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Beyond dual targeting: redefining the treatment horizon for true extramedullary myeloma? - a critical appraisal.

The management of relapsed/refractory multiple myeloma with true extramedullary disease (EMD) remains a critical challenge. The phase 2 RedirecTT-1 study evaluated the combination of two bispecific antibodies, talquetamab (anti-GPRC5D) and teclistamab (anti-BCMA), in this high-risk population. While the reported overall response rate of 79% and 12-month progression-free survival of 61% are promising, a balanced interpretation requires caution. The single-arm design, short follow-up (12.6 months), and indirect comparisons with CAR-T therapy preclude definitive conclusions about comparative effe

Delivering bad news in clinical hematology: a personal perspective.

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… Assuming that their medical education makes them understand the common acronyms and technical details of hematology is not recommended, as with today’s specialization, we find that physicians who are not hematological oncologists are as bewildered about our field as are patients with no medical education …

Distress Screening among Patients with Hematological Malignancies: A Descriptive Cross-sectional Study.

IntroductionDistress is a major concern during diagnosis and treatment of hematological malignancies. The Distress Thermometer is a commonly used screening tool to detect distress. The objectives of this study was to know the prevalence and identify distress score among patients with hematological malignancies in Nepal.MethodsA descriptive cross sectional study was carried out at the Hematology Unit of Civil Service Hospital after obtaining an ethical approval from the Institutional Review Committee (reference number 931/076/077). A convenient sampling technique was used for this study. Statis

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… Pirl WF Muriel A Hwang V Kornblith A Greer J Donelan K et al Screening for psychosocial distress: a national survey of oncologists J Support Oncol 2007 5 10 499 504 18240673 …

Bone metastases: Are we failing our patients?

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… Encouragingly, the Skeletal Care Academy steering committee (composed of international experts in the field of cancer-related bone disease; oncologists, urologists, surgeons, nurses and patient advocacy groups) has put together a Patient Charter, setting out the basic requirements for standards of patient …

The Impact of Iron on Cancer-Related Immune Functions in Oncology: Molecular Mechanisms and Clinical Evidence.

Iron metabolism plays a dual role in cancer, serving as an essential nutrient for cellular functions and a potential catalyst for tumor growth and immune evasion. Here, we cover the complex interplay between iron levels within the serum or in the microenvironment and cancer therapy, focusing on how iron deficiency and overload can impact immune function, tumor progression, and treatment efficacy. On the one hand, we highlight iron deficiency as a factor of primary immune responses and its adverse effects on anti-cancer immunotherapy efficacy. On the other hand, we also stress the impact of iro

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… By integrating iron management into cancer therapy protocols, oncologists can optimize treatment efficacy and improve outcomes for cancer patients. … Impact of Iron-Deficiency Management on Quality of Life in Patients with Cancer: A Prospective Cohort Study (CAMARA Study) Oncologist. 2022;27:328–333. doi: 10.1093/oncolo/oyac005. 15. Knight K., Wade S., Balducci L. …

Utilization and quality of palliative care in patients with hematological and solid cancers: a population-based study.

BackgroundPalliative care (PC) contributes to improved end-of-life care for patients with hematologic malignancies (HM) and solid tumors (ST) by addressing physical and psychological symptoms and spiritual needs. Research on PC in HM vs. ST patients is fragmented and suggests less use.MethodsWe analyzed claims data of all deceased members of a large German health insurance provider for the year before death. First, we analyzed the frequency and the beginning of different types of PC and compared patients with HM vs. ST. Second, we analyzed the adjusted impact of PC use on several end-of-life q

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… Hematologic oncologists recognize the value of hospice care for HM patients, but the dependency on blood transfusions affects the decision to refer to hospice care and the timing of that referral, as revealed in a survey by Odejide et al. (Odejide et al. 2017 ). … Oncologist 26(1):77–83. 10.1002/onco.13515 32915490 10.1002/ONCO.13515 PMC7794182 Moreno-Alonso D Porta-Sales J Monforte-Royo C Trelis-Navarro J Sureda-Balarí A Fernández De Sevilla-Ribosa A Palliative care in patients with haematological neoplasms: an integrative systematic review Palliat Med 2018 …

The needs of cancer patients during the COVID-19 pandemic-psychosocial, ethical and spiritual aspects-systematic review.

The COVID-19 pandemic resulted in unprecedented changes in the functioning of the health care system, which were connected with the occurrence of new challenges for both the health care system's employees and for the patients. The purpose of the present article is to analyze the needs of persons with oncological diseases. Taking into account the multiple aspects of the term health, psychological, social, and existential needs of the patients were analyzed. This article is directed mainly at persons who remain in a direct therapeutic relation with a patient. It is to facilitate recognizing the

Challenges and Advances in Managing Thrombocytopenic Cancer Patients.

