The Two-Step Approach to Allogeneic Hematopoietic Stem Cell Transplantation

Allogeneic hematopoietic stem cell transplantation (HSCT) provides the only potentially curative option for multiple hematological conditions. However, allogeneic HSCT outcomes rely on an optimal balance of effective immune recovery, minimal graft-versus-host disease (GVHD), and lasting control of disease. The quest to attain this balance has proven challenging over the past few decades. The two-step approach to HSCT was conceptualized and pioneered at Thomas Jefferson University in 2005 and remains the main platform for allografting at our institution. Following administration of the transplant conditioning regimen, patients receive a fixed dose of donor CD3+ cells (HSCT step one-DLI) as the lymphoid portion of the graft on day -6 with the aim of optimizing and controlling T cell dosing. Cyclophosphamide (CY) is administered after the DLI (days -3 and -2) to induce donor-recipient bidirectional tolerance. On day 0, a CD34-selected stem cell graft is given as the myeloid portion of the graft (step two). In this two-step approach, the stem cell graft is infused after CY tolerization, which avoids exposure of the stem cells to an alkylating agent, allowing rapid count recovery. Here, the two-step platform is described with a focus on key results from studies over the past two decades. Finally, this review details lessons learned and current strategies to optimize the graft-versus-tumor effect and limit transplant-related toxicities

Strategies Required to improve Students’ Industrial Training Program between Local Businesses and Technical Colleges in Enugu State, Nigeria

Purpose: The aim of the study was to identify the strategies required in improving industrial training programs between local businesses and Technical colleges in Enugu State in Nigeria. Approach/Methodology/Design: Three Research questions and hypotheses guided the study. A descriptive survey research design was adopted for the study. The population for the study was 125 students from Government Technical College Enugu and Government Technical College in Nsukka, 23 owners of local businesses in Enugu state, 35 teachers from Government Technical College Enugu and Government Technical College in Nsukka and 10 co-coordinators from the Industrial Training Fund (ITF) Enugu State. A structured questionnaire was used for data collection. The reliability co-efficiency of the instrument was found to be 0.83. Data collected were analyzed using mean for the research questions, while the null hypotheses were tested using Independent sample t-test at 0.05 level of significance. Findings: Based on the findings, recommendations were made among which are; Local businesses should liaise with technical colleges to fashion out a suitable industrial training program that will improve students’ experience. More funds should be provided by Government to improve the industrial training program. Practical Implications: The study will contribute positively to the understanding of industrial training program in technical colleges. Originality/value: This study innovates by suggesting strategies to improve the industrial training program between local businesses and technical colleges