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Since the outbreak of the COVID-19 pandemic, cases of discrimination and hate crimes against minority populations including international students have soared in the U.S. This study explores the relationship between international students’ perceived discrimination and their self-reported overall health and the role of social support and positive emotions in such relationship. In total, 203 international students studying at two U.S. universities participated in an online survey. The results indicated that (1) when international students perceive higher levels of discrimination, they experience lower levels of positive emotions and have lower levels of perceived social support; and (2) positive emotions were significantly associated with both psychological distress and physical health. Perceived social support was only significantly associated with physical health not psychological distress. We also provided meaningful implications for higher educational institutions that strive to enhance international students’ overall health.

International students continue to experience myriad of challenges, some of which further transpired disproportionately during the COVID-19 pandemic era. To this effect, this study investigated psychological capital (PsyCap), psychological distress, and well-being among 188 international students attending U.S universities. Results using Hayes PROCESS indicated that well-being mediated the relationship between PsyCap and psychological distress and in particular moderated the relationship between PsyCap and depression. When higher education institutions are considering steps to mitigate psychological distress experienced by international students during the COVID-19 pandemic and beyond, based on the findings of our study, we suggest investing efforts and resources into two aspects: (a) promotion of positive mental health and well-being and (b) identification and development of positive psychological capital. We further discuss these results and implications for mental health promotion of international students in light of its limitations and recommendations for future research.

This study examined the relationship between perceived discrimination and psychological distress among international students during the COVID-19 pandemic.A total of 188 international students from two large U.S. universities participated in the study. Perceived discrimination, psychological distress, and demographic information were assessed using self-reported questionnaires.COVID-related variables and perceived discrimination were significantly associated with international students' psychological distress. Their COVID-related anxiety mediated the relationship between perceived discrimination and psychological distress.Initiatives to mitigate the perceived discrimination experienced by international students may improve their mental health.

We report a randomized prospective phase 3 study, designed to evaluate the efficacy and tolerability of idarubicin plus busulfan and cyclophosphamide (IDA-BuCy) versus BuCy in autologous hematopoietic stem-cell transplantation (auto-HSCT) for intermediate-risk acute myeloid leukemia (IR-AML) patients in first complete remission (CR1). One hundred and fifty-four patients were enrolled and randomized to receive IDA-BuCy (IDA 15 mg/m2/day on days -12 to -10, Bu 3.2 mg/kg/day on days -7 to -4, and Cy 60 mg/kg/day on days -3 to -2) or BuCy. The 2-year incidence of relapse was 15.6% and 19.5% in IDA-BuCy and BuCy groups (p = 0.482), respectively. There was no significant overall survival (OS) and disease-free survival (DFS) benefit for IR-AML patients receiving IDA-BuCy (2-year OS 81.8% in IDA-BuCy vs. 83.1% in BuCy, p = 0.798; 2-year DFS 76.6% in IDA-BuCy vs. 79.2% in BuCy, p = 0.693). Grade 3 or worse regimen-related toxicity (RRT) was reported for 22 (28.9%) of 76 and 9 (12.0%) of 75 patients in two groups (p = 0.015), respectively. AEs within 100 days with an outcome of death were reported for 4 (5.3%) and 0 patients in two groups. In conclusion, IDA-BuCy has higher RRT and similar anti-leukemic activity compared with BuCy in IR-AML patients in CR1 undergoing auto-HSCT. Thus, caution should be taken when choosing IDA-BuCy for IR-AML patients in CR1 with auto-HSCT. This trial is registered with ClinicalTrials.gov, NCT02671708, and is complete.

