We report the first case of TTP in a Jehovah's Witness that was successfully managed with the use of pegylated bovine carboxyhaemoglobin as an adjunct medication.
No abstract
e19034 Background: PCBCL is a group of rare lymphoproliferative disorders, with an estimated annual incidence of 2.5 per 1,000,000 persons. Indolent subtypes include Primary Cutaneous Marginal Zone Lymphoma (PCMZL) and Primary Cutaneous Follicular Center Lymphoma (PCFCL). Primary Cutaneous Diffuse Large B-cell Lymphoma (PCDLBCL) is an aggressive subtype with a fatality rate of 50%. The Cutaneous Lymphoma International Prognostic Index (CLIPI) can risk-stratify indolent subtypes, but age is not considered. Here we present our single-institutional analysis of clinicopathologic features and outcomes of patients with PCBCL. Methods: This is a retrospective study of patients evaluated at Moffitt Cancer Center between 01/1990 and 12/2016. Patients were identified using our PCBCL database and diagnosis was verified by independent hematopathologists and dermatopathologists. Staging was determined by ISCL/EORTC criteria. Demographics, subtype, stage, disease course, and CLIPI scores were collected. Continuous and categorical values were tested using Kruskal-Wallis ANOVA method and Fisher’s Exact Test, respectively. Kaplan-Meier curves were produced to determine PFS. Results: We identified 37 patients who met diagnostic criteria for PCBCL (35% PCFCL, 40.5% PCMZL, 13.5% PCDLBCL, and 11% indolent, unspecified). Male:female ratio was 2.4:1. 51% of patients were ≥ 60 years old (yo), and 49% were < 60 yo. 54% had stage T1 disease, 27% T2, and 19% T3. Median PFS for patients <60 was 1.1 years, but was not reached for those ≥60. Mean follow-up time was 2.6 years for all patients. Log-rank test showed a statistically significant difference in PFS between the two age groups (p=0.01). PFS for stage of indolent subtypes showed marginal significance (p <0.06). CLIPI for indolent subtypes did not show a significant difference in PFS. Conclusions: We found that age is a highly statistically significant prognostic parameter in PCBCL, as patients ≥ 60 yo had a longer PFS compared to younger patients, even after adjusting for stage and CLIPI. These results are promising for age as a possible prognostic indicator for PCBCL, but validation is needed with a larger sample size.
e24025 Background: The American Cancer Society (ACS) published Diet and Physical Activity Guidelines in 2020. Emerging evidence suggests that healthy dietary patterns are associated with reduced cancer risk, especially colon and breast. ACS estimates there are 3.5 million breast cancer survivors in the US. The transition from active treatment into survivorship is a critical period where they are uniquely positioned to adapt healthy behaviors, yet there is a lack of empirical research to best guide the transition. Methods: We developed an 8-week breast cancer survivorship program to educate and develop healthy habits. 40 participants were recruited through Moffitt breast and survivorship clinics, social media, and website. Weekly topics were: cancer survivorship, nutrition, emotional health and well-being, exercise, medical management after treatment, grocery store tour, meditation and mindful eating, and moving forward. To assess health-related quality of life (QoL), we used FACT-G Version 4, a validated patient-reported survey with 27 questions and 4 domains of wellbeing (physical, social/family, emotional, and functional) on a 5-point Likert scale (not at all to very much). Similarly, a nutrition questionnaire evaluated the understanding of healthy choices, confidence in making healthy changes, knowing how to purchase healthy foods and read nutrition labels, confidence in preparing healthy foods, and understanding of a plant-based diet. Surveys were administered pre- and post-intervention. Data analysis included those who completed both (n = 30). Pt characteristics and data trends were summarized using descriptive statistics. Paired Wilcoxon rank sum tests were used to assess the significance of the change in scores between surveys. Results: Participant ages ranged from 41 to 77. The majority (34.5%) completed treatment 13-24 months prior. Compared to baseline, greater proportions of participants had positive responses after intervention in all nutrition questions. The nutrition sum was significantly increased by 3.07 (p = 0.0001). There was no significant change in overall QoL (-1.77; p = 0.1178) or sub-domain wellbeing scores. Conclusions: Our 8-week intervention for breast cancer survivors showed significant improvement in nutrition domain. While a small sample size is limiting, it is evident that survivors can improve their confidence in making healthy changes and develop better understanding of a plant-based diet.[Table: see text]
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