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  • 1
    Language: English
    In: The lancet oncology, 2015, Vol.16 (15), p.1525-1536
    Description: Summary Background The standard busulfan–cyclophosphamide myeloablative conditioning regimen is associated with substantial non-relapse mortality in patients older than 40 years with acute myeloid leukaemia who are undergoing allogeneic stem-cell transplantation. Because the combination of busulfan plus fludarabine has been proposed to reduce non-relapse mortality, we aimed to compare this treatment with busulfan plus cyclophosphamide as a preparative regimen in these patients. Methods We did an open-label, multicentre, randomised, phase 3 trial for patients with acute myeloid leukaemia at 25 hospital transplant centres in Italy and one in Israel. Eligible patients were aged 40–65 years, had an Eastern Cooperative Oncology Group performance status less than 3, and were in complete remission. Patients were randomly assigned 1:1 to receive intravenous busulfan plus cyclophosphamide or busulfan plus fludarabine. Treatment allocations were not masked to investigators or patients. Randomisation was done centrally via a dedicated web-based system using remote data entry, with patients stratified by donor type and complete remission status. Patients allocated to busulfan plus cyclophosphamide received intravenous busulfan 0·8 mg/kg four times per day during 2 h infusions for four consecutive days (16 doses from days −9 through −6; total dose 12·8 mg/kg) and cyclophosphamide at 60 mg/kg per day for two consecutive days (on days −4 and −3; total dose 120 mg/kg). Patients allocated to busulfan plus fludarabine received the same dose of intravenous busulfan (from days −6 through −3) and fludarabine at 40 mg/m2 per day for four consecutive days (from days −6 through −3; total dose 160 mg/m2 ). The primary endpoint was 1-year non-relapse mortality, which was assessed on an intention-to-treat basis; safety outcomes were assessed in the per-protocol population. This trial has been completed and is registered with ClinicalTrials.gov , number NCT01191957. Findings Between Jan 3, 2008, and Dec 20, 2012, we enrolled and randomly assigned 252 patients to receive busulfan plus cyclophosphamide (n=125) or busulfan plus fludarabine (n=127). Median follow-up was 27·5 months (IQR 9·8–44·3). 1-year non-relapse mortality was 17·2% (95% CI 11·6–25·4) in the busulfan plus cyclophosphamide group and 7·9% (4·3–14·3) in the busulfan plus fludarabine group (Gray's test p=0·026). The most frequently reported grade 3 or higher adverse events were gastrointestinal events (28 [23%] of 121 patients in the busulfan plus cyclophosphamide group and 26 [21%] of 124 patients in the busulfan plus fludarabine group) and infections (21 [17%] patients in the busulfan plus cyclophosphamide group and 13 [10%] patients in the busulfan plus fludarabine group had at least one such event). Interpretation In older patients with acute myeloid leukaemia, the myeloablative busulfan plus fludarabine conditioning regimen is associated with lower transplant-related mortality than busulfan plus cyclophosphamide, but retains potent antileukaemic activity. Accordingly, this regimen should be regarded as standard of care during the planning of allogeneic transplants for such patients. Funding Agenzia Italiana del Farmaco.
    Subject(s): Hematology, Oncology and Palliative Medicine ; Cyclophosphamide - administration & dosage ; Humans ; Middle Aged ; Hematopoietic Stem Cell Transplantation ; Induction Chemotherapy ; Male ; Vidarabine - analogs & derivatives ; Antineoplastic Agents - administration & dosage ; Busulfan - administration & dosage ; Transplantation, Homologous ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Leukemia, Myeloid, Acute - drug therapy ; Adult ; Female ; Leukemia, Myeloid, Acute - surgery ; Aged ; Vidarabine - administration & dosage ; Transplantation Conditioning ; Cyclophosphamide ; Product development ; Transplantation ; Busulfan ; Mortality ; Stem cells ; Index Medicus
    ISSN: 1470-2045
    E-ISSN: 1474-5488
    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: i-Perception (London), 2020-12, Vol.11 (6), p.2041669520980019-2041669520980019
    Description: We describe a new illusory speed effect arising in visual events developed by Michotte (1946/1963) in studies of causal perception and, more specifically, within the so-called intentional reaction effect: When an Object B is seen intentionally escaping from another Object A, its perceived speed is overestimated. In Experiment 1, we used two-alternative forced choice comparisons to estimate perceived speed scale values for a small square moving either alone or in different contexts known to elicit different impressions of animacy (Parovel et al., 2018). The results showed that B’s speed was overestimated only in the condition in which it moved away from another approaching square moving in a nonrigid way, like a caterpillar. In Experiment 2, we psychophysically measured the magnitude of speed overestimation in that condition and tested whether it could be affected by further animacy cues related to the escaping object (the actual velocity of the square) and to the approaching square (its type of motion: caterpillar or linear). Results confirmed that B’s speed was overestimated up to 10% and that the degree of overestimation was affected by both experimental factors, being greater at higher speeds and when the chasing object moved in an animate fashion. This speed bias might be related to a higher sensitivity of the visual processes to threat-related events such as fighting and chasing, leading to evolutionary adaptive behaviours such as speedy flight from predators, but also empathy and emotion understanding.
