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Sample records for hla-matched sibling allogeneic

  1. Nonmyeloablative HLA-matched sibling allogeneic hematopoietic stem cell transplantation for severe sickle cell phenotype.

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    Hsieh, Matthew M; Fitzhugh, Courtney D; Weitzel, R Patrick; Link, Mary E; Coles, Wynona A; Zhao, Xiongce; Rodgers, Griffin P; Powell, Jonathan D; Tisdale, John F

    2014-07-02

    Myeloablative allogeneic hematopoietic stem cell transplantation (HSCT) is curative for children with severe sickle cell disease, but toxicity may be prohibitive for adults. Nonmyeloablative transplantation has been attempted with degrees of preparative regimen intensity, but graft rejection and graft-vs-host disease remain significant. To determine the efficacy, safety, and outcome on end-organ function with this low-intensity regimen for sickle cell phenotype with or without thalassemia. From July 16, 2004, to October 25, 2013, 30 patients aged 16-65 years with severe disease enrolled in this nonmyeloablative transplant study, consisting of alemtuzumab (1 mg/kg in divided doses), total-body irradiation (300 cGy), sirolimus, and infusion of unmanipulated filgrastim mobilized peripheral blood stem cells (5.5-31.7 × 10(6) cells/kg) from human leukocyte antigen-matched siblings. The primary end point was treatment success at 1 year after the transplant, defined as a full donor-type hemoglobin for patients with sickle cell disease and transfusion independence for patients with thalassemia. The secondary end points were the level of donor leukocyte chimerism; incidence of acute and chronic graft-vs-host disease; and sickle cell-thalassemia disease-free survival, immunologic recovery, and changes in organ function, assessed by annual brain imaging, pulmonary function, echocardiographic image, and laboratory testing. Twenty-nine patients survived a median 3.4 years (range, 1-8.6), with no nonrelapse mortality. One patient died from intracranial bleeding after relapse. As of October 25, 2013, 26 patients (87%) had long-term stable donor engraftment without acute or chronic graft-vs-host disease. The mean donor T-cell level was 48% (95% CI, 34%-62%); the myeloid chimerism levels, 86% (95% CI, 70%-100%). Fifteen engrafted patients discontinued immunosuppression medication with continued stable donor chimerism and no graft-vs-host disease. The normalized hemoglobin and

  2. Analysis of the results of allogeneic hematopoietic stem cell transplantation depending on HLA matching of the unrelated donor / recipient pair

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    Ye. V. Kuzmich

    2015-01-01

    Full Text Available HLA matching of the donor / recipient pair is a major factor associated with the outcome of allogeneic stem cell transplantation. In the presentstudy we analyzed the risk of severe acute graft-versus-host disease, graft failure, 2.year overall survival of the patients after allogeneic stem cell transplantation depending on HLA matching of the unrelated donor / recipient pair.

  3. The impact of HLA matching on long-term transplant outcome after allogeneic hematopoietic stem cell transplantation for CLL: a retrospective study from the EBMT registry

    DEFF Research Database (Denmark)

    Michallet, M; Sobh, M; Milligan, D

    2010-01-01

    We analyzed 368 chronic lymphocytic leukemia patients who underwent allogeneic hematopoietic stem cell transplantation reported to the EBMT registry between 1995 and 2007. There were 198 human leukocyte antigen (HLA)-identical siblings; among unrelated transplants, 31 were well matched in high...... worsened significantly when EBMT risk score increased. HLA matching had no significant impact on relapse (siblings: 24% (21-27); WMUD: 35% (26-44), P=0.11 and MM: 21% (18-24), P=0.81); alemtuzumab T-cell depletion and stem cell source (peripheral blood) were associated with an increased risk. Our findings...... support the use of WMUD as equivalent alternative to HLA-matched sibling donors for allogeneic HSCT in CLL, and justify the application of EBMT risk score in this disease....

  4. GVHD after HLA-matched sibling BMT or PBSCT: Comparison of North American Caucasian and Japanese Populations

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    Kanda, Junya; Brazauskas, Ruta; Hu, Zhen-Huan; Kuwatsuka, Yachiyo; Nagafuji, Koji; Kanamori, Heiwa; Kanda, Yoshinobu; Miyamura, Koichi; Murata, Makoto; Fukuda, Takahiro; Sakamaki, Hisashi; Kimura, Fumihiko; Seo, Sachiko; Aljurf, Mahmoud; Yoshimi, Ayami; Milone, Giuseppe; Wood, William A; Ustun, Celalettin; Hashimi, Shahrukh; Pasquini, Marcelo; Bonfim, Carmem; Dalal, Jignesh; Hahn, Theresa; Atsuta, Yoshiko; Saber, Wael

    2016-01-01

    The risk of acute graft-versus-host disease (GVHD) after HLA-matched sibling bone marrow (BM) transplantation is lower in Japanese than in Caucasian patients. However, race may have differential effect on GVHD dependent on the graft source. North American Caucasian and Japanese patients receiving their first allogeneic BM or peripheral blood stem cell (PBSC) transplantations from an HLA-matched sibling for leukemia were eligible. BM was used in 13% and 53% of Caucasian and Japanese patients, respectively. In multivariate analysis, the interaction term between race and graft source was not significant in any of the models, indicating that graft source does not affect the impact of race on outcomes. The risk of grades III–IV acute GVHD was significantly lower in Japanese than in Caucasian patients (hazard ratio (HR) 0.74, 95% confidence interval (CI) 0.57–0.96), which resulted in lower risk of non-relapse mortality in Japanese patients (HR 0.69, 95% CI 0.54–0.89). The risk of relapse was also lower in this group. Lower risk of non-relapse mortality and relapse resulted in lower overall mortality rates among Japanese patients. In conclusion, irrespective of graft source, the risk of severe acute GVHD is lower in Japanese patients, which results in lower risk of non-relapse mortality. PMID:26762681

  5. The impact of HLA matching on long-term transplant outcome after allogeneic hematopoietic stem cell transplantation for CLL: a retrospective study from the EBMT registry.

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    Michallet, M; Sobh, M; Milligan, D; Morisset, S; Niederwieser, D; Koza, V; Ruutu, T; Russell, N H; Verdonck, L; Dhedin, N; Vitek, A; Boogaerts, M; Vindelov, L; Finke, J; Dubois, V; van Biezen, A; Brand, R; de Witte, T; Dreger, P

    2010-10-01

    We analyzed 368 chronic lymphocytic leukemia patients who underwent allogeneic hematopoietic stem cell transplantation reported to the EBMT registry between 1995 and 2007. There were 198 human leukocyte antigen (HLA)-identical siblings; among unrelated transplants, 31 were well matched in high resolution ('well matched' unrelated donor, WMUD), and 139 were mismatched (MM), including 30 matched in low resolution; 266 patients (72%) received reduced-intensity conditioning and 102 (28%) received standard. According to the EBMT risk score, 11% were in scores 1-3, 23% in score 4, 40% in score 5, 22% in score 6 and 4% in score 7. There was no difference in overall survival (OS) at 5 years between HLA-identical siblings (55% (48-64)) and WMUD (59% (41-84)), P=0.82. In contrast, OS was significantly worse for MM (37% (29-48) P=0.005) due to a significant excess of transplant-related mortality. Also OS worsened significantly when EBMT risk score increased. HLA matching had no significant impact on relapse (siblings: 24% (21-27); WMUD: 35% (26-44), P=0.11 and MM: 21% (18-24), P=0.81); alemtuzumab T-cell depletion and stem cell source (peripheral blood) were associated with an increased risk. Our findings support the use of WMUD as equivalent alternative to HLA-matched sibling donors for allogeneic HSCT in CLL, and justify the application of EBMT risk score in this disease.

  6. HLA-Matched Sibling versus Unrelated versus Haploidentical Related Donor Allogeneic Hematopoietic Stem Cell Transplantation for Patients Aged Over 60 Years with Acute Myeloid Leukemia: A Single-Center Donor Comparison.

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    Devillier, Raynier; Legrand, Faezeh; Rey, Jérôme; Castagna, Luca; Fürst, Sabine; Granata, Angela; Charbonnier, Aude; Harbi, Samia; d'Incan, Evelyne; Pagliardini, Thomas; Faucher, Catherine; Lemarie, Claude; Saillard, Colombe; Calmels, Boris; Mohty, Bilal; Maisano, Valerio; Weiller, Pierre-Jean; Chabannon, Christian; Vey, Norbert; Blaise, Didier

    2018-02-12

    Haploidentical related donor (HRD) allogeneic hematopoietic stem cell transplantation (allo-HSCT) was developed as a valid option for the treatment of acute myeloid leukemia (AML) in the absence of a matched donor. However, many investigators are reluctant to consider the use of this alternative in elderly patients, anticipating high morbidity. Here, we report a single-center comparison of HRD versus matched sibling donor (MSD) and unrelated donor (UD) allo-HSCT for patients with AML aged ≥60 years. Ninety-four patients (MSD: n = 31; UD: n = 30; HRD: n = 33) were analyzed. The median age was 65 (range, 60 to 73) years. We observed a higher cumulative incidence of grade 3 to 4 acute graft-versus-host disease (GVHD) after UD allo-HSCT (MSD versus UD versus HRD: 3% versus 33% versus 6%, respectively; P = .006). Two-year cumulative incidence of moderate or severe chronic GVHD was 17%, 27%, and 16% in the MSD, UD, and HRD groups, respectively (P = .487). No difference was observed in the 2-year cumulative incidence of relapse or nonrelapse mortality (NRM) (relapse: MSD versus UD versus HRD: 32% versus 25% versus 25%, respectively; P = .411; NRM: MSD versus UD versus HRD: 19% versus 27% versus 24%, respectively; P = .709). At 2 years, progression-free survival, overall survival, and GVHD- and relapse-free survival were 48%, 50%, and 39%, respectively, in the MSD group; 48%, 51%, and 23%, respectively, in the UD group; and 50%, 52%, and 32%, respectively, in the HRD group, without statistically significant differences between the groups. We conclude that HRD allo-HSCT is highly feasible and no less efficient than MSD or UD allo-HSCT in patients with AML aged ≥60 years. Thus, the absence of a HLA-identical donor should not limit the consideration of allo-HSCT for the treatment of AML. Copyright © 2018 The American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

  7. Influence of HLA Matching on the Efficacy of Allogeneic Mesenchymal Stromal Cell Therapies for Osteoarthritis and Degenerative Disc Disease

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    Javier García-Sancho, MD, PhD

    2017-09-01

    Conclusions. This lack of reactivity is presumably due to the cooperation of 2 factors, (1 downregulation of the host immune responses by the transplanted MSCs and (2 effective insulation of these cells inside the articular cavity or the intervertebral disc, respectively. Interestingly, better HLA matching did not enhance efficacy. These observations have medical relevance as they support the clinical use of allogeneic cells, at least as a single-dose administration. Multiple-dose applications will require further research to exclude possible sensitization.

  8. Comparative analysis of unrelated cord blood transplantation and HLA-matched sibling hematopoietic stem cell transplantation in children with high-risk or advanced acute leukemia.

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    Zheng, Changcheng; Zhu, Xiaoyu; Tang, Baolin; Yao, Wen; Song, Kaidi; Tong, Juan; Geng, Liangquan; Liu, Huilan; Sun, Zimin

    2015-03-01

    The aim of this report was to present a clinical comparison of unrelated cord blood transplantation (CBT) and human leukocyte antigen (HLA)-matched sibling allogeneic peripheral blood stem cell or bone marrow transplantation (allo-PBSCT/BMT) in children with high-risk or advanced acute leukemia. A total of 115 consecutive pediatric patients received unrelated CBT (n = 90) or sibling allo-PBSCT/BMT (n = 25) between 2000 and 2012. Neutrophil and platelet recovery were significantly delayed after CBT compared to allo-PBSCT/BMT. There was no difference in the incidence of acute graft-versus-host disease (GVHD) or chronic GVHD between the two groups. The cumulative incidence of transplant-related mortality (TRM) was higher in the CBT group than in the allo-PBSCT/BMT group (32.5 vs 12.8 %) (p = 0.03). The cumulative incidence of relapse was 13.1 % after CBT, which was significantly lower than that of after allo-PBSCT/BMT (45.3 %) (p = 0.015). The overall survival (OS) and leukemia-free survival (LFS) in the CBT group were similar to those of the allo-PBSCT/BMT group; however, for acute myeloid leukemia (AML) patients, the 5-year LFS in the CBT group was slightly better than the allo-PBSCT/BMT group (55.7 % for CBT and 32.7 % for allo-PBSCT/BMT) (p = 0.08). Our comparisons suggest that for high-risk or advanced childhood acute leukemia, unrelated CBT has a higher TRM and similar long-term survival, but better antileukemia effect than HLA-matched sibling PBSCT/BMT. New strategies and better supportive care are required to decrease the TRM of CBT.

  9. PBSCT is associated with poorer survival and increased chronic GvHD than BMT in Japanese paediatric patients with acute leukaemia and an HLA-matched sibling donor.

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    Shinzato, Aki; Tabuchi, Ken; Atsuta, Yoshiko; Inoue, Masami; Inagaki, Jiro; Yabe, Hiromasa; Koh, Katsuyoshi; Kato, Koji; Ohta, Hideaki; Kigasawa, Hisato; Kitoh, Toshiyuki; Ogawa, Atsushi; Takahashi, Yoshiyuki; Sasahara, Yoji; Kato, Shun-Ichi; Adachi, Souichi

    2013-09-01

    Peripheral blood stem cells (PBSC) may be used as an alternative to bone marrow (BM) for allogeneic transplantation. Since peripheral blood stem cell bank from unrelated volunteer donor has been started in Japan, use of PBSC allografts may be increased. Therefore we surveyed the outcomes of Japanese leukemia children after PBSC and BM transplantation. This retrospective study compared the outcomes of 661 children (0-18 years) with acute lymphoblastic leukaemia (ALL) or acute myeloid leukaemia (AML) who received their first allogeneic peripheral blood stem cell transplantation (PBSCT; n = 90) or bone marrow transplantation (BMT; n = 571) from HLA-matched siblings between January 1996 and December 2007. Neutrophil recovery was faster after PBSCT than after BMT (ALL: P vs. 9.9%, P = 0.0066; AML: 41.6% vs. 11.1%, P vs. 57.1%, P = 0.0257). The 5-year overall survival (OS) was lower after PBSCT than after BMT for ALL (42.4% vs. 63.7%, P = 0.0032) and AML (49.8% vs. 71.8%, P = 0.0163). Multivariate analysis revealed the use of PBSC was a significant risk factor for DFS and OS. PBSCT and BMT did not differ in relapse rate, acute GvHD for ALL and AML, or in DFS for AML. PBSC allografts in Japanese children engraft faster but are associated with poorer survival and increased chronic GvHD. Copyright © 2013 Wiley Periodicals, Inc.

  10. Comparable Outcomes after HLA-Matched Sibling and Alternative Donor Hematopoietic Cell Transplantation for Children with Fanconi Anemia and Severe Aplastic Anemia.

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    Ebens, Christen L; DeFor, Todd E; Tryon, Rebecca; Wagner, John E; MacMillan, Margaret L

    2018-04-01

    Fanconi anemia (FA)-associated severe aplastic anemia (SAA) requires allogeneic hematopoietic cell transplantation (HCT) for cure. With the evolution of conditioning regimens over time, outcomes of alternative donor HCT (AD-HCT) have improved dramatically. We compared outcomes of HLA-matched sibling donor HCT (MSD-HCT; n = 17) and AD-HCT (n = 57) performed for FA-associated SAA at a single institution between 2001 and 2016. Overall survival at 5 years was 94% for MSD-HCT versus 86% for AD-HCT, neutrophil engraftment was 100% versus 95%, platelet recovery was 100% versus 89%, grade II-IV acute graft-versus-host disease (GVHD) was 6% versus 12%, grade III-IV acute GVHD was 6% versus 4%, and chronic GVHD was 0 versus 7%, with no statistically significant differences by type of transplant. The use of UCB was associated with decreased rates of neutrophil recovery in AD-HCT and platelet recovery in both MSD-HCT and AD-HCT. A trend toward a higher serious infection density before day +100 post-HCT was observed in AD-HCT compared with MSD-HCT (P = .02). These data demonstrate that AD-HCT should be considered at the same time as MSD-HCT for patients with FA-associated SAA. Copyright © 2017 The American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

  11. Post-Transplant Cyclophosphamide and Tacrolimus-Mycophenolate Mofetil Combination Prevents Graft-versus-Host Disease in Allogeneic Peripheral Blood Hematopoietic Cell Transplantation from HLA-Matched Donors.

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    Carnevale-Schianca, Fabrizio; Caravelli, Daniela; Gallo, Susanna; Coha, Valentina; D'Ambrosio, Lorenzo; Vassallo, Elena; Fizzotti, Marco; Nesi, Francesca; Gioeni, Luisa; Berger, Massimo; Polo, Alessandra; Gammaitoni, Loretta; Becco, Paolo; Giraudo, Lidia; Mangioni, Monica; Sangiolo, Dario; Grignani, Giovanni; Rota-Scalabrini, Delia; Sottile, Antonino; Fagioli, Franca; Aglietta, Massimo

    2017-03-01

    Allogeneic hematopoietic cell transplant (HCT) remains the only curative therapy for many hematologic malignancies but it is limited by high nonrelapse mortality (NRM), primarily from unpredictable control of graft-versus-host disease (GVHD). Recently, post-transplant cyclophosphamide demonstrated improved GVHD control in allogeneic bone marrow HCT. Here we explore cyclophosphamide in allogeneic peripheral blood stem cell transplantation (alloPBSCT). Patients with high-risk hematologic malignancies received alloPBSCT from HLA-matched unrelated/related donors. GVHD prophylaxis included combination post-HCT cyclophosphamide 50 mg/kg (days +3 and +4) and tacrolimus/mofetil mycophenolate (T/MMF) (day +5 forward). The primary objective was the cumulative incidence of acute and chronic GVHD. Between March 2011 and May 2015, 35 consecutive patients received the proposed regimen. MMF was stopped in all patients at day +28; the median discontinuation of tacrolimus was day +113. Acute and chronic GVHD cumulative incidences were 17% and 7%, respectively, with no grade IV GVHD events, only 2 patients requiring chronic GVHD immunosuppression control, and no deaths from GVHD. Two-year NRM, overall survival, event-free survival, and chronic GVHD event-free survival rates were 3%, 77%, 54%, and 49%, respectively. The graft-versus-tumor effect was maintained as 5 of 15 patients (33%) who received HCT with evidence of disease experienced further disease response. A post-transplant cyclophosphamide + T/MMF combination strategy effectively prevented acute and chronic GVHD after alloPBSCT from HLA-matched donors and achieved an unprecedented low NRM without losing efficacy in disease control or impaired development of the graft-versus-tumor effect. This trial is registered at clinicaltrials.gov as NCT02300571. Copyright © 2017 The American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

  12. The impact of HLA matching on long-term transplant outcome after allogeneic hematopoietic stem cell transplantation for CLL: a retrospective study from the EBMT registry.

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    Michallet, M.; Sobh, M.; Milligan, D.; Morisset, S.; Niederwieser, D.; Koza, V.; Ruutu, T.; Russell, N.H.; Verdonck, L.; Dhedin, N.; Vitek, A.; Boogaerts, M.; Vindelov, L.; Finke, J.; Dubois, V.; Biezen, A. van; Brand, R.; Witte, T.J.M. de; Dreger, P.

    2010-01-01

    We analyzed 368 chronic lymphocytic leukemia patients who underwent allogeneic hematopoietic stem cell transplantation reported to the EBMT registry between 1995 and 2007. There were 198 human leukocyte antigen (HLA)-identical siblings; among unrelated transplants, 31 were well matched in high

  13. The impact of HLA matching on long-term transplant outcome after allogeneic hematopoietic stem cell transplantation for CLL: a retrospective study from the EBMT registry

    DEFF Research Database (Denmark)

    Michallet, M; Sobh, M; Milligan, D

    2010-01-01

    We analyzed 368 chronic lymphocytic leukemia patients who underwent allogeneic hematopoietic stem cell transplantation reported to the EBMT registry between 1995 and 2007. There were 198 human leukocyte antigen (HLA)-identical siblings; among unrelated transplants, 31 were well matched in high re...

  14. Worse outcome and more chronic GVHD with peripheral blood progenitor cells than bone marrow in HLA-matched sibling donor transplants for young patients with severe acquired aplastic anemia.

    NARCIS (Netherlands)

    Schrezenmeier, H.; Passweg, J.R.; Marsh, J.C.; Bacigalupo, A.; Bredeson, C.N.; Bullorsky, E.; Camitta, B.M.; Champlin, R.E.; Gale, R.P.; Fuhrer, M.; Klein, J.P.; Locasciulli, A.; Oneto, R.; Schattenberg, A.V.M.B.; Socie, G.; Eapen, M.

    2007-01-01

    We analyzed the outcome of 692 patients with severe aplastic anemia (SAA) receiving transplants from HLA-matched siblings. A total of 134 grafts were peripheral blood progenitor cell (PBPC) grafts, and 558 were bone marrow (BM) grafts. Rates of hematopoietic recovery and grades 2 to 4 chronic

  15. Preimplantation genetic diagnosis with HLA matching.

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    Rechitsky, Svetlana; Kuliev, Anver; Tur-Kaspa, Illan; Morris, Randy; Verlinsky, Yury

    2004-08-01

    Preimplantation genetic diagnosis (PGD) has recently been offered in combination with HLA typing, which allowed a successful haematopoietic reconstitution in affected siblings with Fanconi anaemia by transplantation of stem cells obtained from the HLA-matched offspring resulting from PGD. This study presents the results of the first PGD practical experience performed in a group of couples at risk for producing children with genetic disorders. These parents also requested preimplantation HLA typing for treating the affected children in the family, who required HLA-matched stem cell transplantation. Using a standard IVF procedure, oocytes or embryos were tested for causative gene mutations simultaneously with HLA alleles, selecting and transferring only those unaffected embryos, which were HLA matched to the affected siblings. The procedure was performed for patients with children affected by Fanconi anaemia (FANC) A and C, different thalassaemia mutations, Wiscott-Aldrich syndrome, X-linked adrenoleukodystrophy, X-linked hyperimmunoglobulin M syndrome and X-linked hypohidrotic ectodermal displasia with immune deficiency. Overall, 46 PGD cycles were performed for 26 couples, resulting in selection and transfer of 50 unaffected HLA-matched embryos in 33 cycles, yielding six HLA-matched clinical pregnancies and the birth of five unaffected HLA-matched children. Despite the controversy of PGD use for HLA typing, the data demonstrate the usefulness of this approach for at-risk couples, not only to avoid the birth of affected children with an inherited disease, but also for having unaffected children who may also be potential HLA-matched donors of stem cells for treatment of affected siblings.

  16. HLA matching in unrelated donor bone marrow transplantation.

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    Charron, D J

    1996-11-01

    The availability of an HLA-matched sibling donor in only 30% to 35% of patients requiring allogeneic bone marrow transplantation (BMT) has led to the proposal of unrelated donors as an alternative source of bone marrow. The greater HLA incompatibility, which, although present, was undetected until recently in many unrelated donor BMT cases, has resulted in a higher rate of posttransplant complications and impaired acturial survival when compared with HLA-matched sibling BMT. Molecular HLA typing enables us to evaluate the impact of incompatibility at each locus in the outcome of unrelated donor BMT. The overall retrospective data would recommend that HLA-A, -B and -C allelic molecular matching should be implemented in addition to HLA-DR allelic matching. Further retrospective analysis is needed in order to assess which incompatibility or combinations are better tolerated than others. Only the definitive knowledge at the sequence level of the donor and the recipient HLA allelic diversity involved in controlling the allogeneic immune response will allow us to understand the precise biologic rationale of the graft-versus-host disease. Knowledge and control of the HLA incompatibilities should allow us to offset the detrimental effects of histoincompatibility while developing strategies to take advantage of the beneficial graft-versus-leukemia effect. Also the role of minor histocompatibility antigens remains largely unknown and will require careful evaluation before minor antigens can be used as a selection criterion in BMT. Carefully designed prospective studies will enable us to test the impact of each HLA locus. HLA typing and BMT represent a successful example of productive cooperation between basic and clinical sciences that should be pursued for the improvement of the clinical outcome of unrelated donor BMT.

  17. Reduced-Intensity Transplantation for Lymphomas Using Haploidentical Related Donors Versus HLA-Matched Sibling Donors: A Center for International Blood and Marrow Transplant Research Analysis

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    Ghosh, Nilanjan; Karmali, Reem; Rocha, Vanderson; Ahn, Kwang Woo; DiGilio, Alyssa; Hari, Parameswaran N.; Bachanova, Veronika; Bacher, Ulrike; Dahi, Parastoo; de Lima, Marcos; D’Souza, Anita; Fenske, Timothy S.; Ganguly, Siddhartha; Kharfan-Dabaja, Mohamed A.; Prestidge, Tim D.; Savani, Bipin N.; Smith, Sonali M.; Sureda, Anna M.; Waller, Edmund K.; Jaglowski, Samantha; Herrera, Alex F.; Armand, Philippe; Salit, Rachel B.; Wagner-Johnston, Nina D.; Fuchs, Ephraim; Bolaños-Meade, Javier

    2016-01-01

    Purpose Related donor haploidentical hematopoietic cell transplantation (Haplo-HCT) using post-transplantation cyclophosphamide (PT-Cy) is increasingly used in patients lacking HLA-matched sibling donors (MSD). We compared outcomes after Haplo-HCT using PT-Cy with MSD-HCT in patients with lymphoma, using the Center for International Blood and Marrow Transplant Research registry. Materials and Methods We evaluated 987 adult patients undergoing either Haplo-HCT (n = 180) or MSD-HCT (n = 807) following reduced-intensity conditioning regimens. The haploidentical group received graft-versus-host disease (GVHD) prophylaxis with PT-Cy with or without a calcineurin inhibitor and mycophenolate. The MSD group received calcineurin inhibitor–based GVHD prophylaxis. Results Median follow-up of survivors was 3 years. The 28-day neutrophil recovery was similar in the two groups (95% v 97%; P = .31). The 28-day platelet recovery was delayed in the haploidentical group compared with the MSD group (63% v 91%; P = .001). Cumulative incidence of grade II to IV acute GVHD at day 100 was similar between the two groups (27% v 25%; P = .84). Cumulative incidence of chronic GVHD at 1 year was significantly lower after Haplo-HCT (12% v 45%; P < .001), and this benefit was confirmed on multivariate analysis (relative risk, 0.21; 95% CI, 0.14 to 0.31; P < .001). For Haplo-HCT v MSD-HCT, 3-year rates of nonrelapse mortality (15% v 13%; P = .41), relapse/progression (37% v 40%; P = .51), progression-free survival (48% v 48%; P = .96), and overall survival (61% v 62%; P = .82) were similar. Multivariate analysis showed no significant difference between Haplo-HCT and MSD-HCT in terms of nonrelapse mortality (P = .06), progression/relapse (P = .10), progression-free survival (P = .83), and overall survival (P = .34). Conclusion Haplo-HCT with PT-Cy provides survival outcomes comparable to MSD-HCT, with a significantly lower risk of chronic GVHD. PMID:27269951

  18. Outcomes after HLA-matched sibling transplantation or chemotherapy in children with B-precursor acute lymphoblastic leukemia in a second remission: a collaborative study of the Children's Oncology Group and the Center for International Blood and Marrow Transplant Research.

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    Eapen, Mary; Raetz, Elizabeth; Zhang, Mei-Jie; Muehlenbein, Catherine; Devidas, Meenakshi; Abshire, Thomas; Billett, Amy; Homans, Alan; Camitta, Bruce; Carroll, William L; Davies, Stella M

    2006-06-15

    The best treatment approach for children with B-precursor acute lymphoblastic leukemia (ALL) in second clinical remission (CR) after a marrow relapse is controversial. To address this question, we compared outcomes in 188 patients enrolled in chemotherapy trials and 186 HLA-matched sibling transplants, treated between 1991 and 1997. Groups were similar except that chemotherapy recipients were younger (median age, 5 versus 8 years) and less likely to have combined marrow and extramedullary relapse (19% versus 30%). To adjust for time-to-transplant bias, treatment outcomes were compared using left-truncated Cox regression models. The relative efficacy of chemotherapy and transplantation depended on time from diagnosis to first relapse and the transplant conditioning regimen used. For children with early first relapse (children with a late first relapse (> or = 36 months), risks of second relapse were similar after TBI-containing regimens and chemotherapy (RR, 0.92; 95% CI, 0.49-1.70, P = .78). These data support HLA-matched sibling donor transplantation using a TBI-containing regimen in second CR for children with ALL and early relapse.

  19. Alternative allogeneic donor sources for transplantation for childhood diseases: unrelated cord blood and haploidentical family donors.

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    Cairo, Mitchell S; Rocha, Vanderson; Gluckman, Eliane; Hale, Gregory; Wagner, John

    2008-01-01

    Allogeneic stem cell transplantation has been demonstrated to be curative in a wide variety of pediatric malignant and nonmalignant diseases, and can be traced back over 50 years ago to the original report of Thomas et al. HLA matched sibling donors have been the gold standard for pediatric recipients requiring allogeneic donors for both nonmalignant and malignant conditions. However, only 25% of potential pediatric recipients possesses an HLA-matched sibling donor, and the frequency is even less in those with genetic nonmalignant conditions because of genetically affected other siblings within the family. Therefore, 75% to 90% of potential pediatric recipients require alternative allogeneic donor cells for treatment of their underlying conditions. Potential alternative allogeneic donor sources include unrelated cord blood donors, unrelated adult donors, and haploidentical family donors. In this article we review the experience of both unrelated cord blood donor and haploidentical family donor transplants in selected pediatric malignant and nonmalignant conditions.

  20. Donor-Recipient Matching for KIR Genotypes Reduces Chronic GVHD and Missing Inhibitory KIR Ligands Protect against Relapse after Myeloablative, HLA Matched Hematopoietic Cell Transplantation.

    Directory of Open Access Journals (Sweden)

    Rehan Mujeeb Faridi

    Full Text Available Allogeneic hematopoietic cell transplantation (HCT can be curative for many hematologic diseases. However, complications such as graft-versus-host disease (GVHD and relapse of primary malignancy remain significant and are the leading causes of morbidity and mortality. Effects of killer Ig-like receptors (KIR-influenced NK cells on HCT outcomes have been extensively pursued over the last decade. However, the relevance of the reported algorithms on HLA matched myeloablative HCT with rabbit antithymocyte globulin (ATG is used for GVHD prophylaxis remains elusive. Here we examined the role of KIR and KIR-ligands of donor-recipient pairs in modifying the outcomes of ATG conditioned HLA matched sibling and unrelated donor HCT.The study cohort consisted of 281 HLA matched sibling and unrelated donor-recipient pairs of first allogeneic marrow or blood stem cell transplantation allocated into 'discovery' (135 pairs and 'validation' (146 pairs cohorts. High resolution HLA typing was obtained from the medical charts and KIR gene repertoires were obtained by a Luminex® based SSO method. All surviving patients were followed-up for a minimum of two years. KIR and HLA class I distributions of HCT pairs were stratified as per applicable definitions and were tested for their association with cause specific outcomes [acute GVHD grade II-IV (aGVHD, chronic GVHD needing systemic therapy (cGVHD and relapse] using a multivariate competing risks regression model as well as with survival outcomes [relapse-free survival (RFS, cGVHD & relapse free survival (cGRFS and overall survival (OS] by multivariate Cox proportional hazards regression model. A significant association between KIR genotype mismatching (KIR-B/x donor into KIR-AA recipient or vice versa and cGVHD was found in both discovery (p = 0.001; SHR = 2.78; 95%CI: 1.50-5.17 and validation cohorts (p = 0.005; SHR = 2.61; 95%CI: 1.33-5.11. High incidence of cGVHD associated with KIR genotype mismatching was

  1. Donor-Recipient Matching for KIR Genotypes Reduces Chronic GVHD and Missing Inhibitory KIR Ligands Protect against Relapse after Myeloablative, HLA Matched Hematopoietic Cell Transplantation.

    Science.gov (United States)

    Faridi, Rehan Mujeeb; Kemp, Taylor J; Dharmani-Khan, Poonam; Lewis, Victor; Tripathi, Gaurav; Rajalingam, Raja; Daly, Andrew; Berka, Noureddine; Storek, Jan; Masood Khan, Faisal

    2016-01-01

    Allogeneic hematopoietic cell transplantation (HCT) can be curative for many hematologic diseases. However, complications such as graft-versus-host disease (GVHD) and relapse of primary malignancy remain significant and are the leading causes of morbidity and mortality. Effects of killer Ig-like receptors (KIR)-influenced NK cells on HCT outcomes have been extensively pursued over the last decade. However, the relevance of the reported algorithms on HLA matched myeloablative HCT with rabbit antithymocyte globulin (ATG) is used for GVHD prophylaxis remains elusive. Here we examined the role of KIR and KIR-ligands of donor-recipient pairs in modifying the outcomes of ATG conditioned HLA matched sibling and unrelated donor HCT. The study cohort consisted of 281 HLA matched sibling and unrelated donor-recipient pairs of first allogeneic marrow or blood stem cell transplantation allocated into 'discovery' (135 pairs) and 'validation' (146 pairs) cohorts. High resolution HLA typing was obtained from the medical charts and KIR gene repertoires were obtained by a Luminex® based SSO method. All surviving patients were followed-up for a minimum of two years. KIR and HLA class I distributions of HCT pairs were stratified as per applicable definitions and were tested for their association with cause specific outcomes [acute GVHD grade II-IV (aGVHD), chronic GVHD needing systemic therapy (cGVHD) and relapse] using a multivariate competing risks regression model as well as with survival outcomes [relapse-free survival (RFS), cGVHD & relapse free survival (cGRFS) and overall survival (OS)] by multivariate Cox proportional hazards regression model. A significant association between KIR genotype mismatching (KIR-B/x donor into KIR-AA recipient or vice versa) and cGVHD was found in both discovery (p = 0.001; SHR = 2.78; 95%CI: 1.50-5.17) and validation cohorts (p = 0.005; SHR = 2.61; 95%CI: 1.33-5.11). High incidence of cGVHD associated with KIR genotype mismatching was applicable

  2. Low immunosuppressive burden after HLA-matched related or unrelated BMT using posttransplantation cyclophosphamide.

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    Kanakry, Christopher G; Bolaños-Meade, Javier; Kasamon, Yvette L; Zahurak, Marianna; Durakovic, Nadira; Furlong, Terry; Mielcarek, Marco; Medeot, Marta; Gojo, Ivana; Smith, B Douglas; Kanakry, Jennifer A; Borrello, Ivan M; Brodsky, Robert A; Gladstone, Douglas E; Huff, Carol Ann; Matsui, William H; Swinnen, Lode J; Cooke, Kenneth R; Ambinder, Richard F; Fuchs, Ephraim J; de Lima, Marcos J; Andersson, Borje S; Varadhan, Ravi; O'Donnell, Paul V; Jones, Richard J; Luznik, Leo

    2017-03-09

    The intensive and prolonged immunosuppressive therapy required to prevent or treat graft-versus-host disease (GVHD) after allogeneic blood or marrow transplantation (alloBMT) puts patients at substantial risk for life-threatening infections, organ toxicity, and disease relapse. Posttransplantation cyclophosphamide (PTCy) can function as single-agent GVHD prophylaxis after myeloablative, HLA-matched related (MRD), or HLA-matched unrelated (MUD) donor T-cell-replete bone marrow allografting, obviating the need for additional prophylactic immunosuppression. However, patients who develop GVHD require supplemental treatment. We assessed the longitudinal requirement for immunosuppressive therapy in 339 patients treated with this transplantation platform: 247 receiving busulfan/cyclophosphamide (BuCy) conditioning (data collected retrospectively) and 92 receiving busulfan/fludarabine (BuFlu) conditioning (data collected prospectively). Approximately 50% of MRD patients and 30% of MUD patients never required immunosuppression beyond PTCy. In patients requiring further immunosuppression, typically only 1 to 2 agents were required, and the median durations of systemic pharmacologic immunosuppression for the BuCy MRD, BuFlu MRD, BuCy MUD, and BuFlu MUD groups all were 4.5 to 5 months. For these 4 groups, 1-year probabilities of being alive and off all systemic immunosuppression were 61%, 53%, 53%, and 51% and 3-year probabilities were 53%, 48%, 49%, and 56%, respectively. These data suggest that PTCy minimizes the global immunosuppressive burden experienced by patients undergoing HLA-matched alloBMT.

  3. Having a sibling as donor: patients' experiences immediately before allogeneic hematopoietic stem cell transplantation.

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    Kisch, Annika; Bolmsjö, Ingrid; Lenhoff, Stig; Bengtsson, Mariette

    2014-08-01

    Allogeneic hematopoietic stem cell transplantation (HSCT) offers a potential cure for a variety of diseases but is also associated with significant risks. With HSCT the donor is either a relative, most often a sibling, or an unrelated registry donor. The aim was to explore patients' experiences, immediately before transplantation, regarding having a sibling as donor. Ten adult patients with sibling donors were interviewed before admission for HSCT. The interviews were digitally recorded, transcribed verbatim and subjected to qualitative content analysis. The main theme Being in no man's land is a metaphor for the patients' complex situation with its mixture of emotions and thoughts prior to transplantation. The three subthemes Trust in the sibling donor, Concern about others and Loss of control cover the various experiences. The patient's experiences are influenced by their personal situation and the quality of the relationship with the sibling donor. While patients feel secure in having a sibling donor, they are dependent for their survival on the cell donation and feel responsible for the donor's safety during donation. These emotions intensify the patients' sense of dependency and loss of control. In caring for HSCT patients the nurses should be aware of the complexity of the patients' situation and keep in mind that having a sibling donor might imply extra pressure, including a sense of responsibility. Caring for both patients and sibling donors optimally is a challenge, which needs further improvement and exploration. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. [A comparative study of unrelated donor and matched-sibling donor allogeneic hematopoietic stem cell transplantation in children and adolescents with acquired severe aplastic anemia].

    Science.gov (United States)

    Zhou, J; Fu, Y W; Liang, L J; Wang, Q; Han, L J; Zu, Y L; Zhang, Yanli; Zhu, X H; Yu, F K; Fang, B J; Wei, X D; Song, Y P

    2016-12-01

    Objective: To evaluate the efficacy of unrelated donor allogeneic hematopoietic stem cell transplantation(URD allo-HSCT) for children and adolescents with severe aplastic anemia (SAA). Methods: Clinical data of 34 SAA children and adolescents undergoing allo-HSCT were retrospectively analyzed from October 2001 to October 2015. According to the source of donor, the patients were divided into matched sibling donor allo-HSCT group (MSD group) and unrelated donor group (URD group). The clinical outcome of SAA children and adolescents receiving URD allo-HSCT was assessed, and patients in MSD allo-HSCT group were enrolled as control at the same period. Results: The rate of hematopoietic reconstitution, the time of neutrophil and platelet engraftment, incidence of chimerism and graft rejection between two groups were not statistically different.The incidence of acute graft-versus-host disease (GVHD) in URD group was significantly higher than that in MSD group [42.9%(6/14) vs 10.5%(2/19), P =0.047]. The incidence of grade Ⅱ-Ⅳ acute GVHD and chronic GVHD in URD were higher than those in MSD group [21.4%(3/14) vs 5.3%(1/19), P =0.288; 35.7%(5/14) vs 5.3%(1/19), P =0.062, respectively], yet without significant difference between two groups. Other transplant-related complications including pulmonary complications, hemorrhagic cystitis, incidence of EBV and CMV reactivation and venous occlusive disease were comparable with two regimens. Estimated 5-years overall survival (OS) rate and disease free survival (DFS) rate were not statistically significant between URD group and MSD group [(84.4±6.6)% vs (89.4±7.1)%, (82.5±5.4)% vs (82.1±4.3)%; P =0.766, P =0.884, respectively]. Conclusions: By multivariate analysis, the outcome of URD allo-HSCT in SAA children and adolescent is similar to MSD allo-HSCT. It could be an alternative option as the first-line treatment for SAA children and adolescents without HLA matched sibling donors.

  5. Comparison of matched sibling donors versus unrelated donors in allogeneic stem cell transplantation for primary refractory acute myeloid leukemia: a study on behalf of the Acute Leukemia Working Party of the EBMT

    Directory of Open Access Journals (Sweden)

    Eolia Brissot

    2017-06-01

    Full Text Available Abstract Background Primary refractory acute myeloid leukemia (PRF-AML is associated with a dismal prognosis. Allogeneic stem cell transplantation (HSCT in active disease is an alternative therapeutic strategy. The increased availability of unrelated donors together with the significant reduction in transplant-related mortality in recent years have opened the possibility for transplantation to a larger number of patients with PRF-AML. Moreover, transplant from unrelated donors may be associated with stronger graft-mediated anti-leukemic effect in comparison to transplantations from HLA-matched sibling donor, which may be of importance in the setting of PRF-AML. Methods The current study aimed to address the issue of HSCT for PRF-AML and to compare the outcomes of HSCT from matched sibling donors (n = 660 versus unrelated donors (n = 381, for patients with PRF-AML between 2000 and 2013. The Kaplan-Meier estimator, the cumulative incidence function, and Cox proportional hazards regression models were used where appropriate. Results HSCT provide patients with PRF-AML a 2-year leukemia-free survival and overall survival of about 25 and 30%, respectively. In multivariate analysis, two predictive factors, cytogenetics and time from diagnosis to transplant, were associated with lower leukemia-free survival, whereas Karnofsky performance status at transplant ≥90% was associated with better leukemia-free survival (LFS. Concerning relapse incidence, cytogenetics and time from diagnosis to transplant were associated with increased relapse. Reduced intensity conditioning regimen was the only factor associated with lower non-relapse mortality. Conclusions HSCT was able to rescue about one quarter of the patients with PRF-AML. The donor type did not have any impact on PRF patients’ outcomes. In contrast, time to transplant was a major prognostic factor for LFS. For patients with PRF-AML who do not have a matched sibling donor, HSCT from an

  6. Remission induction using alemtuzumab can permit chemotherapy-refractory chronic lymphocytic leukemia (CLL) patients to undergo allogeneic stem cell transplantation.

    Science.gov (United States)

    Knauf, Wolfgang; Rieger, Kathrin; Blau, Wolfgang; Hegenbart, Ute; Von Gruenhagen, Ulrich; Niederwieser, Dietger; Thiel, Eckhard

    2004-12-01

    The outcome of allogeneic stem cell transplantation depends upon the disease status before transplantation. Patients with refractory disease are at high risk for relapse. To improve the curative potential of the transplant procedure, we treated 3 chemotherapy-refractory CLL patients with alemtuzumab before allogeneic stem cell transplantation. Prior to therapy, all patients suffered from B-symptoms, and had massive adenopathy, splenomegaly, thrombocytopenia, and anemia; two patients had hepatomegaly. Alemtuzumab greatly reduced tumor mass in blood and bone marrow, B-symptoms resolved, and organomegaly improved. Two patients became blood product independent. All patients proceeded to transplantation after conditioning with TBI 2 Gy (n=1) or Treosulfan (n=2) in combination with Fludarabine either from an HLA-matched sibling (n=2) or from an HLA-matched unrelated donor (n=1). All patients engrafted, and are alive and well. Two patients reached complete remission (CR); one patient attained stable partial remission (PR). These heavily pre-treated refractory patients gained substantial clinical benefit from alemtuzumab, and received successful allografts.

  7. Reduced-intensity conditioning and HLA-matched haemopoietic stem-cell transplantation in patients with chronic granulomatous disease: a prospective multicentre study.

    Science.gov (United States)

    Güngör, Tayfun; Teira, Pierre; Slatter, Mary; Stussi, Georg; Stepensky, Polina; Moshous, Despina; Vermont, Clementien; Ahmad, Imran; Shaw, Peter J; Telles da Cunha, José Marcos; Schlegel, Paul G; Hough, Rachel; Fasth, Anders; Kentouche, Karim; Gruhn, Bernd; Fernandes, Juliana F; Lachance, Silvy; Bredius, Robbert; Resnick, Igor B; Belohradsky, Bernd H; Gennery, Andrew; Fischer, Alain; Gaspar, H Bobby; Schanz, Urs; Seger, Reinhard; Rentsch, Katharina; Veys, Paul; Haddad, Elie; Albert, Michael H; Hassan, Moustapha

    2014-02-01

    In chronic granulomatous disease allogeneic haemopoietic stem-cell transplantation (HSCT) in adolescents and young adults and patients with high-risk disease is complicated by graft-failure, graft-versus-host disease (GVHD), and transplant-related mortality. We examined the effect of a reduced-intensity conditioning regimen designed to enhance myeloid engraftment and reduce organ toxicity in these patients. This prospective study was done at 16 centres in ten countries worldwide. Patients aged 0-40 years with chronic granulomatous disease were assessed and enrolled at the discretion of individual centres. Reduced-intensity conditioning consisted of high-dose fludarabine (30 mg/m(2) [infants HLA-matched related-donors or HLA-9/10 or HLA-10/10 matched unrelated-donors were infused. The primary endpoints were overall survival and event-free survival (EFS), probabilities of overall survival and EFS at 2 years, incidence of acute and chronic GVHD, achievement of at least 90% myeloid donor chimerism, and incidence of graft failure after at least 6 months of follow-up. 56 patients (median age 12·7 years; IQR 6·8-17·3) with chronic granulomatous disease were enrolled from June 15, 2003, to Dec 15, 2012. 42 patients (75%) had high-risk features (ie, intractable infections and autoinflammation), 25 (45%) were adolescents and young adults (age 14-39 years). 21 HLA-matched related-donor and 35 HLA-matched unrelated-donor transplants were done. Median time to engraftment was 19 days (IQR 16-22) for neutrophils and 21 days (IQR 16-25) for platelets. At median follow-up of 21 months (IQR 13-35) overall survival was 93% (52 of 56) and EFS was 89% (50 of 56). The 2-year probability of overall survival was 96% (95% CI 86·46-99·09) and of EFS was 91% (79·78-96·17). Graft-failure occurred in 5% (three of 56) of patients. The cumulative incidence of acute GVHD of grade III-IV was 4% (two of 56) and of chronic graft-versus-host disease was 7% (four of 56). Stable (≥90%) myeloid

  8. The availability of full match sibling donors and feasibility of allogeneic bone marrow transplantation in Brazil

    Directory of Open Access Journals (Sweden)

    Eid K.A.B.

    2003-01-01

    Full Text Available The feasibility of allogeneic bone marrow transplantation (alloBMT in a developing country has not yet been demonstrated. Many adverse factors including social and economic limitations may reduce the overall results of this complex and expensive procedure. Our objective was to characterize the most important clinical, social and economic features of candidates for transplantation and their potential donors as well as the influence of these factors on overall survival in a retrospective and exploratory analysis at a university hospital. From July 1993 to July 2001, candidates for BMT were referred to the Bone Marrow Transplantation Unit by Hematology and Oncology Centers from several regions of Brazil. A total of 1138 patients were referred to us as candidates for alloBMT. Median age was 25 years (range: 2 months-60 years, 684 (60.1% were males and 454 (39.9% were females. The clinical indications were severe aplastic anemia and hematological malignancies. From the total of 1138 patients, 923 had HLA-typing; 497/923 (53.8% candidates had full match donors; 352/1138 (30.8% were eligible for alloBMT. Only 235 of 352 (66.7% were transplanted. Schooling was 1st to 8th grade for 123/235 (52.3%; monthly family income ranged from US$60 (7% to more than US$400 (36%. Overall survival for patients with chronic myeloid leukemia, severe aplastic anemia and acute myeloid leukemia was 58, 60 and 30%, respectively. Thus, overall survival rates for the most frequent hematological diseases were similar to those reported in the International Registry, except for acute myeloid leukemia. This descriptive and exploratory analysis suggests the feasibility of alloBMT in a developing country like Brazil.

  9. Impact of cyclophosphamide dose of conditioning on the outcome of allogeneic hematopoietic stem cell transplantation for aplastic anemia from human leukocyte antigen-identical sibling.

    Science.gov (United States)

    Mori, Takehiko; Koh, Hideo; Onishi, Yasushi; Kako, Shinichi; Onizuka, Makoto; Kanamori, Heiwa; Ozawa, Yukiyasu; Kato, Chiaki; Iida, Hiroatsu; Suzuki, Ritsuro; Ichinohe, Tatsuo; Kanda, Yoshinobu; Maeda, Tetsuo; Nakao, Shinji; Yamazaki, Hirohito

    2016-04-01

    The standard conditioning regimen in allogeneic hematopoietic stem cell transplantation (HSCT) for aplastic anemia from a human leukocyte antigen (HLA)-identical sibling has been high-dose cyclophosphamide (CY 200 mg/kg). In the present study, results for 203 patients with aplastic anemia aged 16 years or older who underwent allogeneic HSCT from HLA-identical siblings were retrospectively analyzed using the registry database of Japan Society for Hematopoietic Cell Transplantation. Conditioning regimens were defined as a (1) high-dose CY (200 mg/kg or greater)-based (n = 117); (2) reduced-dose CY (100 mg/kg or greater, but less than 200 mg/kg)-based (n = 38); and (3) low-dose CY (less than 100 mg/kg)-based (n = 48) regimen. Patient age and the proportion of patients receiving fludarabine were significantly higher in the reduced- and low-dose CY groups than the high-dose CY group. Engraftment was comparable among the groups. Five-year overall survival (OS) tended to be higher in the low-dose CY group [93.0 % (95 % CI 85.1-100.0 %)] than the high-dose CY [84.2 % (95 % CI 77.1-91.3 %)] or reduced-dose CY groups [83.8 % (95 % CI 71.8-95.8 %); P = 0.214]. Age-adjusted OS was higher in the low-dose CY group than the high- and reduced-dose CY groups with borderline significance (P = 0.067). These results suggest that CY dose can safely be reduced without increasing graft rejection by adding fludarabine in allogeneic HSCT for aplastic anemia from an HLA-identical sibling.

  10. Does a kidney-sharing alliance have to sacrifice cold ischemic time for better HLA matching?

    Science.gov (United States)

    Oniscu, Gabriel C; Plant, William; Pocock, Phil; Forsythe, John L R

    2002-05-27

    The Scotland-Northern Ireland Kidney Allocation Alliance was created in August 1998. The purpose was to optimize the transplant service through increased regional exchange, higher quality matched kidneys, and better organ distribution. An analysis was performed on prospectively collected data regarding retrieval and transplant activity. The degree of HLA matching, the cold ischemic time (CIT), the balance of exchange, and graft survival were analyzed for a 2-year period after the introduction of the new alliance and compared with the last year before alliance. There was a 17.7% increase in the number of transplants performed. In the 2-year period, 78% of kidneys were exported from the retrieving center compared with 55% in the prealliance year, (Pexchanged within the Alliance (P>0.05, Student's t test). The largest center was a net importer of kidneys, whereas small and medium-sized centers balanced their exchange within the 2-year period. The 1-year transplant survival rate improved from 81.5% in the prealliance year to 88.4% at the end of the second year. The introduction of a regional kidney allocation alliance has improved the degree of HLA matching and increased the exchange of organs, without a significant increase in the CIT and any detrimental effect on graft survival.

  11. HLA Match Likelihoods for Hematopoietic Stem-Cell Grafts in the U.S. Registry

    Science.gov (United States)

    Gragert, Loren; Eapen, Mary; Williams, Eric; Freeman, John; Spellman, Stephen; Baitty, Robert; Hartzman, Robert; Rizzo, J. Douglas; Horowitz, Mary; Confer, Dennis; Maiers, Martin

    2018-01-01

    Background Hematopoietic stem-cell transplantation (HSCT) is a potentially lifesaving therapy for several blood cancers and other diseases. For patients without a suitable related HLA-matched donor, unrelated-donor registries of adult volunteers and banked umbilical cord–blood units, such as the Be the Match Registry operated by the National Marrow Donor Program (NMDP), provide potential sources of donors. Our goal in the present study was to measure the likelihood of finding a suitable donor in the U.S. registry. Methods Using human HLA data from the NMDP donor and cord-blood-unit registry, we built population-based genetic models for 21 U.S. racial and ethnic groups to predict the likelihood of identifying a suitable donor (either an adult donor or a cord-blood unit) for patients in each group. The models incorporated the degree of HLA matching, adult-donor availability (i.e., ability to donate), and cord-blood-unit cell dose. Results Our models indicated that most candidates for HSCT will have a suitable (HLA-matched or minimally mismatched) adult donor. However, many patients will not have an optimal adult donor — that is, a donor who is matched at high resolution at HLA-A, HLA-B, HLA-C, and HLA-DRB1. The likelihood of finding an optimal donor varies among racial and ethnic groups, with the highest probability among whites of European descent, at 75%, and the lowest probability among blacks of South or Central American descent, at 16%. Likelihoods for other groups are intermediate. Few patients will have an optimal cord-blood unit — that is, one matched at the antigen level at HLA-A and HLA-B and matched at high resolution at HLA-DRB1. However, cord-blood units mismatched at one or two HLA loci are available for almost all patients younger than 20 years of age and for more than 80% of patients 20 years of age or older, regardless of racial and ethnic background. Conclusions Most patients likely to benefit from HSCT will have a donor. Public investment in

  12. In patients older than 55 years with AML in first CR, should we search for a matched unrelated donor when an old sibling donor is available?

    DEFF Research Database (Denmark)

    Peffault de Latour, R; Labopin, M; Cornelissen, J

    2015-01-01

    Allogeneic hematopoietic transplantation is increasingly used in patients aged 55 years or more with AML. The question of whether outcomes can be improved with an allele-level 8/8 HLA-matched unrelated donor (MUD) rather than an older HLA-matched sibling (MSD, more than 55 years) is still...... unanswered. We thus analyzed outcomes in 714 patients aged 55 years and older with AML in first CR (CR1) who received PBSCs after a reduced-intensity conditioning hematopoietic cell transplant from a MUD (n=310) or a MSD (n=404) in a recent period (2005-2010). The 3-year cumulative incidences (CIs) of non......-relapse mortality were 17% and 23% with MSD and MUD, respectively (P=0.17). The 3-year CIs of relapse were 37% and 30%, respectively (P=0.12), resulting in a 3-year CI of leukemia-free survival of 46% and 47%, respectively (P=0.51). The 3-year overall survival was 49% with both MSD and MUD. In conclusion, HLA...

  13. HLA Matching at the Eplet Level Protects Against Chronic Lung Allograft Dysfunction.

    Science.gov (United States)

    Walton, D C; Hiho, S J; Cantwell, L S; Diviney, M B; Wright, S T; Snell, G I; Paraskeva, M A; Westall, G P

    2016-09-01

    Donor selection in lung transplantation (LTx) is historically based upon clinical urgency, ABO compatibility, and donor size. HLA matching is not routinely considered; however, the presence or later development of anti-HLA antibodies is associated with poorer outcomes, particularly chronic lung allograft dysfunction (CLAD). Using eplet mismatches, we aimed to determine whether donor/recipient HLA incompatibility was a significant predictor of CLAD. One hundred seventy-five LTx undertaken at the Alfred Hospital between 2008 and 2012 met criteria. Post-LTx monitoring was continued for at least 12 months, or until patient death. HLA typing was performed by sequence-based typing and Luminex sequence-specific oligonucleotide. Using HLAMatchmaker, eplet mismatches between each donor/recipient pairing were analyzed and correlated against incidences of CLAD. HLA-DRB1/3/4/5+DQA/B eplet mismatch was a significant predictor of CLAD (hazard ratio [HR] 3.77, 95% confidence interval [CI]: 1.71-8.29 p HLA-DRB1/3/4/5 + DQA/B eplet mismatch was shown to significantly predict RAS (HR 8.3, 95% CI: 2.46-27.97 p HLA-A/B eplet mismatch was shown not to be a significant predictor when analyzed independently but did provide additional stratification of results. This study illustrates the importance of epitope immunogenicity in defining donor-recipient immune compatibility in LTx. © Copyright 2016 The American Society of Transplantation and the American Society of Transplant Surgeons.

  14. [Preimplantation genetic diagnosis in order to choose a saviour sibling].

    Science.gov (United States)

    Shenfield, F

    2005-10-01

    Preimplantation genetic diagnosis with HLA matching in order to bring about the birth of a saviour sibling is not mere instrumentalisation of the future child, as long as the post natal test is used and the future child will be looked after with the same love and care as if he/she had not been selected as well for the purpose.

  15. Degree of Predicted Minor Histocompatibility Antigen Mismatch Correlates with Poorer Clinical Outcomes of Nonmyeloablative Allogeneic Hematopoietic Cell Transplantation

    DEFF Research Database (Denmark)

    Larsen, Malene Erup; Kornblit, B; Larsen, Mette Voldby

    2010-01-01

    In fully HLA-matched allogeneic hematopoietic cell transplantations (HCT), the main mechanism of the beneficial graft-versus-tumor (GVT) effect and of the detrimental graft-versus-host disease (GVHD) is believed to be caused by donor cytotoxic T cells directed against disparate recipient minor hi...

  16. Dynamical System Modeling to Simulate Donor T Cell Response to Whole Exome Sequencing-Derived Recipient Peptides Demonstrates Different Alloreactivity Potential in HLA-Matched and -Mismatched Donor-Recipient Pairs.

    Science.gov (United States)

    Abdul Razzaq, Badar; Scalora, Allison; Koparde, Vishal N; Meier, Jeremy; Mahmood, Musa; Salman, Salman; Jameson-Lee, Max; Serrano, Myrna G; Sheth, Nihar; Voelkner, Mark; Kobulnicky, David J; Roberts, Catherine H; Ferreira-Gonzalez, Andrea; Manjili, Masoud H; Buck, Gregory A; Neale, Michael C; Toor, Amir A

    2016-05-01

    Immune reconstitution kinetics and subsequent clinical outcomes in HLA-matched recipients of allogeneic stem cell transplantation (SCT) are variable and difficult to predict. Considering SCT as a dynamical system may allow sequence differences across the exomes of the transplant donors and recipients to be used to simulate an alloreactive T cell response, which may allow better clinical outcome prediction. To accomplish this, whole exome sequencing was performed on 34 HLA-matched SCT donor-recipient pairs (DRPs) and the nucleotide sequence differences translated to peptides. The binding affinity of the peptides to the relevant HLA in each DRP was determined. The resulting array of peptide-HLA binding affinity values in each patient was considered as an operator modifying a hypothetical T cell repertoire vector, in which each T cell clone proliferates in accordance with the logistic equation of growth. Using an iterating system of matrices, each simulated T cell clone's growth was calculated with the steady-state population being proportional to the magnitude of the binding affinity of the driving HLA-peptide complex. Incorporating competition between T cell clones responding to different HLA-peptide complexes reproduces a number of features of clinically observed T cell clonal repertoire in the simulated repertoire, including sigmoidal growth kinetics of individual T cell clones and overall repertoire, Power Law clonal frequency distribution, increase in repertoire complexity over time with increasing clonal diversity, and alteration of clonal dominance when a different antigen array is encountered, such as in SCT. The simulated, alloreactive T cell repertoire was markedly different in HLA-matched DRPs. The patterns were differentiated by rate of growth and steady-state magnitude of the simulated T cell repertoire and demonstrate a possible correlation with survival. In conclusion, exome wide sequence differences in DRPs may allow simulation of donor alloreactive T

  17. Serum sCD30 in monitoring of alloresponse in well HLA-matched cadaveric kidney transplantations.

    Science.gov (United States)

    Matinlauri, Irma H; Kyllönen, Lauri E J; Salmela, Kaija T; Helin, Heikki; Pelzl, Steffen; Süsal, Caner

    2005-12-27

    In kidney transplantation, pretransplant serum sCD30 testing has been proposed in immunological risk estimation together with anti-HLA antibodies. We evaluated the risks associated with high pretransplant serum sCD30 in well HLA-matched cadaveric kidney recipients recruited in a clinical study comparing different immunosuppressive regimens. Rejection rate was similar in 37 recipients with high pretransplant serum sCD30 compared to 117 recipients with low serum sCD30 (16% vs. 15%, P=NS). Compared to pretransplant levels, the posttransplant sCD30 levels generally decreased, also in patients with rejection, although on day 21 posttransplant, rejecting patients had significantly higher relative sCD30 than nonrejecting patients (PsCD30 levels. High pretransplant sCD30 values were associated with tubulointerstitial rejection. There was no correlation of sCD30 with delayed graft function. Good HLA matching seems to be effective in neutralizing the negative effect of a high pretransplant serum sCD30.

  18. The Privilege of Induction Avoidance and Calcineurin Inhibitors Withdrawal in 2 Haplotype HLA Matched White Kidney Transplantation.

    Science.gov (United States)

    Brifkani, Zaid; Brennan, Daniel C; Lentine, Krista L; Horwedel, Timothy A; Malone, Andrew F; Delos Santos, Rowena; Maw, Thin Thin; Alhamad, Tarek

    2017-03-01

    White recipients of 2-haplotype HLA-matched living kidney transplants are perceived to be of low immunologic risk. Little is known about the safety of induction avoidance and calcineurin inhibitor withdrawal in these patients. We reviewed our experience at a single center and compared it to Organ Procurement and Transplantation Network (OPTN) registry data and only included 2-haplotype HLA-matched white living kidney transplants recipients between 2000 and 2013. There were 56 recipients in a single center (where no induction was given) and 2976 recipients in the OPTN. Among the OPTN recipients, 1285 received no induction, 903 basiliximab, 608 thymoglobulin, and 180 alemtuzumab. First-year acute rejection rates were similar after induction-free transplantation among the center and induced groups nationally. Compared with induction-free transplantation in the national data, there was no decrease in graft failure risk over 13 years with use of basiliximab (adjusted hazard ratio [aHR], 0.86; confidence interval [CI], 0.68-1.08), Thymoglobulin (aHR, 0.92; CI, 0.7-1.21) or alemtuzumab (aHR, 1.18; CI, 0.72-1.93). Among induction-free recipients at the center, calcineurin inhibitor withdrawal at 1 year (n = 27) did not significantly impact graft failure risk (HR,1.62; CI, 0.38-6.89). This study may serve as a foundation for further studies to provide personalized, tailored, immunosuppression for this very low-risk population of kidney transplant patients.

  19. The impact of center experience on results of reduced intensity:allogeneic hematopoietic SCT for AML. An analysis from the Acute Leukemia Working Party of the EBMT

    DEFF Research Database (Denmark)

    Giebel, S; Labopin, M; Mohty, M

    2013-01-01

    Allogeneic hematopoietic SCT with reduced-intensity conditioning (RIC-HSCT) is increasingly adopted for the treatment of older adults with AML. Our goal was to verify for the first time, if center experience influences outcome of RIC-HSCT. Results of 1413 transplantations from HLA-matched related...

  20. Combined HLA matched limbal stem cells allograft with amniotic membrane transplantation as a prophylactic surgical procedure to prevent corneal graft rejection after penetrating keratoplasty: case report

    Directory of Open Access Journals (Sweden)

    Paolo Capozzi

    2014-09-01

    Full Text Available Purpose. To determine if the use of combined HLA matched limbal stem cells allograft with amniotic membrane transplantation (AMT is a safe and effective prophylactic surgical procedure to prevent corneal graft after penetrating keratoplasty (PK. Methods. We report the case of a 17 years old patient with a history of congenital glaucoma, trabeculectomy and multiple corneal graft rejections, presenting total limbal cell deficiency. To reduce the possibility of graft rejection in the left eye after a new PK, a two step procedure was performed. At first the patient underwent a combined HLA matched limbal stem cells allograft (LAT and AMT and then, 10 months later, a new PK. Results. During 12 months of follow-up, the corneal graft remained stable and smooth, with no sign of graft rejection. Conclusions. In our patient, the prophylactic use of LAT from HLA-matched donors and AMT before PK, may result in a better prognosis of corneal graft survival.

  1. Baseline Characteristics Predicting Very Good Outcome of Allogeneic Hematopoietic Cell Transplantation in Young Patients With High Cytogenetic Risk Chronic Lymphocytic Leukemia - A Retrospective Analysis From the Chronic Malignancies Working Party of the EBMT.