Cancer patients have varying incidence, depth and duration of thrombocytopenia. The mainstay of managing severe chemotherapy-induced thrombocytopenia (CIT) in cancer is the use of platelet transfusions. While prophylactic platelet transfusions reduce the bleeding rate, multiple unmet needs remain, such as high residual rates of bleeding, and anticancer treatment dose reductions/delays. Accordingly, the following promising results in other settings, antifibrinolytic drugs have been evaluated for prevention and treatment of bleeding in patients with hematological malignancies and solid tumors. I

Deciding to Enrol in a Cancer Trial: A Systematic Review of Qualitative Studies.

BackgroundClinical trials are essential for the advancement of cancer treatments; however, participation by patients is suboptimal. Currently, there is a lack of synthesized qualitative review evidence on the patient experience of trial entry from which to further develop decision support. The aim of this review is to synthesise literature reporting experiences of participants when deciding to enrol in a cancer clinical trial in order to inform practice.MethodsA systematic review and meta-synthesis of qualitative studies were conducted to describe the experiences of adult cancer patients who d

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… . | Focus Groups | Thematic Analysis | 26 participants (20 patients; 6 medical oncologists) | Lung, Breast & Prostate Cancer | Patients assessed the risks alongside the benefits of the clinical trial. Trust in doctor’s recommendation and severity of patients disease influenced decision making. … Sanders. (2000) 44 | UK | To investigate patients treatment decision-making process. | Observations; In-depth Interviews | Thematic Analysis | Observations of 87 oncologists and patients interactions. 37 patients initially interviewed; 28 interviewed later; a further 11 interviews carried out with oncologists …

Cancer-associated venous thromboembolism: Treatment and prevention with rivaroxaban.

Cancer-associated venous thromboembolism (VTE) is a frequent, potentially life-threatening event that complicates cancer management. Anticoagulants are the cornerstone of therapy for the treatment and prevention of cancer-associated thrombosis (CAT); factor Xa-inhibiting direct oral anticoagulants (DOACs; apixaban, edoxaban, and rivaroxaban), which have long been recommended for the treatment of VTE in patients without cancer, have been investigated in this setting. The first randomized comparisons of DOACs against low-molecular-weight heparin for the treatment of CAT indicated that DOACs are

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… Views from oncologists, hematologists, surgeons, radiation oncologists, and members of the palliative care team responsible for treating CAT were collected. A questionnaire (available in 9 languages) was distributed, and the results are currently being analyzed. … Oncologist. 2014;19:82–93. 37. Mekaj YH, Mekaj AY, Duci SB, Miftari EI. New oral anticoagulants: their advantages and disadvantages compared with vitamin K antagonists in the prevention and treatment of patients with thromboembolic events. Ther Clin Risk Manag. 2015;11:967–77. 38. …

Subcutaneous Administration of Biotherapeutics: An Overview of Current Challenges and Opportunities.

Subcutaneous delivery of biotherapeutics has become a valuable alternative to intravenous administration across many disease areas. Although the pharmacokinetic profiles of subcutaneous and intravenous formulations differ, subcutaneous administration has proven effective, safe, well-tolerated, generally preferred by patients and healthcare providers and to result in reduced drug delivery-related healthcare costs and resource use. The aim of this article is to discuss the differences between subcutaneous and intravenous dosing from both health-economic and scientific perspectives. The article c

Towards a New Dawn for Neuro-Oncology: Nanomedicine at the Service of Drug Delivery for Primary and Secondary Brain Tumours.

(1) Background/Objectives: Primary and secondary brain tumours often hold devastating prognoses and low survival rates despite the application of maximal neurosurgical resection, and state-of-the-art radiotherapy and chemotherapy. One limiting factor in their management is that several antineoplastic agents are unable to cross the blood-brain barrier (BBB) to reach the tumour microenvironment. Nanomedicine could hold the potential to become an effective means of drug delivery to overcome previous hurdles towards effective neuro-oncological treatments. (2) Methods: A scoping review following th

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… Those aspects oblige neuro-oncologists to administer high pharmacological dosages with consequent multifold side effects (e.g., haematopoietic toxicity, hepatotoxicity, nephrotoxicity, ototoxicity, and pulmonary toxicity). … With the rapid development of delivery systems at the nano scale, consisting of either organic or inorganic nanocarriers, such as nanoshells, micelles, liposomes, and nanoparticles, it has been possible to tackle selective cancer targets relevant to neuro-oncologists. …

Clinical Profile and Outcome of Surgical Management of Spinal Tumours in Abuja.

BACKGROUND: Spinal tumours may originate from the native tissues of the spine, spinal cord, or secondary to metastatic spread. Their neurological manifestations are often similar, irrespective of origin. Surgical intervention may be curative in most benign tumours and palliative in metastatic spine tumours. Improvement in the surgical management of spine tumours has resulted in better patients' health-related quality of life. There have been only few reports on surgical management of spinal tumours in Nigeria. OBJECTIVE: The study aimed to retrospectively evaluate the clinical aspects and sho

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… However, these patients were managed in conjunction with oncologists for external beam radiotherapy and chemotherapy where appropriate following histologic diagnosis. …

Short and long term central peripherally inserted catheters in hematological malignancy patients: clinical outcomes and safety. Single centre experience.

