Allogeneic hematopoietic cell transplantation as curative therapy for patients with non-Hodgkin lymphoma: Increasingly successful application to older patients

AbstractNon-Hodgkin lymphoma (NHL) constitutes a collection of lymphoproliferative disorders with widely varying biological, histological, and clinical features. For the B cell NHLs, great progress has been made due to the addition of monoclonal antibodies and, more recently, other novel agents including B cell receptor signaling inhibitors, immunomodulatory agents, and proteasome inhibitors. Autologous hematopoietic cell transplantation (auto-HCT) offers the promise of cure or prolonged remission in some NHL patients. For some patients, however, auto-HCT may never be a viable option, whereas in others, the disease may progress despite auto-HCT. In those settings, allogeneic HCT (allo-HCT) offers the potential for cure. Over the past 10 to 15 years, considerable progress has been made in the implementation of allo-HCT, such that this approach now is a highly effective therapy for patients up to (and even beyond) age 75 years. Recent advances in conventional lymphoma therapy, peritransplantation supportive care, patient selection, and donor selection (including the use of alternative hematopoietic cell donors), has allowed broader application of allo-HCT to patients with NHL. As a result, an ever-increasing number of NHL patients over age 60 to 65 years stand to benefit from allo-HCT. In this review, we present data in support of the use of allo-HCT for patients with diffuse large B cell lymphoma, follicular lymphoma, and mantle cell lymphoma. These histologies account for a large majority of allo-HCTs performed for patients over age 60 in the United States. Where possible, we highlight available data in older patients. This body of literature strongly supports the concept that allo-HCT should be offered to fit patients well beyond age 65 and, accordingly, that this treatment should be covered by their insurance carriers

Burying the 'refuse revolution': the rise of controlled tipping in Britain 1920-1960

The definitive, peer-reviewed and edited version of this article is published in Environment and Planning A, 42, 5, 1033-1048, 2010, 10.1068/a42120.This paper investigates the emergence of ‘controlled tipping’ as the dominant method of municipal waste disposal in Britain between 1920 and 1960. The triumph of controlled tipping, despite the availability of alternative disposal technologies, needs to be understood in the context of the contested meanings of ‘waste’ and ‘wasteland’, which helped to determine attitudes and approaches to disposal. Following the conclusion of the First World War there was an urgent requirement for a cheap means of disposing of increasing amounts of urban municipal waste. The obvious choice was tipping. Before the war, however, refuse tipping had been rejected as insanitary by the emerging waste disposal profession. Public cleansing professionals therefore had to recuperate tipping as a medically and environmentally benign mode of disposal that was reconcilable with the needs of sanitary science and landscape preservation. Controlled tipping, with its combined claims to scientific progress and the revalorization of refuse, enabled dumping to be successfully re-produced as the dominant mode of municipal refuse disposal in Britain. However, tipping faced further challenges after 1945 from changing popular understandings of the value of ‘derelict’ landscapes and from the politics of amenity. The ‘refuse revolution’ was a work in progress

Chapter 13: Space- and Ground-Based Studies of Lightning Signatures

This article provides a brief survey of the space- and ground-based studies of lightning performed by investigators at Los Alamos National Laboratory (LANL). The primary goal of these studies was to further understand unique lightning signatures known as Narrow Bipolar Events (NBEs). First, an overview is presented of the Fast On-orbit Recording of Transient Events (FORTE) satellite and of the ground-based Los Alamos Sferic Array (LASA). This is followed by a summary of the phenomenology, physics, and meteorological context of NBEs and NBE-related discharges. This article also discusses additional radio frequency and optical observations of lightning made by the FORTE satellite and concludes with an outlook on LANL’s growing interest in the use of lightning observations in the study of severe weather and hurricane intensification