NICU Infants & SNHL: Experience of a western Sicily tertiary care centre

Introduction: The variability of symptoms and signs caused by central nervous system (CNS) lesions make multiple sclerosis difficult to recognize,Introduction: This study adds the evaluation of the independent etiologic factors that may play a role in the development of SNHL in a NICU population. We compared neonatal intensive care unit NICU infants with sensorineural hearing loss SNHL to age and gender matched normal hearing NICU controls. Materials and methods: 284 consecutive NICU infants positive to the presence of risk indicators associated with permanent congenital, delayed-onset, or progressive hearing loss underwent to global audiological assessment. The following risk factors were researched, making a distinction between prenatal and perinatal risk factors: in the first group, family history of permanent childhood hearing impairment, consanguinity, pregnant maternal infection and drugs exposition during pregnancy; in the second group, premature birth, respiratory distress, hyperbilirubinemia requiring exchange tranfusion, very low birth weight, cranio-facial abnormality, perinatal infections, ototoxic drugs administration, acidosis, hyponatremia, head trauma. Results: The analysis of the auditory deficit for infants according to numbers of risk factors showed mean values of: 78 + 28.08 dB nHL for infants positive to two risk factors; 75.71 + 30.30 dB nHL in cases positive to three risk factors; 96.66 + 34.46 dB nHL for four risk factors and 85 + 35 dB nHL in case of >5 risk factors. Conclusion: NICU infants have greater chances of developing SNHL, because of the presence of multiple risk factors; in fact, as the number of coexisting risk factors increases, the prevalence rate of SNHL also increases (r=0.81)

Impact of donor age and kinship on clinical outcomes after T-cell-replete haploidentical transplantation with PT-Cy

Donor selection contributes to improve clinical outcomes of T-cell-replete haploidentical stem cell transplantation (haplo-SCT) with posttransplant cyclophosphamide (PT-Cy). The impact of donor age and other non-HLA donor characteristics remains a matter of debate. We performed a multicenter retrospective analysis on 990 haplo-SCTs with PT-Cy. By multivariable analysis, after adjusting for donor/recipient kinship, increasing donor age and peripheral blood stem cell graft were associated with a higher risk of grade 2 to 4 acute graft-versus-host-disease (aGVHD), whereas 2-year cumulative incidence of moderate-tosevere chronic GVHD was higher for transplants from female donors into male recipients and after myeloablative conditioning. Increasing donor age was associated with a trend for higher nonrelapse mortality (NRM) (hazard ratio [HR], 1.05; P 5 .057) but with a significant reduced risk of disease relapse (HR, 0.92; P 5 .001) and improved progressionfree survival (PFS) (HR, 0.97; P 5 .036). Increasing recipient age was a predictor of worse overall survival (OS). Risk of relapse was higher (HR, 1.39; P , .001) in patients aged #40 years receiving a transplant from a parent as compared with a sibling. Moreover, OS and PFS were lower when the donor was the mother rather than the father. Pretransplant active disease status was an invariably independent predictor of worse clinical outcomes, while recipient positive cytomegalovirus serostatus and hematopoietic cell transplant comorbidity index .3 were associated with worse OS and PFS. Our results suggest that younger donors may reduce the incidence of aGVHD and NRM, though at higher risk of relapse. A parent donor, particularly the mother, is not recommended in recipients #40 years