ABSTRACT
BACKGROUND: Hematopoietic stem cell transplantation (HSCT) is an effective mode of consolidation therapy for children with high-risk acute leukemia. In high-income countries, match sibling donor (MSD) and match unrelated donor (MUD) HSCT have similar outcomes, but data are scarce in upper-middle-income countries. Our objective was to compare MSD and MUD HSCT outcomes for children with acute leukemia in Argentina. PATIENTS AND METHODS: This was a single-institution retrospective cohort study. We included children with acute leukemia who underwent HSCT with either MSD or MUD between 2014 and 2019. RESULTS: The study included 45 patients who received MSD (n=27) or MUD (n=18) for acute leukemia. Event-free survival was not significantly different between MSD (62.3±10.7%) versus MUD (54.2±15.0%; P=0.54) at 5 years. Similarly, there was no significant difference in 5-year overall survival between MSD (71.9±9.8%) versus MUD (65.1±13.5%; P=0.38). The cumulative incidence of treatment-related mortality (P=0.31), cumulative incidence of relapse (P=0.99), and proportion with acute-graft-versus-host disease (P=0.76) and chronic-graft-versus-host disease (P=0.68) were also not significantly different. CONCLUSIONS: In Argentina, we did not show significant differences in outcomes between MSD and MUD HSCT for children with high-risk leukemia. Future work should focus on strategies to reduce the relapse risk in children with high-risk leukemia in upper-middle-income countries.
Subject(s)
Hematopoietic Stem Cell Transplantation/mortality , Leukemia/mortality , Siblings , Unrelated Donors/statistics & numerical data , Acute Disease , Argentina/epidemiology , Child , Child, Preschool , Female , Follow-Up Studies , Humans , Leukemia/epidemiology , Leukemia/pathology , Leukemia/therapy , Male , Prognosis , Retrospective Studies , Survival RateABSTRACT
RESUMEN Cuando Douglas McGregor inició sus trabajos relacionados con el lado humano de las empresas, la forma de pensar y de administrar era muy diferente a la que se tiene actualmente. El objetivo de este trabajo fue determinar en el contexto mexicano, la validez y con-fiabilidad del instrumento de medida utilizado en la investigación de grupos de personas anglosajonas, y conocer la relación que existe entre: a) las características de las teorías X y Y de McGregor; b) las formas de retribuir a las personas en una empresa; y c) la satisfacción en el trabajo. Se usó un instrumento de medida con 51 preguntas, que se aplicó a una muestra aleatoria de 233 trabajadores, en el noreste de México. Mediante un modelo de ecuaciones estructurales, se llevó a cabo un análisis factorial exploratorio. Se encontraron resultados que mostraron validez y confiabili-dad en los constructos utilizados. Además, se detectó la existencia de una relación positiva entre la teoría Y con la satisfacción en el trabajo (r = 0.46), mientras que en la teoría X no hubo relación con ninguna variable. Con los diversos hallazgos, se comprueba la relevancia que tienen, en el ambiente laboral mexicano, los aspectos monetarios de la compensación y su influencia positiva en la satisfacción, y en la motivación y actitudes de las personas hacia las actividades que realizan, así como la relevancia de las estrategias de recursos humanos para mantener la satisfacción de los colaboradores.
ABSTRACT When Douglas McGregor started working on the human side of businesses, the way of thinking and managing was very different from the present time. The goal of this research is to determine the validity and reliability of a survey commonly used for conducting research in Anglo-Saxon populations within the Mexican context. We intend to identify the relationship among: a) the components of McGregor's X and Y theory, b) the different forms of compensation to people, and c) job satisfaction. For this research, we administered a 51-item survey to a random sample of 233 workers in the northeastern region of Mexico. An exploratory factor analysis (EFA) was carried out through structural equation modeling. The obtained results showed the validity and reliability of the constructs. In addition, the existence of a positive relationship between theory Y and job satisfaction was found (r = 0.46). On the other hand, theory X showed no relation with any variable. Findings confirm the relevance of the strategies used by human resources departments to maintain employees' motivation and satisfaction. Monetary retribution issues were highly valued within the Mexican work-place environment since they positively influence job satisfaction and workers' motivation to fulfill assigned activities.
ABSTRACT
Our primary objective was to describe the incidence of proven or probable invasive fungal infections (IFIs), a devastating complication of hematopoietic stem cell transplant (HSCT), in HCST in a middle-income country. Secondary objectives were to describe factors associated with IFIs and outcomes. In this single center retrospective study, pediatric patients who underwent a first allogeneic or autologous HSCT from 1998 to 2016 were included. Of the 251 HSCT recipients: 143 transplants were allogeneic and 108 were autologous. Overall, 23 (9%) experienced an IFI, mostly due to yeasts (83%). IFIs were more common in allogeneic HSCT (18/143, 13%) than in autologous HSCT (5/108, 5%; P = .045). Of the 23 patients with IFIs, 14 (61%) died, but only 1 directly from IFI (pulmonary aspergillosis). Overall survival at 3 years was 0.42 ± 0.11 in patients with IFIs and 0.60 ± 0.37 in those without IFIs (P = .049). In Argentina, IFIs during HSCT are common. Recipients of allogeneic HSCT are at higher risk, and IFI is associated with reduced overall survival. Future work should focus on interventions to reduce and improve IFI outcomes in children undergoing transplants in low- and middle-income countries.
