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Influencing factors of cardiorespiratory fitness in allogeneic stem cell transplant candidates prior to transplantation.

PurposeCardiorespiratory fitness (CRF) seems to be prognostic prior to allogeneic stem cell transplantation (allo-HSCT). Influencing factors of CRF in allo-HSCT candidates have not been studied so far. Aim was to identify potentially influencing factors on CRF.MethodsTo assess CRF, a maximal cardiopulmonary exercise test (CPET) was performed on average 2.6 ± 7.2 days prior to admission. A regression analysis was conducted, with the following predictors: gender, age, body mass index (BMI), time between last therapy and allo-HSCT (t_Therapies), number of cardiotoxic therapies (n_Cardiotox), numb

The Surgical Management of Proximal Femoral Metastases: A Narrative Review.

The proximal femur is a common location for the development of bony metastatic disease. Metastatic bone disease in this location can cause debilitating pain, pathologic fractures, reduced quality of life, anemia or hypercalcemia. A thorough history, physical examination and preoperative investigations are required to ensure accurate diagnosis and prognosis. The goals of surgical management is to provide pain relief and return to function with a construct that provides stability to allow for immediate weightbearing. Current surgical treatment options include intramedullary nailing, hemiarthropl

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… Consideration should be given for adjuvant treatment of metastatic lesions with radiation therapy, as advised by a multidisciplinary team including radiation and medical oncologists [ 34 ]. … The majority of orthopaedic oncologists recommend endoprosthetic reconstruction over IMN in patients with prolonged life expectancy [ 68 ]. …

Sense of coherence and its relationship to participation, cancer-related fatigue, symptom burden, and quality of life in women with breast cancer participating in the OptiTrain exercise trial.

Abstract Purpose This study examined the Sense of Coherence (SOC) of patients participating in the randomized controlled ‘Optimal Training for Women with Breast Cancer’ (OptiTrain) study and assessed how patient characteristics were associated with SOC. Secondary aims were to assess the association between SOC and patients’ participation in this study and to determine whether SOC moderates the effect of the 16-week exercise intervention on fatigue, quality of life (QoL), and symptom burden in women with breast cancer undergoing chemotherapy. Methods Modified Poisson regression analyses were co

Pain prevalence and treatment in patients with metastatic bone disease.

The accomplishment of successful pain treatment requires evaluation, characterization and quantification. The present study characterized pain and survival in a cohort of patients with cancer with bone metastasis who were treated with intravenous bisphosphonates. A total of 84 patients self-completed the Brief Pain Inventory (BPI) and 36-Item Short Form Survey (SF-36), between November 2010 and March 2011 with a 5-year survival follow-up as a surrogate marker of cancer burden. The median age was 62 years old (34-85), 64% of patients were female and 58% of these females had breast cancer. In th

Gastrointestinal bleeding as initial presentation of extramedullary plasma cell neoplasms: A case report and review of the literature.

BackgroundPlasma-cell neoplasms rarely involve the gastrointestinal tract and manifest as gastrointestinal bleeding. Plasmablastic myeloma is an aggressive plasma cell neoplasm associated with poor outcomes. A small number of cases with gastrointestinal involvement is reported in the literature and therefore high index of suspicion is essential for avoiding delays in diagnosis and treatment.Case summaryOur aim is to present our experience of a 70-year-old patient with a secondary presentation of plasmablastic myeloma manifesting as unstable upper gastrointestinal bleeding and to review the lit

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… CASE PRESENTATION Chief complaints This is a case of a 70-year-old male patient who initially presented to his oncologist at another hospital with right shoulder and neck pain associated with paraesthesia affecting the C8-T1 dermatome area. … rare cause of gastrointestinal bleeding, patients affected could present clinically unstable requiring an immediate intervention and therefore, by presenting a review of the above mentioned twenty-seven cases, we have created a consolidative reference for further use not only by haematologists and oncologists …

Is De-escalated Bisphosphonates Therapy a Suitable Alternative to Standard Dosing in Malignant Tumor Patients With Bone Metastases: A Systematic Review and Meta-Analysis.

