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Impact of Cytogenetic Abnormalities, Induction and Maintenance Regimens on Outcomes After High-Dose Chemotherapy and Autologous Stem Cell Transplantation in Patients With Newly Diagnosed Multiple Myeloma: A Decade-Long Real-World Experience.

BackgroundHigh-dose chemotherapy and autologous stem cell transplant (HDT-ASCT) has become a standard of care for transplant eligible newly diagnosed multiple myeloma (NDMM) patients. While cytogenetic abnormalities have been shown to affect outcomes after HDT-ASCT in clinical trials, these trials often exclude or underrepresent elderly patients with comorbidities and those belonging to ethnic minorities. We describe our institutional experience highlighting the impact of high-risk cytogenetic abnormalities (HRCAs) on outcomes after HDT-ASCT for NDMM patients.MethodsA total of 449 patients wit

Impact of COVID-19 pandemic on 2-[18F]FDG PET/CT imaging work-flow in a single medical institution: comparison among the three Italian waves.

PurposeTo compare the impact of COVID-19 pandemic on 2-[18F]FDG PET/CT imaging work-flow during the three waves in a medical institution of southern of Italy.MethodsWe retrospectively reviewed the numbers and results of 2-[18F]FDG PET/CT studies acquired during the following three periods of the COVID-19 waves: 1) February 3-April 30, 2020; 2) October 15, 2020-January 15, 2021; and 3) January 18-April 16, 2021.ResultsA total of 861 PET/CT studies in 725 patients (388 men, mean age 64 ± 4 years) was acquired during the three waves of COVID-19 pandemic. The majority (94%) was performed for diagn

Are patients with cancer with sepsis and bacteraemia at a higher risk of mortality? A retrospective chart review of patients presenting to a tertiary care centre in Lebanon.

ObjectiveMost sepsis studies have looked at the general population. The aim of this study is to report on the characteristics, treatment and hospital mortality of patients with cancer diagnosed with sepsis or septic shock.SettingA single-centre retrospective study at a tertiary care centre looking at patients with cancer who presented to our tertiary hospital with sepsis, septic shock or bacteraemia between 2010 and 2015.Participants176 patients with cancer were compared with 176 cancer-free controls.Primary and secondary outcomesThe primary outcome of this study was the in hospital mortality

Early timepoint 99mTc-DPD whole body scintigraphy and quantitative SPECT/CT imaging for diagnosis of cardiac ATTR amyloidosis.

BACKGROUND: Cardiac transthyretin amyloidosis (ATTR-CM) is a progressive myocardial disease ultimately leading to heart failure. Standard diagnostic workup includes 99mTc-DPD scintigraphy performed after 2.5-3 h. The purpose of this study is to compare early (1 h after injection) to late imaging of 99mTc-DPD scintigraphy and SPECT for the detection of ATTR-CM. Early imaging could improve patient comfort and examination efficiency. RESULTS: 50 patients undergoing 99mTc-DPD scintigraphy and SPECT for suspected ATTR-CM were included. Imaging was performed at both 1 h and 2.5-3 h post-injection.

Recognition and management of persistent chylomicronemia: A Joint Expert Clinical Consensus by the National Lipid Association and the American Society for Preventive Cardiology.

Extreme hypertriglyceridemia, defined as triglyceride (TG) levels ≥1000 mg/dL, is almost always indicative of chylomicronemia. The current diagnostic approach categorizes individuals with chylomicronemia into familial chylomicronemia syndrome (FCS; prevalence 1-10 per million), caused by the biallelic combination of pathogenic variants that impair the lipolytic action of lipoprotein lipase (LPL), or multifactorial chylomicronemia syndrome (MCS, 1 in 500). A pragmatic framework should emphasize the severity of the phenotype and the risk of complications. Therefore, we endorse the term "persiste

Causal Estimation of Long-term Intervention Cost-effectiveness Using Genetic Instrumental Variables: An Application to Cancer.

BACKGROUND: This article demonstrates a means of assessing long-term intervention cost-effectiveness in the absence of data from randomized controlled trials and without recourse to Markov simulation or similar types of cohort simulation. METHODS: Using a Mendelian randomization study design, we developed causal estimates of the genetically predicted effect of bladder, breast, colorectal, lung, multiple myeloma, ovarian, prostate, and thyroid cancers on health care costs and quality-adjusted life-years (QALYs) using outcome data drawn from the UK Biobank cohort. We then used these estimates i

Impact of cancer diagnoses on the outcomes of patients with COVID-19: a systematic review and meta-analysis.

