39 Three randomized trials have previously reported a progression-free survival (PFS) advantage for patients receiving thalidomide (T) maintenance post ASCT in MM. Two trials reported an overall survival (OS) advantage but the largest trial reported shows no OS advantage and in very high risk MM the use of T was deleterious. Recent trial reports demonstrate a PFS but not yet an OS advantage for patients receiving maintenance lenalidomide. We report results of NCIC CTG MY.10 which compared treatment with T (200 mg daily) and prednisone (50 mg alternate days) (T/P) until progression versus observation alone when used as maintenance therapy following ASCT. Importantly, OS was the 1ry endpoint of this study, 2ry endpoints were PFS, quality of life (QoL), toxicity, and the incidence of venous thromboembolism events (VTE). Eligibility: Patients with MM who had ASCT within 1 year of beginning initial treatment for their disease. Patients were randomized 60–100 days post ASCT and had no other medical condition precluding long term use of T/P. Results: 332 patients were enrolled. Median age was 58 years and the arms were balanced. Patients were stratified by age (<60 or >60), and CR status post transplant. Median follow up is 4 years. Only 14% of patients were in CR post transplant. 111 patients died (50 versus 61 in T/P vs. observation). The median OS was 5 years for observation, and has not yet been reached for T/P, however T/P maintenance therapy did not significantly prolong OS: p = 0.18, HR of maintenance vs. observation 0.77 (95% CI 0.53–1.13). The 4 year survival rate was 68% for T/P and 60% for observation. Age and response to transplant had no significant association with OS (p=0.21), while higher disease stage was associated with shorter OS (p=0.03). The median PFS was 28 months for T/P versus 17 months for observation: p<0.0001, HR of T/P vs. observation 0.56 (95% CI 0.43 – 0.73). The 4 year PFS rate was 32% for T/P treated patients versus 14% for patients on observation. At relapse, treatment by arm (T/P vs observation) included lenalidomide (39 vs 34%), T (13 vs 22%) or bortezomib (50 versus 46%). Non hematologic toxicities were seen in more patients with treatment (Grade 3: 92% T/P vs 49% observation, grade 4: 16% vs 7%). Common toxicities of all grades that were significantly higher in T/P treated patients included hyperglycemia, edema, hypertension, fatigue, Cushingoid appearance, constipation, mouth dryness, dyspepsia, anxiety, memory loss, sensory neuropathy, tremor, blurred vision, depressed consciousness, cataracts, dyspnea and bruising. 7% of patients on maintenance T/P developed a VTE in the absence of prophylaxis versus 0% on observation. NCIC CTG standardized response analysis was use to compare QoL data between the 2 treatment arms. Overall, patients on T/P had worse QoL specifically in physical (p=0.07), role (p=0.08), cognitive (p = 0.01) and global (p=0.06) domains, and worse symptoms with dyspnea (p = 0.0007), constipation (p<0.0001), thirst (p=0.003), swelling in leg (p=0.03), numbness (p=0.02), dry mouth (p<0.0001), and balance problems (p<0.0001). However, patients on T/P reported improvement in appetite (p 0.02), and sleep (p=0.04). Conclusions: T/P maintenance did not improve overall survival, the primary objective of this trial, although a trend in favor of T/P was seen. In contrast, PFS was significantly improved in the T/P arm while toxicity was demonstrably increased and quality of life diminished. Disclosures: Stewart: Millennium: Consultancy; Celgene: Honoraria. Trudel:Celgene: Honoraria. Bahlis:Celgene: Honoraria, Research Funding, Speakers Bureau. White:Celgene: Honoraria, Research Funding. Meyer:Celgene: Honoraria.
The present study explored the associated factors of intimate partner violence through technological abuse (ITPV) in a sample of 1113 participants aged 18 to 65 (71.3% females). Our research’s primary questions were the following: 1). Is there a significant link between relationship attachment styles and ITPV perpetration or victimization?; 2). Is there a significant link between participants’ demographic and relationship characteristics (i.e., relationship length and partners’ fidelity), online behavior (i.e., benign and toxic disinhibition), moral disengagement, psychological distress), and ITPV perpetration or victimization?; and 3). Did the COVID-19 pandemic increase ITPV perpetration or victimization?. We analyzed our data by creating three different groups, depending on participants’ answers concerning ITPV, i.e., the overall sample, abusers’ and victims’ groups. Our main results suggested significant, positive correlations between ITPV perpetration and victimization, moral disengagement, psychological distress, and online disinhibition. Age negatively correlated with IPVT victimization and perpetration. We also found significant associations between participants’ dominant relationship attachment style and their own and partners’ cheating behavior, as well as ITPV-victimization and perpetration. Finally, 13.7% to 23% of participants in all three groups considered that the Covid-19 increased the frequency of ITPV behaviors (for both abusers and victims). Results are discussed considering their theoretical and practical implications for domestic violence and the potential related prevention and intervention strategies.
IntroductionRomania shares the longest UE border with Ukraine, and since the Russian invasion of Ukraine began, many have been involved in helping the refugees. Consequently, children and adolescents might be directly and indirectly exposed to war-related trauma. In the present exploratory research, we investigated Romanian adolescents’ potential risk and protective factors related to the psychological outcomes of war exposure. Our cross-sectional study was conducted shortly after February 24th (i.e., the first invasion day).MethodsThe sample included 90 Romanian adolescents aged 11 to 15 (M = 12.90, SD = 1.17), residents in Iași, Romania (i.e., 205,7 km from the Ukrainian border). Participants completed self-reported measures of peritraumatic dissociative experiences, knowledge about the conflict in Ukraine, personal, school, and family implications in volunteering/helping behavior, discussions about the conflict, threat perception (self and perceived parental threat), anxiety, social media engagement, resilience, and moral elevation.ResultsThe main findings suggested that participants involved in helping behaviors toward Ukrainian refugees present higher peritraumatic dissociative experiences, anxiety symptoms, and higher moral elevation than boys and participants not involved in these behaviors. Moreover, anxiety symptoms were positively associated with threat perception, peritraumatic dissociation, and social media engagement and negatively related to resilience.DiscussionsFinally, we discuss the implications of our findings concerning their practical utility in managing peritraumatic exposure to war by using interventions designed to increase adolescents’ resilience during difficult times.
IntroductionSocial media use was previously characterized as both a maladaptive coping mechanism, and a source of engagement with peers, suggesting an ambivalent effect. The present study explored how adolescents might use social media as a coping mechanism during the COVID-19 pandemic, using a multidimensional perspective on well-being.MethodsOur sample consisted of 259 Romanian teenagers aged 11–16 (M = 13.38, SD = 0.93, 57% males). We investigated the potential indirect effect of social media use, i.e., its cognitive, affective, and behavioral dimensions on the relationship between depressive symptoms and adolescents' well-being.ResultsAcross all mediation analyses, our results suggested that social media use positively predicted adolescents' well-being. Given the multidimensional approach to both social media use and well-being, our findings suggested that adolescents' well-being was predicted not only by actual social media use behaviors but also by cognitions related to the expectation of receiving gratification on social media and the intense affective states related to the desire to use social media. Also, our data suggested that adolescents with high levels of depressive symptoms might be more likely to capitalize on social media use and have expectations related to receiving approval from others in the context of social media use.DiscussionDepressive symptoms might be more relevant when explaining the cognitive and affective involvement during social media use. However, their ability to predict the actual social media use behaviors may be limited. Furthermore, adolescents that present depressive symptoms might be more prone to use social media, in order to improve their well-being.
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