Curative Allogeneic Stem Cell Transplantation Is Safe and Feasible in Adult Patients with Sickle Cell Disease Despite Lack of Matched Sibling Donor and Presence of Sickle Cell-Related Co-Morbidities

In this study, we review our experience with HSCT for SCD and demonstrate that most patients can receive a curative HSCT despite lack of SIB donor and presence of significant co-morbidities.Methods:All adult SCD patients who received HSCT at our center since 2014 were included. Patients had at least 2 hospitalizations per year for pain crises despite hydroxyurea compliance and evidence of end-organ damage. Patients with a SIB donor (n=6) received conditioning with alemtuzumab and 3Gy TBI (per Hsieh et al, 2009). Patients with MUD/MMUD (n=4) or haploidentical (n=1) donors received conditioning with alemtuzumab, fludarabine, melphalan, and a CD34+ selected graft with CD3+ cell add back on an ongoing clinical trial for non-malignant hematologic diseases. One patient s/p kidney transplant and liver failure requiring TIPS procedure was conditioned with alemtuzumab and 4Gy TBI, received a 10/10 MUD graft, and given post-HSCT cyclophosphamide (50 mg/kg d+3) along with sirolimus continuation as GVHD prophylaxis. GVHD prophylaxis otherwise consisted of sirolimus (n=10) and tacrolimus (n=1). All patients received a G-CSF mobilized peripheral blood stem cell (PBSC) graft and underwent RBC exchange to achieve Hgb S
Source: Blood - Category: Hematology Authors: Tags: 721. Clinical Allogeneic Transplantation: Conditioning Regimens, Engraftment, and Acute Transplant Toxicities Source Type: research

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Publication date: Available online 22 June 2019Source: The Journal of Allergy and Clinical Immunology: In PracticeAuthor(s): Stephen Betschel, Ernie Avilla, Amin Kanani, Monika Kastner, Paul Keith, Karen Binkley, Gina Lacuesta, Rozita Borici-Mazi, Jacquie Badiou, Anne Rowe, William H. Yang, Susan WasermanAbstractBackgroundHAE patients present to the emergency department (ED), where their symptoms are often incorrectly attributed to common allergic and gastrointestinal conditions resulting in major delays in diagnosis and treatment.ObjectiveThe goal of this study was to develop a rapid triage HAE tool for ED settings.Method...
Source: The Journal of Allergy and Clinical Immunology: In Practice - Category: Allergy & Immunology Source Type: research
Hospitals and insurance companies will fight the order, which could reveal their secret negotiations.
Source: NYT - Category: American Health Tags: Health Insurance and Managed Care Prices (Fares, Fees and Rates) Executive Orders and Memorandums Health and Human Services Department Trump, Donald J Azar, Alex M II Source Type: news
ConclusionAs a composite scaffold, an NT-3 sustained-release system cross-linked with an acellular spinal cord scaffold has potential applications for tissue engineering.Graphical abstract
Source: Materials Science and Engineering: C - Category: Materials Science Source Type: research
It could depend on how much the health care system resembles the Danish concrete market.
Source: NYT - Category: American Health Authors: Tags: Prices (Fares, Fees and Rates) Health Insurance and Managed Care United States Economy Hospitals Concrete Source Type: news
This study aimed at investigating CPM magnitude in two distinct subgroups of healthy subjects, presenting low vs. high sensitivity to pain (LSP vs. HSP, respectively), by employing two different thermal paradigms of CPM.MethodNinety-five healthy subjects (out of 293 tested) were identified as LSP (n = 48) or HSP (n = 47) according to their tolerance time to noxious cold stimulation (Cold Pressor Test, 1 °C). All subjects were exposed to two different paradigms of CPM: 1) Fixed temperature ‘test-pain’ (TP) where phasic, fixed painful heat stimuli of 47 °C were ad...
Source: Neuroscience Letters - Category: Neuroscience Source Type: research
Insurance companies say they are owed some $12 billion promised to them in “risk corridor” provisions of the Affordable Care Act.
Source: NYT - Category: American Health Authors: Tags: Health Insurance and Managed Care Patient Protection and Affordable Care Act (2010) Supreme Court (US) Obama, Barack United States Politics and Government Source Type: news
We examined the U.S. thoracic surgery workforce using the 2010 and 2014 Area Health Resource Files. We calculated the density of thoracic surgeons per 100,000 persons for each year at the state and county level. We performed descriptive statistics and developed maps highlighting changes over time and geographic regions.ResultsDespite an overall increase in thoracic surgeons from 2010 to 2014, we observed declining density nationwide (1.5% change) and in sparsely populated states. The difference in thoracic surgeon density widened slightly between 2010 from 0.80 per 100,000 compared to 0.84 per 100,000 in 2014 in all rural ...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
Publication date: Available online 22 June 2019Source: The Annals of Thoracic SurgeryAuthor(s): Dmitry B. Giller, Galina V. Giller, Boris D. Giller, Alexander V. Papkov, Galina V. Scherbakova, Vadim V. Koroev, Oleg Sh. KesaevAbstractA patient with extensive fibro-cavitary pulmonary tuberculosis (TB) and extensively drug-resistant (XDR) Mycobacterium tuberculosis (MTB) underwent bilateral VATS thoracoplasty. An examination four years post-surgery revealed that the patient was in a satisfactory condition and able-bodied.We performed surgery according to our proposed VATS thoracoplasty technique. In the postoperative period, ...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
In this study, we isolated a CCoV, designated HLJ-073, from a dead 6-week-old male Pekingese with gross lesions and diarrhea. Interestingly, sequence analysis suggested that HLJ-073 contained a 350-nt deletion in ORF3abc compared with reference CCoV isolates, resulting in the loss of portions of ORF3a and ORF3c and the complete loss of ORF3b. Phylogenetic analysis based on the S gene showed that HLJ-073 was more closely related to members of the FCoV II cluster than to members of the CCoV I or CCoV II cluster. Furthermore, recombination analysis suggested that HLJ-073 originated from the recombination of FCoV 79-1683 and C...
Source: Archives of Virology - Category: Virology Source Type: research
Oral semaglutide, the investigational first oral GLP-1 receptor agonist, could expand currently suboptimal treatment options for patients with type 2 diabetes and moderate renal impairment.Medscape Medical News
Source: Medscape Transplantation Headlines - Category: Transplant Surgery Tags: Diabetes & Endocrinology News Source Type: news
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