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  • 1
    Language: English
    In: Bone marrow transplantation (Basingstoke), 2015-02, Vol.50 (2), p.181-188
    Description: We analyzed the outcome of 243 children with high-risk (HR) AML in first CR1 enrolled in the AIEOP-2002/01 protocol, who were given either allogeneic (ALLO; n=141) or autologous (AUTO; n=102) hematopoietic SCT (HSCT), depending on the availability of a HLA-compatible sibling. Infants, patients with AML-M7, or complex karyotype or those with FLT3-ITD, were eligible to be transplanted also from alternative donors. All patients received a myeloablative regimen combining busulfan, cyclophosphamide and melphalan; [corrected] AUTO-HSCT patients received BM cells in most cases, while in children given ALLO-HSCT stem cell source was BM in 96, peripheral blood in 19 and cord blood in 26. With a median follow-up of 57 months (range 12-130), the probability of disease-free survival (DFS) was 73% and 63% in patients given either ALLO- or AUTO-HSCT, respectively (P=NS). Although the cumulative incidence (CI) of relapse was lower in ALLO- than in AUTO-HSCT recipients (17% vs 28%, respectively; P=0.043), the CI of TRM was 7% in both groups. Patients transplanted with unrelated donor cord blood had a remarkable 92.3% 8-year DFS probability. Altogether, these data confirm that HSCT is a suitable option for preventing leukemia recurrence in HR children with CR1 AML.
    Subject(s): Autografts ; Follow-Up Studies ; Leukemia, Myeloid, Acute - pathology ; Humans ; Child, Preschool ; Hematopoietic Stem Cell Transplantation ; Infant ; Male ; Survival Rate ; Abnormal Karyotype ; Cord Blood Stem Cell Transplantation ; Leukemia, Myeloid, Acute - mortality ; fms-Like Tyrosine Kinase 3 - genetics ; Disease-Free Survival ; Allografts ; Adolescent ; Myeloablative Agonists - administration & dosage ; Female ; Transplantation Conditioning - methods ; Child ; Leukemia, Myeloid, Acute - therapy ; Leukemia, Myeloid, Acute - genetics ; Transplantation ; Health aspects ; Patient outcomes ; Hematopoietic stem cells ; Index Medicus
    ISSN: 0268-3369
    E-ISSN: 1476-5365
    Source: Nature Open Access
    Source: Academic Search Ultimate
    Source: Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals
    Source: Alma/SFX Local Collection
    Source: © ProQuest LLC All rights reserved〈img src="https://exlibris-pub.s3.amazonaws.com/PQ_Logo.jpg" style="vertical-align:middle;margin-left:7px"〉
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  • 2
    Language: English
    In: Nuclear materials and energy, 2019-05, Vol.19, p.340-345
    Description: •A high-order solver for plasma-edge transport is presented.•Non-aligned discretizations are used to solve the plasma transport equations.•High-order interpolations are able to provide non diffusive solutions even with non-aligned discretizations. [Summary] The control of the power exhaust in tokamaks is still an open issue for the future fusion operations. The heat loads on divertor and limiter PFCs is largely determined by the physics of the Scrape-Off Layer (SOL), and therefore it depends mainly on the geometry of the magnetic surfaces and on the geometry of wall components. A better characterization of the heat exhaust mechanisms requires therefore to improve the capabilities of the transport codes in terms of geometrical description of the wall components and in terms of the description of the magnetic geometry. The possibility of dealing with evolving magnetic configurations becomes also critical: during start-up or control operations, for example, the evolution of particles and heat fluxes is little known, although being critical for the safety of the machine. Hence, among the new capabilities of future transport codes will be the possibility of accurately describe the reactor chamber, and the flexibility with respect the magnetic configuration. In particular, avoiding expensive re-meshing of the computational domain in case of evolving equilibrium is mandatory. In order to fulfill these requirements, in this work a fluid solver based on non-aligned discretization is used to solve the plasma-edge transport equations for density, momentum and energies. Preliminary tests on non-structured meshes and realistic geometries/physical parameters show the pertinency of this novel approach.