Background: Previous studies have preliminarily identified the non-inferior efficacy for reducing skeletal-related event (SRE) rates between de-escalated (Q12w) and standard (Q3-4w) bone-targeting agents therapy in malignant tumor patients with bone metastases. In this study, we aim to make further efforts to analyze whether the de-escalated bisphosphonates (BPs) strategy is a suitable option by comprehensively retrieving and synthesizing state-of-the-art evidence. Methods: An extensive electronic search for randomized controlled trials (RCTs) comparing a BPs standard strategy with the de-esca

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… Discussion The rational dosing interval of BPs has gradually attracted attention especially to oncologists and patients with bone metastases, due to the increased toxicity caused by a long-term medication ( 31 , 32 ). … De-escalated administration of bonetargeted agents in patients with breast and prostate cancer-a survey of Canadian oncologists. J Bone Oncol. (2013) 2:77–83. 10.1016/j.jbo.2013.03.001 32. Hutton B, Morretto P, Emmenegger U, Mazzarello S, Kuchuk I, Addison CL, et al. …

Light Chain (AL) Amyloidosis: The Journey to Diagnosis.

BackgroundLight chain (AL) amyloidosis is a rare, complex disease associated with significant morbidity and mortality. Delays in diagnosis are common and may have detrimental consequences on patients' prognosis. Too little is known regarding the patient journey to diagnosis.ObjectiveThe objective of this study was to describe the patient-reported journey to a correct diagnosis for AL amyloidosis.MethodsUsing a mixed-methods approach, data were collected from clinician (n = 4) and patient (n = 10) interviews and a survey of community-based patients with AL amyloidosis (n = 341). Data were used

Clinical course and end-of-life care in patients who have died after allogeneic stem cell transplantation.

PURPOSE: Allogeneic stem cell transplantation may cure approximately 50% of patients, however, a significant part of the other half might benefit from a high-quality palliative care medicine at the end of life. Somatic, psychic and spiritual needs of these patients may differ from those of patients suffering from incurable solid tumours and are not comprehensively evaluated so far. METHODS: To address this question, data from charts of 123 patients who have died after allogeneic stem cell transplantation were extracted. In detail, the time line of the clinical course, the symptoms, the admini

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… In contrast to oncologists, taking care of patients suffering from solid tumours, there are publications suggesting that haematologists hesitate to switch the therapy goal to symptom control and to consult the palliative care team (Lafond et al. 2015 ; LeBlanc et al. 2015 ). … Oncologist 16(9):1203–1214 Joske D, McGrath P (2007) Palliative care in haematology. Intern Med J 37(9):589–590 Lafond DA, Kelly KP, Hinds PS, Sill A, Michael M (2015) Establishing feasibility of early palliative care consultation in pediatric hematopoietic stem cell transplantation. …

Metastatic spinal tumor.

In accordance with extending survival periods of cancer patients, number of consecutively developing metastatic spinal tumor is also increasing. There have been improvements in the treatment results of metastatic spine tumor by virtue of the developments in diagnostic radiology, chemotherapy, adjuvant treatment, operative device and technique, discrete preoperative plan, and standardized operation. Accordingly, surgical indication has also increased. Clinically, in case of metastatic spine tumor, treatment of tumor itself should be focused on pain relief, preservation of neurologic function, p

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… After diagnosis is made, cure of spine tumor, and enhancement of quality of life may be accomplished through cooperation amongst the radiologists, radiation oncologists, oncologists and pain specialists. References 1. Lee HM. Spinal tumors. In: Suk SI, editor. Textbook of spinal surgery. 2nd ed. …

Performance of six severity-of-illness scores in cancer patients requiring admission to the intensive care unit: a prospective observational study.

