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Work, daily activities and leisure after cancer.

ObjectiveDetermine if cancer survivors have lower participation in paid work, more limitations in daily activities or more limitations in leisure compared with those without cancer, stratified by age (working age ≤65 years; retirement age >65 years). Secondary objectives are identifying sociodemographic or clinical factors associated with work, daily activities or leisure and analysis of the relationship between work, daily activities and leisure.MethodsSecondary analyses, using logistic regression, were performed on three cohorts (lymphoma, prostate and thyroid cancer) from the Dutch Patient

COVID-19 and haematology services in a cancer centre from a middle-income country: adapting service delivery, balancing the known and unknown during the pandemic.

The COVID-19 pandemic has caused major disruptions in multiple spheres of healthcare delivery in the world. Developing nations have had to tackle this unanticipated crisis in the midst of various other healthcare delivery issues and resource constraints. As a tertiary level cancer care provider located in an eastern Indian city, a COVID-19 hotspot, we share our experience from the perspective of haematology and haematopoietic stem cell transplantation (HSCT) services. The primary challenges related to infection control included infection screening and decreasing exposure among patients and hea

Patient-Centered Insights on Treatment Decision Making and Living with Acute Myeloid Leukemia and Other Hematologic Cancers.

Expectations relating to treatment and survival, and factors influencing treatment decisions are not well understood in adult patients with acute myeloid leukemia. This study analyzed combined findings from a targeted literature review with patient-reported information shared on YouTube to further understand patient perspectives in hematologic cancers and, in particular, acute myeloid leukemia. The targeted literature review included articles concerning patient (aged ≥ 18 years) experiences or perspectives in acute myeloid leukemia or other hematologic cancers. YouTube video selection criteria

How I manage frontline transplant-ineligible multiple myeloma.

The Multiple Myeloma (MM) is a plasma cells hematological malignancy with a median age of 69 years at diagnosis. The autologous stem cell transplantation is the standard of care for this disease but less than half of newly diagnosed patients are assessed for this treatment due to comorbidities or complications of disease. The management of transplant ineligible MM patients is based on the balance safety and efficacy of the new available regimen and a careful assessment of the frailty status is mandatory to define the goals. In this review we discuss of the clinical dilemmas in the management a

Evaluation of safety and analgesic consumption in patients with advanced cancer treated with zoledronic acid.

BackgroundThe aim of the study was evaluation of zoledronic acid with regard to safety, effect on analgesic consumption and impact on occurrence of skeletal related events in patients with bone lesions from solid tumors and multiple myeloma.MethodsWe conducted an observational, 12-month, phase IV and multi-center study. One hundred and twenty-five symptomatic (pain) bone-metastatic patients were included between 2007 and 2009: 92 prostate cancers, 28 multiple myelomas, 5 others. They were prescribed monthly infusions of zoledronic acid in accordance to each disease's treatment guidelines. Anal

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… If approached similarly to multiple myeloma, all patients who are treated systemically (hormonally) for prostate cancer would be treated with bisphosphonates, perhaps sparing only patients on watchful waiting, which is equivalent disease stage to smouldering myeloma. …

Management of Patients With Hematologic Malignancies During the COVID-19 Pandemic: Practical Considerations and Lessons to Be Learned.

The COVID-19 pandemic has created unprecedented hurdles to the delivery of care to patients with cancer. Patients with hematologic malignancies appear to have a greater risk of SARS-CoV-2 infection and severe disease due to myelosuppression and lymphopenia. The first challenge, therefore, is how to continue to deliver effective, curative therapy to vulnerable patients and at the same time avoid exposing them, and their health care teams (HCT), to SARS-CoV-2. An additional challenge is the timely completion of the diagnostic and staging studies required to formulate appropriate treatment plans.

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… Consensus guidelines for CLL and indolent lymphomas have long routinely supported watchful waiting and initiation of therapy only when there is a clear indication. These criteria remain valid and should be followed even more strictly during the pandemic. …

Fit theory: A cancer experience grounded theory emerging from semi-structured interviews with cancer patients and informal caregivers in Manitoba Canada during the COVID-19 pandemic.

BackgroundIt is not clear how changes to healthcare delivery related to the COVID-19 pandemic, including virtual care and social distancing restrictions, have impacted the experience of living with cancer. This study aimed to discover a theory capable of describing the cancer experience, how the pandemic impacted it, and for guiding predictions about how to improve it.MethodsBetween October 2020 and July 2021 digitally recorded semi-structured one-on-one interviews were conducted virtually with adult cancer patients and informal caregivers in Manitoba, Canada. Transcriptions and field notes fr

Chronic Lymphocytic Leukemia-Induced Humoral Immunosuppression: A Systematic Review.