    Subject(s): Discontinuous Galerkin ; Plasma physics ; Hybridization ; Tokamaks ; Fusion ; Mechanics ; Reactive fluid environment ; Fluids mechanics ; Engineering Sciences
    ISSN: 2352-1791
    E-ISSN: 2352-1791
    Source: Directory of Open Access Journals
    Source: Alma/SFX Local Collection
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  • 3
    Language: English
    In: BJOG : an international journal of obstetrics and gynaecology, 2014-06, Vol.121 (7), p.856-865
    Description: Objective To evaluate gonadal function and uterine volume in a cohort of female survivors treated by chemotherapy, radiotherapy, and/or stem cell transplantation (SCT) for childhood malignant and non‐malignant diseases. Design An observational study. Setting S. Matteo Hospital, Pavia, Italy. Population A cohort of 135 female survivors. Methods A clinical, hormonal, and ultrasonographic evaluation. Thirty‐three patients (24%) had non‐malignant haematologic diseases (thalassaemia or sickle cell anaemia), 68 (50%) had leukaemia, 23 (17%) had lymphomas, and 11 (8%) had solid tumours. In total, 106 patients had received SCT, preceded by a conditioning regimen. Main outcome measures Anti‐Müllerian hormone (AMH) and Inhibin–B, and uterine volume. Results The median concentrations of AMH and Inhibin–B in the entire cohort were 0.12 ng/ml (interquartile range, IQR, 0.1–0.5 ng/ml) and 3.5 pg/ml (IQR 0.1–13.2 pg/ml), respectively. In a stepwise ordered logistic regression analysis, conventional chemotherapy for the treatment of malignancies, as opposed to total body irradiation (TBI), was the only oncologically significant predictor of increased AMH levels (OR 4.8, 95% CI 1.9–12, P 〈 0.001). Conditioning treatment before or after menarche did not influence AMH concentrations (P = 0.24). The best predictor of reduced uterine volume was TBI during the preparation for the allograft (OR 3.5, 95% CI 1.4–8.4, P = 0.006). Increasing age at treatment (OR 0.86, 95% CI 0.77–0.95, P = 0.04), chemotherapy, as opposed to other treatments (OR 0.09, 95% CI 0.03–0.28, P 〈 0.001), and solid tumours as opposed to either leukaemia/lymphomas or non‐malignant diseases (OR 0.2, 95% CI 0.07–0.56, P = 0.002) were associated with larger uterine volumes. Conclusions Conditioning therapies for SCT, including TBI, had the worst effects on uterine volume and gonadal reserve. Increasing age at treatment and conventional chemotherapy were associated with less detrimental effects on uterine volume.
    Subject(s): gonadal and uterine function ; Antineoplastic treatments ; beta-Thalassemia - therapy ; Ovary - anatomy & histology ; Neoplasms - surgery ; Humans ; Survivors ; Organ Size ; Ovary - physiology ; Combined Modality Therapy ; Neoplasms - drug therapy ; Young Adult ; Anemia, Sickle Cell - therapy ; Neoplasms - therapy ; Uterus - physiology ; Adolescent ; Bone Marrow Transplantation ; Female ; Neoplasms - radiotherapy ; Child ; Chemotherapy ; Sickle cell anemia ; Analysis ; Leukemia ; Inhibin ; Stem cells ; Bone marrow ; Lymphomas ; Transplantation ; Radiotherapy ; Cancer ; Index Medicus ; Abridged Index Medicus
    ISSN: 1470-0328
    E-ISSN: 1471-0528
    Source: Alma/SFX Local Collection
    Source: © ProQuest LLC All rights reserved〈img src="https://exlibris-pub.s3.amazonaws.com/PQ_Logo.jpg" style="vertical-align:middle;margin-left:7px"〉
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  • 4
    Language: English
    In: Leukemia, 2012, Vol.26 (8), p.1886-1888
    Subject(s): Hematologic and hematopoietic diseases ; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis ; Biological and medical sciences ; Medical sciences ; Recurrence ; Leukemia - pathology ; T-Lymphocytes ; Humans ; Hypothyroidism - complications ; Child, Preschool ; Hematopoietic Stem Cell Transplantation ; Leukemia - therapy ; Male ; Lymphocyte Depletion ; Transplantation, Homologous ; Leukemia - complications ; Adolescent ; Female ; Child ; Care and treatment ; Usage ; Relapse ; Leukemia in children ; Patient outcomes ; Physiological aspects ; Transplantation ; Research ; T cells ; Health aspects ; Hematopoietic stem cells ; Diseases ; Index Medicus
    ISSN: 0887-6924
    E-ISSN: 1476-5551
    Source: Nature Open Access
