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Отношение группы по гемато-онкологии к тому, чтобы направлять пациентов на паллиативный уход: качественное исследование.

ЦЕЛЬ: Согласно международной литературе, пациенты с гематологическими заболеваниями часто обращаются к паллиативному лечению (ПХ) на позднем этапе. Цель этого исследования заключается в изучении отношения группы по уходу за гемато-онкологами к направлению пациентов на ПК в больницу четвертого уровня в Боготе (Distrito Capital). МЕТОДЫ: Это аналитическое качественное исследование проводилось в рамках индивидуальных целевых групп в период с мая 2024 и октябрь 2024 в Университете Колумбии в Боготе, Колумбия. Данные анализировались на тематической основе с использованием рамочного анализа - аналит

A Combined Cyto- and Histopathological Diagnostic Approach Reduces Time to Diagnosis and Time to Therapy in First Manifestation of Metastatic Spinal Disease: A Cohort Study.

Malignant spinal lesions (MSLs) are frequently the first manifestation of malignant disease. Spinal care, diagnostic evaluation, and the initiation of systemic therapy are crucial for outcomes in patients (pts) with advanced cancer. However, histopathology (HP) may be time consuming. The additional evaluation of spinal lesions using cytopathology (CP) has the potential to reduce the time to diagnosis (TTD) and time to therapy (TTT). CP and HP specimens from spinal lesions were evaluated in parallel in 61 pts (CP/HP group). Furthermore, 139 pts in whom only HP was performed were analyzed (HP gr

The Acidic Microenvironment: Is It a Phenotype of All Cancers? A Focus on Multiple Myeloma and Some Analogies with Diabetes Mellitus.

Multiple myeloma (MM) is a hematological malignancy with a poor prognosis while with a long and progressive outcome. To date, the therapeutic options are restricted to few drugs, including thalidomide or its derivates and autologous transplantation including stem-cell transplantation. More recently, the use of both proteasome inhibitors and monoclonal antibodies have been included in MM therapy, but the clinical results are still under evaluation. Unfortunately, death rates (within the 5-year overall survival rates) are still very high (45%), with no relevant improvement over the past 10 years

European Expert Panel Consensus on Outpatient Administration of Teclistamab and Talquetamab in Patients With Multiple Myeloma: Feasibility, Key Considerations, and Future Directions.

ObjectivesTeclistamab and talquetamab treatments are typically initiated in a hospital due to the potential risk of cytokine release syndrome. However, emerging data support the potential for outpatient administration (i.e., administration without overnight hospital admission). An expert consensus survey and meeting were conducted among European specialists in multiple myeloma treatment to evaluate current and future outpatient administration with teclistamab and talquetamab in clinical practice.MethodsAll experts completed a 17-question survey, participated in an individual follow-up call, an

How Can Imaging Help the Radiation Oncologist in Multiple Myeloma Treatment.

Multiple myeloma is an incurable malignant tumor of plasma cells of the bone marrow; most patients present a disseminated disease with important bone involvement. Even though a chemotherapy-based approach is the major treatment, radiotherapy often has a supportive role for symptom relief but also a radical role for patients with indolent disease or localized forms. In both cases imaging is the basis for treatment planning and for correct patient classification. This paper aims to describe and summarize how radiation oncologists could use imaging information to personalize the treatment for eac

First-line therapy with daratumumab, lenalidomide and dexamethasone for patient with POEMS syndrome: A case report.

POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, M-protein, skin changes syndrome) is a rare condition due to an underlying plasma cell neoplasm whose clinical presentation can be various so it could lead to delayed diagnosis and treatment. The pathogenesis of the syndrome is not well understood, and its therapy is adapted from other plasma cell disorders with the aim of alleviating symptoms, decreasing end-organ damage, improving quality of life and prolonging overall survival. We report a case of a 71 years-old woman who has been treated with continuous DRd (daratumumab, lenalid

Infection rate and clinical management of cancer patients during the COVID-19 pandemic: experience from a tertiary care hospital in northern Italy.

BackgroundOptimal management of patients with cancer during COVID-19 pandemic is still pending.MethodsOur patients were advised to maintain their scheduled appointments, and planned cancer treatment was continued without unnecessary delays in an outpatient setting. Additional strict preventive infection measures were rapidly implemented at our outpatient department. When COVID-19 test became widely available, universal testing of healthcare workers and vigorous screening of all patients coming to our facility for COVID-19 infection were performed by SARS-CoV-2 real-time reverse transcription P

A rare case of POEMS syndrome presenting as essential thrombocythemia.

Polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, skin changes (POEMS) is a rare paraneoplastic syndrome, and its diagnosis is based on a series of clinical and laboratory findings. We present the case of a 46-year-old woman who was previously diagnosed with essential thrombocythemia. The patient complained about dyspnea on exertion, nausea, burning of the lower limbs, weight loss, recurrent episodes of lower back pain and polymenorrhea. Physical examination revealed hyperpigmentation, livedo reticularis of the lower limbs, sclerodermoid changes and plectrodactyly. A computed t

Clinical and biochemical characteristics for patients with polyneuropathy, organomegaly, endocrinopathy, M-protein, and skin changes syndrome: a pilot observational study.

BACKGROUND: Polyneuropathy, organomegaly, endocrinopathy, M-protein, and skin changes (POEMS) syndrome is rare life-threatening condition associated with a clonal plasma cell neoplasm. OBJECTIVE: The aim of this study is to investigate the clinical and biochemical features in patients with POEMS syndrome before and post-therapy. METHODS: Characteristics of demographic information, underlying diseases, clinical manifestations, laboratory indicators, and imaging examination were retrospectively collected when diagnosed and post-therapy in the patients POEMS syndrome between 2018 and 2024. RES

Voices of Survivorship: The Unmet Needs of Italian Cancer Survivors. A Qualitative Study.

BackgroundThe increasing number of cancer survivors (CSs) globally highlights the critical need for healthcare systems to address their unmet needs. These needs span physical, psychosocial, spiritual, informational, and practical dimensions and, if unaddressed, can impact quality of life and healthcare satisfaction.AimsThis study aimed to identify and understand the unmet needs of CSs in Italy to guide the development of patient-centered survivorship care services.MethodsA cross-sectional qualitative study was conducted between April 2023 and January 2024 at the Comprehensive Cancer Centre of

Cancer Research in the Time of COVID-19: A Colombian Narrative.

Cancer research is deficient in Colombia and efforts and resources diverted due to the COVID-19 pandemic could worsen the situation. We explore the impact of the pandemic on cancer research funding, output, and conduct. We sought information at national level and used the experience of an academic reference center to contrast the impact at institutional level. We searched databases and official documents of national governmental institutions, trial registries, hospital registries, and the Web of Science. We interviewed principal investigators (PIs) to retrieve information on the conduct of can

Reimbursement of licensed cell and gene therapies across the major European healthcare markets.

ObjectiveThe aim of this research is to identify the pricing, reimbursement, and market access (P&R&MA) considerations most relevant to advanced therapy medicinal products (ATMPs) in the Big5EU, and to inform their manufacturers about the key drivers for securing adoption at a commercially viable reimbursed price.MethodologyThe research was structured following three main steps: 1) Identifying the market access pathways relevant to ATMPs through secondary research; 2) Validating the secondary research findings and addressing any data gaps in primary research, by qualitative interviews with nat

Eosinophilic fasciitis (Shulman's disease): review and comparative evaluation of seven patients.

ObjectivesEosinophilic fasciitis (EF) was described in 1974 by Shulman as a rare fibrosing connective tissue disease of unknown etiology. An undetermined trigger is thought to lead to the degranulation of eosinophils that interact with fibroblasts and express fibrogenic cytokines including the transforming factor of tumor growth a and b and interleukins 1 and 6. The purpose of this study was to summarize seven cases of EF in a central hospital.Material and methodsThis was a retrospective and descriptive study of a population with EF of a central hospital. All patients diagnosed with EF in a ho

Nationwide prevalence and characteristics of transthyretin amyloid cardiomyopathy in Sweden.

OBJECTIVE: Transthyretin amyloid cardiomyopathy (ATTR-CM) is a rare, progressive and fatal condition caused by deposition of transthyretin amyloid fibrils in the heart. This study aims to identify all patients diagnosed with ATTR-CM in Sweden, estimate the prevalence of ATTR-CM, describe patient characteristics and mortality, assess the importance of early symptoms (red flags) for identification of ATTR-CM, and compare with patients with heart failure (HF). METHODS: This retrospective study combined multiple national health registers covering all specialist visits and prescriptions for the en

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… Sweden is well positioned for such nationwide studies, given full healthcare coverage, and mandatory reporting of diagnosis codes from all inpatient and outpatient specialist visits and drug prescriptions to nationwide registers. … Due to mandatory reporting these national registers have a high degree of completeness. All data were obtained from the Swedish National Board of Health and Welfare, the data holder of the national registers used in this study. …

The impact of the COVID-19 pandemic on the oncology services demand in a middle-income setting with universal health insurance.

