CD3+ graft cell count influence on chronic GVHD in haploidentical allogeneic transplantation using post-transplant cyclophosphamide.

The effects of graft or donor characteristics in haploidentical hematopoietic cell transplantation (HCT) using post-transplant cyclophosphamide (PT-Cy) are largely unknown. In this multicenter retrospective study we analyzed the correlations between graft cell composition (CD34+, CD3+) and donor features on transplant outcomes in 234 patients who underwent HCT between 2010 and 2016. On multivariate analysis, the use of peripheral blood stem cells (PBSC) was associated with an increased incidence of grade 2-4 acute GVHD [HR 1.94, 95% confidence Interval (CI) = 1.01-3.98, p = 0.05]. An elevated CD3+ graft content was associated with an increased incidence of all-grade chronic GVHD [HR 1.36 (95% CI = 1.06-1.74), p = 0.01]. This effect was confirmed only for the PBSC graft group. A higher CD34+ graft content had a protective role on non-relapse mortality [HR 0.78 (95% CI = 0.62-0.96), p = 0.02] but this was confirmed only for the bone marrow (BM)-derived graft cohort. Donor characteristics did not influence any outcomes. GVHD prophylaxis should be modulated accordingly to CD3+ graft content, especially when a PBSC graft is used. These results need further validation in prospective trials.

Haploidentical transplantation with post-infusion cyclophosphamide in advanced Hodgkin lymphoma.

We investigated the use of haploidentical hematopoietic stem cell transplantation (haplo-HSCT) in the treatment of advanced Hodgkin lymphoma (HL). Sixty-two consecutive HL patients underwent haplo-HSCT. Unmanipulated stem cells and post-transplant cyclophosphamide were given to all patients as GVHD prophylaxis. At 100 days, the cumulative incidence of grades 2-3 and grades 3-4 acute GVHD was 23% and 4%, respectively. The chronic GVHD (cGVHD) cumulative incidence was 16%, with one patient experiencing severe cGVHD. The 3-year OS, PFS, relapse rates and 1-year non-relapse mortality (NRM) were 63%, 59%, 21% and 20%, respectively. Uncontrolled disease status and high hematopoietic cell transplantation comorbidity index (HCT-CI) were associated with lower OS, whereas PBSC was an independent protective factor. Uncontrolled disease and HCT-CI >2 was predictive for NRM. Finally, disease status other than CR was predictive of relapse. In conclusion, haplo-HSCT is a valid treatment in advanced HL, offering excellent rates of survival and acceptable toxicities.

Effect of age and previous autologous transplantation on nonrelapse mortality and survival in patients treated with reduced-intensity conditioning and allografting for advanced hematologic malignancies.

PURPOSE: Older age and a previously failed autologous stem-cell transplantation (SCT) are poor prognostic factors for patients receiving myeloablative conditioning and allogeneic SCT. Reduced-intensity conditioning (RIC) regimens achieved a significant reduction of treatment-related mortality, but the influence of previously described risk factors on the outcome of this novel transplantation strategy have not been fully analyzed yet. PATIENTS AND METHODS: One hundred fifty patients with advanced hematologic malignancies received a RIC regimen containing thiotepa (10 mg/kg), fludarabine (60 mg/m2), and cyclophosphamide (60 mg/kg), followed by an allogeneic transplantation from an HLA-identical sibling donor. Patients were divided into two cohorts according to age; 90 patients were younger than 55 years, and 60 patients were 55 years old or older. The other pretransplantation characteristics were fairly balanced. RESULTS: Actuarial 5-year nonrelapse mortality (NRM) rate was not statistically different between the groups (13% in the younger group and 19% in the older group). By univariate and multivariate analysis, NRM was significantly higher in older patients who previously experienced failure with an autograft. The occurrence of grade 3 to 4 acute graft-versus-host disease (GVHD) or extensive chronic GVHD was associated with a higher NRM in both age cohorts. Overall survival (OS) was not statistically different between the younger (66%) and older groups (61%). By multivariate analysis, refractory disease was associated with a worse OS irrespective of age group. CONCLUSION: RIC transplantations show a rather low NRM, and age > or = 55 years per se cannot be considered a risk factor anymore. The timing of transplantation and novel strategies for the prevention of severe GVHD could further improve patient outcome.

Improvement in the rejection rate of a nulling interferometer by spatial filtering.

We propose applying the techniques of spatial filtering to the concept of interferometric coronography. In such a system, provided that the object being studied is not resolved by the individual apertures of the interferometric array, the beams can be considered as coherent or, more exactly, single mode. Hence spatial filtering allows one to cleanse the beams of imperfections generated by defects on the optical components of the interferometer and thus to obtain very high rejection rates in the destructive output of the interferometer (coronographic output) for an on-axis star. Numerical simulations show that the very stringent constraints on the optical quality of a space IR interferometer aimed at detecting extrasolar planets can be relaxed to values achievable with current technology. In particular, we show that the difficulties induced by dust scattering, small micrometeorite impacts on the primary mirror, and high-frequency ripples of polishing residuals can be eliminated by simple pinhole spatial filtering. The effects, however, will be less dramatic on large-scale defects such as coating defects and pointing errors in the telescopes.