    Science.gov (United States)

    van Gelder, Michel; Ziagkos, Dimitris; de Wreede, Liesbeth; van Biezen, Anja; Dreger, Peter; Gramatzki, Martin; Stelljes, Matthias; Andersen, Niels Smedegaard; Schaap, Nicolaas; Vitek, Antonin; Beelen, Dietrich; Lindström, Vesa; Finke, Jürgen; Passweg, Jacob; Eder, Matthias; Machaczka, Maciej; Delgado, Julio; Krüger, William; Raida, Luděk; Socié, Gerard; Jindra, Pavel; Afanasyev, Boris; Wagner, Eva; Chalandon, Yves; Henseler, Anja; Schoenland, Stefan; Kröger, Nicolaus; Schetelig, Johannes

    2017-10-01

    Patients with genetically high-risk relapsed/refractory chronic lymphocytic leukemia have shorter median progression-free survival (PFS) with kinase- and BCL2-inhibitors (KI, BCL2i). Allogeneic hematopoietic stem cell transplantation (alloHCT) may result in sustained PFS, especially in younger patients because of its age-dependent non-relapse mortality (NRM) risk, but outcome data are lacking for this population. Risk factors for 2-year NRM and 8-year PFS were identified in patients < 50 years in an updated European Society for Blood and Marrow Transplantation registry cohort (n = 197; median follow-up, 90.4 months) by Cox regression modeling, and predicted probabilities of NRM and PFS of 2 reference patients with favorable or unfavorable characteristics were plotted. Predictors for poor 8-year PFS were no remission at the time of alloHCT (hazard ratio [HR], 1.7; 95% confidence interval [CI], 1.1-2.5) and partially human leukocyte antigen (HLA)-mismatched unrelated donor (HR, 2.8; 95% CI, 1.5-5.2). The latter variable also predicted a higher risk of 2-year NRM (HR, 4.0; 95% CI, 1.4-11.6) compared with HLA-matched sibling donors. Predicted 2-year NRM and 8-year PFS of a high cytogenetic risk (del(17p) and/or del(11q)) patient in remission with a matched related donor were 12% (95% CI, 3%-22%) and 54% (95% CI, 38%-69%), and for an unresponsive patient with a female partially HLA-matched unrelated donor 37% (95% CI, 12%-62%) and 38% (95% CI, 13%-63%). Low predicted NRM and high 8-year PFS in favorable transplant high cytogenetic risk patients compares favorably with outcomes with KI or BCL2i. Taking into account the amount of uncertainty for predicting survival after alloHCT and after sequential administration of KI and BCL2i, alloHCT remains a valid option for younger patients with high cytogenetic risk chronic lymphocytic leukemia with a well-HLA-matched donor. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Relapsed Diffuse Large B-Cell Lymphoma Treated by Reduced-Intensity Allogeneic Stem Cell Transplantation with Donor Lymphocyte Infusion

    International Nuclear Information System (INIS)

    Chudhry, Q.N.; Ahmed, P.; Ullah, K.; Satti, T.M.; Raza, S.; Mehmood, S.K.; Akram, M.; Ahmed, S.

    2010-01-01

    A 42 years old male with relapsed diffuse large B-cell lymphoma was given second-line chemotherapy followed by reduced intensity allogeneic stem cell transplantation from HLA matched brother. Twelve weeks post transplant, his disease relapsed evidenced by the appearance of lymphoma cells in the peripheral blood and declining donor chimerism. Donor lymphocyte infusion was given that induced complete lymphoma remission. The patient is well 3 years post transplant with his disease in complete remission. (author)

  3. No improvement of survival with reduced- versus high-intensity conditioning for allogeneic stem cell transplants in Ewing tumor patients

    OpenAIRE

    Thiel, U.; Wawer, A.; Wolf, P.; Badoglio, M.; Santucci, A.; Klingebiel, T.; Basu, O.; Borkhardt, A.; Laws, H.-J; Kodera, Y.; Yoshimi, A.; Peters, C.; Ladenstein, R.; Pession, A.; Prete, A.

    2017-01-01

    Background: Outcomes of Ewing tumor (ET) patients treated with allogeneic stem cell transplantation (allo-SCT) were compared regarding the use of reduced-intensity conditioning (RIC) and high-intensity conditioning (HIC) regimens as well as human leukocyte antigen (HLA)-matched and HLA-mismatched grafts. Patients and methods: We retrospectively analyzed data of 87 ET patients from the European Group for Blood and Marrow Transplantation, Pediatric Registry for Stem Cell Transplantations, Asia ...

  4. Outcomes of Children with Hemophagocytic Lymphohistiocytosis Given Allogeneic Hematopoietic Stem Cell Transplantation in Italy.

    Science.gov (United States)

    Messina, Chiara; Zecca, Marco; Fagioli, Franca; Rovelli, Attilio; Giardino, Stefano; Merli, Pietro; Porta, Fulvio; Aricò, Maurizio; Sieni, Elena; Basso, Giuseppe; Ripaldi, Mimmo; Favre, Claudio; Pillon, Marta; Marzollo, Antonio; Rabusin, Marco; Cesaro, Simone; Algeri, Mattia; Caniglia, Maurizio; Di Bartolomeo, Paolo; Ziino, Ottavio; Saglio, Francesco; Prete, Arcangelo; Locatelli, Franco

    2018-06-01

    We report on 109 patients with hemophagocytic lymphohistiocytosis (HLH) undergoing 126 procedures of allogeneic hematopoietic stem cell transplantation (HSCT) between 2000 and 2014 in centers associated with the Italian Pediatric Hematology Oncology Association. Genetic diagnosis was FHL2 (32%), FHL3 (33%), or other defined disorders known to cause HLH (15%); in the remaining patients no genetic abnormality was found. Donor for first transplant was an HLA-matched sibling for 25 patients (23%), an unrelated donor for 73 (67%), and an HLA-partially matched family donor for 11 children (10%). Conditioning regimen was busulfan-based for 61 patients (56%), treosulfan-based for 21 (20%), and fludarabine-based for 26 children (24%). The 5-year probabilities of overall survival (OS) and event-free survival (EFS) were 71% and 60%, respectively. Twenty-six patients (24%) died due to transplant-related causes, whereas 14 (13%) and 10 (9%) patients experienced graft rejection and/or relapse, respectively. Twelve of 14 children given a second HSCT after graft failure/relapse are alive and disease-free. Use of HLA-partially matched family donors was associated with higher risk of graft failure and thus with lower EFS (but not with lower OS) in multivariable analysis. Active disease at transplantation did not significantly affect prognosis. These data confirm that HSCT can cure most HLH patients, active disease not precluding successful transplantation. Because in HLH patients HLA-haploidentical HSCT performed through CD34 + cell positive selection was found to be associated with poor sustained engraftment of donor cells, innovative approaches able to guarantee a more robust engraftment are warranted in patients given this type of allograft. Copyright © 2018 The American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

  5. Selective Depletion of CD45RA+ T Cells From Allogeneic Peripheral Blood Stem Cell Grafts From HLA-Matched Related and Unrelated Donors in Preventing GVHD

    Science.gov (United States)

    2017-10-25

    Accelerated Phase Chronic Myelogenous Leukemia, BCR-ABL1 Positive; Acute Biphenotypic Leukemia; Acute Leukemia of Ambiguous Lineage; Acute Undifferentiated Leukemia; Adult Acute Lymphoblastic Leukemia in Remission; Adult Acute Myeloid Leukemia in Remission; Blast Phase Chronic Myelogenous Leukemia, BCR-ABL1 Positive; Blastic Plasmacytoid Dendritic Cell Neoplasm; Childhood Acute Lymphoblastic Leukemia in Remission; Childhood Acute Myeloid Leukemia in Remission; Lymphoblastic Lymphoma; Myelodysplastic Syndrome With Excess Blasts; Myelodysplastic Syndrome With Excess Blasts-1; Myelodysplastic Syndrome With Excess Blasts-2; Recurrent Adult Acute Lymphoblastic Leukemia; Recurrent Adult Acute Myeloid Leukemia; Recurrent Childhood Acute Lymphoblastic Leukemia; Recurrent Childhood Acute Myeloid Leukemia; Recurrent Chronic Myelogenous Leukemia, BCR-ABL1 Positive; Refractory Acute Lymphoblastic Leukemia; Refractory Acute Myeloid Leukemia

  6. A Comparative Reference Study for the Validation of HLA-Matching Algorithms in the Search for Allogeneic Hematopoietic Stem Cell Donors and Cord Blood Units

    Science.gov (United States)

    2016-08-15

    donors and cord blood units W. Bochtler1, L. Gragert2, Z. I. Patel3, J. Robinson3,4, D. Steiner5, J. A. Hofmann6, J. Pingel6, A. Baouz7, A. Melis8, J...cord blood units for individual patients is of primary importance. This challenging search process is routinely performed in a donor registry or cord...term ‘ donor ’ to refer to donors of HSCs from bone marrow or peripheral blood and cord blood units and the term ‘ donor registry’ shall include cord blood

  7. Donor cytomegalovirus status influences the outcome of allogeneic stem cell transplant: a study by the European group for blood and marrow transplantation.

    Science.gov (United States)

    Ljungman, Per; Brand, Ronald; Hoek, Jennifer; de la Camara, Rafael; Cordonnier, Catherine; Einsele, Hermann; Styczynski, Jan; Ward, Katherine N; Cesaro, Simone

    2014-08-15

    The use of a cytomegalovirus (CMV)-seronegative donor for a CMV-seronegative allogeneic hematopoietic stem cell transplant (HSCT) recipient is generally accepted. However, the importance of donor serostatus in CMV-seropositive patients is controversial. A total of 49 542 HSCT patients, 29 349 seropositive and 20 193 seronegative, were identified from the European Group for Blood and Marrow Transplantation database. Cox multivariate models were fitted to estimate the effect of donor CMV serological status on outcome. Seronegative patients receiving seropositive unrelated-donor grafts had decreased overall survival (hazard ratio [HR], 1.13; 95% confidence interval [CI], 1.06-1.21; P donors, whereas no difference was seen in patients receiving HLA-matched sibling grafts. Seropositive patients receiving grafts from seropositive unrelated donors had improved overall survival (HR, 0.92; 95% CI, .86-.98; P donors, if they had received myeloablative conditioning. This effect was absent when they received reduced-intensity conditioning. No effect was seen in patients grafted from HLA-identical sibling donors. The same association was found if the study was limited to patients receiving transplants from the year 2000 onward. We confirm the negative impact on overall survival if a CMV-seropositive unrelated donor is selected for a CMV-seronegative patient. For a CMV-seropositive patient, our data support selecting a CMV-seropositive donor if the patient receives a myeloablative conditioning regimen. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  8. Distinct Biomarker Profiles in Ex Vivo T Cell Depletion Graft Manipulation Strategies: CD34+ Selection versus CD3+/19+ Depletion in Matched Sibling Allogeneic Peripheral Blood Stem Cell Transplantation.

    Science.gov (United States)

    Cantilena, Caroline R; Ito, Sawa; Tian, Xin; Jain, Prachi; Chinian, Fariba; Anandi, Prathima; Keyvanfar, Keyvan; Draper, Debbie; Koklanaris, Eleftheria; Hauffe, Sara; Superata, Jeanine; Stroncek, David; Muranski, Pawel; Barrett, A John; Battiwalla, Minoo

    2018-03-01

    Various approaches have been developed for ex vivo T cell depletion in allogeneic stem cell transplantation to prevent graft-versus-host disease (GVHD). Direct comparisons of T cell depletion strategies have not been well studied, however. We evaluated cellular and plasma biomarkers in 2 different graft manipulation strategies, CD3 + CD19 + cell depletion (CD3/19D) versus CD34 + selection (CD34S), and their associations with clinical outcomes. Identical conditions, including the myeloablative preparative regimen, HLA-identical sibling donor, GVHD prophylaxis, and graft source, were used in the 2 cohorts. Major clinical outcomes were similar in the 2 groups in terms of overall survival, nonrelapse mortality, and cumulative incidence of relapse; however, the cumulative incidence of acute GVHD trended to be higher in the CD3/19D cohort compared with the CD34S cohort. A distinct biomarker profile was noted in the CD3/19D cohort: higher levels of ST2, impaired Helios - FoxP3 + Treg reconstitution, and rapid reconstitution of naïve, Th2, and Th17 CD4 cells in the early post-transplantation period. In vitro graft replication studies confirmed that CD3/19D disproportionately depleted Tregs and other CD4 subset repertoires in the graft. This study confirms the utility of biomarker monitoring, which can be directly correlated with biological consequences and possible future therapeutic indications. Published by Elsevier Inc.

  9. RANTES polymorphisms and the risk of graft-versus-host disease in human leukocyte antigen-matched sibling allogeneic hematopoietic stem cell transplantation.

    Science.gov (United States)

    Shin, Dong-Yeop; Kim, Inho; Kim, Jin Hee; Lee, Yun-Gyoo; Kang, Eun Joo; Cho, Hyeon Jin; Lee, Kyung-Hun; Kim, Hye Jin; Park, Eun-Hee; Lee, Jong-Eun; Bae, Ji-Yeon; See, Cha Ja; Yoon, Sung-Soo; Park, Sung Sup; Han, Kyou-Sup; Park, Myoung Hee; Hong, Yun-Chul; Park, Seonyang; Kim, Byoung Kook

    2013-01-01

    We investigated the association between RANTES (regulated upon activation, normal T cell expressed and secreted) polymorphisms and clinical outcomes in patients treated with allogeneic hematopoietic stem cell transplantation (allo-HSCT). Three RANTES gene polymorphisms, i.e., -403G/A (rs2107538), -28C/G (rs2280788) and In1.1T/C (rs2280789), were genotyped, and the effects of the genotypes and haplotypes of RANTES on clinical outcomes were analyzed. The competing risk regression analysis was used to investigate the relationship between the polymorphisms and the cumulative risk of graft-versus-host disease (GVHD). An AGC haplotype in a recessive model showed significant harmful effects on the cumulative risk of acute GVHD and relapse-free survival (adjusted hazard ratios 2.42 and 2.71, 95% confidence intervals 1.29-4.55 and 1.30-5.64; p = 0.018 and 0.024, respectively), whereas a GCT haplotype did not. RANTES polymorphisms were not significantly associated with overall survival and the risk of chronic GVHD. This study suggests that RANTES polymorphisms might be associated with the occurrence of acute GVHD rather than of chronic GVHD and also of relapse-free survival in the patients treated with allo-HSCT. Further larger prospective investigations are needed to establish the role of RANTES polymorphisms in patients treated with allo-HSCT. Copyright © 2012 S. Karger AG, Basel.

  10. BK Virus-Hemorrhagic Cystitis Following Allogeneic Stem Cell Transplantation: Clinical Characteristics and Utility of Leflunomide Treatment

    Directory of Open Access Journals (Sweden)

    Young Hoon Park

    2016-08-01

    Full Text Available Objective: BK virus-hemorrhagic cystitis (BKV-HC is a potential cause of morbidity and mortality in patients having undergone allogeneic stem cell transplantation (Allo-SCT. We analyzed the clinical features of BKV-HC following Allo-SCT and reported the utility of leflunomide therapy for BKV-HC. Materials and methods: From January 2005 to June 2014, among the 69 patients underwent Allo-SCT in our institution, the patients who experienced BKV-HC were investigated retrospectively. Results: Hemorrhagic cystitis (HC was observed in 30 patients (43.5%, and among them, 18 patients (26.1% were identified as BKV-HC. The median age of the patients (12 males and 6 females was 45 years (range, 13-63. Patients received Allo-SCT from acute myeloid leukemia (n=11, aplastic anemia (n=4, myelodysplastic syndrome (n=2, and non-Hodgkin lymphoma (n=1.The donor types were a HLA-matched sibling donor for 6 patients, HLA-matched unrelated donor for 9, and a haploidentical familial donor for 2. The median onset and duration of BKV-HC was on day 21 (range, 7-97 after transplantation and 22 days (range, 6-107. Eleven patients (62.1% had grade I-II HC and seven patients (38.9% had grade III-IV (high-grade HC. Among the seven patients who had high-grade HC, one had complete response (CR, one partial response (PR, and five no response (NR. Among the five non-responders, one died of BKV-HC associated complications. The remaining four patients were treated with leflunomide, with achieving CR (n=2 and PR (n=2. The median duration from the start of leflunomide therapy to response was 13 days (range, 8–17 days. All patients tolerated the leflunomide treatment well, with three patients having mild gastrointestinal symptoms, including anorexia and abdominal bloating. Conclusion: BKV-HC was commonly observed in patients with HC following Allo-SCT. In high-grade BKV-HC patients who fail supportive care, leflunomide may be a feasible option without significant toxicity. Materials

  11. Tacrolimus and mycophenolate mofetil after nonmyeloablative matched-sibling donor allogeneic stem-cell transplantations conditioned with fludarabine and low-dose total body irradiation.

    Science.gov (United States)

    Nieto, Yago; Patton, Nigel; Hawkins, Timothy; Spearing, Ruth; Bearman, Scott I; Jones, Roy B; Shpall, Elizabeth J; Rabinovitch, Rachel; Zeng, Chan; Barón, Anna; McSweeney, Peter A

    2006-02-01

    We evaluated tacrolimus/mycophenolate mofetil (MMF) for graft-versus-host disease (GVHD) prophylaxis after a nonmyeloablative stem cell transplantation (NST) from a matched sibling donor (MSD). Thirty-two patients (median age, 57 years) with advanced hematologic malignancies, who were poor candidates for a conventional myeloablative transplantation, received fludarabine (30 mg/m(2), day -4 to day -2), total-body irradiation (TBI) (200 cGy, day 0), infusion of donor peripheral blood progenitor cells (day 0), oral tacrolimus 0.06 mg/kg twice daily (from day 3), and oral MMF at 15 mg/kg twice daily (days 0-+27). Tacrolimus was tapered from day +100 to day +180 in those patients with indolent malignancies (n = 25), and from day +35 to day +56 in those with aggressive tumors (n = 7). Regimen toxicities and myelosuppression were mild, allowing 75% of patients to have entirely outpatient transplantations. One patient (3%) experienced a nonfatal graft rejection. Rates of grades II-IV and III-IV acute GVHD were 15.6% and 3%, respectively. Acute GVHD was diagnosed at median day +78 (range, days +31-+84). Extensive chronic GVHD was observed in 10 of 24 evaluable patients (41.6%) at a median onset of day +198 (range, days +128-+277), either spontaneously (n = 5) or elicited after tumor progression (n = 5). Five patients experienced transplantation-related mortality (TRM) (15.6%) from either acute GVHD-related multiorgan failure (MOF) (n = 3) or infectious complications (n = 2). At median follow-up of 19 months (range, 2-41 months), the overall survival, progression-free survival, and disease-free survival rates are 62.5%, 50%, and 40%, respectively. In conclusion, the use of tacrolimus/MMF after MSD NST is associated with encouraging rates of GVHD control.

  12. Homozygous HLA-C1 is Associated with Reduced Risk of Relapse after HLA-Matched Transplantation in Patients with Myeloid Leukemia.

    Science.gov (United States)

    Arima, Nobuyoshi; Kanda, Junya; Tanaka, Junji; Yabe, Toshio; Morishima, Yasuo; Kim, Sung-Won; Najima, Yuho; Ozawa, Yukiyasu; Eto, Tetsuya; Kanamori, Heiwa; Mori, Takehiko; Kobayashi, Naoki; Kondo, Tadakazu; Nakamae, Hirohisa; Uchida, Naoyuki; Inoue, Masami; Fukuda, Takahiro; Ichinohe, Tatsuo; Atsuta, Yoshiko; Kanda, Yoshinobu

    2018-04-01

    Natural killer (NK) cells assume graft-versus-leukemia alloreactivity after hematopoietic stem cell transplantation (HSCT) through their inhibitory killer cell immunoglobulin-like receptors (KIRs). KIR2D family members recognize HLA-C alleles with Asn80 (HLA-C1) or Lys80 (HLA-C2). The predominance of HLA-C1 over HLA-C2 and the frequent presence of KIR2DL1 are characteristic of Japanese people. We compared clinical outcomes among homozygous HLA-C1 (HLA-C1/C1) patients and heterozygous HLA-C1/C2 patients who underwent HLA-matched HSCT for hematologic malignancies by assessing the data of 10,638 patients from the Japanese national registry. HLA-C1/C1 recipients had a lower rate of relapse than HLA-C1/C2 recipients after transplantation for acute myelogenous leukemia (AML) (hazard ratio [HR], .79; P = .006) and chronic myelogenous leukemia (CML) (HR, .48; P = .025), but not for acute lymphoblastic leukemia (HR, 1.36), lymphoma (HR, .97), or low-grade myelodysplastic syndrome (HR, 1.40). We then grouped AML and CML patients together and divided them into several subgroups. Advantages of HLA-C1/C1 recipients over HLA-C1/C2 recipients regarding relapse were observed irrespective of donor relation (related: HR, .79, P = .069; unrelated: HR, .77, P = .022), preparative regimen (myeloablative: HR, .79, P = .014; reduced intensity: HR, .73, P = .084), and occurrence of acute graft-versus-host disease (yes: HR, .70, P = .122; no, HR .71, P = .026) or cytomegalovirus reactivation (reactivated: HR .67,P = .054; nonreactivated: HR .71, P = .033); however, these advantages were not observed in recipients with a delay in achieving complete chimerism (HR, 1.06). The advantage of decreasing relapse and extending relapse-free survival of C1/1 over C1/2 KIR-ligand status was most pronounced in T cell-depleted HSCT (HR, .27; P < .001 and HR, .30; P = .002, respectively) and in children age <15 years (HR, .29; P < .001 and HR .31; P

  13. Association of Macroeconomic Factors With Nonrelapse Mortality After Allogeneic Hematopoietic Cell Transplantation for Adults With Acute Lymphoblastic Leukemia: An Analysis From the Acute Leukemia Working Party of the EBMT.

    Science.gov (United States)

    Giebel, Sebastian; Labopin, Myriam; Ibatici, Adalberto; Browne, Paul; Czerw, Tomasz; Socie, Gerard; Unal, Ali; Kyrcz-Krzemien, Slawomira; Bacigalupo, Andrea; Goker, Hakan; Potter, Mike; Furness, Caroline L; McQuaker, Grant; Beelen, Dietrich; Milpied, Noel; Campos, Antonio; Craddock, Charles; Nagler, Arnon; Mohty, Mohamad

    2016-03-01

    From a global perspective, the rates of allogeneic hematopoietic cell transplantation (alloHCT) are closely related to the economic status of a country. However, a potential association with outcome has not yet been documented. The goal of this study was to evaluate effects of health care expenditure (HCE), Human Development Index (HDI), team density, and center experience on nonrelapse mortality (NRM) after HLA-matched sibling alloHCT for adults with acute lymphoblastic leukemia (ALL). A total of 983 patients treated with myeloablative alloHCT between 2004 and 2008 in 24 European countries were included. In a univariate analysis, the probability of day 100 NRM was increased for countries with lower current HCE (8% vs. 3%; p = .06), countries with lower HDI (8% vs. 3%; p = .02), and centers with less experience (8% vs. 5%; p = .04). In addition, the overall NRM was increased for countries with lower current HCE (21% vs. 17%; p = .09) and HDI (21% vs. 16%; p = .03) and for centers with lower activity (21% vs. 16%; p = .07). In a multivariate analysis, the strongest predictive model for day 100 NRM included current HCE greater than the median (hazard ratio [HR], 0.39; p = .002). The overall NRM was mostly predicted by HDI greater than the median (HR, 0.65; p = .01). Both lower current HCE and HDI were associated with decreased probability of overall survival. Both macroeconomic factors and the socioeconomic status of a country strongly influence NRM after alloHCT for adults with ALL. Our findings should be considered when clinical studies in the field of alloHCT are interpreted. ©AlphaMed Press.

  14. Modulation of human allogeneic and syngeneic pluripotent stem cells and immunological implications for transplantation.

    Science.gov (United States)

    Sackett, S D; Brown, M E; Tremmel, D M; Ellis, T; Burlingham, W J; Odorico, J S

    2016-04-01

    Tissues derived from induced pluripotent stem cells (iPSCs) are a promising source of cells for building various regenerative medicine therapies; from simply transplanting cells to reseeding decellularized organs to reconstructing multicellular tissues. Although reprogramming strategies for producing iPSCs have improved, the clinical use of iPSCs is limited by the presence of unique human leukocyte antigen (HLA) genes, the main immunologic barrier to transplantation. In order to overcome the immunological hurdles associated with allogeneic tissues and organs, the generation of patient-histocompatible iPSCs (autologous or HLA-matched cells) provides an attractive platform for personalized medicine. However, concerns have been raised as to the fitness, safety and immunogenicity of iPSC derivatives because of variable differentiation potential of different lines and the identification of genetic and epigenetic aberrations that can occur during the reprogramming process. In addition, significant cost and regulatory barriers may deter commercialization of patient specific therapies in the short-term. Nonetheless, recent studies provide some evidence of immunological benefit for using autologous iPSCs. Yet, more studies are needed to evaluate the immunogenicity of various autologous and allogeneic human iPSC-derived cell types as well as test various methods to abrogate rejection. Here, we present perspectives of using allogeneic vs. autologous iPSCs for transplantation therapies and the advantages and disadvantages of each related to differentiation potential, immunogenicity, genetic stability and tumorigenicity. We also review the current literature on the immunogenicity of syngeneic iPSCs and discuss evidence that questions the feasibility of HLA-matched iPSC banks. Finally, we will discuss emerging methods of abrogating or reducing host immune responses to PSC derivatives. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Sibling Incest.

    Science.gov (United States)

    Phillips-Green, Mary J.

    2002-01-01

    Recently, sibling incest, a type of intrafamilial incest, has received notice from mental health professionals; however, many professionals still do not recognize the seriousness of the problem. This article reviews current research on the individual and family dynamics that allow sibling incest to occur, the effects of sibling incest on victims,…

  16. Thiotepa-based versus total body irradiation-based myeloablative conditioning prior to allogeneic stem cell transplantation for acute myeloid leukaemia in first complete remission: a retrospective analysis from the Acute Leukemia Working Party of the European Group for Blood and Marrow Transplantation.

    Science.gov (United States)

    Eder, Sandra; Labopin, Myriam; Arcese, William; Or, Reuven; Majolino, Ignazio; Bacigalupo, Andrea; de Rosa, Gennaro; Volin, Liisa; Beelen, Dietrich; Veelken, Hendrik; Schaap, Nicolaas P M; Kuball, Jurgen; Cornelissen, Jan; Nagler, Arnon; Mohty, Mohamad

    2016-01-01

    Thiotepa is an alkylating compound with an antineoplastic and myeloablative activity and can mimic the effect of radiation. However, it is unknown whether this new regimen could safely replace the long-established ones. This retrospective matched-pair analysis evaluated the outcome of adults with acute myeloid leukaemia in first complete remission who received myeloablative conditioning either with a thiotepa-based (n = 121) or a cyclophosphamide/total body irradiation-based (TBI; n = 358) regimen for allogeneic hematopoietic stem cell transplantation from an HLA-matched sibling or an unrelated donor. With a median follow-up of 44 months, the outcome was similar in both groups. Acute graft-versus-host disease grade II-IV was observed in 25% after thiotepa-containing regimen versus 35% after TBI (P = 0.06). The 2-yr cumulative incidence of chronic graft-versus-host disease was 40.5% for thiotepa and 41% for TBI (P = 0.98). At 2 yrs, the cumulative incidences of non-relapse mortality and relapse incidence were 23.9% (thiotepa) vs. 22.4% (TBI; P = 0.66) and 17.2% (thiotepa) vs. 23.3% (TBI; P = 0.77), respectively. The probabilities of leukaemia-free and overall survival at 2 yrs were not significantly different between the thiotepa and TBI groups, at 58.9% vs. 54.2% (P = 0.95) and 61.4% vs. 58% (P = 0.72), respectively. Myeloablative regimens using combinations including thiotepa can provide satisfactory outcomes, but the optimal conditioning remains unclear for the individual patient in this setting. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. Older Siblings Influence Younger Siblings' Motor Development

    Science.gov (United States)

    Berger, Sarah E.; Nuzzo, Katie

    2008-01-01

    Evidence exists for two competing theories about the effects of having an older sibling on development. Previous research has found that having an older sibling has both advantages and disadvantages for younger siblings' development. This study examined whether and how older siblings influenced the onset of their own younger siblings' motor…

  18. Preceding immunosuppressive therapy with antithymocyte globulin and ciclosporin increases the incidence of graft rejection in children with aplastic anaemia who underwent allogeneic bone marrow transplantation from HLA-identical siblings.

    Science.gov (United States)

    Kobayashi, Ryoji; Yabe, Hiromasa; Hara, Junichi; Morimoto, Akira; Tsuchida, Masahiro; Mugishima, Hideo; Ohara, Akira; Tsukimoto, Ichiro; Kato, Koji; Kigasawa, Hisato; Tabuchi, Ken; Nakahata, Tatsutoshi; Ohga, Shoichi; Kojima, Seiji

    2006-12-01

    The incidence of graft rejection was determined in 66 children with acquired aplastic anaemia (AA) following bone marrow transplantation (BMT) from a related donor. Eleven of 65 evaluable patients experienced either early or late rejection. Multivariate analysis identified previous immunosuppressive therapy with antithymocyte-globulin (ATG) and ciclosporin (CsA) as a risk factor for graft rejection (relative risk: 16.6, P = 0.001). Patients who received ATG and CsA had a significantly lower probability of failure-free survival than those who did not (69.7 +/- 6.2% vs. 87.9 +/- 8.0%, P = 0.044). These results suggest that BMT should be instituted immediately in children with severe AA who have human leucocyte antigen-identical siblings.

  19. Killer immunoglobulin-like receptor (KIR and HLA genotypes affect the outcome of allogeneic kidney transplantation.

    Directory of Open Access Journals (Sweden)

    Izabela Nowak

    Full Text Available BACKGROUND: Recipient NK cells may detect the lack of recipient's (i.e., self HLA antigens on donor renal tissue by means of their killer cell immunoglobulin-like receptors (KIRs. KIR genes are differently distributed in individuals, possibly contributing to differences in response to allogeneic graft. METHODOLOGY/PRINCIPAL FINDINGS: We compared frequencies of 10 KIR genes by PCR-SSP in 93 kidney graft recipients rejecting allogeneic renal transplants with those in 190 recipients accepting grafts and 690 healthy control individuals. HLA matching results were drawn from medical records. We observed associations of both a full-length KIR2DS4 gene and its variant with 22-bp deletion with kidney graft rejection. This effect was modulated by the HLA-B,-DR matching, particularly in recipients who did not have glomerulonephritis but had both forms of KIR2DS4 gene. In contrast, in recipients with glomerulonephritis, HLA compatibility seemed to be much less important for graft rejection than the presence of KIR2DS4 gene. Simultaneous presence of both KIR2DS4 variants strongly increased the probability of rejection. Interestingly, KIR2DS5 seemed to protect the graft in the presence of KIR2DS4fl but in the absence of KIR2DS4del. CONCLUSIONS/SIGNIFICANCE: Our results suggest a protective role of KIR2DS5 in graft rejection and an association of KIR2DS4 with kidney rejection, particularly in recipients with glomerulonephritis.

  20. Allogeneic tumor cell vaccines

    Science.gov (United States)

    Srivatsan, Sanjay; Patel, Jaina M; Bozeman, Erica N; Imasuen, Imade E; He, Sara; Daniels, Danielle; Selvaraj, Periasamy

    2014-01-01

    The high mortality rate associated with cancer and its resistance to conventional treatments such as radiation and chemotherapy has led to the investigation of a variety of anti-cancer immunotherapies. The development of novel immunotherapies has been bolstered by the discovery of tumor-associated antigens (TAAs), through gene sequencing and proteomics. One such immunotherapy employs established allogeneic human cancer cell lines to induce antitumor immunity in patients through TAA presentation. Allogeneic cancer immunotherapies are desirable in a clinical setting due to their ease of production and availability. This review aims to summarize clinical trials of allogeneic tumor immunotherapies in various cancer types. To date, clinical trials have shown limited success due potentially to extensive degrees of inter- and intra-tumoral heterogeneity found among cancer patients. However, these clinical results provide guidance for the rational design and creation of more effective allogeneic tumor immunotherapies for use as monotherapies or in combination with other therapies. PMID:24064957

  1. Kosten van allogene stamceltransplantaties

    NARCIS (Netherlands)

    M. van Agthoven (Michel); M.T. Groot (Martijn); C.A. Uyl-de Groot (Carin)

    2001-01-01

    textabstractAllogene stamceltransplantatie is een topspecialistische procedure die met succes kan worden ingezet in de behandeling van (hematologische) maligniteiten, met name bij leukemie. Van oudsher worden transplantaten van verwante donoren gebruikt, maar met de mogelijkheden om transplantaten

  2. "Saviour siblings".

    Science.gov (United States)

    Spriggs, M; Savulescu, J

    2002-10-01

    The Victorian Infertility Treatment Authority has given permission to allow tissue typing in combination with preimplantation genetic diagnosis. This is a new application of IVF. Not only will it allow parents to select an embryo free from serious genetic disease it will allow them to simultaneously select for a match so that the umbilical cord blood of the resulting baby can provide stem cells to treat an existing sibling who has a disease.

  3. Sibling negotiation

    OpenAIRE

    Rufus A. Johnstone; Alexandre Roulin

    2003-01-01

    Current discussions of offspring begging typically assume either that it is a signal directed at parents or that it represents a form of scramble competition to gain access to them. However, offspring might also display to inform nest mates that they will contest the next food item to be delivered; in other words, begging (possibly in the absence of parents) might serve purely as a form of negotiation among siblings. Here, we develop a game-theoretical model of this possibility. We assume tha...

  4. The cumulative burden of double-stranded DNA virus detection after allogeneic HCT is associated with increased mortality.

    Science.gov (United States)

    Hill, Joshua A; Mayer, Bryan T; Xie, Hu; Leisenring, Wendy M; Huang, Meei-Li; Stevens-Ayers, Terry; Milano, Filippo; Delaney, Colleen; Sorror, Mohamed L; Sandmaier, Brenda M; Nichols, Garrett; Zerr, Danielle M; Jerome, Keith R; Schiffer, Joshua T; Boeckh, Michael

    2017-04-20

    Strategies to prevent active infection with certain double-stranded DNA (dsDNA) viruses after allogeneic hematopoietic cell transplantation (HCT) are limited by incomplete understanding of their epidemiology and clinical impact. We retrospectively tested weekly plasma samples from allogeneic HCT recipients at our center from 2007 to 2014. We used quantitative PCR to test for cytomegalovirus, BK polyomavirus, human herpesvirus 6B, HHV-6A, adenovirus, and Epstein-Barr virus between days 0 and 100 post-HCT. We evaluated risk factors for detection of multiple viruses and association of viruses with mortality through day 365 post-HCT with Cox models. Among 404 allogeneic HCT recipients, including 125 cord blood, 125 HLA-mismatched, and 154 HLA-matched HCTs, detection of multiple viruses was common through day 100: 90% had ≥1, 62% had ≥2, 28% had ≥3, and 5% had 4 or 5 viruses. Risk factors for detection of multiple viruses included cord blood or HLA-mismatched HCT, myeloablative conditioning, and acute graft-versus-host disease ( P values < .01). Absolute lymphocyte count of <200 cells/mm 3 was associated with greater virus exposure on the basis of the maximum cumulative viral load area under the curve (AUC) ( P = .054). The maximum cumulative viral load AUC was the best predictor of early (days 0-100) and late (days 101-365) overall mortality (adjusted hazard ratio [aHR] = 1.36, 95% confidence interval [CI] [1.25, 1.49], and aHR = 1.04, 95% CI [1.0, 1.08], respectively) after accounting for immune reconstitution and graft-versus-host disease. In conclusion, detection of multiple dsDNA viruses was frequent after allogeneic HCT and had a dose-dependent association with increased mortality. These data suggest opportunities to improve outcomes with better antiviral strategies. © 2017 by The American Society of Hematology.

  5. Prospective, Randomized, Double-Blind, Phase III Clinical Trial of Anti-T-Lymphocyte Globulin to Assess Impact on Chronic Graft-Versus-Host Disease-Free Survival in Patients Undergoing HLA-Matched Unrelated Myeloablative Hematopoietic Cell Transplantation.

    Science.gov (United States)

    Soiffer, Robert J; Kim, Haesook T; McGuirk, Joseph; Horwitz, Mitchell E; Johnston, Laura; Patnaik, Mrinal M; Rybka, Witold; Artz, Andrew; Porter, David L; Shea, Thomas C; Boyer, Michael W; Maziarz, Richard T; Shaughnessy, Paul J; Gergis, Usama; Safah, Hana; Reshef, Ran; DiPersio, John F; Stiff, Patrick J; Vusirikala, Madhuri; Szer, Jeff; Holter, Jennifer; Levine, James D; Martin, Paul J; Pidala, Joseph A; Lewis, Ian D; Ho, Vincent T; Alyea, Edwin P; Ritz, Jerome; Glavin, Frank; Westervelt, Peter; Jagasia, Madan H; Chen, Yi-Bin

    2017-12-20

    Purpose Several open-label randomized studies have suggested that in vivo T-cell depletion with anti-T-lymphocyte globulin (ATLG; formerly antithymocyte globulin-Fresenius) reduces chronic graft-versus-host disease (cGVHD) without compromising survival. We report a prospective, double-blind phase III trial to investigate the effect of ATLG (Neovii Biotech, Lexington, MA) on cGVHD-free survival. Patients and Methods Two hundred fifty-four patients 18 to 65 years of age with acute leukemia or myelodysplastic syndrome who underwent myeloablative HLA-matched unrelated hematopoietic cell transplantation (HCT) were randomly assigned one to one to placebo (n =128 placebo) or ATLG (n = 126) treatment at 27 sites. Patients received either ATLG or placebo 20 mg/kg per day on days -3, -2, -1 in addition to tacrolimus and methotrexate as GVHD prophylaxis. The primary study end point was moderate-severe cGVHD-free survival. Results Despite a reduction in grade 2 to 4 acute GVHD (23% v 40%; P = .004) and moderate-severe cGVHD (12% v 33%; P < .001) in ATLG recipients, no difference in moderate-severe cGVHD-free survival between ATLG and placebo was found (2-year estimate: 48% v 44%, respectively; P = .47). Both progression-free survival (PFS) and overall survival (OS) were lower with ATLG (2-year estimate: 47% v 65% [ P = .04] and 59% v 74% [ P = .034], respectively). Multivariable analysis confirmed that ATLG was associated with inferior PFS (hazard ratio, 1.55; 95% CI, 1.05 to 2.28; P = .026) and OS (hazard ratio, 1.74; 95% CI, 1.12 to 2.71; P = .01). Conclusion In this prospective, randomized, double-blind trial of ATLG in unrelated myeloablative HCT, the incorporation of ATLG did not improve moderate-severe cGVHD-free survival. Moderate-severe cGVHD was significantly lower with ATLG, but PFS and OS also were lower. Additional analyses are needed to understand the appropriate role for ATLG in HCT.

  6. Bullying among siblings.

    Science.gov (United States)

    Wolke, Dieter; Skew, Alexandra J

    2012-01-01

    Parents are often concerned about repeated conflicts between their daughters and sons. However, there is little empirical research of sibling bullying. To conduct a review of existing studies of sibling bullying. Are there any associations between sibling bullying and peer bullying at school? What are the consequences of sibling bullying? Is there good justification why sibling bullying has been so neglected in research? Studies of sibling relationships were reviewed. Four quantitative studies were identified that report on both sibling and peer bullying. Sibling bullying is frequent with up to 50% involved in sibling bullying every month and between 16% and 20% involved in bullying several times a week. Experience of sibling bullying increases the risk of involvement in bullying in school. Both, bullying between siblings and school bullying make unique contributions to explaining behavioral and emotional problems. There is a clear dose-effect relationship of involvement of bullying at home and at school and behavioral or emotional problems. Those involved in both have up to 14 times increased odds of behavioral or emotional problems compared to those involved in only one context or not at all. The empirical evidence is limited and studies are mostly cross-sectional studies. Nevertheless, the review suggests that for those victimized at home and at school behavioral and emotional problems are highly increased. Sibling relationships appear to be a training ground with implications for individual well-being. Strengthening families and parenting skills and increasing sibling support is likely to reduce bullying and increase well-being.

  7. Sibling fairy tales

    Directory of Open Access Journals (Sweden)

    Luisa Brunori

    2014-06-01

    Full Text Available The article offers a reflection on sibling relationships starting from fairy tales. Their archetypical meaning and educative value are particularly analyzed. A selection of fairy tales having sibling relationships as their central theme is discussed.

  8. Personality and Sibling Relationships.

    Science.gov (United States)

    Furman, Wyndol; Lanthier, Richard P.

    1996-01-01

    This study examined the role personality variables play in sibling relationships. It proposed that the characteristics of sibling relationships are influenced by: family constellation variables such as birth order, gender, and age spacing; parent-child relationships including quality of relationship and parent management of siblings; and the…

  9. The Impact of Splenectomy in Myelofibrosis Patients before Allogeneic Hematopoietic Stem Cell Transplantation.

    Science.gov (United States)

    Robin, Marie; Zine, Maryem; Chevret, Sylvie; Meignin, Véronique; Munoz-Bongrand, Nicolas; Moatti, Hannah; Xhaard, Aliénor; Sicre de Fontbrune, Flore; Peffault de Latour, Régis; Sarfati, Emile; Socié, Gérard

    2017-06-01

    Performing a pretransplantation splenectomy in patients with myelofibrosis (MF) is a matter of debate, as while the procedure improves hematological recovery, it may lead to severe morbidities. We retrospectively analyzed data from 85 consecutive patients who underwent transplantation in our center for MF, including 39 patients who underwent splenectomy before their transplantation. A majority of them had primary MF (78%), were considered high-risk patients (84% dynamic international prognostic scoring system intermediate-2 or higher), and had received transplants from HLA-matched sibling donors (56%) after a reduced-intensity conditioning regimen (82%). One-half of all splenectomized patients presented surgical or postsurgical morbidities, most frequently thrombosis and hemorrhage. After adjustment using Cox models, pretransplantation splenectomy was not associated with nonrelapse mortality or post-transplantation relapse but with an improved overall survival (OS) and event-free survival (EFS). We conclude that some patients with huge splenomegaly may undergo pretransplantation splenectomy without a deleterious impact on post-transplantation outcomes. OS and EFS improvement should in confirmed in controlled study. Copyright © 2017 The American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

  10. Long-term control of recurrent or refractory viral infections after allogeneic HSCT with third-party virus-specific T cells.

    Science.gov (United States)

    Withers, Barbara; Blyth, Emily; Clancy, Leighton E; Yong, Agnes; Fraser, Chris; Burgess, Jane; Simms, Renee; Brown, Rebecca; Kliman, David; Dubosq, Ming-Celine; Bishop, David; Sutrave, Gaurav; Ma, Chun Kei Kris; Shaw, Peter J; Micklethwaite, Kenneth P; Gottlieb, David J

    2017-11-14

    Donor-derived adoptive T-cell therapy is a safe and effective treatment of viral infection posttransplant, but it is limited by donor serostatus and availability and by its personalized nature. Off-the-shelf, third-party virus-specific T cells (VSTs) appear promising, but the long-term safety and durability of responses have yet to be established. We conducted a prospective study of 30 allogeneic hemopoietic stem cell transplant (HSCT) patients with persistent or recurrent cytomegalovirus (CMV) (n = 28), Epstein-Barr virus (n = 1), or adenovirus (n = 1) after standard therapy. Patients were treated with infusions of partially HLA-matched, third-party, ex vivo-expanded VSTs (total = 50 infusions) at a median of 75 days post-HSCT (range, 37 to 349 days). Safety, viral dynamics, and immune recovery were monitored for 12 months. Infusions were safe and well tolerated. Acute graft versus host disease occurred in 2 patients, despite a median HLA match between VSTs and the recipient of 2 of 6 antigens. At 12 months, the cumulative incidence of overall response was 93%. Virological control was durable in the majority of patients; the reintroduction of antiviral therapy after the final infusion occurred in 5 patients. CMV-specific T-cell immunity rose significantly and coincided with a rise in CD8 + terminal effector cells. PD-1 expression was elevated on CD8 + lymphocytes before the administration of third-party T cells and remained elevated at the time of viral control. Third-party VSTs show prolonged benefit, with virological control achieved in association with the recovery of CD8 + effector T cells possibly facilitated by VST infusion. This trial was registered at www.clinicaltrials.gov as #NCT02779439 and www.anzctr.org.au as #ACTRN12613000603718.

  11. One hundred patients with acute leukemia treated by chemotherapy, total body irradiation, and allogeneic marrow transplantation

    International Nuclear Information System (INIS)

    Thomas, E.D.; Buckner, C.D.; Banaji, M.

    1977-01-01

    One hundred patients, 54 with acute myelogenous leukemia (AML) and 46 with acute lymphoblastic leukemia (ALL), considered to be in the end stages of their disease, after combination chemotherapy were treated by marrow transplantation. All patients were given a marrow graft from an HLA-identical sibling after receiving 1000-rad total body irradiation (TBI). One group of 43 patients was given cyclophosphamide (CY), 60 mg/kg on each of 2 days, 5 and 4 days before TBI. In a second group of 31 patients, additional chemotherapy was given before CY and TBI. In a third group of 19 patients, BCNU was given before CY and TBI. A fourth group of 7 patients received other chemotherapy regimens before TBI. Six patients died 3 to 17 days after marrow infusion without evidence of engraftment. Ninety-four patients were engrafted rejected and only one patient rejected the graft. Thirteen patients are alive with a marrow graft, on no maintenance antileukemic therapy, and without recurrent leukemia 1--4 1 / 2 yr after transplantation. Three have chronic graft-versus-host disease (GVHD). The relapse rate appeared to be relatively constant over the first 2 yr and was extremely low after that time. Neither survival nor leukemic relapse appeared to be influenced by the type of leukemia nor by the preparative chemotherapy regimen given before TBI. Patients in fair clinical condition at the time of transplantation showed significantly longer survival times than patients in poor condition (p = 0.001). This observation, coupled with the observation that some patients may be cured of their disease, indicates that marrow transplantation should now be undertaken earlier in the management of patients with acute leukemia who have an HLA-matched sibling marrow donor

  12. The Well Siblings of Schizophrenics.

    Science.gov (United States)

    Samuels, Laurel; Chase, Laura

    1979-01-01

    Explores the impact of having a schizophrenic sibling. Subjects functioned at high levels of adjustment. Separated from their families, there followed a period of reinvolvement, including responsibility for the ill sibling. Younger siblings expressed guilt over being well, whereas older siblings expressed guilt over earlier sibling rivalry.…

  13. Hematopoietic Stem Cell Transplantation Using Preimplantation Genetic Diagnosis and Human Leukocyte Antigen Typing for Human Leukocyte Antigen-Matched Sibling Donor: A Turkish Multicenter Study.

    Science.gov (United States)

    Kurekci, Emin; Küpesiz, Alphan; Anak, Sema; Öztürk, Gülyüz; Gürsel, Orhan; Aksoylar, Serap; Ileri, Talia; Kuşkonmaz, Barış; Eker, İbrahim; Cetin, Mualla; Tezcan Karasu, Gülsün; Kaya, Zühre; Fışgın, Tunç; Ertem, Mehmet; Kansoy, Savaş; Yeşilipek, Mehmet Akif

    2017-05-01

    Preimplantation genetic diagnosis involves the diagnosis of a genetic disorder in embryos obtained through in vitro fertilization, selection of healthy embryos, and transfer of the embryos to the mother's uterus. Preimplantation genetic diagnosis has been used not only to avoid the risk of having an affected child, but it also offers, using HLA matching, preselection of potential HLA-genoidentical healthy donor progeny for an affected sibling who requires bone marrow transplantation. Here, we share the hematopoietic stem cell transplantation results of 52 patients with different benign and malign hematological or metabolic diseases or immunodeficiencies whose donors were siblings born with this technique in Turkey since 2008. The median age of the patients' at the time of the transplantation was 8 years (range, 3 to 16 years) and the median age of the donors was 2 years (range, .5 to 6 years). The most common indication for HSCT was thalassemia major (42 of all patients, 80%). The stem cell source in all of the transplantations was bone marrow. In 37 of the transplantations, umbilical cord blood of the same donor was also used. In 50 of the 52 patients, full engraftment was achieved with a mean of 4.6 × 10 6 CD 34 + cells per kg of recipient weight. Ninety-six percent of the patients have been cured through hematopoietic stem cell transplantation without any complication. Primary engraftment failure was seen in only 2 patients with thalassemia major. All of the donors and the patients are alive with good health status. Preimplantation genetic diagnosis with HLA matching offers a life-saving chance for patients who need transplantation but lack an HLA genoidentical donor. Copyright © 2017 The American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

  14. Transplante alogênico de células-tronco hematopoéticas em leucemias agudas: a experiência de dez anos do Hospital das Clínicas da UFMG Allogeneic hematopoietic stem cells transplantation in acute leukemia: ten years of experience in the Hospital das Clínicas - UFMG

    Directory of Open Access Journals (Sweden)

    Rosana M. Lamego

    2010-01-01

    Full Text Available As leucemias agudas são doenças com alta morbimortalidade para as quais o transplante alogênico de medula óssea é uma opção terapêutica eficaz. Neste artigo, relatamos a experiência de um centro brasileiro com pacientes apresentando leucemia aguda que receberam um enxerto de medula óssea ou células-tronco periféricas de um doador familiar HLA idêntico no período de julho de 1995 a dezembro de 2005. Foi realizado um estudo de coorte retrospectivo, analisando dados de 125 pacientes com mediana de idade de 28,7 anos. Oitenta e um pacientes (64,8% apresentavam leucemia mieloide aguda; 38 (30,4%, leucemia linfoide aguda; e seis (4,8%, leucemia bifenotípica. Trinta e dois pacientes encontravam-se em primeira remissão completa, 23 em segunda remissão e 70 com doença avançada (refratários, recidivados ou além da segunda remissão. A sobrevida global estimada em 10 anos foi de 22,9%. Em relação à situação clínica do paciente no momento do transplante, a sobrevida global em dez anos foi de 56,3% para pacientes em primeira remissão, 38% para os pacientes em segunda remissão, e 3,7% para os pacientes com doença avançada. Considerando-se os pacientes transplantados em primeira e segunda remissão, a evolução foi semelhante aos dados disponíveis na literatura. Entretanto, os resultados dos pacientes transplantados em fase avançada foram ruins, devendo-se discutir o papel do transplante para este grupo.Acute leukemias are a group of diseases with high morbimortality. Allogeneic bone marrow transplantation is an efficacious therapeutic option for their treatment. We report the experience of a Brazilian center in respect to acute leukemia patients who received a bone marrow or peripheral blood allograft from a HLA-matched sibling from July 1995 to December 2005. Data were retrospectively collected. The median age of the 125 patients included in the study was 28.7 years. Eighty-one patients presented with acute myeloid leukemia

  15. Sibling differentiation: sibling and parent relationship trajectories in adolescence.

    Science.gov (United States)

    Feinberg, Mark E; McHale, Susan M; Crouter, Ann C; Cumsille, Patricio

    2003-01-01

    Studied here were the links between sibling differences in trajectories of change in the qualities of parent-child relationships and the qualities of sibling relationships across a 2-year period in adolescence. Participants were first- and second-born siblings (M age = 14.94 years for firstborns and M age = 12.46 years for secondborns) from 185 predominantly White, working and middle-class families. In home interviews, siblings reported on their dyadic family relationships. For reports of parent-child warmth but not parent-child conflict, results were consistent with sibling differentiation theory: Increasing differences between siblings over time in parent-child warmth were linked to trajectories of increasing warmth and decreasing conflict in the sibling relationship as reported by firstborns, and increasing warmth in the sibling relationship as reported by secondborns. The findings support the view that sibling differentiation may be a strategy for managing sibling conflict and rivalry.

  16. Relationships between adult siblings

    Directory of Open Access Journals (Sweden)

    Nives Ličen

    2006-12-01

    Full Text Available The author presents learning in private relationships between adult siblings. A concept of a family as microculture is presented, which is a source for giving explanation for random and opportunist learning. The author has used a biographic method of research. Using thematic life stories, which she has familiarized herself with through thematicalbiographical interviews is a basis to establish which events have served for learning in relationships between siblings.

  17. Allogeneic bone marrow transplantation with conditioning regimen to total body irradiation + thiotepa + melphalan for 35 patients with high-risk leukemia

    International Nuclear Information System (INIS)

    Yumura-Yagi, Keiko; Inoue, Masami; Okamura, Takayuki

    1997-01-01

    Thirty-five children with high-risk leukemia received an allogeneic bone marrow transplantation (BMT) following a pre-conditioning regimen consisting of total body irradiation, thiotepa and melphalan. Twenty-one patients had acute lymphocytic leukemia, 6 acute nonlymphocytic leukemia, 2 acute undifferentiated leukemia, 2 acute mixed lineage leukemia, 2 myelodysplastic syndrome and 2 juvenile chronic myeloid leukemia. Sixteen patients received BMT while in complete remission (CR), but 19 were not in CR. Eighteen patients received transplants from HLA-matched related donors, 15 from unrelated donors and 2 from HLA-mismatched related donors. Cyclosporin±methotrexate was used for graft-versus-host disease (GVHD) prophylaxis in the BMTs from related donors and tacrolimus±prednisolone in the BMTs from unrelated donors. Transplant-related death occurred in 12 patients; 5 acute GVHD, 4 infections (3 fungal infections, 1 Cytomegalovirus pneumonia), 1 intracranial haemorrhage and 2 chronic GVHD. Relapses were observed in 6 patients (69, 168, 175, 222, 275 and 609 days post BMT). Event-free survival rate at 2 years is 38.1% in CR patients and 36.9% in nonCR patients. (author)

  18. [Alternatives to allogenous blood transfusion].

    Science.gov (United States)

    Cernea, Daniela; Vlădoianu, Alice; Stoica, Maria; Novac, M; Berteanu, Cristina

    2009-01-01

    Blood transfusion is usually meant to lower morbidity and mortality rates. Allogenous blood transfusion implies certain risks that can be avoided by autologous blood transfusions techniques including: preoperatory autologous blood donation, acute normovolemic hemodilution, intraoperatory and postoperatory blood salvage. Preoperatory blood donation and acute normovolemic hemodilution are used for planned interventions with an estimated blood loss higher than 20% of blood volume. These methods imply Erythropoietin and iron treatment. Intraoperatory and postoperatory blood salvage is performed by personnel trained in blood donation, handling and storage. Autologous blood transfusions are used for certain surgical procedures that commonly require transfusions: orthopedic surgery, radical prostatectomy, cardiovascular surgery, organ transplantation. An alternative to allogenous blood transfusion is the use of artificial oxygen transporters: human or animal hemoglobin solutions or pefluorocarbonate solutions. These solutions do not require cross reactions, do not carry diseases and are generally well tolerated and easily stored in the operating room, ambulance and other transport means. They have however a slight degree of toxicity.

  19. Allogenic bone grafts in post-traumatic juxta-articular defects: Need for allogenic bone banking.

    Science.gov (United States)

    Mishra, Anil Kumar; Vikas, Rohit; Agrawal, H S

    2017-07-01

    Allogenic bone banking provide both structural and granular bone grafts for various orthopaedic, spinal, oncological and dental surgeries. However allogenic bones, presently, are not readily available. This article discusses the clinical applications of the allogenic grafts, the screening criteria and procedure for maintenance of such a bone banking facility. This article demonstrates the effective role of allogenic bone in a case of post-traumatic bone loss situation and discusses the growing need and present situation of bone banking in our country.

  20. Siblings' personality traits and types of sibling relationship in childhood

    Directory of Open Access Journals (Sweden)

    Tina Kavčič

    2011-01-01

    Full Text Available The contribution presents a follow-up study of sibling relationship and personality in 87 sibling dyads in early/middle childhood from parental perspective. At Time 1 all siblings attended pre-school and one year later approximately half of the older siblings entered compulsory school. At both times of measurement siblings' mothers and fathers independently reported on their children's personality characteristics using the Inventory of Child Individual Differences (Halverson et al., 2003; Slovene adaptation, Zupančič & Kavčič, 2009 and on the observed sibling warmth, agonism, and rivalry using the Parental Expectations and Perceptions of Children's Sibling Relationships Questionnaire (Kramer, 2001. The predictive relationship obtained by two sets of cross-rater analyses (between maternal ratings of child personality and paternal reports on sibling relationship, and vice versa suggested that (a personality traits of both siblings and (b the match between siblings' personalities are associated with sibling type (affectionate, involved or average membership. Among personality traits, disagreeableness seems to be an especially significant contributor to sibling relationship quality.

  1. The impact of chronic GVHD on survival of Patients with acute myeloid leukemia after non-T-cell depleted HLA-identical sibling peripheral blood stem cells transplantation

    Directory of Open Access Journals (Sweden)

    farhad Shahsavar

    2012-06-01

    Conclusion: These data indicate that the occurrence of cGVHD is an important predictor of outcome of non-T-cell depleted HLA-identical sibling allogeneic PBSCT, in those AML patients who develope cGVHD have a high chance of survival.

  2. Assessment of Impact of HLA Type on Outcomes of Allogeneic Hematopoietic Stem Cell Transplantation for Chronic Lymphocytic Leukemia.

    Science.gov (United States)

    Hill, Brian T; Ahn, Kwang Woo; Hu, Zhen-Huan; Aljurf, Mahmoud; Beitinjaneh, Amer; Cahn, Jean-Yves; Cerny, Jan; Kharfan-Dabaja, Mohamed A; Ganguly, Siddhartha; Ghosh, Nilanjan; Grunwald, Michael R; Inamoto, Yoshihiro; Kindwall-Keller, Tamila; Nishihori, Taiga; Olsson, Richard F; Saad, Ayman; Seftel, Matthew; Seo, Sachiko; Szer, Jeffrey; Tallman, Martin; Ustun, Celalettin; Wiernik, Peter H; Maziarz, Richard T; Kalaycio, Matt; Alyea, Edwin; Popat, Uday; Sobecks, Ronald; Saber, Wael

    2018-03-01

    Chronic lymphocytic leukemia (CLL) is a common hematologic malignancy with many highly effective therapies. Chemorefractory disease, often characterized by deletion of chromosome 17p, has historically been associated with very poor outcomes, leading to the application of allogeneic hematopoietic stem cell transplantation (allo-HCT) for medically fit patients. Although the use of allo-HCT has declined since the introduction of novel targeted therapy for the treatment of CLL, there remains significant interest in understanding factors that may influence the efficacy of allo-HCT, the only known curative treatment for CLL. The potential benefit of transplantation is most likely due to the presence of alloreactive donor T cells that mediate the graft-versus-leukemia (GVL) effect. The recognition of potentially tumor-specific antigens in the context of class I and II major histocompatibility complex on malignant B lymphocytes by donor T cells may be influenced by subtle differences in the highly polymorphic HLA locus. Given previous reports of specific HLA alleles impacting the incidence of CLL and the clinical outcomes of allo-HCT for CLL, we sought to study the overall survival and progression-free survival of a large cohort of patients with CLL who underwent allo-HCT from fully HLA-matched related and unrelated donors at Center for International Blood and Marrow Transplant Research transplantation centers. We found no statistically significant association of allo-HCT outcomes in CLL based on previously reported HLA combinations. Additional study is needed to further define the immunologic features that portend a more favorable GVL effect after allo-HCT for CLL. Copyright © 2017 The American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

  3. Kidney dysfunction after allogeneic stem cell transplantation

    NARCIS (Netherlands)

    Kersting, S.

    2008-01-01

    Allogeneic stem cell transplantation (SCT) is a widely accepted approach for malignant and nonmalignant hematopoietic diseases. Unfortunately complications can occur because of the treatment, leading to treatment-related mortality. We studied kidney dysfunction after allogeneic SCT in 2 cohorts of

  4. Theoretical Perspectives on Sibling Relationships

    Science.gov (United States)

    Whiteman, Shawn D.; McHale, Susan M.; Soli, Anna

    2011-01-01

    Although siblings are a fixture of family life, research on sibling relationships lags behind that on other family relationships. To stimulate interest in sibling research and to serve as a guide for future investigations by family scholars, we review four theoretical psychologically oriented perspectives—(a) psychoanalytic-evolutionary, (b) social psychological, (c) social learning, and (d) family-ecological systems—that can inform research on sibling relationships, including perspectives on the nature and influences on developmental, individual, and group differences in sibling relationships. Given that most research on siblings has focused on childhood and adolescence, our review highlights these developmental periods, but we also incorporate the limited research on adult sibling relationships, including in formulating suggestions for future research on this fundamental family relationship. PMID:21731581

  5. Sibling influences on prosocial behavior.

    Science.gov (United States)

    Hughes, Claire; McHarg, Gabrielle; White, Naomi

    2018-04-01

    Sibling relationships are characterized by familiarity and emotional intensity. Alongside frequent shared play, sibling interactions feature complementary interactions (e.g. teaching, caregiving) reflecting age-related asymmetries in socio-cognitive skills. These aspects may underpin sibling influences on prosocial behavior: theoretical accounts of social influences on prosocial behavior highlight emotion sharing, goal alignment, the intrinsically rewarding nature of social interaction, and scaffolding of social norms. Taking a fine-grained approach to prosocial behavior, we examine these processes in relation to sibling influences on children's comforting, sharing, and helping. Emergent themes include: developmental change in the nature of sibling influences on prosocial behavior, the need to consider sibling influences in the wider family context, and the importance of individual differences in the quality of sibling relationships. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Outcomes of allogeneic hematopoietic stem cell transplantation for lymphomas: a single-institution experience

    Directory of Open Access Journals (Sweden)

    Mira Romany Massoud

    Full Text Available ABSTRACT Introduction: Allogeneic hematopoietic stem cell transplantation offers the opportunity for extended survival in patients with Hodgkin's and non-Hodgkin lymphomas who relapsed after, or were deemed ineligible for, autologous transplantation. This study reports the cumulative experience of a single center over the past 14 years aiming to define the impact of patient, disease, and transplant-related characteristics on outcomes. Methods: All patients with histologically confirmed diagnosis of Hodgkin's or non-Hodgkin lymphomas who received allogeneic transplantation from 2000 to 2014 were retrospectively studied. Results: Forty-one patients were reviewed: 10 (24% had Hodgkin's and 31 (76% had non-Hodgkin lymphomas. The median age was 50 years and 23 (56% were male. The majority of patients (68% had had a prior autologous transplantation. At the time of allogeneic transplantation, 18 (43% patients were in complete and seven (17% were in partial remission. Most (95% patients received reduced-intensity conditioning, 49% received matched sibling donor grafts, 24% matched-unrelated donor grafts, and 27% received double umbilical cord blood grafts. The 100-day treatment-related mortality rate was 12%. After a median duration of follow up of 17.1 months, the median progression-free and overall survival was 40.5 and 95.8 months, respectively. On multivariate analysis, patients who had active disease at the time of transplant had inferior survival. Conclusions: Allogeneic transplantation results extend survival in selected patients with relapsed/refractory Hodgkin's and non-Hodgkin lymphomas with low treatment-related mortality. Patients who have active disease at the time of allogeneic transplantation have poor outcomes.

  7. Conflict Resolution between Mexican Origin Adolescent Siblings

    Science.gov (United States)

    Killoren, Sarah E.; Thayer, Shawna M.; Updegraff, Kimberly A.

