Dose-adapted post-transplant cyclophosphamide for HLA-haploidentical transplantation in Fanconi anemia.

We developed a haploidentical transplantation protocol with post-transplant cyclophosphamide (CY) for in vivo T-cell depletion (TCD) using a novel adapted-dosing schedule (25 mg/kg on days +3 and +4) for Fanconi anemia (FA). With median follow-up of 3 years (range, 37 days to 6.2 years), all six patients engrafted. Two patients with multiple pre-transplant comorbidities died, one from sepsis and one from sepsis with associated chronic GVHD. Four patients without preexisting comorbidities and early transplant referrals are alive with 100% donor chimerism and excellent performance status. We conclude that adjusted-dosing post-transplant CY is effective in in vivo TCD to promote full donor engraftment in patients with FA

The Primacy of Hope

This paper raises the question of whether there is anything foundational to hopefulness when considering it as a virtue, and uses the Aristotelian distinction between virtue in the “natural sense” and virtue in the “strict sense” to make the claim that hopefulness has a primacy to it. While that primacy rests on the existence of care and responsiveness of community, those caretakers must themselves be possessed of hopefulness, which, at its best will be virtuous