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Background: Despite novel therapeutic agents, most multiple myeloma (MM) patients eventually relapse. Two large phase III trials have shown significantly improved response rates (RR) of lenalidomide/dexamethasone compared with placebo/dexamethasone in relapsed MM (RMM) patients. These results have led to the approval of lenalidomide for RMM patients and lenalidomide/dexamethasone has since become a widely accepted second-line treatment. Furthermore, in RMM patients consolidation with high-dose chemotherapy plus autologous stem cell transplantation has been shown to significantly increase progression free survival (PFS) as compared to cyclophosphamide in a phase III trial. The randomized prospective ReLApsE trial is designed to evaluate PFS after lenalidomide/dexamethasone induction, high-dose chemotherapy consolidation plus autologous stem cell transplantation and lenalidomide maintenance compared with the well-established lenalidomide/dexamethasone regimen in RMM patients.
Methods/Design: ReLApsE is a randomized, open, multicenter phase III trial in a planned study population of 282 RMM patients. All patients receive three lenalidomide/dexamethasone cycles and - in absence of available stem cells from earlier harvesting - undergo peripheral blood stem cell mobilization and harvesting. Subsequently, patients in arm A continue on consecutive lenalidomide/dexamethasone cycles, patients in arm B undergo high dose chemotherapy plus autologous stem cell transplantation followed by lenalidomide maintenance until discontinuation criteria are met. Therapeutic response is evaluated after the 3rd (arm A + B) and the 5th lenalidomide/dexamethasone cycle (arm A) or 2 months after autologous stem cell transplantation (arm B) and every 3 months thereafter (arm A + B). After finishing the study treatment, patients are followed up for survival and subsequent myeloma therapies. The expected trial duration is 6.25 years from first patient in to last patient out. The primary endpoint is PFS, secondary endpoints include overall survival (OS), RR, time to best response and the influence of early versus late salvage high dose chemotherapy plus autologous stem cell transplantation on OS.
Discussion: This phase III trial is designed to evaluate whether high dose chemotherapy plus autologous stem cell transplantation and lenalidomide maintenance after lenalidomide/dexamethasone induction improves PFS compared with the well-established continued lenalidomide/dexamethasone regimen in RMM patients. Trial registration: ISRCTN16345835 (date of registration 2010-08-24).
Introduction: Evidence from a number of open-label, uncontrolled studies has suggested that rituximab may benefit patients with autoimmune diseases who are refractory to standard-of-care. The objective of this study was to evaluate the safety and clinical outcomes of rituximab in several standard-of-care-refractory autoimmune diseases (within rheumatology, nephrology, dermatology and neurology) other than rheumatoid arthritis or non-Hodgkin's lymphoma in a real-life clinical setting.
Methods: Patients who received rituximab having shown an inadequate response to standard-of-care had their safety and clinical outcomes data retrospectively analysed as part of the German Registry of Autoimmune Diseases. The main outcome measures were safety and clinical response, as judged at the discretion of the investigators.
Results: A total of 370 patients (299 patient-years) with various autoimmune diseases (23.0% with systemic lupus erythematosus, 15.7% antineutrophil cytoplasmic antibody-associated granulomatous vasculitides, 15.1% multiple sclerosis and 10.0% pemphigus) from 42 centres received a mean dose of 2,440 mg of rituximab over a median (range) of 194 (180 to 1,407) days. The overall rate of serious infections was 5.3 per 100 patient-years during rituximab therapy. Opportunistic infections were infrequent across the whole study population, and mostly occurred in patients with systemic lupus erythematosus. There were 11 deaths (3.0% of patients) after rituximab treatment (mean 11.6 months after first infusion, range 0.8 to 31.3 months), with most of the deaths caused by infections. Overall (n = 293), 13.3% of patients showed no response, 45.1% showed a partial response and 41.6% showed a complete response. Responses were also reflected by reduced use of glucocorticoids and various immunosuppressives during rituximab therapy and follow-up compared with before rituximab. Rituximab generally had a positive effect on patient well-being (physician's visual analogue scale; mean improvement from baseline of 12.1 mm).
