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Combined Treatment With Cognitive Behavioral Therapy for Insomnia and Acceptance and Commitment Therapy Enhances Objective and Subjective Reports of Sleep in Patients With Advanced Cancer.

BACKGROUND: Sleep difficulties are common for people with advanced cancer and are associated with poorer mood, lower quality of life, and reduced survival. For these patients, insomnia severity ratings are tied to nighttime awakenings, but little is known about the reasons for awakenings. AIMS: This study reports actigraphy sleep outcomes, longitudinal self-reported insomnia severity, and circadian rhythm disruptions from a randomized pilot study comparing a multi-symptom intervention with a wait-list control group for people with advanced cancer. METHODS: Twenty-eight people with advanced c

New Treatment Options in Advanced Stage Follicular Lymphoma.

Follicular lymphoma is one of the most common non-Hodgkin's lymphomas with an expected survival of more than 20 years for the majority of patients. This impressive outcome has been achieved with the introduction of immunochemotherapy, as first line treatment with remissions lasting over 8 years, followed by other treatment options at first or subsequent relapse. However, certain groups of patients still have a poor prognosis. In recent years the efficacy of chemotherapy regimens has been augmented by new compounds selectively targeting the cell surface, intracellular pathways, and/or the micro

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… Immunochemotherapy For patients with a low tumor burden, watchful waiting is still appropriate for those patients with asymptomatic disease since there is little evidence that early intervention in the asymptomatic patient has any effect on overall survival or risk of transformation. 17 This was also … Watchful waiting in low-tumor burden follicular lymphoma in the rituximab era: results of an F2-study database. J Clin Oncol 2012; 30:3848–3853. 18. Nastoupil LJ, Sinha R, Byrtek M, et al. Outcomes following watchful waiting for stage II-IV follicular lymphoma patients in the modern era. …

Результаты среди пациентов MM, получающих раннее вмешательство в процесс развития MRD после автономной трансплантации стволовых клеток.

Для оценки реакции нескольких пациентов, страдающих миеломой (ММ), на лечение необходимо проводить обследование на наличие минимальных остаточных заболеваний (МСД). Многие пациенты, прежде чем удовлетворять критериям клинического или биохимического прогресса (PD), сталкиваются с MRD (MRD-P), в связи с чем возникают вопросы о сроках лечения. В этом ретроспективном исследовании было исследовано воздействие раннего вмешательства (РВ) на прогнозы 42 вновь диагностированные пациенты MM, разработавшие MRD-P после первоначального лечения аутологической трансплантации стволовых клеток. В группе EI (n

Transient Leukemoid Reaction from T-Cell Large Granular Lymphocytes Post Autologous Stem Cell Transplant in a Patient Affected by Hodgkin Lymphoma.

Monoclonal T-cell lymphocytosis has been reported in patients with concomitant autoimmune diseases, viral infections, or immunodeficiencies. Referred to as T-cell large granular lymphocytic leukemia (T-LGLL), most cases cannot identify the triggering cause. Only small case series have been reported in the literature, and no treatment consensus exists. T-cell lymphocytosis may also appear after the transplant of hematopoietic stem cells or solid organs. Rare cases have been reported in patients undergoing autologous stem cell transplant (ASCT) for hematological diseases (including multiple myel

Самочувственное оральное здоровье у гемато-онкологических пациентов и связь с качеством жизни.

ЦЕЛЬ: Оценить самосообщенное состояние орального и перорального здоровья пациентов, у которых диагностируется гемато-онкологическое заболевание. ПАТИЕНТЫ И МЕТОДЫ: Данные собирались с помощью цифрового вопросника в сотрудничестве с голландской организацией пациентов " Гематон " . Вопросники EORTC-QLQ-C30, EORTC-QLQ-OH15, сокращенный Ксеростомический кадастр (XI) и OHIP-14 были использованы. Результаты: Seven hundred five (Включены пациенты)52.5% женщины среднего возраста 63.2 ± 10.1). Большинство из них были диагностированы 2 много лет назад86%) и прошли курс лечения (81%) за свою бо

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… While watchful waiting is applied in patients with slowly progressing malignancies, most patients with hematologic malignancies are treated with chemotherapy, often in combination with immunotherapy or radiotherapy. …

Smartphone Apps for Patients With Hematologic Malignancies: Systematic Review and Evaluation of Content.

