Background.Most patients with primary CNS lymphoma (PCNSL), an aggressive extranodal lymphoma confined to the CNS, have a poor prognosis in spite of development of chemotherapy regimens. First-line treatment consists of high-dose methotrexate-based (HD-MTX) regimen followed by consolidation with autologous stem cell transplantation or whole brain radiotherapy. Given that this tumor manifests predominantly in older patients with median age of 65 years, many patients are unable to tolerate intensive chemotherapy. Moreover, most patients eventually present with relapsed or refractory (r/r) disease. Relapse or refractory (r/r) PCNSL has a poor prognosis with median overall survival not exceeding 3.5 months (Langner-Lemercier et al, 2016) and these patients should be offered a clinical trial whenever possible. These groups are in need of safe, tolerable and effective therapeutic approaches. Primary testicular lymphoma (PTL) shares biological and clinical similarities with PCNSL and often present with CNS involvement. Such patients are also in need of new approaches, especially if they are refractory or not suitable to HD-MTX. Given high PD-1/PD-L1 expression in tumor microenvironment (Berghoff, 2014), immune checkpoint inhibitors were successfully tested in r/r PCNSL and PTL setting. However, data are still scarce and limited to case series (Nayak et al., 2017; Graber et al. 2020). Here we present Pavlov University experience of the treatment of PCNSL and PTL with CNS involvement with PD-1 inhibitor nivolumab. Methods.Eight patients, 2 men and 6 women, with PCNSL and one patient with PTL with CNS involvement treated at the Pavlov University between 2017 and 2020 were included into analysis. Median age at a diagnosis was 62 (28-66) years. Two patients (22%) had ECOG score 3-4 and therefore could not be considered for intensive MTX containing frontline treatment. In all of the cases the tumor histological type was diffuse large B-cell lymphoma. All patients had parenchymal involvement: 7 patients had multifocal disease; deep structures were involved in 2 patients. One patient had leptomeningeal involvement. Nivolumab was used in a first-line setting in 2 patients (22%). In 7 (78%) patients with relapsed/refractory disease, the median number of treatment lines prior to nivolumab was 1 (1-7). Nivolumab was given every 2 weeks in the 100 mg dose. Adverse events were defined according to NCI CTC-AE 5.0. Results.At the time of analysis, the median follow-up was 18 (3-44) months. Median number of nivolumab cycles was 10 (2-23). Seven (78%) patients had an objective response: complete response in 3 patients (33.3%) and partial response in 4 patients (44.4%). Two patients (22.2%) were refractory to treatment. Two-year overall survival (OS) was 44% with median OS of 12 months. Two-year progression-free survival (PFS) was 26% with median of PFS 12 months. Оne responder had a moderate increase of tumor volume on MRI after two months of therapy followed by complete disappearance of brain lesions on sequential imaging at 4 months after treatment initiation. Nivolumab therapy appeared safe with only one patient (11%) having severe adverse event, namely grade 3 alanine aminotransferase and aspartate aminotransferase increase. Conclusion.Nivolumab appears to be safe and effective therapy in PCNSL and PTL with CNS involvement both in first-line and r/r setting. However, in our cohort majority of patients relapsed that suggest that consolidation therapy after remission induction with nivolumab may be crucial for long-term remissions. We also demonstrate that pseudoprogression might be also observed in PCNSL during immunotherapy. Large-scale trials are needed to generate strong evidence for the use of PD-1 inhibitors in PCNSL. Disclosures No relevant conflicts of interest to declare. OffLabel Disclosure: Nivolumab is an anti-PD-1 inhibitor approved for classical Hodgkin lymphoma. There is early clinical data suggesting the efficiency of nivolumab in PCNS lymphoma (Nayak, 2017)
The starting ternary compounds CuInS 2 and CuSbS 2 and alloys of the CuSbS 2 -CuInS 2 system with the molar fractions of CuInS 2 (x) equal to 0. 05, 0.15, 0.25, 0.375, 0.50, 0.625, 0.75, 0.85, and 0.95 were prepared and the phase relations in this system were investigated by X-ray powder diffraction, optical microscopy, scanning electron microscopy, and differential thermal analysis. It was shown that the T-x phase diagram of the CuInS 2 -CuSbS 2 system has a eutectic character with the eutectic temperature of 807 K. The alloys of the CuSbS 2 -CuInS 2 system with the molar fraction of CuInS 2 in the range from 0.038 to 0.941 at room temperature are two-phased, and the limits of solubility are 0.059 molar fractions for CuSbS 2 in CuInS 2 and 0.038 molar fractions for CuInS 2 in CuSbS 2 .
The photoluminescence (PL) properties of ZnSe epitaxial layers grown by metal-organic vapor phase epitaxy are investigated. A correlation between the electron-hole plasma (EHP) band position and the PL intensity is found and on this basis the nonequilibrium carrier lifetime z and the PL efficiency r] are estimated in the ZnSe layers: z = to lo-'' s, r] = 0.1 to 0.001%. It is shown that these paraneters decrease with decreasing layer thickness and with increasing concentration of contaminations and native defects. The influence of the excitation level and temperature on the intensity and peak position of the band at 472 nm in ZnSe : N and the band at 620 nm in undoped ZnSe epilayers at 78 K grown at temperatures of T, > 500 "C are studied. It is supposed that these bands are due to recombinations described in the configurational coordinate model.
The Yb, Er:YCOB and Yb, Er:CBFB crystals with good optical quality were obtained by the Czochralsky technology. Stark structures of 4I11/2, 4I13/2 and 4I15/2 multiplets of Er3+ - ions are determined, and kinetic and spectroscopic parameters of the crystals are designed by the reciprocity and Fuhtbauer-Ladenburg method. The decreasing of the multiphonon nonradiative relaxation probability from the 4i13/2 level of the erbium with reduction of the contents of oxyboron (BO3) complexes in structure of crystals is observed. The high values of the luminescence quantum output - 20 % for 4I13/2 level and emission cross section on the 1.59 µm wavelength of 0.5 10−20cm2 are designed in CBFB crystals. The effective energy transfer of Yb-Er with quantum efficiency not less than 96 % is found in the YCOB crystals. The nonradiative interaction parameters are determined and equal CYb-Er = 7.6 10−39 and CYb-Yb = 5.1TO−40 cm6s−1. Thus CBFB and YCOB crystals are of great interest for getting of 1.5 mm laser generation.
The Yb radiative lifetime of 923 µs has been determined by the extrapolation to the zero concentration of Yb. Quenching of the Yb luminescence is observed in the Yb3+ ,Ce3+ :CaGd4 Si3 O13 (Yb,Ce:CGS) crystals due to their intrinsic defects and Ce3+ ions. The main quenching mechanism is the energy migration through Yb ions to the defects with a micro-parameter CDD (Yb-Yb) = 1.0 × 10-38 cm6 s-1 , and the Yb3+ Ce3+ energy transfer with a micro-parameter CDA = 5.5 × 10-44 cm6 s-1 .
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