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Imatinib has become the gold standard therapy for Ph(+) CML, as it induces complete cytogenetic remission (CCR) in 75-90% of patients in chronic phase (CP), and up to 40% of these patients obtain at least a 3 log reduction of BCR/ABL transcript [Kantarjian HM, Cortes JE, O'Brien S, Luthra R, Giles F, Verstovsek S, et al. Long-term survival benefit and improved complete cytogenetic and molecular response rates with imatinib mesylate in Philadelphia chromosome-positive chronic-phase chronic myeloid leukemia after failure of interferon-alpha. Blood. 2004;104:1979-1988]. However, it is not yet stated whether continued therapy is required to maintain this response or whether imatinib may be discontinued after confirmation of a prolonged complete molecular remission (CMR). We here report on a Ph(+) CML case in long lasting CCR following interferon-alpha treatment (IFN) which reached CMR with imatinib but soon relapsed at molecular level after this latter drug discontinuation; we considered the present observation also in the light of previously reported data.

The objective of the present investigation was the preparation of microspheres consisting of high amylose starch cross-linked in situ by means of sodium trimetaphosphate. 5-fluorouracil was chosen as a model drug. Since this preparation entailed several process and formulation variables, a preliminary screening design was applied to identify the most important factors and thereby simplify the system under study. This was performed with regard to the spherical shape and the capacity of drug encapsulation of the obtainable microparticles. An eight-factor 12-run Plackett-Burman design enabled the factor number to be reduced so that a three-factor face-centered central composite design could subsequently be applied in order to optimize the formulation by response surface methodology. The factors involved in the optimization process were the concentrations of the following components: 5-fluorouracil, starch and cross-linker. The responses evaluated were the morphology of the microspheres (a qualitative response) and the drug encapsulation efficiency. An optimal formulation yielded microparticles that were spherical in shape, with a volume diameter of 25.5 ± 0.6 pm and a narrow particle size distribution. Particle yield ranged from 85 to 98%, the encapsulation efficiency reached about 30% and the drug loading was in the range of 0.8-1.5%. Due to polymer swelling properties, 5-fluorouracil was released in vitro in a sustained manner by an anomalous release mechanism. Microparticles also showed good mucoadhesion properties that would make them suitable for peroral drug administration.

In 1999, WHO proposed a revised classification for myelodysplastic syndromes (MDS). According to this system, FAB low risk MDS (RA and RARS) were defined as such when the presence of dysplastic features was only restricted to the erythroid lineage, and new categories, refractory cytopenia with multilineage dysplasia (RCMD) and refractory cytopenia with multilineage dysplasia and ringed sideroblasts (RCMD-RS), were added. In a retrospective analysis of 240 consecutive patients diagnosed at our institution as having FAB RA and RARS, we reclassified the disease following the WHO criteria and we found that 179/214 patients (84%) still remained in the RA category, while 35/214 (16%) moved to RCMD. Moreover, 17/26 patients (65%) maintained the RARS diagnosis, whereas 9/26 (35%) were re-classified as RCMD-RS. We detected differences among the WHO subgroups as to age and sex distribution as well as to median survival observed by stratifying patients according to different prognostic scoring systems. Furthermore we confirmed the usefulness of WHO segregation with regard to its predictive value for evolution into acute leukaemia. Our study provides evidence that WHO classification may have prognostic impact on MDS subgroups which are usually categorized by FAB as having a favourable outcome.

GaAs/Al-GaAs core-shell nanowires fabricated by molecular beam epitaxy contain quantum confining structures susceptible of producing narrow photoluminescence (PL) and single photons. The nanoscale chemical mapping of these structures is analyzed in 3D by atom probe tomography (APT). The study allows us to confirm that Al atoms tend to segregate within the AlGaAs shells towards the vertices of the hexagons defining the nanowire cross section. We also find strong alloy fluctuations remaining AlGaAs shell, leading occasionally to the formation of quantum dots (QDs). The PL emission energies predicted in the framework of a 3D effective mass model for a QD analyzed by APT and the PL spectra measured on other nanowires from the same growth batch are consistent within the experimental uncertainties.

The Budd-Chiari syndrome (BCS), characterized by the obstruction and occlusion of the suprahepatic veins, is a rare but typical complication occurring in patients with polycythemia vera (PV). We describe three young women who developed BCS as first manifestation of PV, in association with an inherited thrombophilic state and in the absence of concomitant use of oral contraceptives. Our report illustrates the existence of an aggressive form of myeloproliferative disorder, which requires prompt recognition and immediate therapeutic intervention including cytostatic drugs and anticoagulant treatment. Furthermore, we suggest the need of routine screening for thrombophilic state in young women affected by PV.

