirm age, ISS, PC and Cr as robust and independent prognostic factors. Adjusting for these factors, no isolated comorbidity reach statistical significance; however, comorbidity seems to have a role in MM prognosis. More studies are warranted to define the prognostic impact of comorbidities in MM. Disclosures: No relevant conflicts of interest to declare.

Description: Key Points For patients in developing countries with APL, a clinical network of institutions made it possible to reduce significantly the early mortality and improve the OS.