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In times of economic crisis in the destination country, migrants might decide to stay or leave. Having obtained dual citizenship facilitates both options: on the one hand, it allows for a secure stay, without fear of losing residence permits. On the other hand, it allows for either a connected return or new cross-border mobility options, especially in the case of citizenship from the EU. It can also be considered a significant milestone in someone’s migratory trajectory, especially among those who started their migration as undocumented. This paper discusses the ways in which dual citizens interpret this status after the 2008 economic crisis in Spain and shows how it provided many with the opportunity to embark on new migrations within the EU. Drawing on 80 interviews with dual citizens born in Colombia and Ecuador who resided in Madrid and London, the authors argue that dual citizenship is understood as a resource that offers a sense of personal security and an enhancement of one’s position in the global hierarchy of citizenships. Respondents in this study do not consider formal citizenship as a necessary step for emotional belonging, which they base on their daily interactions and relationships.

Objective: Report RESONATE-2 phase 3 study extended long-term follow-up of first-line ibrutinib vs chlorambucil in older patients with CLL/SLL. Methods: Patients (≥65 years [y]) with previously untreated CLL/SLL (without del[17p]) were randomly assigned 1:1 to once-daily ibrutinib 420 mg, until disease progression (PD) or unacceptable toxicity (n=136); or chlorambucil 0.5–0.8 mg/kg, up to 12 cycles (n=133). Outcomes included progression-free survival (PFS), overall survival (OS), overall response rate (ORR), and safety. Long-term responses were investigator-assessed per 2008 iwCLL criteria. Results: With up to 7y of follow-up (median, 74.9 months; range, 0.1–86.8), significant PFS benefit was sustained for patients treated with ibrutinib vs chlorambucil (HR 0.160 [95% CI: 0.111–0.230]). At 6.5y, PFS was 61% vs 9% for ibrutinib vs chlorambucil. PFS benefit was observed consistently, including ibrutinib-treated patients with high-risk genomic features of unmutated IGHV (HR 0.109 [95% CI: 0.063–0.189]) or del(11q) (HR 0.033 [95% CI: 0.010–0.107]). With ibrutinib, 6.5y OS was 78%; ORR was 92%, and complete response (CR/CRi) rate increased to 34%. Ongoing rates of grade ≥3 AEs of interest remained low for hypertension (5–6y interval: 5%, n=4; 6–7y: 4%, n=3) and atrial fibrillation (5–6y: 1%, n=1; 6–7y: 1%, n=1); no grade ≥3 major hemorrhage in 5–7y. One patient (1%) had dose reduction due to grade ≥3 AEs during years 5–6/6–7. Of 31 patients with dose reductions due to any-grade AEs over full follow-up, 22 (71%) had AE resolution/improvement. Primary reason for discontinuation was PD (5–6y: 5%, n=4; 6–7y: 6%, n=4). Any-grade AEs leading to discontinuations were 3% (n=2) in 5–6y and none in 6–7y. With up to 7y of follow-up, 47% of patients remain on single-agent ibrutinib. Conclusions: Long-term RESONATE-2 data demonstrate sustained PFS and OS benefit with first-line ibrutinib treatment for CLL, including for patients with high-risk genomic features. Responses continued to deepen over time. Rates of grade ≥3 AEs of interest continued to be low with rare further discontinuations and dose reductions due to AEs; most AEs leading to dose reduction resolved/improved. Ibrutinib remains well tolerated with no new safety signals. Funding: Pharmacyclics LLC, an AbbVie Company.

Background The treatment for haematological malignancies is lengthy, complex and intense, leading to potentially debilitating symptoms and reduced health-related quality of life. Patients are living longer due to advancements in early detection and significant improvements in treatment. While treatments for haematological malignancies dramatically increase survivability, many patients suffer from debilitating side effects during and following their treatment. Survivors can suffer long-term effects of both treatment and disease. They may be left with permanent, often devastating, physical impairments leading to an increased risk of other illnesses or a lower quality of life. The presentation is part of a mixed methods study and aims to deepen our understanding of the quality of lives of survivors of adult haematological malignancy. The study will contribute to the under-researched topic related to adult survivors of a haematological malignancy. Methods The participants (n = 11) were adults who had completed treatment for a haematological malignancy and were between 1-5 years post-treatment. A qualitative research process of inquiry was used to explore the quality of lives of survivors of haematological malignancy. In-depth face-to-face semi-structured interviews were conducted, based on the content and structure of the interviews envisaged being grounded in the findings of the quantitative phase of the study. Results Four themes and several subthemes were generated and reviewed from the qualitative data analysis. The key themes identified in this cohort were:(1) Physical wellbeing (2) Psychological wellbeing (3) Independence and (4) Supportive care needs. Conclusions Enhancing these survivors’ physical, psychological wellbeing, an understanding of what independence means to them and addressing supportive care needs can optimise their QoL. Knowledge and understanding of these factors and addressing these needs may provide an insight into implementation measures to enhance the same. Legal entity responsible for the study Royal Bournemouth Hospital and Bournemouth University. Funding Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust. Disclosure All authors have declared no conflicts of interest.

We use a central place foraging model of field resource processing to explore the archaeological implications of experimental and ethnographical observations pertaining to the collection and processing of black oak (Quercus kelloggii) and big mussel (Mytilus californianus). These data suggest oak field processing will generally be minimal and confined mainly to drying and that big mussel may be transported unprocessed or completely processed depending on round-trip travel time and mussel colony productivity. Archaeological data further demonstrate that the field processing of mussels is frequently at odds with central place model predictions, suggesting optimization of quantities other than calories and time.