bluuebunny/crossref_metadata_2025_split huggingface dataset:
Return to primary service among bone marrow transplant rehabilitation inpatients: An index for predicting outcomes.
Authors: Fu Jack Brian , Lee Jay Ted , Smith Dennis Wesley 
Published: March 2020

e19509 Background: Inpatient rehabilitation bone marrow transplant patients can be challenging due to their medical fragility. Methods: One hundred forty-seven bone marrow transplant patients admitted to inpatient rehabilitation at a major national cancer hospital between January 1, 2002, and April 15, 2009, regardless of the patient’s primary cancer were retrospectively studied. Return to primary service and factors including age, gender, race, presence of graft-versus-host disease, type of hematopoietic stem cell transplant, type of primary cancer, white blood cell count upon rehabilitation admission, platelet count, albumin level, prealbumin level, creatinine level, and presence of antimicrobial agents were analyzed. Results: Forty-one percent (61/147) of bone marrow transplant patients were transferred from the inpatient rehabilitation unit back to the primary service. Of those transferred back, 38% died after being transferred back to the primary service; 53%, 36%, and 39% of leukemia, lymphoma, and multiple myeloma transplant patients were transferred back to the primary service, respectively. No breast, germinoma, renal, testicular, or Waldenstrom macroglobulinemia patients were transferred back to primary service. Significant relationships were found with a platelet count < 43 (p<.01), a creatinine level > 0.9 (p<.05), the presence of an antibacterial agent (p<.05), the presence of an antifungal agent (p<.05) and leukemia, lymphoma or multiple myeloma type (p<.05). Using these 4 of these factors the Fu index was formulated to determine the likelihood of return to the primary team. Conclusions: Bone marrow transplant patients have a high rate of transfer from the inpatient rehabilitation unit back to the primary service and many of them eventually died while in the hospital. A low platelet count, a high creatinine level, the presence of an antibacterial agent, and the presence of an antifungal agent significantly increased the risk of return to primary. Close follow-up by the primary team while on the inpatient rehabilitation unit is recommended.
Persistent oxaliplatin (OX) induced peripheral neuropathy in patients (pts) with colorectal cancer: A descriptive study.
Authors: Vatandoust Sina , Joshi Rohit , Broadbridge Vy , Pittman Kenneth B. , Adams Jacqueline , Singhal Nimit , Colbeck Margaret , Yeend Susan , Price Timothy Jay 
Published: March 2020

e19513 Background: Available data suggest that the OX-induced neuropathy is usually reversible and a minority of pts will have persistent severe (grade 3) side effects (24.1% any grade and 0.7% grade 3 at 18 months follow up from MOSAIC trial). We have explored the frequency of persistent peripheral neuropathy in pts who received OX for colorectal cancer at 2 local centres in South Australia. Methods: Pts who completed treatment with OX for colorectal cancer at least 20 months prior to entering the study were eligible and were sent consent and questionnaire. Neuropathy questions were adapted from the FACT/GOG-Ntx (V.4) questionnaire. No pts received Calcium and Magnesium with OX. Statistical tests used to analyze the data were t-test and chi- square. Results: Of the 56 eligible pts, 27 consented to enrol in the study. Median age was 66 yrs. 19 were stage 3, 8 stage 4. Mean total OX dose was 712.1 mg/m2 (range: 170 - 1200 mg/m2); mean number of OX cycles was 8.2 (range 2 - 13), median time between last dose of OX and completing the questionnaire was 37 months (range 20 - 93). 7 pts (25.9%) had a history of diabetes mellitus and 7 had significant alcohol intake. No pts had neuropathic symptoms prior to treatment with OX. 25 pts (92.7%) experienced neuropathic symptoms during their treatment, 11 had grade 2, and 2 had grade 3 symptoms (limiting self care activities of daily living). At the time of completing the questionnaire, 17 pts (63%) were still symptomatic with 9 pts (33.3%) having grade 2 and 3 pts (11.1%) having grade 3 neuropathic symptoms. In the cohort of pts with persistent grade 2 symptoms, 3 pts had walking difficulty and 2 pts could not drive safely due to side effects. Persistent grade 2/3 symptoms were more common in pts who received total OX doses of 722 mg/m2 or more (p < 0.05). Conclusions: Our observation indicates that a majority of pts will have persistent neuropathy more than 20 months after completing treatment with OX and a significant proportion will still have grade 2/3 symptoms. Higher total OX dose might be one of the risk factors in this group. These results should be further prospectively evaluated in a larger population as these long term side effects may affect pts’ daily activities and safety.
An innovative approach to post-treatment cancer care: The After Cancer Treatment Transition Clinic (ACTT).
Authors: Townsley Carol A. , Moura Shari , Fitzgerald Barbara , Hawker Gillian , Mosley Jane , Barrett Cris , Fox Catharine , Moore Malcolm J. 
Published: March 2020

