Search

Simple Summary: This prospective study evaluated the prognostic value of selected tools from the comprehensive geriatric assessment (CGA) in elderly patients with diffuse large B-cell lymphoma (DLBCL) or mantle cell lymphoma (MCL) treated with R-CHOP or R-CHOP-like regimens. A total of 62 patients were included in the analysis. The findings indicated that the Lawton Instrumental Activities of Daily Living (iADL) scale was a significant predictor of adverse events and treatment outcomes in this patient population. Background: The prognostic value of the comprehensive geriatric assessment (CGA) is recognized by many in hematology. However, there is no consensus on the utilization of alternative abbreviated methods to assess disabilities in elderly patients with B-cell non-Hodgkin's lymphomas (B-NHLs). Aim: The aim of this study was to prospectively analyze the prognostic value of selected CGA tools in predicting adverse events (AEs) and outcomes of R-CHOP or R-CHOP-like treatment in elderly patients with diffuse large B-cell lymphomas (DLBCLs) or mantle cell lymphomas (MCLs). Methods: All patients who participated in this study underwent the Katz Index of Independence in Activities of Daily Living (ADL), the Lawton Instrumental Activities of Daily Living (iADL) scale, the Vulnerable Elders Survey-13 (VES-13), the Groningen Frailty Index (GFI), and the Mini Nutritional Assessment Short Form (MNA-SF) before starting anticancer treatment. Selected clinical predictors were also included in the study. Results: A total of 62 patients with newly diagnosed DLBCLs or MCLs, treated with R-CHOP in the Department of Hematology, Blood Neoplasm and Bone Marrow Transplantation of Wroclaw University Hospital between 1 July 2018, and 1 July 2020, were included in the study. The median age upon initiation of the treatment was 72 years (range: 61–68). Multinomial logistic regression and Cox proportional hazard regression analysis demonstrated that the iADL scale was significantly associated with response to treatment (OR = 1.21, 95% CI: 1.02–1.44, p = 0.03), was inversely related to non-hematological AEs (OR = 0.81, 95% CI: 0.71–0.92, p = 0.001), and was a statistically significant predictor of longer overall survival (OS) (HR = 0.83, 95% CI: 0.79–0.89, p < 0.001) and longer progression-free survival (PFS) (HR = 0.91, 95% CI: 0.83–0.99, p = 0.03). Conclusions: These results underscore the effectiveness of the iADL scale as a quick, easy-to-use, and universal CGA tool for evaluating crucial functional status before treatment in elderly hematological patients with DLBCLs or MCLs. [ABSTRACT FROM AUTHOR]

Opinion statement: Malignant pleural mesothelioma (MPM) is an aggressive asbestos-associated thoracic malignancy that is usually incurable. As demonstrated in the landmark MARS2 trial, surgical resection does not improve survival outcomes and its role in managing MPM is limited. Whilst platinum-pemetrexed chemotherapy in combination with bevacizumab was the standard first-line approach for unresectable disease, landmark phase 3 trials have now established the role of immune checkpoint inhibitors (CPIs) in the upfront management of unresectable disease: either nivolumab-ipilimumab or carboplatin-pemetrexed-pembrolizumab. Patient selection for optimal strategy remains an ongoing question. For relapsed disease novel genomic-based therapies targeting a range of aberrations including losses of the tumour suppressor genes BAP1, CDKN2A and NF2, are being evaluated. Nonetheless, the future of MPM therapeutics holds promise. Here we overview current treatment strategies in the management of MPM. [ABSTRACT FROM AUTHOR]

Introduction: Along with the pharmacological measures, any complementary therapy is also an important factor for a best outcome as complementary therapy can work in tandem with standard medical management without causing any adverse effect. Reiki is a form of energy healing touch therapy. So along with routine medical measures, some complementary therapy can also be adopted to cope with invasive procedures. However, there is a lack of solid scientific evidence about the clinical benefits of complementary therapy in paediatric patients; especially Reiki Therapy. Hence the study aimed to find the effectiveness of reiki therapy among children undergoing surgery. Materials and Methods: A Quasi experimental pre-test post-test control group research design was adopted for the study. It was conducted among children aged between 6-12 years who undergone elective surgery in Yenepoya Medical College Hospital, Mangaluru. The study participants were recruited using non probability purposive sampling technique. The sample size was 84, allocated 42 each in intervention and control group. Anxiety was assessed one day before surgery, on the day of surgery, 12 hours after surgery, 24 hours after surgery and 48 hours after surgery using the tool modified Yale Pre operative Anxiety Scale. Post operative pain was assessed on 12 hours after surgery, 24 hours after surgery and 48 hours after the surgery using Wong Baker Faces Pain rating scale. The intervention group received reiki therapy two times a day (with a gap of 5 hours in between) on one day before surgery, on the day of surgery, 12 hours after surgery, 24 hours after surgery and 48 hours after surgery, whereas the control group children received the routine care. The obtained data were analyzed using descriptive and inferential statistics. Results: When comparing the post operative pain scores within the intervention and control groups, mean pre- to post-test score showed a significant difference in the intervention group (p<0.05), whereas in control group there is no significant difference found. Within the intervention and control groups, the comparison of the anxiety score showed there is a significant difference in the intervention group (p<0.05), where as in control group there is no significant difference found when comparing the mean pre- to post-test score (p>0.05). Effectiveness of Reiki Therapy between the group showed there is no significant difference when comparing post operative pain between the intervention and control group(p>0.05), while, in case of anxiety between the intervention and control group, there is a significant difference found in the mean post-test scores (p<0.05) for most of the outcome. Conclusion: This study concluded that Reiki therapy is effective in controlling anxiety among children undergoing surgery. It can be implemented in clinical setting for planned surgeries as a preparation to the children to cope with anxiety. [ABSTRACT FROM AUTHOR]