Conclusions: Data from this registry indicate that rituximab is a commonly employed, well-tolerated therapy with potential beneficial effects in standard of care-refractory autoimmune diseases, and support the results from other open-label, uncontrolled studies.
Transverse momentum (pT) spectra of pions, kaons, and protons up to pT=20 GeV/c have been measured in Pb-Pb collisions at sNN−−−√=2.76 TeV using the ALICE detector for six different centrality classes covering 0-80%. The proton-to-pion and the kaon-to-pion ratios both show a distinct peak at pT≈3 GeV/c in central Pb-Pb collisions that decreases towards more peripheral collisions. For pT>10 GeV/c, the nuclear modification factor is found to be the same for all three particle species in each centrality interval within systematic uncertainties of 10-20%. This suggests there is no direct interplay between the energy loss in the medium and the particle species composition in the hard core of the quenched jet. For pT<10 GeV/c, the data provide important constraints for models aimed at describing the transition from soft to hard physics.
Two-particle angular correlations between trigger particles in the forward pseudorapidity range (2.5<|η|<4.0) and associated particles in the central range (|η|<1.0) are measured with the ALICE detector in p-Pb collisions at a nucleon-nucleon centre-of-mass energy of 5.02 TeV. The trigger particles are reconstructed using the muon spectrometer, and the associated particles by the central barrel tracking detectors. In high-multiplicity events, the double-ridge structure, previously discovered in two-particle angular correlations at midrapidity, is found to persist to the pseudorapidity ranges studied in this Letter. The second-order Fourier coefficients for muons in high-multiplicity events are extracted after jet-like correlations from low-multiplicity events have been subtracted. The coefficients are found to have a similar transverse momentum (pT) dependence in p-going (p-Pb) and Pb-going (Pb-p) configurations, with the Pb-going coefficients larger by about 16±6%, rather independent of pT within the uncertainties of the measurement. The data are compared with calculations using the AMPT model, which predicts a different pT and η dependence than observed in the data. The results are sensitive to the parent particle v2 and composition of reconstructed muon tracks, where the contribution from heavy flavour decays are expected to dominate at pT>2 GeV/c.
The production of J/ψ and ψ(2S) was measured with the ALICE detector in Pb-Pb collisions at the LHC. The measurement was performed at forward rapidity (2.5<y<4) down to zero transverse momentum (pT) in the dimuon decay channel. Inclusive J/ψ yields were extracted in different centrality classes and the centrality dependence of the average pT is presented. The J/ψ suppression, quantified with the nuclear modification factor (RAA), was studied as a function of centrality, transverse momentum and rapidity. Comparisons with similar measurements at lower collision energy and theoretical models indicate that the J/ψ production is the result of an interplay between color screening and recombination mechanisms in a deconfined partonic medium, or at its hadronization. Results on the ψ(2S) suppression are provided via the ratio of ψ(2S) over J/ψ measured in pp and Pb-Pb collisions.
We present a measurement of inclusive J/ψ production in p-Pb collisions at sNN−−−√ = 5.02 TeV as a function of the centrality of the collision, as estimated from the energy deposited in the Zero Degree Calorimeters. The measurement is performed with the ALICE detector down to zero transverse momentum, pT, in the backward (−4.46<ycms<−2.96) and forward (2.03<ycms<3.53) rapidity intervals in the dimuon decay channel and in the mid-rapidity region (−1.37<ycms<0.43) in the dielectron decay channel. The backward and forward rapidity intervals correspond to the Pb-going and p-going direction, respectively. The pT-differential J/ψ production cross section at backward and forward rapidity is measured for several centrality classes, together with the corresponding average pT and p2T values. The nuclear modification factor, QpPb, is presented as a function of centrality for the three rapidity intervals, and, additionally, at backward and forward rapidity, as a function of pT for several centrality classes. At mid- and forward rapidity, the J/ψ yield is suppressed up to 40% compared to that in pp interactions scaled by the number of binary collisions. The degree of suppression increases towards central p-Pb collisions at forward rapidity, and with decreasing pT of the J/ψ. At backward rapidity, the QpPb is compatible with unity within the total uncertainties, with an increasing trend from peripheral to central p-Pb collisions.