    Source: Academic Search Ultimate
    Source: Alma/SFX Local Collection
    Source: © ProQuest LLC All rights reserved〈img src="https://exlibris-pub.s3.amazonaws.com/PQ_Logo.jpg" style="vertical-align:middle;margin-left:7px"〉
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  • 5
    Language: English
    In: Bone marrow transplantation (Basingstoke), 2015-02-01, Vol.50 (2), p.320
    ISSN: 0268-3369
    E-ISSN: 1476-5365
    Source: Nature Open Access
    Source: Academic Search Ultimate
    Source: Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals
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  • 6
    Language: English
    In: Nuclear materials and energy, 2017-08, Vol.12, p.187-192
    Description: •Simulations of WEST H-mode divertor scenarios have been performed with SOLEDGE2D-EIRENE.•With nitrogen seeding, lower plasma temperatures at the target plates are achieved together with the required high heat fluxes.•Investigation of divertor geometry and the impact of vertical vs horizontal target plates on neutrals spreading. Simulations of WEST H-mode divertor scenarios have been performed with SOLEDGE2D-EIRENE edge plasma transport code, both for pure deuterium and nitrogen seeded discharge. In the pure deuterium case, a target heat flux of 8 MW/m2 is reached, but misalignment between heat and the particle outflux yields 50 eV plasma temperature at the target plates. With nitrogen seeding, the heat and particle outflux are observed to be aligned so that lower plasma temperatures at the target plates are achieved together with the required high heat fluxes. This change in heat and particle outflux alignment is analysed with respect to the role of divertor geometry and the impact of vertical vs horizontal target plates on neutrals spreading.
    Subject(s): Modeling and Simulation ; Computer Science ; Mechanics ; Fluids mechanics ; Plasmas ; Engineering Sciences ; Plasma Physics ; Physics
    ISSN: 2352-1791
    E-ISSN: 2352-1791
    Source: Directory of Open Access Journals
    Source: Alma/SFX Local Collection
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  • 7
    Language: English
    In: Bone marrow transplantation (Basingstoke), 2008-06, Vol.41 (S2), p.S3-S7
    Description: Over the past decade, relevant improvements and refinements have significantly changed the indications, technique and results obtained with allogeneic hematopoietic SCT (HSCT) in childhood. A fundamental turning point in the history of allogeneic HSCT is represented by the use of placental blood, which was first employed in 1988 in a patient with Fanconi anemia, successfully transplanted with cord blood cells from an HLA-identical sibling. Since then, thousands of children were given an allograft of cord blood-derived hematopoietic progenitors, mainly from an unrelated donor. This large clinical experience has documented that, as compared with BMT, cord blood transplantation (CBT) is associated with reduced incidence and severity of GvHD. The outcome of recipients given unrelated CBT has been reported to be at least as good as that of patients transplanted with either BM or peripheral blood mobilized cells of an unrelated volunteer. Another emerging strategy of HSCT is that of using HLA-partially matched relatives as donors of hematopoietic progenitors. The infusion of a huge number of positively in vitro-selected CD34+ cells, with the concomitant removal of T cells, has been demonstrated to permit sustained engraftment of donor hematopoiesis, without the occurrence of GvHD in the majority of patients transplanted from an HLA-disparate relative. In adults given this type of transplantation, the most favorable results have been reported for AMLs and when the donor displays alloreactivity of natural killer cells. It remains to be definitively proved whether these findings documented in adults maintain their value in pediatric patients transplanted from an HLA-disparate family donor. Finally, the last few years have witnessed the emergence of approaches of adoptive cell therapy aimed at optimizing the results of allograft through strategies able to reinforce immune competence against pathogens, as well as against tumor cells, or at modulating donor T-cell alloreactivity.