All-trans retinoic acid (ATRA) has markedly improved the outcome of APL: however, the incidence of thrombotic events seems to be higher in the ATRA treated patients. To assess the true incidence of such complications, we compared 2 different cohorts of APL patients: 37 patients (M/F 17/20, median age 37 years, range 14 – 58) treated with chemotherapy (CHT) alone (GIMEMA 0389-group A) and 90 patients (M/F 40/50, median age 43.5 years, range 19 – 75) treated with ATRA + CHT (AIDA and AIDA 2000 protocols-group B). In the group A, no patient had thrombotic complications during induction or consolidation treatment: however, among 15 patients who relapsed and received a reinduction treatment with ATRA +/− CHT, 3 (20%) developed a thrombotic disease [1 acute myocardial infarction (AMI), 1 pulmunary embolism, 1 deep venous thrombosis (DVT)]. In the group B, 11/90 patients (M/F 5/6, median age 60 years, range 32 – 71) (12%) had a thrombotic event. Of them, 8 patients developed it during induction (4 episodes of unstable angina, 2 right ventricular thrombosis, 2 DVT), after a median time of 26 days from ATRA treatment (range 3 – 78), a median PLTS count of 208 x 109/l (3/8 patients showed a PLTS count < 50 x 109/l when the thrombotic event occurred) and without prothrombotic biochemical abnormalities. The remaining 3 patients developed a DVT during consolidation phase, after 31, 34 and 37 days respectively from start of 1st consolidation cycle and with a normal PLTS count. No association was observed with ATRA syndrome or haemorrhagic diathesis at presentation, whereas 8/11 patients showed the presence of FLT3-ITD at diagnosis. Phenotypic characterization revealed a classic panel in all patients (CD13+, CD33+, CD9+, MPO+), but a peculiar positivity for CD2 was seen in 7 patients, for CD15 in 3 patients and for both antigens in 1 patient. CD2 antigen is normally found on T cells and mediates adhesion to CD58: it is possible that this aberrant expression on the surface of APL cells play a role in the leuko-agglutination during ATRA treatment, contributing to thromboses in peculiar site, such as right ventriculum. In the 3 patients CD2 negative, we found a similar aberrant expression of CD15, that has been reported in literature as an antigen normally modulated by ATRA, together with other adhesion molecules. The association between CD2 expression, short type of bcr transcript and FLT3 abnormalities has been also confirmed. Our data outline the increase of thrombotic risk linked to ATRA treatment in APL patients, with an incidence of 10 – 15% to be confirmed in other series. We suggest a possible and crucial role of aberrant features at diagnosis, such as phenotype and molecular abnormalities, to explain this high thrombotic incidence: thus, further prospective studies are warranted to analyse clinical and biological factors predisposing to thrombotic disease in such patients.

We describe the first case of secondary acute myeloid leukemia (AML) with t(3;3) (q21;q26) occurring in a human immunodeficiency virus (HIV)-infected patient sequentially treated with chemotherapy and highly active antiretroviral therapy (HAART). The t(3;3) is a nonrandom abnormality found in a small percentage of patients with myelodysplastic syndrome, secondary AML or chronic myeloid leukemia and is strongly associated with abnormal thrombopoiesis and a particularly poor prognosis. So far, it has never been observed in HIV-positive patients. Sporadic cases of AML have been reported in HIV patients and the feasibility of chemotherapy in association with HAART and disease outcome are still not clearly defined. Despite the poor response to chemotherapy in our case, which might also be related to the unfavorable karyotype, the secondary nature of the disease and the HIV positivity, the patient had a relatively long period of survival that could be due to the use of HAART. The association of chemotherapy with HAART appeared to be feasible and tolerable and could be suggested as a choice treatment in this peculiar subset of HIV/AML patients.

The aim of this study was to describe the presenting features, the frequency and outcome of myeloid sarcoma (MS) diagnosed in our Institution from January 1995 to December 2000. Twelve MS were seen and the frequency account for only 2% of all acute myeloid leukemia (AML) patients observed in our department in the same period. Median age was 45 years (range: 4-84). All had been initially misdiagnosed as malignant lymphoma (ML) and a median of 2.9 months (range: 1-6) elapsed between the misdiagnosis and the correct of MS, effectuated in our department. At that time, a bone marrow examination revealed a myelodysplastic condition in seven patients, an infiltration by blast cells >30% in two patients, and normal features in the other three. In the non-leukemic patients a median of 5 months (range: 2-44 months) elapsed between the diagnosis of MS and acute leukemia. In all, 10 patients received intensive treatment. A total of seven patients (70%) achieved MS complete remission (CR). Patients who presented isolated skin localization and received only radiotherapy, obtained a MS-CR, but subsequently developed AML. Only in patients who were treated within 4 months from the initial ML diagnosis we achieved complete remission of both MS and leukemia, whereas in patients who were treated after this time, we obtained a complete disappearance of MS without response at the bone-marrow level, irrespectively of the specific therapy regimen. Median survival time from MS diagnosis was 7 months (range: 1-49 months), and only one patient is still alive, 49 months after bone marrow transplantation. Our data stress the importance of an accurate and prompt identification of this rare form of AML, and suggest that, even in patients with isolated MS, the early administration of AML-like intensive chemotherapy followed by bone marrow transplantation might reduce the risk of subsequently developing systemic disease.