    Subject(s): Velocity ; Visual perception
    ISSN: 2041-6695
    E-ISSN: 2041-6695
    Source: PubMed Central
    Source: ProQuest Central
    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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  • 3
    Language: English
    In: The New England journal of medicine, 2016-01-07, Vol.374 (1), p.43-53
    Description: Antilymphocyte globulin (ATG) added to the conditioning regimen before allogeneic hematopoietic stem-cell transplantation resulted in a lower rate of chronic graft-versus-host disease at 2 years than the rate without ATG (32% vs. 68%), with no apparent increased risk of relapse. Chronic graft-versus-host disease (GVHD) is a major complication of allogeneic stem-cell transplantation that results in later illness and death and a reduction in quality of life. 1 , 2 Risk factors for chronic GVHD are the use of peripheral blood as a source of stem cells, a history of acute GVHD, and the use of donated stem cells with high numbers of T cells. 3 – 7 In a meta-analysis, the Stem Cell Trialists’ Collaborative Group reported an incidence of extensive chronic GVHD of 47% after peripheral-blood stem-cell transplantation from an HLA-identical sibling. 4 In 2012, more than 70% of the stem-cell transplantations performed in . . .
    Subject(s): Graft vs Host Disease - epidemiology ; Prospective Studies ; Humans ; Immunosuppressive Agents - therapeutic use ; Middle Aged ; Proportional Hazards Models ; Child, Preschool ; Male ; Survival Rate ; Transplantation, Homologous ; Incidence ; Young Adult ; Disease-Free Survival ; Graft vs Host Disease - mortality ; Adolescent ; Antilymphocyte Serum - therapeutic use ; Adult ; Female ; Graft vs Host Disease - prevention & control ; T-Lymphocytes - immunology ; Child ; Chronic Disease ; Prevention ; Treatment outcome ; Graft versus host reaction ; Immunoglobulins ; Dosage and administration ; Analysis ; Graft-versus-host reaction ; Transplants & implants ; Leukemia ; Stem cell transplantation ; Lymphocytes T ; Preventive medicine ; Hemopoiesis ; Globulins ; Risk assessment ; Peripheral blood ; Stem cells ; Bone marrow ; Histocompatibility antigen HLA ; Index Medicus ; Abridged Index Medicus
    ISSN: 0028-4793
    E-ISSN: 1533-4406
    Source: Single Journals
    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: Attention, Perception, & Psychophysics, 2018-02, Vol.80 (2), p.553-563
    Description: The aim of this research was to explore the effect of different spatiotemporal contexts on the perceptual saliency of animacy, and the extent of the relationship between animacy and other related properties such as emotions and intentionality. Paired-comparisons and ratings were used to compare the impressions of animacy elicited by a small square moving on the screen, either alone or in the context of a second square. The context element was either static or moving showing an animate-like or a physical-like trajectory, and the target object moved either toward it or away from it. The movement of the target could also include animacy cues (caterpillar-like expanding/contracting phases). To determine the effect of different contexts on the emergence of emotions and intentions, we also recorded and analysed the phenomenological reports of participants. The results show that the context significantly influences the perception of animacy, which is stronger in dynamic contexts than in static ones, and also when the target is moving away from the context element than when it is approaching it. The free reports reveal different proportions in emotional or intentional attributions in the different conditions: in particular, the "moving away" condition is related to negative emotions, while the "approaching" condition evokes positive emotions. Overall, the results suggest that animacy is a graded concept that can be articulated in more general characteristics, like simple aliveness, and more specific ones, like intentions or emotions, and that the spatiotemporal contingencies of the context play a crucial role in making them evident.
