This prospective audit establishes the incidence (per 1000 player match hours) and severity of injuries (time lost and matches missed) at a semi-professional rugby union club (SPRUC). Over the season of 2013/14 injury information regarding event, type, playing position and severity (number of days missed through injury) for all senior male first team players was recorded by medical staff using the Benchmark 54 injury analytics software. Similar to Roberts et al. (BMJ Open 2013;3:e003998) any injury resulting in 8 days or greater absence from match play was recorded. Type of injury was recorded using the Orchard Sports Injury Classification System v10 (Rae et al. Br J Sports Med 2005;39:907–11). Written consent was gained from every player. There were a total of 35 injuries with an injury rate of 1.06 per match. The overall match injury incidence was 54.1/1000 playing hours. Median for time loss from an injury was 30 days and the median number of games missed through injury was three. The most common sites of injury were ankle, knee and shoulder. Contact events accounted for 77% (27/35) of all injuries, of these 60% (17/27) were sustained in the tackle. Joint and ligament injuries were the most frequent type accounting for just under half of all injuries. Fractures caused the greatest time loss with a player missing a mean of 14 games. This audit has recorded a high number of time loss injuries which are costly to the club. This information can help SPRUCs plan for squad sizes and adequate medical staffing. Interventions should focus on injury prevention strategies regarding the tackle event and conditioning exercises for the knee, shoulder and ankle. Further work should examine training injuries and completion of the audit cycle.

IntroductionMaximizing the CD34 cell content of the graft has been reported to lead to faster platelet engraftment and lower requirement for platelet transfusions in patients undergoing autologous stem cell transplantation (A-HSCT). We evaluated the impact of CD34 cell dose on platelet recovery and transfusion requirements in 114 consecutive adults undergoing A-HSCT with a CD34 cell dose of > 2 × 106/kg recipient body weight (BW) infused.MethodsFrom January 2007 to March 2010, 114 adults with NHL (n: 45), multiple myeloma (n: 44), Hodgkin's disease (n: 23) and AML (n: 2) underwent apheresis (range: 1-7) and A-HSCT. Patients were categorized in to 3 groups based on the CD34+ cell dose transplanted [group 1: 2.0-2.99 × 106 (n: 55), group 2: 3.0-5.0 × 106 (n: 38) and group 3: > 5 × 106 CD34/kg recipient BW (n: 21)]. Neutrophil and Platelet engraftment (platelet count > 20,000/ul for 2 consecutive days without platelet support) and transfusion requirements post-transplant were evaluated and correlated with patient's age, diagnosis and number of apheresis.ResultsMedian neutrophil engraftment following transplantation was 11 days in all groups, while median platelet engraftment was 14 days in group 1 and 13 days in groups 2 and 3. Platelet recovery by days 30 and 60 was 90.7%/96.3% in group 1, 94.7%/100% in group 2, 90.5%/95.2% in group 3. Two patients with NHL in group 1 (3.6%) and one with AML in group 3 (4.8%) were platelet-dependent > 60 days post-transplantation. One patient with NHL in group 1 expired on day 6 from transplant-related complications. Median platelet transfusions were 3 doses of platelets in group 1 and 2 doses in other groups. Patient's age, diagnosis and number of apheresis did not affect 30 and 60 day platelet recovery/transfusions post-transplant. Nine patients (7.9%) received plerixafor-mobilized transplants with median platelet engraftment 14 days post-transplant.ConclusionCD34 cell dose did not significantly impact platelet recovery and transfusion requirements post-transplantation with rapid platelet recovery achievable with CD34 cell dose > 2 × 106/kg rec BW. Other factors including the number of platelet precursors in the transplanted product rather than CD34 cell dose may be a more important indicator of platelet recovery post-transplantation. IntroductionMaximizing the CD34 cell content of the graft has been reported to lead to faster platelet engraftment and lower requirement for platelet transfusions in patients undergoing autologous stem cell transplantation (A-HSCT). We evaluated the impact of CD34 cell dose on platelet recovery and transfusion requirements in 114 consecutive adults undergoing A-HSCT with a CD34 cell dose of > 2 × 106/kg recipient body weight (BW) infused.

Larson, Robin RN; Brenner, April RN; Greaney, Karen ANP; Lee, Melinda RD; Arai, Lisa PharmD; Schreiber, Kathryn RN; Gardetto, Nancy FNP-C; Tseng, Marilynne RN; Mosley, Karl RRT; Smith, Robert MD; Maisel, Alan S. MD Author Information