Summary:suppression. Finally, culture conditions may be developed which could be applied to gene transduction protocols. We have previously demonstrated that CD34 + cells, Most investigators initiate stem/progenitor cell expansion selected from peripheral blood progenitor cells (PBPC), with CD34 + cells purified by positive selection since these can be expanded in ex vivo culture and can be infused cells appear to be superior to unselected material. In in tandem with unmanipulated PBPC with little or no addition, up to a 4.0 log depletion of contaminating tumour toxicity. In this study, four patients (two non-Hodgkin's cells can be obtained using CD34 selected starting populymphoma (NHL), two multiple myeloma (MM)) lations. 7 A recent study suggested that any remaining received myeloablative conditioning prior to stem cell tumour cells do not increase in number during ex vivo rescue using ex vivo expanded cells alone. The two expansion, and this may represent a further purging patients with NHL received cyclophosphamide and total effect. 8,9 The first clinical studies using progenitor cells body irradiation (CY/TBI) and the two patients with expanded ex vivo have now been reported. 5,6,10,11 In only MM, busulphan and melphalan (Bu/M). One case one of these studies, in a small number of patients, stem received an inadequate CFU-GM dose, despite expancell rescue was performed using only the expanded cells, sion, and in one case the expanded cells were contamiwithout unmanipulated 'back-up'. 5 Brugger et al 5 expanded nated. No definitive conclusions may therefore be drawn one tenth of a standard peripheral blood progenitor cell concerning engraftment in these two cases. However, (PBPC) product prior to infusion. Six patients were transthe other two cases received high doses of committed planted with expanded cells only, and five of six experiprogenitors. Following infusion of the expanded enced rapid engraftment following high-dose, but nonmaterial, all four patients failed to show sustained myeloablative, chemotherapy. The remaining patient died neutrophil engraftment and none showed evidence of prior to the anticipated time of engraftment. platelet engraftment. Back-up, unmanipulated PBPC In our previous study, we established the safety and were therefore infused on days 14, 34, 32 and 28 and feasibility of transfusing CD34 + cells which had been selecsubsequently all four cases achieved satisfactory ted from cryopreserved PBPC and then expanded ex vivo. 6 engraftment of both neutrophils and platelets. In conTen patients received у20 × 10 4 CFU-GM/kg unmanipclusion, we feel that, CD34 + cells, expanded ex vivo using ulated PBPC in addition to an aliquot of expanded cells the conditions described in this report, may not provide (range 33-279 × 10 4 CFU-GM/kg). There were no toxic durable engraftment following fully myeloablative effects from the progenitor cells which had been generated conditioning.ex vivo. 6 Keywords: ex vivo expansion; CD34 positive; PBPC;The primary objective of this second study was to det...

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Apart from possibly in the best-prognosis group, where results are equivalent, ChlVPP/EVA hybrid produces significantly better FFP, EFS, and OS than VAPEC-B in patients with previously untreated Hodgkin's disease.

INTRODUCTION High short-term failure rates have been reported for a variety of metal-on-metal (MoM) total hip replacements (THRs) owing to adverse reactions to metal debris (ARMD). This has led to the withdrawal of certain poorly performing THRs. This study analysed the outcomes of a MoM THR system. METHODS Between 2004 and 2010, 578 uncemented MoM THRs (511 patients, mean age: 60.0 years) were implanted at one specialist centre. The THR system used consisted of the Corail ® stem, Pinnacle ® cup, Ultamet ® liner and Articul/eze ® femoral head (all DePuy, Leeds, UK). All patients were recalled for clinical review with imaging performed as necessary. RESULTS The mean follow-up duration was 5.0 years (range: 1.0-9.1 years). Overall, 39 hips (6.7%) in 38 patients (all 36mm femoral head size) underwent revision at a mean time of 3.5 years (range: 0.01-8.3 years) from the index THR with 30 revisions (77%) performed in women. The cumulative eight-year survival rate for all THRs was 88.9% (95% confidence interval [CI]: 78.5-93.4%), with no difference (p=0.053) between male (95.2%, 95% CI: 84.2-98.7%) and female patients (85.3%, 95% CI: 70.2-92.1%) at eight years. Seventeen revisions (44%) were performed for ARMD. There was no significant difference in absolute postoperative Oxford hip scores between men and women (p=0.608). The mean acetabular inclination in unrevised THRs was 44.0°. Forty-seven non-revised THRs (8.7%) had blood metal ion concentrations above recommended thresholds (seven had periprosthetic effusions). CONCLUSIONS Although this MoM THR system has not failed as dramatically as other similar designs, we recommend against continued use and advise regular clinical surveillance to identify ARMD early.

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