e19522 Background: Improvements in early detection and cancer therapy have led to better survival rates. Integration of cancer survivorship initiatives as part of cancer care is gaining momentum. However, post cancer treatment follow up care may not be best met in acute cancer clinics. Visits to a large urban cancer centre in Canada have increased by 30% in the past 5 years. These increased volumes have lead to prolongation of patient wait times and increased stress for health care providers. This cancer centre is undergoing a transformative change that focuses on improving the patient cancer care experience. Methods: The development of the ACTT clinic has been a partnered initiative between two academic healthcare centres: an urban cancer centre and a community ambulatory hospital with a focus in chronic disease management. It is being managed by an advanced practice nurse and a GP Oncologist. The ACTT clinic delivers high quality, safe specialized physician and advanced nursing patient care, with engagement of patients/families, oncologists and primary care. The target population is patients who have completed cancer therapy, are well and are at moderate to low risk for cancer recurrence. The initial phase of the project involved transitioning patients with Testes, Melanoma, Breast and Colorectal cancers. Each cancer site group identifies the appropriate processes for clinic functioning at the ACTT, and if required, for appropriate linkages back to acute cancer care and primary care. Results: Over 1,000 patients have been transitioned to ACTT since April 2010 with 10-20 additional patients referred weekly. Essential components of the model include: standard surveillance protocols for recurrence or secondary cancers, management of long term and late effects of cancer treatment, monitoring for distress and health promotion. Standard reporting includes patient assessment and a defined plan of care communicated to their oncologist and primary care. Patient experience evaluation of the program is ongoing. Conclusions: The ACTT clinic initiative has been successful in developing a novel clinic model and has successfully transitioned over 1,000 patients from an acute care cancer clinic.
Pattern of use of complementary alternative medicine (CAM) among cancer patients in Saudi Arabia.
Authors: Al-Dalee Abdelmuniem , Aljubran Ali Husain 
Published: March 2020

e19525 Background: Use of complementary alternative medicine CAM is prevalent among cancer patients in Saudi Arabia. However, there is yet no clear knowledge about the pattern and magnitude of use of CAM. This study explored that area. Methods: The subjects were adult cancer patients who attended the outpatient clinics at King Faisal cancer center in Riyadh, Saudi Arabia. They completed a validated questionnaire of six sections. In this abstract, we only present the data of the fourth section which enquires about the pattern of CAM use. Ingestion or topical application of therapeutic materials as well as recitation of prayers or attending spiritual sessions are all considered CAM. Results: 234 patients participated. Age range: 15-86, median: 40.5 y. Males were 61.5%. 12.4% lived in suburban areas. 41.5% had higher than high school education, and 76% had annual income less than $32,000. 53% of the studied population used CAM before starting conventional therapy, and 47% of them were actually on CAM while on conventional therapy. Honey, whether mixed with herbs or not, was the most commonly used (84% before and 86% after starting conventional therapy). 92% used the holly Quran recitation or Ruqia (Recitation of special prayers). 53 % went at least once to attend a session with a sheikh (spiritual/ religious healer), and 9% of the responding participants attended sessions to undo magic or expel jinn (possessing demon spirit). 92% of CAM users believed that conventional therapy is effective but wanted to try other possible options. Conclusions: Use of CAM is prevalent among cancer patients before starting and while on conventional therapy. Because of the religious nature of the society, attending spiritual healing sessions is very common. Since this study was done among patients who already had chosen to be treated by conventional therapy, the results may under estimate the prevalence of CAM use. A similar study in the community is recommended to include patients who do not seek conventional treatments.
Predictive value of clinical and laboratory findings for overt bone marrow metastasis in patients with solid tumor.
Authors: Filanovsky Kalman , Shvidel Lev , Idelevich Efraim , Feldberg Edit , Shtalrid Mordechai 
Published: March 2020

