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BACKGROUND: Extracorporeal membrane oxygenation (ECMO) has been widely used in patients with COVID-19, but uncertainty remains about the determinants of in-hospital mortality and data on post-discharge outcomes are scarce. The aims of this study were to investigate the variables associated with in-hospital outcomes in patients who received ECMO during the first wave of COVID-19 and to describe the status of patients 6 months after ECMO initiation.METHODS: EuroECMO-COVID is a prospective, multicentre, observational study developed by the European Extracorporeal Life Support Organization. This study was based on data from patients aged 16 years or older who received ECMO support for refractory COVID-19 during the first wave of the pandemic-from March 1 to Sept 13, 2020-at 133 centres in 21 countries. In-hospital mortality and mortality 6 months after ECMO initiation were the primary outcomes. Mixed-Cox proportional hazards models were used to investigate associations between patient and management-related variables (eg, patient demographics, comorbidities, pre-ECMO status, and ECMO characteristics and complications) and in-hospital deaths. Survival status at 6 months was established through patient contact or institutional charts review. This study is registered with ClinicalTrials.gov, NCT04366921, and is ongoing.FINDINGS: Between March 1 and Sept 13, 2020, 1215 patients (942 [78%] men and 267 [22%] women; median age 53 years [IQR 46-60]) were included in the study. Median ECMO duration was 15 days (IQR 8-27). 602 (50%) of 1215 patients died in hospital, and 852 (74%) patients had at least one complication. Multiorgan failure was the leading cause of death (192 [36%] of 528 patients who died with available data). In mixed-Cox analyses, age of 60 years or older, use of inotropes and vasopressors before ECMO initiation, chronic renal failure, and time from intubation to ECMO initiation of 4 days or more were associated with higher in-hospital mortality. 613 patients did not die in hospital, and 547 (95%) of 577 patients for whom data were available were alive at 6 months. 102 (24%) of 431 patients had returned to full-time work at 6 months, and 57 (13%) of 428 patients had returned to part-time work. At 6 months, respiratory rehabilitation was required in 88 (17%) of 522 patients with available data, and the most common residual symptoms included dyspnoea (185 [35%] of 523 patients) and cardiac (52 [10%] of 514 patients) or neurocognitive (66 [13%] of 512 patients) symptoms.INTERPRETATION: Patient's age, timing of cannulation (FUNDING: None.

The majority of patients with large B-cell lymphoma treated with axicabtagene ciloleucel (axi-cel), an anti-CD19 chimeric antigen receptor (CAR) T-cell therapy, develop cytokine release syndrome (CRS). Whether the lack of development of CRS with axi-cel is associated with inferior lymphoma outcomes is unknown. Additionally, relationship between CRS grade and lymphoma outcome is not well established.The US Lymphoma CAR T Consortium includes seventeen US academic centers that contribute data independently of manufacturers. We analyzed the modified intent-to-treat population of 275 patients receiving axi-cel in two different ways: 1) Two group analysis comparing no CRS with any grade CRS; 2) Three group analysis comparing grade 0 CRS with grade 1 to 2 CRS, and grade 3-5 CRS.In this large multi-center observational cohort of 275 patients receiving axi-cel, 9% (n = 24) did not develop CRS, 84% (n = 232) developed grade 1-2 CRS, and 7% (n = 19) developed grade 3 to 5 CRS. Patients without CRS, compared with those having any grade CRS, had similar overall response rates (ORR), lower complete response (CR) rates and inferior progression free survival (PFS) with no statistically significant difference in overall survival (OS). Patients experiencing grade 1 to 2 CRS had superior CR rate and PFS, as compared to those without CRS or with grade 3 to 5 CRS. Grade 3 to 5 CRS was associated with a worse OS.Overall, durable responses were seen in patients that did not develop CRS, however grade 1 to 2 CRS was associated with better outcomes while those with grade 3 to 5 experienced the worse outcomes.