    Subject(s): Experimental phenomenology ; Animacy ; Intentionality ; Causal perception ; Psychology ; Cognitive Psychology ; Negativity bias ; Visual perception ; Cues ; Movement ; Visual Perception - physiology ; Humans ; Male ; Young Adult ; Animals ; Adult ; Choice Behavior - physiology ; Female ; Causality ; Photic Stimulation ; Motion Perception - physiology ; Phenomenology ; Influence ; Animation ; Cognition & reasoning ; Emotions ; Index Medicus
    ISSN: 1943-3921
    E-ISSN: 1943-393X
    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: Science and engineering ethics, 2020-02, Vol.26 (1), p.159-181
    Description: The relationship between stress and unethical behaviour amongst non-tenured research staff in academia is a relatively unexplored phenomenon. The research reported herein was therefore carried out with the aim of exploring the relationship(s) between stress, the socio-organisational factors which contribute to it, job satisfaction, perceptions of job instability, and the occurrence of unethical behaviour in research. 793 Italian researchers participated in the research-all of whom were working on fixed-term contracts-after being individually requested to complete an online questionnaire. The data indicate that unethical behaviours occur with alarming frequency. The stress level reported is quite high, as is the level of perceived job insecurity, both of which impact upon levels of job satisfaction. Perceived stress levels also seem to play a role in the commission of unethical behaviours, but this relationship is irrelevant when one considers the role of social and organisational factors that are known to induce it. Indeed, it seems that there are various socio-organisational determinants of stress that have an obvious direct negative influence on the commission of unethical behaviours more than the stress level per se. This research paints a worrying picture in relation to the psycho-physical state of non-tenured researchers as a result of the working conditions in which they find themselves in Italian universities.
    Subject(s): Cross-Sectional Studies ; Humans ; Research Personnel - psychology ; Male ; Universities - organization & administration ; Job Satisfaction ; Research Personnel - organization & administration ; Research Personnel - ethics ; Contracts - ethics ; Professional Misconduct - psychology ; Professional Misconduct - ethics ; Adult ; Female ; Italy ; Occupational Stress ; Workplace - organization & administration ; Job stress ; Ethics ; Job satisfaction ; Index Medicus ; Bioethics
    ISSN: 1353-3452
    E-ISSN: 1471-5546
    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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  • 6
    Language: English
    In: Bone marrow transplantation (Basingstoke), 2018-03, Vol.53 (3), p.291-299
    Description: Hematopoietic Stem Cell Transplantation activity levels vary across European countries. No data are available on the homogeneity of access to the transplant procedure for patient with leukaemia, within any European country. We measured homogeneity of the rate of alternative donor search in patients affected by acute leukaemia resident in each Italian region and macro-region during years 2010-2013. A total of 2747 alternative donor searches were studied. Twenty-one percent of all donor searches were made through extra-regional migration. Rate of alternative donor searches varied among the country's regions and macro-regions. The rate of donor searches was 38% lower in South Italy than in North Italy, and the rate of alternative donor transplantations performed was 45% lower. A reduced rate of alternative donor search in South macro-region was observed in all age cohorts. Despite the overall allogeneic transplant rate in Italy is relatively high, there are wide regional differences in access to transplant from alternative donor. Extra-regional migration cannot completely compensate for the lower access to transplant of acute leukaemia patients living in those regions where transplant activity is low.
    Subject(s): Acute Disease ; Europe ; Humans ; Middle Aged ; Hematopoietic Stem Cell Transplantation ; Leukemia - therapy ; Male ; Adolescent ; Adult ; Female ; Italy ; Registries ; Tissue Donors - supply & distribution ; Index Medicus
    ISSN: 0268-3369
    E-ISSN: 1476-5365
    Source: Nature Open Access
    Source: Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals
    Source: Alma/SFX Local Collection
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  • 7
    Language: English
    In: Haematologica (Roma), 2010-03-01, Vol.95 (3), p.476-484
    Description: Transfusion-dependency affects the natural history of myelodysplastic syndromes. Secondary iron overload may concur to this effect. The relative impact of these factors on the outcome of patients with myelodysplastic syndrome receiving allogeneic stem-cell transplantation remains to be clarified. We retrospectively evaluated the prognostic effect of transfusion history and iron overload on the post-transplantation outcome of 357 patients with myelodysplastic syndrome reported to the Gruppo Italiano Trapianto di Midollo Osseo (GITMO) registry between 1997 and 2007. Transfusion-dependency was independently associated with reduced overall survival (hazard ratio=1.48, P=0.017) and increased non-relapse mortality (hazard ratio=1.68, P=0.024). The impact of transfusion-dependency was noted only in patients receiving myeloablative conditioning (overall survival: hazard ratio=1.76, P=0.003; non-relapse mortality: hazard ratio=1.70, P=0.02). There was an inverse relationship between transfusion burden and overall survival after transplantation (P=0.022); the outcome was significantly worse in subjects receiving more than 20 red cell units. In multivariate analysis, transfusion-dependency was found to be a risk factor for acute graft-versus-host disease (P=0.04). Among transfusion-dependent patients undergoing myeloablative allogeneic stem cell transplantation, pre-transplantation serum ferritin level had a significant effect on overall survival (P=0.01) and non-relapse mortality (P=0.03). This effect was maintained after adjusting for transfusion burden and duration, suggesting that the negative effect of transfusion history on outcome might be determined at least in part by iron overload. Pre-transplantation transfusion history and serum ferritin have significant prognostic value in patients with myelodysplastic syndrome undergoing myeloablative allogeneic stem cell transplantation, inducing a significant increase of non-relapse mortality. These results indicate that transfusion history should be considered in transplantation decision-making in patients with myelodysplastic syndrome.