    2008-01-01

    We investigated correlates of adolescents' sibling conflict resolution strategies in 246, two-parent Mexican origin families. Specifically, we examined links between siblings' conflict resolution strategies and sibling dyad characteristics, siblings' cultural orientations and values, and sibling relationship qualities. Data were gathered during…

  8. A comparison between allogeneic stem cell transplantation from unmanipulated haploidentical and unrelated donors in acute leukemia

    Directory of Open Access Journals (Sweden)

    Simona Piemontese

    2017-01-01

    Full Text Available Abstract Background In the absence of a HLA-matched related or matched unrelated donor, allogeneic stem cell transplantation (allo-SCT from mismatched unrelated donors or haploidentical donors are potential alternatives for patients with acute leukemia with an indication to allo-SCT. The objective of this study was to compare the outcome of allo-SCT from T cell-replete haploidentical (Haplo versus matched (MUD 10/10 or mismatched unrelated donor at a single HLA-locus (MMUD 9/10 for patients with acute leukemia in remission. Methods Two hundred sixty-five adult patients with de novo acute leukemia in first or second remission that received a Haplo-SCT between January 2007 and December 2013 were compared with 2490 patients receiving a MUD 10/10 and 813 receiving a MMUD 9/10. Propensity score weighted analysis was conducted in order to control for disease risk imbalances between the groups. Results The weighted 3-year non-relapse mortality and relapse incidence were 29 and 30% for Haplo, 21 and 29% for MUD 10/10, and 29 and 25% for MMUD 9/10, respectively. The weighted 3-year leukemia-free survival (LFS and overall survival (OS were 41 and 46% for Haplo, 50 and 56% for MUD 10/10, and 46 and 48% for MMUD 9/10, respectively. Using weighted Cox model, both LFS and OS were significantly higher in transplants from MUD 10/10 compared from those in Haplo but not different between transplants from MMUD 9/10 and Haplo. The type of donor was not significantly associated with neither acute nor chronic graft-versus-host disease. Conclusions Patients with acute leukemia in remission have better outcomes if transplanted from a MUD 10/10. We did not find any significant difference in outcome between transplants from MMUD 9/10 and Haplo, suggesting that both can be equally used in the absence of a 10/10 MUD. Key point 1 Better outcomes using fully (10/10 matched unrelated donor for allo-SCT in acute leukemia in remission. Key point 2 Similar outcomes after allo

  9. Sibling influences on childhood development.

    Science.gov (United States)

    Dunn, J

    1988-03-01

    To summarize the main points concerning sibling influence: 1. That siblings play a causal role in the development of aggressive behavior, in children's style of conflict behavior and in cooperative fantasy play is strongly suggested by recent research. 2. Marked problems in the sibling relationship are indicative of other problems, but a causal role for siblings is not established, other than for aggressive behavior. 3. Family factors are closely involved in the quality of sibling relationships--and thus in sibling influence, namely differential parental behavior, and the emotional climate of the family. That is, it is important not to consider the sibling relationship in isolation from other family relationships. 4. Studies of families under stress indicate heightened importance of these family factors. 5. It is likely, but not yet established, that later-born siblings are influenced by first-born in socio-cognitive development and gender identity. 6. Finally it should be noted that an important theme in current research on siblings is a concern with the question of why siblings develop to be so different from one another. It has been shown that the major source of environmental influence on the development of individual differences is within-family rather than between-family differences in experience (Plomin & Daniels, 1987). The different experiences each sibling may have within their relationship is one potential source of such differential environmental influence. Thus documenting the influence of siblings upon each other takes on added significance: By clarifying the extent and nature of this influence we will gain not only useful clinical information but illumination on a developmental principle of very general significance.

  10. Cytogenetic conversion following allogeneic bone marrow transplantation for advanced chronic myelogenous leukemia

    International Nuclear Information System (INIS)

    McGlave, P.B.; Miller, W.J.; Hurd, D.D.; Arthur, D.C.; Kim, T.

    1981-01-01

    We performed a pilot study to test the effectiveness of allogeneic bone marrow transplantation in the treatment of chronic myelogenous leukemia. Five patients in the advanced stages of chronic myelogenous leukemia (four in blast crisis, one in accelerated phase) with abnormal chromosomes underwent matched-sibling allogeneic bone marrow transplantation after preparation with busulfan, vincristine, cyclophosphamide, and fractionated total body irradiation. Engraftment and conversion to normal chromosome patterns after transplantation occurred in all five patients. None of the patients reverted to an abnormal chromosome pattern or demonstrated clinical or hematologic evidence of recurrent disease during the course of this study; however, longest survival from transplant was 248 days. Allogeneic bone marrow transplantation can eradicate the abnormal clone even in far advanced chronic myelogenous leukemia and can provide normal hematopoiesis. We suggest that clinical complications of chemotherapeutic toxicity and infection were responsible for the short survival in this group of patients, and that these complications could be decreased by performing transplantation in the chronic phase or early accelerated phase of the disease

  11. Clinicopathologic findings following intra-articular injection of autologous and allogeneic placentally derived equine mesenchymal stem cells in horses.

    Science.gov (United States)

    Carrade, Danielle D; Owens, Sean D; Galuppo, Larry D; Vidal, Martin A; Ferraro, Gregory L; Librach, Fred; Buerchler, Sabine; Friedman, Michael S; Walker, Naomi J; Borjesson, Dori L

    2011-04-01

    The development of an allogeneic mesenchymal stem cell (MSC) product to treat equine disorders would be useful; however, there are limited in vivo safety data for horses. We hypothesized that the injection of self (autologous) and non-self (related allogeneic or allogeneic) MSC would not elicit significant alterations in physical examination, gait or synovial fluid parameters when injected into the joints of healthy horses. Sixteen healthy horses were used in this study. Group 1 consisted of foals (n = 6), group 2 consisted of their dams (n = 5) and group 3 consisted of half-siblings (n = 5) to group 1 foals. Prior to injection, MSC were phenotyped. Placentally derived MSC were injected into contralateral joints and MSC diluent was injected into a separate joint (control). An examination, including lameness evaluation and synovial fluid analysis, was performed at 0, 24, 48 and 72 h post-injection. MSC were major histocompatibility complex (MHC) I positive, MHC II negative and CD86 negative. Injection of allogeneic MSC did not elicit a systemic response. Local responses such as joint swelling or lameness were minimal and variable. Intra-articular MSC injection elicited marked inflammation within the synovial fluid (as measured by nucleated cell count, neutrophil number and total protein concentration). However, there were no significant differences between the degree and type of inflammation elicited by self and non-self-MSC. The healthy equine joint responds similarly to a single intra-articular injection of autologous and allogeneic MSC. This pre-clinical safety study is an important first step in the development of equine allogeneic stem cell therapies.

  12. Allogeneic Peripheral Blood Stem Cell Harvest

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. Allogeneic Peripheral Blood Stem Cell Harvest. Mobilization protocol. G-CSF 10 mcg/Kg / day for 5 days. Pheresis. Cobe Spectra; Haemonetics mcs+. Enumeration. CD34 counts; Cfu-GM assays.

  13. Sibling Relationships in Early Childhood.

    Science.gov (United States)

    Dunn, Judy

    1983-01-01

    Reviews and considers the developmental implications of recent evidence on the nature of sibling interaction from observational studies of preschool children. Argues that, in contrast to complementary interaction, sibling influence is most plausibly associated with reciprocal interaction and with sociocognitive development. (Author/RH)

  14. [Siblings of prepubesecent anorexic children].

    Science.gov (United States)

    Noël, L; de Maynadier, L

    2014-10-01

    As professionals working in a specialised unit for prepubescent anorexic children, we are very often concerned with the siblings of our young patients who are daily faced with anorexia nervosa. Although it is an undeniable subject of prevention, research on the topic remains scarce. Based on our clinical experience, this article thus proposes to give a few landmarks to health professionals likely to support these siblings in order to prevent anxious and depressive disorders as well as eating disorders. If guided, supported and informed on anorexia nervosa, siblings can adopt adequate coping strategies when confronted to their sibling's anorexic cognitions and behaviours. We also encourage parents to pay close attention to the needs of their other children, especially to remain receptive to the youngest ones or, if unavailable to find adult carers (grandparents, family, friends). We also guide these children, who are eager to help their anorexic sibling, to remain in a brotherly role. Siblings must be informed about anorexia nervosa. Such information enables them to have a better understanding of their sister's thoughts and attitudes. It also leads to a better understanding of the reasons why anorexia has such a significant impact on family routine, among other things by reducing parental availability. Beyond enabling siblings to adopt adequate coping strategies, such provision of support also contributes to the prevention of mental illness and the maintenance of adequate sibling and family relationships. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  15. Children with Autism & Their Siblings

    Science.gov (United States)

    Cancro, Ralph

    2008-01-01

    The parent of the child with autism is faced with many home management challenges, not the least of which is the achievement of intra-family harmony among siblings. Sibling rivalry occurs in all families. However, the presence of a child with autism may, in some instances, intensify this rivalry. In this article, the author provides tips for…

  16. Sibling Status Effects: Adult Expectations.

    Science.gov (United States)

    Baskett, Linda Musun

    1985-01-01

    This study attempted to determine what expectations or beliefs adults might hold about a child based on his or her sibling status alone. Ratings on 50 adjective pairs for each of three sibling status types, only, oldest, and youngest child, were assessed in relation to adult expectations, birth order, and parental status of rater. (Author/DST)

  17. Total lymphoid irradiation (TLI) for allogeneic bone marrow transplantation in aplastic anemia

    International Nuclear Information System (INIS)

    Yamanashi, Syunji; Yamashita, Takashi; Mochizuki, Sachio; Hoshi, Masataka

    1985-01-01

    We used TLI as immunosuppression for BMT in a patient with aplastic anemia. He recieved high dose cyclophosphamide and single dose TLI with 750 cGy, 12 cGy/min at his midplane, and bone marrow from HLA-matched twin brother. He is surviving without complications at 15 months. This procedure is well tolerated regimen. (author)

  18. Graft-derived anti-HPA-2b production after allogeneic bone-marrow transplantation

    DEFF Research Database (Denmark)

    Taaning, E; Jacobsen, N; Morling, N

    1994-01-01

    We report on a male who received a bone-marrow allograft from his HLA identical sister for acute myelogenous leukaemia. After transplantation, the patient suffered from refractoriness to the transfusions of HLA-matched platelets and a strong platelet-specific antibody, anti-HPA-2b, of IgG1 subcla...

  19. Is sibling rivalry fatal?: siblings and mortality clustering.

    Science.gov (United States)

    Kippen, Rebecca; Walters, Sarah

    2012-01-01

    Evidence drawn from nineteenth-century Belgian population registers shows that the presence of similarly aged siblings competing for resources within a household increases the probability of death for children younger than five, even when controlling for the preceding birth interval and multiple births. Furthermore, in this period of Belgian history, such mortality tended to cluster in certain families. The findings suggest the importance of segmenting the mortality of siblings younger than five by age group, of considering the presence of siblings as a time-varying covariate, and of factoring mortality clustering into analyses.

  20. Alternatives to allogeneic platelet transfusion.

    Science.gov (United States)

    Desborough, Michael J R; Smethurst, Peter A; Estcourt, Lise J; Stanworth, Simon J

    2016-11-01

    Allogeneic platelet transfusions are widely used for the prevention and treatment of bleeding in thrombocytopenia. Recent evidence suggests platelet transfusions have limited efficacy and are associated with uncertain immunomodulatory risks and concerns about viral or bacterial transmission. Alternatives to transfusion are a well-recognised tenet of Patient Blood Management, but there has been less focus on different strategies to reduce bleeding risk by comparison to platelet transfusion. Direct alternatives to platelet transfusion include agents to stimulate endogenous platelet production (thrombopoietin mimetics), optimising platelet adhesion to endothelium by treating anaemia or increasing von Willebrand factor levels (desmopressin), increasing formation of cross-linked fibrinogen (activated recombinant factor VII, fibrinogen concentrate or recombinant factor XIII), decreasing fibrinolysis (tranexamic acid or epsilon aminocaproic acid) or using artificial or modified platelets (cryopreserved platelets, lyophilised platelets, haemostatic particles, liposomes, engineered nanoparticles or infusible platelet membranes). The evidence base to support the use of these alternatives is variable, but an area of active research. Much of the current randomised controlled trial focus is on evaluation of the use of thrombopoietin mimetics and anti-fibrinolytics. It is also recognised that one alternative strategy to platelet transfusion is choosing not to transfuse at all. © 2016 John Wiley & Sons Ltd.

  1. Structural Features of Sibling Dyads and Attitudes toward Sibling Relationships in Young Adulthood

    Science.gov (United States)

    Riggio, Heidi R.

    2006-01-01

    This study examined sibling-dyad structural variables (sex composition, age difference, current coresidence, position adjacency, family size, respondent and/or sibling ordinal position) and attitudes toward adult sibling relationships. A sample of 1,053 young adults (M age = 22.1 years) described one sibling using the Lifespan Sibling Relationship…

  2. Intergenerational Solidarity and Support Between Adult Siblings

    NARCIS (Netherlands)

    Voorpostel, Marieke; Blieszner, Rosemary

    2008-01-01

    Using a Dutch national sample containing 1,259 triads (two siblings, one parent), we examined whether practical support and emotional support between siblings are enhanced by intergenerational solidarity and how this differs for brothers and sisters. Sibling support was affected by sibling dyad

  3. Relative Power in Sibling Relationships across Adolescence

    Science.gov (United States)

    Lindell, Anna K.; Campione-Barr, Nicole

    2017-01-01

    During childhood, older siblings typically hold a more powerful position in their relationship with their younger siblings, but these relationships are thought to become more egalitarian during adolescence as siblings begin to prepare for their relationships as adults and as younger siblings become more socially and cognitively competent. Little…

  4. Sibling Self-Disclosure in Early Adolescence.

    Science.gov (United States)

    Howe, Nina; Aquan-Assee, Jasmin; Bukowski, William M.; Rinaldi, Christina M.; Lehoux, Pascale M.

    2000-01-01

    Studied sibling-directed self-disclosure of 40 preadolescents through interviews, a questionnaire, and subjects' daily diaries. Found that warmth in sibling relationship was most strongly associated with sibling disclosure, but not with rivalry, conflict, or power. Daily sibling disclosures were more strongly associated with reports of unhappy…

  5. Childhood Sibling Relationships of Eminent Canadian Women.

    Science.gov (United States)

    Yewchuk, Carolyn R.; Schlosser, Grace A.

    1996-01-01

    This study compared differences between 72 eminent Canadian women who reported close sibling relationships and 72 similar women who reported no close sibling relationships. Those with close siblings expressed their responsibility within the relationship and rivalry within the sibship. Those not close to siblings often blamed this on age…

  6. Allogenic lyophilized cartilage grafts for craniomaxillofacial reconstruction

    International Nuclear Information System (INIS)

    Pill Hoon Choung

    1999-01-01

    Allogenic lyophilized cartilages were made in our clinic after Sailer methods and some modification. In our clinic, we have used allogenic cartilage grafts on 102 defects of craniomaxillofacial area; 1) for defects from cyst or ameloblastoma, 2) for lack of continuity of the mandible, 3) for rhinoplasty, 4) for paranasal augmentation, 5) for augmentation genioplasty, 6) for reconstruction of orbital floor, 7) for oroantral fistula, 8) for temporal augmentation, 9) for TMJ surgery 10) for condyle defect as a costochondral graft, 11) for filling of tooth socket and alveolus augmentation,12) for correction or orbital height and 13) for guided bone regeneration in peripheral implant. The types of lyophilized cartilage used were chip, sheet and block types developed by freeze-dried methods. Some grafts showed change of ossification, in which case we could perform implant on it. We have good results on reconstruction of craniomaxillofacial defects. Allogenic cartilage have advantages such as 1) it has no immune reaction clinically, 2) it is more tolerable to infection than that of autogenous cartilage, 3) it has character of less resorption which require no over correction, 4) it is easy to manipulate contouring, and 5) it has possibility of undergoing ossification. Allogenic cartilage has been considered as good substitutes for bone. The author would like to report the results on 102 allogenic cartilage have

  7. Perceived sibling relationships of sexual minority youth.

    Science.gov (United States)

    Toomey, Russell B; Richardson, Rhonda A

    2009-01-01

    The purpose of this study was to examine the relationships of sexual minority youth and their siblings. The participants were 56 lesbian, gay, bisexual, or transgender individuals ranging in age from 18 to 24 years, who reported information about a total of 107 siblings. Respondents completed a demographic data questionnaire as well as adapted versions of the Sibling Closeness Scale (SCS) and the Sibling Approval of Sexual Behavior Scale (SASBS) to describe their relationship with each of their siblings. Analyses examined birth order and gender in relation to outness to siblings as well as sibling closeness and approval. Results provide information about disclosure of LGBT status to siblings, elements of closeness and acceptance in sibling relationships of sexual minority youth, and the significance of gender and birth order in these sibling relationships.

  8. Allogeneic bone marrow transplantation with conditioning regimen of total body irradiation/busulfan/melphalan for 16 patients in children with high-risk leukemia and lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Yoshihara, Takao; Fujii, Noriko [Matsushita Memorial Hospital, Moriguchi, Osaka (Japan); Naya, Mayumi [and others

    1999-02-01

    We report the therapeutic results of allogeneic bone marrow transplantations (BMT) for 16 children with high-risk leukemia and lymphoma. The conditioning regimen consisted of total body irradiation (TBI) (12 Gy), busulfan (Bu) (4 mg/kg x 2 days), and melphalan (L-PAM) (70 mg/m{sup 2} x 2 or 3 days). Graft-versus-host disease (GVHD) prophylaxis was performed with cyclosporin (CsA) + methotrexate (MTX) (4 cases) and CsA + MTX-methyl-prednisolone (11 cases). Seven patients had acute lymphocytic leukemia, 6 acute nonlymphocytic leukemia, 2 B-cell type non-Hodgkin`s lymphoma, and 1 peripheral T-cell lymphoma. Nine patients were in complete remission (CR) and 7 in non CR at BMT. Nine patients received transplants from HLA-matched related (MR) donors, 4 from HLA-mismatched related (MisR) donors, and 3 from unrelated (UR) donors. Seven of the cases, all of which were transplanted from MR, have continued complete remission for 15-47 (median 27) months. Nine patients, of which seven were transplanted from MisR/UR, died from complications from fungal pneumonia (3), cytomegalovirus pneumonitis (1), GVHD (1), rhabdomyolysis (1), lymphoproliferative disorder (1), rejection (1), and relapse (1). These results suggest that the combination of TBI, Bu, and L-PAM as a BMT regimen has a significant anti-neoplastic benefit and is considered to be useful; however, considering the high rate of fatal transplant-related complications, more refinement is required, especially for transplants from MisR and UR donors. (author)

  9. Allogeneic bone marrow transplantation with conditioning regimen of total body irradiation/busulfan/melphalan for 16 patients in children with high-risk leukemia and lymphoma

    International Nuclear Information System (INIS)

    Yoshihara, Takao; Fujii, Noriko; Naya, Mayumi

    1999-01-01

    We report the therapeutic results of allogeneic bone marrow transplantations (BMT) for 16 children with high-risk leukemia and lymphoma. The conditioning regimen consisted of total body irradiation (TBI) (12 Gy), busulfan (Bu) (4 mg/kg x 2 days), and melphalan (L-PAM) (70 mg/m 2 x 2 or 3 days). Graft-versus-host disease (GVHD) prophylaxis was performed with cyclosporin (CsA) + methotrexate (MTX) (4 cases) and CsA + MTX-methyl-prednisolone (11 cases). Seven patients had acute lymphocytic leukemia, 6 acute nonlymphocytic leukemia, 2 B-cell type non-Hodgkin's lymphoma, and 1 peripheral T-cell lymphoma. Nine patients were in complete remission (CR) and 7 in non CR at BMT. Nine patients received transplants from HLA-matched related (MR) donors, 4 from HLA-mismatched related (MisR) donors, and 3 from unrelated (UR) donors. Seven of the cases, all of which were transplanted from MR, have continued complete remission for 15-47 (median 27) months. Nine patients, of which seven were transplanted from MisR/UR, died from complications from fungal pneumonia (3), cytomegalovirus pneumonitis (1), GVHD (1), rhabdomyolysis (1), lymphoproliferative disorder (1), rejection (1), and relapse (1). These results suggest that the combination of TBI, Bu, and L-PAM as a BMT regimen has a significant anti-neoplastic benefit and is considered to be useful; however, considering the high rate of fatal transplant-related complications, more refinement is required, especially for transplants from MisR and UR donors. (author)

  10. Development of a coordinated allo T cell and auto B cell response against autosomal PTK2B after allogeneic hematopoietic stem cell transplantation.

    Science.gov (United States)

    Kremer, Anita N; van der Griendt, Judith C; van der Meijden, Edith D; Honders, M Willy; Ayoglu, Burcu; Schwenk, Jochen M; Nilsson, Peter; Falkenburg, J H Frederik; Griffioen, Marieke

    2014-02-01

    It is well known that allo-reactive T cells play a crucial role in graft-versus-leukemia and graft-versus-host disease after allogeneic hematopoietic stem cell transplantation (alloSCT). Allo-reactive CD4(+) T cells can mediate direct cytolysis, but may also stimulate production of IgG antibodies as helper cells. Immune complexes may subsequently be processed and presented by professional antigen presenting cells and stimulate induction of specific CD8(+) T cells. As such, proteins targeted in coordinated T- and B-cell responses may represent a class of immunodominant antigens in clinical responses after alloSCT. We previously identified LB-PTK2B-1T as HLA class II restricted polymorphic antigen in a patient treated with donor lymphocyte infusion for relapsed chronic myeloid leukemia after HLA-matched alloSCT. Since PTK2B has also been described as antibody target, we here investigated whether a coordinated T- and B-cell response against PTK2B was induced. Patient serum before and after alloSCT and donor lymphocyte infusion (DLI) was screened for antibodies, and we indeed observed development of a humoral immune response against PTK2B. Antibodies against PTK2B were only found after DLI and, in contrast to the CD4(+) T cells, recognized a monomorphic region of the protein. To our knowledge, this is the first description of a coordinated allo-reactive CD4(+) T-cell and auto-reactive antibody response against an autosomal antigen.

  11. Naxos Disease in Two Siblings

    Science.gov (United States)

    Meera, G; Prabhavathy, D; Jayakumar, S; Tharini, GK

    2010-01-01

    Naxos disease is a rare cardiocutaneous disorder characterized by palmoplantar keratoderma, woolly hair and arrythmogenic right ventricular cardiomyopathy. We report two siblings with Naxos disease with right middle lobe syndrome in one of them. PMID:21188028

  12. ALLOGENEIC TRANSPLANTATION FOR CHRONIC LYMPHOCYTIC LEUKEMIA

    Directory of Open Access Journals (Sweden)

    Luca Laurenti

    2010-08-01

    Full Text Available Even if Chronic lymphocytic leukemia (CLL often has an indolent behavior with good responsiveness to cytoreductive treatment, about 20% of the patients, so called "poor-risk" patients, show an aggressive course and die within a few years despite early intensive therapies. Criteria for poor-risk disease according to the European Bone Marrow Transplantation (EBMT CLL Transplant Consensus are: purine analogue refractoriness, early relapse after purine analogue combination therapy, CLL with p53 lesion requiring treatment. Allogeneic transplant has potential curative role in CLL, however burden with very  high transplant related mortality (TRM rates of 38-50%: A major advance in reducing the short-term morbidity and mortality of allogeneic stem cell transplantation (SCT has been the introduction of non-myeloablative or reduced intensity conditioning (RIC regimens to allow engraftment of allogeneic stem cells. There is no doubt that the crucial therapeutic principle of allo-SCT in CLL is graft versus leukemia (GVL activity. The major complications of allogeneic SCT in CLL are: chronic graft-versus-host-disease (GVHD affecting quality of life, high graft rejection and infection rates rates correlated with preexisting immunosuppression. Disease relapse remains the major cause of failure after RIC allo-HCT in CLL patients. Sensitive minimal residual disease (MRD quantification has strong prognostic impact after transplant.

  13. Successful allogeneic stem cells transplantation in severe aplastic anaemia complicated by dengue fever

    International Nuclear Information System (INIS)

    Ullah, K.; Satti, T.M.; Ahmed, P.; Raza, A.; Akhtar, F.M.; Tariq, W.U.Z.

    2007-01-01

    Aplastic anaemia is characterized by severe compromise of haematopoiesis and hypocellular bone marrow. Haemorrhagic episodes in patients with aplastic anemia occur usually secondary to thrombocytopenia and require frequent support with platelet concentrates and other blood products. Infection with dengue virus (particularly dengue sero type-2 of South Asian genotype) is associated with dengue haemorrhagic fever. Dengue infection further worsens the disease process in patients with aplastic anaemia due to uncontrolled haemorrhagic diathesis and major organ failure, which may prove fatal in these already immunocompromised patients, if not treated in time. Recent epidemics of dengue haemorrhagic fever has not only affected the southern region of our country but also spread to other areas of the country. With this background, we report a case of aplastic anaemia complicated by dengue haemorrhagic fever who achieved successful engraftment after allogeneic stem cell transplantation from sibling brother and is having normal healthy post transplant life. (author)

  14. Ocular graft versus host disease in allogenic haematopoetic stem cell transplantation in a tertiary care centre in India

    Directory of Open Access Journals (Sweden)

    Rehan Khan

    2015-01-01

    Full Text Available Background & objectives: This study was aimed to report the occurrence of ocular graft versus host disease (oGVHD in allogeneic haematopoietic stem cell transplantation (allo-HSCT patients in a tertiary care hospital setting. Methods: A cross-sectional study of ocular surface of allo-HSCT patients was done. Slit lamp biomicroscopy, symptom score, tear meniscus height, fluorescein tear break-up time, Schirmer′s test I, ocular surface staining, dry eye severity, ocular surface disease index score were done. Indications for allo-HSCT, human leukocyte antigen (HLA matching, GVHD risk factor, systemic manifestation and treatment were also noted. Results: GVHD occurred in 44.4 per cent of 54 allo-HSCT patients (mean age 26.7 ± 12 yr included in the study. GVHD risk factors identified included female gender, relapse, older age of donor, cytomagelo virus (CMV reactivation, and multiparous female donors. oGVHD was noted in 31.5 per cent with mean time to occurrence being 17.8 ± 21.9 months after the allo-HSCT and was observed in 89.5 per cent of chronic GVHD cases. Acute GVHD (oral and dermatological involvement showed a significant association with GVHD in our patients (P< 0.001, 0R 23.0, CI 6.4-82.1. Chronic GVHD was observed to be associated with the occurrence of oGVHD (dry eye (P<0.001, OR = 24.0, CI 0.02 - 0.29. Of the 34 eyes with oGHVD, dry eye of level 3 severity was seen in 16, level 2 in six, level 1 in 12 eyes. Interpretation & conclusions: GVHD occurred in 44.4 per cent of the patients studied in the present study. Acute and chronic GVHD showed a strong association with oGVHD. Dry eye disease due to chronic oGVHD was observed in 17 (31.5% of 54 allo-HSCT patient with chronic oGVHD occurring in 17 (89.4% of chronic GVHD cases in allo-HSCT patients. Our study on oGVHD in post allo-HSCT patients in tertiary care centre points towards the fact that ocular morbidity due to dry eye disease as a result of oGVHD is a cause for concern in these

  15. Comparisons Between Allogeneic Peripheral Blood Stem Cell Transplantation and Allogeneic Bone Marrow Transplantation in Adult Hematologic Disease: A Single Center Experience

    Directory of Open Access Journals (Sweden)

    Yi-Chang Liu

    2003-11-01

    Full Text Available This retrospective study compared the outcomes in 32 adult patients with hematologic diseases (acute myeloid leukemia, acute lymphoblastic leukemia, chronic myeloid leukemia, myelodysplastic syndrome, severe aplastic anemia who received allogeneic bone marrow transplantation (BMT, n = 14; median age, 28 years or allogeneic peripheral blood stem cell transplantation (PBSCT, n = 18; median age, 29 years from human leukocyte antigen-identical sibling donors. Median follow-up was 58 months in BMT recipients and 18 months in PBSCT recipients. Neutrophil (median, Day 8 vs Day 13, p < 0.001 and platelet engraftment (median, Day 9 vs Day 17, p < 0.001 was faster in the PBSCT group than in the BMT group. Patients receiving PBSCT required less platelet transfusion than those receiving BMT (median, 54 units vs 144 units, p < 0.001, but there was no significant difference in red cell transfusion. At 100 days, there was no difference in the incidence of acute graft-versus-host disease (GVHD (42.9% vs 33.3%, p = 0.72 or grade II-IV acute GVHD (14.3% vs 5.6%, p = 0.57, and there was no difference in the cumulative incidence of chronic GVHD (20% vs 33.3%, p = 0.67. No chronic GVHD was noted in any relapsed patients (BMT, 5; PBSCT, 3, and no patients with chronic GVHD during follow-up had a relapse. Relapse was the most frequent cause of death in both groups (BMT, 5/9, 55.6%; PBSCT, 3/4, 75%; p = 0.25; all relapses occurred within 1 year after transplantation. Overall survival was significantly better in the PBSCT group (35.7% vs 77.8%, p = 0.029, but this difference was lost if only hematologic malignancies were analyzed (30.8% vs 63.6%, p = 0.20. Our results are similar to those reported previously, with faster neutrophil and platelet engraftment and less severe acute GVHD and extensive chronic GVHD with PBSCT. Allogeneic PBSCT is a feasible and beneficial alternative to allogeneic BMT in adult hematologic disease.

  16. Bullying among Siblings: The Role of Personality and Relational Variables

    Science.gov (United States)

    Menesini, Ersilia; Camodeca, Marina; Nocentini, Annalaura

    2010-01-01

    This study aimed to investigate: (1) the influence of gender, sibling age, and sibling gender on sibling bullying and victimization; (2) the links between personality characteristics, quality of the sibling relationship, and sibling bullying/victimization; (3) the association between sibling and school bullying/victimization, and the direct and…

  17. Data mining of mental health issues of non-bone marrow donor siblings.

    Science.gov (United States)

    Takita, Morihito; Tanaka, Yuji; Kodama, Yuko; Murashige, Naoko; Hatanaka, Nobuyo; Kishi, Yukiko; Matsumura, Tomoko; Ohsawa, Yukio; Kami, Masahiro

    2011-07-20

    Allogenic hematopoietic stem cell transplantation is a curative treatment for patients with advanced hematologic malignancies. However, the long-term mental health issues of siblings who were not selected as donors (non-donor siblings, NDS) in the transplantation have not been well assessed. Data mining is useful in discovering new findings from a large, multidisciplinary data set and the Scenario Map analysis is a novel approach which allows extracting keywords linking different conditions/events from text data of interviews even when the keywords appeared infrequently. The aim of this study is to assess mental health issues on NDSs and to find helpful keywords for the clinical follow-up using a Scenario Map analysis. A 47-year-old woman whose younger sister had undergone allogenic hematopoietic stem cell transplantation 20 years earlier was interviewed as a NDS. The text data from the interview transcriptions was analyzed using Scenario Mapping. Four clusters of words and six keywords were identified. Upon review of the word clusters and keywords, both the subject and researchers noticed that the subject has had mental health issues since the disease onset to date with being a NDS. The issues have been alleviated by her family. This single subject study suggested the advantages of data mining in clinical follow-up for mental health issues of patients and/or their families.

  18. Sibling Relationships: Parent-Child Agreement and Contributions of Siblings with and without ASD

    Science.gov (United States)

    Braconnier, Megan L.; Coffman, Marika C.; Kelso, Nicole; Wolf, Julie M.

    2018-01-01

    Research on the experiences of siblings of individuals with ASD and the quality of their sibling relationships has yielded mixed results. The present study examined the significance of parent- versus child-report of both positive and negative behaviors exhibited by siblings and their brothers and sisters with ASD within sibling dyads. Findings…

  19. Contributors to Adult Sibling Relationships and Intention to Care of Siblings of Individuals with Down Syndrome

    Science.gov (United States)

    Cuskelly, Monica

    2016-01-01

    The contribution of childhood sibling relationships to adult sibling relationships and intention to provide care was investigated in a sample in which one member of each dyad had Down syndrome. Thirty-nine adult siblings of an adult with Down syndrome who had participated in a study of sibling relationships in childhood/adolescence provided data…

  20. Sibling bereavement and continuing bonds.

    Science.gov (United States)

    Packman, Wendy; Horsley, Heidi; Davies, Betty; Kramer, Robin

    2006-11-01

    Historically, from a Freudian and medical model perspective, emotional disengagement from the deceased was seen as essential to the successful adaptation of bereavement. A major shift in the bereavement literature has occurred and it is now generally accepted that despite the permanence of physical separation, the bereaved remains involved and connected to the deceased and can be emotionally sustained through continuing bonds. The majority of literature has focused on adults and on the nature of continuing bonds following the death of a spouse. In this article, the authors demonstrate how the continuing bonds concept applies to the sibling relationship. We describe the unique continued relationship formed by bereaved children and adolescents following a sibling loss, highlight the factors that influence the siblings continuing bonds expressions, and offer clinical interventions. In our view, mental health professionals can play an important role in helping parents encourage activities that may facilitate the creation and maintenance of continuing bonds in their children.

  1. Sibling popularity: A moderator of sibling influence for adolescent substance use.

    Science.gov (United States)

    Wallace, Lacey N

    Sibling substance use is a known correlate of adolescent substance use. Yet, not all siblings are equally influential. Sibling influence has been found to vary by age gap, sex, and birth order. Little research, however, has investigated whether siblings' peer context is also a source of variation. The present study tested whether more popular siblings were more influential for adolescent use of cigarettes, alcohol, and marijuana. Data were obtained from sibling pairs in the National Longitudinal Study of Adolescent Health. Findings indicate that older siblings have more influence on younger sibling marijuana use when they have more friends. These findings contribute to prior work examining which siblings are more influential and highlight the need to consider siblings as part of a greater peer context.

  2. Life Events, Sibling Warmth, and Youths' Adjustment

    Science.gov (United States)

    Waite, Evelyn B.; Shanahan, Lilly; Calkins, Susan D.; Keane, Susan P.; O'Brien, Marion

    2011-01-01

    Sibling warmth has been identified as a protective factor from life events, but stressor-support match-mismatch and social domains perspectives suggest that sibling warmth may not efficiently protect youths from all types of life events. We tested whether sibling warmth moderated the association between each of family-wide, youths' personal, and…

  3. Sibling curves of quadratic polynomials | Wiggins | Quaestiones ...

    African Journals Online (AJOL)

    Sibling curves were demonstrated in [1, 2] as a novel way to visualize the zeroes of real valued functions. In [3] it was shown that a polynomial of degree n has n sibling curves. This paper focuses on the algebraic and geometric properites of the sibling curves of real and complex quadratic polynomials. Key words: Quadratic ...

  4. Relative Power in Sibling Relationships Across Adolescence.

    Science.gov (United States)

    Lindell, Anna K; Campione-Barr, Nicole

    2017-06-01

    During childhood, older siblings typically hold a more powerful position in their relationship with their younger siblings, but these relationships are thought to become more egalitarian during adolescence as siblings begin to prepare for their relationships as adults and as younger siblings become more socially and cognitively competent. Little is known about relationship factors that may explain this shift in power dynamics, however. The present study therefore examined longitudinal changes in adolescents' and their siblings' perceptions of sibling relative power from age 12 to 18 (n = 145 dyads), and examined whether different levels of sibling relationship positivity and negativity, as well as sibling structural variables, indicated different over-time changes in relative power. Multilevel models indicated that adolescents reported significant declines in their siblings' relative power across adolescence, with older siblings relinquishing the most power over time. However, only siblings with less positively involved relationships reported declines in relative power, suggesting that siblings who maintain highly involved relationships may not become more egalitarian during adolescence. © 2017 Wiley Periodicals, Inc.

  5. Sibling Conflict Resolution Skills: Assessment and Training

    Science.gov (United States)

    Thomas, Brett W.; Roberts, Mark W.

    2009-01-01

    Sibling conflict can rise to the level of a clinical problem. In Phase 1 a lengthy behavioral role-play analog sampling child reactions to normal sibling conflicts was successfully shortened. In Phase 2 normal children who lacked sibling conflict resolution skills were randomly assigned to a Training or Measurement Only condition. Training…

  6. Siblings and the Development of Prosocial Behavior.

    Science.gov (United States)

    Dunn, Judy; Munn, Penny

    1986-01-01

    Examines the capability and motivation of 18- and 24-month-old infants to share, help, comfort, and cooperate with their older siblings; the frequency of such prosocial behavior by both siblings; and the children's response to sibling distress. The relationship between prosocial and conflict behavior was also studied. (HOD)

  7. Sibling Rivalry: A Parent Education Perspective.

    Science.gov (United States)

    Calladine, Carole E.

    1983-01-01

    Identifies three styles of sibling rivalry and three parent leadership styles, discussing parental mediation of sibling disputes through contracting and providing examples of group discipline techniques that facilitate development of less negative forms of rivalry and that support positive sibling bonding. (RH)

  8. Siblings and Mental Illness: Heredity vs. Environment.

    Science.gov (United States)

    Rowe, David C.; Elam, Patricia

    1987-01-01

    Siblings are far more likely to be different than alike in personality and psychopathology. Different genes and different environmental experiences can account for why one sibling becomes mentally ill and another is not affected. Environmental experiences play a much greater role in sibling differentiation than has been previously recognized.…

  9. Sibling Curves 3: Imaginary Siblings and Tracing Complex Roots

    Science.gov (United States)

    Harding, Ansie; Engelbrecht, Johann

    2009-01-01

    Visualizing complex roots of a quadratic equation has been a quest since the inception of the Argand plane in the 1800s. Many algebraic and numerical methods exist for calculating complex roots of an equation, but few visual methods exist. Following on from papers by Harding and Engelbrecht (A. Harding and J. Engelbrecht, "Sibling curves and…

  10. What makes siblings different? The development of sibling differences in academic achievement and interests.

    Science.gov (United States)

    Jensen, Alexander C; McHale, Susan M

    2015-06-01

    To illuminate processes that contribute to the development of sibling differences, this study examined cross-lagged links between parents' beliefs about sibling differences in academic ability and differences between siblings' grade point averages (GPAs), and cross-lagged links between differences in siblings' GPAs and sibling differences in academic interests. Data were collected from mothers, fathers, firstborn youth (M age at Time 1 = 15.71, SD = 1.07), and secondborn youth (M age at Time 1 = 13.18, SD = 1.29) from 388 European American families on 3 annual occasions. Findings revealed that, after controlling for siblings' average grades and prior differences in performance, parents' beliefs about sibling differences in academic ability predicted differences in performance such that youth rated by parents as relatively more competent than their sibling earned relatively higher grades the following year. Siblings' relative school performance, however, did not predict parents' beliefs about differences between siblings' competencies. Further, after controlling for average interests and grades, sibling differences in GPA predicted differences in siblings' interests such that youth who had better grades than their siblings reported relatively stronger academic interests the following year. Differences in interest, however, did not predict sibling differences in GPA. Findings are discussed in terms the role of sibling dynamics in family socialization. (c) 2015 APA, all rights reserved).

  11. Allogeneic radiation chimeras induced in SPF mice

    International Nuclear Information System (INIS)

    Sado, Toshihiko; Kamisaku, Hitoko

    1977-01-01

    During the past two decades much has been learned concerning the immunobiology of bone marrow chimeras induced in experimental animals as well as in man. However, from the basic as well as clinical points of view, there still remain many unsolved questions yet to be resolved. In this presentation, we discussed some of our recent results on the immunobiology of radiation chimeras induced in specific-pathogen-free (SPF) mice. These included the following: (a) contribution of graft versus host reaction (GVHR) as well non- GVHR mediated immunologic mechanism(s) to the expression of immunologic dysfunctions observed in allogeneic and certain semiallogeneic chimeras, (b) existence of immunoregulatory mechanism as a basis for the apparent lack of immunologic reactivity (tolerance) to the host- as well as to the donor-type alloantigens in situ in successful allogeneic bone marrow chimeras, and (c) the effect of microflora of the environment on the stability of such immunoregulatory mechanisms and its possible mechanism of action. (auth.)

  12. Transplantation tolerance after total lymphoid irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Strober, S.; Slavin, S.; Fuks, Z.; Kaplan, H.S.; Gottlieb, M.; Bieber, C.; Hoppe, R.T.; Grumet, F.C.

    1979-03-01

    We have presented an animal model of tissue transplantation tolerance using the unusual effects of TLI on the immune system. The application of TLI to bone marrow and whole-organ transplantation in humans merits further study, since TLI offers several advantages over presently used therapeutic modalities. Current regimens used to prepare patients for marrow transplantation are lethal in the absence of allogeneic marrow engraftment, and marrow donors are restricted to HLA-matched siblings due to the danger of GHVD. On the other hand, TLI is a nonlethal procedure that has been used successfully in animals to transplant allogeneic marrow from unmatched donors without the development of GHVD. Thus, TLI might allow for marrow transplantation in all patients with a single sibling, whereas conventional procedures are feasible in only one of four such cases (probability of finding a single HLA-matched sibling). In addition, the induction of transplantation tolerance with TLI would obviate the requirement for the use of maintenance immunosuppressive drugs after whole-organ transplantation. Systemic infections associated with the use of these drugs currently account for the majority of deaths in heart transplant patients. Serious infectious complications associated with TLI are rare; thus this therapeutic regimen may offer considerable improvement in the long-term survival of organ graft recipients as compared to that presently obtained with immunosuppressive drugs.

  13. ALLOGENEIC TRANSPLANTATION FOR CHRONIC LYMPHOCYTIC LEUKEMIA

    Directory of Open Access Journals (Sweden)

    Patrizia Chiusolo

    2010-05-01

    Full Text Available

    Even if Chronic lymphocytic leukemia (CLL often has an indolent behavior with good responsiveness to cytoreductive treatment, about 20% of the patients, so called "poor-risk" patients, show an aggressive course and die within a few years despite early intensive therapies. Criteria for poor-risk disease according to the European Bone Marrow Transplantation (EBMT CLL Transplant Consensus are: purine analogue refractoriness, early relapse after purine analogue combination therapy, CLL with p53 lesion requiring treatment.

    Allogeneic transplant has potential curative role in CLL, however burden with very  high transplant related mortality (TRM rates of 38-50%:

    A major advance in reducing the short-term morbidity and mortality of allogeneic stem cell transplantation (SCT has been the introduction of non-myeloablative or reduced intensity conditioning (RIC regimens to allow engraftment of allogeneic stem cells. There is no doubt that the crucial therapeutic principle of allo-SCT in CLL is graft versus leukemia (GVL activity.

    The major complications of allogeneic SCT in CLL are: chronic graft-versus-host-disease (GVHD affecting quality of life, high graft rejection and infection rates rates correlated with preexisting immunosuppression. Disease relapse remains the major cause of failure after RIC allo-HCT in CLL patients.

    Sensitive minimal residual disease (MRD quantification has strong prognostic impact after transplant.

     

  14. Outcome of allogeneic hematopoietic stem cell transplantation for childhood acute lymphoblastic leukemia in second complete remission: a single institution study

    Directory of Open Access Journals (Sweden)

    Eun-Jung Lee

    2012-03-01

    Full Text Available Purpose : The survival rate for childhood acute lymphoblastic leukemia (ALL has improved significantly. However, overall prognosis for the 20 to 25% of patients who relapse is poor, and allogeneic hematopoietic stem cell transplantation (HSCT offers the best chance for cure. In this study, we identified significant prognostic variables by analyzing the outcomes of allogeneic HSCT in ALL patients in second complete remission (CR. Methods : Fifty-three ALL patients (42 men, 79% who received HSCT in second CR from August 1991 to February 2009 were included (26 sibling donor HSCTs, 49%; 42 bone marrow transplantations, 79%. Study endpoints included cumulative incidence of acute and chronic graft-versus-host disease (GVHD, relapse, 1-year transplant-related mortality (TRM, disease-free survival (DFS, and overall survival (OS. Results : Cumulative incidences of acute GVHD (grade 2 or above and chronic GVHD were 45.3% and 28.5%, respectively. The estimated 5-year DFS and OS for the cohort was 45.2¡?#?.8%; and 48.3¡?#?%,; respectively. Only donor type, i.e., sibling versus unrelated, showed significant correlation with DFS in multivariate analysis (P=0.010. The rates of relapse and 1 year TRM were 28.9¡?#?.4%; and 26.4¡?#?.1%;, respectively, and unrelated donor HSCT (P=0.002 and HLA mismatch (P =0.022 were significantly correlated with increased TRM in univariate analysis. Conclusion : In this single institution study spanning more than 17 years, sibling donor HSCT was the only factor predicting a favorable result in multivariate analysis, possibly due to increased TRM resulting from unrelated donor HSCT.

  15. Bullying in the family: sibling bullying.

    Science.gov (United States)

    Wolke, Dieter; Tippett, Neil; Dantchev, Slava

    2015-10-01

    Sibling relationships have a substantial and lasting effect on children's development. Many siblings experience some occasional conflict, however, up to 40% are exposed to sibling bullying every week, a repeated and harmful form of intrafamilial aggression. We review evidence on the precursors, factors relating to peer bullying, and mental health consequences of sibling bullying. Parenting quality and behaviour are the intrafamilial factors most strongly associated with bullying between siblings. Sibling bullying increases the risk of being involved in peer bullying, and is independently associated with concurrent and early adult emotional problems, including distress, depression, and self-harm. The effects appear to be cumulative, with those children bullied by both siblings and peers having highly increased emotional problems compared with those bullied by siblings or peers only, probably because they have no safe place to escape from bullying. The link between sibling and peer bullying suggests interventions need to start at home. Health professionals should ask about sibling bullying and interventions are needed for families to prevent and reduce the health burden associated with sibling bullying. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. Attachment to the Romantic Partner and Sibling: Attachment Hierarchies of Twins and Non-Twin Siblings

    Directory of Open Access Journals (Sweden)

    Sascha Schwarz

    2015-12-01

    Full Text Available Previous studies have shown that romantic partners and siblings are important attachment figures. This study compares the attachment to the romantic partner with the attachment to the sibling as a function of the participant’s sibling type among monozygotic (MZ twins, dizygotic (DZ twins, and non-twin (NT siblings. The results show that MZ twins prefer their sibling to their romantic partner whereas DZ twins are equally attached to their sibling and romantic partner. In contrast, NT siblings are more attached to their romantic partner compared to their sibling. These results indicate that genetic relatedness has profound impact on a person’s attachment hierarchy and the relative rank of the romantic partner and the sibling.

  17. Siblings exposed to intimate partner violence: linking sibling relationship quality & child adjustment problems.

    Science.gov (United States)

    Piotrowski, Caroline C; Tailor, Ketan; Cormier, Damien C

    2014-01-01

    Although the majority of families that experience intimate partner violence (IPV) have more than one child, most research to date has focused upon a single child within these families. A significant body of research has indicated siblings play an important role in children's adjustment and well-being. To address this gap, the three main goals of the present study were to compare the adjustment of older and younger siblings exposed to IPV, to describe and compare the quality of these sibling relationships from multiple perspectives, and to investigate how sibling adjustment and relationship quality influence children's adjustment. Forty-seven sibling pairs and their mothers were recruited from the community. Mothers self-reported on their violent experiences using the Conflict Tactics Scale, and also estimated the length of time their children were exposed to IPV. Mothers and children completed assessments of child adjustment and the quality of sibling relationships. Observers also assessed the quality of sibling interaction. Results indicated that adjustment between siblings was highly inter-related. On average, mothers reported sibling relationships as less positive but also as less hostile than did siblings themselves. Higher levels of sibling hostility, lower levels of sibling warmth and higher levels of disengagement each significantly predicted child adjustment; however, these effects were predicated upon the adjustment of the other sibling. The sibling relationships of children exposed to IPV made a difference in their individual adjustment, and their adjustment issues influenced how they feel about and interacted with their sibling. Sibling hostility played a stronger role in adjustment issues than sibling warmth. The nature of sibling influences and the direction of future research were discussed. Copyright © 2013 Elsevier Ltd. All rights reserved.

  18. And What About Siblings? A Longitudinal Analysis of Sibling Effects on Youth's Intergroup Attitudes.

    Science.gov (United States)

    Eckstein, Katharina; Šerek, Jan; Noack, Peter

    2018-02-01

    Within the process of political socialization, the family is of particular importance. Apart from parents, however, little is known about the role of other close family members. The present study examined if siblings affect each other's intergroup attitudes (i.e., intolerance towards immigrants, social dominance orientation). Drawing on a sample of 362 sibling dyads (older siblings: M age  = 17.77, 53.6% female; younger siblings: M age  = 13.61, 61.3% female), the results showed that older siblings' intergroup attitudes predicted younger siblings' attitudes, but this effect was moderated by gender. Specifically, older siblings' intolerance and social dominance orientation were only found to affect their younger sisters, yet not their younger brothers. Although younger siblings' intergroup attitudes had no main effect on older siblings, a significant moderation by age indicated that younger siblings affected older siblings' social dominance orientation with increasing age. These moderation effects of age and gender were not mediated by the quality of family relationships. The findings also remained the same when parental intergroup attitudes were taken into account. While siblings were generally identified as an important agent of political socialization in youth, the results also highlight the necessity to further examine the mechanism that either facilitate or hinder sibling effects.

  19. Mechanisms of Sibling Socialization in Normative Family Development

    Science.gov (United States)

    Whiteman, Shawn D.; Becerra, Julia M.; Killoren, Sarah E.

    2009-01-01

    Siblings are important sources of social influence throughout childhood and adolescence. Nevertheless, the processes by which siblings influence one another remain relatively unexplored. We highlight two theories of sibling influence--sibling deidentification and social learning--that offer insights as to how and why siblings develop similar and…

  20. Personality traits and sibling relationships in emerging adults.

    Science.gov (United States)

    Lanthier, Richard P

    2007-04-01

    Associations between the Big Five personality traits of siblings and the quality of sibling relationships were examined in a sample of 115 college students and one of their older siblings. Big Five traits, as assessed by Goldberg's 100 adjective markers, predicted a large amount of the variability in sibling Warmth and Conflict. Agreeableness was the most consistent predictor of positive sibling outcomes.

  1. Sibling relationships in individuals with Angelman syndrome: A comparative study

    NARCIS (Netherlands)

    Love, V.; Richters, L.P.H.; Didden, H.C.M.; Korzilius, H.P.L.M.; Machalicek, W.A.

    2012-01-01

    Objective: Investigating the impact of Angelman syndrome on the sibling relationship. Methods: This study explored differences in sibling relationships between children with a typically-developing sibling (n = 55) and children with a sibling with Angelman syndrome (n 44). Sibling relationships were

  2. Complications of allogeneic hematopoietic stem cell transplantation.

    Science.gov (United States)

    Arnaout, Karim; Patel, Nihar; Jain, Maneesh; El-Amm, Joelle; Amro, Farah; Tabbara, Imad A

    2014-08-01

    Infection, graft-versus-host disease (GVHD), and to a lesser extent sinusoidal obstructive syndrome (SOS) represent the major causes of morbidity and mortality in patients undergoing allogeneic hematopoietic stem cell transplantation (AHSCT). During the last decade, progress in prevention and treatment of these complications led to improvement in the outcome of these patients. Despite the fact that nonmyeloablative regimens have been increasingly used in elderly patients and in patients with co-morbidities, the nonrelapse related mortality remains a challenge and long-term follow-up is required. The objective of this manuscript is to provide an updated concise review of the complications of AHSCT and of the available treatment interventions.

  3. Enhancing sibling relationships to prevent adolescent problem behaviors: theory, design and feasibility of Siblings Are Special.

    Science.gov (United States)

    Feinberg, Mark E; Sakuma, Kari-Lyn; Hostetler, Michelle; McHale, Susan M

    2013-02-01

    Siblings play a significant but neglected role in family socialization dynamics, and focusing on the sibling relationship is a non-stigmatizing point of entry into the family for prevention programming. Siblings are Special (SAS) was designed as a universal program that targets both sibling relationship and parenting mediating processes in middle childhood to prevent behavior problems in adolescence. We describe the theoretical framework underlying SAS, the SAS curriculum, and the feasibility of the program based on a study of 128 middle-childhood aged sibling dyads. Data on the quality of program implementation, program fidelity, siblings' engagement, and ratings of impact indicated the SAS program was acceptable to families and schools, that the curriculum could be implemented with high fidelity, that siblings and parents participated at high levels and were highly engaged, and that, from the perspective of group leaders, school administrators and parents, the program had a positive impact on the siblings. Copyright © 2012 Elsevier Ltd. All rights reserved.

  4. Self-Representations in Early Adolescence: Variations in Sibling Similarity by Sex Composition and Sibling Relationship Qualities

    Science.gov (United States)

    Gamble, Wendy C.; Card, Noel A.; Yu, Jeong Jin

    2010-01-01

    Self-representations play an important role in adolescent development. This study compared self-representations for siblings and explored whether sibling relationship characteristics are associated with similarities or differences in sibling self-concepts. We examined self-representations of 438 adolescent sibling dyads (M age younger sibling =…

  5. An initial look at sibling reports on children's behavior: comparisons with children's self-reports and relations with siblings' self-reports and sibling relationships.

    Science.gov (United States)

    Epkins, C C; Dedmon, A M

    1999-10-01

    The authors examined siblings' reports of children's depression, anxiety, and aggression, and their reports of the sibling relationship, and compared them with children's self-reports. In two samples, including 169 sibling pairs (age M = 9.98 years, SD = 1.51), no significant differences emerged in the levels of depression and anxiety found in siblings' reports of children's behavior and children's self-reports, although siblings reported children to have significantly higher levels of aggression than the children self-reported. Age, the difference in ages between siblings, sex, and sibling sex were not related to siblings' reports of children's behavior. The relations between children's and siblings' reports of children's behavior were significant, yet moderate (average r = .22). Both siblings' self-reports of internalizing behavior and their perceptions of aspects of the sibling relationship (affection, rivalry, hostility, and satisfaction with the sibling relationship) explained significant, and unique, variance in siblings' reports of children's internalizing behavior. The findings for aggressive behavior were similar, although siblings' perceptions of affection in the sibling relationship were not significantly related to their reports of children's aggression. The potential uses and benefits of sibling reports of children's behavior, and sibling and family relationships, are discussed.

  6. Tensions among siblings in parent care.

    Science.gov (United States)

    Lashewicz, Bonnie; Keating, Norah

    2009-06-01

    From a place of "genealogical equivalence" as children of their parents, siblings spend a lifetime developing separate identities. As parents near the end of their lives, issues of sibling equivalence are renegotiated in the face of equal obligations to provide care and equal entitlement to parent assets. In this paper, we hypothesize how unresolved issues of rivalry for parent affection/attention among siblings may be reasserted when parents need care. Data are drawn from a project about how parent care and assets are shared. In-depth interviews with three sibling groups experiencing conflict over sharing parent care and assets along with six Canadian legal case portrayals of disputes among siblings over how parent care and assets were shared are examined. Findings are that disputes occur when siblings perceive others as dominating parent care and assets through tactics such as separating the parent from other siblings and preventing other siblings from being engaged in decisions about care and assets. Discussion is focused on paradoxes faced by siblings given expectations for equity in parent relationships alongside perceived pre-eminence in care and asset decisions.

  7. Psychosis among "healthy" siblings of schizophrenia patients

    Directory of Open Access Journals (Sweden)

    Partonen Timo

    2006-01-01

    Full Text Available Abstract Background Schizophrenia aggregates in families and accurate diagnoses are essential for genetic studies of schizophrenia. In this study, we investigated whether siblings of patients with schizophrenia can be identified as free of any psychotic disorder using only register information. We also analyzed the emergence of psychotic disorders among siblings of patients with schizophrenia during seven to eleven years of follow-up. Methods A genetically homogenous population isolate in north-eastern Finland having 365 families with 446 patients with a diagnosis of schizophrenia was initially identified in 1991 using four nationwide registers. Between 1998 and 2002, 124 patients and 183 siblings in 110 families were contacted and interviewed using SCID-I, SCID-II and SANS. We also compared the frequency of mental disorders between siblings and a random population comparison group sample. Results Thirty (16% siblings received a diagnosis of psychotic disorder in the interview. 14 siblings had had psychotic symptoms already before 1991, while 16 developed psychotic symptoms during the follow-up. Over half of the siblings (n = 99, 54% had a lifetime diagnosis of any mental disorder in the interview. Conclusion Register information cannot be used to exclude psychotic disorders among siblings of patients with schizophrenia. The high rate of emergence of new psychotic disorders among initially healthy siblings should be taken into account in genetic analysis.

  8. Siblings of children with life-limiting conditions: psychological adjustment and sibling relationships.

    Science.gov (United States)

    Fullerton, J M; Totsika, V; Hain, R; Hastings, R P

    2017-05-01

    This study explored psychological adjustment and sibling relationships of siblings of children with life-limiting conditions (LLCs), expanding on previous research by defining LLCs using a systematic classification of these conditions. Thirty-nine siblings participated, aged 3-16 years. Parents completed measures of siblings' emotional and behavioural difficulties, quality of life, sibling relationships and impact on families and siblings. Sibling and family adjustment and relationships were compared with population norms, where available, and to a matched comparison group of siblings of children with autistic spectrum disorder (ASD), as a comparable 'high risk' group. LLC siblings presented significantly higher levels of emotional and behavioural difficulties, and lower quality of life than population norms. Their difficulties were at levels comparable to siblings of children with ASD. A wider impact on the family was confirmed. Family socio-economic position, time since diagnosis, employment and accessing hospice care were factors associated with better psychological adjustment. Using a systematic classification of LLCs, the study supported earlier findings of increased levels of psychological difficulties in siblings of children with a LLC. The evidence is (i) highlighting the need to provide support to these siblings and their families, and (ii) that intervention approaches could be drawn from the ASD field. © 2016 John Wiley & Sons Ltd.

  9. Siblings' coping strategies and mental health services: a national study of siblings of persons with schizophrenia.

    Science.gov (United States)

    Friedrich, Rose Marie; Lively, Sonja; Rubenstein, Linda M

    2008-03-01

    This study examined the helpfulness of coping strategies and the relative importance of mental health services in coping with schizophrenia from the perspective of siblings. This article presents selected survey data from a national study of 746 respondents that investigated the impact of schizophrenia on siblings' lives. The authors developed the Friedrich-Lively Instrument to Assess the Impact of Schizophrenia on Siblings (FLIISS), a closed-ended questionnaire that included questions about coping strategies and mental health services. Respondents identified services for the ill sibling, including symptom control, adequate housing, and long-term planning, as more important than direct services for themselves. The top-ranked coping strategies were education about schizophrenia, a supportive family, and seeing the ill sibling suffer less because symptoms were controlled. Understanding that families were not to blame for schizophrenia was the most helpful coping strategy for nearly three-fourths of siblings. Siblings had little contact with providers in the past; yet the majority of siblings wanted providers to be available to answer questions and clarify their role in future care. At the time of the study, respondents provided social support and helped with crises, but few coordinated the total care. Siblings identified multiple ways that providers can support and assist them in coping with the impact of schizophrenia. Education and support for siblings without schizophrenia and services for their ill siblings will become increasingly important for the well-being of siblings as they are faced with the responsibility of being the primary caregivers in the future.

  10. Sibling Relationships in Adults Who Have Siblings with or without Intellectual Disabilities

    Science.gov (United States)

    Doody, Mairead A.; Hastings, Richard P.; O'Neill, Sarah; Grey, Ian M.

    2010-01-01

    There is relatively little research on the relationships between adults with intellectual disability and their siblings, despite the potential importance of these relationships for either individual's psychological well-being and future care roles that might be adopted by adult siblings. In the present study, sibling relationships of adults with…

  11. Antibody responses in allogeneic radiation chimeras

    International Nuclear Information System (INIS)

    Coico, R.F.

    1982-01-01

    The construction of long-lived allogeneic radiation chimeras, free of graft-versus-host disease, has been achieved using serologic elimination of Thy 1 + cells from donor bone marrow. Humoral immune function was not restored in these animals as evidenced by lack of primary antibody responses to a T cell-dependent antigen, namely, sheep erythrocytes (SRBC) both in vivo and in vitro. No evidence for a suppressor cell-mediated mechanism was found. Using separated chimera spleen cell populations and specific helper cell soluble mediators, the functional capabilities of chimera B cells, T cells, and macrophages were assessed. These findings suggested that the failure of chimeras to produce antibody is not the result of impaired B cell, T cell, or macrophage function, but rather, that it is due to ineffective cellular interactions. Physiologic cellular interactions depend upon the sharing of major histocompatibility complex (MHC) determinants between interacting cells. However, the self-recognition repertoire of developing T cells may be influenced by the environment which these cells differentiate such that they learn to recognize host MHC determinants as self. These findings support the interpretation that the immunologic hyporeactivity of allogeneic bone marrow chimeras reflects the role of the host environment in restricting the interactive capabilities of donor-derived cells

  12. Current issues in allogeneic islet transplantation.

    Science.gov (United States)

    Chang, Charles A; Lawrence, Michael C; Naziruddin, Bashoo

    2017-10-01

    Transplantation of allogenic pancreatic islets is a minimally invasive treatment option to control severe hypoglycemia and dependence on exogenous insulin among type 1 diabetes (T1D) patients. This overview summarizes the current issues and progress in islet transplantation outcomes and research. Several clinical trials from North America and other countries have documented the safety and efficacy of clinical islet transplantation for T1D patients with impaired hypoglycemia awareness. A recently completed phase 3 clinical trial allows centres in the United States to apply for a Food and Drug Administration Biologics License for the procedure. Introduction of anti-inflammatory drugs along with T-cell depleting induction therapy has significantly improved long-term function of transplanted islets. Research into islet biomarkers, immunosuppression, extrahepatic transplant sites and potential alternative beta cell sources is driving further progress. Allogeneic islet transplantation has vastly improved over the past two decades. Success in restoration of glycemic control and hypoglycemic awareness after islet transplantation has been further highlighted by clinical trials. However, lack of effective strategies to maintain long-term islet function and insufficient sources of donor tissue still impose limitations to the widespread use of islet transplantation. In the United States, wide adoption of this technology still awaits regulatory approval and, importantly, a financial mechanism to support the use of this technology.

  13. Hematopoietic stem cell transplantation for acquired aplastic anemia

    Science.gov (United States)

    Georges, George E.; Storb, Rainer

    2016-01-01

    Purpose of review There has been steady improvement in outcomes with allogeneic bone marrow transplantation (BMT) for severe aplastic anemia (SAA), due to progress in optimization of the conditioning regimens, donor hematopoietic cell source and supportive care. Here we review recently published data that highlight the improvements and current issues in the treatment of SAA. Recent findings Approximately one-third of AA patients treated with immune suppression therapy (IST) have acquired mutations in myeloid cancer candidate genes. Because of the greater probability for eventual failure of IST, human leukocyte antigen (HLA)-matched sibling donor BMT is the first-line of treatment for SAA. HLA-matched unrelated donor (URD) BMT is generally recommended for patients who have failed IST. However, in younger patients for whom a 10/10-HLA-allele matched URD can be rapidly identified, there is a strong rationale to proceed with URD BMT as first-line therapy. HLA-haploidentical BMT using post-transplant cyclophosphamide (PT-CY) conditioning regimens, is now a reasonable second-line treatment for patients who failed IST. Summary Improved outcomes have led to an increased first-line role of BMT for treatment of SAA. The optimal cell source from an HLA-matched donor is bone marrow. Additional studies are needed to determine the optimal conditioning regimen for HLA-haploidentical donors. PMID:27607445

  14. Do Older Siblings Make a Difference? The Effects of Older Sibling Support and Older Sibling Adjustment on the Adjustment of Socially Disadvantaged Adolescents.

    Science.gov (United States)

    Widmer, Eric D.; Weiss, Christopher C.

    2000-01-01

    Examined role of support from a well-adjusted older sibling for positive adjustment of disadvantaged inner-city adolescents. Found that sibling support was nonsignificantly related to delinquency, academic success, and mental health for younger siblings. Only when accompanied by a positive image of their older sibling was support associated with…

  15. Allogeneic hematopoietic stem cell transplantation in Primary Cutaneous T Cell Lymphoma.

    Science.gov (United States)

    Cudillo, Laura; Cerretti, Raffaella; Picardi, Alessandra; Mariotti, Benedetta; De Angelis, Gottardo; Cantonetti, Maria; Postorino, Massimiliano; Ceresoli, Eleonora; De Santis, Giovanna; Nasso, Daniela; Pisani, Francesco; Scala, Enrico; Di Piazza, Fabio; Lanti, Alessandro

    2018-06-01

    In our retrospective study, 16 patients affected by advanced cutaneous T cell lymphoma (CTCL) underwent allogeneic hematopoietic stem cell transplantation (HSCT). Two patients (12.5%) were in complete remission (CR), nine (56.3%) in partial remission (PR), and five (31.2%) with active disease. The patients were transplanted from an HLA-identical (n = 7) from a mismatched (n = 1) or haploidentical (n = 1) sibling, from matched unrelated donor (n = 5), or from a single cord blood unit (n = 2). Conditioning regimen was standard myeloablative in 6 patients and at reduced intensity in 10. Seven patients died from non relapse mortality (NRM) and four patients relapsed or progressed, three of them achieved a second CR after donor lymphocyte infusion (DLI) or chemotherapy plus DLI. To date, with a median follow-up of 76 months (range 6-130), nine patients are alive, eight in CR, and one with active disease. Overall survival (OS) and disease-free survival (DFS) at 1 and 10 years are 61% (95% CI 40-91%) and 54% (95% CI 33-86%), 40% (95% CI 22-74%), and 34% (95% CI 16-68%), respectively. The time from diagnosis to transplant seems to influence negatively both OS (log-rank p < 0.04) and DFS (log-rank p < 0.05). Our results confirm on a long follow-up that CTCL appears particularly susceptible to the graft versus lymphoma (GVL) effect, so that allogeneic HSCT represents a possibility of cure for advanced CTCL. The timing of HSCT in the clinical course of disease remains an open issue.