The growth of compound semiconductor nanowires on the silicon platform has opened many new perspectives in the area of electronics, optoelectronics and photovoltaics. We have grown a 1 × 1 mm2 array of InAs nanowires on p-type silicon for the fabrication of a solar cell. Even though the nanowires are spaced by a distance of 800 nm with a 3.3% filling volume, they absorb most of the incoming light resulting in an efficiency of 1.4%. Due to the unfavourable band alignment, carrier separation at the junction is poor. Photocurrent increases sharply at the surrounding edge with the silicon, where the nanowires do not absorb anymore. This is further proof of the enhanced absorption of semiconductors in nanowire form. This work brings further elements in the design of nanowire-based solar cells.

Magnetic nanotubes (NTs) are interesting for magnetic memory and magnonic applications. We report magnetotransport experiments on individual 10 to 20 mu m long Ni and CoFeB NTs with outer diameters ranging from 160 to 390 nm and film thicknesses of 20 to 40 nm. The anisotropic magnetoresistance (AMR) effect studied from 2 K to room temperature (RT) amounted to 1.4% and 0.1% for Ni and CoFeB NTs, respectively, at RT. We evaluated magnetometric demagnetization factors of about 0.7 for Ni and CoFeB NTs having considerably different saturation magnetization. The relatively large AMR value of the Ni nanotubes is promising for RT spintronic applications. The large saturation magnetization of CoFeB is useful in different fields such as magnonics and scanning probe microscopy using nanotubes as magnetic tips. (C) 2014 Author(s).

We study the neutral exciton (X) and charged exciton (CX) transitions from (Al,Ga)As shell quantum dots located in core-shell nanowires, in the presence of a magnetic field. The g-factors and the diamagnetic coefficients of both the X and the CX depend on the orientation of the field with respect to the nanowire axis. The aspect ratio of the X wavefunction is quantified based on the anisotropy of the diamagnetic coefficient. For specific orientations of the magnetic field, it is possible to cancel the g-factor of the bright states of the X and the CX by means of an inversion of the sign of the hole's g-factor, which is promising for quantum information processing applications.

Introduction The role of bone marrow (BM) involvement as prognostic factor in untreated young patients with diffuse large B-cell lymphoma at poor prognosis is still a matter of debate. Recent data showed an adverse prognostic role of BM involvement in DLBCL including patients both at low and high IPI score (Sehn L et al, J Clin Oncol 2011). On this basis, FIL analyzed the impact of BM involvement in the prospective randomized phase III trial DLCL04 (Vitolo U et al, Blood, ASH annual Meeting 2012) that included only young patients at high-risk age-adjusted IPI (aa-IPI) score 2 or 3. Patients and Methods Inclusion criteria were: age 18-65; untreated DLBCL or follicular grade IIIb; aa-IPI score 2 or 3. Patients were stratified according to aa-IPI and randomized at diagnosis to receive: R-CHOP14 x 8 cycles; R-MegaCHOP14 (1200 mg/sqm Cyclophosphamide, 70 mg/sqm Doxorubicin, standard dose Vincristine and Prednisone) x 6; R-CHOP14 x 4 + R-HDC (Rituximab + High Dose Cytarabine + Mitoxantrone + Dexamethasone) followed by BEAM and ASCT; R-MegaCHOP14 x 4 + R-HDC + BEAM and ASCT. BM biopsy and aspirate were mandatory at diagnosis; at the end of treatment, BM assessment was mandatory only in case of positivity at baseline. BM involvement was defined as concordant if marrow was involved by large B-cell and discordant if involved by small B-cells. Flow cytometry, immunohistochemistry, and/or molecular studies were utilized to confirm a clonal B-cell population. Results From June 2005 to September 2010, 399 patients were randomized to receive: 199 R-HDC+ASCT and 200 R-dose-dense chemotherapy without ASCT. All patients were evaluable for analysis. BM involvement was reported in 84 patients (21%): 39 (20%) in the R-HDC+ASCT group and 45 (22%) in the R-dose-dense chemotherapy group. Pattern of involvement was: concordant in 63 patients, discordant in 14 and not specified in 7 patients. Patients with BM involvement (BM positive: 84) compared to those without BM involvement (BM negative: 315) were significantly older (median age 53 years vs 47 years, p1 43% vs 45%, bulky 25% vs 33%, extranodal sites > 1 26% vs 33%, LDH higher than normal value 93% vs 89%). With a median follow-up of 49 months, 3-year PFS for the whole series of 399 patients enrolled in the trial was: 67% (95% CI: 62-72). Three-year PFS was significantly worse in BM positive vs. BM negative: 46% (95% CI:35-56%) vs. 73% (95% CI:67-77%) p Conclusions Bone marrow involvement, namely concordant pattern, is a strong adverse predictor of outcome in young patients with untreated DLBCL at poor prognosis treated with R-chemotherapy regardless of intensification with HDC+ASCT. New treatment approaches are needed for these high-risk patients at poor prognosis. Disclosures: Vitolo: Roche: Speakers Bureau; Takeda: Speakers Bureau; Celgene: Speakers Bureau.