    Subject(s): Hematologic and hematopoietic diseases ; Other metabolic disorders ; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis ; Biological and medical sciences ; Metabolic diseases ; Medical sciences ; Metals (hemochromatosis...) ; Recurrence ; Iron Overload - prevention & control ; Humans ; Middle Aged ; Male ; Transplantation, Homologous ; Iron Overload - etiology ; Young Adult ; Myelodysplastic Syndromes - therapy ; Blood Transfusion ; Ferritins - blood ; Graft vs Host Disease - mortality ; Adult ; Female ; Retrospective Studies ; Risk Factors ; Hematopoietic Stem Cell Transplantation ; Survival Rate ; Treatment Outcome ; Myelodysplastic Syndromes - complications ; Myelodysplastic Syndromes - diagnosis ; Adolescent ; Aged ; Transplantation Conditioning ; Cohort Studies ; Index Medicus ; transfusion-dependency ; secondary iron overload ; Original ; myelodysplastic syndromes
    ISSN: 0390-6078
    E-ISSN: 1592-8721
    Source: HighWire Press (Free Journals)
    Source: PubMed Central
    Source: Directory of Open Access Journals
    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: Annals of internal medicine, 2010, Vol.153 (10), p.650-654
    Description: Mesenchymal stem cells can differentiate into endothelial cells and participate in angiogenesis in adults. In experimental models of acute myocardial infarction, mesenchymal stem cells led to the recovery of cardiac function through the formation of a new vascular network. To describe treatment with intravenous infusions of expanded autologous mesenchymal stem cells in 1 patient with critical limb ischemia due to systemic sclerosis. Case report. The rheumatology unit at the University of Florence, Florence, Italy. A woman, aged 34 years, with systemic sclerosis who developed acute gangrene of the upper and lower limbs. 3 intravenous pulses of expanded autologous mesenchymal stem cells. Angiography, skin histopathology, and immunohistochemistry. Areas of necrotic skin were reduced after the first mesenchymal stem-cell infusion. After the third infusion, angiography showed revascularization of the patient's extremities. Skin section analysis revealed cell clusters with tubelike structures, and angiogenic factors were strongly expressed. Causality cannot be established by a single case. In patients with systemic sclerosis who have severe peripheral ischemia, intravenous infusion of expanded autologous mesenchymal stem cells may foster the recovery of the vascular network, restore blood flow, and reduce skin necrosis. Fondazione Cassa di Risparmio di Pistoia e Pescia (partial funding).