In view of the inaccuracy of the traditional correlation analysis method, this paper proposes a correlation analysis method between the multifractal characteristics of regional landforms and the development of geological disasters. Firstly, the multifractal characteristics of regional landforms are described by using the basic fractal characteristics of self-similarity or scale invariance. Then the corresponding relation table is established according to the width of the fractal spectrum and the number of landslides and hidden dangers, and the spatial relationship of geological disaster development is analyzed. Combined with the above-mentioned spatial relationship of geological disaster development and the multifractal characteristic data of regional landforms, the correlation coefficient between the two is calculated to complete the correlation analysis between the multifractal characteristics of regional geomorphology and the development of geological disasters. The experimental results show that compared with the traditional correlation analysis method, the correlation analysis results of the multifractal characteristics of regional geomorphology and the development of geological disasters are more accurate.

While the number of Asian international students has increased in postsecondary institutions in the United States over the last two decades, unlike their American peers, these students were reported to have more severe mental health issues with less help-seeking intentions and behavior. This study drew the national data collected by American College Health Association-National College Health Assessment (ACHA-NCHA) from 2011 to 2014 to examine how various factors were associated with help-seeking intentions and behavior among Asian International Students (AIS) in the U.S. After case-wise deletion of missing data, the dataset used in regression analyses included 97,259 college students, including 2999 AISs, who were randomly drawn within the 62 participated postsecondary institutions. The study performed a series of logistic regression with complex survey design that controlled for institutional clustering effects to analyze the relationship between various factors and AISs’ help-seeking intentions and behavior. The results showed that AIS utilized significantly less services and were less willing to seek mental health services than not only American domestic students but also other international students. Variables related to institutional characteristics, demographic information, academic status, and health conditions were found to significantly influence AISs’ help-seeking intentions and behavior. College mental health professionals and university stakeholders need to pay more attention to the mental health needs of AIS. Implications for college mental health professionals and university stakeholders are discussed.

Limited attention has been given to international counseling students (ICSs) enrolled in U.S. counseling programs. This phenomenological study examined the lived experiences of six ICSs in a U.S. counseling program regarding factors that impacted their practicum experience. The study identified three themes: learning and growth process, positive impacting factors, and negative impacting factors. It also provided stakeholder recommendations

Key Points Question Is there an association between dynamic measurable residual disease, treatment, and outcomes among adults with intermediate-risk acute myeloid leukemia? Findings In this registry-based cohort study that included 549 younger patients (aged 14-60 years) with intermediate-risk acute myeloid leukemia, 154 received chemotherapy, 116 received an autologous stem cell transplant, and 279 received an allogeneic stem cell transplant. Results showed that making a postremission treatment choice based on dynamic measurable residual disease was associated with improved outcomes in subgroup analyses. Meaning This study suggests that clinical decisions based on dynamic measurable residual disease might be associated with improved therapy stratification and optimized postremission treatment for patients with intermediate-risk acute myeloid leukemia., Importance Measurable residual disease (MRD) is widely used as a therapy-stratification factor for acute myeloid leukemia (AML), but the association of dynamic MRD with postremission treatment (PRT) in patients with intermediate-risk AML (IR-AML) has not been well investigated. Objective To investigate PRT choices based on dynamic MRD in patients with IR-AML. Design, Setting, and Participants This cohort study examined 549 younger patients with de novo IR-AML in the South China Hematology Alliance database during the period from January 1, 2012, to June 30, 2016, including 154 who received chemotherapy, 116 who received an autologous stem cell transplant (auto-SCT), and 279 who received an allogeneic SCT (allo-SCT). Subgroup analyses were performed according to dynamic MRD after the first, second, and third courses of chemotherapy. The end point of the last follow-up was August 31, 2020. Statistical analysis was performed from December 1, 2019, to September 30, 2020. Exposures Receipt of chemotherapy, auto-SCT, or allo-SCT. Main Outcomes and Measures The primary end points were 5-year cumulative incidence of relapse and leukemia-free survival. Results Subgroup analyses were performed for 549 participants (314 male participants [57.2%]; median age, 37 years [range, 14-60 years]) according to the dynamics of MRD after 1, 2, or 3 courses of chemotherapy. Comparable cumulative incidences of relapse, leukemia-free survival, and overall survival were observed among participants who had no MRD after 1, 2, or 3 courses of chemotherapy. Participants who underwent chemotherapy and those who underwent auto-SCT had better graft-vs-host disease–free, relapse-free survival (GRFS) than those who underwent allo-SCT (chemotherapy: hazard ratio [HR], 0.35 [95% CI, 0.14-0.90]; P = .03; auto-SCT: HR, 0.07 [95% CI, 0.01-0.58]; P = .01). Among participants with MRD after 1 course of chemotherapy but no MRD after 2 or 3 courses, those who underwent auto-SCT and allo-SCT showed lower cumulative incidence of relapse (auto-SCT: HR, 0.25 [95% CI, 0.08-0.78]; P = .01; allo-SCT: HR, 0.08 [95% CI, 0.02-0.24]; P, This registry-based cohort study investigates postremission treatment choices and outcomes based on dynamic measurable residual disease in adults with intermediate-risk acute myeloid leukemia (AML).