BackgroundThe COVID-19 has caused significant mortality and morbidity across the globe. Patients with cancer are especially vulnerable given their immunocompromised state. We aimed to determine the proportion of COVID-19 patients with cancer, their severity and mortality outcomes through a systematic review and meta-analysis (MA).MethodsSystematic review was performed through online databases, PubMed, Medline and Google Scholar, with keywords listed in the Methods section (1 November 2019-31 December 2020). Studies with clinical outcomes of at least 10 COVID-19 patients and at least one with a

CAR-T cell therapies in autoimmune rheumatic diseases: a brief report on the clinical trial landscape, current status, and future perspectives.

Autoimmune rheumatic diseases (ARDs) are chronic inflammatory disorders where B cells play a key role. Traditional B-cell-targeted therapies have limitations, whereas CAR-T-cell therapy, which aims for a broader reset of the B-cell compartment by targeting B-cell surface markers such as CD19 or B-cell maturation antigen (BCMA), has unique advantages. Currently, most CAR-T cell trials for ARDs are in the early stages, with 64.29% (36/56 trials) of studies being phase I trials and only 7.14% (4/56 trials) progressing to phase II trials, primarily focusing on conditions, such as systemic lupus er

Advancing access to CAR T-cell therapy: insights and real-world experience from a community oncology practice.

IntroductionChimeric antigen receptor (CAR) T-cell therapy has transformed the treatment of hematologic malignancies, offering durable remissions for patients with otherwise refractory disease. However, access to these therapies remains limited and primarily restricted to academic medical centers, contributing to significant geographic and demographic disparities in care delivery.MethodsWe conducted a retrospective review of a community practice-based outpatient CAR T-cell therapy program, independent of academic or hospital affiliation, treating patients with relapsed hematologic malignancies

Clinicopathological Features and Prognostic Differences Between Primary and Relapsed or Refractory Extramedullary Multiple Myeloma.

PURPOSE: This study aims to explore the clinicopathological features related to extramedullary multiple myeloma (EMM) occurrence and evaluate prognosis differences between patients with primary EMM (PEMM) and those with relapsed or refractory EMM (R/REMM). PATIENTS AND METHODS: The laboratory test results, clinical, histopathological and immunophenotypic characteristics, cytogenetic changes and prognosis of 203 patients with MM were obtained. The patients were categorized into EMM+ and EMM- groups. Patients in the EMM+ group were further categorized into the PEMM and R/REMM groups based on th

Patient Preferences for Treatment in Relapsed/Refractory Acute Leukemia in the United Kingdom: A Discrete Choice Experiment.

BackgroundAcute leukemia is a cancer of the white blood cells which progresses rapidly and aggressively. There are two types: acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML). The latter has a rare subtype: acute promyelocytic leukemia (APL). For some patients, following first-line treatment, remission is not achieved ("refractory disease"), and for others the leukemia returns after achieving remission ("relapse"). For these individuals, outcomes are typically poor. It is, therefore, important to understand patients' treatment priorities in this context.MethodsBuilding upon

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… Disclosure David John Mott and Chris Skedgel are employees of the Office of Health Economics (OHE), a registered charity, and an Independent Research Organisation, which receives funding from a variety of private and public sector sources. …

Dental management before radiotherapy of the head and neck region: 4-year single-center experience.

OBJECTIVE: To review our experience with a standardized dental management approach in patients with planned radiotherapy of the head and neck region based on preradiation and follow-up data. MATERIAL AND METHODS: Records of patients who underwent radiotherapy between June 2016 and November 2020 were reviewed. Data on dental findings and therapeutic recommendations were extracted from a prospectively managed database. Hospital records were used to obtain follow-up data. RESULTS: Two hundred eighty-one patient records were identified. After the exclusion of 81 patients because of incomplete da

Impact of the comprehensive geriatric assessment on treatment decision in geriatric oncology.

BackgroundThe comprehensive geriatric assessment (CGA) is the gold standard in geriatric oncology to identify patients at high risk of adverse outcomes and optimize cancer and overall management. Many studies have demonstrated that CGA could modify oncologic treatment decision. However, there is little knowledge on which domains of the CGA are associated with this change. Moreover, the impact of frailty and physical performance on change in cancer treatment plan has been rarely assessed.MethodsThis is a cross-sectional study of older patients with solid or hematologic cancer referred by oncolo

Management of bone health in patients with cancer: a survey of specialist nurses.

