Résumé
Background@#Reduced harvest volumes in pediatric donors appear to have the potential to reduce donor-associated risks while maintaining engraftment in recipients; however, the allowable harvest volume reduction remains undefined. @*Methods@#We retrospectively analyzed the data pairs of 553 bone marrow (BM) harvests from pediatric (age at harvest ＜18 yr) sibling donors and clinical outcomes of 553 pediatric (age at infusion ＜14 yr) transplant-naïve recipients to assess the optimal BM harvest volume needed from pediatric donors to obtain the desired CD34+ cell count (≥3.0×10 6 cells per kg of recipient weight), and to study its impact on the clinical outcomes of transplantation in pediatric recipients. @*Results@#The minimum desired CD34+ cell count of ≥3.0×10 6 per kg of recipient weight was achieved for 506 (95.3%) of donor-recipient pairs. The median CD34+ cell yield was 6.4×10 6 per kg of recipient weight (range, 1.2‒33.8×10 6 ) in donors younger than 5 years old at harvest, 4.7×10 6 (range, 0.3‒28.5×10 6 ) in donors aged 5‒10 years and 2.1×10 6 range, 0.3‒11.3×10 6 ) in donors older than 10 years (P ＜0.001). @*Conclusion@#The infused CD34+ cell dose (×10 6 cells/kg of recipient weight) had no impact on GRFS; however, a CD34+ cell dose of ＞7×10 6 cells/kg of recipient weight did not improve hematopoietic recovery
Résumé
Background: Proximal humerus fractures [PHF] are osteoporotic fractures that affect women over 70 years of age. Like fractures of the femoral neck they have become a public health concern. As the population ages there is an increase in the number of people in poor general condition with an increased risk of falls on fragile bones. The incidence of these fractures has increased by 15% per year
Methods: All patients managed for PHF in Saudi Arabia in the past year were included in this prospective study [prospective cohort study; level 2]. Three hundred and twenty-five patients were included with 329 fractures
Results: There was a ratio of two women to one man. At the final follow-up 50 patients had died [15%] and 25 patients were lost to follow-up. The mean age was 70 years old. There were two types of risk factors. The first was fragile bones, and the second was patient specific risk of falls. The severity of the fracture increased with the age of the population. Hospitalization was necessary in 43% of the cases in our study. Surgical management was necessary in 21%. This lack of relationship between the percentage of displaced fractures [58%] and the percentage of surgically treated fractures is a sign of the difficulties of managing this population, which is usually in poor general condition
Conclusion: Proximal humerus fractures [PHF] is frequent and its prevalence is increasing. The ageing population is the cause, resulting in a population that is in poor general condition with an increased risk of falling on increasingly fragile bone. Measures must be taken in this growing population to prevent the risk factors of PHF because management of these fractures may become another source of dependency in the elderly population