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Anticoagulation challenges in cancer patients: prevention, detection, and treatment strategies.

Cancer-associated thrombosis is one of the most common and serious complications in oncology patients, contributing significantly to morbidity and mortality. This prothrombotic state is driven by cancer-related factors, systemic inflammation, and treatment-induced endothelial injury. Anticoagulation management in these patients is challenging, as both thrombotic and bleeding risks must be carefully balanced, particularly in those with cardiovascular comorbidities. This review examines the complexities of anticoagulation in cancer-associated thrombosis through three clinical cases. Case 1 focus

Eliminating REMS for CAR T-Cell Therapies: An Opportunity to Improve Access.

Autologous Chimeric antigen receptor (CAR) T-cell therapies have demonstrated substantial efficacy in patients with relapsed or refractory hematologic malignancies; however, their implementation has been constrained by regulatory barriers. Risk Evaluation and Mitigation Strategies (REMS), mandated by the U.S. Food and Drug Administration (FDA), were initially implemented to mitigate risks associated with cytokine release syndrome (CRS), immune effector cell-associated neurotoxicity syndrome (ICANS), and other treatment-related toxicities. On 27 June 2025, the FDA removed REMS requirements for

Real-world patient characteristics and clinical outcomes in patients with myelofibrosis in Japan.

Anemia is associated with increased morbidity, mortality, healthcare resource utilization, and costs in myelofibrosis. This longitudinal, retrospective, and descriptive cohort study used a Japanese health administrative database (Medical Data Vision) to examine treatment patterns, transfusion burden, healthcare resource utilization, and costs in patients with myelofibrosis and a subset treated with a Janus kinase inhibitor. Ruxolitinib (a Janus kinase inhibitor) was the first targeted therapy for myelofibrosis in Japan (2014). Patients were identified from April 1, 2015 to June 30, 2022. In th

Cross-cultural development of an item list for computer-adaptive testing of fatigue in oncological patients.

IntroductionWithin an ongoing project of the EORTC Quality of Life Group, we are developing computerized adaptive test (CAT) measures for the QLQ-C30 scales. These new CAT measures are conceptualised to reflect the same constructs as the QLQ-C30 scales. Accordingly, the Fatigue-CAT is intended to capture physical and general fatigue.MethodsThe EORTC approach to CAT development comprises four phases (literature search, operationalisation, pre-testing, and field testing). Phases I-III are described in detail in this paper. A literature search for fatigue items was performed in major medical data

Orthopaedic Oncology in Contemporary Practice: A Comprehensive Review of Primary Bone Tumours, Metastatic Pathways, and Evolving Surgical Techniques.

Orthopaedic oncology encompasses the diagnosis and management of primary bone sarcomas and metastatic skeletal disease, requiring integration of oncologic principles with complex musculoskeletal reconstruction. Advances in molecular classification, cross-sectional imaging, systemic therapy, and surgical technology have substantially transformed contemporary clinical practice. This comprehensive review synthesises current evidence across epidemiology, tumour biology, diagnostic strategies, staging systems, multidisciplinary management, reconstructive techniques, complication profiles, and survi

Consideration on Food Effect Studies for Anticancer Drugs Approved in Japan Between 2001 and 2022.

In developing a new drug, studies to evaluate the food effect (FE) on the drug's pharmacokinetics (FE studies) are generally conducted in healthy subjects in the early stages of clinical development. Conversely, for anticancer drugs, which have many adverse effects, it is assumed that FE studies cannot be conducted in healthy subjects. However, many unknowns exist about how FE on oral anticancer drugs is examined in clinical development. In this study, we aimed to examine the characteristics of conducting FE studies on anticancer drugs approved in Japan to date. Between 2001 and 2022, 70 new o

Malignant Pleural Effusion: Palliative Managements and Indication for Pleurodesis Based on Survival Scores.