Most patients with advanced-stage indolent non-Hodgkin lymphoma have multiple relapses. We assessed axicabtagene ciloleucel autologous anti-CD19 chimeric antigen receptor (CAR) T-cell therapy in relapsed or refractory indolent non-Hodgkin lymphoma.ZUMA-5 is a single-arm, multicentre, phase 2 trial being conducted at 15 medical cancer centres in the USA and two medical cancer centres in France. Patients were eligible if they were aged 18 years or older, with histologically confirmed indolent non-Hodgkin lymphoma (follicular lymphoma or marginal zone lymphoma), had relapsed or refractory disease, previously had two or more lines of therapy (including an anti-CD20 monoclonal antibody with an alkylating agent), and an Eastern Cooperative Oncology Group performance score of 0 or 1. Patients underwent leukapheresis and received conditioning chemotherapy (cyclophosphamide at 500 mg/mBetween June 20, 2017, and July 16, 2020, 153 patients were enrolled and underwent leukapheresis, and axicabtagene ciloleucel was successfully manufactured for all enrolled patients. As of data cutoff (Sept 14, 2020), 148 patients had received an infusion of axicabtagene ciloleucel (124 [84%] who had follicular lymphoma and 24 [16%] who had marginal zone lymphoma). The median follow-up for the primary analysis was 17·5 months (IQR 14·1-22·6). Among patients who were eligible for the primary analysis (n=104, of whom 84 had follicular lymphoma and 20 had marginal zone lymphoma), 96 (92%; 95% CI 85-97) had an overall response and 77 (74%) had a complete response. The most common grade 3 or worse adverse events were cytopenias (104 [70%] of 148 patients) and infections (26 [18%]). Grade 3 or worse cytokine release syndrome occurred in ten (7%) patients and grade 3 or 4 neurological events occurred in 28 (19%) patients. Serious adverse events (any grade) occurred in 74 (50%) patients. Deaths due to adverse events occurred in four (3%) patients, one of which was deemed to be treatment-related (multisystem organ failure).Axicabtagene ciloleucel showed high rates of durable responses and had a manageable safety profile in patients with relapsed or refractory indolent non-Hodgkin lymphoma.Kite, a Gilead Company.

Analyze the pattern of disease failure after anti-CD19-directed chimeric antigen receptor T-cell therapy (CART) for non-Hodgkin lymphoma, assess the local control rate of bridging radiotherapy (bRT) and characterize in-field recurrences.We retrospectively reviewed 120 patients with NHL who received CART between 2018 and 2020. Baseline characteristics and treatment outcomes were compared between patients who received bRT and those who did not (noRT).Of the 118 patients included, 14 (12%) received bRT, while 104 (88%) did not. bRT group had more localized and extranodal disease. bRT was delivered with a median dose of 20 Gy (range: 15-36) in 5 fractions (range: 3-24). Pattern of failure analysis revealed that progression involving pre-existing sites was the predominant pattern of failure in both the bRT and noRT groups (86% and 88%, respectively). Median duration of response was 128 days (range: 25-547) for bRT group and 93 days (range: 22-965) for noRT group (p = 0.78). In the bRT group, only 2/15 sites irradiated had infield recurrence and where characterized by bulky disease, SUVMajority of progressions after CART infusion involve pre-existing sites. Bridging RT prior to CART provides excellent in-field local control and durable response. Patients with bulky disease, SUV

Objective: To conduct a proof-of-concept study of the detection of two synthetic models of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) using polarimetric imaging. Methods: Two SARS-CoV-2 models were prepared as engineered lentiviruses pseudotyped with the G protein of the vesicular stomatitis virus, and with the characteristic Spike protein of SARS-CoV-2. Samples were preparations in two biofluids (saline solution and artificial saliva), in four concentrations, and deposited as 5-{\mu}L droplets on a supporting plate. The angles of maximal degree of linear polarization (DLP) of light diffusely scattered from dry residues were determined using Mueller polarimetry of 87 samples at 405 nm and 514 nm. A polarimetric camera was used for simultaneous imaging of several samples under 380-420 nm illumination at angles similar to those of maximal DLP. A per-pixel image analysis included quantification and combination of polarization feature descriptors in other 475 samples. Results: The angles (from sample surface) of maximal DLP were 3 degrees for 405 nm and 6 degrees for 514 nm. Similar viral particles that differ only in the characteristic spike protein of the SARS-CoV-2, their corresponding negative controls, fluids, and the sample holder were discerned from polarimetric image analysis at 10-degree and 15-degree configurations. Conclusion: Polarimetric imaging in the visible spectrum has the potential for non-contact, reagent-free detection of viruses in multiple dry fluid residues simultaneously. Further analysis including real SARS-CoV-2 in human samples -- particularly, fresh saliva -- are required. Significance: Polarimetric imaging under visible light could contribute to fast, cost-effective screening of SARS-CoV-2 and other pathogens.