Background The introduction of new agents has substantially changed the management of patients with multiple myeloma (MM). PATIENTS AND METHODS: We evaluated retrospectively 69 symptomatic newly diagnosed transplant-ineligible MM patients treated at our Institute, between 2004 and 2012, with Melphalan and Prednisone (MP) plus Thalidomide (MPT; 23 patients) or plus Bortezomib (MPV; 30 patients) or plus Lenalidomide (MPR; 16 patients). There were 37 men and 32 woman, median age was 73 years (range 65-84) with 20 patients >75 years, 19 (27.5%) were in stage III according to ISS, 12 (17%) had renal failure (creatinine >1.5 mg/dl at baseline), 7 (10%) an underlying diabetes mellitus and 36 (52%) a cardiovascular disease. Melphalan was given at 9 mg/m2 and Prednisone at 60 mg/m2 orally on days 1-4; Bortezomib at 1.3 mg/m2 intravenously on days 1, 4, 8, 11, 22, 25, 29, 32 for the first 4 cycles and thereafter on days 1, 8, 15, 22; Lenalidomide at 10 mg on days 1-21 and Thalidomide 100 mg/daily were administered orally. All patients received antibacterial prophylaxis; thromboprophylaxis and antiviral prophylaxis were administered to patients treated with IMIDs and Bortezomib, respectively. Aims To evaluate the safety and efficacy within the MPT-, MPV- and MPR-treated groups. Results The overall response rates ( ≥ partial response), according to the IMWG criteria, were 20/23 (87%) in the MPT group, 26/30 (87%) in the MPV group, 11/16 (68%) in the MPR group (including 3, 9, 2 very good partial response and 2, 3, 2 complete response/near complete response, respectively). The median PFS was 29 months (95% CI: 18-NA months) for patients who received MPT, 24 months (95% CI: 20-32 months) with MPV and 21.5 months (95% CI: 17-NA months) with MPR, with no significant differences between the three regimens. Among the 69 patients, the overall grade 3-4 hematologic and non-hematologic toxicities were 36% and 43%, respectively. The most common non-hematologic toxicities included all grades of peripheral neuropathy (14% with MPV, 7.2% with MPT and none with MPR), grade 3-4 infections (7.2% with MPV, 4.3% with MPT and 2.9 with MPR) and grade 3-4 cardiovascular disease (4.3% with MPT, 1.4% with MPV and none with MPR). With the use of thromboprophylaxis in all IMID-treated patients, we observed only one deep vein thrombosis in one patient treated with MPT. Conclusions MPT, MPV and MPR are highly active and well tolerated regimens for previously untreated MM patients. The rates of treatment-associated thrombocytopenia and neutropenia were similar between the 3 different regimens and proved transient, predictable and manageable; few patients required supportive care. The results obtained using MP plus one of the recently developed drugs confirm that MPT, MPV and MPR should be considered the standard of care in the frontline treatment of newly diagnosed transplant-ineligible MM patients. Disclosures: Petrucci: Janssen and Celgene: Honoraria; Bristol-Myers Squibb: Membership on an entity’s Board of Directors or advisory committees.

For oral delivery of antimicrobial and anti-inflammatory drugs, mucoadhesive tablets based on gelatin/hydroxypropylcellulose (HPC), gelatin/hydroxypropylmethylcellulose (HPMC), and gelatin/sodium carboxymethylcellulose (NaCMC) at different ratios were prepared by direct compression of the mixed powders. Metronidazole and benzydamine were used as model drugs. The in vitro bioadhesive properties, evaluated by a commercial tensile tester, were significantly affected by the model substrate employed, that is, a polypropylene (PP) membrane or a biological membrane (eggshell membrane). The use of the biological substrate seemed to supply more reliable data. All studied formulations showed an erosion-diffusion mechanism of release, anomalous or non-Fickian release, in agreement with the behavior of the swellable systems.

The pharmacokinetics of oxycodone hydrochloride were investigated following a single 10 mg buccal dose administered to nine healthy volunteers. Plasma samples were collected up to 24 h after administration and analyzed by an original, sensitive and specific selected ion monitoring (SIM) gas chromatography/mass spectrometry (GC-MS) assay, after purification with a solid-phase extraction procedure. The limit of quantitation was 1 ng/ml using a 1 ml plasma sample. The AUC 0–∞ and the C max data of oxycodone hydrochloride were similar to the values reported in the literature for conventional oral tablets. The t max data obtained seem greater for the buccoadhesive disks compared with other oral dosage forms. Mucoadhesion, mucosal irritation and comfort were assessed. No serious problems were encountered. The administration of the new dosage form to cancer patients produced effective pain control, allowing a reduction in the dosing frequency.

