No abstract

Juan-Carlos Hern andez-Boluda and Ibrahim Yakoub-Agha have senior joint authorship.

Allogeneic hematopoietic cell transplant (allo‐HCT) provides the only potential route to long‐term remission in patients diagnosed with blast phase transformation of myeloproliferative neoplasm (BP‐MPN). We report on a large, retrospective European Society for Blood and Marrow Transplantation registry‐based study of BP‐MPN patients undergoing allo‐HCT. BP‐MPN patients undergoing first allo‐HCT between 2005 and 2019 were included. A total of 663 patients were included. With a median follow‐up of 62 months, the estimated 3‐year overall survival (OS) was 36% (95% confidence interval [CI], 32–36). Factors associated with lower OS were Karnofsky Performance Score (KPS) <90 (hazard ratio [HR] 1.65, p < .001) and active disease at allo‐HCT (HR 1.45, p < .001), whereas patients undergoing allo‐HCT more recently associated with a higher OS (HR 0.96, p = .008). In a selected patient's population, the 3‐year OS of patients undergoing allo‐HCT in complete response (CR) and with a KPS ≥90 was 60%. KPS < 90 (HR 1.4, p = .001) and active disease (HR 1.44, p = .0004) were associated with a lower progression‐free survival (PFS). Conversely, most recent allo‐HCT associated with a higher PFS (HR 0.96, p = .008). Active disease at allo‐HCT (HR 1.34, p = .03) was associated with a higher cumulative incidence of relapse (RI) and allo‐HCT in earlier calendar years (HR 0.96, p = .02) associated with a lower RI. Last, KPS < 90 (HR 1.91, p < .001), active disease (HR 1.74, p = .003) and allo‐HCT from mismatched related donors were associated with a higher non‐relapse mortality (HR 2.66, p = .003). In this large series of BP‐MPN patients, about one third were alive at 3 years after transplantation. Patients undergoing allo‐HCT in the more recent era, with a KPS ≥90 and in CR at transplant had a better prognosis.

ObjectivesTo keep healthcare systems sustainable for future demands, many countries are developing a centralised telephone line for out-of-hours primary care services. To increase the quality of such services, more information is needed on factors that influence caller satisfaction. The aim of this study was to identify demographic and call-related characteristics that are associated with the patient satisfaction of callers to a medical helpline in Denmark.DesignRetrospective cohort study on patient registry data and questionnaire results.SettingNon-emergency medical helpline in the Capital Region of Denmark.ParticipantsA random sample of 30 402 callers to the medical helpline between May 2016 and May 2018.Primary and secondary outcome measuresResponses of a satisfaction questionnaire were linked to demographic and call-related dispatch data. Associations between the characteristics were analysed with multivariable logistic regression analysis with satisfaction as the dependent variable. A subgroup analysis was performed on callers for children aged between 0 and 4 years.ResultsOf the 30 402 analysed callers, 73.0% were satisfied with the medical helpline. Satisfaction was associated with calling for a somatic injury (OR: 1.96, 95% CI: 1.72 to 2.23), receiving a face-to-face consultation (OR: 2.27, 95% CI: 2.04 to 2.50) and a waiting time less than 10 min (OR: 1.82, 95% CI: 1.56 to 2.08). Callers for a 0-year to 4-year-old patient were more likely to be satisfied when they called for a somatic illness or received a telephone consultation, compared with the rest of the population (p<0.0001).ConclusionCallers were in general satisfied with the medical helpline. Satisfaction was associated with reason for encounter, triage response and waiting time. People calling for 0-year to 4-year-old patients were, compared with the rest of the population, more frequently satisfied when they called for a somatic illness or received a telephone consultation.