  16. Sibling Dependence, Uncertainty and Education

    DEFF Research Database (Denmark)

    Lilleør, Helene Bie

    in the educational decision, which is consistent with a human capital portfolio theory of risk diversification and which cannot be explained by sibling rivalry over scarce resources for credit constrained households. The paper thus provides a complementary explanation to why enrolment rates in developing countries......Primary school enrolment rates are continuously low in many developing countries. The main explanation in the economic literature on schooling is focused on credit constraints and child labour, implying that the indirect cost of schooling in terms of foregone earnings is too high. This paper...

  17. Are elder siblings helpers or competitors? Antagonistic fitness effects of sibling interactions in humans

    Science.gov (United States)

    Nitsch, Aïda; Faurie, Charlotte; Lummaa, Virpi

    2013-01-01

    Determining the fitness consequences of sibling interactions is pivotal for understanding the evolution of family living, but studies investigating them across lifetime are lacking. We used a large demographic dataset on preindustrial humans from Finland to study the effect of elder siblings on key life-history traits. The presence of elder siblings improved the chances of younger siblings surviving to sexual maturity, suggesting that despite a competition for parental resources, they may help rearing their younger siblings. After reaching sexual maturity however, same-sex elder siblings' presence was associated with reduced reproductive success in the focal individual, indicating the existence of competition among same-sex siblings. Overall, lifetime fitness was reduced by same-sex elder siblings' presence and increased by opposite-sex elder siblings' presence. Our study shows opposite effects of sibling interactions depending on the life-history stage, and highlights the need for using long-term fitness measures to understand the selection pressures acting on sibling interactions. PMID:23173210

  18. Are Sibling Relationships Protective? A Longitudinal Study

    Science.gov (United States)

    Gass, Krista; Jenkins, Jennifer; Dunn, Judy

    2007-01-01

    Background: Although the protective effects of familial and parental support have been studied extensively in the child psychopathology literature, few studies have explored the protective quality of positive sibling relationships. Methods: A two-wave longitudinal design was used to examine the protective effect of positive sibling relationships…

  19. Prohibitions against Mourning in Childhood Sibling Loss.

    Science.gov (United States)

    Rosen, Helen

    1985-01-01

    Presents findings from a research study on sibling loss in childhood which support the idea that the loss of a sibling in childhood may be an especially significant loss for a child, in that both internal, family, and societal influences prohibit the opportunity to mourn the loss. (Author/NRB)

  20. Sibling Kinnections: A Clinical Visitation Program

    Science.gov (United States)

    Pavao, Joyce Maguire; St. John, Melissa; Cannole, Rebecca Ford; Fischer, Tara; Maluccio, Anthony; Peining, Suzanne

    2007-01-01

    The growing literature on sibling relationships throughout their lifespans is of great importance to those working in the child welfare system, and in adoption services in particular. Sibling bonds are important to all of us, but they are particularly vital to children from disorganized or dysfunctional families. These relationships assume even…

  1. Grieving the Loss of a Sibling

    Science.gov (United States)

    ... roles and responsibilities that may change when a sibling dies. You may take on new responsibilities, such as becoming the oldest child or an only child to whom family members look for leadership. This change can cause you ... cancer. Because you and your siblings share many of the same genes, it is ...

  2. Perceived Sibling Relationships and Adolescent Development.

    Science.gov (United States)

    Yeh, Hsiu-Chen; Lempers, Jacques D.

    2004-01-01

    Utilizing longitudinal, 3-wave data collected from multiple informants (fathers, mothers, and target children) in 374 families, the potential effects of sibling relationships on adolescent development across early and middle adolescence were investigated. Adolescents who perceived their sibling relationships more positively at Time 1 tended to…

  3. The Sibling: A Lifelong Journey of Care.

    Science.gov (United States)

    Liska, Victoria D.

    This paper describes the feelings and needs of children who have siblings with disabilities from the point of view of a woman who has a brother with an intellectual disability. Eight lessons that adult siblings can teach professionals about the significant, often forgotten, family role they play are outlined, supported by descriptive quotations…

  4. Young Children's Apologies to Their Siblings

    Science.gov (United States)

    Schleien, Sara; Ross, Hildy; Ross, Michael

    2010-01-01

    When children apologize, they accept responsibility for wrongdoings and act to reconcile social relationships. Apologies to siblings were coded in 40 families that were observed for 9 h when children were 2 1/2 and 4 1/2 years old, and again 2 years later. We found that sibling apologies were rare, generally simple in form, and more frequent after…

  5. Adult Siblings Consider the Future: Emergent Themes

    Science.gov (United States)

    Davys, Deborah; Mitchell, Duncan; Haigh, Carol

    2016-01-01

    Background: This study aimed to explore the perceptions of adult siblings regarding a future care role and compare with perceived parental wishes as family often provide a key support role in the lives of people who have an intellectual disability. Materials and Method: Semi-structured interviews were undertaken with 15 adult siblings and an…

  6. Sibling Family Practices: Guidelines for Healthy Boundaries

    Science.gov (United States)

    Johnson, Toni Cavanagh; Huang, Bevan Emma; Simpson, Pippa M.

    2009-01-01

    A questionnaire was given to 500 mental health and child welfare professionals asking for maximum acceptable ages for siblings to engage jointly in certain family practices related to hygiene, affection, and privacy. A large proportion of respondents felt it was never acceptable for siblings to take showers together (40%), kiss on the mouth (37%),…

  7. Sibling Relationships among Children with ADHD

    Science.gov (United States)

    Mikami, Amori Yee; Pfiffner, Linda J.

    2008-01-01

    Objective: This study investigated the quality of sibling relationships among children with ADHD relative to those without ADHD. Additional analyses examined whether externalizing and internalizing problems comorbid with ADHD affected sibling relationships. Method: Participants were 77 children with ADHD and 14 nonproblem control children. Sibling…

  8. Interaction between Siblings in Primetime Television Families.

    Science.gov (United States)

    Larson, Mary S.

    1989-01-01

    Analyzes three primetime family sitcoms in order to describe the nature of sibling interaction in television families. Research on television families is examined, and questions are raised concerning the value of television sibling images as role models for real people, and the effects of these models on family and peer relationships. (27…

  9. Parental Perceptions of Children's Sibling Relationships.

    Science.gov (United States)

    Kramer, Laurie; Baron, Lisa A.

    1995-01-01

    Parental appraisals of their children's sibling relationships, and their standards for sibling relationships, were assessed. Although parents reported most concern about their children's Agonism and Rivalry/Competition, the largest discrepancies between parental standards and observations involved behaviors reflecting Warmth. Results endorse…

  10. Relationships between Social Cognition and Sibling Constellations.

    Science.gov (United States)

    Goebel, Barbara L.

    1985-01-01

    First and second born college students (N=178) responded to measures of four social cognition factors. Multivariate analysis of variance identified relationships of social cognition factors with five sibling constellation components: subject's sex, subject's birth order (first or second), adjacent first or second born sibling's sex, spacing…

  11. Allogeneic peripheral blood stem cell transplantation in patients with haematological malignancies

    International Nuclear Information System (INIS)

    Shamsi, T.S.; Irfan, M.; Ansari, S.H.; Farzana, T.; Kahlid, M.Z.; Panwani, V.K.; Baig, M.I.; Shakoor, N.

    2004-01-01

    Objective: To report the initial data on allogeneic peripheral blood stem cell transplantation for haematogical malignancies in Pakistan. Patients and Methods: Patients with haematological malignancies were included who had received allogeneic PBSC transplantation of Filgrastim (rhG-CSF) mobilized peripheral blood stem cells from HLA-identical siblings (except one 5/6 antigen sibling) with Busulphan and Cyclophosphamide standard conditioning therapy in all patients. No patient received antibiotics for gut decontamination. Empirical antibiotics included Ceftriaxone and Amikacin for febrile neutropenia, oral Itraconazole for antifungal prophylaxis while oral acyclovir was used for antiviral prophylaxis. All donors and recipients were CMV IgG positive Cyclosporin A / Methotrexate were given for graft versus host disease (GvHD) prophylaxis. Stem cells were harvested using Haemonetics MCS+ cell separator. All patients received G-CSF starting from day +4 until their neutrophil count rose to normal. Results: There were 21 patients with age range of 8-38 years and male to female ratio of 2:1. Engraftment was achieved in all patients; median time to absolute neutrophil count of > 0.5 x 10/sup 9/I was 10 days (range 8 -12 days) and platelet count of > 20 x 10/sup 9/1 was 14 days (12-17 days). Acute graft versus host disease (aGvHD) was seen in 7 patients; one patient had grade IV skin and hepatic GvHD; another patient had grade III gut GvHD, grade II GvHD was seen in 3 patients while grade I skin aGvHD was seen in 2 patients. Median hospital stay was 34 days. Treatment related mortality was seen in 3 patients (18%). Chronic GvHD was seen in 5 patients. Four more patients died during the follow-up period. Malaria was seen in 2 while tuberculosis developed in one case. Relapse was seen in 2 patients. The estimated probability of survival at one hundred day, at one year and five years was 82, 47 and 40 percent respectively. Conclusion: Haematopoietic stem cell transplant

  12. Sibling advocates of people with intellectual disabilities.

    Science.gov (United States)

    Ying Li, Eria Ping

    2006-06-01

    The aim of this study was to examine the experience of the first generation of sibling advocates in Hong Kong. A qualitative approach was adopted and six sibling advocates of people with intellectual disabilities from one non-government organization were interviewed. Data were analyzed using a constant comparative method and content analysis. Findings revealed that the six participants were reactive in the process of taking up the caregiver responsibility and they performed three functions: to advocate for more service provision, to improve service quality, and to facilitate communication between individual service units and family members of people with intellectual disabilities. All of the participants expressed that they needed support from service providers when they tried to function as the sibling advocates. Strategies to promote the involvement of siblings of people with intellectual disabilities as advocates are discussed and it is expected that more siblings of people with intellectual disabilities will be supported to have a higher level of involvement in advocacy.

  13. Allogeneic cellular immunotherapy for chronic B-cell leukemia

    NARCIS (Netherlands)

    Hoogendoorn, Mels

    2007-01-01

    Allogeneic stem cell transplantation (SCT) following reduced-intensity conditioning (RIC) as treatment modality has curative potential in patients suffering from chronic lymphocytic leukemia (CLL) or mantle cell lymphoma (MCL), illustrating susceptibility of these leukemic cells for the

  14. Considerations of Elder Sibling Closeness in Predicting Younger Sibling Substance Use: Social Learning versus Social Bonding Explanations

    Science.gov (United States)

    Samek, Diana R.; Rueter, Martha A.

    2011-01-01

    Adolescent siblings are often similar in a variety of adjustment outcomes, yet little is known about the processes that explain sibling influences during adolescence. Two alternative explanations were tested, attachment (based in social bonding theory) and anaclitic identification (based in social learning theory). Hypotheses were tested using a sample of 613 adolescent sibling pairs (206 non-adopted, 407 adopted; elder sibling Mage = 16.1, younger sibling Mage = 13.8) across three sibling contexts (gender composition, age difference, and genetic similarity). Attachment explanations were supported such that the greater the perceived sibling emotional and behavioral closeness, the lower the likelihood of substance use; however, there were considerable moderating effects of sibling gender composition. Anaclitic identification explanations were not supported; closeness and elder sibling substance use did not interact to predict younger sibling substance use. Overall, this research adds to a body of work demonstrating important sibling influences on adolescent substance use. PMID:21988080

  15. Sibling relationship quality moderates the associations between parental interventions and siblings' independent conflict strategies and outcomes.

    Science.gov (United States)

    Recchia, Holly E; Howe, Nina

    2009-08-01

    This study extends research on sibling conflict strategies and outcomes by examining unique and interactive associations with age, relative birth order, sibling relationship quality, and caregivers' interventions into conflict. Each of 62 sibling dyads (older sibling mean age = 8.39 years; younger sibling mean age = 6.06 years) discussed 1 recurring conflict alone (dyadic negotiation) and a 2nd conflict with their primary parental caregiver (triadic negotiation). Negotiations were coded for children's conflict strategies, outcomes, and caregiver interventions; each family member provided ratings of sibling relationship quality. Results revealed that age was associated with siblings' constructive strategies, particularly in the dyadic negotiation. With age controlled, younger siblings referred more frequently to their own perspective. Caregivers' future orientation in the triadic negotiation was associated with children's future orientation in the dyadic negotiation; however, this association was most evident when sibling relationship quality was high. Similarly, caregivers' past orientation was positively associated with dyadic compromise, especially when relationship quality was high. Results reveal the value of simultaneously considering associations among parental, affective, and developmental correlates of sibling conflict strategies. (PsycINFO Database Record (c) 2009 APA, all rights reserved).

  16. Present and future of allogeneic natural killer cell therapy

    Directory of Open Access Journals (Sweden)

    Okjae eLim

    2015-06-01

    Full Text Available Natural killer (NK cells are innate lymphocytes that are capable of eliminating tumor cells and are therefore used for cancer therapy. Although many early investigators used autologous NK cells, including lymphokine-activated killer cells, the clinical efficacies were not satisfactory. Meanwhile, human leukocyte antigen (HLA-haploidentical hematopoietic stem cell transplantation revealed the anti-tumor effect of allogeneic NK cells, and HLA-haploidentical, killer cell immunoglobulin-like receptor (KIR ligand-mismatched allogeneic NK cells are currently used for many protocols requiring NK cells. Moreover, allogeneic NK cells from non-HLA-related healthy donors have been recently used in cancer therapy. The use of allogeneic NK cells from non-HLA-related healthy donors allows the selection of donor NK cells with higher flexibility and to prepare expanded, cryopreserved NK cells for instant administration without delay for ex vivo expansion. In cancer therapy with allogeneic NK cells, optimal matching of donors and recipients is important to maximize the efficacy of the therapy. In this review, we summarize the present state of allogeneic NK cell therapy and its future directions.

  17. Support Needs of Siblings of People with Developmental Disabilities

    Science.gov (United States)

    Arnold, Catherine K.; Heller, Tamar; Kramer, John

    2012-01-01

    This qualitative study examines the support needs of adult siblings of people with developmental disabilities. A survey completed by 139 siblings of people with developmental disabilities captured the needs of adult siblings through 2 open-ended questions. A grounded theory approach was used, and the sibling responses anchored the analysis,…

  18. Parental Divorce and Sibling Relationships: A Research Note

    Science.gov (United States)

    Poortman, Anne-Rigt; Voorpostel, Marieke

    2009-01-01

    This study examines long-term effects of parental divorce on sibling relationships in adulthood and the role of predivorce parental conflict. It used large-scale retrospective data from the Netherlands that contain reports from both siblings of the sibling dyad. Results show limited effects of parental divorce on sibling contact and relationship…

  19. Siblings and Theory of Mind in Deaf Native Signing Children.

    Science.gov (United States)

    Woolfe, Tyron; Want, Stephen C.; Siegal, Michael

    2003-01-01

    A study examined the basis of "theory of mind" (ToM) reasoning in 20 native signers (ages 4-8) of British Sign Language. Children and their siblings were given a measure of the quality of sibling relations. Sibling quality as perceived by siblings predicted children's ToM score over age and referential communication. (Contains…

  20. Older (but Not Younger) Siblings Facilitate False Belief Understanding.

    Science.gov (United States)

    Ruffman, Ted; Perner, Josef; Naito, Mika; Parkin, Lindsay; Clements, Wendy A.

    1998-01-01

    Four experiments and an analysis of pooled data from English and Japanese children show a linear increase in understanding false beliefs with number of older siblings; no such effect for children younger than 38 months; no helpful effect of younger siblings at any age; no effect of siblings' gender; and no helpful effect of siblings on a source…

  1. Differential Parental Treatment, Sibling Relationships and Delinquency in Adolescence

    Science.gov (United States)

    Scholte, Ron H. J.; Engels, Rutger C. M. E.; de Kemp, Raymond A. T.; Harakeh, Zeena; Overbeek, Geertjan

    2007-01-01

    The present study examined the moderating effect of the quality of the sibling relationship on the longitudinal association of parental treatment with theft, vandalism, and violence in adolescence. Participants were 416 sibling pairs which were studied over a one-year period. The younger siblings were aged 13 to 15, the older siblings 14 to 17 at…

  2. Sibling relationships in individuals with Angelman syndrome: a comparative study.

    Science.gov (United States)

    Love, Victoria; Richters, Lotte; Didden, Robert; Korzilius, Hubert; Machalicek, Wendy

    2012-01-01

    Investigating the impact of Angelman syndrome on the sibling relationship. This study explored differences in sibling relationships between children with a typically-developing sibling (n = 55) and children with a sibling with Angelman syndrome (n = 44). Sibling relationships were compared on four factors and 16 sub-scales of the Sibling Relationship Questionnaire-Revised. Results showed significant differences in mean scores on each of the four factors (i.e. Warmth/Closeness, Conflict, Rivalry and Dominance/Nurturance) and most of the sub-scales. ANCOVAs showed that demographic variables (number of siblings, living in a two-parent vs single parent household, gender, participant's age, place of residence) did not influence significant differences in sibling relationships between the two groups. Having a brother or sister with Angelman syndrome may influence the way in which the sibling perceives the sibling relationship. This may have important implications for family-centred intervention for this population.

  3. Xeroderma Pigmentosum: Variable Expressions among Three Siblings

    Directory of Open Access Journals (Sweden)

    M Srinivasa Raju

    2010-01-01

    Full Text Available Xeroderma pigmentosum is a rare disorder transmitted in an autosomal recessive manner. It is characterized by photosensitivity, pigmentary changes, premature skin aging, and malignant tumor development. The frequency of this disorder is approximately 1 case per 250.000 population. Two important causes of mortality are metastatic malignant melanoma and squamous cell carcinoma. Here xeroderma pigmentosum in three siblings presenting with variable expressions is reported. The seventy of the condition was more in one of the more sun exposed sibling and had more signs of malignant lesions. Intraoral pigmentation was also present in all the three siblings.

  4. First-born siblings show better second language skills than later born siblings

    OpenAIRE

    Karin eKeller; Karin eKeller; Larissa Maria Troesch; Alexander eGrob

    2015-01-01

    We examined the extent to which three sibling structure variables number of siblings, birth order and presence of an older sibling at school age are linked to the second language skills of bilingual children. The research questions were tested using an ethnically heterogeneous sample of 1209 bilingual children with German as a second language. Controlling for children’s age, sex, nationality, number of children’s books at home, family language and parental German language skills, hierarchical...

  5. The role of older siblings in infant motor development

    OpenAIRE

    Leonard, Hayley; Hill, EL

    2016-01-01

    Previous research has suggested that infant motor skills may be affected by older siblings, but has not considered whether this is due to specific characteristics of the older sibling, or of the quality of the sibling relationship. The current study used a longitudinal diary method to record infant motor milestones from 23 infants with older siblings, along with parent reports and standardised assessments of motor skills. Parent reports of the older siblings’ motor skills and the sibling rela...

  6. Attachment representations, parental differential treatment and sibling relationships.

    OpenAIRE

    Goodman, E.

    2005-01-01

    The purpose of this review is to examine the literature on siblings and sibling relationships. To outline the importance of this under-researched field the review details the link between sibling relationship quality and individual psychosocial outcome. Initial research into the area started with investigations of the influence of structural variables and temperament on sibling relationship quality but found that they explained only a small proportion of the variance in sibling relationship q...

  7. Allogeneic hematopoietic stem cell transplantation in children with primary immunodeficiencies: Hospital Israelita Albert Einstein experience.

    Science.gov (United States)

    Fernandes, Juliana Folloni; Kerbauy, Fabio Rodrigues; Ribeiro, Andreza Alice Feitosa; Kutner, Jose Mauro; Camargo, Luis Fernando Aranha; Stape, Adalberto; Troster, Eduardo Juan; Zamperlini-Netto, Gabriele; Azambuja, Alessandra Milani Prandini de; Carvalho, Bruna; Dorna, Mayra de Barros; Vilela, Marluce Dos Santos; Jacob, Cristina Miuki Abe; Costa-Carvalho, Beatriz Tavares; Cunha, Jose Marcos; Carneiro-Sampaio, Magda Maria; Hamerschlak, Nelson

    2011-06-01

    To report the experience of a tertiary care hospital with allogeneic hematopoietic stem cell transplantation in children with primary immunodeficiencies. Seven pediatric patients with primary immunodeficiencies (severe combined immunodeficiency: n = 2; combined immunodeficiency: n = 1; chronic granulomatous disease: n = 1; hyper-IgM syndrome: n = 2; and IPEX syndrome: n = 1) who underwent eight hematopoietic stem cell transplants in a single center, from 2007 to 2010, were studied. Two patients received transplants from HLA-identical siblings; the other six transplants were done with unrelated donors (bone marrow: n = 1; cord blood: n = 5). All patients had pre-existing infections before hematopoietic stem cell transplants. One patient received only anti-thymocyte globulin prior to transplant, three transplants were done with reduced intensity conditioning regimens and four transplants were done after myeloablative therapy. Two patients were not evaluated for engraftment due to early death. Three patients engrafted, two had primary graft failure and one received a second transplant with posterior engraftment. Two patients died of regimen related toxicity (hepatic sinusoidal obstruction syndrome); one patient died of progressive respiratory failure due to Parainfluenza infection present prior to transplant. Four patients are alive and well from 60 days to 14 months after transplant. Patients' status prior to transplant is the most important risk factor on the outcome of hematopoietic stem cell transplants in the treatment of these diseases. Early diagnosis and the possibility of a faster referral of these patients for treatment in reference centers may substantially improve their survival and quality of life.

  8. Donor Selection for Allogenic Hemopoietic Stem Cell Transplantation: Clinical and Ethical Considerations

    Directory of Open Access Journals (Sweden)

    Irene Riezzo

    2017-01-01

    Full Text Available Allogenic hematopoietic progenitor cell transplantation (allo-HSCT is an established treatment for many diseases. Stem cells may be obtained from different sources: mobilized peripheral blood stem cells, bone marrow, and umbilical cord blood. The progress in transplantation procedures, the establishment of experienced transplant centres, and the creation of unrelated adult donor registries and cord blood banks gave those without an human leucocyte antigen- (HLA- identical sibling donor the opportunity to find a donor and cord blood units worldwide. HSCT imposes operative cautions so that the entire donation/transplantation procedure is safe for both donors and recipients; it carries with it significant clinical, moral, and ethical concerns, mostly when donors are minors. The following points have been stressed: the donation should be excluded when excessive risks for the donor are reasonable, donors must receive an accurate information regarding eventual adverse events and health burden for the donors themselves, a valid consent is required, and the recipient’s risks must be outweighed by the expected benefits. The issue of conflict of interest, when the same physician has the responsibility for both donor selection and recipient care, is highlighted as well as the need of an adequate insurance protection for all the parties involved.

  9. Total Body Irradiation for Allogeneic Bone Marrow Transplantation in Chronic Myelogenous Leukemia

    International Nuclear Information System (INIS)

    Chung, Su Mi; Choi, Ihl Bohng; Kang, Ki Mun; Kim, In Ah; Shinn, Kyung Sub; Kim, Choon Choo; Kim, Dong Jip

    1994-01-01

    Between July 1987 and December 1992, we treated 22 patients with chromic myelogenous leukemia; 14 in the chronic phase and 8 with more advanced disease. All were received with allogeneic bone marrow transplantation from HLA-identical sibling donors after a total body irradiation (TBI) cyclophosphamide conditioning regimen. Patients were non-randomly assigned to either 1200 cGy/6 fractions/3 days (6 patients) or 1320 cGy/8 fractions/4 days (16 patients) by dose of TBI. Of the 22 patients, 8 were prepared with cyclophosphamide alone, 14 were conditioned with additional adriamycin or daunorubicin. To prevent graft versus host disease, cyclosporine was given either alone or in conjunction with methotrexate. The actuarial survival and leukemic-free survival at four years were 58.5% and 41.2%, respectively, and the relapse rate was 36% among 22 patients. There was a statistically significant difference in survival between the patients in chronic phase and more advanced phase (76% vs 33%, p=0.05). The relapse rate of patients receiving splenectomy was higher than that of patients receiving splenic irradiation (50% vs 0%, p=0.04). We conclude that the probability of cure is highest if transplantation is performed while the patient remains in the chronic phase

  10. Total Body Irradiation for Allogeneic Bone Marrow Transplantation in Chronic Myelogenous Leukemia

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Su Mi; Choi, Ihl Bohng; Kang, Ki Mun; Kim, In Ah; Shinn, Kyung Sub; Kim, Choon Choo; Kim, Dong Jip [Catholic University College of Medicine, Seoul (Korea, Republic of)

    1994-06-15

    Between July 1987 and December 1992, we treated 22 patients with chromic myelogenous leukemia; 14 in the chronic phase and 8 with more advanced disease. All were received with allogeneic bone marrow transplantation from HLA-identical sibling donors after a total body irradiation (TBI) cyclophosphamide conditioning regimen. Patients were non-randomly assigned to either 1200 cGy/6 fractions/3 days (6 patients) or 1320 cGy/8 fractions/4 days (16 patients) by dose of TBI. Of the 22 patients, 8 were prepared with cyclophosphamide alone, 14 were conditioned with additional adriamycin or daunorubicin. To prevent graft versus host disease, cyclosporine was given either alone or in conjunction with methotrexate. The actuarial survival and leukemic-free survival at four years were 58.5% and 41.2%, respectively, and the relapse rate was 36% among 22 patients. There was a statistically significant difference in survival between the patients in chronic phase and more advanced phase (76% vs 33%, p=0.05). The relapse rate of patients receiving splenectomy was higher than that of patients receiving splenic irradiation (50% vs 0%, p=0.04). We conclude that the probability of cure is highest if transplantation is performed while the patient remains in the chronic phase.

  11. Sibling relationships in adults who have siblings with or without intellectual disabilities.

    Science.gov (United States)

    Doody, Mairéad A; Hastings, Richard P; O'Neill, Sarah; Grey, Ian M

    2010-01-01

    There is relatively little research on the relationships between adults with intellectual disability and their siblings, despite the potential importance of these relationships for either individual's psychological well-being and future care roles that might be adopted by adult siblings. In the present study, sibling relationships of adults with adult siblings with (N=63) and without (N=123) intellectual disability were explored. Contact, warmth, conflict, and rivalry were measured using questionnaires available as an on-line survey. Expressed emotion was measured using the Five Minute Speech Sample over the telephone to establish an independently coded measure of criticism from the participant towards their sibling. Overall, there were few group differences in contact and sibling relationship. There was less telephone contact in the intellectual disability group, and less reported warmth in the relationship with siblings with intellectual disability although this was mainly associated with severe/profound intellectual disability. Exploratory analyses were conducted of the correlates of sibling relationships in both the intellectual disability and control groups. These analyses revealed a small number of different associations especially for conflict, which was lower when either the participant or sibling was younger in the control group but associated with relative age in the intellectual disability group.

  12. Child passenger injury risk in sibling versus non-sibling teen driver crashes: a US study.

    Science.gov (United States)

    Senserrick, Teresa M; Kallan, Michael J; Winston, Flaura K

    2007-06-01

    Several international jurisdictions allow family exemptions to graduated driver licensing passenger restrictions. The objective of this research was to examine differences in injury risk to US child passengers in crashes involving sibling versus non-sibling teen drivers, and to compare outcomes with crashes involving adult drivers. Insurance claim and telephone survey data were collected on 16 233 child passengers (representing 289 329 children) in 17 US jurisdictions. There was a trend toward higher restraint non-use by child passengers in the non-sibling group than in the sibling group (9.6% vs 4.7%; p = 0.08). Children in the sibling group had a 40% lower risk of injury than those in the non-sibling group (adjusted OR 0.60, 95% CI 0.40 to 0.90); however, injury risk was higher in the sibling group than in children traveling with adults (adjusted OR 1.57, 95% CI 1.09 to 2.26). Child passengers riding with sibling teen drivers may be safer than those riding with non-sibling teens, but not as safe as those riding with adult drivers.

  13. Ocular findings after allogeneic hematopoietic stem cell transplantation.

    Science.gov (United States)

    Tabbara, Khalid F; Al-Ghamdi, Ahmad; Al-Mohareb, Fahad; Ayas, Mouhab; Chaudhri, Naeem; Al-Sharif, Fahad; Al-Zahrani, Hazzaa; Mohammed, Said Y; Nassar, Amr; Aljurf, Mahmoud

    2009-09-01

    To study the incidence, causes, and outcome of major ocular complications in patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT). Retrospective, noncomparative, observational clinical study. The study included a total of 620 patients who underwent allogeneic HSCT in the period from 1997 to 2007 at King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia. Allogeneic HSCT. Patients with ocular complications were referred to the ophthalmology division for complete ophthalmologic examination, including visual acuity, tonometry, Schirmer test, biomicroscopy, and dilated ophthalmoscopy. Laboratory investigations were performed whenever indicated. The incidence and causes of major ocular complications after allogeneic HSCT were determined. Visual acuity at 1 year after allogeneic HSCT was recorded. Major ocular complications occurred in 80 (13%) of 620 patients who underwent allogeneic HSCT. There were 36 male patients (45%) and 44 female patients (55%) with a mean age of 29 years and an age range of 9 to 65 years. Prophylaxis for graft-versus-host disease (GVHD) consisted of cyclosporine and methotrexate in 69 patients, and cyclosporine, methotrexate and corticosteroids, or mycophenolate mofetil in 11 patients. The most frequently encountered ocular complications were chronic GVHD, dry eye syndrome without GVHD, corneal ulcers, cataract, glaucoma, cytomegalovirus retinitis, fungal endophthalmitis, and acquisition of allergic conjunctivitis from atopic donors. There was no correlation between the pattern of ocular complications and the transplanted stem cell source. Best-corrected visual acuity (BCVA) at 1 year after transplantation was less than 20/200 in 13 patients (16%), less than 20/50 in 17 patients (21%), and better than 20/50 in 50 patients (63%). Ocular complications are common in patients undergoing allogeneic HSCT. Early recognition and prompt treatment are important. The author(s) have no proprietary or commercial

  14. Siblings in the context of anorexia nervosa.

    Science.gov (United States)

    Bachner-Melman, Rachel

    2005-01-01

    Sibling relationships may be relevant to the development of anorexia nervosa (AN), yet little research has focused on this aspect of the disorder. A narrative study of four women in various stages of recovery from AN is described and results relevant to sibling relationships are presented, enriched by published anecdotes and case studies. The anorexic interviewees described much antagonism and rivalry and little warmth and intimacy between themselves and their siblings. They seemed to feel they did not belong sufficiently in their families and other social settings despite a strong desire to belong. The sample is small, reports subjective and retrospective and no control group was included. It is suggested that anorexic girls often feel emotionally isolated from and misunderstood by siblings, who may have much to contribute to the process of therapy and recovery.

  15. Tetanus after allogeneic bone-marrow transplantation

    International Nuclear Information System (INIS)

    Kendra, J.R.; Halil, O.; Barrett, A.J.; Selwyn, S.

    1982-01-01

    A brief report is presented of a case of tetanus after allogeneic bone-marrow transplantation complicated by radiation-induced pneumonitis. A 30-year-old army sergeant received a bone-marrow transplant from his brother for the treatment of a granulocytic sarcoma after local radiotherapy to the tumour. Six years earlier he had sustained an open, compound fracture of the left tibia and fibula while on army exercise. At the time a pin and plate had been inserted and booster anti-tetanus administered. Bone-marrow transplantation was performed after total body irradiation. Cyclosporin A was given against graft-versus-host disease. Fifty four days after transplantation tetanus was diagnosed and death followed 14 days later. Necropsy disclosed radiation-induced pneumonitis, but no organisms were cultured from the lungs or the old fracture site. It is suggested that spores were incorporated into the wound site before surgery and that oxygenation around the plate became compromised after transplantation, permitting germination of dormant spores, immunosuppression allowing development of the disease. (U.K.)

  16. Psychosis among "healthy" siblings of schizophrenia patients

    OpenAIRE

    Arajärvi, Ritva; Ukkola, Jonna; Haukka, Jari; Suvisaari, Jaana; Hintikka, Jukka; Partonen, Timo; Lönnqvist, Jouko

    2006-01-01

    Abstract Background Schizophrenia aggregates in families and accurate diagnoses are essential for genetic studies of schizophrenia. In this study, we investigated whether siblings of patients with schizophrenia can be identified as free of any psychotic disorder using only register information. We also analyzed the emergence of psychotic disorders among siblings of patients with schizophrenia during seven to eleven years of follow-up. Methods A genetically homogenous population isolate in no...

  17. The association between unequal parental treatment and the sibling relationship in Finland: The difference between full and half-siblings.

    Science.gov (United States)

    Danielsbacka, Mirkka; Tanskanen, Antti O

    2015-06-24

    Studies have shown that unequal parental treatment is associated with relationship quality between siblings. However, it is unclear how it affects the relationship between full and half-siblings. Using data from the Generational Transmissions in Finland project (n = 1,537 younger adults), we study whether those who have half-siblings perceive more unequal parental treatment than those who have full siblings only. In addition, we study how unequal parental treatment is associated with sibling relationship between full, maternal, and paternal half-siblings. First, we found that individuals who have maternal and/or paternal half-siblings are more likely to have encountered unequal maternal treatment than individuals who have full siblings only. Second, we found that unequal parental treatment impairs full as well as maternal and paternal half-sibling relations in adulthood. Third, unequal parental treatment mediates the effect of genetic relatedness on sibling relations in the case of maternal half-siblings, but not in the case of paternal half-siblings. After controlling for unequal parental treatment, the quality of maternal half-sibling relationships did not differ from that of full siblings, whereas the quality of paternal half-sibling relationships still did. Fourth, the qualitative comments (n = 206) from the same population reveal that unequal parental treatment presents itself several ways, such as differential financial, emotional, or practical support.

  18. The Association between Unequal Parental Treatment and the Sibling Relationship in Finland: The Difference between Full and Half-Siblings

    Directory of Open Access Journals (Sweden)

    Mirkka Danielsbacka

    2015-04-01

    Full Text Available Studies have shown that unequal parental treatment is associated with relationship quality between siblings. However, it is unclear how it affects the relationship between full and half-siblings. Using data from the Generational Transmissions in Finland project (n = 1,537 younger adults, we study whether those who have half-siblings perceive more unequal parental treatment than those who have full siblings only. In addition, we study how unequal parental treatment is associated with sibling relationship between full, maternal, and paternal half-siblings. First, we found that individuals who have maternal and/or paternal half-siblings are more likely to have encountered unequal maternal treatment than individuals who have full siblings only. Second, we found that unequal parental treatment impairs full as well as maternal and paternal half-sibling relations in adulthood. Third, unequal parental treatment mediates the effect of genetic relatedness on sibling relations in the case of maternal half-siblings, but not in the case of paternal half-siblings. After controlling for unequal parental treatment, the quality of maternal half-sibling relationships did not differ from that of full siblings, whereas the quality of paternal half-sibling relationships still did. Fourth, the qualitative comments (n = 206 from the same population reveal that unequal parental treatment presents itself several ways, such as differential financial, emotional, or practical support.

  19. Risk of maltreatment for siblings: Factors associated with similar and different childhood experiences in a dyadic sample of adult siblings.

    Science.gov (United States)

    Witte, Susanne; Fegert, Jörg M; Walper, Sabine

    2018-02-01

    Siblings share the same environment and thus potentially a substantial number of risk factors for child maltreatment. Furthermore, the number of siblings and the sibling constellation itself might pose a risk for child maltreatment. Little is known about the likelihood that more than one child in a family is maltreated and which factors increase the risk. This study sought to investigate similarities and differences in maltreatment in siblings and risk factors associated with the maltreatment of more than one child from the same family. Data on maltreatment during childhood and adolescence, family background, and sibling constellation were collected from 870 pairs of siblings. In the dyadic analyses, siblings reported similar maltreatment experiences, especially when any type of maltreatment was considered. Parents' mental health problems were significant predictors for maltreatment of at least one sibling. Father's mental health problems were predictive of maltreatment of both or only the younger sibling, mother's mental health problems of both or only the older sibling. Closeness in age and same gender of siblings did not emerge as a consistent predictor. The increasing number of siblings was a risk factor for any type of maltreatment of both siblings. The results highlight the need for preventive measures for families with a large number of children and with parents with mental health problems as well as a repeated risk assessment of all siblings in a family when one sibling was maltreated. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. HLA matching and the United Network for Organ Sharing Allocation System: impact of HLA matching on African-American recipients of cadaveric kidney transplants.

    Science.gov (United States)

    Rebellato, Lorita M; Arnold, Angelo N; Bozik, Karen M; Haisch, Carl E

    2002-12-15

    A recent proposal supports the elimination of allocation points for human leukocyte antigen (HLA) mismatches (MM) in cadaveric kidney transplantation. The intent is to increase access for some racial groups that might be disadvantaged by the representation of race-specific HLA in a largely white donor pool. We report our experience from two transplant centers that serve a large African American (AA) patient population. All cadaveric transplants into AA recipients from 1994 to 2000 (n=162) were included in a retrospective review. Superior graft survival was observed in AA recipients of 0 MM transplants. When induction therapy was used, the graft survival at 3 years for the human leukocyte antigen (HLA)-BDR MM grades given allocation points (0,1,2 MM) was 82% versus only 49% for BDR MM grades not given points (3,4 MM: =0.0022). Our collective experience demonstrates that AA patients having HLA-BDR MM grades given allocation points had better graft survival. Removing points for HLA from the national allocation system may result in significantly poorer outcome in AA kidney recipients.

  1. A standardized multidisciplinary approach reduces the use of allogeneic blood products in patients undergoing cardiac surgery

    NARCIS (Netherlands)

    van der Linden, P.; de Hert, S.; Daper, A.; Trenchant, A.; Jacobs, D.; de Boelpaepe, C.; Kimbimbi, P.; Defrance, P.; Simoens, G.

    2001-01-01

    PURPOSE: Individual and institutional practices remain an independent predictor factor for allogeneic blood transfusion. Application of a standardized multidisciplinary transfusion strategy should reduce the use of allogeneic blood transfusion in major surgical patients. METHODS: This prospective

  2. Impact of childhood chronic illnesses on siblings: a literature review.

    Science.gov (United States)

    O' Brien, Irene; Duffy, Anita; Nicholl, Honor

    Childhood illness can have a significant impact on families, particularly on the ill child's siblings. There is a dearth of published literature focusing on the needs of siblings of ill children. This literature review aims to provide an overview of the current healthcare literature in relation to the impact of childhood chronic illness or disability on siblings. A literature review was undertaken by searching the databases CINAHL, PsycINFO, ProQuest and Cochrane Library for relevant articles in English using the search terms: 'siblings', 'chronic illness', 'disability', 'cancer', 'sibling relations', 'sibling adjustment', 'coping', 'family-centred care', 'sibling interventions', 'camps', 'autism', 'Down's syndrome'. Seventeen research studies in total were reviewed. This review focuses on three sibling groups related to children suffering from autism, cancer and Down's syndrome, and are discussed under the following headings: sibling adjustment; family functioning and sibling's coping resources; and intervention programmes. The literature revealed that siblings of children with Down's syndrome were well adjusted to living with their brother or sister. However, there was conflicting information on the adjustment of siblings of children with cancer and autism. An awareness of the harmful effect that living with childhood illness and disability can have on some siblings is essential to enable healthcare professionals to provide supportive interventions to protect siblings' physical and emotional wellbeing.

  3. First-born siblings show better second language skills than later born siblings

    Science.gov (United States)

    Keller, Karin; Troesch, Larissa M.; Grob, Alexander

    2015-01-01

    We examined the extent to which three sibling structure variables number of siblings, birth order, and presence of an older sibling at school age are linked to the second language skills of bilingual children. The research questions were tested using an ethnically heterogeneous sample of 1209 bilingual children with German as a second language. Controlling for children’s age, sex, nationality, number of children’s books at home, family language and parental German language skills, hierarchical regression analyses showed an inverse relationship between the number of siblings and second language skills: the more siblings a child had, the lower was his/her second language proficiency. This relationship was mediated by attendance in early education institutions. Moreover, first-born siblings showed better second language skills than later born siblings. The current study revealed that the resource dilution model, i.e., the decrease in resources for every additional sibling, holds for second language acquisition. Moreover, the results indicate that bilingual children from families with several children benefit from access to early education institutions. PMID:26089806

  4. Longitudinal Links between Older Sibling Features and Younger Siblings' Academic Adjustment during Early Adolescence

    Science.gov (United States)

    Bouchey, Heather A.; Shoulberg, Erin K.; Jodl, Kathleen M.; Eccles, Jacquelynne S.

    2010-01-01

    This study investigated prospective relations between older siblings' support and academic engagement and younger siblings' academic adjustment from 7th to post-8th grade. The study was unique in that it incorporated a sample of both African American and European American adolescents. Also investigated was the extent to which the gender…

  5. First-born siblings show better second language skills than later born siblings

    Directory of Open Access Journals (Sweden)

    Karin eKeller

    2015-06-01

    Full Text Available We examined the extent to which three sibling structure variables number of siblings, birth order and presence of an older sibling at school age are linked to the second language skills of bilingual children. The research questions were tested using an ethnically heterogeneous sample of 1209 bilingual children with German as a second language. Controlling for children’s age, sex, nationality, number of children’s books at home, family language and parental German language skills, hierarchical regression analyses showed an inverse relationship between the number of siblings and second language skills: The more siblings a child had, the lower was his/her second language proficiency. This relationship was mediated by attendance in early education institutions. Moreover, first-born siblings showed better second language skills than later born siblings.The current study revealed that the resource dilution model, i.e., the decrease in resources for every additional sibling, holds for second language acquisition. Moreover, the results indicate that bilingual children from families with several children benefit from access to early education institutions.

  6. Sibling Voices: The Self-Reported Mental Health of Siblings of Children with a Disability

    Science.gov (United States)

    Giallo, Rebecca; Gavidia-Payne, Susana; Minett, Belinda; Kapoor, Aparna

    2012-01-01

    Background: There is increasing interest in the experiences and well-being of siblings growing up with a brother or sister with a disability in Australia. However, research to date has primarily obtained parent reports of sibling adjustment and mental health. Therefore, the aim of the current study was threefold: (1) to report on the mental health…

  7. Siblings of Individuals with an Autism Spectrum Disorder: Sibling Relationships and Wellbeing in Adolescence and Adulthood

    Science.gov (United States)

    Orsmond, Gael I.; Kuo, Hsin-Yu; Seltzer, Marsha Mailick

    2009-01-01

    We investigated sibling relationships and wellbeing in adolescents and adults with a sibling with an autism spectrum disorder (ASD). Adolescents engaged in more shared activities than did adults. Adolescents reported greater social support, greater use of emotion-focused coping strategies, and less use of problem-focused coping than adults. In…

  8. Associations between Social Understanding, Sibling Relationship Quality, and Siblings' Conflict Strategies and Outcomes

    Science.gov (United States)

    Recchia, Holly E.; Howe, Nina

    2009-01-01

    Sibling relationship quality and social understanding (second-order false belief, conflict interpretation, and narrative conflict perspective references) were examined as unique and interactive correlates of sibling conflict behavior in 62 dyads (older M age = 8.39 years and younger M age = 6.06 years). High-quality relationships were associated…

  9. Why Siblings Are Important Agents of Cognitive Development: A Comparison of Siblings and Peers.

    Science.gov (United States)

    Azmitia, Margarita; Hesser, Joanne

    1993-01-01

    Found that, in unstructured building sessions, kindergartners were more likely to observe, imitate, and consult their second- or third-grade siblings than their older peers. Older siblings were also more likely to provide additional explanations and positive feedback than older peers when instructing younger children. (MDM)

  10. Associations between social understanding, sibling relationship quality, and siblings' conflict strategies and outcomes.

    Science.gov (United States)

    Recchia, Holly E; Howe, Nina

    2009-01-01

    Sibling relationship quality and social understanding (second-order false belief, conflict interpretation, and narrative conflict perspective references) were examined as unique and interactive correlates of sibling conflict behavior in 62 dyads (older M age = 8.39 years and younger M age = 6.06 years). High-quality relationships were associated with positive conflict processes. Younger siblings' second-order false belief scores were negatively associated with constructive conflict strategies, and older siblings' narrative self-referential focus was negatively associated with compromise. Associations between younger children's social understanding (conflict interpretation and narrative perspective references) and siblings' dyadic conflict behavior were moderated by relationship quality. Results suggest that links between social understanding and conflict behavior should be considered in conjunction with the quality of children's relationships.

  11. Bacterial infections associated with allogenic bone transplantation

    Directory of Open Access Journals (Sweden)

    Stepanović Željko Lj.

    2015-01-01

    Full Text Available Background/Aim. Bone allografts are frequently used in orthopedic reconstructive procedures carrying a high risk for recipients. To assess the nature and frequency of allograft contamination and associated surgical infection the case records from our institutional bone bank were reviewed. Methods. We retrospectively analyzed the microbiology of discarded bone allografts and the surgical site of the recipients. A case series of patients who acquired surgical site infection after allogenic bone transplantation was presented. Swab culturing was conducted on 309 femoral heads from living donors who underwent partial and total hip arthroplasty between January 2007 and December 2013. To prevent potential bone allograft contamination we used saline solution of 2.0 mg/ml of amikacin during thawing. The overall infection rate was analyzed in 197 recipients. Results. Of the 309 donated femoral heads, 37 were discarded due to bacterial contamination, giving the overall contamination rate of 11.97%. The postoperative survey of 213 bone allotransplantations among 197 recipients showed the infection rate of 2.03%. The coagulase-negative Staphylococcus was the most commonly identified contaminant of bone allografts and recipient surgical sites. Conclusion. The allograft contamination rate and the infection rate among recipients in our institution are in accordance with the international standards. The coagulase-negative Staphylococcus was the most commonly identified contaminant of bone allografts and recipient surgical sites. There is no strong evidence that surgical site infections were associated with bone allograft utilization. We plan further improvements in allograft handling and decontamination with highly concentrated antibiotic solutions in order to reduce infection risk for recipients.

  12. Quality of Sibling Relationship and Substance Misuse: A Comparative Study

    OpenAIRE

    Anastasia Tsamparli; Elvisa Frrokaj

    2016-01-01

    The aim of the current study is to examine the quality of sibling relationship in families with a sibling with substance misuse (SSU) and compare the relationship to families with a sibling with no use (SNU). Thirty-six (36) families participated in the study (17 with SSU and 19 with SNU; N = 144). Semi-structured interviews were conducted with 40 siblings (20 SNU and 20 SSU; 18-31 years old) in order to qualitatively investigate the characteristics of the sibling relationship. The siblings w...

  13. Mechanisms of sibling socialization in normative family development.

    Science.gov (United States)

    Whiteman, Shawn D; Becerra, Julia M; Killoren, Sarah E

    2009-01-01

    Siblings are important sources of social influence throughout childhood and adolescence. Nevertheless, the processes by which siblings influence one another remain relatively unexplored. We highlight two theories of sibling influence-sibling deidentification and social learning-that offer insights as to how and why siblings develop similar and different attributes, attitudes, and behaviors. Recognizing the need to move past post hoc explanations, we suggest several directions for how these two influence processes can be measured directly in future work. Research on sibling influence also can be improved by integrating these theories and attending to their domains of influence.

  14. Ready-made allogeneic ABO-specific serum eye drops

    DEFF Research Database (Denmark)

    Harritshøj, Lene Holm; Nielsen, Connie; Ullum, Henrik

    2014-01-01

    serum treatment. CONCLUSION: Ready-made ABO-identical allogeneic serum eye drops were straightforwardly produced, quality-assured and registered as a safe standard blood product for the treatment of certain cases of severe dry eye disease. Therapeutic efficacy was comparable to previous reports......PURPOSE: To overcome problems and delays of the preparation of autologous serum eye drops, a production line of ABO-specific allogeneic serum eye drops from male blood donors was set up in a blood bank. Feasibility, clinical routine, safety and efficacy were evaluated in a cohort of patients...

  15. Parental Differential Treatment of Siblings in Childhood

    Directory of Open Access Journals (Sweden)

    Tina Kavčič

    2007-03-01

    Full Text Available Parental differential treatment is an important feature of non-shared family environment which contributes to the development of behavioural differences between siblings growing up in the same family. To investigate the frequency, direction, and patterns of parental differential treatment of siblings in Slovene families, mothers and fathers of 93 sibling-pairs in early/middle childhood provided self-reports in a two-wave longitudinal study. Most of the parents reported on low levels of differential treatment, predominantly expressing somewhat more affection and control towards the older than towards the younger sibling. Over a one-year time period, the average frequency of parental differential treatment did not change significantly, whereas the stability was estimated as moderate for maternal and low for paternal assessments. Maternal and paternal self-ratings were moderately correlated. However, the mothers reported on somewhat higher levels of differential control and (only in wave 1 affection than the fathers. Nearly half of the families were characterized by a congruent pattern of parental differential treatment indicating that both parents showed more affection and control towards the older of the two siblings. A complementary family pattern reflecting an opposite direction of maternal and paternal differential treatment emerged in approximately a quarter of the participating families.

  16. Using Twins to Better Understand Sibling Relationships.

    Science.gov (United States)

    Mark, Katharine M; Pike, Alison; Latham, Rachel M; Oliver, Bonamy R

    2017-03-01

    We compared the nature of the sibling relationship in dyads of varying genetic relatedness, employing a behavioural genetic design to estimate the contribution that genes and the environment have on this familial bond. Two samples were used-the Sisters and Brothers Study consisted of 173 families with two target non-twin children (mean ages = 7.42 and 5.22 years respectively); and the Twins, Family and Behaviour study included 234 families with two target twin children (mean age = 4.70 years). Mothers and fathers reported on their children's relationship with each other, via a postal questionnaire (the Sisters and Brothers Study) or a telephone interview (the Twins, Family and Behaviour study). Contrary to expectations, no mean level differences emerged when monozygotic twin pairs, dizygotic twin pairs, and non-twin pairs were compared on their sibling relationship quality. Behavioural genetic analyses also revealed that the sibling bond was modestly to moderately influenced by the genetic propensities of the children within the dyad, and moderately to substantially influenced by the shared environment common to both siblings. In addition, for sibling negativity, we found evidence of twin-specific environmental influence-dizygotic twins showed more reciprocity than did non-twins. Our findings have repercussions for the broader application of results from future twin-based investigations.

  17. Effects of hematopoietic stem cell transplantation on acyl-CoA oxidase deficiency: a sibling comparison study

    Science.gov (United States)

    Monuki, Edwin S.; Powers, James; Schwartz, Phillip H.; Watkins, Paul A.; Shi, Yang; Moser, Ann; Shrier, David A.; Waterham, Hans R.; Nugent, Diane J.; Abdenur, Jose E.

    2015-01-01

    Objective Acyl-CoA oxidase (ACOX1) deficiency is a rare disorder of peroxisomal very-long chain fatty acid oxidation. No reports detailing attempted treatment, longitudinal imaging, or neuropathology exist. We describe the natural history of clinical symptoms and brain imaging in two siblings with ACOX1 deficiency, including the younger sibling's response to allogeneic unrelated donor hematopoietic stem cell transplantation (HSCT). Methods We conducted retrospective chart review to obtain clinical history, neuro-imaging, and neuropathology data. ACOX1 genotyping were performed to confirm the disease. In vitro fibroblast and neural stem cell fatty acid oxidation assays were also performed. Results Both patients experienced a fatal neurodegenerative course, with late-stage cerebellar and cerebral gray matter atrophy. Serial brain magnetic resonance imaging in the younger sibling indicated demyelination began in the medulla and progressed rostrally to include the white matter of the cerebellum, pons, midbrain, and eventually subcortical white matter. The successfully engrafted younger sibling had less brain inflammation, cortical atrophy, and neuronal loss on neuroimaging and neuropathology compared to the untreated older sister. Fibroblasts and stem cells demonstrated deficient very long chain fatty acid oxidation. Interpretation Although HSCT did not halt the course of ACOX1 deficiency, it reduced the extent of white matter inflammation in the brain. Demyelination continued because of ongoing neuronal loss, which may be due to inability of transplant to prevent progression of gray matter disease, adverse effects of chronic corticosteroid use to control graft-versus-host disease, or intervention occurring beyond a critical point for therapeutic efficacy. PMID:24619150

  18. Psychological Adjustment of Siblings of Children Who Are Deaf or Hard of Hearing

    Science.gov (United States)

    Verte, Sylvie; Hebbrecht, Lies; Roeyers, Herbert

    2006-01-01

    This study investigated both the quality of sibling relationships and the psychological adjustment siblings experienced across two groups: siblings of children who are deaf or hard of hearing compared to siblings of children with no disability. Twenty-four siblings of children with hearing loss and 24 siblings of children without a disability…

  19. The Nature and Correlates of Sibling Influence in Two-Parent African American Families

    Science.gov (United States)

    Whiteman, Shawn D.; Becerra Bernard, Julia M.; McHale, Susan M.

    2010-01-01

    Guided by research and theory on sibling similarities and differences, this study explored the nature and correlates of 2 processes of sibling influence--social learning and sibling differentiation--during adolescence. Participants included 2 adolescent-age siblings (M = 16.29 years for older siblings and M = 12.59 years for younger siblings,…

  20. The experiences of Latino siblings of children with developmental disabilities.

    Science.gov (United States)

    Kao, B; Romero-Bosch, L; Plante, W; Lobato, D

    2012-07-01

    This qualitative study explored the experiences of Latino siblings of children with developmental disabilities. Parents and typically developing siblings from 15 Latino families with a child with a developmental disability participated in separate interviews. Using consensual qualitative research methodology, domains reflecting siblings' relationships, emotional experiences and communication about the disability were identified. The child's need for caregiving was a prominent topic in the sibling and parent narratives. Parents reported concerns about siblings' experience of differential treatment, whereas siblings reported concerns about restricted social activities because of their brother/sister. Including multiple informants revealed commonalities and differences in parents' and siblings' perspectives on the impact of a child's disability. The importance of considering sibling adaptation in sociocultural context is discussed. © 2011 Blackwell Publishing Ltd.

  1. Caring for Siblings of Kids With Special Needs

    Science.gov (United States)

    ... problem. If this happens, seek help from a mental health professional for your child. Reviewed by: Larissa Hirsch, MD Date reviewed: August 2015 More on this topic for: Parents Kids Teens Sibling Rivalry Caring for Siblings of Seriously Ill Children ...

  2. Sibling relationships of anxiety disordered children--a research note

    NARCIS (Netherlands)

    Lindhout, Ingeborg E.; Boer, Frits; Markus, Monica T.; Hoogendijk, Thea H. G.; Maingay, Ragna; Borst, Sophie R.

    2003-01-01

    There is a paucity of knowledge on the role of sibling relationships in internalizing disorders. Research in nonclinical populations suggests an association between internalizing problems in children and negative sibling interactions. Further, an association is reported between internalizing

  3. Sibling Gender Composition and Preferences for STEM Education

    DEFF Research Database (Denmark)

    Brenøe, Anne Ardila

    2017-01-01

    of the younger siblings' gender allows me to estimate the causal effect of having an opposite compared to same sex sibling. Overall, having an opposite sex sibling makes educational choices more gender-stereotypical for both genders. Having an opposite sex sibling reduces women's probability to enroll in any......-parent interactions. Parents with mixed sex children gender-specialize their parenting more and spend more quality time with their same sex child than parents with same sex children. Moreover, I show that young boys with an opposite sex sibling are exposed to more gender-stereotypical behavior within the family than......This paper studies how sibling gender composition affects preferences for education within Science, Technology, Engineering, and Mathematics (STEM). To identify the causal effect of sibling gender, I focus on a sample of firstborn children who all have a younger biological sibling. The randomness...

  4. The early development of infant siblings of children with autism spectrum disorder: Characteristics of sibling interactions

    Science.gov (United States)

    Warreyn, Petra; Van der Paelt, Sara; Demurie, Ellen; Roeyers, Herbert

    2018-01-01

    Although sibling interactions play an important role in children’s early development, they are rarely studied in very young children with an older brother or sister with autism spectrum disorder (ASD). This study used a naturalistic, observational method to compare interactions between 18-month-old infants and their older sibling with ASD (n = 22) with a control group of 18-month-old infants and their typically developing (TD) older sibling (n = 29). In addition, role (a)symmetry and the influence of gender were evaluated. Sibling interactions in ASD-dyads were characterized by higher levels of negativity. Although somewhat less pronounced in ASD-dyads, role asymmetry was present in both groups, with the older child taking the dominant position. Finally, siblings pairs with an older sister were characterized by more positive behaviours. Since differences in sibling interactions may alter the developmental trajectories of both siblings, these early relationships should be taken into account in future ASD research and interventions. PMID:29543814

  5. Living with disability. Taking care of siblings

    Directory of Open Access Journals (Sweden)

    Roberta Caldin

    2016-11-01

    Full Text Available The birth of a disabled child is a critical event that places all the members of the family in a condition of great vulnerability. When talking about families with a disabled child, attention is usually focused on the parents. Siblings tend to play a marginal role, as shown in the referred literature, in this specific field of investigation. Communicating diagnosis to siblings means involving them in the process of family change, making them active players rather than “spectators” in their own “existential niche”. Communication of diagnosis is a delicate, continuous process that has to be tackled appropriately, using targeted words and educational actions. Children need help in accepting and welcoming their disabled sibling, with all his/her characteristics (and deficits, through a balanced, pondered approach that includes both the dimension of co-development and the acknowledgement of problematic situations.

  6. Should selecting saviour siblings be banned?

    Science.gov (United States)

    Sheldon, S; Wilkinson, S

    2004-12-01

    By using tissue typing in conjunction with preimplantation genetic diagnosis doctors are able to pick a human embryo for implantation which, if all goes well, will become a "saviour sibling", a brother or sister capable of donating life-saving tissue to an existing child. This paper addresses the question of whether this form of selection should be banned and concludes that it should not. Three main prohibitionist arguments are considered and found wanting: (a) the claim that saviour siblings would be treated as commodities; (b) a slippery slope argument, which suggests that this practice will lead to the creation of so-called "designer babies"; and (c) a child welfare argument, according to which saviour siblings will be physically and/or psychologically harmed.

  7. Life history consequences of mammal sibling rivalry.

    Science.gov (United States)

    Stockley, P; Parker, G A

    2002-10-01

    Mammal life history traits relating to growth and reproduction are extremely diverse. Sibling rivalry may contribute to selection pressures influencing this diversity, because individuals that are relatively large at birth typically have an advantage in competition for milk. However, selection for increased growth rate is likely to be constrained by kin selection and physiological costs. Here, we present and test a model examining the ESS (evolutionarily stable strategy) balance between these constraints and advantages associated with increased prenatal growth in mammal sibling rivalry. Predictions of the model are supported by results of comparative analyses for the Carnivora and Insectivora, which demonstrate an increase in prenatal growth rate with increasing intensity of postnatal scramble competition, and a decrease in postnatal growth rate relative to size at birth. Because increased prenatal growth rates are predicted to select for reduced gestation length under certain conditions, our study also indicates that sibling rivalry may contribute to selection pressures influencing variation in altriciality and precociality among mammals.

  8. Lyophilized allogeneic bone grafts for cystic and discontinuity defects of the jaws

    International Nuclear Information System (INIS)

    Pill Hoon Choung; Eun Seok Kim

    1999-01-01

    Allogenic bone grafts have been used after various processing in each institute was made by lyophilized allogenic bone and used for maxillofacial reconstruction. Three types of lyophilized allogenic bone grafts as powder, chip and block form were performed to reconstruct the following defects: 1) maxillectomy, 2) mandiblectomy, 3) cystectomy, 4) cleft alveolus, 5) gap in orthognathic osteotomy, 6) peri-implant defect, 7) extraction socket, and 8) facial contouring. Above defects can be classified as cystic and discontinuity defects of the maxilia and the mandible. Because discontinuity defects have more difficult problems to reconstruct considering mechanical strength of the allogenic bone. We performed allogenic bone grafts on 50 cystic defects and 12 discontinuity defects of the jaws. Among them, 3 cases were removed due to infection, and the others had no complications. In reconstruction of cystic defects, the defects were filled with allogenic chip which were made from allogenic block bone at the surgery, which later were changed to host bone. Three cases of them showed tooth eruption through the allogenic bone grafting site, changing the eruption pathway, which was interrupted by the lesion. in reconstruction of discontinuity defects, usually allogenic bone has been used as a tray, in which PMCB or demineralized bone chips were filled. But we tried to reconstruct this discontinuity defect using allogeneic bone block without inside filling of PMCB different from tray type. We will present the results of allogenic bone grafts using cranial bone, costochondral graft, and the mandible

  9. Sibling constellation effects on learning and career aspirations of pupils.

    OpenAIRE

    KOROTVIČKOVÁ, Blanka

    2012-01-01

    The thesis "Sibling Constellation Effects on Learning and Career Aspirations of Pupils" is aimed at the description of a relationship between birth order and personality development. It also deals with the general characteristics of sibling constellation and its historical development. It points out the importance of sibling constellation in human life and presents the personality description with regard to birth order in relation to parents, siblings, peers, education and occupation. The the...

  10. Childhood Experiences of Sibling Abuse: An investigation into learned helplessness

    OpenAIRE

    McLaurin, Shamla L.

    2005-01-01

    As various forms of interpersonal family violence receive more attention in the literature, sibling abuse is still in the background. Despite the increasing knowledge about the prevalence, causes, and effects of sibling abuse, many of us continue to relegate it to a childhood occurrence. Sibling abuse symptoms continue to go unrecognized and its demoralizing effects continue to be ignored (Wiehe, 1990). Minimization and denial of sibling abuse have also contributed to constraining the extent ...

  11. Sexual function 1-year after allogeneic hematopoietic stem cell transplantation

    DEFF Research Database (Denmark)

    Noerskov, K. H.; Schjødt, I.; Syrjala, K. L.

    2016-01-01

    Treatment with allogeneic hematopoietic stem cell transplantation (HSCT) is associated with short and long-term toxicities that can result in alterations in sexual functioning. The aims of this prospective evaluation were to determine: (1) associations between HSCT and increased sexual dysfunction...

  12. Soluble urokinase plasminogen activator receptor during allogeneic stem cell transplantation

    DEFF Research Database (Denmark)

    Haastrup, E; Andersen, J; Ostrowski, S R

    2011-01-01

    the course of allogeneic stem cell transplantation (SCT). Twenty SCT patients were included in the study. suPAR was measured by ELISA in daily taken plasma samples during the pretransplant conditioning with chemotherapy and weekly for 1 month after infusion of the graft. suPAR levels before the start...

  13. Single-centre experience of allogeneic haemopoietic stem cell ...

    African Journals Online (AJOL)

    Allogeneic haemopoietic stem cell transplant (Allo-HSCT) is used to treat a broad but well-defined range of paediatric conditions, most frequently in paediatric oncology for treatment intensification or salvage therapy for acute myeloid leukaemia (AML) and acute lymphoblastic leukaemia (ALL). Allo-HSCT is also indicated in.

  14. Progeria in siblings: A rare case report

    Directory of Open Access Journals (Sweden)

    R Sowmiya

    2011-01-01

    Full Text Available Progeria, also known as Hutchinson-Gilford syndrome, is an extremely rare, severe genetic condition wherein symptoms resembling aspects of aging are manifested at an early age. It is an autosomal dominant disorder. It is not seen in siblings of affected children although there are very few case reports of progeria affecting more than one child in a family. Here we are presenting two siblings, a 14-year-old male and a 13-year-old female with features of progeria, suggesting a possible autosomal recessive inheritance.

  15. My older sibling was drunk - younger siblings' drunkenness in relation to parental monitoring and the parent-adolescent relationship.

    Science.gov (United States)

    Gossrau-Breen, Diana; Kuntsche, Emmanuel; Gmel, Gerhard

    2010-10-01

    This study explored the links between having older siblings who get drunk, satisfaction with the parent-adolescent relationship, parental monitoring, and adolescents' risky drinking. Regression models were conducted based on a national representative sample of 3725 8th to 10th graders in Switzerland (mean age 15.0, SD = .93) who indicated having older siblings. Results showed that both parental factors and older siblings' drinking behaviour shape younger siblings' frequency of risky drinking. Parental monitoring showed a linear dose-response relationship, and siblings' influence had an additive effect. There was a non-linear interaction effect between parent-adolescent relationship and older sibling's drunkenness. The findings suggest that, apart from avoiding an increasingly unsatisfactory relationship with their children, parental monitoring appears to be important in preventing risky drinking by their younger children, even if the older sibling drinks in such a way. However, a satisfying relationship with parents does not seem to be sufficient to counterbalance older siblings' influence.