IntroductionThe aim of this study was to evaluate the performance of five general severity-of-illness scores (Acute Physiology and Chronic Health Evaluation II and III-J, the Simplified Acute Physiology Score II, and the Mortality Probability Models at admission and at 24 hours of intensive care unit [ICU] stay), and to validate a specific score - the ICU Cancer Mortality Model (CMM) - in cancer patients requiring admission to the ICU.MethodsA prospective observational cohort study was performed in an oncological medical/surgical ICU in a Brazilian cancer centre. Data were collected over the f

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… Routine clinical rounds, including medical, nurse and physiotherapy staff, and meetings with oncologists, are done each day in the ICU. Approximately 600 patients are admitted each year to the ICU. … The decision regarding whether a patient should be admitted to the ICU is made jointly by the senior intensivist and the oncologist who is responsible for the patient's care. To be admitted to the ICU, patients should be considered to have a chance of being cured or having their cancer controlled. …

Culturally Tailored Home-based Yoga Intervention for Lymphoma Patients on Chemotherapy.

ContextAlthough proven effective in solid cancers, there is a dearth of evidence-based studies supporting yoga as an intervention to improve health-related quality of life (HRQOL) among patients with lymphoma.AimThe aim of this study was to develop a remotely supervised, home-based yoga intervention to improve HRQOL for lymphoma patients undergoing chemotherapy.SettingsThis project was conducted at a tertiary care hospital in Northern India.MethodologyExperts in lymphoma, yoga, psychiatry, and nursing collaborated to formulate the intervention. Following a comprehensive literature review and s

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… They were told to make contact with the investigator as well as the treating hemato oncologist regarding any query on yoga practice during their follow-up visit, or they can contact the investigator through a dedicated mobile phone Modifications | Modifications were made in the intervention after the … Moving forward, it is imperative for researchers, oncologists, and yoga experts to critically consider the development of cancer-specific yoga interventions. These interventions must be tailored to the individual needs of patients and their specific disease characteristics. …

The obesity paradox in multiple myeloma: A report from Multiple Myeloma Research Foundation (MMRF) dataset.

BackgroundObesity is a risk factor for multiple myeloma (MM). However, we still lack knowledge on the clinical course of obese MM patients in a broad view.MethodsHere, we reviewed 568 MM patients recorded in the Multiple Myeloma Research Foundation (MMRF) coMMpass dataset. Patients were divided into the normal and obese groups according body mass index (BMI) at diagnosis, and then the baseline characteristics, cytogenetic abnormalities, treatment variability, and survival outcomes were evaluated in the obese cohort.ResultsWe found no differences in the characteristics when comparing normal and

Optimizing Patient Education of Oncology Medications: A Patient Perspective.

The medication information needs of patients with cancer have been primarily studied using quantitative methods and little qualitative research on this topic exists. The purpose of this study was to explore patients' perspectives of optimal oncology medication education provided to patients at the Nova Scotia Health Authority (NSHA). Adult (≥ 18 years) outpatients in medical, gynecological and hematology oncology at NSHA were invited to participate in focus groups, which were audio-recorded, transcribed and analyzed thematically. Three focus groups, including 21 outpatients, were conducted. Fo

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… Currently at Nova Scotia Health Authority (NSHA), patients typically receive education from their oncologist at diagnosis, from nurses during chemotherapy treatment and a small number of patients may receive education from a pharmacist. … Patient Satisfaction Patients appreciated the care and information they received from their nurses, oncologists, pharmacists, and family doctors. For example, participant C3 commented: “I just would give up I think, if it wasn’t for the nurse. …

Effect of Paget's disease of bone (osteitis deformans) on the progression of prostate cancer bone metastasis.

