Outcome of lower-intensity allogeneic transplantation in non-Hodgkin lymphoma after autologous transplantation failure.

We studied the outcome of allogeneic hematopoietic stem cell transplantation after lower-intensity conditioning regimens (reduced-intensity conditioning and nonmyeloablative) in patients with non-Hodgkin lymphoma who relapsed after autologous hematopoietic stem cell transplantation. Nonrelapse mortality, lymphoma progression/relapse, progression-free survival (PFS), and overall survival were analyzed in 263 patients with non-Hodgkin lymphoma. All 263 patients had relapsed after a previous autologous hematopoietic stem cell transplantation and then had undergone allogeneic hematopoietic stem cell transplantation from a related (n = 26) or unrelated (n = 237) donor after reduced-intensity conditioning (n = 128) or nonmyeloablative (n = 135) and were reported to the Center for International Blood and Marrow Transplant Research between 1996 and 2006. The median follow-up of survivors was 68 months (range, 3-111 months). Three-year nonrelapse mortality was 44% (95% confidence interval [CI], 37%-50%). Lymphoma progression/relapse at 3 years was 35% (95% CI, 29%-41%). Three-year probabilities of PFS and overall survival were 21% (95% CI, 16%-27%) and 32% (95% CI, 27%-38%), respectively. Superior Karnofsky Performance Score, longer interval between transplantations, total body irradiation-based conditioning regimen, and lymphoma remission at transplantation were correlated with improved PFS. Allogeneic hematopoietic stem cell transplantation after lower-intensity conditioning is associated with significant nonrelapse mortality but can result in long-term PFS. We describe a quantitative risk model based on pretransplantation risk factors to identify those patients likely to benefit from this approach.

Detection of geometric, but not topological, spatial transformations in 6- to 12-month-old infants in a visual exploration paradigm.

Several theories of spatial orientation propose that the geometry of an environment plays a privileged role in reorientation, relative to relations between individual landmarks. Infants (N = 90) in three age groups (6, 8 1/2, and 12 months) experienced three conditions: topological, geometric, and control. A round room contained four distinctive objects in a rectangular arrangement on the inside periphery. Infants were familiarized to the array prior to a 2-min test period. In the topological condition, two objects were switched. In the geometric condition, the objects were moved to form an irregular quadrilateral. In the control condition, the array remained unchanged. Infants of 8 1/2 months and over visually explored significantly more in the geometric condition only. An initial study with adults found greater visual exploration in both geometric and topological conditions. These results are discussed in the context of current theories of spatial orientation.