In this large international cohort of patients treated with first-line immunochemotherapy, outcomes following SCNS remain poor. However, a moderate proportion of patients with isolated SCNS who received intensive therapies achieved durable remissions.
Patients with lymphoma, especially those treated with anti-CD20 monoclonal antibodies (MoAb), suffer high COVID-19-associated morbidity and mortality. The goal of this study was to assess the ability of lymphoma patients to generate a sufficient humoral response after two injections of BNT162b2 Pfizer vaccine and to identify factors impacting the response. Antibody titers were measured with the SARS-CoV-2 IgG II Quant (Abbott©) assay in blood samples drawn from lymphoma patients 4±2 weeks after the 2nd vaccine dose. The cutoff for a positive response was set at 50AU/ml. Positive serological responses were observed in 51% of the 162 patients enrolled in this cross-sectional study. In a multivariate analysis, an interval of
Background: One of the main obstacles of providing home-based palliative care to transfusion-dependent hematology patients is the lack of home transfusions services. While healthcare professionals are concerned with safety and cost of home transfusions, the attitude of the patients toward home transfusions are mostly unknown. Aim: To obtain quantitative data regarding the willingness and concerns of transfusion-dependent patients with hematological diseases toward the option of home transfusions. Design: A cross sectional survey including a self-administered questionnaire in one of the three main spoken languages in Israel was administered to patients in 17 hospital hematology outpatient clinics between May 2019 and March 2020. Results: About 52% of 385 patients that participated in the survey preferred home transfusions to hospital transfusions. Gender, age, education, or type of disease were not associated with preference for home transfusions, nor were hospital location or its size. The likelihood to prefer home transfusions was significantly higher among the Hebrew-speakers and those who had not experienced adverse effects previously. The most significant factor associated with preference of home transfusions was a perceived negative effect of hospital-based transfusion on quality of life. The main reason to reject home transfusions was fear of possible adverse effects and concerns over losing contact with the medical staff at the treating hospital. Conclusion: These data suggest that a significant portion of transfusion-dependent patients in Israel view home transfusions as a preferred treatment option and that its successful implementation requires maintaining ongoing contact with the treating hospital.
Introduction: Blood transfusion (BT), albeit lifesaving, is associated with morbidity, mortality and increased hospitalization length. In the last decade, due to BT-related risks the "patient blood management" (PBM) approach has been introduced to clinical practice. PBM focuses on multidisciplinary and multimodal preventive measures aiming to reduce the need for transfusions and ultimately improve patients' clinical outcomes. The 1st pillar of PBM is optimizing the red blood cell mass. Preoperative anemia is prevalent in approximately 25% of the patients undergoing elective total hip replacement surgery. The indications for BT during orthopedic surgery include excessive bleeding or hemodynamic instability and not the hemoglobin (Hb) level. Several studies have shown that preoperative anemia is a risk factor for postoperative complications. Strategies to minimize BT requirement during surgery have mainly focused on lowering transfusion thresholds. Randomized controlled trials have shown that in most clinical scenarios, a restrictive transfusion threshold (Hb level 7-8g/dL) appears to be non-inferior to the liberal transfusion strategy in terms of blood use, morbidity and mortality. Other strategies have not been fully evaluated. We hypothesize that preoperative anemia may lead to redundant blood product use with its inherent complications during elective orthopedic surgery. Methods: Medical files of patients who underwent hip surgery between 2011-2018 at the Rambam Health Care Campus, a tertiary care center in Northern Israel, were reviewed. Data on patient demographics, clinical findings, comorbidities, surgery type, hospitalization length were retrieved. Patients with available Hb level measurements within 90 days pre-surgery were included in the study. Receiving >1 blood unit was considered a surgery complication and such patients were excluded. We created a synthetic data cohort using MDClone Healthcare Data Sandbox. MDClone is an environment enabling fast data extraction and producing synthetic data for analysis that does not require IRB approval. Upon confirming the feasibility of using the synthetic data and receiving IRB approval, data of real patients were compared with those of the synthetic cohort. To track significant differences group means were analyzed using ANOVA followed by Tukey HSD. Results: During the evaluated period, 976 patients underwent elective hip surgery; 383 were excluded from the analysis due to receipt of >1 blood unit or lack of Hb value. Data on 593 patients [women: n=360 (60%)] were included in the final analysis. During surgery, BT was required in 29 % of patients, with this need being slightly higher among women (31.1% vs. 26.6%; p =NS). Patients receiving BT had a significantly lower mean Hb level than those who did not require it (11.94g/dL versus 12.8g/dL for women and 12.3g/dL vs. 13.8g/dL for men; p <0.001). Hospitalization was longer in transfused patients compared to non-transfused ones (mean 7.5 vs. 6.9 days, p =0.018) and in patients with a low Hb level (female <12, male <13.5) than in those with a high Hb level, irrespective of BT receipt (p <0.00045). Patients with at least one of the following diagnoses were significantly more likely to have a lower preoperative Hb level (p <0.05): diabetes, renal failure, ischemic heart disease. No other factors (e.g., patient's weight, red cell distribution width or blood pressure) were predictive of transfusion need. The probability of transfusion of 1 blood unit was 0.43 in the Hb 11g/dL cohort and 0.15 in Hb 13g/dL cohort (35% reduction). Results of real and synthetic data groups are presented in figures 1A & 1B. All differences in mean values between the two datasets were insignificant (p close to 1). Conclusions: Preoperative anemia in patients undergoing elective hip surgery is a risk factor for BT requirement and longer hospitalization. Diagnosis and management of anemia using timely pre-surgery evaluation may minimize intraoperative BT, particularly in women and patients with comorbidities and may shorten the hospitalization length. Synthetic data provide an accurate prediction of real data results. Disclosures No relevant conflicts of interest to declare.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.