Background The initiation of a new drug, for instance, the coronavirus disease 2019 (COVID-19) vaccine in children could be a source of major concern for parents. This study aims to determine the willingness of parents in Malaysia to vaccinate their children younger than 12 years against COVID-19. Methods An online cross-sectional survey was conducted nationwide in Malaysia from August 29, 2021, to October 17, 2021. Parents with children younger than 12 years were enrolled via the snowball sampling method. Results The analysis included data from 3,528 parents (79.5%) of the 4,438 survey responses received. Of these parents, 2,598 (73.6%) were willing, 486 (13.8%) were not willing, and 444 (12.6%) were still hesitant to vaccinate their children against COVID-19. Single parents (odds ratio [OR], 2.0; 95% confidence interval [CI], 1.32–3.04; P = 0.001), parents with secondary or lower education (OR, 1.5; 95% CI, 1.21–1.96; P < 0.001), healthcare workers (OR, 1.7; 95% CI, 1.34–2.26; P < 0.001), parents who had significant contact with COVID-19 (OR, 1.3; 95% CI, 1.09–1.63; P = 0.006), and parents who had been vaccinated against COVID-19 (OR, 15.4; 95% CI, 9.76–24.33; P < 0.001) were found more willing to immunize their children. The common reasons for vaccination given by parents who were willing to immunize their children include protection of children (99.4%), protection of other family members (99.3%), and effectiveness (98.2%). The common reasons against vaccination given by parents who were not willing to immunize their children were uncertainty about the new vaccine (96.1%), concerns about vaccine contents (93.2%), limited vaccine information from physicians (82.3%), and the belief of vaccine was unsafe (79.8%). Conclusions In this study, nearly three-quarters of parents were willing to vaccinate their children younger than 12 years against COVID-19. The parents’ history of COVID-19 vaccination was the strongest independent predictor of their willingness to vaccinate their children. Therefore, future health education for the COVID-19 vaccine should focus on parents who are prone to vaccine refusal or hesitation, address the common reasons for vaccine refusal, and highlight the vaccine’s benefits.

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Background Patients with haematological cancer had considerable symptom burden, in which fatigue was the most prevalent. Almost 70% of haematological cancer patients reported fatigue. Methods We conducted a parallel-group, non-blinded, randomised control trial at the haemato-oncology unit of University Malaya Medical Centre, from 1st October 2019 to 31st May 2020. Patients included were ≥ 18 years, had histopathological diagnosis of haematological cancer, and fatigue score of ≥4 based on the fatigue subscale of Edmonton Symptom Assessment System (ESAS). Patients allocated to the intervention group received standard care plus a guided 30-min mindful breathing session, while those in control group received standard care. The study outcomes include fatigue severity according to the fatigue subscale of ESAS, visual analogue scale of 0 – 10, and Functional Assessment of Chronic Illness Therapy Fatigue Scale Version 4, at minute 0 and minute 30. Results Of 197 patients screened, 80 were eligible and they were equally randomised into 30-min mindful breathing versus standard care. Lymphoma (58.9%) was the commonest haematological malignancy, followed by multiple myeloma (13.8%), acute leukaemia (11.3%), myeloproliferative neoplasm (6.3%), chronic leukaemia (5.0%) and myelodysplastic syndrome (5.0%). There was no difference in the demographic and clinical characteristics between the 2 groups. At minute 0, both arms of patients had similar ESAS-fatigue score (median, 5) and FACIT-fatigue score (mean ± SD, 24.7 ± 10.6 for intervention group versus 24.7 ± 9.7 for control group). At minute 30, intervention group had lower ESAS-fatigue score (median, 3 versus 5) and FACIT-fatigue score (mean ± SD, 17.1 ± 10.5 versus 24.8 ± 11.3) compared to control group. Both the ESAS-fatigue score reduction (median, − 2 versus 0, p = 0.002) and FACIT-fatigue score reduction (mean ± SD, − 6.7 versus + 0.8; p < 0.001) for the intervention group were statistically significant. The calculated effect size Cohen’s d was 1.4 for between-group comparison of differences in total FACIT-fatigue score. Conclusions Our results provide evidence that a single session of 30-min mindful breathing was effective in reducing fatigue in haematological cancer patients. On top of all the currently available methods, 30-min mindful breathing can prove a valuable addition. Trial registration NCT 05029024, date of registration 15th August 2021. (Retrospectively registered).

Aim To retrospectively report the clinical outcomes of non‐Hodgkin's Lymphoma (NHL) patients post high dose therapy (HDT) with autologous haematopoietic stem cell transplant (AHSCT) and determine whether upfront transplant, which is a first‐line consolidative treatment with induction chemotherapy, would be a feasible modality in a resource‐limited country. Methods The medical records for NHL patients who had undergone HDT followed by AHSCT from October 1997 to November 2016 from two hospitals in Klang Valley, Malaysia were obtained from the medical record database and analysed retrospectively through statistical analysis. Results A total of 148 patients were retrospectively identified post‐AHSCT, where the majority of whom had B cell lymphoma (53.4%). Majority of patients (88.5%) were in complete remission before AHSCT. The overall survival (OS) and event‐free survival (EFS) at 3 years were 68.9% and 60.8%, respectively. The major cause of death was disease progression at 73.9%, while transplant‐related mortality was 15.2%, with a median follow‐up period of 179.5 weeks. Conclusion Our study illustrates the promising outcomes of HDT with AHSCT in NHL patients in a resource‐limited country. We recommend larger studies to be conducted in the future with a longer duration of follow‐up to validate our findings.