OBJECTIVE: To evaluate the efficacy and safety of IEAC (idarubici, etoposide, cytosine arabinoside, and cyclophosphamide) and CEAC (lomustine, etoposide, cytosine arabinoside, and cyclophosphamide) high-dose chemotherapy followed by autologous hematopoietic stem cell transplantation (ASCT) in the treatment of lymphoma. METHOD: We retrospectively analyzed the data of 106 lymphoma patients undergoing ASCT from 2013 to 2018 using IEAC (n=43) or CEAC (n=63) regimens. The time of hematopoietic reconstruction, adverse events and the patients' survival outcomes in the two groups were compared to evaluate the efficacy and safety of the two regimens. Univariate and multivariate analyses were performed to identify the factors potentially affecting the patients' survival. RESULTS: In the total of 106 patients, successful hematopoietic reconstruction was achieved in 104 patients and treatment-related deaths occurred in 2 patients. No significant differences were observed in the time to hematopoietic recovery, adverse events or survival outcomes between the patients receiving IEAC and CEAC regimens. In the 104 patients with successful hematopoietic reconstruction who were followed for a median of 27.4 months (range 4.3 to 74.3 months), the 5-year progress-free survival (PFS) and overall survival (OS) rates were 72.9% and 81.9%, respectively. The main adverse events (beyond grade 2 based on CTCAE v5.0) included infection, oral mucositis, nausea and vomiting, liver damage, cardiotoxicity, hypokalemia, and diarrhea. No significant difference was found in the survival outcomes or adverse events between the 2 regimens. T cell lymphoma and failure to achieve complete remission (CR) before ASCT were the risk factors of PFS (P=0.015 and P=0.007, respectively) and OS (P=0.038 and 0.031, respectively). The patients who achieved CR 3 months after the transplantation had higher rates of PFS (P=0.007) and OS (P=0.003). CONCLUSION: IEAC and CEAC regimens prior to by ASCT are both safe and effective in the treatment of lymphoma and can be used as alternative conditioning regimens for lymphoma patients undergoing ASCT.

Acute lymphoblastic leukaemia (ALL) is a malignant proliferative disease that originates from B-lineage or T-lineage lymphoid progenitor cells. Resistance to chemotherapy remains an important factor for treatment failure. The aim of the present study was to investigate drug resistance in T-cell ALL (T-ALL). Bioinformatics analysis of Oncomine and Gene Expression Omnibus data was performed to evaluate the expression of haematopoietic SH2 domain containing (HSH2D) in various lymphomas. HuT-78 cells with HSH2D overexpression and or knockdown were constructed, and the effect on related downstream signalling molecules was detected. To study the effect of HSH2D on methotrexate (MTX) resistance, cell cycle and apoptosis analyses were conducted using flow cytometry, and MTT and EdU assays were used to detect the effect of MTX resistance and HSH2D gene expression on the biological function of HuT-78 cells. Via the analysis of the data sets, it was identified that the expression of HSH2D was downregulated in T-ALL compared with B-cell ALL. Western blotting and reverse transcription-quantitative PCR demonstrated that the overexpression of HSH2 resulted in the inhibition of CD28-mediated IL-2 activation. In related experiments with drug-resistant cell lines, it was determined that HSH2D expression is necessary for HuT-78 cells to be resistant to MTX. In conclusion, the results suggested that HSH2D serves an important role in the resistance of T-ALL to MTX, which provides a potential research target for the study of drug resistance of T-ALL.