    Subject(s): Immunotherapy, Adoptive ; Humans ; Bone Marrow Transplantation - adverse effects ; Hematopoietic Stem Cell Transplantation ; Graft Survival ; Child ; Mesenchymal Stem Cell Transplantation ; Transplantation, Homologous ; Cord Blood Stem Cell Transplantation ; Fetal blood ; Complications and side effects ; Usage ; Transplantation ; Histocompatibility testing ; Methods ; Hematopoietic stem cells ; Index Medicus
    ISSN: 0268-3369
    E-ISSN: 1476-5365
    Source: Nature Open Access
    Source: Academic Search Ultimate
    Source: Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals
    Source: Alma/SFX Local Collection
    Source: © ProQuest LLC All rights reserved〈img src="https://exlibris-pub.s3.amazonaws.com/PQ_Logo.jpg" style="vertical-align:middle;margin-left:7px"〉
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  • 8
    Language: English
    In: Leukemia, 2002, Vol.16 (11), p.2228-2237
    Description: Aims of this study were to verify whether reduction in transplant-related mortality (TRM) of children with acute lymphoblastic leukemia (ALL) in second complete remission (CR) given allogeneic hematopoietic stem cell transplantation (HSCT) from unrelated volunteers has occurred over time and to investigate the role of other variables on the probabilities of relapse, TRM and event-free survival (EFS). We compared results obtained in 26 children given HSCT before January 1998 with those of 37 patients transplanted beyond that date. In all donor-recipient pairs, histocompatibility was determined by serology for HLA-A and -B antigens and by high-resolution DNA typing for DRB1 antigen. High-resolution molecular typing of HLA class I antigens was employed in 20 of the 37 children transplanted more recently. Probability of both acute and chronic GVHD was comparable in the two groups of patients. In multivariate analysis, children transplanted before January 1998, those with T-lineage ALL and those experiencing grade II-IV acute GVHD had a higher relative risk of TRM at 6 months after transplantation. Relapse rate was unfavorably affected by a time interval between diagnosis and relapse 〈30 months. The 2-year probability of EFS for children transplanted before and after 1 January 1998 was 27% (10-44) and 58% (42-75), respectively (P = 0.02), this difference remaining significant in multivariate analysis. EFS of unrelated donor HSCT in children with ALL in second CR has improved in the last few years, mainly due to a decreased TRM. This information is of value for counseling of patients with relapsed ALL.
    Subject(s): Hematologic and hematopoietic diseases ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Bone marrow, stem cells transplantation. Graft versus host reaction ; Transfusions. Complications. Transfusion reactions. Cell and gene therapy ; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis ; Biological and medical sciences ; Medical sciences ; Cyclophosphamide - administration & dosage ; Antineoplastic Combined Chemotherapy Protocols - administration & dosage ; Precursor Cell Lymphoblastic Leukemia-Lymphoma - immunology ; Humans ; Child, Preschool ; Infant ; Male ; Living Donors ; Transplantation, Homologous ; Graft vs Host Disease ; HLA-DR Antigens - genetics ; Precursor Cell Lymphoblastic Leukemia-Lymphoma - therapy ; Time Factors ; Vincristine - administration & dosage ; Female ; Registries ; DNA, Neoplasm - analysis ; Precursor Cell Lymphoblastic Leukemia-Lymphoma - pathology ; Child ; Daunorubicin - administration & dosage ; Prednisone - administration & dosage ; HLA-B Antigens - immunology ; Mercaptopurine - administration & dosage ; Hematopoietic Stem Cell Transplantation ; Survival Rate ; Treatment Outcome ; Remission Induction ; Cytarabine - administration & dosage ; Asparaginase - administration & dosage ; Disease-Free Survival ; HLA-A Antigens - immunology ; HLA-DRB1 Chains ; Adolescent ; Methotrexate - administration & dosage
    ISSN: 0887-6924
    E-ISSN: 1476-5551
    Source: Nature Open Access
    Source: Academic Search Ultimate
    Source: Alma/SFX Local Collection
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  • 9
    Language: English
    In: Plasma physics and controlled fusion, 2021
    Description: The impact of resonant magnetic perturbations (RMP) on the plasma edge equilibrium and on the turbulence is investigated in a circular limited configuration. The study is based on a Braginski-based isothermal fluid model. The flow response of an unperturbed case to a small amplitude three-dimensional single mode RMP is studied and a scan in amplitude and poloidal and toroidal mode number is performed. Special attention is given when magnetic islands appear in the simulation domain on flux surfaces of rational safety factor. Results show an impact of Magnetic Perturbations (MPs) on both the plasma equilibrium and on the turbulence properties, with a deviation to the reference solution which depends on the MPs amplitude and on their wavenumbers. The impact of MPs on turbulence is however globally weaker than on the plasma equilibrium, suggesting a stabilizing effect of the MP on turbulent transport. Experimental trends are recovered such as the density pump-out and the increase of the radial electric field as well as the reorganization of the parallel velocity. The ballooning of the transport is modified under the effect of the perturbations, with a shift of the peaked poloidal region from the upper to the lower outer midplane. In the present model, the SOL width is observed decreasing in the presence of MPs. Turbulence properties are also impacted with the density fluctuations level decreasing in perturbed solutions and the intermittency is globally weakened.