BackgroundHematological malignancies (HMs) are a heterogeneous group of cancers representing a significant cause of morbidity and mortality. The chronification of HMs and the increasing use of smartphones may lead patients to seek their current unmet needs through mobile health apps.ObjectiveThe goal of this review was to identify and assess the quality of smartphone apps aimed at patients diagnosed with HMs.MethodsA systematic search of apps that were aimed at patients diagnosed with HMs, accessed from a Spain IP address, and were available on the iOS (App Store) and Android (Google Play) pla

Tolerability of obinutuzumab therapy in patients with rituximab-relapsed/refractory B-cell malignancies - a retrospective single center cohort study.

Background & aimIn randomised clinical trials, the type II anti-CD20 antibody obinutuzumab has been shown to be more effective than rituximab for therapy of chronic lymphocytic leukemia (CLL) and follicular lymphoma (FL). However, this enhanced efficacy was linked with elevated rates of high-grade adverse events. The aim of this study was to assess the tolerability and toxicity profile of obinutuzumab treatment in routine patients with CLL and FL, of whom the majority had experienced toxicity or resistance to rituximab.MethodsThis retrospective cohort study investigated fifteen obinutuzumab-tr

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… Alternatively, watchful waiting or rituximab monotherapy may be considered to avoid the adverse effects of radiation in selected cases [ 18 ]. For advanced stage disease (Ann Arbor III/IV) no curative therapy is established yet [ 18 ]. …

Examining the levels of psychological support available to patients with haematological cancer in England: a mixed methods study.

ObjectivesThe psychological impact of a haematological malignancy is well documented. However, few studies have assessed the provision of psychological support to people with these diagnoses. This study explores the extent and nature of psychological support for people diagnosed with haematological cancer to inform future service provision.DesignThis study consisted of an online survey with healthcare professionals (phase 1) and qualitative interviews with patients (phase 2) and key health professionals (phase 3). A descriptive analysis of survey data and thematic analysis of interviews were c

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… Some types are chronic and people live with the threat of relapse, resulting in significant uncertainty about their future, higher levels of depression and anxiety and reduced quality of life. 8–10 Some people will have no treatment and will be managed with watchful waiting; but this in itself is something … & wait | 6 | Chemotherapy | 14 | Stem cell therapy | 3 | Radiotherapy | 1 | Immunotherapy | 1 | Other | 3 | Table 3 Key stakeholder characteristics GP, General Practitioner. …

COVID-19 outcomes in patients with hematologic disease.

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Codesigning a supportive online resource for Australian cancer carers: a thematic analysis of informal carers' and healthcare professionals' perspectives about carers' responsibilities and content needs.

ObjectiveTo gather preliminary qualitative data that will assist in the codesign and development of a new informational and supportive website to assist informal cancer carers in Australia.Design and settingUtilising a previously tested codesign process, informal carers' experiences and perspectives, including those of healthcare professionals', were examined via focus groups and/or interviews. Data were analysed via thematic analysis.ParticipantsRural (n=9) and urban (n=11) carers', and healthcare professionals' (n=8) perspectives were collected. Carers participated in a focus group (n=9) or

Management of bone metastasis and cancer treatment-induced bone loss during the COVID-19 pandemic: An international perspective and recommendations.

Optimum management of patients with cancer during the COVID-19 pandemic has proved extremely challenging. Patients, clinicians and hospital authorities have had to balance the risks to patients of attending hospital, many of whom are especially vulnerable, with the risks of delaying or modifying cancer treatment. Those whose care has been significantly impacted include patients suffering from the effects of cancer on bone, where delivering the usual standard of care for bone support has often not been possible and clinicians have been forced to seek alternative options for adequate management.