Background Patients (pts) with aggressive B-cell non-Hodgkin lymphoma (NHL) progressing after anti-CD19 chimeric antigen receptor T (CART) cell therapy have poor prognosis and may benefit from new therapy options through clinical trials. However, in a single center report, only 12% of such pts were treated in trials (Chow et al. Am J Hematol, 2019). Identifying the reasons for this low enrollment is needed to design future studies for this population. Here, we evaluated the eligibility criteria for recent landmark trials for relapsed/refractory aggressive B-cell NHL to learn what eligibility barriers are present. Methods Pts with aggressive B-cell NHL who received FDA-approved CART cell therapy at Mayo Clinic (Rochester, Arizona, Florida) since 2018 and progressed after CART cell therapy were identified. The potential eligibility for the following key trials was evaluated: a) polatuzumab + bendamustine + rituximab, b) tafasitamab + lenalidomide, c) selinexor and d) loncastuximab. The eligibility for each trial was retrospectively assessed at the time of disease progression after CART cell therapy based on hemoglobin (Hb), absolute neutrophils count (ANC), platelet count (Plt), renal and liver function tests, ECOG performance status (PS), and central nervous system (CNS) involvement. Results Seventy-five pts had disease progression to axicabtagene ciloleucel (N=73, 97%) or tisagenlecleucel (N=2, 3%) and are included in this analysis. Median time to progression after CART was 2.1 months (IQR: 1.0 - 3.1). Thirteen (17%) pts were treated in clinical trials after progression following CART cell therapy, while 46 (61%) were treated off trials, and 16 (22%) pts never received any treatment after progression. At a median follow-up of 13.6 months (IQR: 9.1 - 26.7) from CART progression, the median overall survival (mOS) from CART progression was 5.8 months (95% CI 3.5 - 10.1) and 53 (71%) pts died. Thirty-eight pts (51%) did not meet eligibility criteria for any of the 4 recent landmark trials. Hematologic impairment was the most common barrier to inclusion of these patients in clinical trials: Hb < 9 g/dL n=23 (31%) or Hb < 10 g/dL n=36 (48%), ANC < 1.0 x 10 9/L n=19 (25%) or ANC < 1.5 x 10 9/L n=32 (43%), and Plt < 75 x 10 9/L n=30 (40%) or Plt < 90 x 10 9/L n=34 (45%). Renal (n=11, 15%) or liver dysfunction (n=5, 7%), CNS involvement (n=8, 11%) and ECOG PS > 2 (n=3, 4%) were less common reasons leading to exclusion from trials. Post CART trial ineligible pts had significantly shorter time to progression (median 1.7 months, IQR: 1.0 - 2.6 vs. 3.0 months IQR: 1.9 - 3.4, p < 0.01) and inferior overall response to CART (45% vs 67%, p = 0.06) compared to pts who met trial eligibility post CART. Baseline Hb (median Hb 9.5 g/dL, IQR: 8.5 - 10.5 vs. 10.9 g/dL, IQR: 9.7 - 12.2, p < 0.01) and Plt (median Plt 106 x 10 9/L IQR: 54 - 165 vs. 201 x 10 9/L IQR: 141 - 243, p < 0.01) were also significantly lower in pts ineligible for trials post CART. There were no significant differences between pts eligible or ineligible for trials with regards to age (median 59 vs. 60 years), number of prior therapies (median 3 vs. 3), prior autologous stem cell transplant (41% vs. 37%), bridging therapy (65% vs. 63%), baseline ANC (median 4,1 vs. 3,0 x10 9/L), or high-grade (grade ≥ 2) cytokine release syndrome (19% vs. 21%) or neurotoxicity (32%, vs. 42%), respectively. Survival after CART progression was significantly shorter (mOS 2.5 months, 95% CI: 1.6 - 5.1) for the 38 pts ineligible for trials compared to pts eligible for trials (mOS 10.6 months, 95% CI: 8.9 - NA), (p < 0.01). In the 59 pts who received therapy post CART progression, the mOS of pts treated on (n = 13) or off (n = 46) trials was 13.8 months (95% CI: 9.2 - NA) vs. 6.6 months (4.9 - 10.7), respectively (p = 0.047). Conclusion Approximately half of the pts (51%) with aggressive B-cell NHL progressing after CART cell therapy would have be excluded from landmark clinical trials. The current hematologic exclusion criteria are a major barrier to enrollment in clinical trials, which would exclude many pts who have disease progression within 3 months of CART cell therapy (ie, primary refractory disease), in whom cytopenia as a toxicity from therapy is prevalent. Given the known delayed hematologic recovery after CART cell therapy and the unmet need of pts progressing to CART cell therapy, the hematologic exclusion criteria should be adjusted to increase trial participation of this population, especially of those with primary refractory disease. Figure 1 Figure 1. Disclosures Munoz: Gilead/Kite Pharma, Kyowa, Bayer, Pharmacyclics/Janssen, Seattle Genetics, Acrotech/Aurobindo, Beigene, Verastem, AstraZeneca, Celgene/BMS, Genentech/Roche.: Speakers Bureau; Janssen: Research Funding; Pharmacyclics/Abbvie, Bayer, Gilead/Kite Pharma, Pfizer, Janssen, Juno/Celgene, BMS, Kyowa, Alexion, Beigene, Fosunkite, Innovent, Seattle Genetics, Debiopharm, Karyopharm, Genmab, ADC Therapeutics, Epizyme, Beigene, Servier: Consultancy; Seattle Genetics: Research Funding; Millennium: Research Funding; Pharmacyclics: Research Funding; Genentech: Research Funding; Incyte: Research Funding; Portola: Research Funding; Merck: Research Funding; Celgene: Research Funding; Gilead/Kite Pharma: Research Funding; Bayer: Research Funding; Seattle Genetics: Honoraria; Physicians' Education Resource: Honoraria; Targeted Oncology: Honoraria; OncView: Honoraria; Kyowa: Honoraria. Murthy: CRISPR Therapeutics: Research Funding. Maurer: Morphosys: Membership on an entity's Board of Directors or advisory committees, Research Funding; Nanostring: Research Funding; Kite Pharma: Membership on an entity's Board of Directors or advisory committees; Celgene: Research Funding; Genentech: Research Funding; Pfizer: Consultancy, Membership on an entity's Board of Directors or advisory committees. Bennani: Purdue Pharma: Other: Advisory Board; Daichii Sankyo Inc: Other: Advisory Board; Kyowa Kirin: Other: Advisory Board; Vividion: Other: Advisory Board; Kymera: Other: Advisory Board; Verastem: Other: Advisory Board. Paludo: Karyopharm: Research Funding. Wang: Genentech: Research Funding; Incyte: Membership on an entity's Board of Directors or advisory committees, Research Funding; MorphoSys: Research Funding; TG Therapeutics: Membership on an entity's Board of Directors or advisory committees; Eli Lilly: Membership on an entity's Board of Directors or advisory committees; LOXO Oncology: Membership on an entity's Board of Directors or advisory committees, Research Funding; Novartis: Research Funding; InnoCare: Research Funding. Ansell: Bristol Myers Squibb, ADC Therapeutics, Seattle Genetics, Regeneron, Affimed, AI Therapeutics, Pfizer, Trillium and Takeda: Research Funding. Witzig: Karyopharm Therapeutics, Celgene/BMS, Incyte, Epizyme: Consultancy, Membership on an entity's Board of Directors or advisory committees; Celgene/BMS, Acerta Pharma, Kura Oncology, Acrotech Biopharma, Karyopharm Therapeutics: Research Funding. Nowakowski: Celgene, NanoString Technologies, MorphoSys: Research Funding; Celgene, MorphoSys, Genentech, Selvita, Debiopharm Group, Kite/Gilead: Consultancy, Membership on an entity's Board of Directors or advisory committees. Lin: Vineti: Consultancy; Takeda: Research Funding; Sorrento: Consultancy; Novartis: Consultancy; Juno: Consultancy; Legend: Consultancy; Janssen: Consultancy, Research Funding; Bluebird Bio: Consultancy, Research Funding; Celgene: Consultancy, Research Funding; Merck: Research Funding; Gamida Cell: Consultancy; Kite, a Gilead Company: Consultancy, Research Funding.

