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Purpose
To evaluate long-term health risks after allogeneic hematopoietic stem cell transplantation (HSCT) using non-myeloablative total body irradiation (TBI).Methods and materials
All adult patients undergoing non-myeloablative allogeneic HSCT using TBI-based conditioning from 1995 to 2020 at our institution were included. Long-term toxicities, defined as events persisting beyond or occurring after 6 months from the date of transplant, were graded per the National Cancer Institute's Common Terminology Criteria for Adverse Events version 5.0. A competing risk analysis was performed to assess the risk of developing long-term toxicities within major organ systems using the Fine-Gray model. Outcomes were compared with a cohort of patients undergoing myeloablative TBI.Results
A total of 174 patients undergoing nonmyeloablative HSCT were assessed along with 378 myeloablative patients. Nonmyeloablative recipients were older (58 vs 43 years, P < .001), less likely to be transplanted for acute leukemia (35% vs 64%, P < .001), more likely to be transplanted for non-malignant conditions (33% vs 11%, P < .001), and were more likely to have used tobacco (33% vs 22%, P = .009). The median follow-up was 7.4 years. The cumulative incidences of long-term toxicities at 5 years for nonmyeloablative and myeloablative patients, taking into account the competing risk of death, were pulmonary (4% vs 4.8%, P > .9), cardiac (6.8% vs 3.3%, P = .11), renal (4.3% vs 4.1%, P = .9), thyroid (3.6% vs 1.5%, P = .2), other endocrine (3.1% vs 8.8%, P = .04), and cataracts (2.5% vs 2.8%, P = .7). The risk of developing a secondary malignancy was 3.5% vs 1.1% (P = .2) between the 2 cohorts. The proportion of all toxicities that were high-grade (3-5) for nonmyeloablative and myeloablative regimens, respectively, were pulmonary (60% and 69%), cardiac (17% and 45%), renal (27% and 21%), and other endocrine (4% and 2%).Conclusions
Recipients of nonmyeloablative conditioning regimens, despite receiving much lower doses of TBI and chemotherapy, are at risk of developing significant, long-term medical conditions comparable with those undergoing myeloablative HSCT.This thesis explores the ideas, challenges, and hesitations that may arise when women engage in prophetic proclamation from the pulpit. Many women feel called by God to deliver a word of prophecy to their communities, yet they often encounter barriers to being heard and accepted as prophetic voices. Throughout both biblical and modern history, individuals have embodied prophetic actions, and this work affirms that prophecy continues to be an essential means through which God communicates with humanity. If humanity is part of God's creation, then anyone, regardless of gender, can serve as a conduit for God's word.Women have always held equal value before God, yet they have historically been viewed as lesser within society and religious communities. In both the Old and New Testaments, female prophets are present but often underrepresented. While most prophets named in Scripture are men, women also stand in the pulpit alongside their male counterparts, proclaiming messages from God. This thesis argues that women have always played a vital role in the prophetic tradition, even if their contributions have not always been acknowledged. Chapter One introduces the concept of what it means to speak prophetically. Chapter Two examines how theologians have understood the role of the prophet and how this understanding has evolved over time. Chapter Three presents biblical examples of prophetic women in both the Old and New Testaments, supported by insights from biblical commentaries. In Chapter Four, the discussion turns to contemporary implications for those who feel called to prophetic ministry—especially women who have had negative experiences when attempting to speak prophetically. This chapter offers encouragement for women to live into their calling with boldness and faith. Chapter Five concludes with reflections on what it means for women to embody a prophetic vocation today. An appendix includes a guide designed for use in small groups or workshops to help women understand, embrace, and feel empowered in their call to ministry and preaching. Readers are invited to approach this work with an open mind and heart, recognizing that God can and does call anyone to proclaim God's will for creation.
While the New Testament contains a relative paucity of references to age and aging, Luke’s Gospel and Acts stand out as a striking exception. Luke’s infancy narrative includes young characters (John, Jesus, and likely Mary) alongside older characters (Zechariah, Elizabeth, Anna, and by implication, Simeon). The juxtaposition of young and old appears again at Pentecost, where Peter, quoting Joel, declares, “Your young men will see visions, and your old men will dream dreams” (Acts 2:17). While the focus on young and old is rather concentrated in these opening chapters of Luke and Acts, Luke’s narrative includes characters of various ages throughout. Still, scholarship has given little focus to the broader narrative implications of Luke’s depiction of age broadly conceived.
This dissertation offers a historically situated, literary examination of Luke’s narratives to analyze Luke’s depiction of age. By incorporating literary, material, and demographic evidence, both Greco-Roman and Jewish, this dissertation situates Luke’s narratives within their broader cultural milieu. This dissertation argues that Luke’s account of age furthers a particular theme in Luke’s narratives: that of God’s inclusive—and specifically, intergenerational—kingdom. As scholars often discuss, the vision of the kingdom of God in Luke’s Gospel and Acts is inclusive in a variety of ways: namely, it includes rich and poor, Jew and gentile, male and female. In addition to these categories, I suggest that Luke’s vision of the kingdom of God includes young and old—a merism that has received far less attention than the other merisms that also make up God’s kingdom in Luke’s narratives. References to characters’ ages in Luke’s narratives are not merely incidental but rather essential elements of Luke’s narrative and wider theological program. Further, I argue that Luke’s portrayal of God’s kingdom values characters of different ages qua their different ages; that is, children are valued as children and older adults as older adults, and the narratives recognize the nuances of these different life stages.
This dissertation explores the intergenerational transmission of trauma within the Abrahamic narratives of the Hebrew Bible through the lens of Bowen Family Systems Theory. Drawing on theological, psychological, and historical insights, the study investigates how unresolved trauma, emotional projection, and chronic anxiety shape the dynamics of biblical families and influence contemporary faith communities. Central to this work is the analysis of the Binding of Isaac (Akedah) as a foundational trauma story, revealing its implications for spiritual identity and emotional development across generations. The study integrates case studies from congregational life with biblical exegesis to illustrate how self-differentiated leadership can foster healing in churches burdened by historical trauma. Ultimately, it offers a pastoral care framework grounded in trauma-informed theology, emphasizing the redemptive potential of narrative, introspection, and spiritual growth amid generational brokenness.