Secondary immunodeficiency is observed in all patients with chronic lymphocytic leukemia (CLL) in varying degrees. The aim of the study was to review the available literature data on patients with CLL, with particular regard to the pathogenesis of the disease and the impact of humoral immunity deficiency on the clinical and therapeutic approach. A systematic literature review was carried out by two independent authors who searched PubMed databases for studies published up to January 2020. Additionally, Google Scholar was used to evaluate search results and support manual research. The search r

Impact of lenalidomide consolidation on health-related quality of life in chronic lymphocytic leukemia: ancillary study of the phase III CLL6-RESIDUUM trial.

BackgroundWithin the French-Australian CLL6 RESIDUUM trial, an ancillary study aimed at assessing the health-related quality of life (HRQoL) of patients with chronic lymphocytic leukemia (CLL) receiving a two-year consolidation of lenalidomide (LEN) or observation (OBS) after classical immunochemotherapy leaving them with detectable residual disease.MethodsData from French patients involved in this the trial were used here. The EORTC QLQ-C30 version 3 questionnaire was completed by patients at baseline, and then at months 3, 6, 12, 18 and 24 after consolidation. Repeated measures mixed-effects

Variations in specialist palliative care referrals: findings from a population-based patient cohort of acute myeloid leukaemia, diffuse large B-cell lymphoma and myeloma.

OBJECTIVE: To develop and implement a methodology for capturing complete haematological malignancy pathway data and use it to identify variations in specialist palliative care (SPC) referrals. METHODS: In our established UK population-based patient cohort, 323 patients were diagnosed with acute myeloid leukaemia, diffuse large B-cell lymphoma or myeloma between May 2005 and April 2008, and died before April 2010. A day-by-day calendar approach was devised to collect pathway data, including SPC referrals, to supplement routinely collected information on clinical presentation, diagnosis, treatm

Brazilian consensus recommendations on the diagnosis and treatment of light chain amyloidosis.

INTRODUCTION: Systemic immunoglobulin light chain amyloidosis is characterized by the extracellular deposition of misfolded light chains, leading to progressive dysfunction of multiple organs. Diagnosis remains a significant clinical challenge and is frequently delayed due to the presence of nonspecific symptoms, coupled with limited access to specialized diagnostic tools and expertise. Currently, no established national recommendations for the diagnosis and management of this condition exist in Brazil. METHODS: These expert recommendations were developed following a structured advisory meeti

Злоумышленные преобразования у пациентов с моноклонной гаммопатией неизвестного значения, обработанных терипаротидом для остеопороза: ретроспективное исследование двухцентра и анализ французской национальной базы данных о фармакологической бдительности.

UNLABELLED: Была проведена оценка злокачественных трансформаций у пациентов с моноклональной гаммопатией неопределенного значения, обработанных терипаратидом. Среди 29 только пациенты two Перешел к гематологическому искусству.one Множественная миелома, one Макроглобулинемия Уолденстрёма). Эти выводы обнадеживают и свидетельствуют о том, что ТПТ может оставаться одним из вариантов для отдельных пациентов с тяжелым остеопорозом и MGUS. ЦЕЛЬ: Остеопороз является широко распространенным заболеванием костей с ограниченными терапевтическими возможностями, особенно у пациентов, страдающих множественн

Heyde Syndrome Unveiled: A Case Report with Current Literature Review and Molecular Insights.

Heyde syndrome, marked by aortic stenosis, gastrointestinal bleeding from angiodysplasia, and acquired von Willebrand syndrome, is often underreported. Shear stress from a narrowed aortic valve degrades von Willebrand factor multimers, leading to angiodysplasia formation and von Willebrand factor deficiency. This case report aims to raise clinician awareness of Heyde syndrome, its complexity, and the need for a multidisciplinary approach. We present a 75-year-old man with aortic stenosis, gastrointestinal bleeding from angiodysplasia, and acquired von Willebrand syndrome type 2A. The patient w

Presumptive Prostate Cancer Presenting as Low Back Pain in the Chiropractic Office: Two Cases and Literature Review.

Prostate cancer is a common type of cancer in men and may metastasize to the spine and pelvis, causing back and/or radicular pain that appears to be musculoskeletal. This presents a diagnostic challenge and can be complicated by a lack of routine screening for prostate cancer. In two similar cases, elderly males (ages 78 and 82) with no known history of cancer and no previous prostate-specific antigen screening presented to a chiropractor with chronic, worsening radiating low back pain. In each case, a previous provider obtained radiographs and ascribed symptoms to a non-cancerous etiology (i.