  16. Examining the role of communication on sibling relationship quality and interaction for sibling pairs with and without a developmental disability.

    Science.gov (United States)

    Smith, Ashlyn L; Romski, Maryann; Sevcik, Rose A

    2013-09-01

    This study examined communication interaction patterns when one sibling had a developmental disability as well as the role of communication skills in sibling relationship quality. Thirty sibling dyads were categorized into one of three communication status groups: emerging, context-dependent, and independent communicators. Independent communicators and their siblings did not differ in terms of syntactic complexity but typically developing siblings dominated the interaction and exhibited greater lexical diversity regardless of communication status. Communication status did not impact the warmth/closeness, rivalry, or conflict in the sibling relationship, but siblings of independent communicators engaged in the greatest amount of helping and managing behaviors. These results represent a first step in understanding the role of communication skills in the sibling relationship for families of children with disabilities.

  17. Siblings, Language, and False Belief in Low-Income Children

    Science.gov (United States)

    Tompkins, Virginia; Farrar, M. Jeffrey; Guo, Ying

    2013-01-01

    The authors examined the relationship between number of siblings and false belief understanding (FBU) in 94 low-income 4-5-year-olds. Previous research with middle-income children has shown a positive association between number of siblings and FBU. However, it is unclear whether having multiple siblings in low-income families is related to better…

  18. Social and Emotional Adjustment of Siblings of Children with Autism

    Science.gov (United States)

    Pilowsky, Tammy; Yirmiya, Nurit; Doppelt, Osnat; Gross-Tsur, Varda; Shalev, Ruth S.

    2004-01-01

    Background: Social and emotional adjustment of siblings of children with autism was examined, to explore their risk or resilience to effects of genetic liability and environmental factors involved in having a sibling with autism. Method: Social-emotional adjustment, behavior problems, socialization skills, and siblings' relationships were compared…

  19. Young Children's Personal Accounts of Their Sibling Disputes

    Science.gov (United States)

    Wilson, Anne E.; Smith, Melissa D.; Ross, Hildy S.; Ross, Michael

    2004-01-01

    We investigated children's personal representations of significant sibling conflicts. Forty pairs of siblings were interviewed separately about the same disputes. Although they described the same episodes, both older (M age = 7.0) and younger (M age = 4.4) siblings ascribed more serious transgressions to their opponents than to themselves. They…

  20. Siblings within Families: Levels of Analysis and Patterns of Influence

    Science.gov (United States)

    Jenkins, Jennifer; Dunn, Judy

    2009-01-01

    The study of siblings has become increasingly central to developmental science. Sibling relationships have unique effects on development, and sibling designs allow researchers to isolate causal mechanisms in development. This volume emphasizes causal mechanisms in the social domain. We review the preceding chapters in relation to six topics: a…

  1. Perceived Support in Sibling Relationships and Adolescent Adjustment

    Science.gov (United States)

    Branje, Susan J. T.; Van Lieshout, Cornelis F. M.; Van Aken, Marcel A. G.; Haselager, Gerbert J. T.

    2004-01-01

    Background: Siblings may support each other, but also reveal fierce rivalry and mutual aggression. Supportive sibling relationships have been linked to the development of psychosocial competence of children. In the present longitudinal study, we will focus on the development of perceived support in sibling dyads and on the influence of sibling…

  2. Psychological Adjustment of Siblings to a Child with Diabetes.

    Science.gov (United States)

    Hollidge, Colin

    2001-01-01

    Examines the psychological adjustment of well child siblings living with siblings with diabetes. Psychological adjustment was assessed by measuring self-concept; behavioral difficulties; competence; anxiety; and depression on standardized tests. The well siblings demonstrated significant internal psychological stressors and maintained high levels…

  3. Review of Sibling Interventions with Children with Autism

    Science.gov (United States)

    Banda, Devender R.

    2015-01-01

    Fifteen intervention studies were reviewed that included children with autism and their typical siblings. Overall, results across several studies reveal that siblings can have positive impacts on social and communication skills in children with autism. However, methodological variations and mixed results in studies that included siblings as…

  4. Forgotten family members: the importance of siblings in early psychosis.

    Science.gov (United States)

    Bowman, Siann; Alvarez-Jimenez, Mario; Wade, Darryl; McGorry, Patrick; Howie, Linsey

    2014-08-01

    This paper reviews the evidence on the significance of sibling inclusion in family interventions and support during early psychosis. This narrative review presents the current research related to the importance of family work during early psychosis, the needs and developmental significance of siblings during adolescence and early adulthood, the protective effects of sibling relationships, and the characteristics of early psychosis relevant to the sibling experience. It will also review the evidence of the sibling experience in chronic physical illness and disability, as well as long-term psychotic illness. Despite the evidence that working with families is important during early psychosis, siblings have been largely ignored. Siblings are an important reciprocal relationship of long duration. They play an important role in development during adolescence and early adulthood. These relationships may be an underutilized protective factor due to their inherent benefits and social support. Developmental theories imply that early psychosis could negatively impact the sibling relationship and their quality of life, effecting personality development and health outcomes. The evidence shows that adolescent physical illness or disability has a significantly negative impact on the sibling's quality of life and increases the risk for the onset of mental health issues. Long-term psychotic illness also results in negative experiences for siblings. Current evidence shows that siblings in early psychosis experience psychological distress and changes in functional performance. Further research using standard measures is required to understand the impact early psychosis has on the sibling relationship and their quality of life. © 2013 Wiley Publishing Asia Pty Ltd.

  5. Reframing Paul's sibling language in light of Jewish epistolary forms ...

    African Journals Online (AJOL)

    However, Jewish dimensions (particularly ethnic dimensions) of Paul's sibling language still remain unexplored in current scholarship. Furthermore, scholars have not drawn much attention to how Jewish letter writers use sibling terms in their letters. This article offers a new interpretation on Paul's sibling language in light of ...

  6. Parental divorce and sibling relationships : a research note

    NARCIS (Netherlands)

    Poortman, A.R.; Voorpostel, M.B.J.

    2009-01-01

    This study examines long-term effects of parental divorce on sibling relationships in adulthood and the role of predivorce parental conflict. It used large-scale retrospective data from the Netherlands that contain reports from both siblings of the sibling dyad. Results show limited effects of

  7. Sibship size, sibling cognitive sensitivity, and children's receptive vocabulary.

    Science.gov (United States)

    Prime, Heather; Pauker, Sharon; Plamondon, André; Perlman, Michal; Jenkins, Jennifer

    2014-02-01

    The aim of the current study was to examine the relationship between sibship size and children's vocabulary as a function of quality of sibling interactions. It was hypothesized that coming from a larger sibship (ie, 3+ children) would be related to lower receptive vocabulary in children. However, we expected this association to be moderated by the level of cognitive sensitivity shown by children's next-in-age older siblings. Data on 385 children (mean age = 3.15 years) and their next-in-age older siblings (mean age = 5.57 years) were collected and included demographic questionnaires, direct testing of children's receptive vocabulary, and videos of mother-child and sibling interactions. Sibling dyads were taped engaging in a cooperative building task and tapes were coded for the amount of cognitive sensitivity the older sibling exhibited toward the younger sibling. Hierarchical regression analyses were conducted and showed an interaction between sibship size and sibling cognitive sensitivity in the prediction of children's receptive vocabulary; children exposed to large sibships whose next-in-age older sibling exhibited higher levels of cognitive sensitivity were less likely to show low vocabulary skills when compared with those children exposed to large sibships whose siblings showed lower levels of cognitive sensitivity. Children who show sensitivity to the cognitive needs of their younger siblings provide a rich environment for language development. The negative impact of large sibships on language development is moderated by the presence of an older sibling who shows high cognitive sensitivity.

  8. Effects of Sibling Structure and Interaction on Children's Categorization Style

    Science.gov (United States)

    Cicirelli, Victor G.

    1973-01-01

    One hundred sixty sibling pairs from two child families were sampled for sibling interaction behaviors as they relate to measures of categorization style. The study provides additional evidence of the importance of a child's siblings to his cognitive development. (Editor/RK)

  9. Siblings of the Hearing Impaired: Perspectives for Parents.

    Science.gov (United States)

    Atkins, Dale V.

    1987-01-01

    The author describes the concerns and needs of siblings of hearing-impaired children, offering practical suggestions for parents, educators, and mental health and community service workers. Examples of successful programs for siblings that provide emotional support, training and information about their siblings' disability, and effective…

  10. The Siblings Relationship of Adolescents with and without Intellectual Disabilities

    Science.gov (United States)

    Begum, Gazi; Blacher, Jan

    2011-01-01

    The sibling relationship of adolescents with and without intellectual disabilities was examined. Participants were 70 sibling dyads--each dyad was comprised of one 12-year old adolescent with (N = 23) or without intellectual disabilities (N = 47). Sibling relationships, behavior problems, and social skills were assessed using mother reports.…

  11. Bidirectional Associations between Sibling Relationships and Parental Support during Adolescence

    Science.gov (United States)

    Derkman, Marleen M. S.; Engels, Rutger C. M. E.; Kuntsche, Emmanuel; van der Vorst, Haske; Scholte, Ron H. J.

    2011-01-01

    Sibling relationships and parental support are important for adolescents' development and well-being, yet both are likely to change during adolescence. Since adolescents participate in both the sibling relationship and the parent-child relationship, we can expect sibling relationships and parental support to be associated with each other.…

  12. Bidirectional Associations Between Sibling Relationships and Parental Support During Adolescence

    NARCIS (Netherlands)

    Derkman, M.M.S.; Engels, R.C.M.E.; Kuntsche, E.N.; Vorst, H. van der; Scholte, R.H.J.

    2011-01-01

    Sibling relationships and parental support are important for adolescents' development and well-being, yet both are likely to change during adolescence. Since adolescents participate in both the sibling relationship and the parent-child relationship, we can expect sibling relationships and parental

  13. Bidirectional associations between sibling relationships and parental support during adolescence

    NARCIS (Netherlands)

    Derkman, M.M.S.; Engels, R.C.M.E.; Kuntsche, E.N.; Vorst, H. van der; Scholte, R.H.J.

    2010-01-01

    Sibling relationships and parental support are important for adolescents’ development and well-being, yet both are likely to change during adolescence. Since adolescents participate in both the sibling relationship and the parent–child relationship, we can expect sibling relationships and parental

  14. Sibling Relationships Cognition in Japanese Female University Students

    Science.gov (United States)

    Sawai, Misae; Kato, Daiki

    2017-01-01

    This study examined the factor structure of sibling relationships in Japanese female university students. Two hundred and fifteen Japanese female university students participated in this study. The Adult Sibling Relationship Scale (ASRQ, Stocker et al., 1997) was used to measure sibling relationship cognition. The model was constructed as a result…

  15. Sibling Relationships and Influences in Childhood and Adolescence

    Science.gov (United States)

    McHale, Susan M.; Updegraff, Kimberly A.; Whiteman, Shawn D.

    2012-01-01

    The authors review the literature on sibling relationships in childhood and adolescence, starting by tracing themes from foundational research and theory and then focusing on empirical research during the past 2 decades. This literature documents siblings' centrality in family life, sources of variation in sibling relationship qualities, and the…

  16. Processes of Sibling Influence in Adolescence: Individual and Family Correlates

    Science.gov (United States)

    Whiteman, Shawn D.; Christiansen, Abigail

    2008-01-01

    This study examined the nature and correlates of adolescents' perceptions of sibling influence. Participants included 2 siblings (firstborn age M = 17.34; second-born age M = 14.76 years) from 191 maritally intact families. Adolescents' perceptions of sibling influence were measured via coded responses to open-ended questions about whether their…

  17. Siblings of the Handicapped: A Literature Review for School Psychologists.

    Science.gov (United States)

    Hannah, Mary Elizabeth; Midlarsky, Elizabeth

    1985-01-01

    Siblings of handicapped children may have adjustment problems associated with increased family responsibilities, increased parental expectations, and perceived parental neglect in favor of the disabled sibling. Problems may be related to socioeconomic status; family size; age, sex, and birth order of the sibling; and severity of the handicap. (GDC)

  18. Factors Related to Sibling Removal after a Child Maltreatment Fatality

    Science.gov (United States)

    Damashek, Amy; Bonner, Barbara L.

    2010-01-01

    Objectives: Many children who die from abuse or neglect are survived by siblings. However, little data are available about what happens to these siblings after the victim's death, such as whether they are removed from their home. Even less is known about how decisions are made regarding sibling removal following a child fatality. This study…

  19. Allogeneic transplantation for multiple myeloma: late relapse may occur as localised lytic lesion/plasmacytoma despite ongoing molecular remission.

    Science.gov (United States)

    Byrne, J L; Fairbairn, J; Davy, B; Carter, I G; Bessell, E M; Russell, N H

    2003-02-01

    Allogeneic SCT for myeloma may be curative for young patients, but its role remains controversial because of a reported high TRM in some series. Since 1991, we have performed 25 allografts for myeloma using fully matched sibling donors. Of the 18 evaluable patients, 13 achieved CR at a median time of 2.5 months post-transplant. The five patients who were not in CR when assessed at 3 months received a short course of alpha-interferon and four subsequently achieved CR with this approach at a median of 82 days. One patient who failed to respond to IFN went on to achieve CR after four doses of DLI therapy, thus giving an overall CR rate of 72%. Seven patients have relapsed at a median of 4.7 years post-transplant (range 1.38-7.7 years) including two patients who had received IFN therapy. In five of these cases, relapse has been as a localised area of bone disease or isolated plasmacytoma with no evidence of marrow involvement by trephine biopsy or molecular analysis. All patients with localised relapse were treated with local radiotherapy +/-DLI and four are currently disease free despite two patients having had further treatment for a second localised lesion. Six patients died of TRM (24%) and the OS at 8 years is currently 69% with an EFS of 26%. These results suggest that allogeneic SCT for myeloma can be carried out with an acceptable TRM and a high CR rate. However, late relapses as localised disease may be a frequent finding and may represent foci of myeloma not eradicated by the conditioning. The use of pretransplant MRI scanning and top-up radiotherapy to involved areas may be useful in preventing this type of relapse.

  20. Biosimilar G-CSF based mobilization of peripheral blood hematopoietic stem cells for autologous and allogeneic stem cell transplantation.

    Science.gov (United States)

    Schmitt, Michael; Publicover, Amy; Orchard, Kim H; Görlach, Matthias; Wang, Lei; Schmitt, Anita; Mani, Jiju; Tsirigotis, Panagiotis; Kuriakose, Reeba; Nagler, Arnon

    2014-01-01

    The use of granulocyte colony stimulating factor (G-CSF) biosimilars for peripheral blood hematopoietic stem cell (PBSC) mobilization has stimulated an ongoing debate regarding their efficacy and safety. However, the use of biosimilar G-CSF was approved by the European Medicines Agency (EMA) for all the registered indications of the originator G-CSF (Neupogen (®) ) including mobilization of stem cells. Here, we performed a comprehensive review of published reports on the use of biosimilar G-CSF covering patients with hematological malignancies as well as healthy donors that underwent stem cell mobilization at multiple centers using site-specific non-randomized regimens with a biosimilar G-CSF in the autologous and allogeneic setting. A total of 904 patients mostly with hematological malignancies as well as healthy donors underwent successful autologous or allogeneic stem cell mobilization, respectively, using a biosimilar G-CSF (520 with Ratiograstim®/Tevagrastim, 384 with Zarzio®). The indication for stem cell mobilization in hematology patients included 326 patients with multiple myeloma, 273 with Non-Hodgkin's lymphoma (NHL), 79 with Hodgkin's lymphoma (HL), and other disease. 156 sibling or volunteer unrelated donors were mobilized using biosimilar G-CSF. Mobilization resulted in good mobilization of CD34+ stem cells with side effects similar to originator G-CSF. Post transplantation engraftment did not significantly differ from results previously documented with the originator G-CSF. The side effects experienced by the patients or donors mobilized by biosimilar G-CSF were minimal and were comparable to those of originator G-CSF. In summary, the efficacy of biosimilar G-CSFs in terms of PBSC yield as well as their toxicity profile are equivalent to historical data with the reference G-CSF.

  1. Tolerance, immunocompetence, and secondary disease in fully allogeneic radiation chimeras

    International Nuclear Information System (INIS)

    Rayfield, L.S.; Brent, L.

    1983-01-01

    The aim of this study was to ascertain the extent to which secondary disease and mortality in fully allogeneic chimeras (C57BL leads to CBA) is caused (if at all) by a delayed graft-versus-host reaction. Adult CBA males were thymectomized, irradiated, and reconstituted with T-lymphocyte-depleted C57BL or CBA bone marrow cells (BMC), followed three weeks after irradiation by implantation under the kidney capsule of thymic lobes from C57BL or CBA fetal or adult donors. These mice were observed for the development of secondary disease for periods in excess of 250 days, and they were examined at 5 weeks or 4 months for T lymphocyte reactivity and tolerance to alloantigens, using the cell-mediated lympholysis assay (CML). The following results were obtained. First, removal of T lymphocytes with anti-Thy 1 antibody and complement from allogeneic bone marrow did not prevent wasting and eventual death, although it prolonged the lifespan of mice substantially. Second, T lymphocytes generated from bone marrow-derived precursor cells became tolerant of the histocompatibility antigens of the thymus donor strain but remained normally reactive to third-party antigens. Third, allogeneic radiation chimeras did not survive as well as animals reconstituted with syngeneic cells, even when they were demonstrably tolerant in CML. Fourth, C57BL BMC maturing in a CBA host equipped with a C57BL thymus graft did not become tolerant of host antigens, indicating that extra-thymic tolerance does not occur in fully allogeneic--as opposed to semiallogeneic--chimeras. It is argued that the function of B lymphocytes and/or accessory cells is impaired in fully allogeneic radiation chimeras, and that the mortality observed was directly related to the resulting immunodeficiency. The relevance of the results described in this paper to clinical bone marrow transplantation is discussed

  2. 'Mini' total body irradiation and allogeneic bone marrow transplantation

    International Nuclear Information System (INIS)

    Gocheva, L.; Sergieva, K.; Koleva, I.; Avramova, V.; Vassileva, V.; Georgieva, S.; Sultanov, B.

    2006-01-01

    Full text: The total body irradiation (TBI) combined with intensive chemotherapy plays an important role in the preparation of patients for bone marrow transplantation (BMT). The first autologous BMT in Bulgaria was performed in 1997 in the Specialized Pediatric Hospital for Active Treatment (SPHAT) of oncohematological diseases. The first TBI, followed by allogeneic BMT, was carried out in 2002 in the 'Queen Giovanna' University Hospital, after which its routine application as a basic form of large field radiotherapy and a main stage of the conditioning regimen for BMT was started. Fourteen allogeneic BMTs including TBI as a basic conditioning regimen have been performed till May 2006. The objective of the present report is to present the first clinical observations in the Bulgarian oncological practice on 'mini' TBI followed by allogeneic blood stem cell transplantation. During the period October 2005 - May 2006, 'mini' TBI followed by allogeneic BMT was carried out for two patients of the age 43 and 50 years. The diagnosis of both patients was acute non-lymphoblastic leukemia, in the remission stage, after one relapse, respectively. Intensive preceding chemotherapy was applied for both patients. A conditioning regimen was applied including the fludarabine purine analogue (3 x 30 mg/m 2 ) and 200 cGy TBI. It was followed by transplantation of allogeneic cell concentrate containing 2.5 x10 6 /kg CD34+ and 4.0 x10 6 /kg CD34+ blood stem cells of partially compatible family donors (a sister and a son), which were tolerable for the patients without complications. Cyclosporine and mycophelonate mofetile were applied as post-transplantation treatment. Active antibiotic, antiviral, symptomatic and substituting therapy, as well as GvHD prophylaxis was applied for both patients. Good clinical tolerance was recorded for the applied low dose conditioning regimen. The patients were discharged within 30 days in good general condition and stable draft action, with

  3. Psychological Adjustment and Sibling Relationships in Siblings of Children with Autism Spectrum Disorders: Environmental Stressors and the Broad Autism Phenotype

    Science.gov (United States)

    Petalas, Michael A.; Hastings, Richard P.; Nash, Susie; Hall, Louise M.; Joannidi, Helen; Dowey, Alan

    2012-01-01

    Research with siblings of children with Autism Spectrum Disorders (ASD) suggests that they may be at increased risk for behavioural and emotional problems and relatively poor sibling relationships. This study investigated a diathesis-stress model, whereby the presence of Broad Autism Phenotype features in the typically developing siblings might…

  4. Psychosocial Adjustment and Sibling Relationships in Siblings of Children with Autism Spectrum Disorder: Risk and Protective Factors

    Science.gov (United States)

    Walton, Katherine M.; Ingersoll, Brooke R.

    2015-01-01

    This study compared sibling adjustment and relationships in siblings of children with Autism Spectrum Disorder (ASD-Sibs; n = 69) and siblings of children with typical development (TD-Sibs; n = 93). ASD-Sibs and TD-Sibs demonstrated similar emotional/behavioral adjustment. Older male ASD-Sibs were at increased risk for difficulties. Sibling…

  5. Examining the Role of Communication on Sibling Relationship Quality and Interaction for Sibling Pairs with and without a Developmental Disability

    Science.gov (United States)

    Smith, Ashlyn L.; Romski, MaryAnn; Sevcik, Rose A.

    2013-01-01

    This study examined communication interaction patterns when one sibling had a developmental disability as well as the role of communication skills in sibling relationship quality. Thirty sibling dyads were categorized into one of three communication status groups: emerging, context-dependent, and independent communicators. Independent…

  6. Family Perspectives on Siblings' Conflict Goals in Middle Childhood: Links to Hierarchical and Affective Features of Sibling Relationships

    Science.gov (United States)

    Recchia, Holly E.; Witwit, Ma-ab

    2017-01-01

    This study examined parents' and children's descriptions of older and younger siblings' conflict goals in the late preschool and middle childhood years, and how these attributions were related to sibling relationship quality. Parents and 4- to 10-year-old children from 62 families were interviewed separately about siblings' motivations in two…

  7. Adolescent Sibling Relationship Quality and Adjustment: Sibling Trustworthiness and Modeling, as Factors Directly and Indirectly Influencing These Associations

    Science.gov (United States)

    Gamble, Wendy C.; Yu, Jeong Jin; Kuehn, Emily D.

    2011-01-01

    The main goal of this study was to examine the direct and moderating effects of trustworthiness and modeling on adolescent siblings' adjustment. Data were collected from 438 families including a mother, a younger sibling in fifth, sixth, or seventh grade (M = 11.6 years), and an older sibling (M = 14.3 years). Respondents completed Web-based…

  8. Number of Siblings, Sibling Spacing, Sex, and Birth Order: Their Effects on Perceived Parent-Adolescent Relationships.

    Science.gov (United States)

    Kidwell, Jeannie S.

    1981-01-01

    Examined the effect of the sibling structures of number and spacing, sex composition, and birth order on adolescents' perceptions of the power and support dimensions of parental behavior. Results suggest that research focusing on birth order must control for number of siblings, spacing, and sex composition of siblings. (Author)

  9. Siblings and children's time use in the United States

    Directory of Open Access Journals (Sweden)

    Rachel Dunifon

    2017-11-01

    Full Text Available Background: Eighty-two percent of children under age 18 live with at least one sibling, and the sibling relationship is typically the longest-lasting family relationship in an individual's life. Nevertheless, siblings remain understudied in the family demography literature. Objective: We ask how having a sibling structures children's time spent with others and in specific activities, and how children's time and activities with siblings vary by social class, gender, and age. Methods: We use time diary data from the US Panel Study of Income Dynamics' Child Development Supplement (PSID-CDS, comparing the time use of children with and without siblings and presenting regression-adjusted descriptive statistics on patterns among those with siblings. Results: Children with siblings spend about half of their discretionary time engaged with siblings. They spend less time alone with parents and more time in unstructured play than those without siblings. Brothers and more closely spaced siblings spend more time together and more time in unstructured play. For example, boys with at least one brother spend five more hours per week with their siblings and over three more hours per week in unstructured play than boys with no brothers. Conclusions: The presence and characteristics of siblings shape children's time use in ways that may have implications for child development. Contribution: This is the first study to use children's time diary data to examine how the presence and characteristics of siblings structure ways in which children spend their time. This contributes to our broader understanding of sibling relationships and family dynamics.

  10. Siblings of Youth with Autism Spectrum Disorders: Theoretical Perspectives on Sibling Relationships and Individual Adjustment

    Science.gov (United States)

    McHale, Susan M.; Updegraff, Kimberly A.; Feinberg, Mark E.

    2015-01-01

    A burgeoning research literature investigates the sibling relationships of youth with Autism Spectrum Disorder (ASD) and their implications for individual adjustment. Focusing on four relationship domains-- behaviors, emotions, cognitions and involvement—and toward advancing this generally atheoretical literature, we review and apply tenets from a range of theoretical perspectives in an effort to illuminate the mechanisms underlying sibling relationship experiences and their adjustment implications. Our review suggests new directions for research to test theoretically-grounded hypotheses about how sibling relationships develop and are linked to individual adjustment. In addition, we consider how identifying underlying bio-psycho-social processes can aid in the development of interventions to promote warm and involved sibling relationships and positive youth development. PMID:26476737

  11. Sibling recognition and the development of identity: intersubjective consequences of sibling differentiation in the sister relationship.

    Science.gov (United States)

    Vivona, Jeanine M

    2013-01-01

    Identity is, among other things, a means to adapt to the others around whom one must fit. Psychoanalytic theory has highlighted ways in which the child fits in by emulating important others, especially through identification. Alternately, the child may fit into the family and around important others through differentiation, an unconscious process that involves developing or accentuating qualities and desires in oneself that are expressly different from the perceived qualities of another person and simultaneously suppressing qualities and desires that are perceived as similar. With two clinical vignettes centered on the sister relationship, the author demonstrates that recognition of identity differences that result from sibling differentiation carries special significance in the sibling relationship and simultaneously poses particular intersubjective challenges. To the extent that the spotlight of sibling recognition delimits the lateral space one may occupy, repeatedly frustrated desires for sibling recognition may have enduring consequences for one's sense of self-worth and expectations of relationships with peers and partners.

  12. Impact of stem cell source on allogeneic stem cell transplantation outcome in hematological malignancies

    Directory of Open Access Journals (Sweden)

    Stamatović Dragana

    2011-01-01

    Full Text Available Background/Aim. Peripheral blood (PB is used more frequently as a source of stem cells (SCs for allogeneic transplantation. However, the influence of cell source on the clinical outcome of SC transplantation is not yet well established. The aim of this study was to compare the results of PBSC transplantation (PBSCT with bone marrow transplantation (BMT on the basis of engraftment, frequency and severity of immediate (mucositis, acute Graft versus Host Disease - aGvHD and delayed (chronic GvHD - cGvHD complications, as well as transplant-related mortality (TRM, transfusion needs, relapses and overall survival (OS. Methods. We analyzed 158 patients, women/men ratio 64/94 median age 29 (range 9-57, who underwent allogeneic SC transplantation between 1989 and 2009. All included patients had diseases as follows: acute myeloid leukemia (AML - 39, acute lymphoblastic leukemia (ALL - 47, chronic myeloid leukemia (CML - 32, myelodysplastic syndrome (MDS - 10, Hodgkin’s lymphoma (HL - 2, multiple myeloma (MM - 3, granulocytic sarcoma (GrSa - 3, severe aplastic anemia (sAA - 22. The patients underwent transplantations were divided into two groups: BMT group (74 patients and PBSCT group (84 patients. Each recipient had HLA identical sibling donor. SCs from bone marrow were collected by multiple aspirations of iliac bone and from PB by one “Large Volume Leukapheresis” (after recombinant human granulocyte colony stimulating factor, rHuG-CSF application (5-12 μg/kgbm, 5 days. Conditioning regimens were applied according to primary disease, GvHD prophylaxis consisted of combination of a cyclosporine A and methotrexate. Results. Engraftment, according to the count of polymorphonuclear and platelets, were significantly (p < 0.001 faster in the PBSCT vs BMT group. The needs for transfusion support were significantly (p < 0.01 higher in the BMT group. Those patients had more frequently oropharingeal mucositis grade 3/4 (33.3% vs 10.0%, p < 0.05. There were

  13. Autologous transplantation versus allogeneic transplantation in patients with follicular lymphoma experiencing early treatment failure.

    Science.gov (United States)

    Smith, Sonali M; Godfrey, James; Ahn, Kwang Woo; DiGilio, Alyssa; Ahmed, Sairah; Agrawal, Vaibhav; Bachanova, Veronika; Bacher, Ulrike; Bashey, Asad; Bolaños-Meade, Javier; Cairo, Mitchell; Chen, Andy; Chhabra, Saurabh; Copelan, Edward; Dahi, Parastoo B; Aljurf, Mahmoud; Farooq, Umar; Ganguly, Siddhartha; Hertzberg, Mark; Holmberg, Leona; Inwards, David; Kanate, Abraham S; Karmali, Reem; Kenkre, Vaishalee P; Kharfan-Dabaja, Mohamed A; Klein, Andreas; Lazarus, Hillard M; Mei, Matthew; Mussetti, Alberto; Nishihori, Taiga; Ramakrishnan Geethakumari, Praveen; Saad, Ayman; Savani, Bipin N; Schouten, Harry C; Shah, Nirav; Urbano-Ispizua, Alvaro; Vij, Ravi; Vose, Julie; Sureda, Anna; Hamadani, Mehdi

    2018-04-12

    Early treatment failure (ETF) in follicular lymphoma (FL), defined as relapse or progression within 2 years of frontline chemoimmunotherapy, is a newly recognized marker of poor survival and identifies a high-risk group of patients with an expected 5-year overall survival (OS) rate of approximately 50%. Transplantation is an established option for relapsed FL, but its efficacy in this specific ETF FL population has not been previously evaluated. This study compared autologous hematopoietic stem cell transplantation (auto-HCT) with either matched sibling donor (MSD) or matched unrelated donor (MUD) allogeneic hematopoietic cell transplantation (allo-HCT) as the first transplantation approach for patients with ETF FL (age ≥ 18 years) undergoing auto-HCT or allo-HCT between 2002 and 2014. The primary endpoint was OS. The secondary endpoints were progression-free survival, relapse, and nonrelapse mortality (NRM). Four hundred forty FL patients had ETF (auto-HCT, 240; MSD hematopoietic stem cell transplantation [HCT], 105; and MUD HCT, 95). With a median follow-up of 69 to 73 months, the adjusted probability of 5-year OS was significantly higher after auto-HCT (70%) or MSD HCT (73%) versus MUD HCT (49%; P = .0008). The 5-year adjusted probability of NRM was significantly lower for auto-HCT (5%) versus MSD (17%) or MUD HCT (33%; P ETF, undergoing auto-HCT for FL have low NRM and a promising 5-year OS rate (70%). MSD HCT has lower relapse rates than auto-HCT but similar OS. Cancer 2018. © 2018 American Cancer Society. © 2018 American Cancer Society.

  14. Parent & Child Perceptions of Child Health after Sibling Death

    OpenAIRE

    Roche, Rosa M.; Brooten, Dorothy; Youngblut, JoAnne M.

    2016-01-01

    Background Understanding children?s health after a sibling?s death and what factors may affect it is important for treatment and clinical care. This study compared children?s and their parents? perceptions of children?s health and identified relationships of children?s age, gender, race/ethnicity, anxiety, and depression and sibling?s cause of death to these perceptions at 2 and 4 months after sibling death. Methods 64 children and 48 parents rated the child?s health ?now? and ?now vs before?...

  15. From Parents to Siblings and Peers

    Directory of Open Access Journals (Sweden)

    Isabelle Roskam

    2015-10-01

    Full Text Available The objective of the current research was to test the hypotheses arising from the epigenetic view of social development and from the wider perspective offered by the social network model with three interactional systems, that is, child–parent, child–sibling, and child–peer. They were tested in two prospective longitudinal studies using a multi-informant and multi-method strategy. Study 1 was conducted among 83 children and their parents and Study 2 among 190 children. Attachment security with parents was assessed when the children were 4 years of age, relationships with siblings at 5 years of age, and relationships with peers at 6 years of age. Attachment to parent was found to explain a limited part of variations in later social relationships with siblings and peers. The sibling interactional system had a consistent and enduring effect on later peer relationships. With regard to the two theoretical backgrounds under consideration, neither was able to account for equivocal findings displayed in the two studies as well as in previous research. The wonderful story of social development seems to be a very complex process for which new models are needed.

  16. Life Span Personality Stability in Sibling Statuses.

    Science.gov (United States)

    Rosenberg, B. G.

    Personality stability and change in sibling status in the one- and two-child-family are examined in this Study. Q-sort data were analyzed for the same 33 male and 34 female subjects during four periods of their lives-- early and late adolescence and early and middle adulthood. Results indicate that stability of personality was greatest during…

  17. The Family Contexts of Children's Sibling Relationships.

    Science.gov (United States)

    McHale, Susan M.; Crouter, Ann C.

    1996-01-01

    Unlike much previous research on sibling relationships, which emphasizes the congruence across various types of family experiences, the research described in this article explored between-family differences in patterns of experiences within families. The work is built upon Bronfenbrenner's ecological model and Magnusson's interactional…

  18. Sibling Gender Configuration and Family Processes

    NARCIS (Netherlands)

    van der Pol, Lotte D.; Mesman, Judi; Groeneveld, Marleen G.; Endendijk, Joyce J.; van Berkel, Sheila R.; Hallers-Haalboom, Elizabeth T.; Bakermans-Kranenburg, Marian J.

    2016-01-01

    The current study focuses on the effects of sibling gender configuration on family processes during early childhood. In a sample of 369 two-parent families with two children (youngest 12 months, oldest about 2 years older), both siblings’ noncompliant and oppositional behaviors and fathers’ and

  19. Allogeneic hematopoietic stem-cell transplantation for chronic lymphocytic leukemia with 17p deletion: a retrospective European Group for Blood and Marrow Transplantation analysis.

    Science.gov (United States)

    Schetelig, Johannes; van Biezen, Anja; Brand, Ronald; Caballero, Dolores; Martino, Rodrigo; Itala, Maija; García-Marco, José A; Volin, Liisa; Schmitz, Norbert; Schwerdtfeger, Rainer; Ganser, Arnold; Onida, Francesco; Mohr, Brigitte; Stilgenbauer, Stephan; Bornhäuser, Martin; de Witte, Theo; Dreger, Peter

    2008-11-01

    Patients with chronic lymphocytic leukemia (CLL) and 17p deletion (17p-) have a poor prognosis. Although allogeneic hematopoietic stem-cell transplantation (HCT) has the potential to cure patients with advanced CLL, it is not known whether this holds true for patients with 17p-CLL. Baseline data from patients, for whom information on the presence of 17p-CLL was available, were downloaded from the European Group for Blood and Marrow Transplantation database. Additional information on the course of CLL and follow-up was collected with a questionnaire. A total of 44 patients with 17p-CLL received allogeneic HCT between March 1995 and July 2006 from a matched sibling (n = 24) or an alternative donor (n = 20). 17p-CLL had been diagnosed by fluorescent in situ hybridization in 82% of patients and by conventional banding in 18% of patients. The median age was 54 years. Before HCT, a median of three lines of chemotherapy had been administered. At HCT, 53% of patients were in remission. Reduced-intensity conditioning was applied in 89% of patients. Acute, grade 2 to 4 graft-versus-host disease (GVHD) occurred in 43% of patients, and extensive chronic GVHD occurred in 53% of patients. At last follow-up, 19 patients were alive, with a median observation time of 39 months (range, 18 to 101 months). Three-year overall survival and progression-free survival rates were 44% and 37%, respectively. The cumulative incidence of progressive disease at 4 years was 34%. No late relapse occurred in nine patients with a follow-up longer than 4 years. Allogeneic HCT has the potential to induce long-term disease-free survival in patients with 17p-CLL.

  20. Allogeneic hematopoietic cell transplantation (allogeneic HCT) for treatment of pediatric Philadelphia chromosome-positive acute lymphoblastic leukemia (ALL).

    Science.gov (United States)

    Burke, Michael J; Cao, Qing; Trotz, Barb; Weigel, Brenda; Kumar, Ashish; Smith, Angela; Verneris, Michael R

    2009-12-15

    Allogeneic hematopoietic cell transplant (HCT) with best available donor for children with Philadelphia positive (Ph+) acute lymphoblastic leukemia (ALL) has previously been considered standard practice. Since the introduction of imatinib into the treatment of this disease, the role of allogeneic HCT is more uncertain. We investigated the impact of remission status, graft source, and imatinib use on transplant outcomes for 37 children with Ph+ ALL who received an allogeneic HCT at the University of Minnesota between 1990 and 2006. The median age at HCT was 7.47 (range; 1.4-16.4) years. Thirteen patients received imatinib therapy pre- and/or post-HCT (imatinib group) and 24 patients, received either no imatinib (n = 23) or only post-HCT relapse (n = 1) (non-imatinib group). There was no difference in disease-free survival (DFS) or relapse between the imatinib and non-imatinib groups at 3 years (62%/15% vs. 53%/26%; P = 0.99; 0.81, respectively). There was no significant difference in transplant outcomes between matched related donor or unrelated donor (umbilical cord blood or matched unrelated marrow) recipients whereas patients receiving allogeneic HCT in first remission (CR1) had superior DFS and less relapse compared to patients transplanted in >or=CR2 (71%/16% vs. 29%/36%; P = 0.01; P = 0.05). Based on this retrospective analysis at a single institution, the use of imatinib either pre- and/or post-transplant does not appear to significantly impact outcomes for children with Ph+ ALL and allogeneic HCT with the best available donor should be encouraged in CR1.

  1. Familial risk and sibling mentalization: Links with preschoolers' internalizing problems.

    Science.gov (United States)

    Rodrigues, Michelle; Binnoon-Erez, Noam; Prime, Heather; Perlman, Michal; Jenkins, Jennifer M

    2017-09-01

    The current study explored whether older sibling mentalization moderated the relationship between familial risk for internalizing symptoms and the development of future internalizing problems in the younger siblings, referred to as target children. Data were collected on 397 older siblings at Time 1 (T1) when target children were newborn and their older siblings were on average 2.61 years old (SD = .75). Target children were on average 1.60 years old at Time 2 (T2). Internalizing problems were assessed via mother and partner reports. Familial risk was operationalized as the average of all older siblings' level of internalizing problems. Older sibling mentalization, indexed by internal state talk and reasoning, was observed and coded during a sibling pretend-play interaction at T2. Results revealed a significant interaction between familial risk of internalizing problems and older siblings' mentalizing abilities, showing that familial risk was related to target children's internalizing problems in the absence of sibling mentalization. Familial risk was not associated with target children's internalizing problems when siblings demonstrated mentalizing abilities. Findings support the need to consider sibling mentalization as a protective factor for children's internalizing problems. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  2. Assessing functional impairment in siblings living with children with disability.

    Science.gov (United States)

    Goudie, Anthony; Havercamp, Susan; Jamieson, Barry; Sahr, Timothy

    2013-08-01

    The purpose of this study was to empirically test if siblings of children with disability had higher levels of parent-reported behavioral and emotional functional impairment compared with a peer group of siblings residing with only typically developing children. This was a retrospective secondary analysis of data from the Medical Expenditure Panel Survey. We included only households with at least 2 children to ensure sibling relationships. Two groups of siblings were formed: 245 siblings resided in households with a child with disability and 6564 siblings resided in households with typically developing children. Parents responded to questions from the Columbia Impairment Scale to identify functional impairment in their children. On the basis of parent reports and after adjusting for sibling demographic characteristics and household background, siblings of children with disability were more likely than siblings residing with typically developing children to have problems with interpersonal relationships, psychopathological functioning, functioning at school, and use of leisure time (P siblings of children with disability classified with significant functional impairment was 16.0% at the first measurement period and 24.2% at the second (P siblings of typically developing children there was a smaller percentage increase from 9.5% to 10.3% (P mental health services and, as such, early assessment and interventions to limit increasing severity and short- to long-term consequences need to be addressed. Health care professionals need to consider a family-based health care approach for families raising children with disability.

  3. The Project TALENT Twin and Sibling Study.

    Science.gov (United States)

    Prescott, Carol A; Achorn, Deanna Lyter; Kaiser, Ashley; Mitchell, Lindsey; McArdle, John J; Lapham, Susan J

    2013-02-01

    Project TALENT is a US national longitudinal study of about 377,000 individuals born in 1942-1946, first assessed in 1960. Students in about 1,200 schools participated in a 2-day battery covering aptitudes, abilities, interests, and individual and family characteristics (Flanagan, 1962; www.projectTALENT.org). Follow-up assessments 1, 5, and 11 years later assessed educational and occupational outcomes. The sample includes approximately 92,000 siblings from 40,000 families, including 2,500 twin pairs and 1,200 other siblings of twins. Until recently, almost no behavior genetic research has been conducted with the sample. In the original data collection information was not collected with the intent to link family members. Recently, we developed algorithms using names, addresses, birthdates, and information about family structure to link siblings and identify twins. We are testing several methods to determine zygosity, including use of yearbook photographs. In this paper, we summarize the design and measures in Project TALENT, describe the Twin and Sibling sample, and present our twin-sib-classmate model. In most twin and family designs, the 'shared environment' includes factors specific to the family combined with between-family differences associated with macro-level variables such as socioeconomic status. The school-based sampling design used in Project TALENT provides a unique opportunity to partition the shared environment into variation shared by siblings, specific to twins, and associated with school- and community-level factors. The availability of many measured characteristics on the family, schools, and neighborhoods enhances the ability to study the impact of specific factors on behavioral variation.

  4. Positive and Negative Interactions Observed Between Siblings: Moderating Effects for Children Exposed to Parents’ Conflict

    OpenAIRE

    Iturralde, Esti; Margolin, Gayla; Spies Shapiro, Lauren A.

    2013-01-01

    This study investigated links between interparental conflict appraisals (specifically threat and self-blame), sibling relationship quality (positive and negative dimensions), and anxiety in sibling pairs comprised of an adolescent and a younger sibling close in age. Sibling relationship quality was measured through behavioral observation. Links between self-blame and anxiety were moderated by sibling relationship quality. In older siblings, positive behavior with a sibling was associated with...

  5. Living with a brother or sister with epilepsy: siblings' experiences.

    Science.gov (United States)

    Hames, Annette; Appleton, Richard

    2009-12-01

    There is conflicting evidence about the impact of disability upon siblings, and very little research on the siblings of children with epilepsy. There is some evidence that siblings who have less accurate information exhibit more distress. The aim of this study was to assess siblings' response to having a brother or sister with epilepsy and to begin to develop information for them. Parents of children attending paediatric neurology outpatient departments were invited to participate in a pilot study. Parents who consented to take part were asked if they had previously received information for siblings. Parents and siblings participated in a semi-structured interview and siblings were also invited to submit a personal account of living with a brother or sister who had epilepsy. Twenty-five families with a child with epilepsy aged 2.5-15 years initially agreed to take part. None of the families stated that they had ever seen or received any information specifically for siblings. Fourteen siblings from the 25 families, aged 8-25 years, provided a personal account of what it was like living with a brother or sister with epilepsy. Siblings' accounts included both negative and positive feelings, and specifically feelings of care and love for their sibling. This initial study suggests that siblings of children with epilepsy have many positive but also early negative feelings. The results are limited by the size of the study, the fact that most siblings were older sisters, and the mean time since diagnosis was 6 years. Finally, it is hoped that the personal accounts collected in this study will be published for the benefit of other siblings of children with epilepsy.

  6. Sibling relationship quality and psychosocial outcomes among adult siblings of individuals with autism spectrum disorder and individuals with intellectual disability without autism.

    Science.gov (United States)

    Tomeny, Theodore S; Ellis, Brandi M; Rankin, James A; Barry, Tammy D

    2017-03-01

    Research on adult typically-developing (TD) siblings of individuals with developmental disabilities remains limited, and outcomes for TD siblings appear to vary widely. For the current study, 82 adult TD siblings of individuals with autism spectrum disorder (ASD) or intellectual disability (ID) completed questionnaires about themselves and their affected sibling. Results of this study suggest that the attitudes possessed by adult TD siblings are important to consider when understanding adult TD sibling outcomes. Specifically, data indicate that higher levels of positive sibling relationship attitudes are related to TD siblings providing more aid/support to their sibling with a disability, along with having higher levels of general life satisfaction, and negatively related to levels of stress and depressive symptoms among TD siblings. Consistent with previous child research, siblings of individuals with ASD reported fewer positive sibling relationship attitudes compared to siblings of individuals with ID. Finally, group membership related to aid provided, depressive symptoms, and stress of TD siblings indirectly through sibling relationship attitudes. Overall, results indicate that sibling relationship attitudes may be particularly important to consider when conceptualizing sibling relationships when one sibling has an intellectual or developmental disability. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Sibling influence on mexican-origin adolescents' deviant and sexual risk behaviors: the role of sibling modeling.

    Science.gov (United States)

    Whiteman, Shawn D; Zeiders, Katharine H; Killoren, Sarah E; Rodriguez, Sue Annie; Updegraff, Kimberly A

    2014-05-01

    A growing body of research indicates that siblings uniquely influence each other's health risk behaviors during adolescence and young adulthood. Mechanisms underlying these associations, however, are largely unknown because they are rarely tested directly. The present study addressed this gap by examining the role of sibling modeling in explaining changes in Mexican-origin youths' deviant and sexual risk behaviors over time. The sample included 380 Mexican-origin siblings (older sibling age: M = 21.18, SD = 1.59; younger sibling age: M = 18.19, SD = .46) from (N = 190) families. Participants provided self-reports of their sibling relationship qualities, including modeling, as well as their engagement in deviant and sexual risk-taking behaviors in two home interviews across a 2-year span. A series of residualized regression models revealed that younger siblings' perceptions of modeling moderated the links between older siblings' deviant and sexual risk behaviors and younger siblings' subsequent behaviors in those same domains. Specifically, high levels of modeling predicted stronger associations between older siblings' earlier and younger siblings' later risk behaviors controlling for younger siblings' earlier behaviors as well as variables that have been used as proxies for social learning in previous research. Social learning mechanisms, especially modeling, are salient processes through which older siblings transmit norms and expectations regarding participation in health risk behaviors. Future research should continue to explore the ways in which siblings influence each other because such processes are emerging targets for intervention and prevention. Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  8. Polymorphism in the interleukin-7 receptor-alpha and outcome after allogeneic hematopoietic cell transplantation with matched unrelated donor

    DEFF Research Database (Denmark)

    Shamim, Z; Spellman, S; Haagenson, M

    2013-01-01

    Interleukin-7 (IL-7) is essential for T cell development in the thymus and maintenance of peripheral T cells. The α-chain of the IL-7R is polymorphic with the existence of SNPs that give rise to non-synonymous amino acid substitutions. We previously found an association between donor genotypes...... significance of IL-7Rα SNP genotypes in 590-recipient/donor pairs that received HLA-matched unrelated donor HCT for haematological malignancies. Consistent with the primary studies, the rs1494555GG and rs1494558TT genotypes of the donor were associated with aGvHD and chronic GvHD in the univariate analysis...

  9. Pelvic reconstruction with allogeneic bone graft after tumor resection

    Science.gov (United States)

    Wang, Wei; Bi, Wen Zhi; Yang, Jing; Han, Gang; Jia, Jin Peng

    2013-01-01

    OBJECTIVES : Pelvic reconstruction after tumor resection is challenging. METHODS: A retrospective study had been preformed to compare the outcomes among patients who received pelvic reconstructive surgery with allogeneic bone graft after en bloc resection of pelvic tumors and patients who received en bloc resection only. RESULTS: Patients without reconstruction had significantly lower functional scores at 3 months (10 vs. 15, P = 0.001) and 6 months after surgery (18.5 vs. 22, P = 0.0024), a shorter duration of hospitalization (16 day vs. 40 days, P 0.05). CONCLUSIONS : Pelvic reconstruction with allogeneic bone graft after surgical management of pelvic tumors is associated with satisfactory surgical and functional outcomes. Further clinical studies are required to explore how to select the best reconstruction method. Level of Evidence IV, Case Series. PMID:24453659

  10. Single Cell HLA Matching Feasibility by Whole Genomic Amplification and Nested PCR

    Institute of Scientific and Technical Information of China (English)

    Xiao-hong Li; Fang-yin Meng

    2004-01-01

    @@ PCR based single-cell DNA analysis has been widely used in forensic science, preimplantation genetic diagnosis and so on. However, the original sample cannot be efficiently retrieved following single cell PCR, consequently the amount of information gained is limited. HLA system is too sophisticated that it is very hard to complete HLA typing by single cell. A Taq polymerase-based method using random primers to amplify whole genome termed as whole genome amplification (WGA) has demonstrated to be a useful method in increasing the copies of minimum sample. We establish a technique in this study to amplify HLA-A and HLA-B loci at same time in a single cell using WGA.

  11. Financial burden in recipients of allogeneic hematopoietic cell transplantation.

    Science.gov (United States)

    Khera, Nandita; Chang, Yu-hui; Hashmi, Shahrukh; Slack, James; Beebe, Timothy; Roy, Vivek; Noel, Pierre; Fauble, Veena; Sproat, Lisa; Tilburt, Jon; Leis, Jose F; Mikhael, Joseph

    2014-09-01

    Although allogeneic hematopoietic cell transplantation (HCT) is an expensive treatment for hematological disorders, little is known about the financial consequences for the patients who undergo this procedure. We analyzed factors associated with its financial burden and its impact on health behaviors of allogeneic HCT recipients. A questionnaire was retrospectively mailed to 482 patients who underwent allogeneic HCT from January 2006 to June 2012 at the Mayo Clinic, to collect information regarding current financial concerns, household income, employment, insurance, out-of-pocket expenses, and health and functional status. A multivariable logistic regression analysis identified factors associated with financial burden and treatment nonadherence. Of the 268 respondents (56% response rate), 73% reported that their sickness had hurt them financially. All patients for whom the insurance information was available (missing, n = 13) were insured. Forty-seven percent of respondents experienced financial burden, such as household income decreased by >50%, selling/mortgaging home, or withdrawing money from retirement accounts. Three percent declared bankruptcy. Younger age and poor current mental and physical functioning increased the likelihood of financial burden. Thirty-five percent of patients reported deleterious health behaviors because of financial constraints. These patients were likely to be younger, have lower education, and with a longer time since HCT. Being employed decreased the likelihood of experiencing financial burden and treatment nonadherence due to concern about costs. A significant proportion of allogeneic HCT survivors experience financial hardship despite insurance coverage. Future research should investigate potential interventions to help at-risk patients and prevent adverse financial outcomes after this life-saving procedure. Copyright © 2014 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

  12. Delayed allogeneic skin graft rejection in CD26-deficient mice.

    Science.gov (United States)

    Zhao, Xiangli; Zhang, Kai; Daniel, Peter; Wisbrun, Natali; Fuchs, Hendrik; Fan, Hua

    2018-03-23

    Organ transplantation is an effective therapeutic tool for treating many terminal diseases. However, one of the biggest challenges of transplantation is determining how to achieve the long-term survival of the allogeneic or xenogeneic transplant by, for example, preventing transplant rejection. In the current study, CD26 gene-knockout mice were used to investigate the potential role of CD26/dipeptidyl peptidase-4 (DPPIV) in allogeneic skin graft rejection by tail-skin transplantation. Compared with wild-type (CD26 +/+ ) counterparts, CD26 -/- mice showed reduced necrosis of grafts and delayed graft rejection after skin transplantation. Concentrations of serum IgG, including its subclasses IgG1 and IgG2a, were significantly reduced in CD26 -/- mice during graft rejection. Moreover, after allogeneic skin transplantation, the secretion levels of the cytokines IFN-γ, IL-2, IL-6, IL-4, and IL-13 were significantly reduced, whereas the level of the cytokine IL-10 was increased in the serum of CD26 -/- mice compared with that in the serum of CD26 +/+ mice. Additionally, the concentration of IL-17 in serum and the percentage of cells secreting IL-17 in mouse peripheral blood lymphocytes (MPBLs) were both significantly lower, while the percentage of regulatory T cells (Tregs) was significantly higher in MPBLs of CD26 -/- mice than in those of CD26 +/+ mice. Furthermore, a lower percentage of CD8 + T cells in MPBLs and fewer infiltrated macrophages and T cells in graft tissues of CD26 -/- mice were detected during graft rejection. These results indicate that CD26 is involved in allogeneic skin graft rejection and provides another hint that CD26 deficiency leads to less rejection due to lower activation and proliferation of host immune cells.

  13. Allogeneic stem cell transplantation in acute myeloid leukemia

    Directory of Open Access Journals (Sweden)

    Natasha Ali

    2012-11-01

    Full Text Available We report a case series of 12 patients with acute myeloid leukemia who underwent allogeneic stem cell transplant with a matched related donor. Male to female ratio was 1:1. The main complication post-transplant was graft-versus-host disease (n=7 patients. Transplant-related mortality involved one patient; cause of death was multi-organ failure. After a median follow up of 36.0±11.3 months, overall survival was 16%.

  14. Rabbit articular cartilage defects treated by allogenic chondrocyte transplantation

    OpenAIRE

    Boopalan, P. R. J. V. C.; Sathishkumar, Solomon; Kumar, Senthil; Chittaranjan, Samuel

    2006-01-01

    Articular cartilage defects have a poor capacity for repair. Most of the current treatment options result in the formation of fibro-cartilage, which is functionally inferior to normal hyaline articular cartilage. We studied the effectiveness of allogenic chondrocyte transplantation for focal articular cartilage defects in rabbits. Chondrocytes were cultured in vitro from cartilage harvested from the knee joints of a New Zealand White rabbit. A 3 mm defect was created in the articular cartilag...

  15. The role of older siblings in infant motor development.

    Science.gov (United States)

    Leonard, Hayley C; Hill, Elisabeth L

    2016-12-01

    Previous research has suggested that infant motor skills may be affected by older siblings but has not considered whether this is due to specific characteristics of the older sibling or of the quality of the sibling relationship. The current study used a longitudinal diary method to record infant motor milestones from 23 infants with older siblings along with parent reports and standardized assessments of motor skills. Parent reports of the older siblings' motor skills and the sibling relationship were also collected until the infants were 18months old. The motor skills, age, and sex of the older siblings were not significantly related to any measure of infant motor development. A significant correlation was revealed between perceived agonism between siblings and infant fine motor skills at 18months, suggesting the importance of considering reciprocal effects of motor development on sibling relationships. Overall, the suggestion that older siblings may provide a good model of motor skills for infants is not supported by the current data. In the future, it will be important to assess the dynamic interactions between different factors in predicting infant motor development, allowing early identification of motor difficulties, which could affect other areas of cognitive development and health. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Reducing sibling conflict in maltreated children placed in foster homes.

    Science.gov (United States)

    Linares, L Oriana; Jimenez, Jessica; Nesci, Cristina; Pearson, Eva; Beller, Sarah; Edwards, Nancy; Levin-Rector, Alison

    2015-02-01

    Sibling aggression among maltreated children placed in foster homes is linked to other externalizing problems and placement disruption. The reduction of sibling conflict and aggression may be achieved via a multicomponent ecologically focused intervention for families in the foster care system. The focus of the study is to evaluate the feasibility and short-term effectiveness of a transtheoretical intervention model targeting sibling pairs and their foster parent that integrates family systems, social learning theory, and a conflict mediation perspective. In this pilot study, sibling pairs (N = 22) and their foster parent were randomized into a three-component intervention (n = 13) or a comparison (n = 9) group. Promoting Sibling Bonds (PSB) is an 8-week prevention intervention targeting maltreated sibling pairs ages 5-11 years placed together in a foster home. The siblings, parent, and joint components were delivered in a program package at the foster agency by a trained two-clinician team. Average attendance across program components was 73 %. Outcomes in four areas were gathered at pre- and postintervention: observed sibling interaction quality (positive and negative) including conflict during play, and foster parent reports of mediation strategies and sibling aggression in the foster home. At postintervention, adjusting for baseline scores and child age, intervention pairs showed higher positive (p conflict during play (p conflict mediation strategies than those in the comparison group (p conflict and promote parental mediation, which together may reduce sibling aggression in the foster home.

  17. [Sibling relations between individuation and attachment: attempt at a conceptualization].

    Science.gov (United States)

    Seiffge-Krenke, I

    2001-01-01

    Although sibling relationships can be considered as one of the most durable and intensive relationships, not much research in developmental psychology and family research has been done on this issue. The strong focus on parents, more specifically on mothers, stood in the way of adequate conceptualization and understanding of the function and contribution of siblings to individual development and family interaction. In this contribution a conceptualization of sibling relationships is presented. Siblings as objects of aggressive and sexual feelings as well as the function of siblings in the family system, for example, as parentification and negative identity is emphasized. In addition, the different qualities of sibling relationships, for example, envy, rivalry, similarity, and difference, are emphasized. The function of siblings as love objects is stressed, and the role of siblings as support as well as teaching object is illustrated. Finally, it is emphasized that, similar to relationships between parents and child, the quality of sibling relationships changed over time and leads, for example, to a detachment between sibling relationships during adolescence.

  18. Chimeric autologous/allogeneic constructs for skin regeneration.

    Science.gov (United States)

    Rasmussen, Cathy Ann; Tam, Joshua; Steiglitz, Barry M; Bauer, Rebecca L; Peters, Noel R; Wang, Ying; Anderson, R Rox; Allen-Hoffmann, B Lynn

    2014-08-01

    The ideal treatment for severe cutaneous injuries would eliminate the need for autografts and promote fully functional, aesthetically pleasing autologous skin regeneration. NIKS progenitor cell-based skin tissues have been developed to promote healing by providing barrier function and delivering wound healing factors. Independently, a device has recently been created to "copy" skin by harvesting full-thickness microscopic tissue columns (MTCs) in lieu of autografts traditionally harvested as sheets. We evaluated the feasibility of combining these two technologies by embedding MTCs in NIKS-based skin tissues to generate chimeric autologous/allogeneic constructs. Chimeric constructs have the potential to provide immediate wound coverage, eliminate painful donor site wounds, and promote restoration of a pigmented skin tissue possessing hair follicles, sweat glands, and sebaceous glands. After MTC insertion, chimeric constructs and controls were reintroduced into air-interface culture and maintained in vitro for several weeks. Tissue viability, proliferative capacity, and morphology were evaluated after long-term culture. Our results confirmed successful MTC insertion and integration, and demonstrated the feasibility of generating chimeric autologous/allogeneic constructs that preserved the viability, proliferative capacity, and structure of autologous pigmented skin. These feasibility studies established the proof-of-principle necessary to further develop chimeric autologous/allogeneic constructs for the treatment of complex skin defects. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

  19. Clinical Allogeneic and Autologous Islet Cell Transplantation: Update

    Directory of Open Access Journals (Sweden)

    Shinichi Matsumoto

    2011-06-01

    Full Text Available Islet cell transplantation is categorized as a β-cell replacement therapy for diabetic patients who lack the ability to secrete insulin. Allogeneic islet cell transplantation is for the treatment of type 1 diabetes, and autologous islet cell transplantation is for the prevention of surgical diabetes after a total pancreatectomy. The issues of allogeneic islet cell transplantation include poor efficacy of islet isolation, the need for multiple donor pancreata, difficulty maintaining insulin independence and undesirable side effects of immunosuppressive drugs. Those issues have been solved step by step and allogeneic islet cell transplantation is almost ready to be the standard therapy. The donor shortage will be the next issue and marginal and/or living donor islet cell transplantation might alleviate the issue. Xeno-islet cell transplantation, β-cell regeneration from human stem cells and gene induction of the naïve pancreas represent the next generation of β-cell replacement therapy. Autologous islet cell transplantation after total pancreatectomy for the treatment of chronic pancreatitis with severe abdominal pain is the standard therapy, even though only limited centers are able to perform this treatment. Remote center autologous islet cell transplantation is an attractive option for hospitals performing total pancreatectomies without the proper islet isolation facilities.

  20. Allogeneic Mesenchymal Stem Cell Treatment Induces Specific Alloantibodies in Horses

    Directory of Open Access Journals (Sweden)

    Sean D. Owens

    2016-01-01

    Full Text Available Background. It is unknown whether horses that receive allogeneic mesenchymal stem cells (MSCs injections develop specific humoral immune response. Our goal was to develop and validate a flow cytometric MSC crossmatch procedure and to determine if horses that received allogeneic MSCs in a clinical setting developed measurable antibodies following MSC administration. Methods. Serum was collected from a total of 19 horses enrolled in 3 different research projects. Horses in the 3 studies all received unmatched allogeneic MSCs. Bone marrow (BM or adipose tissue derived MSCs (ad-MSCs were administered via intravenous, intra-arterial, intratendon, or intraocular routes. Anti-MSCs and anti-bovine serum albumin antibodies were detected via flow cytometry and ELISA, respectively. Results. Overall, anti-MSC antibodies were detected in 37% of the horses. The majority of horses (89% were positive for anti-bovine serum albumin (BSA antibodies prior to and after MSC injection. Finally, there was no correlation between the amount of anti-BSA antibody and the development of anti-MSC antibodies. Conclusion. Anti allo-MSC antibody development was common; however, the significance of these antibodies is unknown. There was no correlation between either the presence or absence of antibodies and the percent antibody binding to MSCs and any adverse reaction to a MSC injection.

  1. Reduction in requirements for allogeneic blood products: nonpharmacologic methods.

    Science.gov (United States)

    Hardy, J F; Bélisle, S; Janvier, G; Samama, M

    1996-12-01

    Various strategies have been proposed to decrease bleeding and allogeneic transfusion requirements during and after cardiac operations. This article attempts to document the usefulness, or lack thereof, of the nonpharmacologic methods available in clinical practice. Blood conservation methods were reviewed in chronologic order, as they become available to patients during the perisurgical period. The literature in support of or against each strategy was reexamined critically. Avoidance of preoperative anemia and adherence to published guidelines for the practice of transfusion are of paramount importance. Intraoperatively, tolerance of low hemoglobin concentrations and use of autologous blood (predonated or harvested before bypass) will reduce allogeneic transfusions. The usefulness of plateletpheresis and retransfusion of shed mediastinal fluid remains controversial. Intraoperatively and postoperatively, maintenance of normothermia contributes to improved hemostasis. Several approaches have been shown to be effective. An efficient combination of methods can reduce, and sometimes abolish, the need for allogeneic blood products after cardiac operations, inasmuch as all those involved in the care of cardiac surgical patients adhere thoughtfully to existing transfusion guidelines.

  2. Selective engraftment of the granulocyte compartment after allogeneic bone marrow transplantation in a patient with severe aplastic anemia.

    Science.gov (United States)

    Barriga, F J; Legues, M E; Bertin, P

    1996-05-01

    We present a patient with severe aplastic anemia who had partial engraftment with full chimerism after allogeneic bone marrow transplantation from an HLA identical sibling. A 3-year-old girl with severe aplastic anemia (SAA) received a bone marrow transplantation (BMT) from an HLA identical brother 9 months after her diagnosis. Before BMT she was red blood cell tranfusion dependent, had an absolute neutrophil count (ANC) of 1,000-1,500 x 10(9)/1 and a platelet count of 15-19,000 x 10(9)/1. She was conditioned with 800 cGy total body irradiation (TBI) and cyclophosphamide and received 3X10(8) nucleated cells/kg. She reached an ANC of 1500 x 10(9)/1 on day +35 but her reticulocyte and platelet counts did not recover. A bone marrow aspirate and biopsy post BMT showed hypoplasia with marked decrease in megakaryocyte and red blood cell precursors. The granulocyte compartment showed a left shift with predominance of promyelocytes and myelocytes. The karyotype showed full chimerism (46,XY) with no 46,XX metaphases. This case illustrates the possibility of a bone marrow microenvironment defect as the cause of SAA.

  3. Rituximab administration within 6 months of T cell-depleted allogeneic SCT is associated with prolonged life-threatening cytopenias.