Long-range angular correlations on the near and away side in p–Pb collisions at √sNN=5.02 TeV
(2013)
Angular correlations between charged trigger and associated particles are measured by the ALICE detector in p–Pb collisions at a nucleon–nucleon centre-of-mass energy of 5.02 TeV for transverse momentum ranges within 0.5<pT,assoc<pT,trig<4 GeV/c. The correlations are measured over two units of pseudorapidity and full azimuthal angle in different intervals of event multiplicity, and expressed as associated yield per trigger particle. Two long-range ridge-like structures, one on the near side and one on the away side, are observed when the per-trigger yield obtained in low-multiplicity events is subtracted from the one in high-multiplicity events. The excess on the near-side is qualitatively similar to that recently reported by the CMS Collaboration, while the excess on the away-side is reported for the first time. The two-ridge structure projected onto azimuthal angle is quantified with the second and third Fourier coefficients as well as by near-side and away-side yields and widths. The yields on the near side and on the away side are equal within the uncertainties for all studied event multiplicity and pT bins, and the widths show no significant evolution with event multiplicity or pT. These findings suggest that the near-side ridge is accompanied by an essentially identical away-side ridge.
Wiederfang von zwei Sumpfmeisen (Parus palustris) nach einer Serie von Orientierungsversuchen
(1989)
We controlled two Marsh Tits in mist nets after they have been in orientation experiments for several weeks and released at the site of capture. One was controlled 1 1/2 years after the tests. There does not seem to be any impact of the experiments on the ability to survive well.
Hochwasserereignisse sind von besonderer Bedeutung, da sie die Auenlandschaft räumlich und zeitlich strukturieren und so eine große Vielfalt an Habitaten schaffen. Mollusken sind von großem Artenreichtum, der in den mitteleuropäischen Flussauen am höchsten ist. Sie sind relativ leicht zu determinieren und besitzen zudem eine geringe Mobilität und dementsprechend kleine Minimalareale. Darüber hinaus sind Ökologie und Habitatansprüche der meisten Arten gut bekannt. Dadurch eignen sich Mollusken sehr gut zur ökologischen Charakterisierung (Indikation) und zur naturschutzfachlichen Bewertung von Auenökosystemen. Obwohl in zahlreichen Studien bereits Molluskenzönosen in Auen beschrieben wurden, ist über die Reaktion von Mollusken auf Hochwasser, insbesondere Extremhochwasser, wenig bekannt, zumal kaum Daten vorliegen, die den Zustand vor und nach einem Extremereignis beschreiben. In diesem Beitrag werden die kurz- und mittelfristigen Auswirkungen des Sommerhochwassers 2002 auf Molluskengemeinschaften im Auengrünland der Mittleren Elbe beschrieben.
Mollusken eignen sich aufgrund ihrer spezifischen Eigenschaften sehr gut zur ökologischen Charakterisierung, naturschutzfachlichen Bewertung und Beweissicherung bei bevorstehenden Veränderungen innerhalb ihrer Lebensräume. Durch ihre geringe aktive Mobilität sind sie sehr stark an ihren Lebensraum gebunden. Ihre Biologie, Ökologie und Habitatansprüche sind gut bekannt. Gerade in Flussauen erreichen Mollusken sehr hohe Arten- und je nach standörtlichen Verhältnissen sehr hohe Individuenzahlen. Im Herbst 2006 sowie im Frühjahr und Herbst 2007 wurden Molluskenproben auf den Wiesen im Roßlauer Oberluch und auf zwei Referenzstandorten in der Kliekener Altaue entnommen mit dem Ziel, den Status Quo vor der Deichöffnung festzuhalten und die Entwicklung dieser Artengruppe nach der Deichrückverlegungsmaßnahme zu analysieren. Bislang liegen die Status-Quo-Ergebnisse der Herbst- und Frühjahrsaufsammlungen aus den Jahren 2006 und 2007 vor.