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Background:The administration of a new drug such as the COVID-19 vaccine in children could be a major concern for their parents. This study aims to assess the willingness of Malaysian parents to vaccinate their children < 12 years old against COVID-19. Methods:An online cross-sectional study was conducted nationwide in Malaysia from 29th August 2021 to 17th October 2021. Parents with children < 12 years old were recruited by the snowball sampling method. Results:Of the 4,438 survey responses received, 3,528 (79.5%) parents were included in the analysis. Of these parents, 2,598 (73.6%) were willing, 486 (13.8%) were not willing, and 444 (12.6%) were still undecided to vaccinate their children against COVID-19. Those who were single parent [odds ratio (OR): 2.0, 95% confidence internal (CI): 1.32 – 3.04, p = 0.001], had secondary or lower education (OR: 1.5, 95% CI: 1.21 – 1.96, p < 0.001), worked as healthcare worker (OR: 1.7, 95% CI: 1.34 – 2.26, p < 0.001), had significant contact with COVID-19 (OR: 1.3, 95% CI: 1.09 – 1.63, p = 0.006), and already received COVID-19 vaccine (OR: 15.4, 95% CI: 9.76 – 24.33, p < 0.001) were significantly more willing to vaccinate their children against COVID-19. The common reasons given by parents who were willing to vaccinate their children against COVID-19 include vaccination could protect their children (99.4%), the vaccination could protect other family members (99.3%), and the vaccine was effective (98.2%). The common reasons given by parents who were not willing to vaccinate their children against COVID-19 include the uncertainty towards the new vaccine (96.1%), worry about the vaccine contents (93.2%), limited information about the vaccine from the doctors (82.3%), and believed the vaccine was unsafe (79.8%)Conclusions:Nearly three-quarters of Malaysian parents were willing to vaccinate their children < 12 years old against COVID-19. The COVID-19 vaccination history of the parents was the strongest independent predictor for their willingness to vaccinate their children. Future health education should target parents at risk of vaccine refusal or hesitation, focus to address the common reasons for refusing the COVID-19 vaccine, and highlight the benefits of the COVID-19 vaccine.

Hematopoietic stem cell transplantation(HSCT)is now widely practiced worldwide. It has the potential to cure many hematological diseases, such as acute leukemia and thalassemia. As an emerging country, Malaysia has made advancements despite many challenges. HSCT has evolved rapidly since the first pediatric allogeneic HSCT case in 1987. The first adult HSCT was performed 5 years later in 1993. Currently, a total of 13 hospitals offer HSCT services throughout Malaysia. These include private healthcare services, substantially funded government hospitals governed by the Ministry of Health, and partially funded teaching hospitals governed by the Ministry of Education. Until 2015, 1,987 allogeneic and 1,648 autologous HSCT procedures were performed. This article narrates the history and development of HSCT in Malaysia and briefly discusses the challenging issues in this area.

Background:Patients with haematological cancer had considerable symptom burden, in which fatigue was the most prevalent. Almost 70% of haematological cancer patients reported fatigue. Methods:We conducted a parallel-group, non-blinded, randomised control trial at the haemato-oncology unit of University Malaya Medical Centre, from 1st October 2019 to 31st May 2020. Patients included were ≥ 18 years, had histopathological diagnosis of haematological cancer, and fatigue score of ≥ 4 based on the fatigue subscale of Edmonton Symptom Assessment System (ESAS). Patients allocated to the intervention group received standard care plus a guided 30-minute mindful breathing session, while those in control group received standard care. The study outcomes include fatigue severity according to the fatigue subscale of ESAS, visual analogue scale of 0 – 10, and Functional Assessment of Chronic Illness Therapy Fatigue Scale Version 4, at minute 0 and minute 30. Results: Of 197 patients screened, 80 were eligible and they were equally randomised into 30-minute mindful breathing versus standard care. Lymphoma (58.9%) was the commonest haematological malignancy, followed by multiple myeloma (13.8%), acute leukaemia (11.3%), myeloproliferative neoplasm (6.3%), chronic leukaemia (5.0%) and myelodysplastic syndrome (5.0%). There was no difference in the demographic and clinical characteristics between the 2 groups. At minute 0, both arms of patients had similar ESAS-fatigue score (median, 5) and FACIT-fatigue score (mean ± SD, 24.7 ± 10.6 for intervention group versus 24.7 ± 9.7 for control group). At minute 30, intervention group had lower ESAS-fatigue score (median, 3 versus 5) and FACIT-fatigue score (mean ± SD, 17.1 ± 10.5 versus 24.8 ± 11.3) compared to control group. Both the ESAS-fatigue score reduction (median, -2 versus 0, p = 0.002) and FACIT-fatigue score reduction (mean ± SD, -6.7 versus +0.8; p < 0.001) for the intervention group were statistically significant. The calculated effect size Cohen’s d was 1.4 for between-group comparison of differences in total FACIT-fatigue score.Conclusions:Our results provide evidence that a single session of 30-minute mindful breathing was effective in reducing fatigue in haematological cancer patients. On top of all the currently available methods, 30-minute mindful breathing can prove a valuable addition.