Purpose/Objective(s) Anti-CD19-directed chimeric antigen receptor T-cell therapy (CART) is a new treatment option for patients with relapsed and/or refractory non-Hodgkin lymphoma (NHL). We reviewed the outcomes of patients receiving CART and the potential role of bridging radiation therapy (bRT) in reducing local recurrences. Materials/Methods Following IRB approval, we retrospectively reviewed 120 patients with NHL who received CART between 2018 and 2020 at a multi-site single institution. Baseline clinical and treatment characteristics were compared between patients who received bRT (≤30 days prior to CART or after leukapheresis) and those who did not using chi-square and Fisher's exact tests. Overall-survival (OS) and progression-free survival (PFS) were defined from date of CART infusion and estimated by Kaplan-Meier curves. Response rate was based on the post-CART PET scan with the best attained response. Results Of 120 patients who received CART, 2 (1.7%) died soon after CART infusion from infection. Of the 118 remaining patients (88% diffuse large B-cell, 7.5% high-grade B-cell, 2.5% mantle cell, 2% primary mediastinal B-cell), 14 (12%) received bRT, while 104 (88%) did not (noRT). There were no significant differences in the baseline clinicopathological characteristics between the two groups. bRT was delivered with a median dose of 20 Gy (range 15-36) in 5 fractions (range: 3-24). No grade 2+ radiation-related toxicities were noted. Median time between end of bRT and the CART infusion was 19 days (range: 8-38). Rates of grade > 2 ICANS (21% vs 16%; P = .70) and CRS (7% vs 2%; P = .32) were not significantly different between bRT and noRT, respectively. Median follow-up was 7 months (range: 1-31). There were 42 (36%) deaths: 31 due to progression, 9 due to infection and 2 of unknown causes. The 6-month and 1-year OS were 67% and 67% for the bRT, and 76% and 63% for the noRT groups, respectively (P = .96). The median time to CART failure for the cohort was 78 days (range: 22-627). The 6-month and 1-year PFS were 47% and 47% for the bRT, and 47% and 42% for the noRT groups, respectively (P = .73). Median time to achieve the best response on PET scan was 30 days (range 22-382). Sixty patients (51%) achieved complete remission to CART, 7 (50%) in the bRT group and 53 (51%) in the noRT group, while 40 (34%) achieved partial remission, 5 (36%) in the bRT group and 35 (34%) in the noRT group (P = .97). For the entire cohort, pattern of failure analysis revealed that progression in pre-existing sites alone or in combination with new sites was the predominant site of failure in the bRT and noRT groups (86% and 88%, respectively). However, 71.4% of progressions in the bRT group occurred outside the RT field (n = 5), compared to 28.6% (n = 2) inside the RT field. Conclusion Bridging RT prior to CAR T-cell infusion is well tolerated and appears to provide excellent in-field local control. Large prospective studies evaluating the value of integrating bRT with CAR T-cell therapy are needed.