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… Watchful waiting. Scheduled visits of patients with stable disease can be delayed with safety. Alternatively, blood examination in local laboratories and consultation via telemedicine is encouraged. … Watchful waiting may be considered for patients with biochemical relapses, especially for patients with a slow and gradual increase in the paraprotein level. …

Shared care follow-up of patients with B-cell neoplasms based on nurse-led telephone consultations and PRO-data: a feasibility study from the North Denmark Region.

BackgroundPatients with B-cell neoplasms in remission are monitored with regular physician visits at the hospital. The current standard follow-up procedure is not evidence-based or individualized to patient needs. To improve and individualize the follow-up, we investigated the feasibility of a shared care follow-up initiative, with alternating physician visits and nurse-led telephone consultations and assessments based on patient-reported outcome (PRO) data.MethodsPatients ≥18 years diagnosed with B-cell neoplasms were eligible for the study when they were in remission and stable without treat

The outcome of COVID-19 in patients with hematological malignancy.

ObjectiveThe aim of this study was to examine the effect of coronavirus disease 2019 (COVID-19) on the malignancy-related clinical course and overall survival, and to determine the factors affecting mortality.MethodsThis retrospective study included 77 patients with hematological cancer and COVID-19. Patients were sub-grouped for analysis as survivors and non-survivors.ResultsCOVID-19 was seen more frequently in myeloproliferative neoplasms (MPN), non-Hodgkin lymphoma (NHL) and multiple myeloma (MM) patients. Mortality rate due to COVID-19 was 20.8%. No statistically significant difference was

Factors associated with treatment resumption and long-term outcomes after ICU discharge in patients with hematological malignancies.

PURPOSE: Post-intensive care syndrome may result in persistent functional impairments that may jeopardize the feasibility of anticancer therapy in patients with hematological malignancies (HMs), thereby adversely affecting long-term survival. Our purpose was to identify factors associated with anticancer therapy resumption after ICU discharge and to assess five-year survival. METHODS: This single-center retrospective observational study included consecutive adults with HMs admitted to intensive care unit (ICU) between 2014 and 2019. Multivariable analyses were performed to identify factors ass

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… We recorded the following characteristics of the HM: date of diagnosis, whether the diagnosis was made during the ICU stay, HM type, HM status at ICU admission (remission, new diagnosis, relapse diagnosis, progressive despite ongoing treatment, non-progressive with ongoing treatment, or watchful waiting … In addition, 85/247 (34.4%) patients were receiving active treatment and had non-progressive disease, 17/247 (6.9%) patients had progressive disease despite receiving active treatment, and 13/247 (5.3%) patients were being managed by watchful waiting. …

Antibodies to watch in 2013: Mid-year update.

The transitions of antibody therapeutics to late-stage clinical development, regulatory review and the market are proceeding at a rapid pace in 2013. Since late 2012, two monoclonal antibody (mAb) therapeutics (itolizumab, trastuzumab emtansine) received their first approvals, first marketing applications for three mAbs (vedolizumab, ramucirumab, obinutuzumab) were submitted to regulatory agencies, and five mAbs (brodalumab, MABp1, moxetumomab pasudotox, tildrakizumab, rilotumumab) entered their first Phase 3 studies. The current total of commercially-sponsored antibody therapeutics undergoing

High patient satisfaction and increased physical activity following a remote multidisciplinary team multiple myeloma clinic.

PURPOSE: Patients with multiple myeloma suffer from disease-related complications such as bone destruction, toxicities from repeated therapies and age-related co-morbidities. With improved treatment options, patients are living longer and have specific survivorship needs such as low exercise levels that need to be addressed. In this study, we designed, implemented and evaluated a multidisciplinary team (MDT) myeloma clinic that provided participants with tailored exercise and lifestyle advice. METHODS: The Promoting Individualised Self-Management and Survivorship (PrISMS) clinic was set up in

Clinical context and communication in shared decision-making about major surgery: Findings from a qualitative study with colorectal, orthopaedic and cardiac patients.