Abstract 688 Introduction. The prognosis of young DLBCL patients at high risk treated with standard R-CHOP is still rather poor. The role of intensified HDC+ASCT in first line treatment is still a matter of debate in the Rituximab era. The FIL planned a prospective randomized phase III trial with a 2×2 factorial design aimed at investigating the possible benefit of intensification with R-HDC+ASCT after R-dose-dense chemotherapy delivered at two different level of dose (R-CHOP14/R-MegaCHOP14). Patients and methods. The primary end-point was to increase 2-year Progression Free Survival (PFS) from 50% of the standard dose-dense arm (R-dose-dense chemotherapy) to 65% in the experimental arm (R-dose-dense chemotherapy followed by R-HDC +ASCT). Secondary end-point was the comparison between two different schemes of dose dense chemotherapy, R-CHOP14 and R-MegaCHOP14. Inclusion criteria were: age 18–65; untreated DLBCL; age-adjusted IPI (aa-IPI) score 2 or 3. Patients were stratified according to aa-IPI and randomized at diagnosis to receive: R-CHOP14 × 8 cycles; R-MegaCHOP14 (1200 mg/sqm Cyclophosphamide, 70 mg/sqm Doxorubicin, standard dose Vincristine and Prednisone) × 6; R-CHOP14 × 4 + R-HDC (Rituximab + High Dose Cytarabine + Mitoxantrone + Dexamethasone) followed by BEAM and ASCT; R-MegaCHOP14 × 4 + R-HDC + BEAM and ASCT. G-CSF support was mandatory. Central nervous system prophylaxis was done according to the Italian Society of Hematology guidelines. Results. From June 2005 to September 2010, 412 patients were enrolled. Histology was centrally reviewed in 90% of cases. Thirteen patients were excluded because of different histological subtypes in 10 and active hepatitis HCV and HBV in 3. 399 patients were eligible and randomized: 199 to R-HDC+ASCT and 200 to R-dose-dense chemotherapy without ASCT; according to the type of chemotherapy 203 were randomized to RCHOP14 and 196 to R-MegaCHOP14. All patients were evaluable for analysis. Clinical characteristics were: median age 49 (range 18;65); stage II/III/IV 6/29/65%; LDH higher than normal value 89%; ECOG PS >1 43%; aa-IPI score 2/3 74/26%; all characteristics were well balanced between patients treated with or without ASCT. In the R-HDC+ASCT group, 151 patients (76%) completed the treatment and 177 (88%) in the R-dose-dense chemotherapy arms. Complete Remission (CR) was seen in 296 (74%) patients; CR was 76% in R-HDC+ASCT vs. 72% in the R-dose-dense chemotherapy arms. Overall 26 patients (7%) had a partial remission and 64 (16%) did not respond. Treatment-related deaths occurred in 13 (3%) patients: 8 (4%) in the R-HDC+ASCT arms vs. 5 (2.5%) in R-dose-dense arms. Grade III/IV extrahematological toxicities were reported in 85 patients (43%) in the R-HDC+ASCT vs. 38 (19%) in R-dose-dense arms. With a median follow-up of 36 months, 3-year PFS and 3-year Overall Survival (OS) rates for the whole series were: 64% (95% CI:59–69) and 79% (95% CI:74–83) respectively. Patients randomized to R-HDC+ASCT had a 3-year PFS of 70% (95% CI:63–76) compared to 59% of those treated with R-dose-dense only (95% CI:51–66); p = .010 (Figure 1) with a HR of 0.64 (95% CI: 0.46–0.91, p = .012). No difference in 3-year PFS was observed between R-CHOP14 and R-MegaCHOP14. According to aa-IPI, 3-year PFS in R-HDC+ASCT vs R-dose-dense arms were: aa-IPI score 2 74% (95%CI:65–80) vs. 63% (95%CI:54–71) p = .047; aa-IPI score 3 59% (95% CI:45–71) vs. 46% (95% CI:32–59), p= .121. At the time of this analysis, 3-year OS is 81% (95% CI:74–86) in R-HDC+ASCT vs. 78% (95% CI:70–83) in R-dose-dense chemotherapy patients, p= .556. In a Cox-model including the four arms and assuming R-CHOP14 as reference, the risk of relapse was significantly reduced in both ASCT arms with a major effect in the R-CHOP14+R-HDC+ASCT arm (HR=0.58, 95% CI=0.36–0.93, p= .025) and a slight minor HR reduction in the R-MegaCHOP14+R-HDC+ASCT arm (HR=0.68, 95% CI=0.42–1.09 p= .109). Moreover PFS in both arms (ASCT vs no ASCT) was further compared within pre-planned subgroups analysis according to the type of dose-dense chemotherapy, age, gender, aa-IPI and bone marrow involvement: the benefit of R-HDC+ASCT in PFS was maintained across all subgroups with no statistically significant interaction. Conclusions. R-dose-dense chemotherapy followed by R-HDC and BEAM with ASCT significantly reduced the risk of progression compared to standard dose-dense chemotherapy (R-CHOP14 or R-MegaCHOP14) in young patients with high-risk DLBCL. Disclosures: Vitolo: Roche: Membership on an entity's Board of Directors or advisory committees. Zaja:Roche: Membership on an entity's Board of Directors or advisory committees.

