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Classic Hodgkin lymphoma (cHL) patients with relapsed or refractory disease may benefit from allogeneic hematopoietic cell transplantation (allo-HCT), but many lack a matched sibling donor (MSD). Herein, we compare outcomes of 2 reduced-intensity conditioning (RIC) Ha platforms in cHL: T cell-replete related donor haploidentical (haplo) HCT with a post-transplant cyclophosphamide (PTCy)-based approach versus an MSD/calcineurin inhibitor (CNI)-based approach. The study included 596 adult patients who underwent a first RIC allo-HCT for cHL between 2008 and 2016 using either a haplo-PTCy (n = 139) or MSD/CNI-based (n = 457) approach. Overall survival (OS) was the primary endpoint. Secondary endpoints included acute graft-versus-host disease (aGVHD) and chronic GVHD (cGVHD), nonrelapse mortality (NRM), relapse/progression, and progression-free survival (PFS). On multivariate analysis, there was no significant difference between haplo/PTCy and MDS/CNI-based approaches in terms of OS (hazard ratio [HR], 1.07; 95% confidence interval [CI], .79 to 1.45; P = .66) or PFS (HR, .86; 95% CI, .68 to 1.10; P=.22). Haplo/PTCy was associated with a significantly higher risk of grades II to IV aGVHD (odds ratio [OR], 1.73, 95% CI, 1.16 to 2.59; P=.007), but the risk of grades III to IV aGVHD was not significantly different between the 2 cohorts (OR, .61; 95% Cl, .29 to 1.27; P=.19). The haplo/PTCy platform provided a significant reduction in cGVHD risk (HR, .45; 95% CI, .32 to .64; P < .001), and a significant reduction in relapse risk (HR, .74; 95% CI, .56 to.97; P=.03). There was a statistically nonsignificant trend toward higher NRM with a haplo/PTCy approach (HR, 1.65; 95% Cl, .99 to 2.77; P = .06). Haplo/PTCy-based approaches are associated with lower incidences of cGVHD and relapse, with PFS and OS outcomes comparable with MSD/CNI-based approaches. There was a leaning toward higher NRM with a haplo/PTCy-based platform. These data show that haplo/PTCy allo-HCT in cHL results in survival comparable with MSD/CNI-based allo-HCT. (C) 2019 American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc.

Objective The aim of this study was to study the implication of volume change of bupivacaine in the duration of motor and sensory blocks for early ambulation of the patient and in the rate of complications among patients. Patients and methods A total of 80 adult patients of ASA I, II, or III status, scheduled for lower limb surgery under regional anesthesia by femoral and sciatic nerve blocks, were included in this randomized prospective study. Patients were randomly divided into two equal groups (group I and group II). A total volume of 40 ml of bupivacaine 0.3% was used for peripheral nerve blockade in group I: 20 ml for femoral nerve blockade and 20 ml for sciatic nerve blockade; and a total volume of 60 ml of bupivacaine 0.3% was used in group II: 30 ml for femoral nerve blockade and 30 ml for sciatic nerve blockade. Assessment of the sensory and the motor blocks was carried out including onset of anesthesia and duration of both sensory and motor blocks. The assessment was carried out intraoperatively at 10, 20, and 30 min after the establishment of the procedure, and then at 6, 12, and 24 h after performing the block. Results The onset of the block was significantly shorter in group II. The sensory block was significantly denser in group II at 12 h. The motor block was less dense in group II at 12 and 24 h. The pain scale was less in group II at 6 and 12 h. Conclusion This study revealed that increasing the volume of the local anesthetics hastened the onset of the anesthesia and increased the duration and the density of the sensory block.