    Science.gov (United States)

    McIver, Zachariah; Stephens, Nicole; Grim, Andrew; Barrett, A John

    2010-11-01

    The monoclonal anti-CD20 antibody Rituximab (RTX) is increasingly used in allogeneic stem cell transplantation (SCT) to treat lymphoproliferative disorders and chronic graft-versus-host disease (GVHD). RTX administration can be complicated by delayed and prolonged neutropenia, but the mechanism is unclear. We report the occurrence of profound cytopenias following RTX given in the conditioning regimen or early after T cell-deplete SCT to treat B cell lymphoproliferative disorders or chronic GVHD (cGVHD). Between 2006 and 2009, 102 patients (median age: 43 years, range: 13-68 years), received a myeloablative matched-sibling T cell-deplete SCT for lymphoid or myeloid hematologic disorders. Neutropenia occurring within 4 weeks of treatment developed in 16 of 17 patients given RTX within the first 190 days after SCT. Fourteen patients developed severe neutropenia (count SCT compared to patients with cGVHD not treated with early RTX (P SCT experienced only moderate neutropenia 3 to 5 months after treatment lasting 10 to 20 days while maintaining absolute neutrophil count (ANC) >1.0 × 10⁹/L. Although RTX rapidly controlled cGVHD, we conclude that its administration early after T cell-deplete SCT is associated with prolonged profound and life-threatening cytopenias, and should be avoided. Published by Elsevier Inc.

  4. Conditioning with Treosulfan and Fludarabine Followed by Allogeneic Hematopoietic Cell Transplantation for High-Risk Hematologic Malignancies

    Science.gov (United States)

    Nemecek, Eneida R.; Guthrie, Katherine A.; Sorror, Mohamed L.; Wood, Brent L.; Doney, Kristine C.; Hilger, Ralf A.; Scott, Bart L.; Kovacsovics, Tibor J.; Maziarz, Richard T.; Woolfrey, Ann E.; Bedalov, Antonio; Sanders, Jean E.; Pagel, John M.; Sickle, Eileen J.; Witherspoon, Robert; Flowers, Mary E.; Appelbaum, Frederick R.; Deeg, H. Joachim

    2010-01-01

    In this prospective study 60 patients of median age 46 (range 5–60) years, with acute myeloid leukemia (AML; n=44), acute lymphoblastic leukemia (ALL; n=3), or myelodysplastic syndrome (MDS; n=13) were conditioned for allogeneic hematopoietic cell transplantation with a treosulfan/fludarabine combination. Most patients were considered at high risk for relapse or non-relapse mortality (NRM). Patients received intravenous treosulfan, 12 g/m2/day (n=5) or 14 g/m2/day (n=55) on days -6 to -4, and fludarabine (30 mg/m2/day) on days -6 to -2, followed by infusion of marrow (n=7) or peripheral blood stem cells (n=53) from HLA-identical siblings (n=30) or unrelated donors (n=30). All patients engrafted. NRM was 5% at day 100, and 8% at 2 years. With a median follow-up of 22 months, the 2-year relapse-free survival for all patients was 58% and 88% for patients without high risk cytogenetics. The 2-year cumulative incidence of relapse was 33% (15% for patients with MDS, 34% for AML in first remission, 50% for AML or ALL beyond first remission and 63% for AML in refractory relapse). Thus, a treosulfan/fludarabine regimen was well tolerated and yielded encouraging survival and disease control with minimal NRM. Further trials are warranted to compare treosulfan/fludarabine to other widely used regimens, and to study the impact of using this regimen in more narrowly defined groups of patients. PMID:20685259

  5. Perceptions of emotion expression and sibling-parent emotion communication in Latino and non-Latino white siblings of children with intellectual disabilities.

    Science.gov (United States)

    Long, Kristin A; Lobato, Debra; Kao, Barbara; Plante, Wendy; Grullón, Edicta; Cheas, Lydia; Houck, Christopher; Seifer, Ronald

    2013-06-01

    Examine general emotion expression and sibling-parent emotion communication among Latino and non-Latino white (NLW) siblings of children with intellectual disabilities (ID) and matched comparisons. 200 siblings (ages 8-15 years) completed the newly developed Sibling-Parent Emotion Communication Scale and existing measures of general emotion expression and psychosocial functioning. Preliminary analyses evaluated scale psychometrics across ethnicity. Structure and internal consistency of the emotion expression and communication measures differed by respondent ethnicity. Latino siblings endorsed more general emotion expression problems and marginally lower sibling-parent emotion communication than NLW siblings. Siblings of children with ID reported marginally more general emotion expression problems than comparisons. Emotion expression problems and lower sibling-parent emotion communication predicted more internalizing and somatic symptoms and poorer personal adjustment, regardless of ID status. Siblings of children with ID endorsed poorer personal adjustment. Cultural differences in emotion expression and communication may increase Latino siblings' risk for emotional adjustment difficulties.

  6. Only full-sibling families evolved eusociality

    DEFF Research Database (Denmark)

    Boomsma, Jacobus J; Beekman, Madeleine; Cornwallis, Charlie K

    2011-01-01

    Arising from M. A. Nowak, C. E. Tarnita & E. O. Wilson 466, 1057-1062 (2010); Nowak et al. reply. The paper by Nowak et al. has the evolution of eusociality as its title, but it is mostly about something else. It argues against inclusive fitness theory and offers an alternative modelling approach...... that is claimed to be more fundamental and general, but which, we believe, has no practical biological meaning for the evolution of eusociality. Nowak et al. overlook the robust empirical observation that eusociality has only arisen in clades where mothers are associated with their full-sibling offspring; that is......, in families where the average relatedness of offspring to siblings is as high as to their own offspring, independent of population structure or ploidy. We believe that this omission makes the paper largely irrelevant for understanding the evolution of eusociality....

  7. A new method of prefabricated vascularized allogenic bone grafts for maxillo-mandibular reconstruction

    International Nuclear Information System (INIS)

    Pill-Hoon Choung

    1999-01-01

    Although there are various applications of allogenic bone grafts, a new technique of prevascularized lyophilized allogenic bone grafting for maxillo-mandibular reconstruction will be presented. Allogenic bone has been made by author's protocol for jaw defects as a powder, chip or block bone type. The author used lyophilized allogenic bone grafts for discontinuity defects as a block bone. In those cases, neovascularization and resorption of the allogenic bone were important factors for success of grafting. To overcome the problems, the author designed the technique of prefabricated vascularization of allogenic bone, which was lyophilized cranium, with an application of bovine BMP or not. Lyophilized cranial bone was designed for the defects and was put into the scalp. After confirming a hot spot via scintigram several months later, vascularized allogenic bone was harvested pedicled on the parietotemporal fascia based on the superficial temporal artery and vein. Vascularized allogenic cranial bone was rotated into the defect and fixed rigidly. Postoperatively, there was no severe resorption and functional disturbance of the mandible. In this technique, BMP seems to be an important role to help osteogenesis and neovascularization. Eight patients underwent prefabricated vascularization of allogenic bone grafts. Among them, four cases of reconstruction in mandibular discontinuity defects and one case of reconstruction in maxillectomy defect underwent this method, which will be presented with good results. This method may be an alternative technique of microvascular free bone graft

  8. Relationship of Sibling Structure and Interaction to Categorization Ability. Final Report.

    Science.gov (United States)

    Cicirelli, Victor G.; And Others

    This study identified behaviors of sibling pairs interacting on a cognitive task and related these behaviors to sibling structure variables (age and sex of each sibling and age spacing between them) and to measure of cognitive abilities of the younger sibling. Subjects were 160 sibling pairs randomly selected from appropriate subpopulations of…

  9. Sibling Relationships and Adolescents' Mental Health: The Interrelationship of Structure and Quality

    Science.gov (United States)

    Yuan, Anastasia S. Vogt

    2009-01-01

    Although sibling structure influences some aspects of adolescents' well-being, including deviance and educational achievement, little research has explored the association between sibling structure and adolescents' mental health. This study explores how sibling structure (the number of siblings, full versus step- or half-siblings, the relative age…

  10. The Impact of Sibling Warmth and Conflict on Children's Social Competence with Peers.

    Science.gov (United States)

    Lockwood, Rebecca L.; Kitzmann, Katherine M.; Cohen, Robert

    2001-01-01

    Examined links between children's sibling and peer relationships. Found that sibling warmth was associated with more positive peer relations; sibling conflict was associated with both positive and negative peer outcomes, independent of sibling warmth; and sibling relationships were not more strongly associated with measures of friendships quality…

  11. Adult Female and Male Siblings of Persons with Disabilities: Findings from a National Survey

    Science.gov (United States)

    Hodapp, Robert M.; Urbano, Richard C.; Burke, Meghan M.

    2010-01-01

    In this study, the authors used a national, Web-based survey to examine female and male siblings of individuals with disabilities. More than 1,160 adult siblings completed a 163-question survey about themselves, their siblings, and their sibling relationships. Most respondents reported fairly close contact with their siblings and positive sibling…

  12. Accommodative spasm in siblings: A unique finding

    Directory of Open Access Journals (Sweden)

    Rutstein Robert

    2010-01-01

    Full Text Available Accommodative spasm is a rare condition occurring in children, adolescents, and young adults. A familial tendency for this binocular vision disorder has not been reported. I describe accommodative spasm occurring in a brother and sister. Both children presented on the same day with complaints of headaches and blurred vision. Treatment included cycloplegia drops and bifocals. Siblings of patients having accommodative spasm should receive a detailed eye exam with emphasis on recognition of accommodative spasm.

  13. Accommodative spasm in siblings: A unique finding

    Science.gov (United States)

    Rutstein, Robert P

    2010-01-01

    Accommodative spasm is a rare condition occurring in children, adolescents, and young adults. A familial tendency for this binocular vision disorder has not been reported. I describe accommodative spasm occurring in a brother and sister. Both children presented on the same day with complaints of headaches and blurred vision. Treatment included cycloplegia drops and bifocals. Siblings of patients having accommodative spasm should receive a detailed eye exam with emphasis on recognition of accommodative spasm. PMID:20534925

  14. Should Selecting Saviour Siblings be Banned?

    OpenAIRE

    Sheldon, Sally; Wilkinson, Stephen

    2004-01-01

    By using tissue typing in conjunction with preimplantation genetic diagnosis doctors are able to pick a human embryo for implantation which, if all goes well, will become a "saviour sibling", a brother or sister capable of donating life-saving tissue to an existing child. \\ud \\ud This paper addresses the question of whether this form of selection should be banned and concludes that it should not. Three main prohibitionist arguments are considered and found wanting: (a) the claim that saviour ...

  15. Reduced-intensity conditioning regimen using low-dose total body irradiation before allogeneic transplant for hematologic malignancies: Experience from the European Group for Blood and Marrow Transplantation

    International Nuclear Information System (INIS)

    Belkacemi, Yazid; Labopin, Myriam; Hennequin, Christophe; Hoffstetter, Sylvette; Mungai, Raffaello; Wygoda, Marc; Lundell, Marie; Finke, Jurgen; Aktinson, Chris; Lorchel, Frederic; Durdux, Catherine; Basara, Nadezda

    2007-01-01

    Purpose: The high rate of toxicity is the limitation of myelobalative regimens before allogeneic transplantation. A reduced intensity regimen can allow engraftment of stem cells and subsequent transfer of immune cells for the induction of a graft-vs.-tumor reaction. Methods and Materials: The data from 130 patients (80 males and 50 females) treated between 1998 and 2003 for various hematologic malignancies were analyzed. The median patient age was 50 years (range, 3-72 years). Allogeneic transplantation using peripheral blood or bone marrow, or both, was performed in 104 (82%), 22 (17%), and 4 (3%) patients, respectively, from HLA identical sibling donors (n = 93, 72%), matched unrelated donors (n = 23, 18%), mismatched related donors (4%), or mismatched unrelated donors (6%). Total body irradiation (TBI) at a dose of 2 Gy delivered in one fraction was given to 101 patients (78%), and a total dose of 4-6 Gy was given in 29 (22%) patients. The median dose rate was 14.3 cGy/min (range, 6-16.4). Results: After a median follow-up period of 20 months (range, 1-62 months), engraftment was obtained in 122 patients (94%). Acute graft-vs.-host disease of Grade 2 or worse was observed in 37% of patients. Multivariate analysis showed three favorable independent factors for event-free survival: HLA identical sibling donor (p < 0.0001; relative risk [RR], 0.15), complete remission (p < 0.0001; RR, 3.08), and female donor to male patient (p = 0.006; RR 2.43). For relapse, the two favorable prognostic factors were complete remission (p < 0.0001, RR 0.11) and HLA identical sibling donor (p = 0.0007; RR 3.59). Conclusions: In this multicenter study, we confirmed high rates of engraftment and chimerism after the reduced intensity regimen. Our results are comparable to those previously reported. Radiation parameters seem to have no impact on outcome. However, the lack of a statistically significant difference in terms of dose rate may have been due, in part, to the small population

  16. Self-reported behaviour problems and sibling relationship quality by siblings of children with autism spectrum disorder.

    Science.gov (United States)

    Hastings, R P; Petalas, M A

    2014-11-01

    There are few published research studies in which siblings of children with autism spectrum disorder (ASD) provide self-reports about their own behavioural and emotional problems and their sibling relationships. Reliance on parent reports may lead to incomplete conclusions about the experiences of siblings themselves. Siblings 7-17 years and their mothers from 94 families of children with ASD were recruited. Mothers reported on family demographics, the behavioural and emotional problems of their child with ASD, and on their own symptoms of depression. Siblings reported on their relationship with their brother or sister with ASD, and siblings 11+ years of age also self-reported on their behavioural and emotional problems. Compared with normative British data, siblings reported very slightly elevated levels of behavioural and emotional problems. However, none of the mean differences were statistically significant and all group differences were associated with small or very small effect sizes - the largest being for peer problems (effect size = 0.31). Regression analysis was used to explore family systems relationships, with sibling self-reports predicted by the behaviour problems scores for the child with ASD and by maternal depression. Maternal depression did not emerge as a predictor of siblings' self-reported sibling relationships or their behavioural and emotional problems. Higher levels of behaviour problems in the child with ASD predicted decreased warmth/closeness and increased conflict in the sibling relationship. These data support the general findings of recent research in that there was little indication of clinically meaningful elevations in behavioural and emotional problems in siblings of children with ASD. Although further research replication is required, there was some indication that sibling relationships may be at risk where the child with ASD has significant behaviour problems. © 2014 John Wiley & Sons Ltd.

  17. 'Adoption' by maternal siblings in wild chimpanzees.

    Directory of Open Access Journals (Sweden)

    Catherine Hobaiter

    Full Text Available The adoption of unrelated orphaned infants is something chimpanzees and humans have in common. Providing parental care has fitness implications for both the adopter and orphan, and cases of adoption have thus been cited as evidence for a shared origin of an altruistic behaviour. We provide new data on adoptions in the free-living Sonso chimpanzee community in Uganda, together with an analysis of published data from other long-term field sites. As a default pattern, we find that orphan chimpanzees do not become adopted by adult group members but wherever possible associate with each other, usually as maternal sibling pairs. This occurs even if both partners are still immature, with older individuals effectively becoming 'child household heads'. Adoption of orphans by unrelated individuals does occur but usually only if no maternal siblings or other relatives are present and only after significant delays. In conclusion, following the loss of their mother, orphaned chimpanzees preferentially associate along pre-existing social bonds, which are typically strongest amongst maternal siblings.

  18. Relationship between siblings and psychological adjustment in adolescents:

    Directory of Open Access Journals (Sweden)

    Karen Ripoll

    2009-10-01

    Full Text Available This study evaluated the effect of parent-child relationship quality (acceptance and differential treatment over dimensions of the quality of sibling relationships (warmth and conflict and psychological adjustment in 69 adolescent sibling dyads. The effects of parent-child relationships were evaluated both at the individual and dyadic levels. In older siblings, the father-child relationship had a significant effect on both their perception of warmth in the sibling relationship and psychological adjustment. In younger siblings, there was a significant dyadic effect of the older sibling’s perceived acceptance by mother on their perception of warmth in the sibling relationship. Results are analyzed based on the literature and questions for future research are proposed.

  19. Perceptions of sibling relationships during middle childhood and adolescence.

    Science.gov (United States)

    Buhrmester, D; Furman, W

    1990-10-01

    Children in grades 3, 6, 9, and 12 were administered the Sibling Relationship Questionnaire. Relationships were rated as progressively more egalitarian across the 4 grade groups, with adolescents reporting less dominance and nurturance by their older siblings than younger participants. Adolescents also reported less companionship, intimacy, and affection with siblings than younger participants reported. Levels of perceived conflict with younger siblings were moderately high across all 4 grades, whereas ratings of conflict with older siblings were progressively lower across the 4 grades. The findings suggested that sibling relationships: (a) become more egalitarian and less asymmetrical with age, (b) become less intense with age, and (c) encompass experiences that are partially determined by the child's standing in the family constellation.

  20. Sibling deidentification in the clinic: devil vs. angel.

    Science.gov (United States)

    Schachter, F F

    1985-09-01

    A four-member family structure consisting of two siblings contrasting in personality (sibling deidentification) and each identified with a different parent (split-parent identification) was recently reported (15). In well-functioning families, this tetrad or quadrangle is wide-spread in the first pair of siblings in the family and tends to be more common in same-sex pairs, suggesting that sibling deidentification is designed to mitigate the relatively intense sibling rivalry characteristic of these pairs and hence to maintain family harmony. In this collated case report, deidentification is found to follow the same pattern in 39 clinic first pairs. However, contrasting attributes are varied and nonevaluative in nonclinic pairs but mainly "good-bad" in clinic pairs, with polarization extreme. Results suggest that nonclinic siblings negotiate their identity (being) much as they negotiate about possessions (having) and that negotiations are blocked in clinic pairs, freezing mythic devil or angel identity. Intervention is directed at dislodging this block.

  1. Sibling genes as environment: Sibling dopamine genotypes and adolescent health support frequency dependent selection.

    Science.gov (United States)

    Rauscher, Emily; Conley, Dalton; Siegal, Mark L

    2015-11-01

    While research consistently suggests siblings matter for individual outcomes, it remains unclear why. At the same time, studies of genetic effects on health typically correlate variants of a gene with the average level of behavioral or health measures, ignoring more complicated genetic dynamics. Using National Longitudinal Study of Adolescent Health data, we investigate whether sibling genes moderate individual genetic expression. We compare twin variation in health-related absences and self-rated health by genetic differences at three locations related to dopamine regulation and transport to test sibship-level cross-person gene-gene interactions. Results suggest effects of variation at these genetic locations are moderated by sibling genes. Although the mechanism remains unclear, this evidence is consistent with frequency dependent selection and suggests much genetic research may violate the stable unit treatment value assumption. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. Reducing Sibling Conflict in Maltreated Children Placed in Foster Homes

    Science.gov (United States)

    Linares, L. Oriana; Jimenez, Jessica; Nesci, Cristina; Pearson, Eva; Beller, Sarah; Edwards, Nancy; Levin-Rector, Alison

    2016-01-01

    Sibling aggression among maltreated children placed in foster homes is linked to other externalizing problems and placement disruption. The reduction of sibling conflict and aggression may be achieved via a multicomponent ecologically focused intervention for families in the foster care system. The focus of the study is to evaluate the feasibility and short-term effectiveness of a transtheoretical intervention model targeting sibling pairs and their foster parent that integrates family systems, social learning theory, and a conflict mediation perspective. In this pilot study, sibling pairs (N=22) and their foster parent were randomized into a three-component intervention (n=13) or a comparison (n=9) group. Promoting Sibling Bonds (PSB) is an 8-week prevention intervention targeting maltreated sibling pairs ages 5–11 years placed together in a foster home. The Siblings, Parent, and Joint components were delivered in a program package at the foster agency by a trained two-clinician team. Average attendance across program components was 73%. Outcomes in four areas were gathered at pre-and post-intervention: observed sibling interaction quality (positive and negative) including conflict during play, and foster parent reports of mediation strategies and sibling aggression in the foster home. At post-intervention, adjusting for baseline scores and child age, intervention pairs showed higher positive (p<.001) and negative (p<.05) interaction quality, and lower sibling conflict during play (p <.01) than comparison pairs. Foster parents in the intervention group reported a higher number of conflict mediation strategies than those in the comparison group (p <.001). Foster parents in the intervention group reported lower sibling physical aggression from the older toward the younger child than those in the comparison group (p <.05). Data suggest that the PSB intervention is a promising approach to reduce conflict and promote parental mediation which together may reduce

  3. Pretense of parentage by siblings in immigration: Polesky's paradox reconsidered.

    Science.gov (United States)

    Wenk, Robert E; Shao, Alison

    2014-02-01

    Older and younger siblings occasionally attempt to impersonate parent and child to expedite immigration under US family-based visa policies. The rate with which full siblings escape detection by current relationship tests is unknown. Retrospective study of full-sibling immigrant pairs was undertaken to determine the proportion that show insufficient genetic evidence to exclude parentage. Sibship and parentage indices (SI and PI) were compared/case in unexcluded sibling cases and true parent-child cases. Alleles shared per short-tandem-repeat locus were compared in sibling and parent-child pairs. The proportion of successful parentage fraud by siblings was estimated from the parentage exclusion rate among immigrants and the proportion of sibships without genetic inconsistencies (GIs). When 11 to 25 independent loci were tested per two-sibling case to verify or refute parentage, tests failed to demonstrate any GI in 9% and PI was greater than SI in seven of 10 of these cases. Another 29% of full-sibling pairs demonstrated insufficient evidence (fewer than two GIs) to exclude parentage. Thus, 0.4% of sibling pairs could falsely claim a parent-child relationship and show no GIs. Another 1.4% could make that false claim and not present sufficient evidence to be excluded. At present, with no evidence of parentage exclusion in a full-sibling pair, the relative magnitudes of PI and SI are misleading relationship indicators because too few loci are examined and rates of sharing one and two alleles/locus vary greatly in parentage and sibling pairs. Only evidence of exclusion ascertains false parentage claims by siblings. Nevertheless, the expected rate of successful fraud is quite low. © 2013 American Association of Blood Banks.

  4. Adolescents' Social Skills in Friendship : The influence of sibling relationship

    OpenAIRE

    藤田, 文; Aya, Fujita

    1998-01-01

    The purpose of this study was to investigate the influence of the sibling relationship on the adolescents' social skills in friendship. One hundred and seventy-seven undergraduate students were asked to complete a questionnaire regarding their sibling relationship and their social skills in friendship. Their sibling relationship was categorized eight types; close, intimate, hostile, dominate, intimate-hostile, intimate-dominate, hostile-dominate, separate. The result showed that the students ...

  5. Sibling Rivalry in Educational Attainment: The German Case

    OpenAIRE

    Ira N. Gang; Thomas Bauer

    2000-01-01

    Recent studies exploring sibling rivalry in the allocation of household resources in the U.S. produce conflicting results. We contribute to this discussion by addressing the role of sibling rivalry in educational attainment in Germany. Using the German Socioeconomic Panel (GSOEP) we are able to distinguish how the effects of sibling rivalry vary by cultural affiliation, i.e., among families of West German, East German and foreign origin. We also point out and correct for a reference group pro...

  6. Appetite and growth: a longitudinal sibling analysis.

    Science.gov (United States)

    van Jaarsveld, Cornelia H M; Boniface, David; Llewellyn, Clare H; Wardle, Jane

    2014-04-01

    Identifying early markers of future obesity risk can help target preventive interventions. Several studies have shown that a heartier appetite in infancy is a risk factor for more rapid weight gain, but to date no investigations have been able to rule out familial confounding. To use a sibling design (data from same-sex, dizygotic twin pairs) to test the hypothesis that sibling differences in infant appetite predicted differential weight gain during childhood. Gemini is a population-based twin cohort among the general United Kingdom population born between March 1, 2007, and December 15, 2007. Growth trajectories were analyzed from birth to age 15 months. Appetite-discordant pairs were selected from 800 nonidentical, same-sex twin pairs. Appetite during the first 3 months of life was assessed with the food responsiveness (FR) and satiety responsiveness (SR) subscales from the Baby Eating Behaviour Questionnaire. Discordance was defined as a within-pair difference of at least 1 SD. A mean of 11.5 weight measurements per child were available between birth and age 15 months. Multilevel models, adjusted for sex and birth weight, compared growth curves for the higher-appetite vs lower-appetite twins. In total, 172 pairs were discordant for SR and 121 pairs for FR. Within-pair analyses showed that those with higher FR and those with lower SR grew faster than their sibling. At age 6 months, those with higher FR were 654 (95% CI, 395-913) g heavier and at age 15 months were 991 (95% CI, 484-1498) g heavier. For sibling pairs discordant for SR, the weight differences between siblings were 637 (95% CI, 438-836) g at age 6 months and 918 (95% CI, 569-1267) g at age 15 months. A heartier appetite (indexed with higher FR or lower SR) in early infancy is prospectively associated with more rapid growth up to age 15 months in a design controlling for potential familial confounding, supporting a causal role for appetite in childhood weight gain. Appetite could be an early marker

  7. Impact of childhood chronic illnesses on siblings: a literature review.

    LENUS (Irish Health Repository)

    O' Brien, Irene

    2012-02-01

    BACKGROUND: Childhood illness can have a significant impact on families, particularly on the ill child\\'s siblings. There is a dearth of published literature focusing on the needs of siblings of ill children. AIM: This literature review aims to provide an overview of the current healthcare literature in relation to the impact of childhood chronic illness or disability on siblings. METHOD: A literature review was undertaken by searching the databases CINAHL, PsycINFO, ProQuest and Cochrane Library for relevant articles in English using the search terms: \\'siblings\\

  8. Cancer risk in siblings of children with congenital malformations

    DEFF Research Database (Denmark)

    Sun, Yuelian; Wu, Chunsen; Arah, Onyebuchi A

    2016-01-01

    PURPOSE: Cancer and birth defects cluster in families more often than expected by chance, but the reasons are neither well known nor well studied. METHODS: From singletons born alive in Denmark between 1 January 1977 and 31 December 2007, we identified children who had no congenital malformations...... but had a full or half sibling with a congenital malformation (CM) diagnosed in the first year of life; this constituted the exposed group, while children whose siblings had no such condition constituted a reference group. We estimated cancer risks for children who had a full sibling or a half sibling...

  9. Dead or Alive? Knowledge about a Sibling's Death Varies by Genetic Relatedness in a Modern Society

    Directory of Open Access Journals (Sweden)

    Thomas V. Pollet

    2009-01-01

    Full Text Available Using a large sample of non-institutionalized individuals from the Netherlands (n = 7610, we examined the influence of relatedness on an individual's knowledge about whether their sibling is alive or not. Respondents were generally less likely to know whether their sibling was alive if they were not fully related. The effects were stronger for differences between paternal half-siblings and full siblings than for differences between maternal half-siblings and full siblings.

  10. Dead or Alive? Knowledge about a Sibling's Death Varies by Genetic Relatedness in a Modern Society

    OpenAIRE

    Pollet, Thomas; Nettle, Daniel

    2009-01-01

    Using a large sample of non-institutionalized individuals from the Netherlands (n = 7610), we examined the influence of relatedness on an individual's knowledge about whether their sibling is alive or not. Respondents were generally less likely to know whether their sibling was alive if they were not fully related. The effects were stronger for differences between paternal half-siblings and full siblings than for differences between maternal half-siblings and full siblings.

  11. Siblings of Youth with Autism Spectrum Disorders: Theoretical Perspectives on Sibling Relationships and Individual Adjustment

    Science.gov (United States)

    McHale, Susan M.; Updegraff, Kimberly A.; Feinberg, Mark E.

    2016-01-01

    A burgeoning research literature investigates the sibling relationships of youth with autism spectrum disorder (ASD) and their implications for individual adjustment. Focusing on four relationship domains--behaviors, emotions, cognitions and involvement--and toward advancing this generally atheoretical literature, we review and apply tenets from a…

  12. RENAL ALLOGENEIC TRANSPLANTATION IN PATIENT WITH HAEMOPHILIA B

    Directory of Open Access Journals (Sweden)

    N. V. Purlo

    2014-01-01

    Full Text Available We report the case of successful renal allogeneic transplantation and treatment in a 56-year-old patient with haemophilia B at Hematology Research Center. He has received replacement therapy by factor IX since 2010. The transplant is marked with good renal function during 13 post-transplant months without episodes of rejection or bleeding complications. The complicated surgical interventions are possible in patients with haemophilia В аnd end-stage chronic renal failure in the presence of replacement therapy of IX factor for the purpose of achievement of optimum hemostasis.

  13. Upaya Mengatasi Sibling Rivalry melalui Layanan Konseling Kelompok

    Directory of Open Access Journals (Sweden)

    Eli Turniati

    2015-12-01

    Full Text Available Penelitian ini dilakukan berdasarkan fenomena yang terjadi pada siswa kelas VI SDN Sendangmulyo 02 kecamatan Tembalang kota Semarang yang mengalami sibling rivalry. Tujuan penelitian ini yaitu untuk mengetahui apakah konseling kelompok dapat mengatasi sibling rivalry pada siswa kelas VI SDN Sendangmulyo 02. Jenis penelitian adalah penelitian eksperiment dengan desain penelitian one group pre-test dan pos-test design. Subyek penelitian ini, siswa kelas VI SDN Sendangmulyo 02 yang memiliki tingkat sibling rivalry tinggi yang diperoleh dari hasil DCM dan rekomendasi dari guru kelas yaitu terjaring 10 siswa. Metode pengumpulan data menggunakan skala psikologis berupa skala sibling rivalry. Analisis data menggunakan teknik analisis data deskriptif persentase dan uji wilcoxon. Hasil penelitian menunjukan sibling rivalry siswa sebelum diberi perlakuan berupa konseling kelompok dalam kategori tinggi (75.14%. Setelah diberikan konseling kelompok menunjukkan perbedaan, dilihat dari hasil pos test rata-rata sibling rivalry siswa menurun yaitu berada pada kategori rendah (42,95%. Hal tersebut menunjukan bahwa sibling rivalry dapat diatasi melalui layanan konseling kelompok This research was conducted based on phenomena that occur in grade VI SDN Sendangmulyo 02 Tembalang Semarang who experienced sibling rivalry. The purpose of this research is to find out if counseling groups can overcome sibling rivalry at grade VI SDN Sendangmulyo 02. This type of research is research research design alphabets experiment one group pre test and post test design. The subject of this study, students of class VI SDN Sendangmulyo 02 that has a high level of sibling rivalry that results obtained from DCM and the recommendations of the master class that is netted 10 students. Method of data collection using a scale of psychological scale in the form of sibling rivalry. Data analysis data analysis techniques using a descriptive percentage and wilcoxon test. The research results

  14. Dyssegmental dysplasia in siblings: Prenatal ultrasonic diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Andersen, P.E. Jr.; Hauge, M.; Bang, J.

    1988-01-01

    Two cases of dyssegmental dysplasia (type Silverman-Handmaker) in siblings are presented. The first-born died at the age of 3 months and the second fetus was followed during pregnancy with ultrasound examinations. In the 20th week of gestation marked shortening of the extremities was found; a female infant showing the same radiologic bony malformations as the firstborn was born by cesarean section. These cases support the autosomal recessive inheritance and demonstrate the possibility of prenatal diagnosis in this type of micromelic dwarfism. (orig.)

  15. Preimplantation HLA typing for stem cell transplantation treatment of hemoglobinopathies

    Directory of Open Access Journals (Sweden)

    Anver Kuliev

    2014-09-01

    Full Text Available Preimplantation genetic diagnosis (PGD for HLA typing is steadily becoming an option for at risk couples with thalassemic children, requiring HLA matched bone marrow transplantation treatment. The paper presents the world’s largest PGD experience of 475 cases for over 2 dozens thalassemia mutations, resulting in birth of 132 unaffected children. A total of 146 cases were performed together with preimplantation HLA typing, resulting in detection and transfer of HLA matched unaffected embryos in 83 of them, yielding the birth of 16 HLA matched children, potential donors for their affected siblings. The presented experience of HLA matched stem cell transplantation for thalassemia, following PGD demonstrated a successful hematopoietic reconstitution both for younger and older patients. The data show that PGD is an efficient approach for HLA matched stem cell transplantation treatment for thalassemia.

  16. Psychological Symptomatology in Siblings of Children with ADHD

    Science.gov (United States)

    Listug-Lunde, Lori; Zevenbergen, Andrea A.; Petros, Thomas V.

    2008-01-01

    Objective: Studies utilizing parent-report measures have identified above average levels of internalizing and externalizing problems in siblings of children diagnosed with ADHD. Scant research has examined siblings' self-report on standardized measures of emotional functioning. The current study examined parent-reported and child self-reported…

  17. Relational Aggression in Sibling and Peer Relationships during Early Childhood

    Science.gov (United States)

    Ostrov, Jamie M.; Crick, Nicki R.; Stauffacher, Kirstin

    2006-01-01

    The role of siblings ("N" = 50) in the display of physical and relational aggression among peers during early childhood was explored. Specifically, sibling pairs' rates of physical and relational aggression were assessed in their independent social contexts. Findings indicated low to moderate levels of intercorrelation between physical and…

  18. Adolescent Depression and Time Spent with Parents and Siblings

    Science.gov (United States)

    Desha, Laura N.; Nicholson, Jan M.; Ziviani, Jenny M.

    2011-01-01

    This study examines adolescent depressive symptoms and the quantity and quality of time spent by adolescents with their parents and siblings. We use measures of the quality of relationships with parents and siblings as proxy indicators for the quality of time spent with these social partners. The study emphasizes the salience of parent…

  19. Types of sons/siblings, fraternal function and peers

    Directory of Open Access Journals (Sweden)

    Luisa Brunori

    2013-12-01

    Full Text Available In this article, the author starts by exploring family dynamics using the psychodynamic-groupanalytic paradigm to explore the intertwined relationships amongst the family figures like son, daughter, parents and sibling. The work focuses on the analysis of the psychological aspects related to siblings in the family, birth order and their consequences.

  20. Support Between Siblings and Between Friends : Two Worlds Apart?

    NARCIS (Netherlands)

    Voorpostel, Marieke; Lippe, Tanja van der

    2007-01-01

    This research examines whether siblings and friends resemble each other in supportive behavior. Using a Dutch national sample of 6,289 individuals containing 12,578 relationships with siblings and friends, we investigated the relative importance of gender composition, geographical proximity,

  1. Sibling Socialization: The Effects of Stressful Life Events and Experiences

    Science.gov (United States)

    Conger, Katherine J.; Stocker, Clare; McGuire, Shirley

    2009-01-01

    Stressful life events and experiences may disrupt the typical day-to-day interactions between sisters and brothers that provide the foundation of sibling socialization. This chapter examines four experiences that may affect patterns of sibling interaction: parental marital conflict, parental divorce and remarriage, foster care placement, and a…

  2. Caregiving, perceptions of maternal favoritism, and tension among siblings.

    Science.gov (United States)

    Suitor, J Jill; Gilligan, Megan; Johnson, Kaitlin; Pillemer, Karl

    2014-08-01

    Studies of later-life families have revealed that sibling tension often increases in response to parents' need for care. Both theory and research on within-family differences suggest that when parents' health declines, sibling relations may be affected by which children assume care and whether siblings perceive that the parent favors some offspring over others. In the present study, we explore the ways in which these factors shape sibling tension both independently and in combination during caregiving. In this article, we use data collected from 450 adult children nested within 214 later-life families in which the offspring reported that their mothers needed care within 2 years prior to the interview. Multilevel analyses demonstrated that providing care and perceiving favoritism regarding future caregiving were associated with sibling tension following mothers' major health events. Further, the effects of caregiving on sibling tension were greater when perceptions of favoritism were also present. These findings shed new light on the conditions under which adult children are likely to experience high levels of sibling tension during caregiving. Understanding these processes is important because siblings are typically the individuals to whom caregivers are most likely to turn for support when assuming care of older parents, yet these relationships are often a major source of interpersonal stress. © The Author 2013. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  3. Perceived support in sibling relationships and adolescent adjustment

    NARCIS (Netherlands)

    Branje, S.J.T.; Lieshout, C.F.M. van; Aken, M.A.G. van; Haselager, G.J.T.

    2004-01-01

    Background: Siblings may support each other, but also reveal fierce rivalry and mutual aggression. Supportive sibling relationships have been linked to the development of psychosocial competence of children. In the present longitudinal study, we will focus on the development of perceived support in

  4. Infant-mother and infant-sibling attachment in Zambia.

    Science.gov (United States)

    Mooya, Haatembo; Sichimba, Francis; Bakermans-Kranenburg, Marian

    2016-12-01

    This study, the first in Zambia using the Strange Situation Procedure (SSP) to observe attachment relationships and the "very first" observational study of infant-sibling attachment, examined patterns of infant-mother and infant-sibling attachment, and tested their association. We included siblings who were substantially involved in caregiving activities with their younger siblings. We hypothesized that infants would develop attachment relationships to both mothers and siblings; the majority of infants would be classified as securely attached to both caregivers, and infant-mother and infant-sibling attachment would be unrelated. The sample included 88 low-income families in Lusaka, Zambia (average of 3.5 children; SD = 1.5). The SSP distributions (infant-mother) were 59% secure, 24% avoidant and 17% resistant, and 46% secure, 20% avoidant, 5% resistant and 29% disorganized for three- and four-way classifications, respectively. The infant-sibling classifications were 42% secure, 23% avoidant and 35% resistant, and 35% secure, 23% avoidant, 9% resistant and 33% disorganized for three- and four-way classifications, respectively. Infant-mother and infant-sibling attachment relationships were not associated.

  5. Parents, Siblings, and Peers: Close Social Relationships and Adolescent Deviance.

    Science.gov (United States)

    Ardelt, Monika; Day, Laurie

    2002-01-01

    Examined relations between parents, older siblings, peers, adolescents' individual characteristics, and adolescents' deviant attitudes and behaviors among inner-city families. Structural equation models showed that older deviant siblings had the strongest effect on adolescent deviance. Positive family relationships, parental support, and…

  6. Korean sibling caregivers of individuals diagnosed with schizophrenia

    Directory of Open Access Journals (Sweden)

    Mijung Park

    2017-12-01

    Full Text Available Siblings of individuals diagnosed with schizophrenia are an important source of family caregiving. Unfortunately, limited information is available about sibling caregivers because existing studies have focused on other family relationships such as parents, spouses, and children. To fill the knowledge gap, the purpose of this study is to describe Korean sibling caregivers’ experience with individuals diagnosed with schizophrenia. Guided by Colaizzi’s descriptive phenomenological methodology, we conducted in-depth, semi-structured, face-to-face interviews with eight individuals who have a sibling (1 diagnosed with schizophrenia and (2 hospitalized in an inpatient psychiatric unit. We discerned six key themes: sorrow, burnout, shame, different perspectives in life, acceptance, and responsibility. We categorized these themes into three groups: suffering, hope, and responsibility and obligation. Sibling caregivers of individuals with schizophrenia experience a mixture of several emotions. Participants loved their brother or sister with schizophrenia, but at the same time they felt shame and fear. While they were burdened by the responsibilities of caregiving, they remained loyal to their sibling with schizophrenia, continuing to help their siblings reach their full potential. Although participants were confused about the symptoms of schizophrenia, they were committed to learning more about the illness. Because we conducted the current study in Korea, the findings of this study may be unique to Korea culture. Further studies are needed to compare and contrast nuanced differences in sibling caregivers’ experience among different cultural groups.

  7. Birth Order, Sibling IQ Differences, and Family Relations.

    Science.gov (United States)

    Pfouts, Jane H.

    The differential impact of birth order and IQ on sibling roles were examined with particular interest focused on achievement outcomes. Subjects were a stratified sample of 37 pairs of near-in-age siblings, all within the normal range in personality and IQ, but differing significantly in scores on the Slosson IQ Test. Results indicate that when the…

  8. Cortical Excitability Measures in Patients and Unaffected Siblings

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2013-05-01

    Full Text Available Researchers at St Vincent's Hospital, Victoria, Australia, measured cortical excitability using transcranial magnetic stimulation in 157 patients with epilepsy (95 generalized and 62 focal and their asymptomatic siblings and results were compared to those of 12 controls and 20 of their siblings.

  9. Socialization, Social Cognitive Factors and the Sibling Relationship.

    Science.gov (United States)

    Howe, Nina

    Two separate studies suggest that the development of positive sibling relations may be related to siblings' social-cognitive skills (Stewart & Marvin, 1984) and the nature of mothers' conversations with their children (Dunn & Kendrick, 1982). The purpose of the present study was to provide a synthesis of these two studies and to demonstrate the…

  10. A report of heat stroke in two Nigerian siblings

    African Journals Online (AJOL)

    2014-05-31

    May 31, 2014 ... Two Nigerian siblings aged ... Case Report. Two male siblings, aged 3 (Case 1) and 5‑year‑old (Case 2) ... stroke with the resultant neurological and multi organ dysfunction,[11] ... urine color cleared within 24 h of admission.

  11. Alcohol-related morbidity and mortality within siblings

    DEFF Research Database (Denmark)

    Søndergaard, Grethe; Osler, Merete; Andersen, Anne-Marie Nybo

    2015-01-01

    AIMS: To estimate the association between educational status and alcohol-related somatic and non-somatic morbidity and mortality among full siblings in comparison with non-related individuals. DESIGN: Cohort study. SETTING: Denmark. PARTICIPANTS: Approximately 1.4 million full siblings born in De...

  12. Helping as Coping by Siblings of the Disabled.

    Science.gov (United States)

    Midlarsky, Elizabeth; Hannah, Mary Elizabeth

    Research has shown that siblings can experience either negative or positive mental health outcomes as a result of having a brother or sister with disabilities. When maladjustment occurs, it is frequently attributed to the stress of excessive helping. This research-based paper proposes that siblings of children with disabilities, perceiving…

  13. The effect of educational interventions with siblings of hospitalized children.

    Science.gov (United States)

    Gursky, Barbara

    2007-10-01

    Research has demonstrated that siblings of chronically ill children can experience significant emotional and behavior changes; however, few studies have looked at the specific impact of pediatric hospitalization on the nonhospitalized child. Studies also indicate that children who receive age-appropriate information are better equipped to handle the stress and anxiety often associated with hospitalization.This study explored whether siblings of hospitalized children who received educational interventions had lower anxiety levels compared to siblings who did not receive interventions. A pretest-posttest experimental design was used with 50 subjects, ages 6-17 years, recruited from a children's hospital within a university medical center. Subjects were matched according to age, sex, and race, with 25 siblings each in the experimental and control groups. Siblings assigned to the experimental group received interventions from a standardized educational intervention protocol developed by the researcher. Interventions focused on teaching the sibling about hospitalization, illness or injury, and treatment for the patient, based on cognitive stages of development. All interventions were conducted by child life specialists on staff at the hospital with extensive training and experience in preparation and procedural teaching. Results shows that siblings who received educational interventions had significantly lower anxiety levels after interventions, compared to siblings who did not receive interventions. These findings have significant impact on children's health care and supporting family needs when a child is hospitalized.

  14. Outcomes in Adult Life among Siblings of Individuals with Autism

    Science.gov (United States)

    Howlin, Patricia; Moss, Philippa; Savage, Sarah; Bolton, Patrick; Rutter, Michael

    2015-01-01

    Little is known about adult siblings of individuals with autism. We report on cognitive, social and mental health outcomes in 87 adult siblings (mean age 39 years). When younger all had been assessed either as being "unaffected" by autism (n = 69) or as meeting criteria for the "Broader Autism Phenotype" (BAP, n = 18). As…

  15. Hostile siblings in the abused child’s mind

    DEFF Research Database (Denmark)

    Grünbaum, Liselotte

    , in an experience of siblings as representing violent inner parental objects not fully differentiated from hostile sibling objects, e.g. linked to a fantasy of an inattentive breast-mother feeding herself and a violent paternal part-object, the two of them in a fused state becoming merged as an undifferentiated...

  16. The Lived Experience of Losing a Sibling through Murder

    African Journals Online (AJOL)

    denise

    siblings. Homicide survivor bereavement, as a grief experience relative to other ... who have lost a child through murder, and, to a lesser ... siblings taking on the role of protector of their parents ...... fearful and angry feelings that contribute to their ... the adolescent to young adult transition: A developmental resilience model.

  17. Adult Sibling Relationships with Brothers and Sisters with Severe Disabilities

    Science.gov (United States)

    Rossetti, Zach; Hall, Sarah

    2015-01-01

    The purpose of this qualitative study was to examine perceptions of adult sibling relationships with a brother or sister with severe disabilities and the contexts affecting the relationships. Adult siblings without disabilities (N = 79) from 19 to 72 years of age completed an online survey with four open-ended questions about their relationship…

  18. Shyness, Sibling Relationships, and Young Children's Socioemotional Adjustment at Preschool

    Science.gov (United States)

    Graham, Allison A.; Coplan, Robert J.

    2012-01-01

    The purpose of this research was to examine the moderating role of sibling relationship quality in the associations between shyness and indices of socioemotional adjustment in an early childhood education context. Participants were 79 children ages 4 to 6 (M = 4.74 years) who had at least one sibling. Parents completed ratings of child shyness,…

  19. Autism Spectrum Disorders and Sibling Relationships: Research and Strategies

    Science.gov (United States)

    Beyer, Julia F.

    2009-01-01

    Significant attention has been paid in the literature to sibling relationships and the effects of birth order, family size, and gender on such relationships. Although these are important areas to study, there is relatively little research on the effects of autism spectrum disorders (ASD) on sibling relationships. The existent research identifies…

  20. Latino Adolescents' Academic Motivation: The Role of Siblings

    Science.gov (United States)

    Alfaro, Edna C.; Umana-Taylor, Adriana J.

    2010-01-01

    Guided by an ecological perspective, two competing models were tested to examine how sibling relationship quality directly predicted or interacted with academic support from siblings to predict Latino adolescents' academic motivation (N = 258). Gender differences were examined utilizing multiple group analysis in structural equation modeling.…

  1. Conflict and Friendship in Sibling Relationships: A Review.

    Science.gov (United States)

    Newman, Joan

    1994-01-01

    Reviews research findings about the nature and development of typical sibling relationships. Discusses two important themes, the role of children's social cognition skills, and the role of the demands of the relationship. Addresses two questions: (1) the prevalence and features of sibling rivalry and conflict; and (2) the characteristics of…

  2. Sibling Squabbles: How to Cope With Your Children Fighting.

    Science.gov (United States)

    Branvold, Sharon L.

    1995-01-01

    This article discusses what is normal and what is not regarding sibling rivalry, jealousy, and squabbling, and it provides some guidance for parents on handling conflict. The article also discusses three major sources of sibling conflict (jealousy, being left alone together, and family trips) and offers suggestions for dealing with each case. (SM)

  3. Compensatory Effects of Sibling Support in Preadolescence and Adolescence.

    Science.gov (United States)

    Milevsky, Avidan; Levitt, Mary J.

    The current study is an examination of how support from siblings relates to academic competence in early adolescence, with a focus on the compensatory effects of sibling support. Participants were 694 African-American, European-American, and Hispanic-American students, ranging in age from 11 to 15. Participants were interviewed in school regarding…

  4. Maintaining Sibling Relationships for Children in Foster and Adoptive Placements.

    Science.gov (United States)

    James, Sigrid; Monn, Amy R; Palinkas, Lawrence A; Leslie, Laurel K

    2008-01-01

    To better understand the nature of sibling relationships among children in foster or adoptive placement and the challenges and processes involved in maintaining these relationships, we conducted an exploratory analysis of data collected from semi-structured interviews with caregivers of 14 foster and adopted children in San Diego County. We identified three patterns of placement histories and living situations which appeared to impact the degree of contact maintained with siblings: (1) children who had never lived together and were not currently placed together; (2) children who at some point lived with or were placed together with their siblings, but were now separated from them; and (3) children who had lived with their siblings all their life and were placed together with at least some of their siblings at the time of the interview. Children's current living situations and placement histories, caregivers' experiences and perceptions of feasibility and desirability of sibling contact, and the sibling relationship itself are primary determinants in the development and maintenance of contact between siblings. Implications for child welfare policy and practice are discussed.

  5. "Barter", "Deals", "Bribes" and "Threats": Exploring Sibling Interactions

    Science.gov (United States)

    McIntosh, Ian; Punch, Samantha

    2009-01-01

    This article investigates forms of strategic interaction between siblings during childhood. The authors argue that these interactions, characterized by notions of reciprocity, equivalence and constructions of fairness, are worked out in relation to responsibility, power, knowledge and sibling status. Birth order and age are not experienced as…

  6. Associations between Family Communication Patterns, Sibling Closeness, and Adoptive Status

    Science.gov (United States)

    Samek, Diana R.; Rueter, Martha A.

    2011-01-01

    Previous research has demonstrated the protective effect of family and sibling closeness on child adjustment, but fewer studies have investigated how closeness is promoted within families. Guided by Family Communication Patterns Theory, we tested the association between family communication and sibling emotional and behavioral closeness, and…

  7. Validation of the EBMT risk score in chronic myeloid leukemia in Brazil and allogeneic transplant outcome.

    Science.gov (United States)

    De Souza, Carmino Antonio; Vigorito, Afonso Celso; Ruiz, Milton Artur; Nucci, Márcio; Dulley, Frederico Luiz; Funcke, Vaneusa; Tabak, Daniel; Azevedo, Alexandre Mello; Byington, Rita; Macedo, Maria Cristina; Saboya, Rosaura; Penteado Aranha, Francisco José; Oliveira, Gislaine Barbosa; Zulli, Roberto; Martins Miranda, Eliana Cristina; Azevedo, Wellington Moraes; Lodi, Fernanda Maria; Voltarelli, Júlio Cesar; Simões, Belinda Pinto; Colturato, Vergílio; De Souza, Mair Pedro; Silla, Lúcia; Bittencourt, Henrique; Piron-Ruiz, Lilian; Maiolino, Angelo; Gratwohl, Alois; Pasquini, Ricardo

    2005-02-01

    The management of chronic myeloid leukemia (CML) has changed radically since the introduction of imatinib therapy. The decision of whether to offer a patient a hematopoietic stem cell transplant (HSCT) must be based on the probability of success of the procedure. The aim of this retrospective analysis of 1,084 CML patients who received an allogeneic HSCT in 10 Brazilian Centers between February 1983 and March 2003 was to validate the EBMT risk score. The study population comprised 647 (60%) males and 437 (40%) females, with a median age of 32 years old (range 1 - 59); 898 (83%) were in chronic phase, 146 (13%) were in accelerated phase and 40 (4%) were in blast crisis; 151 (14%) were younger than 20 years old, 620 (57%) were between 20 and 40 and 313 (29%) were older than 40; 1,025 (94%) received an HLA fully matched sibling transplant and only 59 (6%) received an unrelated transplant. In 283 cases (26%) a male recipient received a graft from a female donor. The interval from diagnosis to transplantation was less than 12 months in 223 (21%) cases and greater in 861 (79%). The overall survival, disease-free survival, transplant-related mortality and relapse incidence were 49%, 50%, 45% and 25%, respectively. Of the 1084 patients, 179 (17%) had a risk score of 0 or 1, 397 (37%) had a score of 2, 345 (32%) had a score of 3, 135 (12%) had a score of 4 and 28 (2%) a score of 5 or 6. The overall survival (OS) rate in patients with risk scores 0-1 and 2 was similar (58% and 55%, respectively) but significantly better than that in patients with scores 3 or more (score 3 - 44%, 4 - 36 % and 5-6 - 27%, respectively) pp<0.001). Disease-free survival (DFS) and transplant related mortality (TRM) in a patients with a score of 3 or more were 46% and 49%, respectively and the relapse rate beyond score 5-6 was 77%. Disease status had a negative impact on all outcomes (OS, DFS, TRM, and relapse). The OS rate for male recipients of a graft from a female donor was 40% compared to 52

  8. Concordance of visual and structural features between siblings with albinism.

    Science.gov (United States)

    Heinmiller, Laura J; Holleschau, Ann; Summers, C Gail

    2016-02-01

    To evaluate similarities and differences in visual function and ocular structure between siblings with albinism. The medical records of all siblings diagnosed with albinism were retrospectively reviewed. Comparisons were made using examination at oldest age for younger sibling and examination closest to that age for older siblings. A total of 111 patients from 54 families were studied. Mean age was 12.9 years (range, 2 months to 44.2 years). Mean difference in ages between sibling pair examinations was 11.5 months (range, 0-87 months). Of 45 families, best-corrected visual acuity was equal in 9 (20%), within 1/2 octave in 9 (20%), >1/2 but albinism should be counseled with due caution because visual function is often disparate despite similar structural findings. Copyright © 2016 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

  9. Altered cognitive development in the siblings of individuals with schizophrenia

    Science.gov (United States)

    Barch, Deanna M.; Cohen, Rachel; Csernansky, John

    2014-01-01

    The goal of the current study was to further investigate the late neurodevelopmental hypothesis of schizophrenia by examining cross-sectional, age-related changes in cognitive function among young adult: 1) siblings of individuals with schizophrenia (N = 66); (2) healthy control participants (N = 77); and (3) the siblings of healthy controls (N = 77). All subjects participated in a battery of tasks in four domains: 1) IQ; 2) working memory; 3) episodic memory; and 4) executive function. We found significant group differences in the relationships between age and performance in working memory and episodic memory, with similar patterns for executive function and verbal IQ. The siblings of individuals with schizophrenia showed impaired performance in working memory, episodic memory, and executive function. In addition, healthy controls and/or their siblings showed age-related improvements in all four cognitive domains, while the siblings of individuals with schizophrenia only showed this for verbal IQ. PMID:25485180

  10. Cognitive abilities in siblings of children with autism spectrum disorders.

    Science.gov (United States)

    Gizzonio, Valentina; Avanzini, Pietro; Fabbri-Destro, Maddalena; Campi, Cristina; Rizzolatti, Giacomo

    2014-07-01

    The aim of the present study was to assess the cognitive profiles of children with autistic spectrum disorder and of their healthy siblings (Siblings). With the term cognitive profile, we indicate the relationship extant among the values of verbal and performance subtests of the Wechsler Intelligence Scale. The conducted statistical analyses indicated that, although siblings showed a normal intelligent quotient and did not differ in this aspect from typically developing group, their cognitive profile was amazingly similar to that of their relatives affected by autism. A k-means clustering analysis on the values of single subtests further confirmed this result, showing a clear separation between typically developing children on the one side, and autistics and their siblings on the other. We suggest that the common cognitive profile observed in autistic children and their siblings could represent a marker of liability to autism and, thus, a possible intermediate phenotype of this syndrome.

  11. Altered cognitive development in the siblings of individuals with schizophrenia.

    Science.gov (United States)

    Barch, Deanna M; Cohen, Rachel; Csernansky, John

    2014-03-01

    The goal of the current study was to further investigate the late neurodevelopmental hypothesis of schizophrenia by examining cross-sectional, age-related changes in cognitive function among young adult: 1) siblings of individuals with schizophrenia (N = 66); (2) healthy control participants (N = 77); and (3) the siblings of healthy controls (N = 77). All subjects participated in a battery of tasks in four domains: 1) IQ; 2) working memory; 3) episodic memory; and 4) executive function. We found significant group differences in the relationships between age and performance in working memory and episodic memory, with similar patterns for executive function and verbal IQ. The siblings of individuals with schizophrenia showed impaired performance in working memory, episodic memory, and executive function. In addition, healthy controls and/or their siblings showed age-related improvements in all four cognitive domains, while the siblings of individuals with schizophrenia only showed this for verbal IQ.

  12. Group intervention for siblings of children with disabilities: a pilot study in a clinical setting.

    Science.gov (United States)

    Granat, Tina; Nordgren, Ingrid; Rein, George; Sonnander, Karin

    2012-01-01

    To study the effectiveness of a group intervention in a clinical setting designed to increase knowledge of disability and improve sibling relationship among siblings of children with disabilities. A self-selected sample of 54 younger and older siblings with typical development (ages 8-12 years) of children with attention deficit hyperactivity disorder (ADHD) (9), Asperger syndrome (7), autistic disorder (13), physical disability (8) and intellectual disability (17) participated in collateral sibling groups. The Sibling Knowledge Interview (SKI) and Sibling Relationship Questionnaire (SRQ) were administered pre- and post-intervention. SKI scores increased (p sibling groups showed significantly different (p siblings of children with disabilities. In view of the limited empirical research on group interventions for siblings of children with disabilities future work is needed to investigate the effectiveness of such interventions. Particular attention should be given to siblings of children with autism and siblings of children with intellectual disability.

  13. Quality of Sibling Relationship and Substance Misuse: A Comparative Study

    Directory of Open Access Journals (Sweden)

    Anastasia Tsamparli

    2016-03-01

    Full Text Available The aim of the current study is to examine the quality of sibling relationship in families with a sibling with substance misuse (SSU and compare the relationship to families with a sibling with no use (SNU. Thirty-six (36 families participated in the study (17 with SSU and 19 with SNU; N = 144. Semi-structured interviews were conducted with 40 siblings (20 SNU and 20 SSU; 18-31 years old in order to qualitatively investigate the characteristics of the sibling relationship. The siblings were not identified with any psychopathology, according to SCL-90R. Moreover, we considered the family cohesion and adaptability, as identified by the FACES III (administered to the whole sample and the family constellation (including number of children, birth order, gender, family size, family structure, years of substance misuse and socioeconomic level. The results of the thematic analysis seem to support Furman and Buhrmester’s (1985 framework, in the context of SNU families. Nevertheless, when considering families with SSU the framework is enriched with a new axis: Loss/mourning. The substance misuse seems to provoke an overturn of the representation of the sibling relationship: the behavioral changes (i.e. disengagement of the sibling with drug use are experienced as a loss by the sibling non user, thus triggering the psychological process of ‘mourning’. Moreover, in these families, the sibling with no drug use seem to experience differential parenting, they feel neglected, angry and they take up a parental role towards the SSU, whom they experience as “sensitive” and “vulnerable”.

  14. Victimization by Siblings in Children with Disability or Weight Problems.

    Science.gov (United States)

    Tucker, Corinna J; Finkelhor, David; Turner, Heather

    Children with a physical disability, psychological disorder, or of nonnormative weight are often targets of peer victimization. Sibling victimization, however, is more common than peer victimization, but rarely explored. We investigated linkages between sibling victimization and whether children had a physical disability, psychological disorder (i.e., internalizing disorder, attention deficit disorder/attention-deficit hyperactivity disorder), and were perceived by parents as being thinner than average or overweight. Also, we explored how the extent and kinds of sibling victimization experiences were related to these characteristics in childhood. A US probability sample of adult caregivers of a child aged 0 to 9 (N = 780; 50% women; mean age 4.58) in 2-child households who completed a telephone interview. Controlling for other forms of maltreatment and individual and family characteristics, children with a physical disability and parent-perceived children who are thinner than average and children who are overweight experienced more sibling victimization. Children with an internalizing disorder experienced less sibling victimization. Sibling victimization did not differ for children with and without ADHD. Children perceived to be overweight by parents and children with a physical disability were at increased risk of experiencing more types of sibling victimization. Children with a physical disability had greater odds of being victims of property victimization by a sibling. Children with a physical disability or perceived as different from average weight are at risk for sibling victimization. Using a nationally representative sample, this is the first study to highlight the importance of screening for sibling victimization in families of children with a disability and/or nonnormative weight status.

  15. Sibling cycle piston and valving method

    Science.gov (United States)

    Mitchell, Matthew P. (Inventor); Bauwens, Luc (Inventor)

    1990-01-01

    A double-acting, rotating piston reciprocating in a cylinder with the motion of the piston providing the valving action of the Sibling Cycle through the medium of passages between the piston and cylinder wall. The rotating piston contains regenerators ported to the walls of the piston. The piston fits closely in the cylinder at each end of the cylinder except in areas where the wall of the cylinder is relieved to provide passages between the cylinder wall and the piston leading to the expansion and compression spaces, respectively. The piston reciprocates as it rotates. The cylinder and piston together comprise an integral valve that seqentially opens and closes the ports at the ends of the regenerators alternately allowing them to communicate with the expansion space and compression space and blocking that communication. The relieved passages in the cylinder and the ports in the piston are so arranged that each regenerator is sequentially (1) charged with compressed working gas from the compression space; (2) isolated from both expansion and compression spaces; (3) discharged of working gas into the expansion space; and (4) simultaneously charged with working gas from the expansion space while being discharged of working gas into the compression space, in the manner of the Sibling Cycle. In an alterate embodiment, heat exchangers are external to the cylinder and ports in the cylinder wall are alternately closed by the wall of the piston and opened to the expansion and compression spaces through relieved passages in the wall of the reciprocating, rotating piston.

  16. Saviour siblings and collective family interests.

    Science.gov (United States)

    Taylor-Sands, Michelle

    2010-09-01

    In this article, I will explore the ethical concerns arising out of the use of preimplantation tissue typing (PTT) to create saviour siblings. There are two main ethical concerns about the welfare of the child to be born as a result of PTT. The first is whether the child to be born is treated as a commodity, as simply a means to save the life of his or her sibling. The second is whether the child to be born will be harmed as a result of PTT, either physically, psychologically or socially. These two ethical concerns reflect an individualistic approach to the welfare of the child, whose interests are treated as largely separate to the interests of other family members. I will argue that the welfare of the child born as a result of PTT should be conceived more broadly to include not only the child's individual interests, but also the collective interests the child shares with his or her family. I base this broader conception of welfare on the notion of human flourishing, which recognises that the welfare of a child is inextricably connected to the welfare of the intimate collective that is his or her family. The collective interests of intimate family members are particularly relevant in the context of PTT, as the members are engaged in a shared journey to save the life of an ill child.

  17. Elemental abundances of solar sibling candidates

    International Nuclear Information System (INIS)

    Ramírez, I.; Lambert, D. L.; Endl, M.; Cochran, W. D.; MacQueen, P. J.; Bajkova, A. T.; Bobylev, V. V.; Roederer, I. U.; Wittenmyer, R. A.

    2014-01-01

    Dynamical information along with survey data on metallicity and in some cases age have been used recently by some authors to search for candidates of stars that were born in the cluster where the Sun formed. We have acquired high-resolution, high signal-to-noise ratio spectra for 30 of these objects to determine, using detailed elemental abundance analysis, if they could be true solar siblings. Only two of the candidates are found to have solar chemical composition. Updated modeling of the stars' past orbits in a realistic Galactic potential reveals that one of them, HD 162826, satisfies both chemical and dynamical conditions for being a sibling of the Sun. Measurements of rare-element abundances for this star further confirm its solar composition, with the only possible exception of Sm. Analysis of long-term high-precision radial velocity data rules out the presence of hot Jupiters and confirms that this star is not in a binary system. We find that chemical tagging does not necessarily benefit from studying as many elements as possible but instead from identifying and carefully measuring the abundances of those elements that show large star-to-star scatter at a given metallicity. Future searches employing data products from ongoing massive astrometric and spectroscopic surveys can be optimized by acknowledging this fact.

  18. Epilepsy phenotypes in siblings with Norrie disease.

    Science.gov (United States)

    Okumura, Akihisa; Arai, Eisuke; Kitamura, Yuri; Abe, Shinpei; Ikeno, Mitsuru; Fujimaki, Takuro; Yamamoto, Toshiyuki; Shimizu, Toshiaki

    2015-11-01

    Norrie disease is an X-linked recessive disorder that is characterized by congenital blindness. Although epileptic seizures are observed in some patients with Norrie disease, little is known about this phenomenon. Here, we report the manifestation of epilepsy in siblings with Norrie disease to increase our knowledge of epilepsy in this condition. Three brothers with congenital blindness were diagnosed with Norrie disease after genetic analyses indicated the deletion of exon 2 of the NDP gene. The eldest brother had suffered from epileptic seizures since the age of 11years, and his seizures were resistant to antiepileptic drugs. Although the second brother had no epileptic seizures, the youngest sibling had experiences epileptic seizures since the age of 8years. His seizures were controlled using lamotrigine and levetiracetam. An electroencephalography (EEG) revealed epileptiform discharges in the occipital areas in all three brothers. A study of these patients will increase our knowledge of epilepsy in patients with Norrie disease. Copyright © 2015 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

  19. Bronchiolitis obliterans syndrome after allogeneic hematopoietic SCT: phenotypes and prognosis.

    Science.gov (United States)

    Bergeron, A; Godet, C; Chevret, S; Lorillon, G; Peffault de Latour, R; de Revel, T; Robin, M; Ribaud, P; Socié, G; Tazi, A

    2013-06-01

    Bronchiolitis obliterans syndrome (BOS) after allogeneic hematopoietic SCT (HSCT) is recognized as a new-onset obstructive lung defect (OLD) in pulmonary function testing and is related to pulmonary chronic GVHD. Little is known about the different phenotypes of patients with BOS and their outcomes. We reviewed the data of all allogeneic HSCT recipients referred to our pulmonary department for a non-infectious bronchial disease between 1999 and 2010. We identified 103 patients (BOS (n=77), asthma (n=11) and chronic bronchitis (n=15)). In patients with BOS, we identified two functional phenotypes: a typical OLD, that is, forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) ratio <0.7 (n=53), and an atypical OLD with a concomitant decrease in the FEV1 <80% and FVC <80% predicted with a normal total lung capacity (n=24). The typical OLD was characterized by more severe FEV1 and fewer centrilobular nodules on the computed tomography scan. The FEV1 was not significantly affected during the follow-up, regardless of the phenotype. In addition to acute and extensive chronic GVHD, only the occurrence of BOS soon after transplantation and the intentional treatment of BOS with steroids were associated with a poor survival. The determination of patient subgroups should be explored to improve the management of this condition.