In this study, we explore East Asian graduate students’ socio-cultural and psychological adjustment in a U.S. Midwestern University. Eight participants were interviewed about their acculturation challenges as well as their effective coping strategies. Data were analyzed using open-coding techniques and five themes emerged: three themes summarized the challenges, including challenges due to cultural differences, lack of support in a foreign environment, and financial stress; and the other two themes that described the coping strategies were utilizing external resources and developing self-adjustment strategies.

Dust transport and deposition processes are important for understanding the environmental risk of dust storms. This study investigated characteristics of dustfall at two rural sites and four urban sites from dust sources to downwind regions during three dust storms (DS1: March 19–22, DS2: April 24–26, DS3: May 7–10, 2010). Analysis of near-surface instantaneous maximum wind speed and prevailing wind direction revealed the dust storms bursted out from northwestern arid and semiarid regions to eastern China. Microaggregates, angular, subangular, columnar, subrounded, and spherical particles were identified by scanning electron microscope. Dust deposition flux (DDF) during the dust storms was significantly high at sites near sand deserts and sandy land. During DS2, DDF was 25.1, 9.9, 2.3, and 1.5 g m−2 in Jingbian, Shapotou, Lanzhou, and Beijing, respectively. The three dust storms contributed 7.3% of Beijing’s annual dustfall in 2010, which suggests anthropogenic dust might contribute the majority of annual dustfall in urban areas. The mass medium diameter of dustfall during DS2 in Shapotou, Jingbian, Lanzhou, and Beijing was 26.1, 9.0, 16.4, and 15.5 μm, respectively. Urban dustfall contained more heavy metals, sulfur and arsenic than rural dustfall. Cadmium contamination was identified in all urban dust particles. Anthropogenic pollutants in combination with mineral dust might lead to complex environmental risk on local, regional, and global scales. China’s environmental pollution control should integrate reductions in land desertification and multisource anthropogenic emissions within the context of climate change mitigation.

The physicochemical characteristics of household dust in a typical metropolitan city (i.e., Beijing, the urban region) and a remote village in western of China (the rural region) were investigated and compared. The results show that the particles of household dust in both the regions could be classified as six types: micro-aggregates, biogenic, spherical, subrounded, subangular, and angular in morphology. Most dust particles were found to belong to the latter three types and belonged to mineral particles. The average particle size (aerodynamic equivalent diameter) of household dust was 16.1 and 14.9 μm in the rural and urban regions, respectively. Dust particles with diameters 10–20 μm were the highest by number in the both regions, while dust diameters from 30 to 40 μm and from 20 to 30 μm were the highest by volume in the urban and rural regions, respectively. The minerals in household dust particles in both the rural and urban regions were primarily quartz, albite, calcite, and dolomite. The average percentages of macro-element species (Si, Al, Ca, Fe, K, Mg, Na, P, and Ti) in household dust in the rural and urban regions were lower than those in the corresponding outdoor dust and their background values, except for Ca. Silicon, Al, Ca, Fe, and K were the predominant elements distributed in household dust in both the rural and urban regions. The concentrations of the studied macro-elements in the rural household dust were lower than those in the urban household dust, being in agreement with the relationship of the reference crust element content in the rural and urban regions. The average percentages of the ions in the rural and urban household dust were generally higher than those in the corresponding outdoor dust. The levels of SO 4 2− , NO 3 − , Cl − , and Ca 2+ in the urban household dust were higher than those in the rural, owing to human activities. The deposition rate of household dust in the rural region (i.e., 15.3 ± 2.6 g m −2 year −1 ) was approximately 10 times greater than that observed in the urban region due to worse tightness of the houses. Dust at homes was one of the significant sources of PM 10 in the residential environment through resuspension, and the studied properties of household dust are closely related to human health. Household dust in both the rural and urban regions of China should not be ignored.