Abstract 730 Background: Carfilzomib is a novel, irreversible proteasome-inhibitor with a significant activity and favourable toxicity profile. Here we evaluated efficacy and safety of the combination carfilzomib-cyclophosphamide-dexamethasone in elderly (≥ 65 years) newly diagnosed MM patients. Methods: The Bryant and Day two-stage design was used to evaluate both efficacy and safety. Patients received oral cyclophosphamide (300 mg/m2 on days 1,8,15), oral dexamethasone (40 mg on days 1, 8, 15, 22) and iv carfilzomib (20 mg/m2 on days 1, 2, and 36 mg/m2 on days 8, 9, 15, 16, cycle 1; 36 mg/m2 on days 1, 2, 8, 9, 15, 16, cycles 2–9) every 28 days for 9 cycles, followed by maintenance with iv carfilzomib (36 mg/m2 on days 1, 2, 15, 16) every 28 days until progression or intolerance. Results: Thirty-four patients were enrolled: median age was 70 years, 21% of patients were older than 75 years, 24% had reduced creatinine clearance ( Grade (G) 4 hematologic toxicities included neutropenia (1 patient, 5%). At least one G3-4 non-hematologic event was reported in 4 patients (21%): pneumonia and bronchitis (2 patients, 10%), atrial fibrillation (1 patient, 5%) and renal failure (1 patient, 5%). Only 1 patient (5%) developed G1 peripheral neuropathy. No patient discontinued treatment and 4 patients (21%) required carfilzomib dose reductions due to adverse events (G4 neutropenia, G3 pneumonia, G3 atrial fibrillation and G3 renal failure). Conclusions: Carfilzomib-cyclophosphamide-dexamethasone showed encouraging activity in patients with newly diagnosed MM. The combination was well tolerated with a frequency of at least one G3-4 non-hematologic adverse event of 21%. Results will be updated at the meeting. Disclosures: Palumbo: Onyx: Honoraria. Bringhen:Onyx: Honoraria.

Introduction: Bortezomib is a proteasome inhibitor that targets myeloma cell and its bone marrow micro-environment. Intravenous Bortezomib (1.3 mg/m2 administered on days 1,4,8 and 11 of a 21 day cycle), with or without dexamethasone, is effective and well tolerated in patients with relapsed/refractory multiple myeloma (MM).Methods: We treated a MM patient with Cystic Fibrosis with Bortezomib alone to avoid the use of corticosteroid and consequently the risk of lung infection reactivations, first of all due to the patient Pseudomonas aeruginosa colonization. Bortezomib was administrated at 1.3 mg/m2 on days 1,4,8 and 11 with a 10 day rest period and four 21-day cycles were administered. We evaluate the treatment response and toxicity.Results: After four cycles of therapy the patient achieved a very good partial response (VGPR) according to the IMWG response criteria, without clinically significant side effects.Conclusions: Bortezomib can be successfully utilized for the management of this difficult disease situation

Defined magnetization states in magnetic nanotubes could be the basic building blocks for future memory elements. To date, it has been extremely challenging to measure the magnetic states at the single-nanotube level. We investigate the magnetization states of an individual Ni nanotube by measuring the anisotropic magnetoresistance effect at cryogenic temperature. Depending on the magnitude and direction of the magnetic field, we program the nanotube to be in a vortex- or onion-like state near remanence.

Abstract 3965 Introduction. Gene-profiling studies demonstrated a constitutive activation of the NFκB signalling pathway in Mantle Cell Lymphoma (MCL) and Marginal Zone Lymphoma (MZL). Bortezomib, a potent inhibitor of the 26S proteasome, is a good candidate to block this pathway and was tested in relapsed or refractory MCL with encouraging results (objective response up to 45%, with a median PFS of 5–7 months). In vitro, the combination of Bortezomib and Rituximab has been shown synergistic apoptosis and enhanced NFkB depletion in MCL and MZL cells. Aim. On these bases, the IIL conducted a phase II multicenter study to evaluate safety and efficacy of Rituximab and Bortezomib combination in relapsed/refractory indolent non-follicular lymphoma (Linfocytic Lymphoma, LL, or MZL) and MCL not eligible for high-dose chemotherapy. Patients and methods. Inclusion criteria were: age 18–75 years, histological proven relapsed or refractory LL, MZL and MCL after 1–4 lines of therapies. Treatment plan was: one course of four weekly intravenous bolus of 1.6 mg/sqm Bortezomib in combination with four infusion of 375 mg/sqm Rituximab followed by two courses of four weekly bolus of 1.6 mg/sqm Bortezomib. Patients with complete (CR), partial remission (PR) and stable disease at the intermediate evaluation were planned to be given three further courses with the same schedule. Results. From September 2006 to March 2008, 55 patients entered into the study. Central histology revision was performed. Forty-nine patients fulfilled inclusion criteria and were evaluable. Clinical characteristics were: median age 68 (50-74) years; 16 LL, eight MZL, 25 MCL; 42 stage III/IV; 33 bone marrow involvement; 20 at intermediate-high/high International Prognostic Index (IPI) risk. Thirty-eigh patients performed more than two prior lines of chemotherapy; 34 were Rituximab-pretreated; 21 refractory and 28 relapsed disease. Overall Response Rate (ORR) was 53% (CR 26.5%, PR 26.5%); no response 43% and 4% off therapy for other causes. ORR by histology was: 37% in LL, 50% in MZL and 64% in MCL. ORR was not adversely affected by Rituximab pretreatment: Rituximab-pretreated 62% and Rituximab-naïve 33%. ORR was higher in relapsed patients compared with refractory ones: 64% and 38% (p .06). (Table 1). With a median follow-up of 25 months, 2-year Overall Survival (OS) was 80% (95%CI: 66–89) and 2-year PFS was 25% (95%CI: 14–38) (Figure 1A, 1B). Two-year PFS by histology was shown in Figure 1C. A total of 233 courses were delivered with a median of 4.7 courses/patient. Thirty patients completed the treatment plan; 19 did not due to progression disease in 13, adverse events in five (concomitant gastric neoplasia, neurotoxicity grade II, sepsis, pleural effusion and toxic death due to interstitial pneumonia). Grade 3–4 CTC haematological toxicity was rare: neutropenia in 5% of the courses and thrombocytopenia in Table 1. ORR (%) MCL/MZL/LL 64/50/37 Rituximab-pretreated/Rituximab-naive 62/33 N of prior therapies Disclosures: Off Label Use: The use of Bortezomib is off-label in Relapsed/Refractory Indolent Non-Follicular and Mantle Cell Lymphoma. Vitolo:Roche-Italy: Advisory committee; Celgene-Italy: Advisory committee; Janssen-Cilag: Lecture Fee.

