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Neutropenia postchemotherapy is associated with favorable outcomes, which was attributed to optimal dosing. However, little is known about the neutrophil decline rate as a predictor of cancer outcomes, which may reflect a dynamic marker of chemosensitivity. We assessed the association between the neutrophil decline rate and disease outcomes in a known cohort of 212 lymphoma patients, treated with thiotepa, etoposide, cyclophosphamide, cytarabine, and melphalan (TECAM) conditioning followed by autologous transplant in our center between 2000 and 2013. Slower neutrophil decline rate was correlated with worse overall survival, mediated not by shorter time to progression (TTP), but rather by worse survival post-progression, possibly pointing to chemosensitivity at each line of therapy as the responsible mechanism. The effect was seen across histologies and was independent of stronger predictors of outcome like performance status (PS) and response before transplant. Prospective research is needed to confirm our results and expand their validity to other clinical scenarios.

Introduction: Thalassemia major (TM) is an inherited disorder caused by ineffective erythropoiesis. At the present time, allogeneic stem cell transplantation (allo-SCT) is a curative option. Conventional busulfan and cyclophosphamide based myeloablative conditioning regimens are limited by increased toxicity, especially in high-risk patients. Replacement of cyclophosphamide with fludarabine has reduced toxicity and nonrelapse mortality (NRM), thus improving outcomes. We analyzed long-term data of our fludarabine-based myeloablative, reduced toxicity protocol, specifically in high-risk patients., Methods: We retrospectively analyzed a cohort of 47 consecutive patients with TM undergoing allo-SCT from matched donors, using the fludarabine-based regimen (reduced toxicity regimen). The median age of the cohort was 10 years. Thirty-eight patients (80%) were in the high-risk and nine patients (20%) were in the low-risk category. The primary aim of this analysis was thalassemia-free survival (TFS)., Results: The rejection rate was 11% within high-risk patients with NRM of 2%. With a median follow-up period of 7 years (1-15 years), the 10-year TFS in the entire cohort was 87%, and the overall survival (OS) was 97%. The 10-year TFS and OS among the low-risk and high-risk groups were 90% versus 84%, respectively (P = 0.45) and 100% versus 96%, respectively (P = 0.5), and both subsets of patients did equally well., Conclusion: In conclusion, replacement of high-dose cyclophosphamide with fludarabine is well tolerated with minimal regimen-related toxicity and acceptable rejection rates, especially in high-risk patients., (© 2018 Wiley Periodicals, Inc.)

Background: Prenatal education has many benefits to both mother and child. In Israel, prenatal classes are offered to pregnant women in their third trimester from all cultures and sectors. However, Israeli Muslim Arab women often do not attend these classes., Aim: To explore factors influencing the intention of Muslim Arab women in Israel to attend prenatal classes, using the Theory of Planned Behavior., Methods: The study was a cross-sectional quantitative correlational design. A convenience sample consisting of 200 Arab Muslim women completed a questionnaire based on the literature review and the theoretical model., Findings: The research findings indicate that women's intention to attend prenatal classes increases with more positive beliefs and attitudes toward prenatal education, greater subjective social pressure to attend classes, and with higher perceived control of attending such classes. The higher a woman's age and level of education, the greater her intention to attend classes. This study shows that the spouse is the most significant factor influencing women's decisions on this matter., Conclusion: In order to raise the intentions of Muslim Arab women in Israel to attend prenatal classes, policy makers must design programs to increase the awareness of prenatal education among both women and men in the Muslim Arab sector, emphasizing its benefits for mothers, infants, and families as a whole. Classes should reflect the uniqueness of Israeli Muslim Arab culture and combine traditional and modern outlooks., (Copyright © 2015 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.)