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… After discussing treatment options with the oncologist, the patient chose to forego biopsy, radiation, and chemotherapy, instead electing for watchful waiting and symptom management. …

Autologous stem cell transplantation for multiple myeloma patients whose myeloma-defining event was SLiM.

In 2014, the International Myeloma Working Group (IMWG) updated the criteria for diagnosing myeloma and added three additional criteria to the traditional Calcium elevation, Renal impairment, Anemia, Bone disease (CRAB) criteria, called the Sixty % marrow plama cells, Light chain ratio >60, Mri demonstates lytic lesions (SLiM) criteria (clonal bone marrow plasma cells ≥60%, involved to uninvolved free light chain ratio (FLCr) ≥100 and >1 focal lesion on magnetic resonance imaging (MRI)). We report on the outcomes of 30 patients who underwent autologous stem cell transplantation (ASCT) where th

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… Moreover, with the major progress that has occurred in the treatment of MM, and although watchful waiting may have been appropriate in an era of alkylating agents and corticosteroids, intervention seemed justifiable for ultra‐high‐risk patients given the availability of safer and more effective treatments …

Primary central nervous system lymphomas: EHA-ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up.

This EHA-ESMO Clinical Practice Guideline provides key recommendations for managing primary DLBCL of the CNS.The guideline covers clinical, imaging and pathological diagnosis, staging and risk assessment, treatment and follow-up.Algorithms for first-line and salvage treatments are provided.The author group encompasses a multidisciplinary group of experts from different institutions and countries in Europe.Recommendations are based on available scientific data and the authors' collective expert opinion.

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… Consolidation with WBRT at conventional doses (40 Gy ± boost) has been increasingly abandoned in elderly patients with PCNSL due to the high risk of severe neurotoxicity, 66 whereas ‘watchful waiting’ is suggested only in patients in CR after well‐established induction immunoChT. … Watchful waiting can be considered in elderly patients in CR after induction with an established drug combination [II, B]. …

Physical Performance, Sarcopenia and Malnutrition-Basic Test Set for Everyday Use in Cancer Therapy.

PURPOSE: Testing physical performance, malnutrition, and sarcopenia is recommended in numerous guidelines for hematological-oncological patients. However, due to economic conditions and the large number of test options, these tests have not made it into clinical routine. The aim of this study is to propose a practical compromise that could allow routine testing under the current conditions. METHODS: We conducted a prospective, monocentric, small-scale cohort study. In our interdisciplinary tumor outpatient clinic, we investigated time required for malnutrition screening (PG-SGA long form), ma

Dying of Stress: Chemotherapy, Radiotherapy, and Small-Molecule Inhibitors in Immunogenic Cell Death and Immunogenic Modulation.

Innovative strategies to re-establish the immune-mediated destruction of malignant cells is paramount to the success of anti-cancer therapy. Accumulating evidence suggests that radiotherapy and select chemotherapeutic drugs and small molecule inhibitors induce immunogenic cell stress on tumors that results in improved immune recognition and targeting of the malignant cells. Through immunogenic cell death, which entails the release of antigens and danger signals, and immunogenic modulation, wherein the phenotype of stressed cells is altered to become more susceptible to immune attack, radiother

Does Double Mean Trouble? Coexistence of Myeloproliferative and Lymphoproliferative Neoplasms.

Background: The occurrence of myeloproliferative neoplasms (MPNs) that evolve into each other is well-described, as is this occurrence of lymphoproliferative neoplasms (LPNs). However, less is known about rare MPN/LPN coexistence, and the aim of our study was to analyze charachteristics of these patients after long term follow-up. Methods: Fourteen patients with MPN/LPN coexistence were diagnosed and treated according to guidelines at a single university center across two decades. Results: The overall median age was 53 years (22-69). MPNs patients with subsequent LPNs had a shorter period of s

Role of bendamustine in the treatment of chronic lymphocytic leukemia.

Major advances in the management of patients with chronic lymphocytic leukemia (CLL) include an enhanced ability to make an accurate diagnosis and define clinically meaningful prognostic groups, while improving outcome through more effective therapeutic regimens and supportive care. Nevertheless, CLL remains an incurable disorder and new, active agents are needed. Bendamustine, a unique cytotoxic agent with structural similarities to both alkylating agents and antimetabolites, was recently approved by the US Food and Drug Administration for treatment of CLL and rituximab-refractory indolent no