e19529 Background: Bone marrow (BM) involvement is not a rare finding in advanced stages of solid tumors, it may have a profound influence on prognosis and affect a treatment approach. Methods: 103 patients (pts) with an advanced metastatic solid tumor were included in retrospective study. BM metastasis were diagnosed in 72 cases according to Bone marrow biopsy (BMB) ; 31 other metastatic pts. didn't have a marrow spread. We analyzed a basic demographic characteristics, localization of primary tumors and metastasis, laboratory tests, blood smears, BM aspirates (BMA) and biopsies reports.Results: Pts in both groups had comparable median age, gender distribution, pattern of primary tumor and metastatic spread. Hematological parameters' strong correlated with marrow metastasis were: anemia 83% vs. 61% p=0.015 ,thrombocytopenia 55% vs.16% p<0.001 with higher MPV p=0.01, hypocellular/ dry tap marrow aspirate 58% vs.14% p=0.001 and leukoerythroblastic blood smear 82% vs.0% p<0.0001. Leukoerythroblastosis(LEB) in 92% reflected hypocellular aspirate was not included in final analysis because of low rate recorder blood smears. Analysis of biochemical finding showed higher increase by 2 upper limits (>2ULN) of LDH and ALP in the metastatic BM cohort: 50% vs. 16% and 35% vs. 9%, p=0.002 and p=0.007 respectively. Factors predicted metastatic BM by multivariate analysis were: thrombocytopenia <50x109/L OR 14.4 95%CI (1.6-128), hypocellular BMA OR 7.0 95%CI (1.82-21.2) and alkaline phosphatase >2ULN levels OR 6.5 95%CI ( 1.2-35.3). Causes which influenced the survival of pts with BM metastasis: thrombocytopenia < 50X109/ L median survival 0.8 month 95% CI (0.1-1.5) vs. 4.1m 95%CI( 2.0-6.1), LDH level >2ULN 1.8m 95%CI(0.5-3.0) vs.4.7m 95%CI(3.0-6.3) and tumor presenting with BM metastasis vs. previously recognized carcinoma with BM involvement 1.8m 95% CI(0.3-3.0) vs.4.0 m.95%CI(1.3-6.7).Conclusions: Our study demonstrated that thrombocytopenia , alkaline phosphatase level>2ULN and probably LEB reflect hypoplastic BM predict BM metastasis in cancer patients; furthermore, thrombocytopenia, LDH>2ULN and BM metastasis in a clinical presentation affect their survival.
Emotional reactions of children and adolescents to the advanced oncologic disease of the parents: Preliminary results.
Authors: Rodriguez-Morera Anna , Limonero Joaquin T. , del Barco Sonia , Porta Rut 
Published: March 2020

e19542 Background: To describe perceptions of children and adolescents on advanced or terminal oncological disease of their parents, and some factors affecting these perceptions. Methods: Sample of 30 children and adolescents, aged between 5 to 18 years old, whose parents were in treatment or follow-up for advanced oncological disease. We used a semi-structured interview, reflecting the perceptions of ill parents, healthy parents and children. Also, parents were asked for the information they thought their children had about the disease. All participants older than 12 years old, gave Informed Consent to participate in the study. Results: Children and adolescents, described the disease of their parents mixing objetivable data (88.9%) and subjective perceptions (66.7%) with the expression of wishes (44.4%). Up to 76.7 % of ill parents and 82.6% of healthy parents, tended to minimize the capacity of understanding of the disease by their children. The perception that the patient and the healthy parent had of the information of the children correlates positively and significantly (r=0.59; p<0.01) and (r=0.53, p<0.01) respectively with the minimization or maximization of the capabilities of coping that the parents had of their children. There was a significant correlation (r=0.50, p<0.05), between the perceptions from the patient and his partner regarding the information and knowledge that their children have from the disease. Mothers, were the ones usually to decide the type, quality and quantity of information to provide to their children. Conclusions: Most parents and patients tend to underestimate the capacity of understanding of the children and teenagers, being mothers the ones to decide, in most cases, the amount and quality/quantity of the information given to their children about the illness. It would be necessary to attend from the beginning of the disease, the needs of parents with minor children, as well as the needs of their children, in order to help the adaptation to the serious illness from one of their parents, and detect and treat if necessary, cases of psychological vulnerability that can develop psychopathology symptoms.
Venous thromboembolism as a relevant toxicity in cancer patients treated in phase I studies.
Authors: Mandala Mario , Grosso Federica , Vitalini Cristina , Corradino Irene , Labianca Roberto , Colombini Sonia , Sanfilippo Roberta , De Pascale Antonella , Marsoni Silvia 
Published: March 2020

