White Blood Cell Count Nadir and Duration of Aplasia Do Not Associate with Treatment Outcome in Adult Patients with Acute Myeloid Leukemia Undergoing Intensive Chemotherapy.

INTRODUCTION: Adult patients with acute myeloid leukemia (AML) are usually treated with intensive chemotherapy, leading to prolonged bone marrow aplasia. It is usually assumed that a short duration of aplasia could be a surrogate marker of poor therapeutic efficacy in clearing bone marrow blasts, especially in older patients. No studies have evaluated the usefulness of such a surrogate marker in younger AML patients treated with intensive chemotherapy. MATERIALS AND METHODS: In the present study, we retrospectively assessed the role of white blood cell (WBC) count nadir and duration of aplasia in 68 patients with AML treated with intensive chemotherapy and potentially candidate to stem cell transplantation. RESULTS: The median (interquartile range) bone marrow aplasia was 25 days, and the mean WBC count nadir from chemotherapy start was at day +12, whereas the median neutrophil recovery occurred at day +24. No significant differences were found between responders and nonresponders for mean aplasia duration (25 vs. 26 days, p value = 0.76), mean WBC count nadir (12 vs. 12 days, p value = 0.86), and median neutrophil recovery (24 vs. 24, p value = 0.67). DISCUSSION: The present study evaluated the potential prognostic role of WBC count nadir and duration of aplasia, demonstrating that they are not associated with treatment outcomes in adult patients with AML treated with intensive chemotherapy. Therefore, a short duration of aplasia seems not linked to poor therapeutic efficacy in clearing bone marrow blasts. Our findings, although needing validation in larger and more homogeneous cohorts, may offer helpful clues in the management of aplasia of AML patients.

Integrated system of phytodepuration and water reclamation: A comparative evaluation of four municipal wastewater treatment plants.

In dry regions, water resources have become increasingly limited, and the use of alternative sources is considered one of the main strategies in sustainable water management. A highly viable alternative to commonly used water resources is treated municipal wastewater, which could strongly benefit from advanced and low-cost techniques for depuration, such as the integrated system of phytodepuration (ISP). The current manuscript investigates four Italian case studies with different sizes and characteristics. The raw wastewaters and final effluents were sampled on a monthly basis over a period of up to five years, allowing the quantification of the ISP performances. The results obtained show that the investigated plants are characterized by an average efficiency value of approximately 83% for chemical oxygen demand removal, 84% for biochemical oxygen demand, 89% for total nitrogen, 91% for total phosphorus, and 85% for total suspended solids. Moreover, for three of the case studies, the ISP final effluent is suitable for irrigation, and in the fourth case study, the final effluent can be released in surface water.

Integrated System of Phytodepuration for Agroindustrial Wastewater: Three Different Case Studies.

The effluents deriving from agricultural industries are sources of wastewater sensibly different from common civil wastewater treatment plants effluents, because they are characterized by significant amounts of nutrients and organic load. Agricultural industries require considerable water volumes for processing the farm products, in doing so generating huge volumes of wastewater, with high concentration of chemical oxygen demand (COD), nitrogen (N) and phosphorus (P). Advanced and low cost techniques for water depuration are required in such circumstances, as the use of Integrated System of Phytodepuration (ISP). In the present work, three different case studies (a dairy, a pig feedlot and a vinegar industry) are investigated: the performances of the ISPs were evaluated analyzing raw wastewaters and final effluents over a period ranging from 2 to 4 years. The results obtained show that the designed ISPs are characterized by a mean efficiency value higher than 85% for COD removal, 73% for N and 85% for P. Moreover, for the pig feedlot the ISP final effluent is characterized by a quality level not only suited for the release into surface waters but also for irrigation, while for the other two case studies is possible to release the final effluent in surface water.

The Integrated System of Phytodepuration of Sile River Natural Park.

The water conservation topic is likely to become increasingly important and alternative water resources employment should be considered as one possible response to the challenges of fresh water demand and environmental protection; among alternative water sources, municipal wastewaters represent one of the most profitable source but in order to reuse them they need adequate and advanced depuration techniques, such as the use of Integrated System of Phytodepuration (ISP). Across a 3-year sampling period, the performances of an ISP within the Natural Park of the Sile River in the Northern Italy were evaluated, analyzing raw wastewater and final effluent characteristics according to the recommendations of European and Italian legislation. The investigated ISP represents one of the first attempts designed in Italy to improve the efficiency of an existing wastewater treatment plant, able to serve 8000 equivalent inhabitants. The results obtained during the 3 years of analysis show that the designed ISP is characterized by a general efficiency value higher than 87% for TSS removal, 79% for TN, 91% for BOD5 and 86% for COD; moreover the ISP final effluent is characterized by a quality not only suited for release into surface waters but also for irrigation.