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Background Patient-reported outcomes (PROs), including symptoms and quality of life (QOL) measures capture the patient-centered experience of hematopoietic stem cell transplantation (HSCT). They enhance patient-provider communication and allow for symptom intervention. PROMIS-29 is one of the NIH developed and validated tools for collecting PROs. It examines 7 domains: physical function, anxiety, depression, fatigue, sleep disturbance, social participation, and pain interference. We have piloted its use in the HSCT patients. Methods Twenty five patients both pre- and post- hematopoietic stem cell transplantation (allogeneic, n = 14; autologous, n = 11) were surveyed using the PROMIS 29 scale. Patients ranged from 4.6 months pre-transplant to 5.8 years post-transplant. The patients completed the PROMIS-29 survey in the waiting room prior to their scheduled appointments. Results The top three reported concerns were decreased physical function (38.5%), fatigue (30.8%) and pain (20%). Fatigue remained a prominent complain with patients commonly reporting moderate to severe fatigue post-transplant. Strikingly, patients reported fatigue commonly whether they were within a year of their transplant or several years out from their transplant. Conclusions PROs, such as PROMIS-29, provide valuable insight into the HSCT patient experience and QOL. Our pilot data, demonstrates that these symptoms can persist long after the patient has been cured of their hematologic malignancy. We are broadening the implementation of this survey to capture all HSCT recipients. We plan to use the results to enhance communication at our outpatient visits. We also plan to use the aggregated data to define areas for future intervention to help our patients cope following transplantation. [ABSTRACT FROM AUTHOR]

A 54‐year‐old man recently diagnosed with small lymphocytic lymphoma (SLL) had waxing and waning, indurated, erythematous plaques on his legs, with leukopenia and anemia disproportionate to the SLL burden in his marrow and pelvic lymph nodes. Punch biopsy of a plaque performed to evaluate for leukemia cutis revealed a lymphocytic lobular‐panniculitis‐like infiltrate resembling lupus panniculitis, but a preponderance of CD8+/Ki‐67+ T‐cells surrounding adipocytes raised concern for subcutaneous panniculitis‐like T‐cell lymphoma (SPTCL). Additional immunohistochemistry (IHC) studies showed that the adipotropic T‐cells expressed TCR‐gamma, supporting the rare, unexpected diagnosis of Primary cutaneous gamma‐delta T‐cell lymphoma (PCGDTCL). The patient subsequently met diagnostic criteria for hemophagocytic lymphohistiocytosis (HLH). PCGDTCL is an aggressive, HLH‐associated lymphoma requiring different management than SPTCL and SLL. This case illustrates how PCGDTCL can co‐exist with B‐cell lymphoma and resemble panniculitis on biopsies. PCGDTCL and SPTCL should enter the differential diagnosis whenever patients present with the constellation of lobular panniculitis and unexplained cytopenias. In the present case, close clinicopathologic correlation and judicious use of IHC on a small sample allowed for a prompt diagnosis. [ABSTRACT FROM AUTHOR]

• Transplantation is a complicated and prolonged process for patients. • The out-of-pocket expenses and time commitment for caregivers of transplant recipients are substantial. • These results demonstrate a compelling need to address caregiver support due to their significant out-of-pocket expenses and time commitment. The emotional and physical toll on caregivers of cancer patients is well documented, but research evaluating the financial burdens and time commitments of caregivers is limited. We suspected that the rural location of our cancer center would intensify these burdens for caregivers. We conducted a prospective trial to assess the out-of-pocket expenses and time commitment of caregivers of hematopoietic stem cell transplantation recipients within the first 4 weeks after discharge from the hospital from a National Cancer Institute (NCI)-designated comprehensive cancer center. These results show that caregivers of autologous recipients paid out-of-pocket expenses of $196 over 4 weeks. If lost wages were included, the expenses increased to $736 during this period. Caregivers of allogeneic recipients had out-of-pocket expenses of $110 in 4 weeks, or a total of $610 when lost wages were included. In the month after discharge from the hospital, caregivers traveled a median distance of 450 miles or 560 miles, depending on whether the patient received an autologous transplant or an allogeneic transplant, respectively. These results demonstrate a compelling need to address caregiver support, given the significant financial out-of-pocket expenses and time commitment. [ABSTRACT FROM AUTHOR]