Outcomes of Chronic Phase Chronic Myeloid Leukemia after Treatment with Multiple Tyrosine Kinase Inhibitors
JOURNAL OF CLINICAL MEDICINE
Authors: Kong, Jee Hyun; Winton, Elliott F.; Heffner, Leonard T.; Gaddh, Manila; Hill, Brittany; Neely, Jessica; Hatcher, Angela; Joseph, Meena; Arellano, Martha; El-Rassi, Fuad; Kim, Audrey; Khoury, Jean Hanna; Kota, Vamsi K.
We sought to evaluate the outcomes of chronic phase (CP) chronic myeloid leukemia (CML) in an era where five tyrosine kinase inhibitors (TKIs) are commercially available for the treatment of CML. Records of patients diagnosed with CP CML, treated with TKIs and referred to our center were reviewed. Between January 2005 and April 2016, 206 patients were followed for a median of 48.8 (1.4-190.1) months. A total of 76 (37%) patients received one TKI, 73 (35%) received two TKIs and 57 (28%) were exposed to >3 TKIs (3 TKIs, n = 33; 4 TKIs, n = 17; 5 TKIs, n = 7). Nineteen (9.2%) patients progressed to advanced phases of CML (accelerated phase, n = 6; myeloid blastic phase, n = 4; lymphoid blastic phase, n = 9). One third (n = 69) achieved complete molecular response (CMR) at first-line treatment. An additional 55 patients achieved CMR after second-line treatment. Twenty-five patients (12.1%) attempted TKI discontinuation and 14 (6.8%) stopped TKIs for a median of 6.3 months (range 1-53.4). The 10-year progression-free survival and overall survival (OS) rates were 81% and 87%, respectively. OS after 10-years, based on TKI exposure, was 100% (1 TKI), 82% (2 TKIs), 87% (3 TKIs), 75% (4 TKIs) and 55% (5 TKIs). The best OS was observed in patients tolerating and responding to first line TKI, but multiple TKIs led patients to gain treatment-free remission.
Single-ended ring oscillators: analysis and design
IET CIRCUITS DEVICES & SYSTEMS
Authors: Zafarkhah, Elnaz; Maymandi-Nejad, Mohammad; Zare, Maryam
In this study the authors propose a novel and straightforward design procedure for the single-ended ring oscillator (SERO). This procedure determines the values of the circuit parameters to reach the desired oscillation frequency while the power consumption and the area are minimised and the noise is kept below the desired value. Furthermore, the authors analyse the SERO and suggest a practical formula for the oscillation frequency. In comparison to the conventional equations, the derived formula is accurate as well as explicit. The accuracy of the proposed frequency equation is verified using simulation. The average of the absolute errors over a wide range of parameters is 2.52%, and the worst case error is 9.64%. In addition, the power consumption of the SERO is analysed and a formula is presented for estimating the power consumption.