To understand the characteristics of the nebkhas in barchan interdune areas, isolated barchan dunes at the southeast margin of the Badain Jaran Desert in China and Nitraria tangutorun nebkhas in the interdune areas were selected, and the morphometric parameters, spatial patterns, and granulometric characteristics of the nebkhas in various interdune zones were compared. According to the locations relative to barchan dunes, the interdune areas were divided into three zones: the windward interdune zone (Zw), the leeward interdune zone (Zl), and the horn interdune zone (Zh). The zone that is proximal to barchan dunes and has never been disturbed by barchan dunes was also selected (Zi). The morphometric parameters were measured through a satellite image and field investigation. The population density and spatial patterns were analyzed using the satellite image, and surface sediment samples of the nebkhas and barchan dunes were collected for grain size analysis. The morphometric parameters of Nitraria tangutorun nebkhas in the interdune zones differ significantly. The nebkhas in Zh are larger than those observed in the other zones, and the nebkhas are the smallest in Zl. In all of the zones, the long-axis orientation of the nebkhas is perpendicular to the prevailing wind direction. The population density of the nebkhas in Zw is relatively higher, whereas the density in Zh and Zl becomes obviously lower. The spatial distribution of nebkhas in all of the zones can be categorized as a dispersed pattern. The sediments of the nebkhas are coarsest in Zh and finest in Zl. In addition, the sediments of the nebkhas in all of the zones are finer than those of barchan dunes. The amount of sand captured by the nebkhas in the interdune areas is approximately 20% of the volume of barchan dunes. The variations of the nebkhas' sizes, spatial pattern and sediment are subjected to migration, flow field and sand transport of barchan dunes and sand accumulation with plant growth in the interdune areas, which suggest complex mutual interactions between barchan dunes and the nebkhas in the interdune areas.

Air pollutant emissions from agricultural burning are observed every year after harvest in China. While agriculture is not the main contributor to air pollution in China, agricultural activities can cause severe pollution events. Recognizing the key mechanisms involved in this process offers an opportunity to minimize pollution events caused by agricultural burning. In this paper, we review the meteorological conditions present during a selected air pollution episode and discuss those conditions using standard meteorological observations. The spatio-temporal variations of PM2.5 concentrations following agricultural burning in Beijing were measured from October 4 to October 7, 2013. This time period coincides with a Chinese public holiday and was selected because the influence of other anthropogenic emissions on air quality was strongly reduced during those days. As a result, we were able to identify the key sources and progress of a severe air pollution event. On October 4, average PM_(2.5) concentration in Beijing continuously increased from 49.7 μg m^(-3) at 1:00 to 302.5 μg m^(-3) at 23:00. Heavily polluted air (＞ 300 μg m^(-3)) initially appeared in southeastern Beijing on the afternoon of October 4. On October 5 and in the early morning of October 6, heavily polluted air masses moved into central Beijing, the inner suburbs, and the suburbs. From 0:00 on October 6 to 15:00 on October 7, the average PM_(2.5) concentration in Beijing decreased from 291.6 μg m^(-3) to 19.2 μg m^(-3). Active fire information derived from the MODIS sensors and back trajectory analysis show that field burning of agricultural residues after a harvest triggered and massively contributed to this severe air pollution event. The results improve our understanding of PM_(2.5) air pollution development processes, and they provide scientific support for the Chinese government to accelerate emission reductions from the field burning of agricultural residues.