Neoplastic pleural effusion is one in which malignant neoplastic cells are detected in the pleural fluid or in the parietal pleura. When secondary, it confirms disseminated neoplastic disease and suggests a reduced life expectancy and low quality of life. This review was described by a group of physician members of the Brazilian Society of Oncological Surgery regarding the treatment of neoplastic pleural effusion, developed to guide surgeons, palliative care physicians and clinical oncologists in their clinical practice to assess patients indicated for pleurodesis based on survival scores.

Combined approach to treatment of advanced stages of medication-related osteonecrosis of the jaw patients.

INTRODUCTION: Increased incidence of localized osteonecrosis in the jaw bones caused by bisphosphanate use and reduced quality of life of the patients led researchers to diagnose the disease in the early period and to investigate the effective treatment modality. OBJECTIVE: Treatment of medication-related osteonecrosis of the jaw patients is based on individual protocols from clinical experience, as there are no definitive treatment guidelines. In view of the lack of consensus on the effectiveness of medication-related osteonecrosis of the jaw treatments in the literature, the aim of this stu

Blood and marrow transplantation during the emerging COVID-19 pandemic: the Seattle approach.

On January 20, 2020, the first patient with coronavirus disease 2019 (COVID-19) in the United States of America was diagnosed in Washington state, which subsequently experienced rapidly increasing numbers of COVID-19 cases, hospitalizations, and deaths. This placed the Seattle Blood and Marrow Transplant Program at Fred Hutchinson Cancer Research Center (Fred Hutch) in the national epicenter of this pandemic. Here, we summarize the experience gained during our rapid response to the COVID-19 pandemic. Our efforts were aimed at safely performing urgent and potentially life-saving stem cell trans

The burden of metastatic disease of the femur on the Medicare system.

BackgroundIn the United States, over 1,650,000 new cases of cancer are being diagnosed yearly with almost 50 % of them being the top five bone-seeking cancers. Since cancer risk increases with age, this suggests that orthopedic oncology services may be a strain on the Medicare system. The femur is the most common site of long bone metastases. Prophylactic fixation techniques prevent pathologic fractures, reduce morbidities, and enhance the quality of life of patients with femoral metastases. This study aims to assess the rate of metastatic disease to the skeleton and evaluate the use and finan

The impact of COVID-19 on autologous stem cell transplantation in multiple myeloma: A single-centre, qualitative evaluation study.

Autologous stem cell transplantation (ASCT) is standard of care in biologically fit, newly diagnosed multiple myeloma (MM) patients, offering better therapeutic outcomes and improved quality of life (QoL). However, with the UK's 1st national lockdown on 23/03/2020, several guidelines recommended deferring ASCT due to risks of infection, with resource limitations forcing some units to suspend ASCT entirely. Such changes to patients' treatment plans inevitably altered their lived experience during these uncertain times with expected impact on QoL. We conducted a qualitative study using semi-stru

Impact of hospital variation in hematologic malignancy patient proportions on outcomes of chronic lymphocytic leukemia patients undergoing cardiac surgery: insights from nationwide data analysis.

OBJECTIVE: This study aimed to investigate the impact of the proportion of hematologic malignancy patients in hospitals on the prognosis of chronic lymphocytic leukemia (CLL) patients undergoing cardiac surgery. Perioperative management of CLL patients is complex, particularly regarding immunosuppression and infection risks. METHODS: This retrospective study utilized data from the National Inpatient Sample (NIS) from 2010 to 2021. Adult CLL patients undergoing cardiac surgery were included, categorizing hospitals into five quintiles based on hematologic malignancy patient proportions. Outcome

Metastatic bone disease in proximal femur. Outcome of surgical treatments. - Do we know what to do?

BACKGROUND: Skeletal metastases related pathological fracture reconstruction methods in proximal femur range from osteosynthesis to tumor prostheses with acetabular reconstruction, depending on lesion size and location. This retrospective study, of 299 patients surgically treated for proximal femur metastases, investigates implant survival, complications, and functional outcomes of various surgical strategies for treating pathological fractures of the proximal femur. PATIENTS AND METHODS: This retrospective study of 299 patients surgically treated for proximal femur metastases, investigates i

State-of-the-art imaging for diagnosis of metastatic bone disease.

