Outcomes following autologous hematopoietic stem cell transplant for patients with relapsed Wilms' tumor: a CIBMTR retrospective analysis.

Despite the marked improvement in the overall survival (OS) for patients diagnosed with Wilms' tumor (WT), the outcomes for those who experience relapse have remained disappointing. We describe the outcomes of 253 patients with relapsed WT who received high-dose chemotherapy (HDT) followed by autologous hematopoietic stem cell transplant (HCT) between 1990 and 2013, and were reported to the Center for International Blood and Marrow Transplantation Research. The 5-year estimates for event-free survival (EFS) and OS were 36% (95% confidence interval (CI); 29-43%) and 45% (95 CI; 38-51%), respectively. Relapse of primary disease was the cause of death in 81% of the population. EFS, OS, relapse and transplant-related mortality showed no significant differences when broken down by disease status at transplant, time from diagnosis to transplant, year of transplant or conditioning regimen. Our data suggest that HDT followed by autologous HCT for relapsed WT is well tolerated and outcomes are similar to those reported in the literature. As attempts to conduct a randomized trial comparing maintenance chemotherapy with consolidation versus HDT followed by stem cell transplant have failed, one should balance the potential benefits with the yet unknown long-term risks. As disease recurrence continues to be the most common cause of death, future research should focus on the development of consolidation therapies for those patients achieving complete response to therapy

The role and potential of umbilical cord blood in an era of new therapies: a review

In light of pioneering findings in the 1980s and an estimation of more than 130 million global annual births, umbilical cord blood (UCB) is considered to be the most plentiful reservoir of cells and to have regenerative potential for many clinical applications. Although UCB is used mainly against blood disorders, the spectrum of diseases for which it provides effective therapy has been expanded to include non-hematopoietic conditions; UCB has also been used as source for regenerative cell therapy and immune modulation. Thus, collection and banking of UCB-derived cells have become a popular option. However, there are questions regarding the cost versus the benefits of UCB banking, and it also raises complex ethical and legal issues. This review discusses many issues surrounding the conservation of UCB-derived cells and the great potential and current clinical applications of UCB in an era of new therapies. In particular, we describe the practical issues inherent in UCB collection, processing, and long-term storage as well as the different types of ‘stem’ or progenitor cells circulating in UCB and their uses in multiple clinical settings. Given these considerations, the trend toward UCB will continue to provide growing assistance to health care worldwide

Development of new Cartesian explicit solver for hydrodynamic flows

International audienc

Water Wave Propagation using SPH Models

International audienc

Simulation of extreme wave impacts on a FLNG

International audienc

Advances in the development of a new cartesian explicit solver for hydrodynamics

In order to efficiently address complex problems in hydrodynamics, the advances in the dev lopment of a new method are presented here. This new CFD solver aims at obtaining a good compromise in terms of accuracy, computational efficiency, and easy handling of complex geometries. The chosen method is an Explicit Cartesian Finite Volume method for Hydrodynamics (ECFVH) based on a compressible (hyperbolic) solver, with an embedded method for interfaces and geometry handling. The solver's explicit nature is obtained through a weakly-compressible approach chosen to simulate nearly-incompressible flows. The explicit cell-centered resolution allows for an efficient solving of very large simulations together with a straightforward handling of multi-physics. The use of an embedded Cartesian grid ensures accuracy and efficiency, but also implies the need for a specific treatment of complex solid geometries, such as the cut-cell method in the fixed or moving body frame. Robustness of the cut-cell method is ensured by specific procedures to circumvent small cell volume numerical errors. A characteristic flux method for solving the hyperbolic part of the Navier-Stokes equations is used and introduces numerical viscosity. This viscosity is evaluated prior to modeling viscous and turbulent effects. In a first approach presented here viscous effects are computed via a finite difference Laplacian operator introduced as a source term. This solver is validated on 2-D test cases