Autologous stem cell transplantation may be curative for patients with follicular lymphoma with early therapy failure without the need for immunotherapy

Objective/Background: Patients with follicular lymphoma (FL) with early therapy failure (ETF) within 2 years of frontline therapy have poor overall survival (OS). We recently reported the results of autologous stem cell transplantation (ASCT) in patients from the Grupo Español de Linfomas y Trasplantes de Médula Ósea (GELTAMO) registry treated with rituximab prior to ASCT and with ETF after first-line immunochemotherapy, leading to 81% 5-year OS since ASCT. We explored whether ASCT is also an effective option in the pre-rituximab era—that is, in patients treated in induction and rescued only with chemotherapy. Methods: ETF was defined as relapse/progression within 2 years of starting first-line therapy. We identified two groups: the ETF cohort (n = 87) and the non-ETF cohort (n = 47 patients receiving ASCT but not experiencing ETF following first-line therapy). Results: There was a significant difference in 5-year progression-free survival between the ETF and non-ETF cohorts (43% vs. 57%, respectively; p = .048). Nevertheless, in patients with ETF with an interval from first relapse after primary treatment to ASCT of <1 year, no differences were observed in 5-year progression-free survival (48% vs. 66%, respectively; p = .44) or in 5-year OS (69% vs. 77%, p = .4). Patients in the ETF cohort transplanted in complete remission showed a plateau in the OS curves, at 56%, beyond 13.7 years of follow-up. Conclusion: ASCT may be a curative option for ETF in patients who respond to rescue chemotherapy, without the need for immunotherapy or other therapies, and should be considered as an early consolidation, especially in patients with difficult access to rituximab

DAMPAK PEMBERIAN KREDIT TERHADAP USAHA KECIL DAN MENENGAH PADA PROGRAM KEMITRAAN DAN BINA LINGKUNGAN (PKBL) PT. TASPEN (PERSERO) CABANG BENGKULU

Krisis ekonomi yang berkepanjangan sejak tahun 1997-1998 mengakibatkan perekonomian Indonesia mengalami krisis di berbagai sektor. Sampai saat ini perekonomian Indonesia masih mengalami krisis moneter yang berkepanjangan, yang diakibatkan oleh tingginya tingkat pengangguran, hutang luar negeri, korupsi, ditambah dengan sumber daya manusia yang kurang berkualitas, dan pesaingan usaha yang semakin ketat. Tujuan penelitian ini adalah mengetahui dampak pemberian kredit terhadap usaha kecil dan menengah program Kemitraan dan Bina Lingkungan PT. TASPEN (Persero) usaha kecil dan menengah di provinsi Bengkulu . Pada Program Kemitraan dan Bina Lingkungan (PKBL) PT. TASPEN (persero) Kantor Cabang Bengkulu. Istilah kredit bukan hal yang asing dalam kehidupan sehari-hari. Berbagai macam transaksi sudah banyak dijumpai seperti jual beli barang dengan cara kreditan. Jual beli tersebut tidak dilakukan secara tunai (kontan), tetapi pembayaran harga barang dilakukan dengan angsuran. Sektor bisnis merupakan sektor yang sangat berperan bagi negara kita sebagai negara yang sedang berkembang. Usaha kecil merupakan sektor usaha yang banyak mendapatkan perhatian dari berbagai kalangan. Hal ini layak diterima usaha kecil karena peranannya yang sangat dominan dalam pembangunan nasional indonesia. PKBL terdiri dari dua jenis program yaitu program kemitraan dengan usaha kecil dan program bina lingkungan. Menurut peraturan menteri BUMN nomor PER- 05/MBU/2007, program kemitraan adalah program untuk meningkatkan kemampuan usaha kecil agar menjadi tangguh dan mandiri melalui pemanfaatan dana dari bagian laba BUMN (pemberian pinjaman dana bergulir). Sedangkan program bina lingkungan adalah program pemberdayaan kondisi sosial masyarakat oleh BUMN melalui pemanfaatan dana dari bagian laba BUMN. Sampel penelitian yang digunakan sebanyak 33 Usaha Kecil dan Menengah .Kredit Usaha Kecil Menengah yang disalurkan oleh PT.TASPEN (Persero) Kantor Cabang Bengkulu yang diberikan pada Program Kemitraan dan Bina Lingkungan (PKBL) adalah kredit yang diberikan kepada usaha kecil peorangan dan koperasi yang memiliki prospek ke depan. Merupakan dana pinjaman lunak bergulir untuk UKM mitra binaan (unit usaha kecil) yang dimulai tahun 2006, 2008, 2009, 2010. Metode yang digunakan adalah Metode Pengumpulan Data yaitu studi Pustaka dan studi lapangan yaitu mengadakan penelitian secara langsung objek yang diteliti dengan cara sebagai berikut: wawancara, observasi, dokumentasi. Analisis data menggunakan teknik analisis One Way ANOVA , One Way ANOVA atau uji F merupakan perbandingan antara sumber varian yaitu varian karena perlakuan dan varian karena pengaruh acak (Cooper & Emory C, 1996). Data yang diperoleh dianalisis secara statistik dengan uji One Way Anova menggunakan program SPSS for Windows Release 17.0 dan p <0,05 dipilih sebagai tingkat minimal signifikansinya. Hasil uji One-Way ANOVA yang telah dilakukan mengindikasikan bahwa uji-F Signifikan pada kelompok uji, ini ditunjukkan oleh nilai p = 0,000 lebih kecil daripada Nilai Kritik α = 0,05. Diketahui bahwa terdapat perbedaan yang signifikan pada omzet sebelum mendapatkan kredit dengan omzet setelah mendapatkan kredit, maka berpengaruh positif dan signifikan terhadap perkembangan Usaha Kecil dan Menengah yaitu kenaikan pada omzet sebelum menerima kredit dengan setelah menerima kredit. Hasil tersebut bisa dilihat pada tabel 4.6 sebesar 0,000 yang artinya signifikan pada taraf signifikansi 5% atau 0,05. Hasil penelitian ini menunjukkan bahwa pemberian kredit berpengaruh positif terhadap kenaikan omzet setelah menerima kredit