The Alxa Plateau in north China is characterized by frequent sand dust storm activity, desertification, various blown sand hazards and extensive sand dunes. Three of China’s major sand deserts, the Badain Jaran (BJ), Tengger and Ulan Buh (UB), are distributed in this region. The BJ desert lies to the northwest and is separated from the other two deserts by mountains Yabrai and Alateng. However, the dominant northwest wind could transport sand from the BJ to the other two deserts through several corridors. Locating the sand source for these deserts is fundamental in understanding the formation and evolution of the aeolian landforms. It has been proposed that the sand in the Tengger desert is from the BJ desert. However, evidence supporting the hypothesis is still limited. To estimate the sand contribution of the BJ to the Tengger desert, we measured wind speeds at a 2 m height above the ground for the period from November 2010 to December 2011. We then calculated the amount of sand transport and observed the speed of dune migration in the junction part of the two deserts. Sand-transporting winds (⩾6.0 m s−1) occurred mostly in spring and winter, and accounted for 16.4% of the total of the year. The prevailing wind directions were NW, WNW and NNW, and were occupied 61.9% of the total frequency of sand-transporting winds. The frequencies of winds decreased with increasing wind speed, and strong wind frequencies (⩾17.0 m s−1) were 5.3% of the sand-transporting winds. In comparison to adjacent areas, the drift potential in the corridor was several times higher, indicating an obvious effect of narrowing. During the period of observation, 752 sand-transporting events occurred with durations from 10 to 1940 min (32 h). In the corridor, the sand transport flux was 372 tons m−1 yr−1, an order of magnitude larger than previous estimation, and the annual total amount of sand transported through the corridor was over 5 million tons, indicating a substantial sand supply from the BJ to the Tengger desert. Sand transport in spring and winter accounted for 99.8% of annual total. The amount of sand transported by a single sand-transporting event varied greatly, up to five orders of magnitude.

In this article, natural factors in the farming-pastoral ecotone that might have influenced the blown sand hazards in Beijing in 2000 are analyzed. In the farming-pastoral ecotone, blown sand activities took place primarily in springtime, during which 39.8 percent of the annual frequency of erosive winds above threshold occurred. The prevailing directions of the erosive winds were NNW, NW, NWW, and N, with frequencies of 47, 20, 13, and 9 percent respectively. Sand entrainment and dust emission are influenced by erosive wind frequency, soil moisture, and land use and cover change. Favorable wind characteristics and a lasting drought in 1999 and 2000 may have produced ideal conditions for land surface desiccation, vegetation degradation, and land surface mobility and the occurrence of intense sand- and dust storms in Beijing.

The linkage of surface runoff in urban areas to water quantity and quality has been studied extensively in the literature. Many computer models based on different routing theories have been developed to simulate the rainfall-runoff process in urban areas. Those computer models are classified into two categories: hydrologic models and hydraulic models. Hydrologic models are based on a hypoth- esized relation between outflow and water storage in the watershed, which is often modeled as a conceptual reservoir. The nonlinear reservoir method is a typical hydrologic routing method applied in models such as the Stormwater Management Model (SWMM). Hydraulic models are based on approximations of the real physical rainfall-runoff process. Kinematic-wave theory, utilized by many models including the Dynamic Watershed Simulation Model, is a commonly used hydraulic routing method. Previously unpublished experimental data obtained from the Watershed Experimentation System at the University of Illinois at Urbana-Champaign, Ill. were used to test the accuracy of these two routing methods. The nonlinear reservoir routing method as applied in SWMM may provide acceptable results for storms with durations longer than the watershed time of concentration (42 experiments )( average model fit efficiencyE = 0.88), but for storms with durations less than or equal to the time of concentration (26 experiments), poor results were obtained (average E= 0.07). More accurate results generally were obtained using kinematic-wave routing (average E= 0.928 and 0.807 for storm durations exceeding and not exceeding the watershed time of concentration, respectively). These results fit with the theoretical basis of the kinematic-wave theory that considers the actual physical processes in surface flow generation, while the nonlinear reservoir method does not consider the impact from the time lag needed for the flow depth to grow so that runoff can commence.