BackgroundPatients with cancer can experience bone metastases and/or cancer treatment-induced bone loss (CTIBL), and the resulting bone complications place burdens on patients and healthcare provision. Management of bone complications is becoming increasingly important as cancer survival rates improve. Advances in specialist oncology nursing practice benefit patients through better management of their bone health, which may improve quality of life and survival.MethodsAn anonymised online quantitative survey asked specialist oncology nurses about factors affecting their provision of support in

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… There was a wide range of institution types represented in the survey (e.g. public sector, general hospital) (Table 1 ). …

Ibandronate to treat skeletal-related events and bone pain in metastatic bone disease or multiple myeloma: a meta-analysis of randomised clinical trials.

ObjectiveRandomised controlled trials (RCTs) have given contradictory results about the efficacy and safety of ibandronate in treating metastatic bone disease (MBD) or multiple myeloma. This review meta-analysed the literature to gain a more comprehensive picture.DesignSystematic review and meta-analysis of ibandronate compared with placebo or zoledronate.Data sourcesPubMed, EMBASE and the Cochrane Library databases were systematically searched to identify RCTs published up to March 2015 evaluating ibandronate to treat MBD or multiple myeloma.Review method10 RCTs involving 3474 patients were i

Current landscape of clinical development and approval of advanced therapies.

Advanced therapy medicinal products (ATMPs) are innovative therapies that mainly target orphan diseases and high unmet medical needs. The uncertainty about the product's benefit-risk balance at the time of approval, the limitations of nonclinical development, and the complex quality aspects of those highly individualized advanced therapies are playing a key role in the clinical development, approval, and post-marketing setting for these therapies. This article reviews the current landscape of clinical development of advanced therapies, its challenges, and some of the efforts several stakeholde

Несоответствие между готовностью к вакцинации и фактическим состоянием вакцинации SARS-COV-2 у людей с множественным склерозом: продольное исследование.

Фон/цели: Заражение острым острым респираторным синдромом коронавируса типа 2 (SARS-COV-2) создает значительный риск для здоровья, особенно для лиц с хроническими заболеваниями. Множественный склероз (MS) является наиболее распространенным хроническим неврологическим расстройством с иммунной помощью, и вакцинация имеет важное значение для его лечения. Цель этого исследования заключалась в сопоставлении заявленной готовности к вакцинации против SARS-COV-2 с фактическим состоянием вакцинации людей с MS (PwMS) и выявлении факторов, объясняющих это несоответствие. Методы: В продольном двухцентрово

Bridging the gap: a pre-post feasibility study of embedding exercise therapy into a co-located cancer unit.

PurposeTo establish the feasibility of embedding a flexible, exercise-based rehabilitation program into a cancer treatment unit to allow cancer survivors early exercise support.MethodA pre-post study was conducted using Bowen's Framework to describe key domains of feasibility: demand (referrals), acceptability (uptake, attendance, satisfaction), implementation (resources), practicality (adverse events, costs) and limited-efficacy (function, quality of life, self-efficacy). Participants were medically stable, adult cancer survivors receiving curative or palliative treatment for cancer at the he

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… Independent Hospital Pricing Authority (2019) National Hospital Cost Data Collection Report, Public Sector, Round 21 (Financial year 2016–17) 46. …

:: < < Достижение цели в отношении оптимальной стратегии по борьбе с раком посевов: систематический обзор с использованием мета-анализа > > .

Комбинационные режимы продемонстрировали превосходство над отдельными агентами в привязке к ресектированному раку поджелудочной железы (ПХ), однако данных, подтверждающих определение наилучшего режима, не имеется. Эта работа была направлена на сопоставление эффективности и безопасности moFOLFIRINOX, gemcitabine+capecitabine и gemcitabine+nab/paclitaxel у пациентов с ПК. Был проведен метаанализ для прямого сопоставления между испытаниями на сопоставление комбинированных режимов и монотерапией жемчуга. Впоследствии было проведено косвенное сопоставление между испытаниями по изучению эффективност

Optimal Treatment of Retinal Vein Occlusion: An Updated Canadian Review and Recommendations.

Retinal vein occlusion (RVO) represents a heterogeneous group of disorders that remains the second most common retinal vascular disease and can be associated with vision loss. RVO confers a substantial burden of illness that affects patients, caregivers, medical systems, and physicians. Complications of RVO - including cystoid macular edema, macular ischemia, and neovascularization sequelae - may result in severe visual morbidity and blindness. Canadian expert consensus recommendations on the optimal treatment of patients with RVO were published in 2015. Since that time, advances in diagnosis