Receipt, Circulo Cubano Sección de Instrucción of Mother\u27s Day Event, May 9, 1932

Circulo Cubano Sección de Instrucción: Mother’s Day event receipt of items purchased. Signed by Armando Galeo (vice secretary).https://digitalcommons.usf.edu/cuban_club_records/1025/thumbnail.jp

Receipt, Circulo Cubano Sección de Instrucción of Mother\u27s Day Event, May 9, 1932

Circulo Cubano Sección de Instrucción: Mother’s Day event receipt of items purchased. Signed by Armando Galeo (vice secretary).https://digitalcommons.usf.edu/cuban_club_records/1025/thumbnail.jp

Health and well-being in urban environment: from policies to pratice

O aumento da concentração da população nas cidades direcionou os países e organizações a questionarem-se sobre o rumo dos meios urbanos na oferta de qualidade de vida aos seus habitantes e da sua sustentabilidade. A Organização Mundial da Saúde (OMS) lançou o projeto Cidades Saudáveis para incentivar ao nível local o planeamento de ações para a promoção da saúde das populações e da sustentabilidade das cidades. Viana do Castelo, tendo inserido a saúde na sua agenda política, tem vindo a operacionalizar projetos de intervenção nos determinantes da saúde, com especial enfoque na área do ambiente e da mobilidade, cujas ações e resultados são apresentados neste artigo.The increasing number of people in the city takes the countries and organizations to ask themselves about the direction of urban areas in the provision of quality life and sustainability. WHO promote the Healthy Cities project to encourage local planning actions to provide more health and sustainability for cities. Viana do Castelo follows this direction developing a monitoring that allows reflection on the promotion of their well-being and health care to citizens.(undefined

Autologous Stem Cell Transplantation for Follicular Lymphoma: Favorable Long-Term Survival Irrespective of Pretransplantation Rituximab Exposure

High-dose chemotherapy supported by autologous stem cell transplantation (HDT/ASCT) has contributed to modify the natural history of follicular lymphoma (FL); however, an overall survival (OS) benefit has been demonstrated at relapse only after a rituximab-free chemotherapy regimen. A total of 655 patients with FL were reported to the Spanish GELTAMO (Grupo Español de Linfomas y Trasplantes de Médula Ósea) registry and underwent first ASCT between 1989 and 2007. A total of 203 patients underwent ASCT in first complete response (CR1), 174 in second complete response (CR2), 28 in third complete response (CR3), 140 in first partial response (PR1), 81 in subsequent PR, and 29 with resistant/refractory disease; 184 patients received rituximab before ASCT. With a median follow-up of 12 years from ASCT, median progression-free survival (PFS) and overall survival (OS) were 9.7 and 21.3 years, respectively. Actuarial 12-year PFS and OS were 63% (95% confidence interval [CI], 58%-68%) and 73% (95% CI, 68%-78%), respectively, for patients in CR (with a plateau in the curve beyond 15.9 years), 25% (95% CI, 19%-28%) and 49% (95% CI 42%-56%), respectively, for patients in PR, and 23% (95% CI, 8%-48%) and 28% (95% CI, 9%-45%), respectively, for patients with resistant/refractory disease (P < .001). In patients who received rituximab before ASCT, the estimated 9-year PFS and OS from ASCT were 59.5% (95% CI, 51%-67%) and 75% (95% CI, 68%-83%), respectively. Interestingly, for patients who underwent transplantation in CR ≥2 or PR ≥2 who had received rituximab before ASCT (n = 90), 9-year PFS and OS were 61% (95% CI, 51%-73%) and 75% (95% CI, 65%-80%), respectively, with no relapses occurring beyond 5.1 years after ASCT. The cumulative incidence of second malignancies in the global series was 6.7% at 5 years and 12.8% at 10 years. This analysis strongly suggests that ASCT is a potentially curative option for eligible patients with FL. In the setting of relapse, it is of especial interest in pretransplantation rituximab-sensitive patients with FL