ALBERT

Description: Solar radiation incident at the Earth’s surface (Rs) is an essential component of the total energy exchange between the atmosphere and the surface. Reanalysis data have been widely used, but a comprehensive validation using surface measurements is still highly needed. In this study, we evaluated the Rs estimates from six current representative global reanalyses (NCEP–NCAR, NCEP-DOE; CFSR; ERA-Interim; MERRA; and JRA-55) using surface measurements from different observation networks [GEBA; BSRN; GC-NET; Buoy; and CMA] (674 sites in total) and the Earth’s Radiant Energy System (CERES) EBAF product from 2001 to 2009. The global mean biases between the reanalysis Rs and surface measurements at all sites ranged from 11.25 W/m2 to 49.80 W/m2. Comparing with the CERES-EBAF Rs product, all the reanalyses overestimate Rs, except for ERA-Interim, with the biases ranging from −2.98 W/m2 to 21.97 W/m2 over the globe. It was also found that the biases of cloud fraction (CF) in the reanalyses caused the overestimation of Rs. After removing the averaged bias of CERES-EBAF, weighted by the area of the latitudinal band, a global annual mean Rs values of 184.6 W/m2, 180.0 W/m2, and 182.9 W/m2 were obtained over land, ocean, and the globe, respectively.

Description: The acute myeloid leukemia in elderly patients (EAML) is always associated with low complete remission (CR) rate and a poor survival due to prolonged pancytopenia and resistance of leukemic blasts to chemotherapy. The standard or high dose induction chemotherapy improved CR rate but remission is usually transient. Nonmyeloablative allergenic stem cell transplantation shows some curative effects but associated with severe graft-versus-host disease (GVHD). Recently, our clinical studies showed that HLA-mismatched microtransplantation (MST) could increase CR rate and improve the survival but without GVHD. However, it is still lack of data and multicentre studies about MST in such patients. Here, we designed a multicentre study about microtransplantation in combination with chemotherapy in such patients and elevate effects and toxicity. Method. Total of the 148 patients with AML at the age of 60 years or over from May 2005 to May 2014, were enrolled in this study from the 11 hematology disease centers in China. The diagnosed was defined by the French-American-British (FAB) and WHO criteria. Chromosomal and immunephenotyping analyses were performed by pre-treatment of bone marrow obtained. Patients with acute promyelocytic leukemia or with a blast crisis of chronic myeloid leukemia were excluded. High risk was defined by the presence of complex cytogenetic abnormalities (with 3 or more cytogenetic abnormalities), secondary AML, or a WBC count of 50,000/µL or above. Other patients were considered at a standard risk. In accordance with the Helsinki Declaration, written informed consent for enrollment in this study was obtained from the patients or their legal guardians and the donors. Induction therapy includes cytarabine and anthracycline followed by HLA-mismatched G-CSF Mobilization HLA-mismatched donor peripheral stem cells (G-PBSC) infusion. The patients who achieved complete remission (CR) further received two courses of cytarabine as post-remission chemotherapy. None of the patients received any GVHD prophylactic treatment and further maintenance therapy. The donor and recipient HLA-A, HLA-B, HLA-C, HLA-DRB1 and HLA-DQB1 alleles were genotyped using a PCR-SSP method. All of 148 patients had HLA-mismatched related or unrelated donors including 126 with a family-related donor, 16 with a distantly related donor and 6 with an unrelated donor. G-PBSC infusion: the median number of mononuclear cells, CD34+ and CD3+ T cells infused per course was 2.9 (1.2-5.2)´108/kg, 1.7(1.1-4.6)´106/kg and 0.9(0.5-2.6)´108/kg, respectively. Results. Total of 148 patients were divided into three groups with 60-65 years (n=54), 66-70 years (n=41) and over 71 years (n=53). The overall CR rate was 77% and CR rate of the first cycle of induction chemotherapy was 55.3%. The CR rate was not significantly different among the patients with 60-64 years (74.1%), 65-70 years (80.4%), and over 71 years (77.4%). The CR rate was much higher in the standard group than in the high risk group (88.2% vs. 63.3%, P=0.04). The early death rate and severe infection was no significantly different among three groups. The median recovery time of neutrophils and platelets was 12d and 14d, which were not significantly different among three groups. The probabilities of 12 months OS, 24 months and 36 months were not significantly different among the patients with 60-65 years (80.9%, 60.9% and 55.8%), 66-70 years (65.4%, 46.5% and 34.9%) and over 71 years (71.3%, 30.6% and 26.8%). No definite clinical acute or chronic GVHD was observed in all of the patients but two patients who developed a severe acute GVHD and dead on day 36. A frequencies of HLA-A0201/2402WT1+CD8+ T-cells was 0.23% which is no significantly difference between the patients with low 70 years or more. The donor micro-chimerism was detected in 11 of the 18 female patients with a range of 0.0000151- 0.0386 copies of gene expression. In conclusion, the microtransplantation combined conventional chemotherapy can result in a higher CR rate and OS with a shorter duration of pancytopenia, lower severe infections and hardly no GVHD, suggested that it is a much safer and effective new therapy for elderly AML patients including those who over 70 years old. Disclosures No relevant conflicts of interest to declare.

Description: The optimal therapy for intermediate-risk patients with acute myeloid leukemia (AML) in first complete remission (CR1) is uncertain. Recent studies shown that microtransplantation (MST) can improve survival in AML-CR1 patients. However, a comparison study between the MST and nonmyeloablative stem cell transplantation (NST) is lacking. 156 intermediate-risk AML-CR1 patients aged 9 to 59 years were enrolled in this study. 57 patients who had a HLA-identical donors were assigned to receive NST therapy with graft-versus-host disease (GVHD) prophylaxis. The other 99 who had no HLA-identical donors including 86 family-related, 9 distantly related and 4 unrelated donor were assigned to receive MST therapy but without GVHD prophylaxis. The probabilities of 10-year overall survival and leukemia-free survival was comparable in the MST-group and NST-group (70.7% vs. 61.4% and 59.6% vs. 57.9%). The NST-group exhibited a higher full donor chimerism (96.5%) and higher GVHD (33.3%), whereas the MST-group produced a higher donor microchimerism (75%), slightly higher relapse (32.3% vs. 22.8%) and significantly lower non-relapse mortality (6.9% vs. 19.3%, P=0.021) but without GVHD. In the MST-group, the patients with increase of WT1+ CD8+ T cells exhibited significantly higher leukemia-free survival and lower relapse than those without (92.0% vs. 40.0%, P=0.003; 8.0% vs. 50%, P=0.009). These results indicate that, compared to NST, MST produced a comparable survival, less transplantation-related mortality, avoidance of clinical GVHD and overcome limitations of HLA-barrier, suggesting a much safe and effective therapy for intermediate-risk AML-CR1, particularly for those without a HLA-identical donor. Disclosures No relevant conflicts of interest to declare.