ALBERT

Description: Background: MCL is an aggressive and prognostically unfavorable subtype of B-cell NHL, with a 5-yr survival rate 50,000/ml was 〉20 wks and were transfusion dependent. No pt developed serious infections. Conclusions: 90Y-Zevalin consolidated the therapeutic benefit of FCM±R in 13 MCL pts. Fludarabine, a known radiosensitizer, can reduce tumor burden before RIT and enhance the therapeutic benefit of non-myeloablative doses of 90Y-Zevalin, but may also ↑ the toxicity from RIT. Although we have shown 90Y-Zevalin has negative effects on stem and early progenitor cells, 90Y-Zevalin can be safely given after fludarabine-based therapy to MCL pts.

Description: Background: The 5-yr survival rate is

Description: Background: We have shown that administration of 90Y-Zevalin to consolidate the therapeutic effects of fludarabine, cyclophosphamide, and mitoxatrone (FCM) ± rituximab (R) in the FCM ± R à 90Y-Zevalin MCL trial from the Polish Lymphoma Research Group (PLRG) Multicenter Study resulted in PRs with FCM ± R becoming CRs after 90Y-Zevalin. This finding could potentially benefit many MCL patients whose disease prognosis is poor. Our initial findings indicate that hematologic toxicity, as measured by duration of PMNs 〈 1000/ml and PLTs 〈 50,000/ml, is manageable, with recovery complete within 7–13 wks after 90Y-Zevalin. Other researchers have reported that low dose rate radiation therapy is known to cause prolonged marrow damage to progenitors and stromal cells and reduce stem cell yields. Therefore, we specifically studied the hematologic toxicity of this consolidation regimen with 90Y-Zevalin and the radiosensitizing drug fludarabine. Methods: We enrolled 10 histopathologically confirmed MCL patients (stage III-IV) who were ineligible for SCTs. Patients were treated with 3–6 cycles of FCM ± R. Patients were given 250 mg/m2 of R followed 1 wk later with a second dose of R + 90Y-Zevalin (11 or 15 MBq = 0.3 or 0.4 mCi/Kg based on PLT count; maximum dose = 32 mCi). Cytopenia was assessed with full blood counts every wk until recovery. Trephine biopsies were performed before 90Y-Zevalin dosing and at 2 and 6 wks after 90Y-Zevalin to assess marrow cellularity and stromal cells. At the same time points, mantle cell (CD19+CD20+CD5+CD23−) infiltration of bone marrow (BM) was assessed by flow cytometry; myeloid clonogenic capacity (CFU-GM, BFU-E, CFU-GEMM, CFU-Meg) was evaluated by cell culture; and BM stroma function was measured by assaying 5 cytokines: GM-CSF, EPO, TPO, IL-3, and SCF. Results were compared with 7 historical follicular lymphoma (FL) patients who received 90Y-Zevalin without fludarabine following relapse after chemoimmunotherapy (R-CHOP). Results: The level of neutro- and thrombocytopenia was greater in patients who received FCM ± R à 90Y-Zevalin than in patients who received only 90Y-Zevalin. A 2- to 4-fold greater degree of clonogenic capacity impairment was seen with FCM ± R 90Y-Zevalin compared with only 90Y-Zevalin, except for the CFU-Megs profiles, which were similar in both groups. A 7- to 10-fold ↓ in myeloid stem and progenitor cells in response to FCM + R à RIT was associated with a ↓ in PMNs and PLTs. However, hematopoietic recovery was not prolonged in the fludarabine-pretreated group and did not correlate with the duration of CFU-GM and CFU-GEMM suppression. Stromal cells experienced minimal, transitory (fully reversible by 2 wks) impairment, suggesting a negligible adverse effect of 90Y-Zevalin on BM stroma. Compared with pre-90Y-Zevalin values, GM-CSF levels ↓ 2-fold at wk 4, and TPO and IL-3 ↓ 30% and 3-fold, respectively, at wk 2. EPO levels ↓ 3-fold during the first 4 wks and paralleled decreases in BFU-Es. Conclusions: The consolidation of FCM ± R with 90Y-Zevalin in MCL patients is a promising therapeutic approach. The FCM + R 90Y-Zevalin treatment resulted in significant damage to myeloid stem and progenitor cells and increased neutro- and thrombocytopenia compared with 90Y-Zevalin alone, but cytopenias are still manageable and hematopoietic recovery occurs within 9–12 wks after 90Y-Zevalin. Clinicians must monitor the amount of BM infiltration and the BM hypocellularity after FCM + R before administering 90Y-Zevalin.

Description: Winter storms are an important factor affecting the Polish coast. Short-term water-level variations caused by winter storms significantly alter the coast in the non-tidal Baltic Sea, where extreme water levels depend on the volume of water flowing in from the North Sea. If the Baltic does not have the time to “fill in,” high wind speeds and wave heights are insufficient to cause major damage. Although this phenomenon has been widely discussed in literature, no studies focused on western Poland have comprehensively documented the evolution of both the foreshore and nearshore coastal profile. This paper describes the meteorological and hydrological conditions of the severe storm Xavier, which traversed the Polish coast from December 5–7, 2013, as well as its impacts on the bathymetric and topographic profile of the coast along the pier in Międzyzdroje. Shoreline changes caused by the Xavier storm are compared with the effects of smaller events that occurred in 2014. The results show that winter storm Xavier completely rebuilt the profile of the coast. The foreshore was eroded and beach elevation was reduced by an average of 0.5 m. Accumulation was observed in the vicinity of the water line down to a depth of 1 m. Furthermore, erosion processes dominated in the nearshore section with an average value of 0.27 m and a maximum of 0.62 m, with a small exception at a depth of 2 m. Although the erosion rates caused by Xavier were significant, in some sections they were comparable to the effects of shorter and weaker storms that occurred in the area both before and after Xavier.

Description: Coastal erosion is a major issue facing Europe that will only worsen under future climate change and the resulting sea level rise. One effect of erosion is the loss of ecosystem services, which are provided by coastal areas, such as provisioning, regulating, habitat, and cultural services. These services can be quantified in monetary terms. Here, we present comprehensive estimates of future decline in coastal ecosystem services due to the erosion of sandy coastlines. We used datasets derived from remote sensing products: a pan-European land cover/use dataset (Corine Land Cover) and new global probabilistic coastal erosion projections constrained by artificial and topographical barriers to erosion. The results include historical changes (2000-2018) and projections under two emission scenarios (RCP4.5 and RCP8.5) for 2050 and 2100 together with uncertainty bounds. We estimate that in 2018, the coastal zone (excluding open sea) included 579,700 km2 of habitats generating 494 billion euros of services annually. The future sea-level rise could erode 1.0% [90% confidence interval 0.7-1.5%] of the 2018 area under RCP4.5, and 1.2% [0.7-2.2%] under RCP8.5. The decline in services would be even greater: 4.2% [3.0-6.1%] under RCP4.5, and 5.1% [3.3-8.5%] under RCP8.5. The highest absolute losses would be sustained by salt marshes, while relative losses would be highest in beaches, sands, and dunes. The most affected countries in relative economic terms would be Denmark, Albania, Greece, Estonia, and Finland, but countries such as Germany, the Netherlands, and France would be among those losing the largest share of their coastal ecosystem services. Regional analysis using NUTS 3 regions shows high diversity of the impacts, with many regions along the North Sea and eastern Mediterranean Sea that are heavily affected by coastal erosion-induced loss of ecosystem services. The study highlights the urgency of undertaking mitigation actions.