BackgroundPatients with prostate cancer tend to die from bone metastases. Until now, no evidence has shown that Paget's disease of bone (PDB) affects the progression of bone metastasis or overall survival of patients with prostate cancer.MethodsWe searched our patient database for men who had presented with prostate cancer and PDB between June 1993 and March 2009, and identified best-matched control patients according to stage, grade, age, date of diagnosis, treatment, and race.ResultsAmong 1346 consecutive patients with prostate cancer diagnosed before 2008, 15 were confirmed to have comorbid

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… We identified 1346 consecutive patients who had been evaluated by one medical oncologist (S-MT) either as a new patient or one seen for a consultation in the Genitourinary Medical Oncology clinic at the MD Anderson Cancer Center during the period from 1 June 1993, through 31 March 2009. … By searching our institutional billing data for ‘osteitis deformans’ using ICD code 731.0, we identified an additional 26 patients with prostate cancer and PDB, who had been evaluated during the same period but by different oncologists. Thus, our total population in the Paget’s group was 41. …

Risks and benefits of bisphosphonates.

Bone is the most common site for metastasis in cancer and is of particular clinical importance in breast and prostate cancers due to the prevalence of these diseases. Bone metastases result in considerable morbidity and complex demands on health care resources, affecting quality of life and independence over years rather than months. The bisphosphonates have been shown to reduce skeletal morbidity in multiple myeloma as well as a wide range of solid tumours affecting bone by 30-50%. Quite appropriately, these agents are increasingly used alongside anticancer treatments to prevent skeletal comp

Eosinophilic Dermatosis of Hematological Malignancy.

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Exploring the role of viral hepatitis in plasma cell disorders.

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… Close collaboration between hematologists/oncologists and hepatologists is essential to optimize treatment outcomes and minimize complications. Prevention strategies are also crucial in mitigating the impact of viral hepatitis in patients with MM and other monoclonal gammopathies. …

Emerging Immunotherapy and Antibody-Derived Therapeutics for the Treatment of Advanced Non-Small-Cell Lung Cancer: A Review.

Background: In the last decade, a surge of advancements in and approvals of immunotherapies has revolutionized the treatment of non-small-cell lung cancer (NSCLC). Even as an increasing number of immune checkpoint inhibitors and antibody-drug conjugates gained FDA approval for the remarkable response and durable remission they imparted to some patients, persistent challenges of primary and acquired resistance, imperfect predictive biomarkers, and toxicity remain. Methods: This review identifies and summarizes the most significant emerging clinical data being reported for immunotherapies in NSC

Molecular Mechanisms and Biomarkers Associated with Chemotherapy-Induced AKI.

Acute kidney injury (AKI) is a life-threatening condition characterized by a rapid and transient decrease in kidney function. AKI is part of an array of conditions collectively defined as acute kidney diseases (AKD). In AKD, persistent kidney damage and dysfunction lead to chronic kidney disease (CKD) over time. A variety of insults can trigger AKI; however, chemotherapy-associated nephrotoxicity is increasingly recognized as a significant side effect of chemotherapy. New biomarkers are urgently needed to identify patients at high risk of developing chemotherapy-associated nephrotoxicity and s

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… Concerning cancer patients, all lifestyle modifications and new drugs implementation should always be collectively discussed with patients and oncologists. … A Systematic Review of Strategies to Prevent Cisplatin-Induced Nephrotoxicity Oncologist 2017 22 609 619 10.1634/theoncologist.2016-0319 28438887 PMC5423518 62. Fang C.-Y. Lou D.-Y. Zhou L.-Q. Wang J.-C. Yang B. He Q.-J. Wang J.-J. Weng Q.-J. …

Molecular Mechanism and Prevention Strategy of Chemotherapy- and Radiotherapy-Induced Ovarian Damage.

Fertility preservation is an emerging discipline, which is of substantial clinical value in the care of young patients with cancer. Chemotherapy and radiation may induce ovarian damage in prepubertal girls and young women. Although many studies have explored the mechanisms implicated in ovarian toxicity during cancer treatment, its molecular pathophysiology is not fully understood. Chemotherapy may accelerate follicular apoptosis and follicle reservoir utilization and damage the ovarian stroma via multiple molecular reactions. Oxidative stress and the radiosensitivity of oocytes are the main c