A phytochemical study has been carried out on the surface exudate of Salvia x jamensis, which showed a significant platelet antiaggregating activity. The known compounds isopimaric acid (2), 14-α-hydroxy-isopimaric acid (3), 3β-hydroxy-isopimaric acid (4), 7,8β-dihydrosalviacoccin (5), betulinic acid (6), and ursolic acid (7) were isolated together with the new diterpene 1. The structure of 1 was determined as 15,16-epoxy-cleroda-3-en-7α,10β-dihydroxy-12,17;19,18-diolide on the basis of spectroscopic data analysis. Among all tested compounds, 2 showed a significant concentration-dependent antiaggregating activity when ADP (3 μM) was used as agonist on rat platelets. Conversely, 1 increased ADP–induced platelet aggregation.

Potts networks, in certain conditions, hop spontaneously from one discrete attractor state to another, a process we have called latching dynamics. When continuing indefinitely, latching can serve as a model of infinite recursion, which is nontrivial if the matrix of transition probabilities presents a structure, i.e. a rudimentary grammar. We show here, with computer simulations, that latching transitions cluster in a number of distinct classes: effectively random transitions between weakly correlated attractors; structured, history-dependent transitions between attractors with intermediate correlations; and oscillations between pairs of closely overlapping attractors. Each type can be described by a reduced set of equations of motion, which, once numerically integrated, matches simulations results. We propose that the analysis of such equations may offer clues on how to embed meaningful grammatical structures into more realistic models of specific recursive processes.

Roberto Latagliata a,∗, Massimo Breccia a, Ida Carmosino a, Chiara Sarlo a, Enrico Montefusco a, Marco Mancini a, Fiammetta Natalino a, Antonio Chistolini a, Rosa De Cuia a, Eleonora Russo a, Giacomo Salvatore Morano a, Francesca Biondo a, Antonio Spadea b, Franco Mandelli a, Giuliana Alimena a a Dipartimento di Biotecnologie Umane ed Ematologia, Universita “La Sapienza” di Roma, Via Benevento 6-00161, Rome, Italy b Ematologia, Istituto Regina Elena, Rome, Italy

The introduction of Imatinib in the treatment of Chronic Myelogenous Leukemia (CML) leads to the achievement of Complete Cytogenetic Response (CCR) in about 70% of patients: however, in the remaining 30% of patients there is a persistance of Ph+ cells also after standard (400 mg/day) and increased (600 mg/day) dose of Imatinib. These patients are thus cytogenetically resistant to Imatinib alone and their management is at present unclear. From 11/2002 to 11/2003, 10 patients in chronic phase (6 male and 4 female, median age 52.5 years, range 29 – 68 years) with persistance of 100% Ph+ cells (9 patients) or BCR/ABL + cells (1 patient with Ph- BCR/ABL+ CML at onset) after standard (at least 6 months of treatment) followed by increased dose (at least 3 months of treatment) of Imatinib alone, were considered resistant and added Hydroxyurea (HU) to Imatinib. Seven patients have been pretreated with IFN before Imatinib; median times from diagnosis and from Imatinib treatment to HU addition were 51 months (range 23 – 151) and 14 months (range 10 – 31), respectively. HU was given according to WBC count: patients with WBC < 10 x 109/l started HU at the dose of 1 g/day, patients with WBC > 10 x 109/l at the dose of 1.5 g/day. Imatinib was continued at the same previous dosage (600 mg/day in 6 patients and 400 mg/day in 4 patients who did not tolerate increased dosage for hematological toxicity). Three patients achieved a complete response (2 CCR after 3 and 12 months respectively and 1 molecular complete response after 9 months in the patient Ph- BCR/ABL+ at onset) and 1 patient achieved a partial CR (Ph+ < 33%) after 9 months: the remaining 6 patients were resistant with persistance of 100% Ph+ cells. Toxicity was mild and only 1 patient discontinued for 2 weeks the association due to transient thrombocytopenia: no extra-hematological toxicity has been recorded. After a median follow-up of 14 months (range 20 – 10), 2 patients (1 resistant and 1 after 5 months from the achievement of CCR) evolved in Blastic Phase (BP), 5 patients are in stable chronic phase with 100% Ph+ cells and 3 patients are still in response after 4,6 and 7 months respectively. In conclusion, the association of HU with Imatinib seems capable to induce cytogenetic response in at least one third of patients resistant to Imatinib alone, with minimal toxicity: a longer follow-up and a comparison with other associations is needed to evaluate the quality and duration of response in such group of patients.