Infrared single-mode fiber-optic Fourier-transform spectrometry and double Fourier interferometry.

An infrared single-mode fiber-optic Fourier-transform spectrometer constructed for the demonstration of the technique is described, in which beam splitting and beam combining are performed with fiber-optic directional couplers and the optical path difference scan is generated by stretching fibers. Experiments done with this fiber-optic Fourier-transform spectrometer are presented. A spectral resolution of 1328 at 2.2 µm can be achieved. The experimental results show the feasibility of fiber-optic Fourier-transform spectrometry and double Fourier interferometry.

Performance analyses of an infrared single-mode all-fiber-optic Fourier-transform spectrometer.

Stretching one of a pair of fiber arms can be done to realize optical phase modulation for an IR single-mode all-fiber-optic Fourier-transform spectrometer (FTS). But this operation will inevitably limit the physical performance of a FTS. We study these limits theoretically and experimentally. The optical path difference (OPD) will be dispersive. At the first-order approximation, this OPD dispersion will result in a shift in the recovered spectra. The spectral resolution and the sampling distance will also be dispersive. Linear birefringence introduced when a curved fiber is stretched will affect the final spectra. This effect can be eliminated by real-time compensation and (or) by system design. Errors encountered uniquely in the all-fiber-optic FTS in the optical phase domain, such as the fiber-parameter errors, nonlinearity of the piezoelectric cylinder, and their effects on the spectra are analyzed, from which we deduce the requirements for calibration. Finally, calibration methods for optical phase modulation are discussed.

[Corneal lesions caused by air bag. Apropos of a case]. / Lésions cornéennes par "air bag". A propos d'un cas.

The authors report the case of a patient with bilateral corneal lesions due to air bag inflation after a motor vehicle accident. The drivers air bag had inflated normally during the collision. Four similar cases, one with bursting of the bag, have been reported in the literature. Further improvement of this device should take this potential risk for the eyes into account.

[Neurological complications of zona. Apropos of a case]. / Complications neurologiques du zona. A propos d'un cas.

A 70 year old woman had left sixth nerve palsy, following an ophthalmic zona. Later she had controlateral hemiplegia with expression aphasia. Corticosteroid therapy improved the situation. The pathogenesis of this complication is discussed in this article. Ischaemic vasculitis is now a well known complication of herpes zoster which has already appeared in the literature. The case presented was related to ischaemia of the anterior artery of the troncus infero-lateral of Heubner's artery confirmed by further exploration.

[Traditional treatment of cataract in Niger. Apropos of 22 cases]. / Traitement traditionnel de la cataracte au Niger. A propos de 22 cas.

Empiric treatment of cataracts by couching is still commonly performed by traditional healers in West Africa. In the ophthalmology department in the regional hospital of Zinder, in Niger, 22 cases have been identified and their complications treated medically and surgically. The semiotic analysis demonstrated the diversity of methods used, sometimes successfully by the traditional healers. Apart from the classical technics of luxation in the vitreous, we have observed a number of cases with integrity of the posterior capsule and disappearance of the nucleus. These last observations have lead us to believe that certain traditional healers may use local plants with phakolytic effects in their pharmacopia.

[Conjunctival myiasis, a frequent pathology in Corsica]. / Les myiases conjonctivales, une pathologie fréquente en Corse.

Fifteen cases have been reported and treated in the Ajaccio eye department. The larva involved is most of the time Oestrus ovis and is responsible for an acute unilateral conjunctivitis. The conjunctiva is swollen and scattered with petechiae due to the hooks of the larva. Five to 15 maggots are extracted with a forceps after instillation of topical anesthetic, leading to relief of symptoms within a few days.

A foodborne outbreak of Norwalk virus gastroenteritis. Evidence for post-recovery transmission.

From November 10-16, 1982, 220 (57%) of 383 attendees at eight banquets for which food had been prepared at a single hotel restaurant and the employees of the hotel had onset of Norwalk virus gastroenteritis. Epidemiologic investigation of the three largest banquets confirmed consumption of potato and fruit salads (banquet A), coleslaw (banquet B), and tossed salad (banquet C) to be significantly associated with illness. Between November 8-19, similar illness occurred in seven (54%) of 13 hotel kitchen employees. The foods implicated in banquets A and B were prepared by one salad worker during her acute illness and up to 48 hours following her recovery. A second salad worker prepared the implicated tossed salad for banquet C 24 hours following her recovery. To the authors' knowledge, this is the first foodborne outbreak investigation demonstrating Norwalk viral excretion and transmission by a food handler after recovery from illness and either person-to-person or vehicle-borne transmission between food handlers with subsequent transmission by more than one food handler to patrons.