Metastatic bone disease (MBD) is common-it is detected in up to 65-75% of patients with breast or prostate cancer, in over 35% of patients with lung cancer; and almost all patients with symptomatic multiple myeloma have focal lesions or a diffuse bone marrow infiltration. Metastatic bone disease can cause a variety of symptoms and is often associated with a poorer prognosis, with high social and health-care costs. Population-based cohort studies confirm significantly increased health-care utilization costs in patients presenting with cancer with MBD compared with those without MBD. The prolong

Malignant Melanoma Bone Metastasis With Unknown Primary Site: A Case Report and Literature Review.

IntroductionCases of malignant melanoma first identified in bone are relatively uncommon. Approximately 4.3% of the patients will have metastasis, among which 23% will have metastasis to the bone.Case presentationThis article presents a case involving malignant melanoma with a metastatic lesion located at the distal femur, which was the initial symptom observed. The patient was a 21-year-old male who was admitted to the hospital due to intermittent pain in his lower left thigh. Imaging studies indicated bone destruction in the distal left femur, and pathological and immunohistochemical confirm

Nonrestrictive diet does not increase infections during post-HSCT neutropenia: data from a multicenter randomized trial.

Infections are a major cause of morbidity and mortality during neutropenia after hematopoietic stem cell transplantation (HSCT). The use of a low-microbial protective diet (PD) in the peritransplantation period is a standard of care, although its efficacy has never been tested prospectively. We conducted a multicenter, randomized, noninferiority trial, enrolling all consecutive adult patients undergoing high-dose induction chemotherapy or HSCT with the objective to compare nonrestrictive diet (NRD) vs PD. Overall, 222 patients were enrolled, randomly assigned, and analyzed. One hundred seventy

Nursing Procedures for the Prevention and Treatment of Mucositis Induced by Cancer Therapies: Clinical Practice Guideline Based on an Interdisciplinary Consensus Process and a Systematic Literature Search.

BackgroundPatients with cancer receiving tumor therapy often suffer from oral mucositis.ObjectivesThe aim of this project was to summarize experiences with nursing procedures by experts in integrative oncology and to establish recommendations for nursing interventions that can prevent or cure mucositis.MethodsThe study design was an interdisciplinary consensus process based on a systematic literature search.ResultsThe panel discussed and agreed on 19 nursing procedures, which included mouthwashes, such as teas, supplements, oil applications, and different kinds of ice cubes to suck, as well as

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… This method represents a significant advancement in non-invasive cardiovascular diagnosis and has the potential to improve patient management, reduce unnecessary procedures by reassessing the need of surgical interventions, improving medical management, and optimize clinical outcomes. …

Lymph node metastasis in cancer progression: molecular mechanisms, clinical significance and therapeutic interventions.

Lymph nodes (LNs) are important hubs for metastatic cell arrest and growth, immune modulation, and secondary dissemination to distant sites through a series of mechanisms, and it has been proved that lymph node metastasis (LNM) is an essential prognostic indicator in many different types of cancer. Therefore, it is important for oncologists to understand the mechanisms of tumor cells to metastasize to LNs, as well as how LNM affects the prognosis and therapy of patients with cancer in order to provide patients with accurate disease assessment and effective treatment strategies. In recent years

Risk of malignancy in kidney transplant recipients: a nationwide population-based cohort study.

BackgroundPost-transplant malignancy is major morbidity complicated in kidney transplantation (KT). In Korea, a few studies have investigated the sex- and age-dependent risk for post-transplant malignancy among KT recipients on a large scale.MethodsWe utilized a national health insurance database in Korea to investigate the relative risk of post-transplant malignancy in 12,634 KT recipients between 2007 and 2017. The same number of patients with acute appendicitis was included as a control group. The relative risk of malignancy was estimated using a multivariable-adjusted Cox model, and intera