Background : Autologus hematopoietic stem cell transplantation (auto-HSCT) has now been widely used in treatment ofhematologic malignancies, some solid tumor, and autoimmune diseases and so on. Engraftment failure (EF) is a severe complication after auto-HSCT, and is occurring in 2% to 9.5% of patients. Although this complication is becoming increasingly uncommon with the wide application of mobilized peripheral blood stem cells (PBSCs) instead of bone marrow (BM), it is still associated with considerable morbidity and mortality related to an increasing risk of hemorrhagic complications and infections. In this study, we retrospectively analyzed risk factors of primary EF after auto-HSCT. Method: For the purpose of this study, EF was defined as an absolute neutrophil count (ANC)≦0.5×109/L and a platelet (PLT) count≦20×109/L for at least 35 consecutive days post-transplantation, with hypoplastic BM and without primary disease relapse. Two hundred and five patients undergoing auto-HSCT from Nanfang Hospital of Southern Medical University, Guangzhou General Hospital of Guangzhou Military Command and Zhongshan City People’s Hospital of Guangdong Province, were included in this study between March 2004 and March 2014. They were divided into two groups according to the presence (EF group) or absence (non-EF group) of primary EF. The clinical and transplantation-related characteristics were collected and compared between groups. Then we would choose some factors to perform a risk analysis for EF. Results: The median age of 205 patients was 39 years (range 14 to 60 years). Primary diseases included acute myelogenous leukemia (n=120), non-Hodgkin lymphoma (n=49), multiple myeloma (n=36). Eighteen patients (8.78%) developed primary EF after auto-HSCT. There were significant differences regarding infection during the period from transplantation to hematopoietic reconstruction or EF, and the doses of CD34+ cells infused between groups (P values were 0.010 and 0.044). Results of univariate models of binary logistic regression analysis showed that the number of chemotherapy cycles, infection during the period from transplantation to hematopoietic reconstruction or EF and the doses of CD34+ cells infused were related to primary EF after auto-HSCT (P values were 0.017, 0.040 and 0.018). The results of multivariate analysis for the above 3 factors showed that too much chemotherapy cycles pre-transplantation (P=0.032, odds ratio [OR] = 3.140, 95% confidence interval [CI], 1.101 to 8.956) was a risk factor for primary EF after auto-HSCT and the number of CD34+ cells transfused was a protective factor for it (P=0.035, OR= 3.249, 95% CI, 1.088 to 9.704). The 5-year overall survival, disease-free survival and cumulative incidence of tumor relapse post-transplantation were 68.3% (95% CI, 60.6%-76.0%), 63.0% (95% CI, 58.0%-68.0%) and 37.0% (95% CI, 32.0%-42.0%). Conclusion: The number of chemotherapy cycles is a risk factor for primary EF after auto-HSCT, which may be due to the damaged BM microenvironment by chemotherapy drugs. However, the number of CD34+ cells transfused is a protective factor for it. Disclosures Liu: It was supported by National Natural Science Foundation of China (81270647, 81300445, 81200388); National High Technology Research and Development Program of China (863 Program) (2011AA020105); National Public Health Grand Research Foundation (201202017);: Research Funding; It was supported by Natural Science Foundation of Guangdong Province (S2012010009299); the project of health collaborative innovation of Guangzhou city (201400000003-4, 201400000003-1);: Research Funding; It was supported by the Technology Plan of Guangdong Province of China (2012B031800403); the project of the Zhujiang Science & Technology Star of Guangzhou city (2013027).: Research Funding.