Objective Historically, nearly all relapses in classical Hodgkin lymphoma (cHL) occur within the first 5 years of treatment (Radford et al., BMJ 1997;314:346). In ECHELON-1, brentuximab vedotin, doxorubicin, vinblastine, and dacarbazine (A+AVD) significantly improved modified progression-free survival (PFS) versus doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) in patients with stage III/IV cHL (Connors et al., NEJM 2018;378:331). We report updated efficacy and safety results; median follow-up was 60.9 months. Design This phase 3, open-label study (NCT01712490) randomized patients with previously untreated stage III/IV cHL to receive 6 cycles of A+AVD or ABVD. Patients underwent an interim positron emission tomography scan after cycle 2 (PET2). An exploratory analysis of PFS per investigator was conducted. Results There were 664 and 670 patients randomized to receive A+AVD and ABVD, respectively. 64%, 62%, and 58% of patients had stage IV disease, extranodal involvement at diagnosis, and B symptoms, respectively. Five-year PFS was 82.2% (95% confidence interval [CI]: 79.0–85.0) with A+AVD and 75.3% (95% CI: 71.7–78.5) with ABVD. Overall, PFS favored A+AVD (hazard ratio [HR]: 0.681; 95% CI: 0.534–0.867; P=0.002). PFS benefits were observed regardless of PET2 status and International Prognostic Score. Estimated 5-year PFS with A+AVD versus ABVD was 84.9% versus 78.9% in PET2-negative patients (HR: 0.663; 95% CI: 0.502–0.876; P=0.004), and 60.6% versus 45.9% in PET2-positive patients (HR: 0.702; 95% CI: 0.393–1.255; P=0.229). Treatment-emergent peripheral neuropathy (PN) resolved or improved in 85% (n=375/443) and 86% (n=245/286) of the patients with PN on A+AVD and ABVD, respectively. Secondary malignancies occurred in 19 and 29 patients with A+AVD and ABVD, respectively. A total of 131 female patients or partners of male patients reported a pregnancy; both arms showed similar proportions of ongoing pregnancies or live births. Conclusions At 5 years, A+AVD still demonstrates clinically meaningful improvement in PFS versus ABVD, independent of PET2 status, with a manageable safety profile, including resolution or improvement of PN. The PFS benefit observed with A+AVD at this important milestone suggests that A+AVD is an attractive treatment option for all patients with previously untreated stage III/IV cHL. Funding Millennium Pharmaceuticals and Seagen