e19549 Background: To investigate the risk factors and the relevance of venous thromboembolism (VTE) among the reported toxicities in advanced cancer patients treated in phase I studies. Methods: Patients enrolled and treated in phase I studies conducted by SENDO (Southern Europe New Drugs Organization) Foundation between 2000 and 2010 in 15 experimental centres were considered for the study. Clinical data, including adverse events, were prospectively collected during the studies and retrospectively pooled for VTE analysis. Results: Data of 1,415 pts were considered for analysis. 526 (37.2%) patients were males, median age was 57.3 years (range: 13-85). 85% of patients had metastatic disease, while the remaining had locally advanced irresectable disease. For 706 (49.9%) of the patients the study treatment was with cytotoxic agent(s) only, for 314 with target therapy(ies) only, while the remaining patients received a target therapy in combination with a cytotoxic drug. 56 (3.96%) patients who developed a VTE, almost all (89.3%) during the course of treatment, the remaining during the follow-up. At multivariate analysis gynecologic (HR: 2.7, p< 0.012; 95% CI: 1.241 - 5.889) and gastrointestinal tumors (HR 3.32, p< 0.019; 95% CI: 1.22 - 9.08) as well as cytotoxic plus antiangiogenic agents (HR 2.5, p< 0.038; 95% CI: 1.05 - 5.96) were statistically correlated with VTE development. The adverse events were the main reason for discontinuation in 230 pts. VTE was the fourth most common cause of drug discontinuation among this subgroup of patients. The median time from first drug administration to discontinuation was 1.4 for VTE and 2.3 months for the other AEs, respectively (p=0.02) Conclusions: VTE is a relatively common complication among patients treated in the context of phase I studies and may influence the early drug discontinuation. Tumour site and the combination of chemotherapy and antiangiogenic therapy predict VTE development.
Attitudes regarding informing clinical study result to participants in Japan.
Authors: Miki Izumi , Sato Keiko , Nakahama Hiroko , Katsumata Noriyuki , Watanabe Toru 
Published: March 2020

e19557 Background: Informing the participants about study result is increased demand in recent years. Some studies reported that almost all participants want to receive study result. However, how much information do participants want and how do researcher offer were not mentioned. Moreover there were concerned about resource for providing study result and the attitude regarding informing result to participants in Japan was not studied. The purpose of this study was aimed to discuss and propose the way of informing study results to Japanese participants. Methods: Summarizing study result and a self-administrated questionnaire survey were conducted. Summary was created from abstract of academic paper with lay language and illustration using color. Objective study was Oral Uracil and Tegafur Compared With Classic Cyclophosphamide, Methotrexate, Fluorouracil As Postoperative Chemotherapy in Patients With Node-Negative, High-Risk Breast Cancer: National Surgical Adjuvant Study for Breast Cancer 01 Trial “N-SAS-BC01 trial”(J Clin Oncol 2009). Objective subject was participants of N-SAS-BC01 trial in National Cancer Center Hospital. A cross table and inductive analyze were performed. Results: Summary of result was made A4 (letter size) form 4sheet. 58 patients responded to questionnaire of 116 patients (50%). In 58 responders, 92% of them preferred to be informed of the result. About 80% of responders answered that summary was clear to understand and 30% of them reported that the document should contain more information. The way of receive result preferred by the mail. When the result included bad news, 67% of responders wanted to receive result; on the other hand, three patients answered that they would not to receive because of psychological harmful influence. Conclusions: These answers suggested that participants in Japan desired to inform study result. Therefore, Clinical study result should be provided participants whenever it takes time to get results, including bad news in a careful way. Summary of result should be created using lay language and illustration. Planning the cost, keeping participant contact list, and noticing participants that study result would be informed were needed at the start of the study.
Treatment of patients with chemotherapy-induced PPE using a prevention ointment containing high concentrations of antioxidants.
Authors: Lademann Juergen , Martschick Anja , Darvin Maxim E. , Kluschke Franziska , Zastrow Leonhard , Chekerov Radoslav , Sehouli Jalid 
Published: March 2020

