The emerging role of measurable residual disease detection in AML in morphologic remission.

Despite the increasing knowledge of the genomic landscape of acute myeloid leukemia (AML), prediction merely based on genetics fails to anticipate outcome, presumably due to the heterogeneous composition of the leukemic clone determining complex interactions between different genetic abnormalities. Therefore, the introduction of a post-treatment biomarker exploring the quality of response to therapy such as assessment of measurable (previously minimal) residual disease (MRD) may lead to refinements of the prognostic assessment in AML. In this view, the European LeukemiaNet has recently endorsed the achievement of a MRD negative morphologic complete remission as a purpose the treatment. Techniques like multiparametric flow cytometry and reverse transcriptase-quantitative polymerase chain reaction have reached a level of sensitivity and specificity that make them ready for introduction in clinical practice. In the present review, we will give an update on the efforts in harmonization and/or standardization of MRD assessment in AML, focusing on the newest acquisitions in the clinical applications of MRD, and considering issues like relationship of MRD with leukemic stem cells or MRD assessment in peripheral blood.

Minimal residual disease negativity in elderly patients with acute myeloid leukemia may indicate different postremission strategies than in younger patients.

In the present analysis, we evaluated whether in elderly acute myeloid leukemia (AML) patients (>60 years), minimal residual disease (MRD) assessed by flow cytometry may have a role in guiding choice of postremission strategies. We analyzed 149 young and 61 elderly adults who achieved morphological CR after induction course of EORTC/GIMEMA protocols. Elderly patients reached a postconsolidation MRD negative status less frequently than younger ones (11 vs 28 %, p = 0.009). MRD negativity resulted in a longer 5-year disease-free survival (DFS) both in elderly (57 vs 13 %, p = 0.0197) and in younger patients (56 vs 31 %, p = 0.0017). Accordingly, 5-year cumulative incidence of relapse (CIR) of both elderly (83 vs 42 %, p = 0.045) and younger patients (59 vs 24 % p = NS) who were MRD positive doubled that of MRD negative ones. Nevertheless, CIR of MRD negative elderly patients was twofold higher than that of younger MRD negative ones (42 vs 24 %, p = NS). In conclusion, elderly patients in whom chemotherapy yields a MRD negative CR have duration of DFS and rate of CIR significantly better than those who remain MRD positive. Nonetheless, the high CIR rate observed in the elderly suggests that MRD negativity might have different therapeutic implications in this population than in the younger counterpart.

Deformities of chironomid larvae and heavy metal pollution: from laboratory to field studies.

Mouthpart deformities of Chironomus riparius larvae (Diptera) have been investigated to evaluate the toxic effects of contamination by heavy metals in the Genna Stream (Central Italy), situated in an area subjected to intensive swine farms (40000 heads). The livestock farming (fertirrigation) contributes to metal pollution of the Genna Stream with an increase of copper, zinc, cadmium, chromium and nickel in the sediments of the downstream stations. The incidence of mentum deformities was very high at all sampling stations, about 56%. The highest values of deformities were found in the intermediate river reach (St. 3: 65%) and in March (66%), mainly due to an increase in severe deformities. The high incidence of severe deformities (30%) is attributed to the high pollution level by heavy metals in the sediments, in particular to copper and zinc, which showed the highest average value at St. 3 and in March. This field study reflected the relationships between sediment metal concentrations and chironomid mouthpart deformities, previously observed in laboratory tests, and highlighted these deformities as toxicity endpoints. This feature paves the way for their use as an effective tool in freshwater bioassessment monitoring programs to evaluate the toxic effects of metal contamination in freshwater ecosystems.

Actinosporean stages of Myxozoan parasites of oligochaetes from Nera River basin, Central Italy.

The aim of this study was to check the occurrence of actinosporean stages of Myxozoan parasites of oligochaetes in the Nera River basin (Central Italy). The investigation was conducted near twelve trout farms (rainbow and brown trout) along the Nera River and in the littoral of the Piediluco Lake. Four actinosporean types, belonging to the collective groups aurantiactinomyxon, triactinomyxon, raabeia and echinactinomyxon, were detected in some of the biotopes investigated (Piediluco Lake and Sordo River). Differential diagnosis, carried out on a sub-sample of spores, showed a complete fitting with forms previously described in literature, with the exception of the triactinomyxon type.