Emergence and evolution of TP53 mutations are a key feature of disease progression in myelodysplastic patients with lower-risk del(5q) treated with lenalidomide.

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This paper takes as its point of departure the European Commission's position, set out in 2005, which laid clear emphasis on aid and trade as tools for controlling immigration. We attempt to subject this position to empirical investigation. We exploit data on bilateral aid, trade and migration flows between developed and developing countries, for the period 2000–10, adopting an instrumental variable approach to address the endogeneity issue due to potential simultaneity bias. Our results establish that increasing aid and trade with developing countries is likely to fail to contain immigration, at least in the short run. The pattern of results is consistent with the hypothesis that promoting development in migrant‐sending countries, or cooperating with such countries to control migration outflows, is not sufficient to lessen immigration. Increasing visa restrictions and controls at borders is generally controversial; still, the results imply that policymakers cannot attain their short‐term immigration goals with the so‐called smart solutions of aid and trade.

Next-generation sequencing (NGS) is used to investigate the presence of somatic mutations. The utility of incorporating routine sequencing to guide diagnosis and therapeutic decisions remains unclear. We report the findings of an observational, multicenter study that aimed to assess the impact of somatic mutation testing by NGS in a reallife setting of chronic myeloid malignancies. A total of 177 patients were enrolled, partitioned into two overlapping groups. In group A (n=94), the indication was to search for clonal hematopoiesis, in a context of suspected myelodysplastic syndrome or myeloproliferative neoplasia. In group B (n=95), the theranostic impact of somatic mutations was studied. A panel of 34 genes was used on DNA extracted from blood or bone marrow samples. Within group A, the detection of clonal hematopoiesis supported the diagnosis of chronic myeloid malignancies for 31 patients while the absence of clonal hematopoiesis ruled out the suspected diagnosis in 47 patients. Within group B, NGS identified prognostically relevant somatic mutations in 32 patients, which had a therapeutic impact in 18 cases. By determining the presence or absence of somatic mutations, the application of NGS in daily practice was found to be useful for an integrated final diagnosis in 83% of the patients. Moreover, the search for somatic mutations had a prognostic impact that led to treatment modification in 19% of the cases. This study outlines the fact that adequate implementation of new investigations may have a significant positive medico-economic impact by enabling appropriate management of patients.

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