Background Engraftment failure (EF) is a formidable complication after autologous hematopoietic stem cell transplantation (auto-HSCT). Mesenchymal stem cells (MSCs) and cord blood (CB) have been found to support hematopoiesis. Thus, we designed a multicenter randomized clinical trial to investigate the effects and safety of MSCs alone or combined with CB infusion for patients with EF. Methods Twenty-two patients were randomly assigned to receive the treatment with MSCs alone (MSCs group, n=11) or MSCs combined with CB (CB group, n=11). MSCs were administered once every 2 weeks (2 doses were a cycle) in both groups, and single-unit CB was administered at the same day with the first application of MSCs in CB group; After one cycle of treatments (within 28 days), the patients who did not response to MSCs would receive the therapeutic schedule in CB group, and those patients with partial response (PR) in MSCs group and those without complete response (CR) in CB group would continue another cycle of MSCs treatment. If patients did not obtain CR after two cycles of treatments (within 56 days), they would receive other treatments including allogeneic HSCT. Results After the first treatment cycle, the effect rates were not significant difference in MSCs and CB groups (7/11 vs. 9/11, P=0.635), and the median time of hematopoietic reconstruction was 22 (18-28) and 17 (13-22) days, respectively (P=0.036) in MSCs and CB group. There was statistically significant difference regarding neutrophil engraftment, with 17 (range 9-28) and 8 (range 6-14) days respectively (P=0.030), but no difference regarding platelet engraftment, with 21 (range 18-28) and 18 (range 11-21) days respectively (P=0.092) between MSCs and CB groups. After two cycles of treatments, 17 patients obtained CR, 2 PR and 3 NR. CB chimerisms were not detected by short tandem repeat (STR) at +15 and +30 days after CB infusion. None of the patients experienced any adverse events of grade 3/4 with the Common Terminology Criteria for Adverse Events v3.0 (CTCAE v3.0) and acute GVHD or chronic GVHD during the period of study treatment and follow-up. One patient with PR in MSCs group and 1 NR in CB group received allogeneic HSCT at +249 and +273 days after auto-HSCT because of EF and primary disease relapse, respectively. At a median follow-up time of 345 (range 129–784) days post-transplantation, 16 patients remained alive, 3 died of relapse of primary diseases and 1 died of CMV pneumonia following allo-HSCT. None of patients developed EBV-DNA viremia and EBV-associated diseases in two groups. The 2-year overall survival, disease-free survival and tumor relapse post-transplantation were 75.2% (95% CI, 63.2-87.2%), 79.5% (95% CI, 70.1-88.9%) and 20.5% (95% CI, 11.1-29.9%) respectively. Conclusions Our data suggest that ex-vivo-expanded MSCs derived from HLA-mismatched BM alone or combined with unrelated CB are effective to EF after auto-HSCT. CB can facilitate the effect of MSCs to EF. Both two strategies do not result in GVHD or increase the risk of primary diseases relapse in patients with EF. This trial was registered at www.clinicaltrials.govas#NCT01763099. Disclosures: Liu: It was supported by 863 Program (No. 2011AA020105) and National Public Health Grand Research Foundation (Grant No. 201202017).: Research Funding; It was supported by National Natural Science Foundation of China (Grant No.81000231, No.81270647) and Science and Technology Program of Guangzhou of China (11A72121174). : Research Funding.

Imatinib can induce complete molecular remission (CMR) in relapse chronic myelogenous leukemia (CML) after allogeneic hematopoietic stem cell transplantation, but it is indefinite whether imatinib is required to maintain CMR. We retrospectively reviewed 37 relapse CML post-transplants treated with imatinib (n = 20) or donor lymphocyte infusion (DLI) (n = 17). The rate of CMR was 85% and 76.47% (P = 0.509) and treatment-related mortality was 0% and 29.4% (P = 0.019), respectively, in imatinib and DLI groups. Fifteen patients obtaining CMR voluntarily ceased imatinib, and did not experience relapse. The 8-year overall survival (OS) after relapse was 85%±8% and 40.3±12.1% (P = 0.017), and disease-free survival (DFS) after relapse was 85%±8% and 40.3±12.1% (P = 0.011), respectively, in imatinib and DLI groups. Imatinib resulted in higher OS and DFS than that of DLI in relapse CML. Imatinib maintenance might not be required for patients with relapse CML post-transplants after they achieved full donor chimerism and CMR.