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pubmed: Eur J Hem[jour]



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A systematic review of health-related quality of life in longitudinal studies of myeloma patients.
Related Articles

A systematic review of health-related quality of life in longitudinal studies of myeloma patients.

Eur J Haematol. 2017 Mar 21;:

Authors: Nielsen LK, Jarden M, Andersen CL, Frederiksen H, Abildgaard N

Abstract
OBJECTIVES: Multiple myeloma (MM) patients report high symptom burden and reduced health-related quality of life (HRQoL) compared to patients with other haematological malignancies. The aim of this review was to analyze published longitudinal studies including MM patients according to a change in HRQoL scores, which is perceived as beneficial to the patient according to two published guidelines.
METHODS: A literature search was performed May 2016. Publications with longitudinal follow-up using the EORTC QLQ-C30 instrument for HRQoL measurement of physical functioning, global quality of life, fatigue and/or pain were included. An analysis of mean change from baseline was carried out according to minimal important difference (MID).
RESULTS: Large and medium HRQoL improvements were reported during first-line treatments. No clinically beneficial change or deteriorations in scores of global QoL or fatigue were reported during relapse treatment. HRQoL data during maintenance therapy are sparse and inconclusive.
CONCLUSIONS: Guidelines for interpreting changes in HRQoL including definitions of MID have been developed, however consensus is missing. Improvements in HRQoL are far more likely to occur during first-line compared to relapsed treatment regimens. The background of these findings should be in focus in future studies and HRQoL measurements should be integrated in maintenance studies. This article is protected by copyright. All rights reserved.

PMID: 28322018 [PubMed - as supplied by publisher]




Infectious complications in patients with myelodysplastic syndromes: a review of the literature with emphasis on patients treated with 5-azacitidine.
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Infectious complications in patients with myelodysplastic syndromes: a review of the literature with emphasis on patients treated with 5-azacitidine.

Eur J Haematol. 2017 Mar 21;:

Authors: Radsak M, Platzbecker U, Schmidt CS, Hofmann WK, Nolte F

Abstract
Myelodysplastic syndromes (MDS) are oligo-clonal diseases of the hematopoietic stem cell compartment resulting in peripheral cytopenias and a tendency of developing acute myeloid leukemia (AML). MDS show an incidence of approximately 4/100.000/year. However, MDS are mainly a disease of the elderly with a sharp increase in incidence in the age decade above 70 years. Due to the demographic change in western countries, it is expected that the MDS will play an increasing role for these health systems. Although anemia is the predominant cytopenia in the majority of patients, about 30-50% of patients suffer from neutropenia of varying severity. Risk assessment was initially done based on the particular subtypes within the FAB classification(1) . The international prognostic scoring system (IPSS) was the first to include - beside medullary blast count and karyotype - the number of cytopenias and thereby indirectly taking the neutrophil count into consideration(2) . Finally, in 2012 the revised IPSS included the severity of neutropenia into risk stratification(3) . This article is protected by copyright. All rights reserved.

PMID: 28321924 [PubMed - as supplied by publisher]




Retrospective evaluation of Venous Thromboembolism (VTE): are all transient provoking events the same?
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Retrospective evaluation of Venous Thromboembolism (VTE): are all transient provoking events the same?

Eur J Haematol. 2017 Mar 21;:

Authors: Chua CC, Lim HY, Tacey M, Nandurkar H, Ho P

Abstract
OBJECTIVES: Venous thromboembolism (VTE) provoked by transient risk factors has traditionally been classified as a single entity with lower risk of recurrence. We evaluated the association between different categories of transient provoking factors and the relative risk of recurrence.
METHODS: Retrospective evaluation of VTE events in non-cancer patients from July 2011 to December 2012 at two tertiary institutions in Australia with a minimum follow up of 24 months.
RESULTS: 747 VTE cases were identified and following exclusion of cases with mortality within 30 days of presentation (n=26), unprovoked cases (40.2%) had a higher risk of recurrence (4.6 versus 2.3/100 event-years, p=0.01). Provoking factors included surgery (40.4%), injury (16.7%), medical-related factors including non-surgical hospitalisation or active infection (22.0%), travel (13.2%) and oestrogen-related (6.5%). Air travel had the highest recurrence rate of 5.9/100 event-years, comparable to unprovoked VTE. VTE provoked by surgery showed lower recurrence rate at 1.8/100 event-years (p=0.03). 62.5% of patients with provoked VTE recurred with an unprovoked event.
CONCLUSION: Transient provoking factors for VTE are heterogeneous with varying potency and should not be considered a single entity. The high recurrence rate after travel-provoked VTE suggests that it is a "minor", if not negligible provoking factor with higher thrombotic predisposition. This article is protected by copyright. All rights reserved.

PMID: 28321922 [PubMed - as supplied by publisher]