    Subject(s): Modeling and Simulation ; Computer Science ; Reactive fluid environment ; Plasmas ; Engineering Sciences ; Physics
    ISSN: 0741-3335
    E-ISSN: 1361-6587
    Source: IOPscience extra
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  • 10
    Language: English
    In: Bone marrow transplantation (Basingstoke), 2003-06-01, Vol.31 (11), p.987-993
    Description: We evaluated the outcome of 63 children given haematopoietic stem cell transplantation from unrelated donors (URD-HSCT) prospectively selected using DNA high-resolution typing of both HLA class I and class II loci. Thirty patient/donor pairs (48%) were fully matched. Among the others, HSCT was performed in the presence of one (n=22), two (n=9), or three (n=2) HLA disparities. Patients had either malignant (n=46) or non-malignant (n=17) disease. In all cases, graft-versus-host disease (GVHD) prophylaxis consisted of cyclospor-in A, short-term methotrexate and pretransplant anti-thymocyte globulin. The probability of haematopoietic recovery at day 100 was 97%. Two patients experienced primary graft failure. The cumulative probability of grades III-IV acute GVHD and of extensive chronic GVHD equalled 8 and 14%, respectively. A total of 12 patients died of transplant-related complications. The probability of transplant-related mortality (TRM) at 100 and 180 days was 10 and 15%, respectively, whereas the cumulative incidence of TRM was 22%. The probability of GVHD-related mortality equalled 6% at 2.5 years. The overall and disease-free survival rates were 67 and 65%, respectively. URD-HSCT with donor selection based on high-resolution HLA typing is associated with low incidence of both severe acute GVHD and graft failure. The observed outcome is comparable to that of children transplanted from HLA-identical siblings.
    Subject(s): Graft vs Host Disease - epidemiology ; HLA-D Antigens - genetics ; Histocompatibility Testing ; Humans ; Middle Aged ; Child, Preschool ; Probability ; Infant ; Survival Rate ; Treatment Outcome ; Histocompatibility Antigens Class I - genetics ; Hematologic Diseases - classification ; Hematopoietic Stem Cell Transplantation - mortality ; Hematologic Diseases - therapy ; Incidence ; Adolescent ; Hematopoietic Stem Cell Transplantation - adverse effects ; Tissue Donors - statistics & numerical data ; Adult ; Child ; Care and treatment ; Usage ; Patient outcomes ; Graft versus host reaction ; Transplantation ; Research ; Blood diseases ; Histocompatibility testing ; Hematopoietic stem cells ; Cancer in children ; Index Medicus
    ISSN: 0268-3369
    E-ISSN: 1476-5365
    Source: Nature Open Access
    Source: Academic Search Ultimate
    Source: Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals
    Source: Alma/SFX Local Collection
    Source: © ProQuest LLC All rights reserved〈img src="https://exlibris-pub.s3.amazonaws.com/PQ_Logo.jpg" style="vertical-align:middle;margin-left:7px"〉
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