Introduction The prognostic value of B-cell lymphoma 2 (BCL2) expression in de novo diffuse large B-cell lymphoma (DLBCL) treated with immunochemotherapy is of interest to define a target patient population for clinical development of BCL2 inhibitors. We aimed to develop a reproducible immunohistochemistry algorithm and assay to determine BCL2 protein expression and assess the prognostic value of BCL2 in newly diagnosed DLBCL cohorts. Patients and Methods The prospectively defined algorithm incorporated BCL2 staining intensity and percentage of BCL2-positive cells. Functionally relevant cutoffs were based on the sensitivity of lymphoma cell lines to venetoclax. This assay was highly reproducible across laboratories. The prognostic impact of BCL2 expression was assessed in DLBCL patients from the phase 3 MAIN (n = 230) and GOYA (n = 366) trials, and a population-based registry (n = 310). Results Approximately 50% of tumors were BCL2 positive, with a higher frequency in high International Prognostic Index (IPI) and activated B-cell–like DLBCL subgroups. BCL2 expression was associated with poorer progression-free survival in the MAIN study (hazard ratio [HR], 1.66; 95% confidence interval [CI], 0.81-3.40; multivariate Cox regression adjusted for IPI and cell of origin). This trend was confirmed in the GOYA and registry cohorts in adjusted multivariate analyses (GOYA: HR, 1.72; 95% CI, 1.05-2.82; registry: HR, 1.89; 95% CI, 1.29-2.78). Patients with BCL2 immunohistochemistry-positive and IPI-high disease had the poorest prognosis: 3-year progression-free survival rates were 51% (GOYA) and 37% (registry). Conclusion Findings support use of our BCL2 immunohistochemistry scoring system and assay to select patients with BCL2-positive tumors for future studies.

Objective: Here, we report interim results from ZUMA-5, a Phase 2 study of axi-cel, an autologous anti-CD19 chimeric antigen receptor (CAR) T cell therapy, in patients with relapsed/refractory iNHL. Design: Adults with relapsed/refractory follicular lymphoma (FL) or marginal zone lymphoma (MZL) after ≥2 lines of therapy (including an anti-CD20 monoclonal antibody with an alkylating agent) were eligible. Patients were leukapheresed and received conditioning chemotherapy followed by axi-cel at 2 × 106 CAR T cells/kg. The primary endpoint was objective response rate (ORR) by central review (Cheson, et al. J Clin Oncol. 2014). Secondary endpoints included duration of response (DOR), progression-free survival (PFS), overall survival (OS), safety, and blood levels of CAR T cells. Results: As of 8/20/19, 94 patients (80 FL; 14 MZL) received axi-cel (median follow-up, 11.5 months). Median age was 63 years, 51% of patients had ≥3 FLIPI, 59% had high tumor bulk, 66% progressed Conclusions: Axi-cel showed significant clinical benefit, with high response rates, and a manageable safety profile in patients with relapsed/refractory iNHL. Funding provided by Kite, a Gilead Company.

This work deals with a Distribution Static Synchronous Compensator (D-STATCOM) based on a current-source converter for low and medium voltage distribution systems, specifically small and medium manufactures industries which are fined if the displacement power factor is below given limits. The D-STATCOM is analyzed using its mathematical model, showing the strong relation of the D-STATCOM power losses and its DC current level. Using the operating region of the D-STATCOM, an operating sub-region is defined such that the minimum DC current is used for a required reactive compensation, which leads to reducing the operating losses in the D-STATCOM. Also, Selective Elimination Harmonic is used to modulate the equipment to reduce the switching frequency while ensuring a desired current quality in the D-STATCOM input. As a result, a simple control strategy is proposed that uses a fixed modulation index while a phase control regulates the DC current to the lowest value required for reactive power compensation. Mathematical analysis jointly with simulated and experimental results corroborates the proposal, showing that it is possible to achieve a suitable compensation capability for improving the efficacy of the STATCOM.