e19558 Background: The palmar-plantar erythrodysesthesia syndrome (PPE) is a cutaneous side effect often observed in patients under chemotherapy, e.g., with pegylated liposomal doxorubicin. This side effect entails a reduction in the antioxidative potential of the skin due to intensive radical formation. Recently, it was demonstrated that topical treatment of patients with an ointment containing high concentrations of antioxidants is an efficient prevention strategy against PPE when applied before the beginning of chemotherapy. In a 5-year observation period at the Department of Dermatology of the Charité we selected patients, who had developed a PPE during treatment with a variety of chemotherapeutics. The aim of the present study was to investigate whether the antioxidant containing ointment is also suited to treat PPE, which occurred during treatment of 13 types of cancer with chemotherapeutics besides doxorubicin. Methods: In 5 years, 68 patients having developed PPE during treatment with 12 different chemotherapeutics, including pegylated liposomal doxorubicin, capecitabin and sorafenib applied an ointment containing antioxidants with a high radical protection factor (RPF). 46 patients exhibited PPE grade III and 22 patients PPE grade II. All patients were treated with the antioxidant-containing ointment, which was applied at least twice daily in the palmar and plantar regions. Results: Treatment with the antioxidant-containing ointment resulted in a distinct regression or disappearance of PPE. After 4 weeks of treatment the PPE grade III originally diagnosed in 46 patients had reduced to grade II in 6 and to grade I in 33 patients. In 7 patients the PPE had completely disappeared. The PPE grade II diagnosed in 22 patients had alleviated to grade I in 7, and completely disappeared in 15 patients. Conclusions: Obviously, cutaneous side effects entailing radical formation processes are also induced by other types of chemotherapeutics. An antioxidant containing ointment with high RPF is not only suited to prevent PPE in patients under doxorubicin therapy, but is also effective in treating PPE caused by other chemotherapeutics.
Triiodothyronine [T3]-induced hypothyroxinemia: Response and survival in a compassionate care cancer patient population.
Authors: Hercbergs Aleck A , Garfield David H. , Ashur-Fabian Osnat 
Published: March 2020

e19573 Background: Increased survival under chemically induced hypothyroidism has been reported in cancer patients with poor prognosis, but the associated morbidity can deter patient compliance. Acting via a receptor site upon the plasma membrane avβ3 integrin, L-thyroxine (T4) in physiological concentrations non-genomically activates mitogenesis and neo-angiogenesis of cancer cells and proliferating vascular endothelium. Occlusion of the receptor by tetraiodothyroacetic acid (tetrac), a T4 derivative, induces apoptosis, inhibits angiogenesis and enhances chemotherapy and radiation. 3, 5, 3’-Triiodo-L-thyronine (T3) in physiological concentrations is significantly less mitogenic than T4 and inhibits pituitary release of thyrotropin (TSH). Absence of TSH, but with T3 support, depletes circulating T4 without resultant hypothyroidism. Methods: 21 cancer patients at dispersed clinical sites with stage 4 solid tumors and projected limited survival received T3 [n=10] only or with methimazole (MT) [n=9]. Serum TSH, free T4 (FT4) and T3 concentrations were obtained initially, then monthly. FT4 levels below lower normal range were achieved in all patients within 3 to 12 weeks. Results: See Table. Conclusions: T3 treatment with resultant hypothyroxinemia in poor prognosis cancer patients was associated with favorable response rates in 17/19 subjects. Two others with aggressive tumors had extended survival on long-term T3. [Table: see text] [Table: see text] [Table: see text]