    Subject(s): Biological and medical sciences ; General aspects ; Medical sciences ; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis ; Humans ; Ischemia - therapy ; Leg - blood supply ; Necrosis - therapy ; Scleroderma, Systemic - complications ; Adult ; Arm - blood supply ; Female ; Ischemia - pathology ; Mesenchymal Stem Cell Transplantation ; Mesenchymal Stromal Cells - physiology ; Neovascularization, Physiologic ; Ischemia - etiology ; Case studies ; Care and treatment ; Usage ; Systemic scleroderma ; Angiography ; Scleroderma (Disease) ; Stem cells ; Physiological aspects ; Diagnosis ; Risk factors ; Angiogenesis ; Heart attacks ; Index Medicus ; Abridged Index Medicus
    ISSN: 0003-4819
    E-ISSN: 1539-3704
    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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  • 9
    Language: English
    In: BMJ quality & safety, 2012-12, Vol.21 (Suppl 1), p.i58-i66
    Description: Background Cross-unit handovers transfer responsibility for the patient among healthcare teams in different clinical units, with missed information, potentially placing patients at risk for adverse events. Objectives We analysed the communications between high-acuity and low-acuity units, their content and social context, and we explored whether common conceptual ground reduced potential threats to patient safety posed by current handover practices. Methods We monitored the communication of five content items using handover probes for 22 patient transitions of care between high-acuity ‘sender units’ and low-acuity ‘recipient units’. Data were analysed and discussed in focus groups with healthcare professionals to acquire insights into the characteristics of the common conceptual ground. Results High-acuity and low-acuity units agreed about the presence of alert signs in the discharge form in 40% of the cases. The focus groups identified prehandover practices, particularly for anticipatory guidance that relied extensively on verbal phone interactions that commonly did not involve all members of the healthcare team, particularly nursing. Accessibility of information in the medical records reported by the recipient units was significantly lower than reported by sender units. Common ground to enable interpretation of the complete handover content items existed only among selected members of the healthcare team. Conclusions The limited common ground reduced the likelihood of correct interpretation of important handover information, which may contribute to adverse events. Collaborative design and use of a shared set of handover content items may assist in creating common ground to enable clinical teams to communicate effectively to help increase the reliability and safety of cross-unit handovers.
    Subject(s): Patient Handoff - organization & administration ; Europe ; Humans ; Models, Organizational ; Focus Groups ; Cooperative Behavior ; Patient Care Team ; Interprofessional Relations ; Data Collection ; Medical Staff, Hospital - standards ; Patient Handoff - standards ; Hospitals, Teaching ; Checklist ; Interviews as Topic ; Quality of Health Care - standards ; Continuity of Patient Care - standards ; Communication ; Health administration
    ISSN: 2044-5415
    E-ISSN: 2044-5423
    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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  • 10
    Language: English
    In: Annals of hematology, 2012-06, Vol.91 (6), p.931-939
    Description: Patients who relapse after an autologous hematopoietic stem cell transplantation (SCT) have a very poor prognosis. We have retrospectively analyzed diffuse large B cell lymphoma patients who underwent an allo-SCT after an auto-SCT relapse reported in the Gruppo Italiano Trapianto di Midollo Osseo (GITMO) database. From 1995 to 2008, 3449 autologous transplants were reported in the GITMO database. Eight hundred eighty-four patients relapsed or progressed after transplant; 165 patients, 19% of the relapsed patients, were treated with allo-transplant. The stem cell donor was related to the patient in 108 cases. A reduced intensity conditioning regimen was used in 116. After allo-SCT, 72 patients (43%) obtained a complete response and 9 obtained a partial response with an overall response rate of 49%; 84 patients (51%) experienced rapid progression of disease. Ninety-one patients died, 45 due to disease and 46 due to treatment-related mortality. Acute graft-versus-host disease was recorded in 57 patients and a chronic GvHD in 38 patients. With a median follow-up of 24 months (2–144) after allo, overall survival (OS) was 39%, and after a median of 21 months (2–138) after allo, progression-free survival (PFS) was 32%. Multivariate analysis indicated that the only factors affecting OS were status at allo-SCT, and those affecting PFS were status at allo-SCT and stem cell donor. This retrospective analysis shows that about one-fifth of patients with diffuse large B cell lymphoma who experience relapse after autologous transplantation may be treated with allogeneic transplantation. Moreover, the only parameter affecting either OS or PFS was the response status at the time of allo-SCT.
    Subject(s): Medicine & Public Health ; Hematology ; Oncology ; Diffuse large B cell lymphoma ; Graft versus lymphoma ; Allogeneic stem cell transplantation ; Salvage therapy ; Autologous stem cell transplantation ; Reduced intensity conditioning regimen ; Hematology - organization & administration ; Recurrence ; Humans ; Middle Aged ; Male ; Transplantation, Autologous ; Transplantation, Homologous ; Lymphoma, Large B-Cell, Diffuse - mortality ; Societies, Medical - organization & administration ; Young Adult ; Lymphoma, Large B-Cell, Diffuse - therapy ; Lymphoma, Large B-Cell, Diffuse - epidemiology ; Adolescent ; Adult ; Female ; Italy ; Aged ; Retrospective Studies ; Hematopoietic Stem Cell Transplantation - methods ; Databases, Factual ; Medical research ; Care and treatment ; Analysis ; Stem cells ; Medicine, Experimental ; Bone marrow ; Development and progression ; Lymphomas ; Transplantation ; Hematopoietic stem cells ; Tumors ; Index Medicus
    ISSN: 0939-5555
    E-ISSN: 1432-0584
    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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