Introduction Outcomes with salvage regimens in pts with MCL who progress after Bruton tyrosine kinase inhibitor (BTKi) therapy are poor. ZUMA-2 is a Phase 2, registrational, multicenter study evaluating KTE-X19, an autologous anti-CD19 CAR T cell therapy, in pts with R/R MCL (1-5 therapies, including a BTKi). We present interim efficacy and safety results. Objectives Evaluate efficacy and safety of KTE-X19 in R/R MCL. Methods Eligible pts (≥ 18 y) with R/R MCL had an ECOG of 0-1 and ≤ 5 prior therapies, including chemotherapy, an anti-CD20 antibody, and a BTKi. Pts underwent leukapheresis and conditioning chemotherapy followed by KTE-X19 infusion at 2 × 106 cells/kg. Bridging therapy with dexamethasone, ibrutinib, or acalabrutinib was permitted. The primary endpoint was objective response rate (ORR; complete response [CR] + partial response) assessed by an Independent Review Committee per the Lugano Classification (Cheson, et al. J Clin Oncol. 2014). Interim efficacy endpoints were investigator-assessed using the revised IWG Response Criteria for Malignant Lymphoma (Cheson, et al. J Clin Oncol. 2007). Key secondary endpoints were duration of response (DOR), progression-free survival (PFS), overall survival (OS), frequency of adverse events (AEs), and blood levels of CAR T cells and cytokines. Sixty pts received KTE-X19; here, we present results in pts with ≥ 1 y follow-up. Updated results in all 60 pts will be reported in the presentation. Results As of May 30, 2018, 28 pts received KTE-X19 with ≥ 1 y follow-up (median, 13.2 mo). The median age was 65 y; 43% of pts had an ECOG score of 1; 21% had blastoid morphology; 82% had stage IV disease; 50% had intermediate/high-risk MIPI; and 86% received a median of 4 prior therapies. In 20 of 28 pts with available data, the median Ki-67 index was 38%. Eight pts received bridging therapy; all had disease present post-bridging. Investigator-assessed ORR was 86% (95% CI, 67-96) with a CR rate of 57% (95% CI, 37-76). As of May 30, 2018, 75% of responders remained in response, and 64% of treated pts had ongoing responses. The 12-month rates of DOR, PFS, and OS were 83% (95% CI, 60-93), 71% (95% CI, 50-84), and 86% (95% CI, 66-94), respectively; medians were not reached. The most common Grade ≥ 3 AEs were anemia (54%), platelet count decreased (39%), and neutropenia (36%). Grade 3/4 cytokine release syndrome (CRS) assessed by Lee et al. (Blood. 2014) and Grade 3/4 neurologic events (NE) occurred in 18% and 46% of pts, respectively, with no Grade 5 events. CRS and NE were generally reversible. There was 1 Grade 5 AE of organizing pneumonia. Median CAR T cell levels measured by peak and area under the curve were 99 cells/µL (range, 0.4-2589) and 1542 cells/µL (range, 5.5-27239), respectively. Conclusion With ≥ 1 y follow-up, KTE-X19 demonstrated significant and durable clinical benefit, with a manageable safety profile in pts with R/R MCL for whom there are no curative treatment options.

Resumen Fundamento y objetivo La obesidad puede acompanarse de peores resultados tras cirugia cardiaca. Nuestro objetivo es evaluar las consecuencias de la obesidad en relacion con la aparicion de complicaciones postoperatorias, la estancia y la mortalidad. Metodo Estudio observacional, prospectivo y multicentrico de pacientes recogidos en el registro ARIAM de cirugia cardiaca de adultos entre marzo de 2008 y marzo de 2011. Se han analizado variables clinicas, del acto quirurgico, complicaciones postoperatorias y mortalidad, comparando los grupos de pacientes con indice de masa corporal (IMC) mayor o menor de 30 kg/m2. Resultados El estudio incluye 4.172 pacientes con una edad media (DE) de 64,03 (12,08) anos, IMC de 28,53 (4,7) kg/m2 y EuroSCORE de 5,58 (2,91). En 1.490 pacientes (35,7%) el IMC fue mayor de 30 kg/m2. No se encontraron diferencias en el desarrollo de complicaciones posquirurgicas globales (33% en obesos y 35,8% en no obesos, p = 0,07). Los pacientes obesos mostraron menor necesidad de reintervencion quirurgica y menor incidencia de accidente cerebrovascular en el postoperatorio (p Conclusiones Los enfermos obesos sometidos a cirugia cardiaca presentan una mortalidad, complicaciones y estancia similares a las de los no obesos. Estos pacientes son reintervenidos con menos frecuencia, aunque es mas habitual el desarrollo de fracaso renal agudo en el postoperatorio.

This paper has analysed the effect of the utilization of internal finned tubes for the design of parabolic trough collectors with computational fluid dynamics tools. Our numerical approach has been qualified with the computational estimation of reported experimental data regarding phenomena involved in finned tube applications and solar irradiation of parabolic trough collector. The application of finned tubes to the design of parabolic trough collectors must take into account features as the pressure losses, thermal losses and thermo-mechanical stress and thermal fatigue. Our analysis shows an improvement potential in parabolic trough solar plants efficiency by the application of internal finned tubes.

