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Persons with clinically significant tinnitus also may have mild sensorineural hearing loss (MSNHL). The purpose of this study was to describe patients with tinnitus and MSNHL and factors predicting hearing-aid uptake (HAU). We conducted a retrospective chart review with regression modeling of patients presenting to a specialty tinnitus clinic over a 2.5-year period. Stepwise logistic regression on data from patient charts was conducted. Of 133 patients seen, two-thirds had MSNHL (95% confidence interval [CI]: 58.9–75.0; mean age = 53.4 years; standard deviation = 14.5); approximately 50% had severe-to-catastrophic tinnitus. Logistic regression indicated that four-frequency pure-tone average (FFPTA; left) (β = 0.3899, χ 2 = 10.96, degrees of freedom [DF] = 1, p = 0.0009) and age (β = 0.1273, χ 2 = 4.86, DF = 1, p = 0.0274) were positively associated with HAU; tinnitus severity was inversely related (β = − 1.0533, χ 2 = 4.24, DF = 1, p = 0.0395). Adjusting for key variables, odds of receiving hearing aids was 1.14 (95% CI: 1.01–1.27) times higher with every year increase in age, 1.48 (95% CI: 1.17–1.86) times higher per one point increase in FFPTA (left), and 0.35 (95% CI: 0.13–0.95) times less per one point increase in tinnitus severity score. Reasons why HAU was not high for this special sample of young adults with severe tinnitus and MSNHL are discussed; hearing aid treatment requires extensive counseling and follow-up for this population.

Busulfan (BU) and Fludarabine (F) has been reported by de Lima et al. to be a well-tolerated myeloablative conditioning regimen with 3% incidence of hemorrhagic cystitis (Blood2004;104:857). Between 5/2005 and 5/2006, we performed allogeneic stem cell transplantation (SCT) in 29 patients following BU+F (n=17) and other (n=12) myeloablative regimens. Nineteen (66%) patients were in remission and 10 (34%) had active disease at BMT. Twenty patients had AML, 4 ALL and 5 had other malignancies. Busulfan was given at 130mg/M2 over 3 hours on 4 successive days, along with Fludarabine 40mg/M2 on 4 successive days. Eighteen (72%) had matched-related 7 (24%) had matched-unrelated donor (MUD) transplant. GVHD prophylaxis consisted of Tacrolimus and low-dose Methotrexate. Thymoglobulin (n=4) and CAMPATH (n=3) were given along with conditioning in MUD/one-antigen mismatch transplant recipients (5 BU+F and 2 other). As of August 1st, 2006, 19 (65%) patients are alive. Of 26 evaluable patients, the incidence of bacterial (59% vs. 89%), fungal (29% vs. 11%) infections were similar between Bu+F and other group, respectively. CMV reactivation was observed in 78% in other group as compared to 35% in BU+F recipients (p=0.09). Hemorrhagic cystitis (HC) occurred in 6 patients (35%) in BU+F group and in 1 (11%) patient in other group (p=0.35). BK virus was detected by quantitative PCR in all patients with HC. Two BK(+) cases were in BU+F+CAMPATH group. Considering 18 AML patients who received transplant in remission and had at least 2 months of follow-up, 5 patients (38%) in BU+F group relapsed within 6 months of transplant. Two out of 5 patients relapsed in the other group. Our findings suggest that BU+F myeloablative conditioning appears to be associated with high incidence of BK-related hemorrhagic cystitis and may have long-term consequences. Further studies are warranted.