Treatment Response and Outcomes in Post-transplantation Lymphoproliferative Disease vs Lymphoma in Immunocompetent Patients

International audiencePosttransplantation lymphoproliferative disorder (PTLD) after solid organ transplantation may carry a poorer prognosis than lymphoma in immunocompetent individuals, but comparative data are lacking. In a retrospective, single-center, case-control study, 21 cases of PTLD were identified in patients undergoing kidney transplantation since 2000, and compared to 42 nontransplanted controls cared for in the same institution and matched for age, prognostic index, and cerebral localization. Two-year and 5-year overall survival was 57% and 44%, respectively, in PTLD patients and 71% and 58% in controls (log-rank test P = .20). On multivariable analysis, overall survival was similar for PTLD and control patients (hazard ratio 1.71, 95% confidence interval 0.81 to 3.61, P = .16). Response rate to first-line chemotherapy was similar between the 2 groups. Death was due to progression of the disease in 46% vs 94% of PTLD and control patients, respectively (P < .01), or sepsis in 31% vs 0% (P = .03). Treatment-related mortality was significantly higher in PTLD (19%) than in controls (0%, P = .03). In conclusion, response to first-line chemotherapy and overall survival are similar in PTLD and control patients, whereas causes of death were significantly different. Better prevention and management of infectious complications could improve the results in PTLD patients

Capturing complexity in how configurations of firm Internal Orientations impact corporate social performance outcomes: Breaking from the dominant logic of symmetric-variable to asymmetric-case-based theory and testing

This study exemplifies how an asymmetric and case based (configurational) research approach (using fuzzy state logic and complexity theory) is useful for conceptualization and explanation of complex topics and heterogeneous outcomes. The study here analyses the recipes (condition combinations) for Internal Orientation constructs (IO: strategic intent, CSP management, strategic orientation and industrial standards) among multi-national companies (MNCs) indicating “high” levels of corporate social performance (CSP) and the “United Nations Principles for Responsible Investment” (UNPRI) ESG factor framework (Environment, Social-human rights, and Governance) – separately and as a whole. The study applies a mixed methods research design and includes comparing ESG with financial performance across a “Top-100 Sustainable Companies Index” (n?=?82 of MNCs trading on the Swedish stock exchange). The study's findings support the core tenets of complexity theory; all four IO constructs affect a high E or S or G outcome but not all three outcomes in combination