ObjectiveTo characterise the population and describe the complications in patients with hematologic malignancies who underwent implantation of a peripherally inserted central catheter (PICC) or midline catheter (MC) for the administration of chemotherapy or oncologic support.MethodsThe retrospective descriptive study included patients with hematologic malignancies who underwent PICC or MC implantation between July 2022 and 2024. All patients are part of the institution-based prospective observational Evidence - Verification - Analysis study. Variables related to device type were obtained from

A Multidisciplinary Rehabilitation Approach for a Patient With Diffuse Large B-cell Lymphoma and Bone Metastasis: A Case Report.

Cancer is often accompanied by bone metastasis, which may lead to skeletal-related events (SREs), such as pain, hypercalcemia, pathological fractures, spinal cord compression, orthopedic surgical intervention, and palliative radiation directed at the bone. Herein, we report the case of a 75-year-old female patient diagnosed with diffuse large B-cell lymphoma (DLBCL) with bone metastasis and a pathological fracture of the right iliac bone. The management strategy and follow-up were determined by a multidisciplinary cancer board comprising physicians, physiatrists, orthopedic surgeons, radiologi

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… Additionally, a multidisciplinary cancer board meeting involving physicians, physiatrists, orthopedic surgeons, radiation oncologists, and rehabilitation therapists was held to discuss the patient’s condition and management of bone metastasis, including surgical, radiation, and rehabilitation options …

"Мой язык": Любопытный случай кровавого сэндвича и реактивации вируса Джона Каннингема в эпоху иммуномодулирующих средств.

Прогрессивная многофукальная лейкоэнцефалопатия (ПМЛ) является редким диагнозом, связанным с высокой смертностью в различных клинических условиях. Вирус John Cunningham (JC) (JCV) был объяснен PML. ОЖЦ, как правило, оказывает воздействие на пациентов с ВИЧ/СПИДом, твердыми органами и гематологическими заболеваниями, а также на пациентов, проходящих курс лечения иммуномодулятивными препаратами (ИМИД), как, например, помалидомид. В настоящее время имеется ограниченное число зарегистрированных случаев заболевания множественной миеломой (ММ), которые разработали ПМЛ, о которых сообщалось в литерат

Effects of a physiotherapeutic protocol in cardiorespiratory, muscle strength, aerobic capacity and quality of life after hematopoietic stem cell transplantation.

ObjectiveTo analyze the effects of hospital cardiorespiratory physical therapy protocol on the functional capacity and quality of life of patients submitted to hematopoietic stem cell transplantation (HSCT).MethodsFrom January to December 2019, bilateral dynamometry, Manovacuometry and Ventilometry, peak expiratory flow "Peak Flow", 6-min walk test (6MWT), SF-36 Quality of Life Questionnaire and Visual Analog Scale (VAS) were applied in patients who have undergone an allogeneic or autologous hematopoietic stem cell transplantation (HSCT), pre-conditioning (initial evaluation) and pre-discharge

Prospective Survey of Financial Toxicity Measured by the Comprehensive Score for Financial Toxicity in Japanese Patients With Cancer.

PurposeWe previously reported on the pilot study assessing the feasibility of using the Japanese translation of the Comprehensive Score for Financial Toxicity (COST) tool to measure financial toxicity (FT) among Japanese patients with cancer. In this study, we report the results of the prospective survey assessing FT in Japanese patients with cancer using the same tool.Patients and methodsEligible patients were receiving chemotherapy for a solid tumor for at least 2 months. In addition to the COST survey, socioeconomic characteristics were collected by using a questionnaire and medical records

Delirium in cancer patients admitted to the intensive care unit: a retrospective study.

ObjectiveTo describe the occurrence of delirium in cancer patients admitted to the intensive care unit according to clinical and demographic characteristics.MethodsA retrospective study was conducted with 135 adults admitted to the intensive care unit of a public cancer hospital in the city of Rio de Janeiro, Brazil, between January and March 2016. Fisher's exact test and the linear association test were used to identify statistically significant associations between the occurrence of delirium and categorical and ordinal variables, respectively, considering a p-value ResultsThe overall occurre

Effectiveness of darbepoetin alfa in multiple myeloma patients receiving chemotherapy including novel agents.

BackgroundThe aim of this study was to evaluate the effects of darbepoetin alfa (DA) on hemoglobin (Hb) concentration and the need for transfusions in multiple myeloma (MM) patients receiving chemotherapy with novel agents.MethodsOf 251 patients with MM who received DA therapy for at least 4 weeks, 142 who did not receive RBC transfusion during 4 weeks after DA initiation and started DA therapy at baseline Hb ResultsAfter 4 weeks of DA therapy, 80 (60.6%) of 132 patients with evaluable data had Hb that increased ≥1.0 g/dL from baseline, while 50 (37.9%) had Hb that increased ≥2.0 g/dL from bas