Stem cell transplantation from unrelated donors is associated with an increased risk of graft failure and graft-versus-host disease (GVHD). Addition of pretransplant antithymocyte globulin (ATG), ...although reducing the risk of graft rejection and GVHD, bears the risk of overimmunosuppression, resulting in an increased relapse rate and transplant-related mortality. Therefore, we evaluated in 21 consecutive patients receiving unrelated stem cell grafts from either HLA-matched (38%) or -mismatched (62%) donors whether low-dose rabbit ATG added to cyclosporin A and methotrexate at a total dose of 3.5 mg/kg for HLA-identical and 5.0 mg/kg for HLA-mismatched transplants given in two divided doses on days -2 and -1 provides sufficient immunosuppression for prevention of GVHD and graft rejection but is associated with an acceptable risk of relapse and transplant-related mortality. Stable leukocyte engraftment was achieved in all patients (100%). Overall survival after a median follow-up of 26 (median, range 14-42) months was 56 +/- 26% (95% confidence interval, CI) and the overall relapse rate at 3 years was 24 +/- 21%. Three-year survival for standard-risk patients, i.e., chronic myeloid leukemia (CML) in first chronic phase or acute leukemia in first complete remission, was 87% +/- 13% versus 40% +/- 31% for patients with more advanced disease. The incidence of acute GVHD II-IV degrees was 55 +/- 22%; that of severe acute GVHD III-IV degrees was 21 +/- 19%. Chronic GVHD was observed in 5/17 (29%) patients surviving more than 100 days post stem cell transplantation. Transplant-related mortality was 16 +/- 15% (95% CI) at day + 100 and 25 +/- 19% (95% CI) at 1 year after the transplant. The data presented show that pretransplant in vivo T cell depletion with low-dose rabbit ATG results in a low transplant-related mortality due to a low incidence of severe acute and chronic GVHD and a low relapse rate. To find out the optimal rabbit ATG dose in the unrelated stem cell transplantation setting, further dose-finding studies comparing high- and low-dose regimens are necessary.
Wood cellulose is a desirable inexpensive, abundant and biodegradable substrate material for flexible organic electronics. While paper-based conductors are easily achieved, their applicability for ...diode architectures is challenging. To diminish short circuits, smoothing fillers and coatings are used before diode deposition. In this report, an alternative approach for use of cellulose in organic photovoltaics is demonstrated, using natural, rough unmodified kraft pulp fiber networks as a carrier of a diode architecture. Silver nanowires are adsorbed by the hydroxyl groups of cellulose fiber, forming the semi-transparent anode. The follow-on coatings for the diode are simply deposited as a mantle on these fiber anodes. The potential of this approach is demonstrated by the first production of cellulose fiber-based P3HT:PCBM photovoltaic devices, showing clear diode behaviour in the dark and a significant photoresponse under illumination. Fill factors near 35 % and open-circuit voltages of 0.2 V were achieved without any optimization. Devices show even noticeable photocurrent at low unfavourable light conditions, indicating their advantageous capture of stray light within the paper fiber network. These results highlight that for “paper” diodes, its natural properties can be turned into advantages, instead of seeking routes to suppress them.
BACKGROUNDThe number of long-term survivors of breast cancer has increased over recent decades because of many treatment advances. Thus, long-term quality of life (QoL) and factors affecting it are ...of growing research interest.OBJECTIVEThe authors investigated longitudinal changes in QoL and anxiety in breast cancer patients and differences in QoL and anxiety in various oncological subgroups.METHODA group of 236 women with a primary diagnosis of breast cancer or carcinoma in-situ completed questionnaires after surgical treatment, 6 months, and 12 months post-surgery.RESULTSQoL scores of breast cancer patients improved over time, but impairments in terms of anxiety, body image, and sexual functioning were still observed. Younger patients were more likely to be distressed by cancer diagnosis and treatment.DISCUSSIONSurgical modality and tumor prognostic factors, however, seemed to play a minor role in patients' subjective QoL, which is discussed in terms of the "well-being paradox."
Background The number of long-term survivors of breast cancer has increased over recent decades because of many treatment advances. Thus, long-term quality of life (QoL) and factors affecting it are ...of growing research interest. Objective The authors investigated longitudinal changes in QoL and anxiety in breast cancer patients and differences in QoL and anxiety in various oncological subgroups. Method A group of 236 women with a primary diagnosis of breast cancer or carcinoma in-situ completed questionnaires after surgical treatment, 6 months, and 12 months post-surgery. Results QoL scores of breast cancer patients improved over time, but impairments in terms of anxiety, body image, and sexual functioning were still observed. Younger patients were more likely to be distressed by cancer diagnosis and treatment. Discussion Surgical modality and tumor prognostic factors, however, seemed to play a minor role in patients’ subjective QoL, which is discussed in terms of the “well-being paradox.”
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