The number of HLA-haploidentical hematopoietic cell transplants continues to increase worldwide due to recent improvements in outcomes, allowing more patients with hematological malignancies and ...non-malignant disorders to benefit from this procedure and have a chance to cure their disease. Despite these encouraging results, questions remain as multiple donors are usually available for transplantation, and choosing the best HLA-haploidentical donor for transplantation remains a challenge. Several approaches to haploidentical transplantation have been developed over time and, based on the graft received, can be grouped as follows: T-cell depleted haploidentical transplants, either complete or partial, or with T-cell replete grafts, performed with post-transplant cyclophosphamide-based graft-versus-host disease (GVHD) prophylaxis, or G-CSF-primed bone marrow graft and enhanced GVHD prophylaxis. Carefully selecting the donor can help optimize transplant outcomes for recipients of haploidentical donor transplants. Variables usually considered in the donor selection include presence of donor-specific antibodies in the recipient, donor age, donor/recipient gender and ABO combinations, and immunogenic variables, such as natural killer cell alloreactivity or KIR haplotype. Here we provide a comprehensive review of available evidence for selecting haploidentical donors for transplantation, and summarize the recommendations from the European Society for Blood and Marrow Transplantation (EBMT) on donor selection for different transplant platforms.
Patients undergoing neoadjuvant chemotherapy before surgery for advanced ovarian cancer may have impaired functional capacity, nutritional status, and emotional well-being.
TRAINING-01 aims to ...determine if a connected pre-habilitation program during neoadjuvant chemotherapy for patients treated for an advanced ovarian cancer will improve physical capacity before major abdomino-pelvic surgery.
A pre-habilitation program during neoadjuvant chemotherapy will bring a fitter patient to surgery and will decrease treatment morbidity and improve oncological outcomes.
This study is a prospective, multi-center, phase III study. The pre-habilitation program consists of providing multi-dimensional support during neoadjuvant chemotherapy using connected devices. The control group will receive usual care.
Eligible patients will be women with International Federation of Gynecology and Obstetrics stage III-IV advanced ovarian cancer undergoing neoadjuvant chemotherapy. Patients must be able to perform a cardiopulmonary exercise test.
The primary endpoint will be the comparison of the variation in maximum oxygen uptake (VO
max) between baseline and surgery in the pre-habilitation group and control groups.
136 patients (68 per arm) will be recruited to demonstrate a medium standardized effect d=0.5 in the variations of VO
max between baseline and surgery.
The duration of the study includes 24 months of recruitment and 5 years of follow up. We anticipate reporting primary endpoint results in 2024.
TRAINING-01-IPC 2018-039 (NCT04451369).
Qu’est-ce qu’être vieux ? Ben Soussan, Patrick
M.S. Médecine sciences,
10/2007, Letnik:
23, Številka:
Hors série n° 3
Journal Article, Conference Proceeding
Recenzirano
Odprti dostop
L’auteur propose une analyse anthropologique et phénoménologique de la vieillesse, à partir de sa réalité et de ses représentations dans nos sociétés contemporaines. Depuis Sophocle ou Freud, et, ...plus près de nous, Jankélévitch ou Debray, du continent africain à l’Occident, il suit les arcanes du procès en dépendance et en altérité qui est fait à la vieillesse, secret honteux et sujet interdit de notre modernité qui sacrifie continument au sacro-saint paradigme du jeunisme. Il plaide en faveur d’une nouvelle vieillesse qui ne serait plus ce temps exilé, antichambre du mourir, mais une aventure de vie, avec son rythme, sa place et son projet en soi.
The author proposes an anthropological and phenomenological analysis of elderly, from its reality and from its representations in our contemporary societies. Since Sophocles or Freud, and closer of us, Jankélévitch or Debray, of the West African, he follows the mysteries of the lawsuit in dependence and in otherness which is made for the elderly, shameful and subject secret forbids of our modernity which sacrifices continument in sacrosanct paradigm of the « jeunisme ». He pleads in favour of a new old age which would not be any more this exiled time, anteroom of to die, but an adventure of life, with its rhythm, its place and its project in itself.
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