Using an optimally coupled nanometer-scale superconducting quantum interference device, we measure the magnetic flux originating from an individual ferromagnetic Ni nanotube attached to a Si cantilever. At the same time, we detect the nanotube's volume magnetization using torque magnetometry. We observe both the predicted reversible and irreversible reversal processes. A detailed comparison with micromagnetic simulations suggests that vortex-like states are formed in different segments of the individual nanotube. Such stray-field free states are interesting for memory applications and non-invasive sensing., 12 pages, 4 figures

Due to its non-destructive and its micro-spatial resolution, Raman spectroscopy is a powerful tool for a rapid structural and compositional characterization of nanoscale materials. Here, by combining the compositional dependence of the Raman peaks with the existence of photonic modes in the nanowires, we address the composition inhomogeneities of AlxGa1-xAs/GaAs core/shell structures. The experimental results are validated with complementary chemical composition maps of the nanowire cross-sections and finite-difference time-domain simulations of the photonic modes. (C) 2014 AIP Publishing LLC.

Gels containing chlorhexidine, based on hydroxyethylcellulose or its mixtures with either hydroxypropylmethylcellulose or chitosan, were prepared and characterized by in vitro drug release, swelling, mucoadhesion and rheological studies. All formulations provided a controlled drug delivery showing in general a decrease in drug release rate with the increase of the total polymer concentration. Formulations containing either hydroxyethylcellulose or its mixtures with hydroxypropylmethylcellulose presented similar strength of gel network that was markedly higher compared to gels based on mixtures with chitosan at the same total polymer concentration. Drug release was more sustained when gel components were mixtures of hydroxyethylcellulose and hydroxypropylmethylcellulose. Mucoadhesion was similar for all preparations. Viscosity measurements gave higher values in correspondence to higher total polymer concentrations. A candidate vaginal gel formulation containing hydroxyethylcellulose at 2.5% (w/w) induced a clinical remission in 93% of patients affected by bacterial vaginosis compared to 76% of patients belonging to a metronidazole treatment group, and in 84% of subjects with Candida infections compared to 83% receiving clotrimazole. No adverse events were reported during the trial in any patient. Patient compliance with the mucoadhesive gel was good.

A study has been carried out on the surface exudate of Salvia x jamensis, which showed a significant phytotoxic activity against Papaver rhoeas L. and Avena sativa L.. Bioguided separation of the exudate yielded active fractions from which 3 beta-hydroxy-isopimaric acid (1), hautriwaic acid (2), betulinic acid (3), 7,8 beta-dihydrosalviacoccin (4), isopimaric acid (5), 14 alpha-hydroxy-isopimaric acid (7), 15,16-epoxy-7 alpha, 10 beta-dihydroxy-clerod-3,13(16),14-trien-17,12;18,19-diolide (8), cirsiliol (5,3',4'-trihydroxy-6,7-dimethoxyflavone, 9) and two new neoclerodane diterpenes (6 and 10) were isolated. The structures of 6 and 10 were identified as 15,16-epoxy-10 beta-hydroxy-clerod-3,13(16),14-trien-17,12;18,19-diolide and 15,16-epoxy-7 alpha,10-dihydroxy-clerod-2,13(16),14-trien-17,12;18,19-diolide respectively on the basis of spectroscopic data analysis. All compounds, but 7, 8 and 10, were active in inhibiting the germination of the tested species.

Recent experimental and theoretical work has focused on ferromagnetic nanotubes due to their potential applications as magnetic sensors or as elements in high-density magnetic memory. The possible presence of magnetic vortex states—states which produce no stray fields—makes these structures particularly promising as storage devices. Here we investigate the behavior of the magnetization states in individual Ni nanotubes by sensitive cantilever magnetometry. Magnetometry measurements are carried out in the three major orientations, revealing the presence of different stable magnetic states. The observed behavior is well-described by a model based on the presence of uniform states at high applied magnetic fields and a circumferential onion state at low applied fields.

Stenosi del giunto pielo-ureterale, biomarcatori urinari, fibrosi, funzione renale, matrice extracellulare.