AimWe analyze the impact of the COVID-19 pandemic on oncology service demand in a middle-income country with universal health coverage.MethodsWe collected data from January 1st-2017 to December 31th-2021 at a reference center in Bogotá-Colombia regarding first-time consultations of cross-cutting services (clinical oncology, hematology, palliative care, radiation oncology); specialized multidisciplinary units (breast, prostate, lung, stomach); inpatient and outpatient systemic therapy; radiotherapy; oncology surgery; and bone marrow transplant. A descriptive time series analysis was performed,

POEMS SYNDROME: an Update.

POEMS syndrome is a rare, chronic and disabling condition. The causes of this condition remain unknown; however, chronic overproduction of proinflammatory cytokines appears to be a major contributor. Early diagnosis is essential to start treatment before the clinical state of the patient becomes compromised. A complete evaluation of the disease at its onset is critical to the treatment decision. In localized disease, curative doses of radiation (50 Gy) is the recommended therapy. On the other hand, patients with disseminated disease should be given systemic therapy. Treatment-related morbidity

Polyneuropathy, organomegaly, endocrinopathy, M-protein, skin changes syndrome with dilated cardiomyopathy: A case report.

BackgroundPolyneuropathy, organomegaly, endocrinopathy, M-protein, skin changes (POEMS) syndrome is a rare paraneoplastic syndrome that encompass multiple systems. The most common clinical symptoms of POEMS syndrome are progressive sensorimotor polyneuropathy, organ enlargement, endocrine disorders, darkening skin, a monoclonal plasma cell proliferative disorder, and lymph node hyperplasia. The organomegaly consists of hepatosplenomegaly and/or lymphadenopathy; cases of cardiomyopathy are rare. Diagnoses are often delayed because of the atypical nature of the syndrome, exposing patients to pos

Временная плазмоцитома костей: исключительная локализация плазматомы одиночных костей, подчеркивающая роль мультимодальной съемки и многодисциплинарного управления.

Одинокая плазмоцитома (SP), редкая форма неоплазмы плазменных клеток, характеризуется моноклонным распространением плазменных клеток в локальном повреждении костей или мягких тканей. Временная плазмоцитома - это редкое проявление этого состояния, которое часто сопровождается такими неспециальными симптомами, как потеря слуха, утенок и краниальный нервный дефицит. Диагноз часто является сложным, учитывая совпадение с другими патологиями, такими, как холеститома и параганлиома. Гистопатологический анализ обычно показывает наличие листов плазменных клеток, которые подтверждаются иммунохимией для

Beyond the Obstruction: Recognising Polyneuropathy, Organomegaly, Endocrinopathy, Monoclonal Plasma Cell Disorder, and Skin Changes (POEMS) Syndrome in a Patient With Budd-Chiari Syndrome.

Polyneuropathy, organomegaly, endocrinopathy, monoclonal plasma cell disorder, and skin changes (POEMS) syndrome is a rare paraneoplastic disorder caused by an underlying monoclonal plasma cell neoplasm. We report a rare case of a 52-year-old man who presented with subacute sensorimotor neuropathy, hepatosplenomegaly, ascites, pleural effusion, thrombocytosis, gynecomastia, and osteosclerotic bone lesions. Investigations revealed elevated vascular endothelial growth factor (VEGF) levels and clonal plasma cells, consistent with POEMS syndrome. He was also found to have hepatic vein thrombosis,

State of the Art of Cardiac Amyloidosis.

Cardiac amyloidosis is defined by extracellular deposition of misfolded proteins in the heart. The most frequent cases of cardiac amyloidosis are caused by transthyretin and light chain amyloidosis. This condition is underdiagnosed, and its incidence has been continuously rising in recent studies because of the aging of the population and the development of noninvasive multimodal diagnostic tools. Amyloid infiltration affects all cardiac tunics and causes heart failure with preserved ejection fraction, aortic stenosis, arrythmia, and conductive disorder. Innovative, specific therapeutic approa