  20. Central nervous system infection following allogeneic hematopoietic stem cell transplantation.

    Science.gov (United States)

    Hanajiri, Ryo; Kobayashi, Takeshi; Yoshioka, Kosuke; Watanabe, Daisuke; Watakabe, Kyoko; Murata, Yutaka; Hagino, Takeshi; Seno, Yasushi; Najima, Yuho; Igarashi, Aiko; Doki, Noriko; Kakihana, Kazuhiko; Sakamaki, Hisashi; Ohashi, Kazuteru

    2017-03-01

    Here, we described the clinical characteristics and outcomes of central nervous system (CNS) infections occurring after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in a single institution over the previous 6 years. Charts of 353 consecutive allogeneic transplant recipients were retrospectively reviewed for CNS infection. A total of 17 cases of CNS infection were identified at a median of 38 days (range, 10-1028 days) after allo-HSCT. Causative pathogens were human herpesvirus-6 (n=6), enterococcus (n=2), staphylococcus (n=2), streptococcus (n=2), varicella zoster virus (n=1), cytomegalovirus (n=1), John Cunningham virus (n=1), adenovirus (n=1), and Toxoplasma gondii (n=1). The cumulative incidence of CNS infection was 4.1% at 1 year and 5.5% at 5 years. Multivariate analysis revealed that high-risk disease status was a risk factor for developing CNS infection (p=.02), and that overall survival at 3 years after allo-HSCT was 33% in patients with CNS infection and 53% in those without CNS infection (p=.04). Copyright © 2016 King Faisal Specialist Hospital & Research Centre. Published by Elsevier Ltd. All rights reserved.

  1. Endocrinopathies after Allogeneic and Autologous Transplantation of Hematopoietic Stem Cells

    Directory of Open Access Journals (Sweden)

    Francesco Orio

    2014-01-01

    Full Text Available Early and late endocrine disorders are among the most common complications in survivors after hematopoietic allogeneic- (allo- and autologous- (auto- stem cell transplant (HSCT. This review summarizes main endocrine disorders reported in literature and observed in our center as consequence of auto- and allo-HSCT and outlines current options for their management. Gonadal impairment has been found early in approximately two-thirds of auto- and allo-HSCT patients: 90–99% of women and 60–90% of men. Dysfunctions of the hypothalamus-pituitary-growth hormone/insulin growth factor-I axis, hypothalamus-pituitary-thyroid axis, and hypothalamus-pituitary-adrenal axis were documented as later complicances, occurring in about 10, 30, and 40–50% of transplanted patients, respectively. Moreover, overt or subclinical thyroid complications (including persistent low-T3 syndrome, chronic thyroiditis, subclinical hypo- or hyperthyroidism, and thyroid carcinoma, gonadal failure, and adrenal insufficiency may persist many years after HSCT. Our analysis further provides evidence that main recognized risk factors for endocrine complications after HSCT are the underlying disease, previous pretransplant therapies, the age at HSCT, gender, total body irradiation, posttransplant derangement of immune system, and in the allogeneic setting, the presence of graft-versus-host disease requiring prolonged steroid treatment. Early identification of endocrine complications can greatly improve the quality of life of long-term survivors after HSCT.

  2. Theory-of-Mind Development and Early Sibling Relationships after the Birth of a Sibling: Parental Discipline Matters

    Science.gov (United States)

    Song, Ju-Hyun; Volling, Brenda L.

    2018-01-01

    This study investigated relations among children's Theory-of-Mind (ToM) development, early sibling interactions, and parental discipline strategies during the transition to siblinghood. Using a sample of firstborn children and their parents (N = 208), we assessed children's ToM before the birth of a sibling and 12 months after the birth, and…

  3. Perceptions of Siblings with Autism and Relationships with Them: European American and Asian American Siblings Draw and Tell

    Science.gov (United States)

    Sage, Kara D.; Jegatheesan, Brinda

    2010-01-01

    Background: This study examined typically developing children's perceptions of their siblings with autism and their relationships with them in a European American and an Asian American family. Method: Data were drawn from interviews with the siblings using the "draw-and-tell" technique and participant observation in the homes of the 2 families.…

  4. Sibling Influence on Mexican-Origin Adolescents’ Deviant and Sexual Risk Behaviors: The Role of Sibling Modeling

    Science.gov (United States)

    Whiteman, Shawn D.; Zeiders, Katharine H.; Killoren, Sarah E.; Rodriguez, Sue Annie; Updegraff, Kimberly A.

    2013-01-01

    Purpose A growing body of research indicates that siblings uniquely influence each other’s health risk behaviors during adolescence and young adulthood. Mechanisms underlying these associations, however, are largely unknown because they are rarely tested directly. The present study addressed this gap by examining the role of sibling modeling in explaining changes in Mexican-origin youths’ deviant and sexual risk behaviors over time. Methods The sample included 380 Mexican-origin siblings (older sibling age: M = 21.18, SD = 1.59; younger sibling age: M = 18.19, SD = .46) from (N = 190) families. Participants provided self-reports of their sibling relationship qualities, including modeling, as well as their engagement in deviant and sexual risk taking behaviors in two home interviews across a two-year span. Results A series of residualized regression models revealed that younger siblings’ perceptions of modeling moderated the links between older siblings’ deviant and sexual risk behaviors and younger siblings’ subsequent behaviors in those same domains. Specifically, high levels of modeling predicted stronger associations between older siblings’ earlier and younger siblings’ later risk behaviors controlling for younger siblings’ earlier behaviors as well as variables that have been used as proxies for social learning in previous research. Conclusions Social learning mechanisms, especially modeling, are salient processes through which older siblings transmit norms and expectations regarding participation in health risk behaviors. Future research should continue to explore the ways in which siblings influence each other because such processes are emerging targets for intervention and prevention. PMID:24287013

  5. Allogenic blood transfusion following total hip arthroplasty: results from the nationwide inpatient sample, 2000 to 2009.

    Science.gov (United States)

    Saleh, Anas; Small, Travis; Chandran Pillai, Aiswarya Lekshmi Pillai; Schiltz, Nicholas K; Klika, Alison K; Barsoum, Wael K

    2014-09-17

    The large-scale utilization of allogenic blood transfusion and its associated outcomes have been described in critically ill patients and those undergoing high-risk cardiac surgery but not in patients undergoing elective total hip arthroplasty. The objective of this study was to determine the trends in utilization and outcomes of allogenic blood transfusion in patients undergoing primary total hip arthroplasty in the United States from 2000 to 2009. An observational cohort of 2,087,423 patients who underwent primary total hip arthroplasty from 2000 to 2009 was identified in the Nationwide Inpatient Sample. International Classification of Diseases, Ninth Revision, Clinical Modification procedure codes 99.03 and 99.04 were used to identify patients who received allogenic blood products during their hospital stay. Risk factors for allogenic transfusions were identified with use of multivariable logistic regression models. We used propensity score matching to estimate the adjusted association between transfusion and surgical outcomes. The rate of allogenic blood transfusion increased from 11.8% in 2000 to 19.0% in 2009. Patient-related risk factors for receiving an allogenic blood transfusion include an older age, female sex, black race, and Medicaid insurance. Hospital-related risk factors include rural location, smaller size, and non-academic status. After adjusting for confounders, allogenic blood transfusion was associated with a longer hospital stay (0.58 ± 0.02 day; p conservation methods. Copyright © 2014 by The Journal of Bone and Joint Surgery, Incorporated.

  6. Allogeneic CD19-CAR-T cell infusion after allogeneic hematopoietic stem cell transplantation in B cell malignancies.

    Science.gov (United States)

    Liu, Jun; Zhong, Jiang F; Zhang, Xi; Zhang, Cheng

    2017-01-31

    Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is considered the cornerstone in treatment of hematological malignancies. However, relapse of the hematological disease after allo-HSCT remains a challenge and is associated with poor long-term survival. Chimeric antigen receptor redirected T cells (CAR-T cells) can lead to disease remission in patients with relapsed/refractory hematological malignancies. However, the therapeutic window for infusion of CAR-T cells post allo-HSCT and its efficacy are debatable. In this review, we first discuss the use of CAR-T cells for relapsed cases after allo-HSCT. We then review the toxicities and the occurrence of graft-versus-host disease in relapsed patients who received CAR-T cells post allo-HSCT. Finally, we review clinical trial registrations and the therapeutic time window for infusion of CAR-T cells post allo-HSCT. The treatment of allogeneic CAR-T cells is beneficial for patients with relapsed B cell malignancies after allo-HSCT with low toxicities and complications. However, multicenter clinical trials with larger sample sizes should be performed to select the optimal therapeutic window and confirm its efficacy.

  7. Busulfan, cyclophosphamide and fractionated total body irradiation as a conditioning regimen for allogeneic bone marrow transplantation in patients with non-lymphocytic hematopoietic malignancies

    International Nuclear Information System (INIS)

    Watanabe, Hiroshi

    1996-01-01

    Allogeneic bone marrow transplantation (BMT) with the conditioning regimen of 8 mg/kg of busulfan (BUS), 120 mg/kg of cyclophosphamide (CPM) and 10 Gy of total body irradiation (TBI) was evaluated in the patients with non-lymphocytic hematopoietic malignancies. The disease distribution of the 22 patients was as follows; 14 in the standard risk group (SRG), 8 in the high risk group (HRG). SRG included the patients with acute myeloid leukemia (AML) in the first complete remission, chronic myelogenous leukemia (CML) in chronic phase and myelodysplastic syndrome with refractory anemia, while HRG included the patients with refractory AML and CML in blastic phase. The median age of patients was 33 years old (y.o.), and the median observation period was 34.5 months No relapse occurred, but 8 patients (36%) died of various complications. Ail the patients who died of interstitial pneumonitis (4 cases) were 40 y.o. and more. Acute graft-versus-host disease (GvHD) and chronic GvHD were clinically controllable. The probability of disease-free survival rate at 5 years (5y-DFS) was 50.0% in overall patients. The 5y-DFS was 57.1% in HRG (7 cases), while 54.3% in SRG (13 cases) donated from the HLA identical siblings (20 cases). In these 13 patients in SRG, the 5y-DFS was 100% in patients under 40 y.o. (6 cases), while the probability of disease-free survival rate at 3 years was 68.6% and the 5y-DFS was 0% in patients over 40 y.o. (7 cases). Our data indicate that the conditioning regimen combining BUS, CPM and TBI for allogeneic BMT is promising for the treatment of the patients of HRG and the patients under 40 y.o. in SRG. (author)

  8. Busulfan, cyclophosphamide and fractionated total body irradiation as a conditioning regimen for allogeneic bone marrow transplantation in patients with non-lymphocytic hematopoietic malignancies

    Energy Technology Data Exchange (ETDEWEB)

    Watanabe, Hiroshi [Jikei Univ., Tokyo (Japan). School of Medicine

    1996-11-01

    Allogeneic bone marrow transplantation (BMT) with the conditioning regimen of 8 mg/kg of busulfan (BUS), 120 mg/kg of cyclophosphamide (CPM) and 10 Gy of total body irradiation (TBI) was evaluated in the patients with non-lymphocytic hematopoietic malignancies. The disease distribution of the 22 patients was as follows; 14 in the standard risk group (SRG), 8 in the high risk group (HRG). SRG included the patients with acute myeloid leukemia (AML) in the first complete remission, chronic myelogenous leukemia (CML) in chronic phase and myelodysplastic syndrome with refractory anemia, while HRG included the patients with refractory AML and CML in blastic phase. The median age of patients was 33 years old (y.o.), and the median observation period was 34.5 months No relapse occurred, but 8 patients (36%) died of various complications. Ail the patients who died of interstitial pneumonitis (4 cases) were 40 y.o. and more. Acute graft-versus-host disease (GvHD) and chronic GvHD were clinically controllable. The probability of disease-free survival rate at 5 years (5y-DFS) was 50.0% in overall patients. The 5y-DFS was 57.1% in HRG (7 cases), while 54.3% in SRG (13 cases) donated from the HLA identical siblings (20 cases). In these 13 patients in SRG, the 5y-DFS was 100% in patients under 40 y.o. (6 cases), while the probability of disease-free survival rate at 3 years was 68.6% and the 5y-DFS was 0% in patients over 40 y.o. (7 cases). Our data indicate that the conditioning regimen combining BUS, CPM and TBI for allogeneic BMT is promising for the treatment of the patients of HRG and the patients under 40 y.o. in SRG. (author)

  9. The Association of Sibling Relationship and Abuse with Later Psychological Adjustment

    Science.gov (United States)

    Mackey, Amber L.; Fromuth, Mary Ellen; Kelly, David B.

    2010-01-01

    This study of 59 undergraduate men and 85 undergraduate women explored how defining emotional and physical sibling abuse affected the frequency of reported sibling abuse. In addition, the current study examined how the emotional context of the sibling relationship (i.e., rivalry and conflict) moderated the relationship between sibling abuse and…

  10. "Who Said You Could Wear My Sweater?" Adolescent Siblings' Conflicts and Associations with Relationship Quality

    Science.gov (United States)

    Campione-Barr, Nicole; Smetana, Judith G.

    2010-01-01

    A new measure of sibling conflict was used to identify 2 types of conflicts in 115 adolescent sibling pairs (older siblings, M = 15.59, SD = 2.01 years; younger siblings, M = 13.02, SD = 2.06 years). Conflicts overall were more frequent than intense and more likely to involve the invasion of the personal domain than conflicts involving equality…

  11. Child, Parent and Family Factors as Predictors of Adjustment for Siblings of Children with a Disability

    Science.gov (United States)

    Giallo, R.; Gavidia-Payne, S.

    2006-01-01

    Background: Siblings adjust to having a brother or sister with a disability in diverse ways. This study investigated a range of child, parent and family factors as predictors of sibling adjustment outcomes. Methods: Forty-nine siblings (aged 7-16 years) and parents provided information about (1) sibling daily hassles and uplifts; (2) sibling…

  12. Siblings: Brothers and Sisters of People Who Have Mental Retardation. Arc Q & A Series.

    Science.gov (United States)

    Arc, Arlington, TX.

    Basic information about siblings of people with mental retardation is presented in a question-and-answer format. The following questions are addressed: "Is having a sibling with a disability different than having a sibling who does not have a disability?"; "What are some of the concerns of siblings of people with disabilities?"; "Are there any…

  13. Genetic Mediation of the Home Environment during Infancy: A Sibling Adoption Study of the HOME.

    Science.gov (United States)

    Braungart, Julia M.; And Others

    1992-01-01

    The home environment of nonadoptive and adoptive sibling pairs was assessed using the Home Observation for Measurement of the Environment when each sibling was one and two years of age. Correlations between home environment scores for nonadoptive siblings were greater than those for adoptive siblings. (BC)

  14. Sibling Relationships When a Child Has Autism: Marital Stress and Support Coping.

    Science.gov (United States)

    Rivers, Jessica Wood; Stoneman, Zolinda

    2003-01-01

    Family systems theory was employed to study sibling relationships in 50 families with a child (ages 4-12) with autism. Typically developing siblings expressed satisfaction with their sibling relationships. Parents were somewhat less positive about the sibling relationships. Stress in the marital relationship was associated with compromised sibling…

  15. Applied Behavior Analysis Programs for Autism: Sibling Psychosocial Adjustment during and Following Intervention Use

    Science.gov (United States)

    Cebula, Katie R.

    2012-01-01

    Psychosocial adjustment in siblings of children with autism whose families were using a home-based, applied behavior analysis (ABA) program was compared to that of siblings in families who were not using any intensive autism intervention. Data gathered from parents, siblings and teachers indicated that siblings in ABA families experienced neither…

  16. Understanding Adolescent Delinquency: The Role of Older Siblings' Delinquency and Popularity with Peers

    Science.gov (United States)

    Craine, Jessica L.; Tanaka,Teri A.; Nishina, Adrienne; Conger, Katherine J.

    2009-01-01

    The present study examined delinquency concordance and the moderating effects of younger sibling perceptions of older sibling popularity in a sample of 587 adolescent sibling pairs. Using a social learning framework and taking dyad composition into account, perceptions of popularity were hypothesized to strengthen siblings' concordance for…

  17. Gratitude for Help among Adult Friends and Siblings

    Directory of Open Access Journals (Sweden)

    Anna Rotkirch

    2014-10-01

    Full Text Available Although gratitude is a key prosocial emotion reinforcing reciprocal altruism, it has been largely ignored in the empirical literature. We examined feelings of gratitude and the importance of reciprocity in same-sex peer relations. Participants were 772 individuals (189 men; mean age = 28.80 who completed an online survey using a vignette design. We investigated (i differences in reported gratitude and the importance of reciprocity among same-sex siblings and same-sex friends, and (ii how relationship closeness moderates these associations. Based on the theory of kin altruism, we expect that people would feel more grateful towards friends than towards their siblings, and that lack of gratitude or failure to pay back a loan would bother more with friends than with siblings, irrespective of emotional closeness. Results showed that levels of gratitude and expectations of reciprocity were higher towards friends compared to siblings. This was the case also after controlling for emotional closeness. Being close generally made participants feel more grateful and expect lower displays of gratitude in the other. Closeness was also strongly associated with emotional gratitude among siblings compared to friends. We conclude that feelings and displays of gratitude have a special role in friendships. Although a close sibling may elicit as much gratitude as a friend does, even a very close friend is not exempt from the logic of reciprocity in the same way that a sibling is.

  18. Gratitude for help among adult friends and siblings.

    Science.gov (United States)

    Rotkirch, Anna; Lyons, Minna; David-Barrett, Tamas; Jokela, Markus

    2014-07-06

    Although gratitude is a key prosocial emotion reinforcing reciprocal altruism, it has been largely ignored in the empirical literature. We examined feelings of gratitude and the importance of reciprocity in same-sex peer relations. Participants were 772 individuals (189 men; mean age = 28.80) who completed an online survey using a vignette design. We investigated (i) differences in reported gratitude and the importance of reciprocity among same-sex siblings and same-sex friends, and (ii) how relationship closeness moderates these associations. Based on the theory of kin altruism, we expect that people would feel more grateful towards friends than towards their siblings, and that lack of gratitude or failure to pay back a loan would bother more with friends than with siblings, irrespective of emotional closeness. Results showed that levels of gratitude and expectations of reciprocity were higher towards friends compared to siblings. This was the case also after controlling for emotional closeness. Being close generally made participants feel more grateful and expect lower displays of gratitude in the other. Closeness was also strongly associated with emotional gratitude among siblings compared to friends. We conclude that feelings and displays of gratitude have a special role in friendships. Although a close sibling may elicit as much gratitude as a friend does, even a very close friend is not exempt from the logic of reciprocity in the same way that a sibling is.

  19. Sibling experiences after a major childhood burn injury.

    Science.gov (United States)

    Lehna, Carlee

    2010-01-01

    The purpose of this research project was to understand, primarily from the sibling perspective, the effect of a child's major burn injury on his or her sibling. A mixed method qualitative dominant design was implemented using the life story method for the qualitative portion. Additionally, the Sibling Relationship Questionnaire -Revised (SRQ-R) was used as a structured interview guide and for calculating scoring data to explore sibling relationship factors of warmth/closeness, rivalry, conflict, and relative status/power. Participants from 22 family cases (one or multiple family members) and 40 individuals were interviewed. To capture impact on the family over time, interviews began a minimum of two years post-burn. The central thematic pattern for the sibling relationship in families having a child with a major burn injury was that of normalization. Two components of normalization were described: areas of normalization and the process of adjustment. Areas of normalization were found in play and other activities, in school and work, and in family relations with siblings. The process of adjustment was varied and often gradual, involved school and work re-entry, and in some instances, seemed to change life perspective. Clinical implications in providing family-centered care can focus on promoting normalization by assessing and supporting siblings who may only be occasionally seen in the hospital or clinic.

  20. The Siblings With Ischemic Stroke Study (SWISS Protocol

    Directory of Open Access Journals (Sweden)

    Hardy John

    2002-02-01

    Full Text Available Abstract Background Family history and twins studies suggest an inherited component to ischemic stroke risk. Candidate gene association studies have been performed but have limited capacity to identify novel risk factor genes. The Siblings With Ischemic Stroke Study (SWISS aims to conduct a genome-wide scan in sibling pairs concordant or discordant for ischemic stroke to identify novel genetic risk factors through linkage analysis. Methods Screening at multiple clinical centers identifies patients (probands with radiographically confirmed ischemic stroke and a family history of at least 1 living full sibling with stroke. After giving informed consent, without violating privacy among other family members, the proband invites siblings concordant and discordant for stroke to participate. Siblings then contact the study coordinating center. The diagnosis of ischemic stroke in potentially concordant siblings is confirmed by systematic centralized review of medical records. The stroke-free status of potentially discordant siblings is confirmed by validated structured telephone interview. Blood samples for DNA analysis are taken from concordant sibling pairs and, if applicable, from 1 discordant sibling. Epstein-Barr virus-transformed lymphoblastoid cell lines are created, and a scan of the human genome is planned. Discussion Conducting adequately powered genomics studies of stroke in humans is challenging because of the heterogeneity of the stroke phenotype and the difficulty of obtaining DNA samples from clinically well-characterized members of a cohort of stroke pedigrees. The multicentered design of this study is intended to efficiently assemble a cohort of ischemic stroke pedigrees without invoking community consent or using cold-calling of pedigree members.

  1. Parent & Child Perceptions of Child Health after Sibling Death.

    Science.gov (United States)

    Roche, Rosa M; Brooten, Dorothy; Youngblut, JoAnne M

    Understanding children's health after a sibling's death and what factors may affect it is important for treatment and clinical care. This study compared children's and their parents' perceptions of children's health and identified relationships of children's age, gender, race/ethnicity, anxiety, and depression and sibling's cause of death to these perceptions at 2 and 4 months after sibling death. 64 children and 48 parents rated the child's health "now" and "now vs before" the sibling's death in an ICU or ER or at home shortly after withdrawal of life-prolonging technology. Children completed the Child Depression Inventory and Spence Children's Anxiety Scale. Sibling cause of death was collected from hospital records. At 2 and 4 months, 45% to 54% of mothers' and 53% to 84% of fathers' ratings of their child's health "now" were higher than their children's ratings. Child health ratings were lower for: children with greater depression; fathers whose children reported greater anxiety; mothers whose child died of a chronic condition. Children's ratings of their health "now vs before" their sibling's death did not differ significantly from mothers' or fathers' ratings at 2 or 4 months. Black fathers were more likely to rate the child's health better "now vs before" the death; there were no significant differences by child gender and cause of death in child's health "now vs before" the death. Children's responses to a sibling's death may not be visually apparent or become known by asking parents. Parents often perceive their children as healthier than children perceive themselves at 2 and 4 months after sibling death, so talking with children separately is important. Children's perceptions of their health may be influenced by depression, fathers' perceptions by children's anxiety, and mother's perceptions by the cause of sibling death.

  2. Sibling risk of anxiety disorders based on hospitalizations in Sweden.

    Science.gov (United States)

    Li, Xinjun; Sundquist, Jan; Sundquist, Kristina

    2011-04-01

    This study used nationwide hospital records to examine sibling risk of any type of anxiety disorder in Sweden over a 40-year period. This study, carried out between 1 January 1968 and 31 December 2007, of the entire population of Sweden, linked information on family relationships from the nationwide Multi-Generation Register with information from the nationwide Swedish Hospital Discharge Register on first diagnosis of anxiety disorder. A total of 42,602 persons hospitalized for anxiety disorders and 2093 affected siblings were identified. Standardized incidence ratios (SIR) were calculated by comparing risk in siblings of persons hospitalized for anxiety disorders with risk in persons whose siblings had no hospital diagnosis of anxiety disorders. The sibling risk was 2.26, which was independent of sex and age differences between siblings. The SIR was highest in siblings sibling diagnosed with any anxiety disorder resulted in increased risks of a number of disorders; the highest increased risk was of social phobia (SIR 3.68, 95% confidence interval, 1.68-7.69). Risk of panic disorder, generalized anxiety disorder, mixed anxiety and depressive disorder, and obsessive-compulsive disorder was raised in female but not male siblings. Heritable effects likely play an important role in the cause of anxiety disorders, but the extent of their role remains to be established. Important contributions could be made by studies of gene-environment interactions that have sufficient sample sizes to produce reliable results. © 2011 The Authors. Psychiatry and Clinical Neurosciences © 2011 Japanese Society of Psychiatry and Neurology.

  3. [Early sibling aggression in mammals and its hormonal correlates].

    Science.gov (United States)

    Antonevich, A L; Naĭdenko, S V

    2007-01-01

    Early sibling aggression is a widespread phenomenon in birds. Ornithologists distinguish species with "obligate" and "facultative" siblicide. Sibling aggression was described in some mammal species: the domestic pig (Sus scrofa), the spotted hyena (Crocuta crocuta), the Eurasian lynx (Lynx lynx), and the Iberian lynx (L. par-dinus). In all of them, sibling aggression corresponds well with the "facultative" siblicide model in birds. Sibling aggression was observed at the age of 36-64 days in both lynx species. It is usually restricted to a single fight and can change the hierarchical structure and growth rate of the kittens. In the spotted hyena and the domestic pig, the frequency and intensity of aggressive interactions between siblings are strongest during the first days of postnatal ontogeny and then decrease gradually. The newborns of these species are much developed than newborn lynx kittens. Usually adult lynx females, in contrast to hyenas and pigs, try to stop sibling fights. This is probably related to the larger parental investment at the time of the fight in lynxes (a kitten's body weight is about 10% of the mother's) than in pigs (0.5%) and hyenas (1.9%). Sibling aggression in spotted hyenas could be related to the high level of androstenedione and is not related to testosterone concentration. In the Eurasian lynx, female sibs attack their littermates slightly more often than male sibs do, and sibling aggression is not testosterone-dependent. Hormones secreted by the adrenal glands may play an important role in this phenomenon. The data available so far, however, do not positively confirm the presence of hormonal trigger effects in mammal sibling aggression.

  4. Mothers', fathers', and siblings' perceptions of parents' differential treatment of siblings: Links with family relationship qualities.

    Science.gov (United States)

    Jensen, Alexander C; McHale, Susan M

    2017-10-01

    A family systems perspective directs attention to the potentially different experiences and perspectives of family members. This study examined parents' differential treatment (PDT) of siblings, discrepancies between parent and youth reports of PDT, and their links with relationships between adolescents and their mothers and fathers across three years. Participants were first- (Time 1 M age = 15.71, SD = 1.07) and secondborn (Time 1 M age = 13.18, SD = 1.29) siblings from 381, predominately white, working and middle class families. Analyses revealed that siblings' perceptions of being favored predicted less conflict with and greater warmth from both mothers and fathers, primarily for secondborn adolescents. Larger discrepancies between maternal and youth reports of differential affection were linked to more maternal conflict and less warmth for firstborns. These findings may suggest a hierarchy within families: parents may serve as referents for firstborns and firstborns as referents for secondborns. Copyright © 2017 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  5. Metaphyseal osteopathy in three Australian Kelpie siblings.

    Science.gov (United States)

    Greenwell, C M; Brain, P H; Dunn, A L

    2014-04-01

    Metaphyseal osteopathy (MO) was diagnosed in three Australian Kelpie puppies that were presented for veterinary assessment of lameness. The three puppies were siblings. Each was from a different litter by the same breeding pair. The puppy in case one was seen by the authors, and the puppies in cases two and three were patients at other veterinary hospitals. However, the medical records and radiographs were examined and reviewed for this report. Radiographic investigation of the lameness revealed pathognomonic appearance of MO affecting the metaphyseal region of the long bones in all three puppies. The diagnosis was confirmed on histopathology in one patient. MO is considered a disease of large and giant-breed dogs, being rarely reported in non-large-breed dogs, and has not been reported in the Australian Kelpie, which is considered a medium-breed dog. This case series suggests a previously unreported breed predisposition to MO in the Australian Kelpie. © 2014 Australian Veterinary Association.

  6. The Perceptions of Professionals Toward Siblings of Individuals With Intellectual and Developmental Disabilities.

    Science.gov (United States)

    Burke, Meghan M; Lee, Chung Eun; Arnold, Catherine K; Owen, Aleksa

    2017-04-01

    Adult siblings of individuals with intellectual and developmental disabilities (IDD) report struggling to navigate the adult disability service delivery system and collaborate with professionals. To date, though, it is unclear how professionals encourage sibling involvement and, accordingly, the facilitators and challenges in working with siblings. For this study, 290 professionals participated in a national web-based survey; participants answered three open-ended questions about ways to involve siblings, positive experiences with siblings, and challenges in working with siblings. Professionals reported person-level and systems-level supports to encourage sibling involvement. Also, professionals reported enjoying working with cohesive families of individuals with IDD and witnessing the benefits that siblings bring to their brothers and sisters with IDD. Challenges in working with siblings included: lack of sibling involvement, systemic barriers, and caregiving burden. Implications for future research and practice are discussed.

  7. Sibling death and death fear in relation to depressive symptomatology in older adults.

    Science.gov (United States)

    Cicirelli, Victor G

    2009-01-01

    Previously overlooked factors in elders' depressive symptomatology were examined, including death fear, sibling death, and sibling closeness. Participants were 150 elders (61 men, 89 women) aged 65-97 years with at least one sibling. Measures were proportion of deceased siblings, sibling closeness, the Death Fear Subscale of the Death Attitude Profile-Revised, and the Center for Epidemiological Studies-Depression scale (20-item adult form). Age and education were exogenous variables in a structural equation model. Death fear, sibling closeness, and proportion of dead siblings were directly related to depression, with path coefficients of .42, -.24, and .13, respectively. Proportion of dead siblings had indirect effects on depression, as did age and education. Depressive symptomatology in old age is influenced by death fear related to sibling death as well as by poor relationships with them; it must be understood within a situational context including death fear and sibling relationships.

  8. Positive and Negative Interactions Observed Between Siblings: Moderating Effects for Children Exposed to Parents’ Conflict

    Science.gov (United States)

    Iturralde, Esti; Margolin, Gayla; Spies Shapiro, Lauren A.

    2012-01-01

    This study investigated links between interparental conflict appraisals (specifically threat and self-blame), sibling relationship quality (positive and negative dimensions), and anxiety in sibling pairs comprised of an adolescent and a younger sibling close in age. Sibling relationship quality was measured through behavioral observation. Links between self-blame and anxiety were moderated by sibling relationship quality. In older siblings, positive behavior with a sibling was associated with an attenuated relation between self-blame and anxiety. A paradoxical moderating effect was found for negative interactions; for both younger and older siblings, a relation between self-blame and anxiety was weakened in the presence of sibling negativity. Results offered support for theorized benefits of sibling relationship quality in helping early adolescents adjust to conflict between parents. PMID:24244080

  9. Applied behavior analysis programs for autism: sibling psychosocial adjustment during and following intervention use.

    Science.gov (United States)

    Cebula, Katie R

    2012-05-01

    Psychosocial adjustment in siblings of children with autism whose families were using a home-based, applied behavior analysis (ABA) program was compared to that of siblings in families who were not using any intensive autism intervention. Data gathered from parents, siblings and teachers indicated that siblings in ABA families experienced neither significant drawbacks nor benefits in terms of their behavioral adjustment, sibling relationship quality and self-concept compared to control group siblings, either during or following intervention use. Parents and siblings perceived improvements in sibling interaction since the outset of ABA, with parents somewhat more positive in their views than were siblings. Social support was associated with better sibling outcomes in all groups. Implications for supporting families using ABA are considered.

  10. The role of siblings in identity development in adolescence and emerging adulthood.

    Science.gov (United States)

    Wong, Thessa M L; Branje, Susan J T; VanderValk, Inge E; Hawk, Skyler T; Meeus, Wim H J

    2010-10-01

    This study examined the role of siblings on identity formation in adolescence and emerging adulthood, using a three-wave longitudinal design. Measures of identity formation were filled out by 498 sibling dyads. Sibling effects differed as a function of age and gender configuration within the dyads. Controlled for age, earlier-born siblings reported the most advanced levels of identity formation, and later-born siblings the lowest. Positive relations between siblings' identity and changes in identity of respondents provided support for modeling processes between siblings. The identity of earlier-born same-sex siblings, in particular, tends to be important in influencing identity formation. Contrary to the expectations, differentiation processes between siblings did not appear to influence identity formation. It is apparent from this study that both the gender and birth order of siblings affect whether their own identity formation processes influence those of adolescents and emerging adults.

  11. Sibling violence silenced: rivalry, competition, wrestling, playing, roughhousing, benign.

    Science.gov (United States)

    Phillips, Debby A; Phillips, Kate H; Grupp, Kitty; Trigg, Lisa J

    2009-01-01

    In this article, sibling violence and the silence surrounding it is explicated through professional literature and research findings, exemplars from clinical practice, and statistics. Theoretical positions and discourse analysis have been used to help explain how regular broken bones, bruises, lacerations, and verbal humiliation can be minimized as normal sibling rivalry or roughhousing, which does not cause serious consequences. Nursing should be on the front lines of ending practices of violence. Recognizing sibling violence as such is part of this work and is a social justice issue.

  12. G-CSF-primed BM for allogeneic SCT: revisited.

    Science.gov (United States)

    Pessach, I; Resnick, I; Shimoni, A; Nagler, A

    2015-07-01

    G-SCF-mobilized PBSC (GPB) grafts have a higher cell dose and somewhat more committed progenitor cells than steady-state BM (SBM), resulting in faster engraftment and faster immunological reconstitution. On the other hand, transplant related mortality (TRM), disease-free survival (DFS) and overall survival (OS) are similar both for PB and for BM. In contrast to SBM, G-CSF-primed BM (GBM) grafts stimulate HSC proliferation, increasing cell dose and thus resulting in faster engraftment because of higher cell dose infused, or because of treatment with G-CSF. Furthermore, GBM may induce tolerance and functional modulations in donor hematopoiesis and immunity, further reducing GVHD incidence, which is already lower with SBM compared with GPB grafts. Overall, a growing body of clinical evidence suggests that GBM transplants may share the advantages of GPB transplantations, without the associated increased risk of GVHD, and might be an attractive graft source for allogeneic SCTs.

  13. How and when I do allogeneic transplant in CLL.

    Science.gov (United States)

    Gribben, John G

    2018-05-11

    Allogenic stem cell transplantation (allo-SCT) has been considered the treatment of choice for high-risk patients with chronic lymphocytic leukemia (CLL) and the only approach offered with curative intent in this disease. The availability novel agents including the B cell receptor inhibitors (BCRi) ibrutinib, acalabrutinib and idelalisib, as well as venetoclax which targets the BCL2 pathway and the success of these agents in treating high-risk disease patients has made it more difficult to assess who and when in their treatment course allo-SCT should be considered. In this review, I will discuss the different treatment options available for the treatment of high-risk CLL and how allo-SCT fits into the treatment algorithm in the era of novel agents. Copyright © 2018 American Society of Hematology.

  14. Immune Reconstitution after Allogeneic Hematopoietic Stem Cell Transplantation

    Science.gov (United States)

    Ogonek, Justyna; Kralj Juric, Mateja; Ghimire, Sakhila; Varanasi, Pavankumar Reddy; Holler, Ernst; Greinix, Hildegard; Weissinger, Eva

    2016-01-01

    The timely reconstitution and regain of function of a donor-derived immune system is of utmost importance for the recovery and long-term survival of patients after allogeneic hematopoietic stem cell transplantation (HSCT). Of note, new developments such as umbilical cord blood or haploidentical grafts were associated with prolonged immunodeficiency due to delayed immune reconstitution, raising the need for better understanding and enhancing the process of immune reconstitution and finding strategies to further optimize these transplant procedures. Immune reconstitution post-HSCT occurs in several phases, innate immunity being the first to regain function. The slow T cell reconstitution is regarded as primarily responsible for deleterious infections with latent viruses or fungi, occurrence of graft-versus-host disease, and relapse. Here we aim to summarize the major steps of the adaptive immune reconstitution and will discuss the importance of immune balance in patients after HSCT. PMID:27909435

  15. Sibling Death and Death Fear in Relation to Depressive Symptomatology in Older Adults

    OpenAIRE

    Cicirelli, Victor G

    2009-01-01

    Previously overlooked factors in elders' depressive symptomatology were examined, including death fear, sibling death, and sibling closeness. Participants were 150 elders (61 men, 89 women) aged 65--97 years with at least one sibling. Measures were proportion of deceased siblings, sibling closeness, the Death Fear Subscale of the Death Attitude Profile--Revised, and the Center for Epidemiological Studies--Depression scale (20-item adult form). Age and education were exogenous variables in a s...

  16. Aggression between siblings : associations with the home environment and peer bullying

    OpenAIRE

    Tippett, Neil; Wolke, Dieter

    2015-01-01

    Sibling aggression is a common form of intra-familial aggression, yet has been largely neglected by research. Using an inclusive measure of sibling aggression, this study investigated, firstly, prevalence of sibling aggression and associations with family and household characteristics, and secondly, the relationship between sibling aggression and peer bullying. Participants were 4,237 adolescents from Wave 1 of Understanding Society. Four types of sibling aggression were measured: physical, v...

  17. Child, parent and family factors as predictors of adjustment for siblings of children with a disability.

    Science.gov (United States)

    Giallo, R; Gavidia-Payne, S

    2006-12-01

    Siblings adjust to having a brother or sister with a disability in diverse ways. This study investigated a range of child, parent and family factors as predictors of sibling adjustment outcomes. Forty-nine siblings (aged 7-16 years) and parents provided information about (1) sibling daily hassles and uplifts; (2) sibling coping; (3) parent stress; (4) parenting; and (5) family resilience. Multiple regression techniques were used. It was found that parent and family factors were stronger predictors of sibling adjustment difficulties than siblings' own experiences of stress and coping. Specifically, socio-economic status, past attendance at a sibling support group, parent stress, family time and routines, family problem-solving and communication, and family hardiness-predicted sibling adjustment difficulties. Finally, siblings' perceived intensity of daily uplifts significantly predicted sibling prosocial behaviour. The results revealed that the family level of risk and resilience factors were better predictors of sibling adjustment than siblings' own experiences of stress and coping resources, highlighting the importance of familial and parental contributions to the sibling adjustment process. The implications of these results for the design of interventions and supports for siblings are discussed.

  18. Longitudinal associations among parental acceptance, familism values, and sibling intimacy in Mexican-origin families.

    Science.gov (United States)

    Killoren, Sarah E; Wheeler, Lorey A; Updegraff, Kimberly A; Rodríguez de Jésus, Sue A; McHale, Susan M

    2015-06-01

    Prospective associations among parent-adolescent acceptance and familism values in early and middle adolescence and sibling intimacy in late adolescence and young adulthood were assessed in 246 Mexican-origin families. Older sibling gender and sibling gender constellation were investigated as moderators of these associations. Sibling intimacy was stable over time and younger siblings with older sisters reported higher levels of sibling intimacy than those with older brothers. As predicted, stronger familism values were associated with greater sibling intimacy, but this link was evident only for older sisters and for girl-girl dyads. The links from mother- and father-acceptance to sibling intimacy also depended on the gender constellation of the sibling dyad: Higher levels of maternal warmth were associated with greater sibling intimacy for older sisters and girl-girl sibling pairs but higher levels of paternal warmth were linked to greater sibling intimacy only for older siblings in mixed-gender sibling dyads. Findings are consistent with prior research on the role of gender in family relationships but extend this work to encompass the effects of both parents' and siblings' gender, as well as the role of sociocultural values in parents' socialization influences. © 2015 Family Process Institute.

  19. Allogeneic epidermal substitutes in the treatment of chronic diabetic leg and foot ulcers

    Directory of Open Access Journals (Sweden)

    Andrea Marchesi

    2014-09-01

    Full Text Available Aim: Diabetic foot ulcers are the most common cause of nontraumatic lower extremity amputations in the industrialized world. Tissue-engineering products offer a lower extremity salvage strategy when healing does not proceed according to the standard of care. New allogeneic sheets are available for the management of diabetic leg and foot ulcers. Methods: The endpoints of this case series study regard preliminary outcomes of the application of allogeneic keratinocytes composed of benzyl ester of hyaluronic acid to 16 diabetic foot and leg ulcers in 11 patients with type 2 diabetes mellitus. Results: Between 21 and 70 days after cellular therapy, 6 out of 16 lesions were completely healed, reducing the wound dimension by 70% and improving the wound bed score by 52%. Conclusion: The clinical results of the new allogeneic sheets indicate that allogeneic keratinocytes may represent an effective and safe therapy for diabetic foot and leg ulcers in the multidisciplinary approach to this diabetes-related complication.

  20. Allogeneic tumor cell vaccines: the promise and limitations in clinical trials.

    Science.gov (United States)

    Srivatsan, Sanjay; Patel, Jaina M; Bozeman, Erica N; Imasuen, Imade E; He, Sara; Daniels, Danielle; Selvaraj, Periasamy

    2014-01-01

    The high mortality rate associated with cancer and its resistance to conventional treatments such as radiation and chemotherapy has led to the investigation of a variety of anti-cancer immunotherapies. The development of novel immunotherapies has been bolstered by the discovery of tumor-associated antigens (TAAs), through gene sequencing and proteomics. One such immunotherapy employs established allogeneic human cancer cell lines to induce antitumor immunity in patients through TAA presentation. Allogeneic cancer immunotherapies are desirable in a clinical setting due to their ease of production and availability. This review aims to summarize clinical trials of allogeneic tumor immunotherapies in various cancer types. To date, clinical trials have shown limited success due potentially to extensive degrees of inter- and intra-tumoral heterogeneity found among cancer patients. However, these clinical results provide guidance for the rational design and creation of more effective allogeneic tumor immunotherapies for use as monotherapies or in combination with other therapies.

  1. Current status of grafts and implants in rhinoplasty: Part II. Homologous grafts and allogenic implants.

    Science.gov (United States)

    Sajjadian, Ali; Naghshineh, Nima; Rubinstein, Roee

    2010-03-01

    After reading this article, the participant should be able to: 1. Understand the challenges in restoring volume and structural integrity in rhinoplasty. 2. Identify the appropriate uses of various homologous grafts and allogenic implants in reconstruction, including: (a) freeze-dried acellular allogenic cadaveric dermis grafts, (b) irradiated cartilage grafts, (c) hydroxyapatite mineral matrix, (d) silicone implants, (e) high-density polyethylene implants, (f) polytetrafluoroethylene implants, and (g) injectable filler materials. 3. Identify the advantages and disadvantages of each of these biomaterials. 4. Understand the specific techniques that may aid in the use these grafts or implants. This review specifically addresses the use of homologous grafts and allogenic implants in rhinoplasty. It is important to stress that autologous materials remain the preferred graft material for use in rhinoplasty, owing to their high biocompatibility and low risk of infection and extrusion. However, concerns of donor-site morbidity, graft availability, and graft resorption have motivated the development and use of homologous and allogenic implants.

  2. Socially disadvantaged parents of children treated with allogeneic haematopoietic stem cell transplantation (HSCT)

    DEFF Research Database (Denmark)

    Larsen, Hanne Bækgaard; Heilmann, Carsten; Johansen, Christoffer

    2013-01-01

    PURPOSE: This study was undertaken to test a daily Family Navigator Nurse (FNN) conducted intervention program, to support parents during the distressful experience of their child's Allogeneic Haematopoietic Stem Cell Transplantation (HSCT). METHODS: A qualitative analysis of the supportive...

  3. Comparison of immune reconstitution after allogeneic vs. autologous stem cell transplantation in 182 pediatric recipients

    Directory of Open Access Journals (Sweden)

    V. Wiegering

    2017-03-01

    Conclusion: Children undergoing a HSCT show a different pattern of immune reconstitution in the allogeneic and autologous setting. This might influence the outcome and should affect the clinical handling of infectious prophylaxis and re-vaccinations.

  4. Histone deacetylase inhibition regulates inflammation and enhances Tregs after allogeneic hematopoietic cell transplantation in humans

    NARCIS (Netherlands)

    Choi, S.W.; Gatza, E.; Hou, G.; Sun, Y; Whitfield, J.; Song, Y.; Oravecz-Wilson, K.; Tawara, I.; Dinarello, C.A.; Reddy, P.

    2015-01-01

    We examined immunological responses in patients receiving histone deacetylase (HDAC) inhibition (vorinostat) for graft-versus-host disease prophylaxis after allogeneic hematopoietic cell transplant. Vorinostat treatment increased histone acetylation in peripheral blood mononuclear cells (PBMCs) from

  5. Treatment options for patients with acute myeloid leukemia with a matched sibling donor: a decision analysis.

    Science.gov (United States)

    Sung, Lillian; Buckstein, Rena; Doyle, John J; Crump, Michael; Detsky, Allan S

    2003-02-01

    The role of allogeneic bone marrow transplantation (BMT) in the consolidation of young adults with acute myeloid leukemia (AML) with matched sibling donors (MSD) is controversial. Although BMT is associated with increased event free survival compared with intensive chemotherapy (CT) consolidation, BMT also is associated with increased treatment-related mortality and likely decreased quality of life and life expectancy in patients who do not develop recurrent disease. The authors used decision analysis to compare three strategies for maximizing quality-adjusted life years (QALYs) in patients with AML in first remission with an MSD: BMT All, BMT None (consolidation CT only), or BMT in high-risk patients, as defined by baseline cytogenetic testing (Test strategy). A second decision-analysis tree was then constructed that compared BMT with CT specifically for patients with intermediate cytogenetics. Using expected QALYs as the outcome measure, the Test, BMT All, and BMT None strategies were associated with 20.10 QALYs, 19.63 QALYs, and 18.38 QALYs, respectively. Thus, the Test strategy, with CT for low-risk patients and BMT for intermediate risk and high-risk patients, was expected to be the optimal strategy. In the intermediate cytogenetic decision analysis, although the expected QALY for BMT recipients was higher compared with CT recipients (19.78 QALYs vs. 18.75 QALYs), because of uncertainty in variable estimates, the optimal choice was less clear. CT consolidation is a reasonable option for patients with AML who have favorable cytogenetics, even if an MSD is available. This model provides a framework from which patients with AML and their physicians can make decisions about consolidation therapy. Copyright 2003 American Cancer Society.DOI 10.1002/cncr.11098

  6. Who's the Boss? Patterns of Control in Adolescents' Sibling Relationships.

    Science.gov (United States)

    Tucker, Corinna Jenkins; Updegraff, Kimberly A; Baril, Megan E

    2010-12-01

    The goals of this study were to examine longitudinal changes in perceived control in adolescents' sibling relationships and to describe the nature and correlates of three distinct control patterns: Firstborn dominant, equal, and secondborn dominant. Firstborn and secondborn adolescents in 184 predominately European-American families participated in home interviews and a series of phone interviews as part of a longitudinal a study of family relationships and adolescent development. Findings revealed changes in control over three years as well as sibling differences. In addition, different patterns of control were linked to qualities of the sibling relationship and to adolescent adjustment. The different roles that firstborn and secondborn siblings assume, and why these roles are linked to relationship experiences and adjustment, are discussed.

  7. Fragile X syndrome in two siblings with major congenital malformations

    Energy Technology Data Exchange (ETDEWEB)

    Giampietro, P.F.; Haas, B.R.; Lipper, E. [Cornell Univ. Medical Center, New York, NY (United States)] [and others

    1996-05-17

    We report on 2 brothers with both fragile X and VACTERL-H syndrome. The first sibling, age 5, had bilateral cleft lip and palate, ventricular septal defect, and a hypoplastic thumb. The second sibling, age 2{1/2}, had a trachesophageal fistula, esophageal atresia, and vertebral abnormality. High-resolution chromosome analysis showed a 46,XY chromosome constitution in both siblings. By PCR and Southern blot analysis, the siblings were found to have large triplet repeat expansions in the fragile X gene (FMR 1) and both had methylation mosaicism. Enzyme kinetic studies of iduronate sulfatase demonstrated a two-fold increase in activity in the first sib as compared to the second. Possible mechanisms through which the fragile X mutation can cause down-regulation of adjacent loci are discussed. 24 refs., 4 figs.

  8. My sister's keeper?: genomic research and the identifiability of siblings

    Directory of Open Access Journals (Sweden)

    Kohane Isaac S

    2008-07-01

    Full Text Available Abstract Background Genomic sequencing of SNPs is increasingly prevalent, though the amount of familial information these data contain has not been quantified. Methods We provide a framework for measuring the risk to siblings of a patient's SNP genotype disclosure, and demonstrate that sibling SNP genotypes can be inferred with substantial accuracy. Results Extending this inference technique, we determine that a very low number of matches at commonly varying SNPs is sufficient to confirm sib-ship, demonstrating that published sequence data can reliably be used to derive sibling identities. Using HapMap trio data, at SNPs where one child is homozygotic major, with a minor allele frequency ≤ 0.20, (N = 452684, 65.1% we achieve 91.9% inference accuracy for sibling genotypes. Conclusion These findings demonstrate that substantial discrimination and privacy risks arise from use of inferred familial genomic data.

  9. On the Origins of Entrepreneurship: Evidence from Sibling Correlations

    DEFF Research Database (Denmark)

    Lindquist, Matthew J.; Sol, Joeri; Van Praag, Mirjam

    . We test this assumption and assess the importance of family background and neighborhood effects as determinants of entrepreneurship, by estimating sibling correlations in entrepreneurship. We find that between 20 and 50 percent of the variance in different entrepreneurial outcomes is explained...... by factors that siblings share (i.e., family background and neighborhood effects). The average is 28 percent. Hence, entrepreneurship is far less than fully determined at a young age. Our estimates increase only a little when allowing for differential treatment within families by gender and birth order. We...... then investigate a comprehensive set of mechanisms that explain sibling similarities. Parental entrepreneurship plays a large role in explaining sibling similarities, as do shared genes. We show that neighborhood effects matter, but are rather small, particularly when compared with the overall importance of family...

  10. Choanal atresia in siblings; Case report | Kaitesi | East and Central ...

    African Journals Online (AJOL)

    Choanal atresia is an uncommon and often poorly recognized cause of unilateral or bilateral nasal obstruction. This report describes the case of bilateral choanal atresia in two consecutive siblings and describes the methods of treatment offered.

  11. Psychoeducation for siblings of people with severe mental illness.

    Science.gov (United States)

    Sin, Jacqueline; Jordan, Cheryl D; Barley, Elizabeth A; Henderson, Claire; Norman, Ian

    2015-05-08

    Many people with severe mental illness (SMI) have siblings. Siblings are often both natural agents to promote service users' recovery and vulnerable to mental ill health due to the negative impact of psychosis within the family. Despite a wealth of research evidence supporting the effectiveness of psychoeducation for service users with SMI and their family members, in reducing relapse and promoting compliance with treatment, siblings remain relatively invisible in clinical service settings as well as in research studies. If psychoeducational interventions target siblings and improve siblings' knowledge, coping with caring and overall wellbeing, they could potentially provide a cost-effective option for supporting siblings with resulting benefits for service users' outcomes. To assess the effectiveness of psychoeducation compared with usual care or any other intervention in promoting wellbeing and reducing distress of siblings of people affected by SMI.The secondary objective was, if possible, to determine which type of psychoeducation is most effective. We searched the Cochrane Schizophrenia Group Trials Register and screened the reference lists of relevant reports and reviews (12th November 2013). We contacted trial authors for unpublished and specific data on siblings' outcomes. All relevant randomised controlled trials focusing on psychoeducational interventions targeting siblings of all ages (on their own or amongst other family members including service users) of individuals with SMI, using any means and formats of delivery, i.e. individual (family), groups, computer-based. Two review authors independently screened the abstracts and extracted data and two other authors independently checked the screening and extraction process. We contacted authors of trials to ascertain siblings' participation in the trials and seek sibling-specific data in those studies where siblings' data were grouped together with other participants' (most commonly other family members

  12. Older Siblings Affect Gut Microbiota Development in Early Childhood

    DEFF Research Database (Denmark)

    Laursen, Martin Frederik; Zachariassen, Gitte; Bahl, Martin Iain

    .006) at 18 months. Further, having older siblings was associated with increased relative abundance of several bacterial taxa at both 9 and 18 months of age. Compared to the effect of having siblings, presence of household furred pets and early life infections had less pronounced effects on the gut microbiota....... Gut microbiota characteristics were not significantly associated with cumulative occurrence of eczema and asthmatic bronchitis during the first three years of life. Conclusions: Presence of older siblings is associated with increased gut microbial diversity and richness during early childhood, which...... could contribute to the substantiation of the hygiene hypothesis. However, no associations were found between gut microbiota and atopic symptoms of eczema and asthmatic bronchitis during early childhood and thus further studies are required to elucidate whether sibling-associated gut microbial changes...

  13. Exploring sibling attitudes towards participation when the younger ...

    African Journals Online (AJOL)

    Data from a study involving parents of preschool children who were receiving ... Typically developing children who have a younger sibling with a disability often feel inadequately supported and excluded ..... from pressure where children.

  14. Second myeloablative allogeneic stem cell transplantation (SCT) using cord blood for leukemia relapsed after initial allogeneic SCT.

    Science.gov (United States)

    Konuma, Takaaki; Ooi, Jun; Takahashi, Satoshi; Tomonari, Akira; Tsukada, Nobuhiro; Kato, Seiko; Sato, Aki; Monma, Fumihiko; Kasahara, Senji; Uchimaru, Kaoru; Iseki, Tohru; Tojo, Arinobu; Asano, Shigetaka

    2009-06-01

    There are many reports of second allogeneic stem cell transplantation (allo-SCT) using cord blood (CB) for graft failure after initial allo-SCT. However, the efficacy of second allo-SCT using CB for patients with leukemia relapsed after initial allo-SCT is unknown. We report the results of second allo-SCT using CB in seven adult patients with leukemia relapsed after initial allo-SCT. All patients received a myeloablative conditioning regimen including oral busulfan 16 mg/kg, intravenously fludarabine 100mg/m(2) and cyclophosphamide 120 mg/kg. All but one patient had myeloid reconstitution and four patients remain alive at between 4 and 40 months after second SCT. We conclude that second myeloablative allo-SCT using CB may be feasible in selected patients with the relatively younger age, less organ damage and longer time interval between first and second allo-SCT.

  15. Comparative analysis of autologous blood transfusion and allogeneic blood transfusion in surgical patients

    OpenAIRE

    Long, Miao-Yun; Liu, Zhong-Han; Zhu, Jian-Guang

    2014-01-01

    Objective: To investigate application effects of autologous blood transfusion and allogeneic blood transfusion in surgically treated patients receiving spine surgery, abdomen surgery and ectopic pregnancy surgery. Methods: 130 patients who would undergo selective operations were divided into autologous transfusion group and allogeneic transfusion group. Both groups received the same anesthesia, and there was no significant difference in transfusion volume or fluid infusion volume. Results: Th...

  16. Achieving an early pregnancy following allogeneic uterine transplantation in a rabbit model

    OpenAIRE

    Saso, Srdjan; Petts, Gemma; David, Anna L.; Thum, Meen-Yau; Chatterjee, Jayanta; Vicente Antón, José Salvador; Marco Jiménez, Francisco; Corless, David; Boyd, Michael; Noakes, David; Lindsay, Iain; Del Priorei, Giuseppe; Ghaem-Maghami, Sadaf; Smith, J. Richard

    2015-01-01

    [EN] Objective: Uterine transplantation (UTx) has been proposed as a treatment option for women diagnosed with absolute uterine factor infertility (AUFI). The goal of UTx remains achieving pregnancy and live birth of a healthy neonate following allogeneic UTx. Our aim was to assess whether fertility was possible following allogeneic uterine transplantation (UTx), when the recipient had demonstrated long-term survival and had been administered immunosuppression. Study desig...

  17. Establishment of donor Chimerism Using Allogeneic Bone Marrow with AMP Cell Co-infusion

    Science.gov (United States)

    2017-09-01

    AWARD NUMBER: W81XWH-15-1-0234 TITLE: Establishment of donor Chimerism Using Allogeneic Bone Marrow with AMP Cell Co-infusion PRINCIPAL...14/2017 4. TITLE AND SUBTITLE Establishment of donor Chimerism Using Allogeneic Bone Marrow with AMP Cell Co-infusion 5a. CONTRACT NUMBER 5b. GRANT...tolerance induction of all types of allografts. In this study, we investigate whether co-infusion of amnion- derived multipotent progenitor (AMP) cells

  18. Prosocial competencies among adolescent siblings of the physically disabled

    OpenAIRE

    Lidia Perenc; Mieczysław Radochoński; Anna Radochońska

    2015-01-01

    Background The current study examined possible prosocial benefits of having a disabled sibling. Until now research has mainly focused on the negative effects of having a sibling with a disability. We hypothesized that regular and frequent interactions with a disabled person should result in an increase of positive attitude and empathy toward other people who are in a disadvantageous situation. Participants and procedure A sample of 208 students from public secondary school...

  19. Examining Courtesy Stigma in Siblings of People with Down Syndrome

    OpenAIRE

    Fulk, Kelly

    2014-01-01

    The purpose of this study was to determine whether siblings of people with Down syndrome face courtesy stigma, a stigma acquired as a result of an association with a person from a stigmatized group. The central hypothesis was that the majority of people who have a sibling with Down syndrome face courtesy stigma during both adolescence and adulthood. The data supports this hypothesis, showing that 76% of respondents reported courtesy stigma as adolescents and 62% reported courtesy stigma as ad...

  20. Altered cognitive development in the siblings of individuals with schizophrenia

    OpenAIRE

    Barch, Deanna M.; Cohen, Rachel; Csernansky, John

    2013-01-01

    The goal of the current study was to further investigate the late neurodevelopmental hypothesis of schizophrenia by examining cross-sectional, age-related changes in cognitive function among young adult: 1) siblings of individuals with schizophrenia (N = 66); (2) healthy control participants (N = 77); and (3) the siblings of healthy controls (N = 77). All subjects participated in a battery of tasks in four domains: 1) IQ; 2) working memory; 3) episodic memory; and 4) executive function. We fo...

  1. Upaya Mengatasi Sibling Rivalry melalui Layanan Konseling Kelompok

    OpenAIRE

    Eli Turniati; Eko Nusantoro

    2015-01-01

    Penelitian ini dilakukan berdasarkan fenomena yang terjadi pada siswa kelas VI SDN Sendangmulyo 02 kecamatan Tembalang kota Semarang yang mengalami sibling rivalry. Tujuan penelitian ini yaitu untuk mengetahui apakah konseling kelompok dapat mengatasi sibling rivalry pada siswa kelas VI SDN Sendangmulyo 02. Jenis penelitian adalah penelitian eksperiment dengan desain penelitian one group pre-test dan pos-test design. Subyek penelitian ini, siswa kelas VI SDN Sendangmulyo 02 yang memiliki ting...

  2. Expression of antigens coded in murine leukemia viruses on thymocytes of allogeneic donor origin in AKR mice following syngeneic or allogeneic bone marrow transplantation

    International Nuclear Information System (INIS)

    Wustrow, T.P.; Good, R.A.

    1985-01-01

    Removal of T-lymphocytes from marrow inoculum with monoclonal antibody plus complement permitted establishment of long-lived allogeneic chimeras between C57BL/6 and AKR/J mice. Development of leukemia was prevented for 15 mo. Protection from leukemia occurred with both young (4 wk) and older (4 mo) recipients. AKR mice reconstituted with syngeneic marrow or control AKR mice all developed leukemia-lymphoma before 1 yr of age. During spontaneous lymphomagenesis in AKR mice, amplified expression of gag or env gene-coded virus antigens on the surface of thymocytes preceded leukemia development and evidence for amplification of other virus genes. These changes generally appeared before 6 mo. Similar viral gene expression and viral gene amplification occurred in the thymus and spleen cells of leukemia-resistant chimeric mice. Using monoclonal antibodies to Mr 70,000 glycoprotein epitopes characteristic of ecotropic, xenotropic, or dualtropic viruses, antigens marking each virus form were found on thymocytes of allogeneic 4-wk and 4-mo chimeras as well as on the cells of AKR mice and of AKR mice reconstituted with syngeneic marrow. Flow cytometric analysis showed amplification of the virus genes in mice protected from leukemia-lymphoma by allogeneic bone marrow transplantation from leukemia-resistant mice. Allogeneic chimeras and syngeneically transplanted mice both showed evidence of accelerated viremia and of recombinant virus formation. The findings suggest that an event essential to leukemogenesis which occurs within the AKR lymphoid cells or their environment is lacking in the allogeneic chimeras. The nature of this influence of a resistance gene or genes introduced into AKR mice by allogeneic bone marrow transplantation deserves further study

  3. [Sibling relations in processing sexual trauma: the film "The Celebration"

    Science.gov (United States)

    Sohni, H

    2001-01-01

    Movies appeal as a subject of psychoanalytical art interpretation due to their structural closeness to "scenical understanding" and enrich our Insight into human relationships. The movie Das Pest is worth seeing because of its particular aesthetic form and because of its message about sibling relationships. According to the assessment of film journalists the movie shows the dismantling of middle class society and the reinscenation of destructive violence. In this author's interpretation, however, the movie leads out of passing violence on through the generations and herein differs from numerous current movies about siblings. The movie is about the process of a constructive development in the reciprocal relationships between four siblings and shows this in the formal structure of a film. With countertransference and our "viewing habits" the author discusses why this development could be overlooked. The movie shows neither a sibling fixation nor an idealization of sibling love as a regressive, timeless topos, but rather a horizontal relationship process. This is open towards partners and allows for a conciliatory attitude towards the parents. The movie is able to show this process conclusively under the burden of intergenerational violence and in its creativity enriches our image of sibling relationships.

  4. Response to 'A relational approach to Saviour Siblings?' by Selgelid.

    Science.gov (United States)

    Taylor-Sands, Michelle

    2016-10-01

    In his concise argument, 'A relational approach to saviour siblings?', Selgelid reiterates some of the arguments raised in the author meets critics discussion of my book, Saviour Siblings In this response, I highlight an important misunderstanding in one of the arguments put forward by Selgelid, which forms the basis of a large portion of his analysis. Contrary to what Selgelid contends, I do not use the deafness case in my discussion of the non-identity problem to contend that the case of selecting for deafness is ethically different from the case of saviour siblings. As I state in my reply, I use the case of deafness not as a comparator for saviour siblings but rather to illustrate the different categories of risk that apply in selection cases Given this confusion, I restate my objection to relying on the non-identity problem in evaluating risk of harm associated with the embryo biopsy process for preimplantation genetic diagnosis. Finally, I reiterate that the individual interests of saviour siblings remain important in the decision-making matrix and emphasise that Saviour Siblings offers a more contextualised approach to the welfare of the child in selective reproduction, which includes both individual and collective interests. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  5. Expressed emotion in children: associations with sibling relationships.

    Science.gov (United States)

    Yelland, I; Daley, D

    2009-07-01

    To investigate the reliability and validity of the expressed emotion (EE) measure, the Pre-school Five Minute Speech Sample (PFMSS), in child-to-child sibling relationships. A total of 106 boys aged 7-11 were recruited from 12 mainstream primary schools in North Wales. The children completed the PFMSS regarding their sibling and two self-report measures of sibling relationship: the Sibling Relationship Questionnaire (SRQ) and a Child Visual Analogue Scale (CVAS). The parents of 60 participants completed the Strengths and Difficulties Questionnaire regarding the behavioural problems of the participating child and his younger sibling. The PFMSS demonstrated good inter-rater and code-recode reliability. The significant associations between EE dimensions such as relationship, positive comments and critical comments with various components of the SRQ and CVAS provided support for the concurrent validity of the PFMSS. Significantly higher levels of Conflict and Rivalry and significantly lower levels of Warmth/Closeness on the SRQ were reported by children with high EE, demonstrating good discriminant validity for the PFMSS. There was no significant association between the child's EE profile and the behavioural difficulties of both siblings as reported by parents. The study found that the PFMSS is a valid and reliable measure of child EE. Future research is needed to clarify the concurrent validity of the warmth and initial statement components of the measure as well as the association between EE dimensions and behaviour.

