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While performance since the introduction of the JACIE quality management system has been shown to be improved for allogeneic hematopoietic stem cell transplants (HSCT), impact on autologous-HSCT remains unclear in Europe. Our study on 2697 autologous-HSCT performed in adults in 17 Belgian centres (2007-2013) aims at comparing the adjusted 1 and 3-yr survival between the different centres & investigating the impact of 3 centre-related factors on performance (time between JACIE accreditation achievement by the centre and the considered transplant, centre activity volume and type of HSCT performed by centres: exclusively autologous vs both autologous & allogeneic). We showed a relatively homogeneous performance between Belgian centres before national completeness of JACIE implementation. The 3 centre-related factors had a significant impact on the 1-yr survival, while activity volume and type of HSCT impacted the 3-yr survival of autologous-HSCT patients in univariable analyses. Only activity volume (impact on 1-yr survival only) and type of HSCT (impact on 1 and 3-yr survivals) remained significant in multivariable analysis. This is explained by the strong relationship between these 3 variables. An extended transplantation experience, i.e., performing both auto & allo-HSCT, appears to be a newly informative quality indicator potentially conveying a multitude of underlying complex factors.

To respond to the legitimate questions raised by the application of invasive methods of monitoring and life-support techniques in cancer patients admitted in the ICU, the European Lung Cancer Working Party and the Groupe de Recherche Respiratoire en Réanimation Onco-Hématologique, set up a consensus conference. The methodology involved a systematic literature review, experts’ opinion and a final consensus conference about nine predefined questions 1. Which triage criteria, in terms of complications and considering the underlying neoplastic disease and possible therapeutic limitations, should be used to guide admission of cancer patient to intensive care units? 2. Which ventilatory support [High Flow Oxygenation, Non-invasive Ventilation (NIV), Invasive Mechanical Ventilation (IMV), Extra-Corporeal Membrane Oxygenation (ECMO)] should be used, for which complications and in which environment? 3. Which support should be used for extra-renal purification, in which conditions and environment? 4. Which haemodynamic support should be used, for which complications, and in which environment? 5. Which benefit of cardiopulmonary resuscitation in cancer patients and for which complications? 6. Which intensive monitoring in the context of oncologic treatment (surgery, anti-cancer treatment …)? 7. What specific considerations should be taken into account in the intensive care unit? 8. Based on which criteria, in terms of benefit and complications and taking into account the neoplastic disease, patients hospitalized in an intensive care unit (or equivalent) should receive cellular elements derived from the blood (red blood cells, white blood cells and platelets)? 9. Which training is required for critical care doctors in charge of cancer patients? Supplementary Information The online version contains supplementary material available at 10.1007/s00134-021-06508-w.

Purpose of review Choosing an optimal treatment in older patients with indolent lymphomas is a challenge for hematooncologists. They must concomitantly treat some potentially curable entities, manage other symptomatic incurable diseases and protect their patients from life-threatening toxicities. Specific recommendations for older patients with different subtypes of marginal zone lymphomas are thus required in terms of treatment and supportive care. Recent findings All the data in the literature agree that the therapeutic approach of older patients with malignant hemopathies should include the appraisal of their life expectancy and of the prognostic factors of their tumor, the evaluation of their physiological and cognitive functions and their socioeconomic environment, and their expectancy in terms of quality of life. Major progresses have, therefore, been achieved in the management of lymphoma patients of 80 years and older. Summary With an optimal ‘geriatric assessment’, most of the recommended treatments are also appropriate in older marginal zone lymphoma patients. Extranodal MALT lymphoma: eradication of the pathogen is a major part of the first-line therapy. Prognosis is excellent in early stages. In advanced stages, observation and anti-CD20 antibodies with or without cytostatic drugs are recommended. Nodal MZL: Usually confined to lymph nodes, bone marrow and peripheral blood, they should be managed as follicular lymphomas. Splenic MZL: in this unique entity involving the spleen, the bone marrow and the peripheral blood. Hepatitis infection should be eradicated before considering treatment. Only symptomatic patients require to be treated by splenectomy and/or anti-CD20 antibodies.

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