Increasing numbers of older people undergo major surgery in the United Kingdom (UK), with many at high risk of complications due to age, co-morbidities or frailty. This article reports on a study of such patients and their clinicians engaged in shared decision-making. Shared decision-making is a collaborative approach that seeks to value and centre patients' preferences, potentially addressing asymmetries of knowledge and power between clinicians and patients by countering medical authority with greater patient empowerment. We studied shared decision-making practices in the context of major su

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… + wait | Evaluative P08 | 1 | 70 (M) | 4+ | Knee pain (replacement 18 months ago) | 1, with surgeon Or04 (Oct-19) | Wife | Further investigations /watch + wait | Evaluative P09 | 2 | 81 (F) | 5 | Knee pain | 1, with surgeon Or05 (Oct-19) | Friend | Knee replacement | Evaluative Cardiac patients (n = … Further questioning revealed recent episodes of acute illness which changed the clinician’s framing of surgery to remove a small bowel tumour as potentially life-saving to possibly life-limiting, and a subsequent mutual commitment by clinician and patient to ‘watchful waiting’ rather than surgery; this …

"Is this the GVHD?" A qualitative exploration of quality of life issues in individuals with graft-versus-host disease following allogeneic stem cell transplant and their experiences of a specialist multidisciplinary bone marrow transplant service.

BackgroundGraft-versus-host disease (GVHD) is a significant cause of morbidity and mortality following allogeneic stem cell transplantation. These patients face unique challenges due to the complexity of GVHD which can affect multiple organ systems, and the toxicity of treatments. Despite the known impact on quality of life (QOL), qualitative data within the bone marrow transplantation (BMT) literature is rare, and there has been no qualitative work exploring patient experience of specialist healthcare provision for GVHD in the United Kingdom.MethodsWe conducted a primary explorative qualitati

How to treat primary cutaneous B cell lymphoma - Results from a monocentric cohort study on 98 patients.

BACKGROUND: Primary cutaneous B cell lymphomas (CBCL) are chronic diseases with frequent relapses. Time to next treatment (TTNT) is an endpoint reflecting clinical benefit of treatments including patient perspectives. The objectives were to evaluate clinical characteristics, survival, prognosis and TTNT in CBCL. PATIENTS AND METHODS: In this monocentric study, clinical data were extracted between 1998 and 2022. TTNT were calculated. Univariate and multivariate analyses were conducted. RESULTS: Altogether, 46 patients with follicle center lymphoma (pcFCL), 41 with marginal zone lymphoprolifer

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… Apart from watchful waiting, treatment of pcMZLPD patients may be deemed necessary due to possible impairment of quality of life from visible skin lesions or itching, which can increase patients’ urge to seek treatment. … In the current study, watchful waiting was done in exceptional cases only, because to our knowledge, there is no evidence supporting watchful waiting in pcMZLPD. 5 , 6 While pcFCL and pcMZLPD as indolent CBCL diseases entities show a good prognosis, patients with DLBCL‐LT still have a poor survival. …

The Value of Pharmaceutical Industry-Sponsored Patient Registries in Oncology Clinical Research.

In May 2019, the US Food and Drug Administration (FDA) released the Framework for FDA's Real-World Evidence (RWE) Program, a draft guidance to evaluate the potential use of real-world data in facilitating regulatory decisions. As a result, pharmaceutical companies and medical communities see patient registries, which are large, prospective, noninterventional cohort studies, as becoming increasingly important in providing evidence of treatment effectiveness and safety in clinical practice. Patient registries are designed to collect longitudinal clinical data on a broad population to address cri

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… For example, the LymphoCare Registry observed better outcomes in patients with follicular lymphoma (FL) who received rituximab maintenance. 55 LymphoCare also generated key data suggesting that a proportion of patients with FL may benefit from watchful waiting. 12 In another example, the AVIDA registry … Outcomes following watchful waiting for stage II-IV follicular lymphoma patients in the modern era. Br J Haematol. 2016;172(5):724-734. 10.1111/bjh.13895 13. Rifkin RM, Abonour R, Terebelo H, et al. Connect ® MM registry: the importance of establishing baseline disease characteristics. …