  6. Functional studies on lymphocytes from two siblings with congential hypogammaglobulinaemia

    International Nuclear Information System (INIS)

    Tauris, P.; Wendelboe Hansen, P.

    1983-01-01

    Two brothers with hypogammaglobulinaemia classified as common variable immunodeficiency (CVID) were investigated for distribution of pheripheral blood lymphocyte (PBL) subpopulations, DNA synthesis and plaque-forming cell (PFC) capability of pokeweed mitogen (PWM) activated autologous and allogenic cocultures. Both patients had a decreased absolute number of T cells and normal or elevated levels of surface immunoglobulin (SmIg) bearing cells. Isolated B cells cocultured with autologous or allogeneic 4000 r irradiated T cells responded subnormally to PWM monitored by the 3 H-thymidine incorporation in microcultures whereas B cells cocultured with allogeneic untreated normal T cells proliferated normally. PBL from parallel macrocultures of unfractionated or T/B separated patients' cells were not able to produce plaques using a reversed haemolytic protein A assay. Addition of glucocorticoid to unfractionated PBL did not reverse the unresponsiveness. In allogeneic cocultures patients' untreated or 2000 r irradiated T cells induced a normal PFC response. Normal untreated T cells induced a reduced number of IgM- and IgG-PFC from patients' B cells but this response was almost eliminated using irradiated normal T cells. These results demonstrate a primary B cell defect in the patients and indicate an impaired cooperation between patients' B and T cells. Activation of patients' B cells to Ig secretion requires the presence of proliferating T cells. (author)

  7. 'Recognized, Valued and Supported'? The Experiences of Adult Siblings of People with Autism Plus Learning Disability.

    Science.gov (United States)

    Tozer, Rosemary; Atkin, Karl

    2015-07-01

    The potential of adult siblings to offer long-term support to a brother or sister with autism is rarely realized. To understand this, our study explores the expectations of social care among adult siblings. Using qualitative interviews, we spoke to 21 adult siblings about their family relationships and engagement with service delivery, met with 12 of their siblings with autism and talked to 12 social care staff. Siblings, although reflecting on the difficulties of growing up with someone who had autism, expressed a commitment towards their brother or sister. Most wanted involvement in their care. While some siblings described positive relationships with services, many felt marginalized. Practitioners largely confirmed their perceptions, while offering a justification for why they struggled to engage with adult siblings. By understanding the way relationships between siblings change over time, adult siblings' contribution to the lives of their disabled brother or sister can be better supported. © 2015 John Wiley & Sons Ltd.

  8. Sibling rivalry and the new baby: anticipatory guidance and management strategies.

    Science.gov (United States)

    Sawicki, J A

    1997-01-01

    Sibling rivalry can be found in many families and frequently creates a stressful and challenging situation for parents. The arrival of a new baby often causes older siblings to feel displaced, frustrated, angry, and even unloved. Age, gender, personality and temperament, and parental behavior are factors that appear to influence the degree to which sibling rivalry occurs. Common reactions of older siblings to the birth of a new baby include aggression toward the newborn, behavioral regression, and attention seeking behavior, as well as independence and maturity. Anticipatory guidance is recommended to help parents adequately prepare their older child for the arrival of a new sibling. Strategies for managing sibling rivalry include open parent-child communication, equal treatment of siblings, non-intervention in sibling conflicts, distraction, and separation. Parents can minimize feelings of jealousy between siblings by providing a supportive, nurturing environment that allows each child to feel secure and loved.

  9. An Adapted Measure of Sibling Attachment: Factor Structure and Internal Consistency of the Sibling Attachment Inventory in Youth.

    Science.gov (United States)

    Noel, Valerie A; Francis, Sarah E; Tilley, Micah A

    2018-04-01

    Parent-youth and peer relationship inventories based on attachment theory measure communication, trust, and alienation, yet sibling relationships have been overlooked. We developed the Sibling Attachment Inventory and evaluated its psychometric properties in a sample of 172 youth ages 10-14 years. We adapted the 25-item Sibling Attachment Inventory from the Inventory of Parent and Peer Attachment-Revised peer measure. Items loaded onto three factors, identified as communication, trust, and alienation, α = 0.93, 0.90, and 0.76, respectively. Sibling trust and alienation correlated with depression (r s  = -0.33, r s  = 0.48) and self-worth (r s  = 0.23; r s  = -0.32); sibling trust and alienation correlated with depression after controlling for parent trust and parent alienation (r s  = -0.23, r s  = 0.22). Preliminary analyses showed good internal consistency, construct validity, and incremental predictive validity. Following replication of these properties, this measure can facilitate large cohort assessments of sibling attachment.

  10. Sibling Relationships and Empathy Across the Transition to Adolescence Sibling Relationships and Empathy Across the Transition to Adolescence

    Science.gov (United States)

    Lam, Chun Bun; Solmeyer, Anna R.; McHale, Susan M.

    2012-01-01

    Although socioemotional competencies have been identified as key components of youths’ positive development, most studies on empathy are cross-sectional, and research on the role of the family has focused almost exclusively on parental socialization. This study examined the developmental course of empathy from age 7 to 14 and the within-person associations between sibling warmth and conflict and youths’ empathy. On three occasions across 2 years, mothers, fathers, and the two eldest siblings from 201 White, working- and middle-class families provided questionnaire data. Multilevel models revealed that, controlling for youths’ pubertal status and parental education, girls’ empathy increased during the transition to adolescence and then leveled off, but boys’ lower levels of empathy remained relatively unchanged. Moreover, controlling for parental responsiveness and marital love, at times when firstborns and second-borns reported more sibling warmth and less sibling conflict than usual, they also reported more empathy than usual. The within-person association between sibling warmth and empathy also became stronger over time. Findings highlight gender differences in empathy development and the unique role of siblings in shaping each other’s socioemotional characteristics during adolescence. PMID:22714744

  11. At issue: siblings of patients with schizophrenia: sibling bond, coping patterns, and fear of possible schizophrenia heredity.

    Science.gov (United States)

    Stålberg, Gabriella; Ekerwald, Hedvig; Hultman, Christina M

    2004-01-01

    Siblings of schizophrenia patients are from the patient's perspective important support providers, but most studies on family burden have focused on the parental role. This study aims to develop a detailed analysis of the psychological aspects of having a sibling with schizophrenia. We did a qualitative study with audiotaped semistructured interviews of 16 siblings. The reliability of the inductive categorization of data was high. A unifying theme appeared to be an emotional sibling bond characterized by feelings of love, sorrow, anger, envy, guilt, and shame. The major categories linked to coping with the situation were avoidance, isolation, normalization, caregiving, and grieving. A third major theme consisted of a fear of possible schizophrenia heredity. The siblings described concerns about the impact of a family history of psychiatric illness, a fear of becoming mentally ill, and reflections about "bad genes." Our findings support earlier findings of coping patterns but complement them by providing a model that includes awareness of genetic vulnerability as an important part of siblings' subjective burden.

  12. Cochlear Implantation in Siblings With Refsum's Disease.

    Science.gov (United States)

    Stähr, Kerstin; Kuechler, Alma; Gencik, Martin; Arnolds, Judith; Dendy, Meaghan; Lang, Stephan; Arweiler-Harbeck, Diana

    2017-08-01

    Whether the origin of severe hearing loss in Refsum's syndrome is caused by cochlear impairment or retrocochlear degeneration remains unclear. This case report aims to investigate hearing performance before and after cochlear implantation to shed light on this question. Also, identification of new mutations causing Refsum's syndrome would be helpful in generating additional means of diagnosis. A family of 4 individuals was subjected to genetic testing. Two siblings (56 and 61 years old) suffered from severe hearing and vision loss and received bilateral cochlear implants. Genetic analysis, audiological outcome, and clinical examinations were performed. One new mutation in the PHYH gene (c.768del63bp) causing Refsum's disease was found. Preoperative distortion product otoacoustic emissions (DPAOEs) were absent. Postoperative speech perception in Freiburger speech test was 100% for bisyllabic words and 85% (patient No. 1) and 65% (patient No. 2), respectively, for monosyllabic words. Five years after implantation, speech perception remained stable for bisyllabic words but showed decreasing capabilities for monosyllabic words. A new mutation causing Refsum's disease is presented. Cochlear implantation in case of severe hearing loss leads to an improvement in speech perception and should be recommended for patients with Refsum's disease, especially when the hearing loss is combined with a severe loss of vision. Decrease of speech perception in the long-term follow-up could indicate an additional retrocochlear degeneration.

  13. The effect of total body irradiation dose and chronic graft-versus-host disease on leukaemic relapse after allogeneic bone marrow transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Frassoni, F; Bacigalupo, A [Ospedale San Martino (Italy). Centro Trapianti Midollo Osseo; Scarpati, D [Univ. di Genova (Italy). Ist. di Radiologia; and others

    1989-10-01

    One-hundred and five patients undergoing allo-geneic bone marrow transplantation (BMT) for acute myeloid leukaemia (AML) (n=61) and chronic myeloid leukaemia (n=44) were analysed for risk factors associated with relapse. All patients received marrow from an HLA identical sibling after preparation with cyclophosphamide 120 mg/kg and total body irradiation (TBI) 330 cGy on each of the three days prior to transplantation. A multivariate Cox analysis indicated that a lower TBI dose (less than 990 cGy) was the most significant factor associated with relapse and the second most important factor associated with recurrence of leukaemia was the absence of chronic graft-versus-host-disease (cGvHD). Actuarial relapse incidence was 62%, 28% and 18% for patients with no, limited or extensive chronic GvHD respectively. However, chronic GvHD had no significant impact on survival. Combined stratification for TBI dose and cGvHD showed that the dose effect of TBI on relapse was evident both in patients with and without cGvHD. Chronic GvHD influenced the risk of relapse only in patients receiving less than 990 cGy. These results suggest that a higher dose of TBI, within this schedule, produced long-term disease-free survival in the majority of AMLs and CMLs. Minor radiobiological side effects were experienced, but a small reduction of the dose may significantly increase the risk of relapse. (author).

  14. The effect of total body irradiation dose and chronic graft-versus-host disease on leukaemic relapse after allogeneic bone marrow transplantation

    International Nuclear Information System (INIS)

    Frassoni, F.; Bacigalupo, A.; Scarpati, D.

    1989-01-01

    One-hundred and five patients undergoing allo-geneic bone marrow transplantation (BMT) for acute myeloid leukaemia (AML) (n=61) and chronic myeloid leukaemia (n=44) were analysed for risk factors associated with relapse. All patients received marrow from an HLA identical sibling after preparation with cyclophosphamide 120 mg/kg and total body irradiation (TBI) 330 cGy on each of the three days prior to transplantation. A multivariate Cox analysis indicated that a lower TBI dose (less than 990 cGy) was the most significant factor associated with relapse and the second most important factor associated with recurrence of leukaemia was the absence of chronic graft-versus-host-disease (cGvHD). Actuarial relapse incidence was 62%, 28% and 18% for patients with no, limited or extensive chronic GvHD respectively. However, chronic GvHD had no significant impact on survival. Combined stratification for TBI dose and cGvHD showed that the dose effect of TBI on relapse was evident both in patients with and without cGvHD. Chronic GvHD influenced the risk of relapse only in patients receiving less than 990 cGy. These results suggest that a higher dose of TBI, within this schedule, produced long-term disease-free survival in the majority of AMLs and CMLs. Minor radiobiological side effects were experienced, but a small reduction of the dose may significantly increase the risk of relapse. (author)

  15. Outcome of children with high-risk acute myeloid leukemia given autologous or allogeneic hematopoietic cell transplantation in the aieop AML-2002/01 study.

    Science.gov (United States)

    Locatelli, F; Masetti, R; Rondelli, R; Zecca, M; Fagioli, F; Rovelli, A; Messina, C; Lanino, E; Bertaina, A; Favre, C; Giorgiani, G; Ripaldi, M; Ziino, O; Palumbo, G; Pillon, M; Pession, A; Rutella, S; Prete, A

    2015-02-01

    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.

  16. Second allogeneic stem cell transplant for aplastic anaemia: a retrospective study by the Severe Aplastic Anaemia Working Party of the European Society for Blood and Marrow Transplantation.

    Science.gov (United States)

    Cesaro, Simone; Peffault de Latour, Regis; Tridello, Gloria; Pillon, Marta; Carlson, Kristina; Fagioli, Franca; Jouet, Jean-Pierre; Koh, Mickey B C; Panizzolo, Irene Sara; Kyrcz-Krzemien, Slawomira; Maertens, Johan; Rambaldi, Alessandro; Strahm, Brigitte; Blaise, Didier; Maschan, Alexei; Marsh, Judith; Dufour, Carlo

    2015-11-01

    We analysed the outcome of a second allogeneic haematopoietic stem cell transplant (alloHSCT) in 162 patients reported to the European Society for Blood and Marrow Transplantation between 1998 and 2009. Donor origin was a sibling in 110 and an unrelated donor in 52 transplants, respectively. The stem cell source was bone marrow in 31% and peripheral blood in 69% of transplants. The same donor as for the first alloHSCT was used in 81% of transplants whereas a change in the choice of stem cell source was reported in 56% of patients, mainly from bone marrow to peripheral blood. Neutrophil and platelet engraftment occurred in 85% and 72% of patients, after a median time of 15 and 17 days, respectively. Grade II-IV acute graft-versus-host disease (GVHD) and chronic GVHD occurred in 21% and 37% of patients, respectively. Graft failure (GF) occurred in 42 patients (26%). After a median follow-up of 3·5 years, the 5-year overall survival (OS) was 60·7%. In multivariate analysis, the only factor significantly associated with a better outcome was a Karnofsky/Lansky score ≥80 (higher OS). We conclude that a second alloHSCT is feasible rescue option for GF in SAA, with a successful outcome in 60% of cases. © 2015 John Wiley & Sons Ltd.

  17. Roles of Toll-like receptors in allogeneic islet transplantation.

    Science.gov (United States)

    Ro, Han; Hong, Juho; Kim, Beom Seok; Lee, Eun Won; Kim, Myung-Gyu; Han, Kyu Hyun; Yeom, Hye-Jung; Lee, Eun Mi; Jeong, Jong Cheol; Oh, Kook-Hwan; Ahn, Curie; Yang, Jaeseok

    2012-11-27

    Toll-like receptors (TLRs) are involved in the rejection of solid organ allografts. However, the roles of TLRs in islets are still controversial. We investigated the roles of TLRs in donor islets together with those in recipients in allogeneic islet transplantation. To assess the roles of TLRs in either donor islets or recipients, allogeneic islet transplantation was performed using myeloid differentiation factor 88 (MyD88)-knockout (KO), TLR4-KO, or Toll/interleukin-1 receptor domain-containing adaptor-inducing interferon-β (TRIF)-KO mice. Both polyriboinosinic polyribocytidylic acid and lipopolysaccharide (LPS) stimulation induced the mRNA expression of regulated and normal T cell expressed and secreted, interferon-γ-inducible protein-10, monocyte chemotactic protein-1, interleukin-8, and inducible nitric oxide synthase in murine islets, whereas the induction was attenuated in TRIF-KO, interferon-β promoter stimulator-1-KO, and TLR4-KO mice. When islets from MyD88-KO, TLR4-KO, or TRIF-KO C57BL/6 mice were transplanted to BALB/c recipients, graft survival was not better than that of wild-type (WT) islets. However, the survival of the MyD88-KO islet allograft was significantly prolonged when combined with anti-CD40L. In parallel, LPS stimulation in donor islets interfered with anti-CD40L blockade-mediated long-term survival of islet allografts in TLR4-KO recipients. LPS stimulation increased the perigraft infiltration of both T cells and macrophages. Then again, when islets from WT BALB/c mice were transplanted to MyD88-KO, TRIF-KO, or WT C57BL/6 mice, there was no difference in graft survival, although some of the MyD88-KO recipients obtained long-term graft survival. However, anti-CD40L prolonged graft survival significantly in MyD88-KO recipients. The absence of MyD88 in either donors or recipients decreased the perigraft infiltration of inflammatory cells when combined with anti-CD40L. TLRs in both donor islets and recipients are involved in islet allograft

  18. Familial concordance of phenotype and microbial variation among siblings with CF.

    Science.gov (United States)

    Picard, Elie; Aviram, Micha; Yahav, Yaakov; Rivlin, Joseph; Blau, Hanna; Bentur, Lea; Avital, Avraham; Villa, Yael; Schwartz, Shepard; Kerem, Batsheva; Kerem, Eitan

    2004-10-01

    The clinical spectrum of cystic fibrosis (CF) is influenced by the cystic fibrosis transmembrane conductance regulator (CFTR) genotype. However, variable courses of the disease were demonstrated among patients with identical genotypes. Since siblings share identical CFTR mutations and environmental factors, they can serve as a model to assess the effect of modifier genes on disease expression, and also to evaluate cross-infection. The aim of this study was to compare disease expression among siblings with CF. All sibling pairs treated at 7 CF centers in Israel were included in the study. Data were collected from patients' medical charts. Fifty families with at least 2 siblings were identified. As expected, the second-born sibling was diagnosed at an earlier age compared to the first-born. The mode of CF presentation at diagnosis showed significant familial concordance. In the families where the first sibling presented with gastrointestinal manifestations, 79% of the second siblings also presented with gastrointestinal manifestations. When gastrointestinal manifestations were absent in the first sibling, only 12% of the second siblings presented with gastrointestinal manifestations (P sibling presented with respiratory symptoms, 60% of the second siblings presented with the similar symptoms. However, when the first sibling presented without respiratory symptoms, only 12% of the second siblings presented with respiratory symptoms (P sibling had MI, 8 (80%) of the subsequent siblings had MI. On the other hand, in the 39 families where the first-born sibling did not have MI, only 2 (5%) subsequent siblings had MI (P siblings. P. aeruginosa grew from sputum in 89% of our study patients. When P. aeruginosa was isolated from the first-born patient, 91% of the second siblings were also positive for P. aeruginosa, whereas when the initial sibling was not a carrier of P. aeruginosa, only 50% of subsequent siblings were positive (P sibling than in the first for the two

  19. Siblings Promote a Type 1/Type 17-oriented immune response in the airways of asymptomatic neonates

    DEFF Research Database (Denmark)

    Wolsk, Helene Mygind; Chawes, Bo L.; Følsgaard, Nilofar V.

    2016-01-01

    -related mediators. This was supported by the PCA showing a highly significant difference between children with vs. without siblings: p...BACKGROUND: Siblings have been shown to reduce the risk of later asthma and allergy, but the mechanism driving this association is unknown. The objective was to study whether siblings affect the airway immune response in healthy neonates. We hypothesized that siblings exert immune modulatory......-cohort (COPSAC2010). The association between airway mediator levels and presence of siblings was investigated using conventional statistics and principle component analyses (PCA). RESULTS: Neonates with siblings had an up-regulated level of airway immune-mediators, with predominance of Type 1- and Type 17...

  20. Sibling Competition & Growth Tradeoffs. Biological vs. Statistical Significance.

    Science.gov (United States)

    Kramer, Karen L; Veile, Amanda; Otárola-Castillo, Erik

    2016-01-01

    Early childhood growth has many downstream effects on future health and reproduction and is an important measure of offspring quality. While a tradeoff between family size and child growth outcomes is theoretically predicted in high-fertility societies, empirical evidence is mixed. This is often attributed to phenotypic variation in parental condition. However, inconsistent study results may also arise because family size confounds the potentially differential effects that older and younger siblings can have on young children's growth. Additionally, inconsistent results might reflect that the biological significance associated with different growth trajectories is poorly understood. This paper addresses these concerns by tracking children's monthly gains in height and weight from weaning to age five in a high fertility Maya community. We predict that: 1) as an aggregate measure family size will not have a major impact on child growth during the post weaning period; 2) competition from young siblings will negatively impact child growth during the post weaning period; 3) however because of their economic value, older siblings will have a negligible effect on young children's growth. Accounting for parental condition, we use linear mixed models to evaluate the effects that family size, younger and older siblings have on children's growth. Congruent with our expectations, it is younger siblings who have the most detrimental effect on children's growth. While we find statistical evidence of a quantity/quality tradeoff effect, the biological significance of these results is negligible in early childhood. Our findings help to resolve why quantity/quality studies have had inconsistent results by showing that sibling competition varies with sibling age composition, not just family size, and that biological significance is distinct from statistical significance.

  1. School attendance in childhood cancer survivors and their siblings.

    Science.gov (United States)

    French, Amy E; Tsangaris, Elena; Barrera, Maru; Guger, Sharon; Brown, Robert; Urbach, Stacey; Stephens, Derek; Nathan, Paul C

    2013-01-01

    To investigate school absenteeism among childhood cancer survivors and their siblings and examine factors related to absenteeism in survivors. A cross-sectional study was conducted among consecutive cancer survivors attending a large pediatric cancer survivor clinic. Absenteeism rates were obtained for survivors and their closest in age sibling from school report cards. Absenteeism was compared with a population control group of 167752 students using 1-sample t tests. The Child Vulnerability Scale, Pediatric Quality of Life Inventory, and Behavior Assessment System for Children were administered to survivors. Univariate and multiple regression analyses assessed variables associated with days absent. One hundred thirty-one survivors (median age at assessment: 13.4 years, range 8.0-19.2; median age at diagnosis: 9.4 years, range 4.3-17.3) and 77 siblings (median age at assessment: 13 years, age range 7-18) participated. Survivors and siblings missed significantly more school days than the population control group (mean ± SD: 9.6 ± 9.2 and 9.9 ± 9.8 vs 5.0 ± 5.6 days, respectively, P sibling pairs (N = 77), there was no difference in absenteeism (9.6 ± 9.2 vs 9.9 ± 9.8 days, P = .85). Absenteeism in survivors was significantly associated with a low Pediatric Quality of Life Inventory Physical Health Summary Score (P = .01). Parents' perception of their child's vulnerability and emotional and social functioning were not associated with absenteeism. Childhood cancer survivors and siblings miss more school than the general population. The only predictor of absenteeism in survivors is poor physical quality of health. More research should be devoted to school attendance and other outcomes in siblings of childhood cancer survivors. Copyright © 2013 Mosby, Inc. All rights reserved.

  2. Sibling Competition & Growth Tradeoffs. Biological vs. Statistical Significance.

    Directory of Open Access Journals (Sweden)

    Karen L Kramer

    Full Text Available Early childhood growth has many downstream effects on future health and reproduction and is an important measure of offspring quality. While a tradeoff between family size and child growth outcomes is theoretically predicted in high-fertility societies, empirical evidence is mixed. This is often attributed to phenotypic variation in parental condition. However, inconsistent study results may also arise because family size confounds the potentially differential effects that older and younger siblings can have on young children's growth. Additionally, inconsistent results might reflect that the biological significance associated with different growth trajectories is poorly understood. This paper addresses these concerns by tracking children's monthly gains in height and weight from weaning to age five in a high fertility Maya community. We predict that: 1 as an aggregate measure family size will not have a major impact on child growth during the post weaning period; 2 competition from young siblings will negatively impact child growth during the post weaning period; 3 however because of their economic value, older siblings will have a negligible effect on young children's growth. Accounting for parental condition, we use linear mixed models to evaluate the effects that family size, younger and older siblings have on children's growth. Congruent with our expectations, it is younger siblings who have the most detrimental effect on children's growth. While we find statistical evidence of a quantity/quality tradeoff effect, the biological significance of these results is negligible in early childhood. Our findings help to resolve why quantity/quality studies have had inconsistent results by showing that sibling competition varies with sibling age composition, not just family size, and that biological significance is distinct from statistical significance.

  3. Performance analysis of deciduous morphology for detecting biological siblings.

    Science.gov (United States)

    Paul, Kathleen S; Stojanowski, Christopher M

    2015-08-01

    Family-centered burial practices influence cemetery structure and can represent social group composition in both modern and ancient contexts. In ancient sites dental phenotypic data are often used as proxies for underlying genotypes to identify potential biological relatives. Here, we test the performance of deciduous dental morphological traits for differentiating sibling pairs from unrelated individuals from the same population. We collected 46 deciduous morphological traits for 69 sibling pairs from the Burlington Growth Centre's long term Family Study. Deciduous crown features were recorded following published standards. After variable winnowing, inter-individual Euclidean distances were generated using 20 morphological traits. To determine whether sibling pairs are more phenotypically similar than expected by chance we used bootstrap resampling of distances to generate P values. Multidimensional scaling (MDS) plots were used to evaluate the degree of clustering among sibling pairs. Results indicate an average distance between siblings of 0.252, which is significantly less than 9,999 replicated averages of 69 resampled pseudo-distances generated from: 1) a sample of non-relative pairs (P < 0.001), and 2) a sample of relative and non-relative pairs (P < 0.001). MDS plots indicate moderate to strong clustering among siblings; families occupied 3.83% of the multidimensional space on average (versus 63.10% for the total sample). Deciduous crown morphology performed well in identifying related sibling pairs. However, there was considerable variation in the extent to which different families exhibited similarly low levels of phenotypic divergence. © 2015 Wiley Periodicals, Inc.

  4. [Allogeneic vascularized transplantation in cases of bone and joint defects].

    Science.gov (United States)

    Hofmann, G O; Kirschner, M H; Gonschorek, O; Bühren, V

    1999-06-01

    This paper presents preliminary results of allogeneic vascularized transplantations of three femoral diaphyses and four total human knee joints. Grafts were harvested from multi-organ-donors and immediately transplanted. Osteosyntheses were performed employing intramedullary nails. Vascular pedicles of the grafts were anastomosed in end-to-side technique. Immunosuppression mainly based on Cyclosporine and Azathioprine. Grafts' perfusion was demonstrated by DSA and Duplex-sonograms, bone metabolism by SPECT-scintigraphy. Five months following transplantation osteotomies demonstrated consolidation in conventional X-rays. Biopsies of the grafted bone revealed intact osteocytes and arthroscopy demonstrated intact synovial, chondral and ligamentous structures. From the technical aspect vascularized transplantation of the femoral diaphyses and total knee joints is feasible. The main problems are of immunologic nature. Transplantations were performed respecting the ABO-compatibility but with a large HLA-mismatch. Acute and chronic rejection crises may damage the grafts. At least in synovial joints live-long immunosuppression of the recipients seems to be unavoidable.

  5. EXPERIENCE OF USING ALLOGENIC BIOIMPLANTS IN LARYNGEAL RESECTION

    Directory of Open Access Journals (Sweden)

    E. N. Novozhilova

    2017-01-01

    Full Text Available Introduction. Currently, a great importance is being attached to improvement of the surgical component of combination treatment of locally advanced laryngeal cancer. New technological capabilities (transoral microsurgery of the larynx and robotic surgery offer great opportunities for early cancer stages. However, in some cases capabilities of endoscopic laser intervention are limited. Therefore, open laryngeal resection is still relevant as it serves as the only type of radical organ preservation treatment for stages Т2–Т3. But major laryngeal resection is associated with a problem of tissue defect closure.The article describes data on the use of biocompatible materials, their advantages and disadvantages. The study objective is to present experience of using a Russian allogenic bioimplant for plastic reconstruction of the opening of the larynx after laryngeal resection.Materials and methods. The authors present their experience of using a Russian bioimplant produced in collaboration with the Samara Tissue Bank of the Research Institute of Experimental Medicine and Biotechnology of the Samara State Medical University. The material was tested in anterolateral laryngeal resection with simultaneous reconstruction in 5 patients with stages Т2–Т3 laryngeal cancer and in a patient with chondrosarcoma.Conclusion. The Russian biocompatible implant served as a reliable, simple, cheap, and effective variant of plastic material for reconstruction of the larynx.

  6. T cell reconstitution in allogeneic haematopoietic stem cell transplantation

    DEFF Research Database (Denmark)

    Kielsen, K; Jordan, K K; Uhlving, H H

    2015-01-01

    Infections and acute graft-versus-host disease (aGVHD) are major causes of treatment-related mortality and morbidity following allogeneic haematopoietic stem cell transplantation (HSCT). Both complications depend on reconstitution of the T-lymphocyte population based on donor T cells. Although...... it is well established that Interleukin-7 (IL-7) is a cytokine essential for de novo T cell development in the thymus and homoeostatic peripheral expansion of T cells, associations between circulating levels of IL-7 and T cell reconstitution following HSCT have not been investigated previously. We...... in patients treated with anti-thymocyte globulin (ATG) compared with those not treated with ATG (P = 0.0079). IL-7 levels at day +7 were negatively associated with T cell counts at day +30 to +60 (at day +60: CD3(+) : β = -10.6 × 10(6) cells/l, P = 0.0030; CD8(+) : β = -8.4 × 10(6) cells/l, P = 0.061; CD4...

  7. Pneumatosis intestinalis in children after allogeneic bone marrow transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Yeager, A M; Kanof, M E; Lake, A M; Kramer, S S; Jones, B; Saral, R; Santos, G W

    1987-01-01

    Four children, ages 3 to 8 years, developed pneumatosis intestinalis (PI) after allogeneic bone marrow transplantation (BMT) for acute leukemia or severe aplastic anemia. PI was detected at a median of 48 days (range, 10-63 days) after BMT and was associated with abdominal symptoms and clinical signs. All patients had severe systemic and/or highgrade cutaneous acute graft-versus-host disease (AGVHD) at some time after BMT and were receiving corticosteroids at the time of development of PI; however, PI was associated with concomitant severe AGVHD in only one patient. One patient with PI had Hafnia alvei bacteremia and another patient had gastroenteritis due to rotavirus and adenovirus. All patients were treated with supportive care and systemic broad-spectrum antibiotics, and PI resolved 2-16 days after onset. Two patients died with BMT-associated complications unrelated to PI. Multiple factors contribute to the development of PI after BMT, and the prognosis for recovery from PI is good with medical management alone. Overall survival in these patients is dependent on the frequency and severity of other conditions, such as AGVHD and opportunistic infections, after BMT.

  8. Allogenic banking of dental pulp stem cells for innovative therapeutics.

    Science.gov (United States)

    Collart-Dutilleul, Pierre-Yves; Chaubron, Franck; De Vos, John; Cuisinier, Frédéric J

    2015-08-26

    Medical research in regenerative medicine and cell-based therapy has brought encouraging perspectives for the use of stem cells in clinical trials. Multiple types of stem cells, from progenitors to pluripotent stem cells, have been investigated. Among these, dental pulp stem cells (DPSCs) are mesenchymal multipotent cells coming from the dental pulp, which is the soft tissue within teeth. They represent an interesting adult stem cell source because they are recovered in large amount in dental pulps with non-invasive techniques compared to other adult stem cell sources. DPSCs can be obtained from discarded teeth, especially wisdom teeth extracted for orthodontic reasons. To shift from promising preclinical results to therapeutic applications to human, DPSCs must be prepared in clinical grade lots and transformed into advanced therapy medicinal products (ATMP). As the production of patient-specific stem cells is costly and time-consuming, allogenic biobanking of clinical grade human leukocyte antigen (HLA)-typed DPSC lines provides efficient innovative therapeutic products. DPSC biobanks represent industrial and therapeutic innovations by using discarded biological tissues (dental pulps) as a source of mesenchymal stem cells to produce and store, in good manufacturing practice (GMP) conditions, DPSC therapeutic batches. In this review, we discuss about the challenges to transfer biological samples from a donor to HLA-typed DPSC therapeutic lots, following regulations, GMP guidelines and ethical principles. We also present some clinical applications, for which there is no efficient therapeutics so far, but that DPSCs-based ATMP could potentially treat.

  9. Pneumatosis intestinalis in children after allogeneic bone marrow transplantation

    International Nuclear Information System (INIS)

    Yeager, A.M.; Kanof, M.E.; Lake, A.M.; Kramer, S.S.; Jones, B.; Saral, R.; Santos, G.W.

    1987-01-01

    Four children, ages 3 to 8 years, developed pneumatosis intestinalis (PI) after allogeneic bone marrow transplantation (BMT) for acute leukemia or severe aplastic anemia. PI was detected at a median of 48 days (range, 10-63 days) after BMT and was associated with abdominal symptoms and clinical signs. All patients had severe systemic and/or highgrade cutaneous acute graft-versus-host disease (AGVHD) at some time after BMT and were receiving corticosteroids at the time of development of PI; however, PI was associated with concomitant severe AGVHD in only one patient. One patient with PI had Hafnia alvei bacteremia and another patient had gastroenteritis due to rotavirus and adenovirus. All patients were treated with supportive care and systemic broad-spectrum antibiotics, and PI resolved 2-16 days after onset. Two patients died with BMT-associated complications unrelated to PI. Multiple factors contribute to the development of PI after BMT, and the prognosis for recovery from PI is good with medical management alone. Overall survival in these patients is dependent on the frequency and severity of other conditions, such as AGVHD and opportunistic infections, after BMT. (orig.)

  10. Sibling Relationships and Adolescent Adjustment: Longitudinal Associations in Two-Parent African American Families.

    Science.gov (United States)

    Whiteman, Shawn D; Solmeyer, Anna R; McHale, Susan M

    2015-11-01

    Sibling relationships have been described as love-hate relationships by virtue of their emotional intensity, but we know little about how sibling positivity and negativity operate together to affect youth adjustment. Accordingly, this study charted the course of sibling positivity and negativity from age 10 to 18 in African American sibling dyads and tested whether changes in relationship qualities were linked to changes in adolescents' internalizing and externalizing behaviors. Participants were consecutively-born siblings [at Time 1, older siblings averaged 14.03 (SD = 1.80) years of age, 48 % female; younger siblings averaged 10.39 (SD = 1.07) years of age, 52 % female] and two parents from 189 African American families. Data were collected via annual home interviews for 3 years. A series of multi-level models revealed that sibling positivity and sibling negativity declined across adolescence, with no significant differences by sibling dyad gender constellation. Controlling for age-related changes as well as time-varying parent-adolescent relationship qualities, changes in sibling negativity, but not positivity, were positively related to changes in adolescents' depressive symptoms and risky behaviors. Like parent-adolescent relationships, sibling relationships displayed some distancing across adolescence. Nevertheless, sibling negativity remained a uniquely important relational experience for African American adolescents' adjustment.

  11. Sibling relationship quality and Mexican-origin adolescents' and young adults' familism values and adjustment

    Science.gov (United States)

    Killoren, Sarah E.; De Jesús, Sue A. Rodríguez; Updegraff, Kimberly A.; Wheeler, Lorey A.

    2015-01-01

    We examined profiles of sibling relationship qualities in 246 Mexican-origin families living in the United States using latent profile analyses. Three profiles were identified: Positive, Negative and Affect-Intense. Links between profiles and youths’ familism values and adjustment were assessed using longitudinal data. Siblings in the Positive profile reported the highest familism values, followed by siblings in the Affect-Intense profile and, finally, siblings in the Negative profile. Older siblings in the Positive and Affect-Intense profiles reported fewer depressive symptoms than siblings in the Negative profile. Further, in the Positive and Negative profiles, older siblings reported less involvement in risky behaviors than younger siblings. In the Negative profile, younger siblings reported greater sexual risk behaviors in late adolescence than older siblings; siblings in opposite-sex dyads, as compared to same-sex dyads, engaged in riskier sexual behaviors. Our findings highlight sibling relationship quality as promotive and risky, depending on sibling characteristics and adjustment outcomes. PMID:28239217

  12. Changes in siblings after the death of a child from cancer.

    Science.gov (United States)

    Foster, Terrah L; Gilmer, Mary Jo; Vannatta, Kathryn; Barrera, Maru; Davies, Betty; Dietrich, Mary S; Fairclough, Diane L; Gerhardt, Cynthia A

    2012-01-01

    Few studies have examined changes in siblings after the death of a brother or sister, particularly from mother, father, and sibling perspectives within the first year after death. This descriptive study identified and assessed the frequency of changes in siblings after a child's death from cancer. Participants were recruited from cancer registries at 3 hospitals in the United States and Canada 3 to 12 months after the child's death. Thirty-six mothers, 24 fathers, and 39 siblings from 40 families were included. Semistructured interviews using open-ended questions were conducted with each parent and sibling separately in the home. Content analysis identified emerging themes, and the McNemar tests compared frequencies between each paired set of reports (sibling vs mother, sibling vs father, mother vs father). Sixty-nine percent of participants reported personal changes in siblings (eg, changes in personality, school work, goals/life perspective, activities/interests). Forty-seven percent noted changes in siblings' relationships with family members and peers. Only 21% of participants reported no changes attributed to the death. Comparisons of frequencies across informants were not significant. Most siblings experienced changes in multiple areas of their lives after the death of a brother or sister to cancer. Some changes reflected siblings that were positively adapting to the death, whereas other changes reflected difficulties. Our findings offer guidance to improve aftercare for bereaved siblings and their families. Additional research is needed to further delineate the needs of bereaved siblings and to develop strategies to promote adaptation to loss.

  13. Emotional Experiences Among Siblings of Children With Rare Disorders.

    Science.gov (United States)

    Haukeland, Yngvild B; Fjermestad, Krister W; Mossige, Svein; Vatne, Torun M

    2015-08-01

    This research aimed to provide new knowledge about the emotional experiences of siblings of children with rare disorders. Qualitative thematic analysis was conducted based on videotapes of 11 support groups for 58 siblings aged 7-17 years (Mage = 11.4 years, SD = 2.4) of children with rare disorders. Participants described contradictory emotions in three main contexts: (1) implications of the disorder (knowledge, medical issues, prognosis); (2) consequences for family life (practical implications, limitations of the child with disorder, perspectives on the sibling relationship); and (3) consequences for social life (reflections about (ab)normality, reactions from others). Passive coping strategies were frequently described relative to active coping strategies. An emerging dilemma for participants was hiding versus sharing emotional experiences. Siblings' emotional experiences are characterized by diverse and contradictory feelings. Interventions to promote emotional health in siblings of children with rare disorder should address this complexity. © The Author 2015. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  14. Birth spacing, sibling rivalry and child mortality in India.

    Science.gov (United States)

    Whitworth, Alison; Stephenson, Rob

    2002-12-01

    The detrimental impact of short preceding birth intervals on infant and early childhood mortality is well documented in demographic literature, although the pathways of influence within the relationship remain an area of debate. This paper examines the impact of the length of the preceding birth interval on under-two mortality in India, and examines the pathways through which short preceding birth intervals may lead to an increased risk of mortality. Three mortality periods are examined: neonatal, early post neonatal and late post-neonatal and toddler, using the 1992 Indian National Family Health Survey. A multilevel modelling approach is used to account for the hierarchical nature of the data. The determinants of infants following a short or long birth interval are also examined. The results show that short preceding birth intervals (sibling rivalry is a pathway through which short birth intervals influence mortality, with the death of the previous sibling removing the competition for scarce resources, and resulting in lower risks of mortality than if the previous sibling was still alive. The greatest risks of an infant following a short birth interval are among those whose previous sibling died, high parities, those with young mothers, and those whose previous sibling was breastfed for a short duration. Copyright 2002 Elsevier Science Ltd.

  15. Sibling rivalry: training effects, emergence of dominance and incomplete control.

    Science.gov (United States)

    Benhaiem, Sarah; Hofer, Heribert; Kramer-Schadt, Stephanie; Brunner, Edgar; East, Marion L

    2012-09-22

    Within-brood or -litter dominance provides fitness-related benefits if dominant siblings selfishly skew access to food provided by parents in their favour. Models of facultative siblicide assume that dominants exert complete control over their subordinate sibling's access to food and that control is maintained, irrespective of the subordinate's hunger level. By contrast, a recent functional hypothesis suggests that subordinates should contest access to food when the cost of not doing so is high. Here, we show that within spotted hyena (Crocuta crocuta) twin litters, dominants most effectively skew access to maternal milk in their favour when their aggression prompts a highly submissive response. When hungry, subordinates were less submissive in response to aggression, thereby decreasing lost suckling time and increasing suckling time lost by dominants. In a species where adult females socially dominate adult males, juvenile females were more often dominant than males in mixed-sex litters, and subordinate sisters used more effective counter-tactics against dominant brothers than subordinate brothers against dominant sisters. Our results provide, to our knowledge, the first evidence in a mammal that dominant offspring in twin litters do not exert complete control over their sibling's access to resources (milk), and that sibling dominance relationships are influenced by sibling sex and training effects.

  16. A standardized multidisciplinary approach reduces the use of allogeneic blood products in patients undergoing cardiac surgery.

    Science.gov (United States)

    Van der Linden, P; De Hert, S; Daper, A; Trenchant, A; Jacobs, D; De Boelpaepe, C; Kimbimbi, P; Defrance, P; Simoens, G

    2001-10-01

    Individual and institutional practices remain an independent predictor factor for allogeneic blood transfusion. Application of a standardized multidisciplinary transfusion strategy should reduce the use of allogeneic blood transfusion in major surgical patients. This prospective non randomized observational study evaluated the effects of a standardized multidisciplinary transfusion strategy on allogeneic blood products exposure in patients undergoing non-emergent cardiac surgery. The developed strategy involved a standardized blood conservation program and a multidisciplinary allogeneic blood transfusion policy based mainly on clinical judgement, not only on a specific hemoglobin concentration. Data obtained in a first group including patients operated from September 1997 to August 1998 (Group pre: n=321), when the transfusion strategy was progressively developed, were compared to those obtained in a second group, including patients operated from September 1998 to August 1999 (Group post: n=315) when the transfusion strategy was applied uniformly. Patient populations and surgical procedures were similar. Patients in Group post underwent acute normovolemic hemodilution more frequently, had a higher core temperature at arrival in the intensive care unit and presented lower postoperative blood losses at day one. Three hundred forty units of packed red blood cells were transfused in 33% of the patients in Group pre whereas 161 units were transfused in 18% of the patients in Group post (P <0.001). Pre- and postoperative hemoglobin concentrations, mortality and morbidity were not different among groups. Development of a standardized multidisciplinary transfusion strategy markedly reduced the exposure of cardiac surgery patients to allogeneic blood.

  17. Sibling Group Play Therapy: An Effective Alternative with an Elective Mute Child.

    Science.gov (United States)

    Barlow, Karen; And Others

    1986-01-01

    Presents the case study of an elective mute child. Describes the effects of sibling play therapy and lists implications for school counselors who might use group or sibling play therapy in their developmental guidance programs. (ABB)

  18. Siblings of children with cystic fibrosis: quality of life and the impact of illness.

    Science.gov (United States)

    Havermans, T; Wuytack, L; Deboel, J; Tijtgat, A; Malfroot, A; De Boeck, C; Proesmans, M

    2011-03-01

    To asses self-reported quality of life (QoL) and perception of impact of illness on siblings of children with cystic fibrosis (CF). The Child Health Questionnaire was used to assess QoL. The Sibling Perception Questionnaire was used to assess impact of illness. Siblings of children with CF (n= 39) rated their QoL higher than siblings of healthy children on most QoL domains (e.g. Physical Functioning, Behavior, Mental Health). Siblings older than the child with CF reported a higher impact of CF than younger siblings. Perceived impact of illness was higher when the child with CF had been hospitalized or was intermittent or chronically infected with Pseudomonas aeruginosa. Siblings of children with CF reported a good QoL. QoL and impact of illness were related to indices of CF severity. Insight into sibling-issues helps CF teams to provide family-oriented care. © 2010 Blackwell Publishing Ltd.

  19. [Application of Multiple Genetic Markers in a Case of Determination of Half Sibling].

    Science.gov (United States)

    Yang, Xue; Shi, Mei-sen; Yuan, Li; Lu, Di

    2016-02-01

    A case of half sibling was determined with multiple genetic markers, which could be potentially applied for determination of half sibling relationship from same father. Half sibling relationship was detected by 39 autosomal STR genetic markers, 23 Y-chromosomal STR genetic markers and 12 X -chromosomal STR genetic markers among ZHAO -1, ZHAO -2, ZHAO -3, ZHAO -4, and ZHAO-5. According to autosomal STR, Y-STR and X-STR genotyping results, it was determined that ZHAO-4 (alleged half sibling) was unrelated with ZHAO-1 and ZHAO-2; however, ZHAO-3 (alleged half sibling), ZHAO-5 (alleged half sibling) shared same genetic profile with ZHAO-1, and ZHAO-2 from same father. It is reliable to use multiple genetic markers and family gene reconstruction to determine half sibling relationship from same father, but it is difficult to determination by calculating half sibling index with ITO and discriminant functions.

  20. Still the Favorite? Parents’ Differential Treatment of Siblings Entering Young Adulthood

    Science.gov (United States)

    Siennick, Sonja E.

    2013-01-01

    This study examined within-family stability in parents’ differential treatment of siblings from adolescence to young adulthood and the effect of differential treatment in young adulthood on grown siblings’ relationship quality. The author used longitudinal data on parent – child and sibling relations from the sibling sample of the National Longitudinal Study of Adolescent Health (N = 1,470 sibling dyads). Within-dyad fixed effects regression models revealed that the adolescent sibling who was closer to parents went on to be the young adult sibling who was closer to and received more material support from parents. Results from an actor – partner interdependence model revealed that differential parental financial assistance of young adult siblings predicted worse sibling relationship quality. These findings demonstrate the lasting importance of affect between parents and offspring earlier in the family life course and the relevance of within-family inequalities for understanding family relations. PMID:24244050

  1. Searching for solar siblings among the HARPS data

    Science.gov (United States)

    Batista, S. F. A.; Adibekyan, V. Zh.; Sousa, S. G.; Santos, N. C.; Delgado Mena, E.; Hakobyan, A. A.

    2014-04-01

    The search for solar siblings has been particularly fruitful in the past few years. At present, there are four plausible candidates reported in the literature: HIP21158, HIP87382, HIP47399, and HIP92831. In this study we conduct a search for solar siblings among the HARPS high-resolution FGK dwarfs sample, which includes precise chemical abundances and kinematics for 1111 stars. Using a new approach based on chemical abundance trends with condensation temperature, kinematics, and ages we found one (additional) potential solar sibling candidate: HIP97507. Based on observations collected at the La Silla Paranal Observatory, ESO (Chile) with the HARPS spectrograph at the 3.6-m telescope (ESO runs ID 72.C-0488, 082.C-0212, and 085.C-0063).

  2. Overweight in Singletons Compared to Children with Siblings

    DEFF Research Database (Denmark)

    Hunsberger, Monica; Formisano, Annarita; Reisch, Lucia

    2012-01-01

    and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS (IDEFICS). The present analysis is based on measured anthropometry and parent or guardian-reported socio-demographic characteristics. Subjects include 12 720 children aged 2–9 years for whom number of siblings was known......The aim of this study was to compare the prevalence of overweight in only children to those with siblings and to explore potential behavioral mediating factors. This study relies upon cross-sectional data collected at survey centers in eight European countries participating in Identification....... Singletons were more likely (odds ratio 1.52, 95% confidence interval (CI):1.34–1.72) to be overweight than their peers with siblings when controlling for factors related to childhood overweight, including survey country, parental education, parental weight, maternal age, child's age, birth weight and gender...

  3. Class Origin and Sibling Similarities in Long-run Income

    DEFF Research Database (Denmark)

    Andrade, Stefan Bastholm

    2016-01-01

    Sibling correlations have gained increasing prominence in inequality studies as a Measurement of the total impact of family background on individual outcomes. Whilst previous studies have tended to use traditional socio-economic measures such as parent’s income or education, this paper introduces......’ education and income – include modifications of the Erikson–Goldthorpe–Portocarero schemes ranging from 3 to 15 classes and Grusky’s microclass scheme of 72 classes. The results show that although class adds to explanations of the family influence on children’s income, most of the sibling similarities...... are not explained by parental education, income or class. Depending on gender, the class schemes explain between 8 and 13 per cent of the sibling similarities and 15 to 20 per cent when parents’ income and educations are also included. Models with different class schemes demonstrate that elaborated versions...

  4. Dynamic and heterogeneous effects of sibling death on children's outcomes.

    Science.gov (United States)

    Fletcher, Jason; Vidal-Fernandez, Marian; Wolfe, Barbara

    2018-01-02

    This paper explores the effects of experiencing the death of a sibling on children's developmental outcomes. Recent work has shown that experiencing a sibling death is common and long-term effects are large. We extend understanding of these effects by estimating dynamic effects on surviving siblings' cognitive and socioemotional outcomes, as well as emotional and cognitive support by parents. Using the Children of the National Longitudinal Survey of Youth 1979 (CNLSY79), we find large initial effects on cognitive and noncognitive outcomes that decline over time. We also provide evidence that the effects are larger if the surviving child is older and less prominent if the deceased child was either disabled or an infant, suggesting sensitive periods of exposure. Auxiliary results show that parental investments in the emotional support of surviving children decline following the death of their child.

  5. Upset in response to a Sibling's partner's infidelities.

    Science.gov (United States)

    Michalski, Richard L; Shackelford, Todd K; Salmon, Catherine A

    2007-03-01

    Using data collected from people with at least one brother and one sister, and consistent with an evolutionary perspective, we find that older men and women (a) are more upset by a brother's partner's sexual infidelity than by her emotional infidelity and (b) are more upset by a sister's partner's emotional infidelity than by his sexual infidelity. There were no effects of participant sex or sex of in-law on upset over a sibling's partner's infidelities, but there was an effect of participant sex on reports of upset over one's own partner's infidelities. The results suggest that the key variable among older participants is the sex of the sibling or, correspondingly, the sex of the sibling's partner, as predicted from an evolutionary analysis of reproductive costs, and not the sex of the participant, as predicted from a socialization perspective. Discussion offers directions for future work on jealousy.

  6. In Silico Derivation of HLA-Specific Alloreactivity Potential from Whole Exome Sequencing of Stem Cell Transplant Donors and Recipients: Understanding the Quantitative Immunobiology of Allogeneic Transplantation

    Directory of Open Access Journals (Sweden)

    Max eJameson-Lee

    2014-11-01

    Full Text Available Donor T cell mediated graft versus host effects (GVH may result from the aggregate alloreactivity to minor histocompatibility antigens (mHA presented by the HLA molecules in each donor-recipient pair undergoing stem cell transplantation (SCT. Whole exome sequencing has previously demonstrated a large number of nonsynonymous single nucleotide polymorphisms (SNP present in HLA-matched recipients of SCT donors (GVH direction. The nucleotide sequence flanking each of these SNPs was obtained and the amino acid sequence determined. All the possible nonameric-peptides incorporating the variant amino acid resulting from these SNPs were interrogated in-silico for their likelihood to be presented by the HLA class I molecules using the Immune Epitope Database stabilized matrix method (SMM and NetMHCpan algorithms. The SMM algorithm predicted that a median of 18,396 peptides weakly bound HLA class I molecules in individual SCT recipients, and 2,254 peptides displayed strong binding. A similar library of presented peptides was identified when the data was interrogated using the NetMHCpan algorithm. The bioinformatic algorithm presented here demonstrates that there may be a high level of mHA variation in HLA-matched individuals, constituting an HLA-specific alloreactivity potential.

  7. “Life Still Isn't Fair”: Parental Differential Treatment of Young Adult Siblings

    OpenAIRE

    Jensen, Alexander C.; Whiteman, Shawn D.; Fingerman, Karen L.; Birditt, Kira S.

    2013-01-01

    Parental differential treatment has been linked to individual well-being and sibling relationship quality in childhood, adolescence, and middle adulthood, but has not been examined in young adulthood. Data were collected from 151 pairs of young adult siblings (N = 302, Mean age = 23.90, SD = 5.02). Two siblings in each family reported on treatment from mothers and fathers, depressive symptoms, and sibling relationship quality. Using multi-level modeling, analyses examined the role of favoriti...

  8. Incidence of Urinary Tract Infection Among Siblings of Children With Vesicoureteral Reflux.

    Science.gov (United States)

    Nelson, Caleb P; Finkelstein, Jonathan A; Logvinenko, Tanya; Schuster, Mark A

    2016-07-01

    Siblings of children with vesicoureteral reflux (VUR) are at elevated risk of VUR. Screening siblings may identify VUR before a clinical illness such as a urinary tract infection (UTI), but the benefit of screening has not been demonstrated. We sought to determine the incidence of UTI among siblings, and we hypothesized that the sibling UTI rate is similar between screened and unscreened siblings. We performed a retrospective cohort analysis using insurance claims data (January 1, 2000, to December 31, 2009). Within each family, we identified the index VUR patient and siblings; we included siblings who were enrolled in the insurance plan from birth for at least 1 year. We identified siblings who were screened for VUR and/or had UTI. We investigated the association of screening and UTI, controlling for patient characteristics and clustering within families. Among 617 siblings (associated with 497 index patients), 317 (51%) were girls. Median insurance enrollment time was 53.0 months, with 424 enrolled ≥3 years. Among those with 1 or 3 years of enrollment, the proportions of siblings who experienced UTI was 8.4% (52 of 617) and 10.4% (44 of 424), respectively. Median age at initial UTI was 32.7 months. A total of 223 siblings (36.0%) underwent sibling screening. There was no significant difference in UTI between screened and unscreened siblings (odds ratio 1.57, 95% confidence interval 0.87-2.85; P = .14). In multivariate analysis, screening was not associated with sibling UTI incidence (odds ratio 1.33, 95% confidence interval 0.68-2.60; P = .40). Although UTI is relatively common among siblings of VUR patients, there was no statistically significant difference in UTI incidence between screened and unscreened siblings. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  9. Patterns and Predictors of Anxiety among Siblings of Children with Autism Spectrum Disorders

    OpenAIRE

    Shivers, Carolyn M.; Deisenroth, Lauren K.; Taylor, Julie Lounds

    2013-01-01

    The purpose of this study was to examine patterns of anxiety among siblings of children with autism spectrum disorders (ASD), and determine the characteristics of the child with ASD and their parents that predicted anxiety. Data was collected from 1755 siblings of children with ASD whose families participated in the Simons Simplex Collection; siblings ranged in age from 3 to 18 years (M=9 years). Male siblings were at increased risk for sub-clinical anxiety problems during middle childhood. P...

  10. The experiences of living with a sibling who stutters: a preliminary study.

    Science.gov (United States)

    Beilby, Janet M; Byrnes, Michelle L; Young, Kate N

    2012-06-01

    Stuttering impacts on the child in a variety of ways, notably in terms of communicative impairment and psychosocial impact. In addition, the stuttering disorder has a holistic impact, affecting those with whom the child who stutters lives. Within the family constellation, the closest person to the individual who stutters is often their sibling. This study investigated the experiences of fluent siblings of children who stutter to examine the impact that stuttering may have on their lives. A mixed methods research design incorporated qualitative semi-structured interviews and quantitative questionnaires. The results of the qualitative investigation revealed four aspects of children's lives that were affected by having a sibling who stuttered: the relationship between siblings, the impact on the fluent sibling, the impact on the parent relationship with both children, and the impact on the sibling's relationship with others. Findings revealed that siblings of children who stutter exhibited strongly negative emotions, and differing levels of responsibility associated with their involvement in the actual stuttering management programme. Furthermore, for the fluent sibling, secondary to having a brother or sister who stuttered, communication with and attention from their parents was variable. The results of the quantitative component of the study revealed children who stutter and their siblings demonstrated significantly greater closeness, and concurrently, increased conflict and status disparity than did the control fluent sibling dyads. The parents of the experimental sibling dyads also demonstrated significantly greater partiality towards a child, namely the child who stuttered, than did the parents of the control sibling dyads. The reader will be able to: (1) identify the themes associated with having a sibling who stutters; (2) identify how the quality of the sibling relationship differs between sibling dyads that do and do not consist of a sibling who stutters; and

  11. Sibling Relationships and Adolescent Adjustment: Longitudinal Associations in Two-Parent African American Families

    OpenAIRE

    Whiteman, Shawn D.; Solmeyer, Anna R.; McHale, Susan M.

    2015-01-01

    Sibling relationships have been described as love-hate relationships by virtue of their emotional intensity, but we know little about how sibling positivity and negativity operate together to affect youth adjustment. Accordingly, this study charted the course of sibling positivity and negativity from age 10 to 18 in African American sibling dyads and tested whether changes in relationship qualities were linked to changes in adolescents’ internalizing and externalizing behaviors. Participants ...

  12. A dyadic analysis of siblings' relationship quality, behavioural responses, and pain experiences during experimental pain.

    Science.gov (United States)

    Schinkel, Meghan G; Chambers, Christine T; Corkum, Penny; Jacques, Sophie

    2018-04-16

    Research on family factors in paediatric pain has primarily focused on parents; the role of siblings has been largely ignored. This study examined whether sibling relationship quality was related to siblings' behaviours during experimental pain, and whether the behaviours of an observing sibling were related to children's pain outcomes. Ninety-two sibling dyads between 8-12 years old completed both observational and questionnaire measures of sibling relationship quality. Children took turns completing the cold pressor task (CPT) in a counterbalanced order with their sibling present. Pain outcomes (intensity, fear, tolerance) were recorded for each sibling, and the behaviour of the observing and participating siblings during the CPT were coded as attending, non-attending, and coping/encouragement. Structural equation modelling, using the actor-partner interdependence model, was conducted to analyse the dyadic data. While participating in the CPT with their sibling present, greater levels of warmth and positivity in the sibling relationship were related to children engaging in more non-attending behaviours and less attending behaviours. Greater levels of attending behaviours by the observing child was related to the sibling having a lower pain tolerance, and greater levels of coping/encouragement behaviours by the observing child was related to the sibling reporting greater pain intensity and fear during the CPT. Children with warmer/positive sibling relationships were more likely to respond to acute pain by shifting the focus away from their pain experience (e.g., through distraction) when a sibling was present. Pain-focused behaviours by an observing sibling are related to greater child pain and fear during experimental pain.

  13. Complexities of sibling analysis when exposures and outcomes change with time and birth order

    OpenAIRE

    Sudan, M; Kheifets, LI; Arah, OA; Divan, HA; Olsen, J

    2014-01-01

    In this study, we demonstrate the complexities of performing a sibling analysis with a re-examination of associations between cell phone exposures and behavioral problems observed previously in the Danish National Birth Cohort. Children (52,680; including 5441 siblings) followed up to age 7 were included. We examined differences in exposures and behavioral problems between siblings and non-siblings and by birth order and birth year. We estimated associations between cell phone exposures and b...

  14. Long-term outcomes among older patients following nonmyeloablative conditioning and allogeneic hematopoietic cell transplantation for advanced hematologic malignancies

    DEFF Research Database (Denmark)

    Sorror, Mohamed L; Sandmaier, Brenda M; Storer, Barry E

    2011-01-01

    A minimally toxic nonmyeloablative regimen was developed for allogeneic hematopoietic cell transplantation (HCT) to treat patients with advanced hematologic malignancies who are older or have comorbid conditions.......A minimally toxic nonmyeloablative regimen was developed for allogeneic hematopoietic cell transplantation (HCT) to treat patients with advanced hematologic malignancies who are older or have comorbid conditions....

  15. DAS181 Treatment of Severe Parainfluenza Virus 3 Pneumonia in Allogeneic Hematopoietic Stem Cell Transplant Recipients Requiring Mechanical Ventilation

    Directory of Open Access Journals (Sweden)

    B. Dhakal

    2016-01-01

    Full Text Available Parainfluenza virus (PIV may cause life-threatening pneumonia in allogeneic hematopoietic stem cell transplant (HSCT recipients. Currently, there are no proven effective therapies. We report the use of inhaled DAS181, a novel sialidase fusion protein, for treatment of PIV type 3 pneumonia in two allogeneic hematopoietic SCT recipients with respiratory failure.

  16. Body Talk: Siblings' Use of Positive and Negative Body Self-Disclosure and Associations with Sibling Relationship Quality and Body-Esteem.

    Science.gov (United States)

    Greer, Kelly Bassett; Campione-Barr, Nicole; Lindell, Anna K

    2015-08-01

    The sibling relationship has been deemed the quintessential "love-hate relationship." Sibling relationships have also been found to have both positive and negative impacts on the adjustment of youth. Unlike previous research, however, the present study examined the associations between siblings' positive and negative body-related disclosures with relationship quality and body-esteem. Additionally, ordinal position, individual sex, and sibling sex composition were tested as moderators. Participants included 101 predominantly White and middle class adolescent sibling dyads (54 % female adolescents, with relatively equal sibling gender compositions). Older siblings were, on average, 16.46 (SD = 1.35) years old with younger siblings an average of 13.67 (SD = 1.56) years. Adolescents completed questionnaires and data were analyzed using Actor-Partner Interdependence Modeling, which focused on disclosure to and from dyad members. In general, sibling body-related disclosure was positive for the quality of the sibling relationship, regardless of the valance of disclosure. Also, adolescents' body esteem was greater when adolescents reported disclosing (i.e., actor-effects) about positive or negative body issues to their siblings (particularly for females). Conversely, when adolescents received positive or negative body-related disclosures from their siblings (i.e., partner-effects), adolescents reported lower levels of body esteem (particularly for girls and younger siblings). Thus, the impact of body-related disclosure on adolescents' feelings of body esteem appear to be associated more with whether they are the discloser or the one being disclosed to, while the impact on the quality of the relationship has simply more to do with whether or not they are generally disclosing to one another.

  17. Adolescents' experiences of having a stillborn half-sibling.

    Science.gov (United States)

    Avelin, Pernilla; Gyllenswärd, Göran; Erlandsson, Kerstin; Rådestad, Ingela

    2014-01-01

    Although there is an increasing interest in siblings' experiences of loss and grief there is limited knowledge of adolescent's own perspectives, especially in a unique situation as after stillbirth in a reconstituted family. The authors interviewed 13 bereaved adolescents. They were sad that their family was not the same and expressed feelings of being inside family grief, yet outside, because they did not have full access in their reconstituted family. An implication of present findings is that it is important to include all the members of the family in the grieving process, even half-siblings of the deceased child.

  18. Books for siblings of children having illness or disability.

    Science.gov (United States)

    Ahmann, E

    1997-01-01

    A child's disability or acute or chronic illness has an effect on all family members, including siblings of the affected child. Children's books, fiction and non-fiction, can be used to support siblings by providing information, addressing feelings, offering insight, assuring the child that others have had similar problems, and facilitating coping. Nurses can introduce children and their families to useful books by having books or book covers on display that the child can choose from; providing families with lists of books; and/or assessing the child's needs, interests and reading level, and recommending a specific title.

  19. Sibling jealousy and aesthetic ambiguity in Austen's Pride and Prejudice.

    Science.gov (United States)

    Hanly, Margaret Ann Fitzpatrick

    2009-04-01

    Jane Austen's most popular novel, Pride and Prejudice (1813), illuminates and is illuminated by psychoanalytic aesthetics. When Austen dramatizes unconscious oedipal/sibling rivalries, irony acts as a type of aesthetic ambiguity (E. Kris 1952). A psychoanalytic perspective shows that Austen uses a grammar of negatives (negation, denial, minimization) to achieve the dual meanings of irony, engaging the reader's unconscious instinctual satisfactions, while at the same time protecting the reader from unpleasant affects. Austen's plot, which portrays regressions driven by sibling jealousy, reveals that a new tolerance of remorse and depression in her heroine and hero leads to psychic growth.

  20. Allogenic sedimentary components of Bear Lake, Utah and Idaho

    Science.gov (United States)

    Rosenbaum, J.G.; Dean, W.E.; Reynolds, R.L.; Reheis, M.C.

    2009-01-01

    Bear Lake is a long-lived lake filling a tectonic depression between the Bear River Range to the west and the Bear River Plateau to the east, and straddling the border between Utah and Idaho. Mineralogy, elemental geochemistry, and magnetic properties provide information about variations in provenance of allogenic lithic material in last-glacial-age, quartz-rich sediment in Bear Lake. Grain-size data from the siliciclastic fraction of late-glacial to Holocene carbonate-rich sediments provide information about variations in lake level. For the quartz-rich lower unit, which was deposited while the Bear River fl owed into and out of the lake, four source areas are recognized on the basis of modern fluvial samples with contrasting properties that reflect differences in bedrock geology and in magnetite content from dust. One of these areas is underlain by hematite-rich Uinta Mountain Group rocks in the headwaters of the Bear River. Although Uinta Mountain Group rocks make up a small fraction of the catchment, hematite-rich material from this area is an important component of the lower unit. This material is interpreted to be glacial fl our. Variations in the input of glacial flour are interpreted as having caused quasi-cyclical variations in mineralogical and elemental concentrations, and in magnetic properties within the lower unit. The carbonate-rich younger unit was deposited under conditions similar to those of the modern lake, with the Bear River largely bypassing the lake. For two cores taken in more than 30 m of water, median grain sizes in this unit range from ???6 ??m to more than 30 ??m, with the coarsest grain sizes associated with beach or shallow-water deposits. Similar grain-size variations are observed as a function of water depth in the modern lake and provide the basis for interpreting the core grain-size data in terms of lake level. Copyright ?? 2009 The Geological Society of America.