Este artículo analiza el rendimiento a largo plazo de los sistemas fotovoltaicos (FV) colectivos fuera de la red en áreas rurales. El uso de sistemas fotovoltaicos colectivos para la electrificación de pueblos pequeños y medianos en países en desarrollo ha aumentado en los últimos años. Básicamente se configuran como instalaciones aisladas (híbridas diésel o fotovoltaica pura) sin conexión con otras redes eléctricas. Sus condiciones particulares (aislados) y lugares habituales de instalación (lejos de centros comerciales/industriales) requieren una tecnología autónoma y confiable. Factores diferentes pero relacionados afectan su desempeño y el suministro de energía; algunos de ellos son estrictamente técnicos, pero otros dependen de cuestiones externas como el recurso de energía solar y el consumo de energía y energía de los usuarios. El trabajo presentado se basa en la operación de campo de doce instalaciones fotovoltaicas colectivas que suministran electricidad a pueblos sin red ubicados en la provincia de Jujuy, Argentina. Cinco de ellos cuentan con generadores fotovoltaicos como única fuente de energía mientras que otros siete cuentan con el apoyo de grupos diésel. Se analiza la evolución de la demanda de carga, la productividad energética y el consumo de combustible. Además, también se discuten las estrategias de generación de energía (PV/diesel). Reflejos ► La demanda de energía en la electrificación rural fuera de la red aumenta a tasas razonables. ► El perfil de demanda de energía y el diseño del sistema afectan en gran medida el rendimiento de los sistemas fotovoltaicos puros y fotovoltaicos híbridos. ► Se pueden lograr grandes ahorros de combustible mediante la instalación de paneles fotovoltaicos combinados con generadores diésel. ► El monitoreo de los sistemas fotovoltaicos es una actividad útil para la planificación de la gestión. This article analyses the long-term performance of collective off-grid photovoltaic (PV) systems in rural areas. The use of collective PV systems for the electrification of small medium-size villages in developing countries has increased in the recent years. They are basically set up as stand-alone installations (diesel hybrid or pure PV) with no connection with other electrical grids. Their particular conditions (isolated) and usual installation places (far from commercial/industrial centers) require an autonomous and reliable technology. Different but related factors affect their performance and the energy supply; some of them are strictly technical but others depend on external issues like the solar energy resource and users’ energy and power consumption. The work presented is based on field operation of twelve collective PV installations supplying the electricity to off-grid villages located in the province of Jujuy, Argentina. Five of them have PV generators as unique power source while other seven include the support of diesel groups. Load demand evolution, energy productivity and fuel consumption are analyzed. Besides, energy generation strategies (PV/diesel) are also discussed. Highlights ► Energy demand in off-grid rural electrification increases at reasonable rates. ► Energy demand profile and system design strongly affects pure PV and hybrid-PV systems performance. ► High fuel savings can be achieved by installing PV arrays combined with diesel generators. ► Monitoring PV systems is a helpful activity for management planning.

The heterogeneous incoming heat flux in solar parabolic trough absorber tubes generates huge temperature difference in each pipe section. Helical internal fins can reduce this effect, homogenising the temperature profile and reducing thermal stress with the drawback of increasing pressure drop. Another effect is the decreasing of the outer surface temperature and thermal losses, improving the thermal efficiency of the collector. The application of internal finned tubes for the design of parabolic trough collectors is analysed with computational fluid dynamics tools. Our numerical approach has been qualified with the computational estimation of reported experimental data regarding phenomena involved in finned tube applications and solar irradiation of parabolic trough collector. The application of finned tubes to the design of parabolic trough collectors must take into account issues as the pressure losses, thermal losses and thermo-mechanical stress, and thermal fatigue. Our analysis shows an improvement potential in parabolic trough solar plants efficiency by the application of internal finned tubes.

This paper presents a simple mathematical model to estimate shading losses on PV arrays. The model is applied directly to power calculations, without the need to consider the whole current–voltage curve. This allows the model to be used with common yield estimation software. The model takes into account both the shaded fraction of the array area and the number of blocks (a group of solar cells protected by a bypass diode) affected by shade. The results of an experimental testing campaign on several shaded PV arrays to check the validity of model are also reported.

State-of-the-art concepts for solar thermal power systems are based on parabolic trough, tower or parabolic disks either heating molten salts, mineral oil, air or generating steam. We propose in this paper, a conceptual design of a solar boiler. This concept comes from the conventional thermal power plants boiler, with the difference that the heat comes from mirrors that concentrate the solar radiation on wall-type array of solar collectors, instead of coming from fuel flames and hot gases. In our preliminary performance, analysis of this innovative solar boiler applied to electricity production, we have found that overall efficiency of the conversion from direct solar irradiation energy to electricity is above 20%, which is comparable to the value of parabolic trough and central tower technologies. Besides that, the concept seems very robust and could overcome some drawbacks derived from pressure losses, control complexity and material thermo-mechanical stress.

This paper describes the practical design of a portable capacitive load based on insulated gate bipolar transistors (IGBTs), which is used to measure the I–V characteristics of PV arrays with short-circuit currents up to 80 A and open circuit voltages up to 800 V. Such measurement allows on-site characterization of PV arrays under real operating conditions and also provides information for the detection of potential array anomalies, such as broken cells or defective connections. The presented I–V load is easy to reproduce and low-cost, characteristics that are within the reach of small-scale organizations involved in PV electrification projects.