bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health-related quality of life and economic burden in Chinese patients with cutaneous T-cell lymphoma.
Authors: Wang Yang , Sun Jianfang , Sun Huiping , Zhang Mingzhi , Li Zhiming , Zhao Haifeng , Xie Linna , Huang Wenrong , Yan Xiaojing , Du Xiwen , Li Xiaojiao , Jin Hui , Shi Yuankai 
Published: June 2023

e19533 Background: Cutaneous T-cell lymphoma (CTCL) is a rare type of non-Hodgkin lymphoma. As described in European Organization for Research and Treatment of Cancer Consensus, the subtypes of mycosis fungoides (MF) and Sézary Syndrome (SS) comprised roughly 55% and 5% of CTCL, respectively. The clinical presentations of MF and SS include skin lesion, tumors, ulcerations, systemic involvements and even death. This study aimed to measure the overall HRQoL and economic burden of MF and SS patients in China. Methods: A cross-sectional survey was conducted from 21 July 2022 to 24 October 2022. Eligible adult participants with a pathologically confirmed diagnosis of either MF or SS were recruited from specialty or general hospitals across China. All participants were asked to complete a questionnaire that assessed HRQoL and annual economic burden. Validated instruments in Chinese, specifically the EuroQoL Group’s five-level QoL five-dimensional questionnaire (EQ-5D-5L), Functional Assessment of Cancer Therapy-General (FACT-G), and Skindex-29, were used to assess general, cancer and skin-related HRQoL. All HRQoL outcomes were calculated using the scoring system provided by the institutions, and EQ-5D utility scores were mapped using the China time trade-off value sets. As for economic burden, it was investigated from the societal perspective, as the direct medical costs, direct non-medical costs, and productivity loss were all calculated. Results: A total of 61 patients were recruited and completed the survey. Patients resided in 38 cities of 21 provinces across China. 56 patients (92%) were diagnosed with MF and 5 (8%) with SS. 56% were male, with a mean age of 39 years. Half of the patients had early-stage disease (defined as less than stage IIB, patch or plaque), with the remainder having late-stage disease. Among the recruited patients, 43 (70%) received skin-directed therapy, and 55 (90%) received systemic therapy. As for HRQoL measures, EQ-5D utility score was 0.79 (±0.18), FACT-G score was 61.3 (±12.4), and the Skindex-29 score was 43.4 (±24.2). Comparison between patients with early-stage disease and late-stage is presented in the table. As for economic burden, the annual per capita cost for MF and SS patients was CNY 86,729 (USD 12,428), which greatly exceeded the annual disposable income in 2022 (CNY 36,883, equals USD 5,440). Conclusions: This was the first study investigating economic burden and HRQoL using patient-reported outcomes conducted in mainland China. The findings suggested that MF and SS has significantly compromised patients’ HRQoL and posed substantial economic burden. [Table: see text]
Diffuse large B-cell lymphoma in HHV8+ multicentric castleman disease: A national analysis of demographic features.
Authors: Whooley Maximillian , Keirns Darby , Wu Xinxin , Luker Andrew , Silberstein Peter T. , Hsia Beau 
Published: June 2023

e19535 Background: Diffuse large B-cell lymphoma (DLBCL) in human herpesvirus 8 associated (HHV8+) multicentric Castleman disease (MCD) is a rare type of DLBCL. DLBCL, the most common non-Hodgkin lymphoma, is a cancer arising in the lymphatics. HHV8+ MCD is a lymphoproliferative disorder usually occurring in HIV patients. Patients who develop DLBCL in this setting typically die within a year. Prior National Cancer Database (NCDB) studies have assessed survival and demographics in the broader category of CD20- LBCLs, but have not specifically examined the socioeconomic and demographics associated with DLBCL in HHV8+ MCD. Methods: A retrospective analysis of NCDB data from 2010 – 2020 included patients diagnosed with DLBCL in HHV8+ MCD (N = 237). Demographic factors such as sex, race, Hispanic ethnicity, income status, insurance status, Charlson-Deyo score, facility type/location, and metastasis at diagnosis were evaluated with descriptive statistics. Primary site was also examined. Incidence trends were assessed via regression analysis. Results: A total of 237 patients with DLBCL in HHV8+ MCD were identified in the database, with an average incidence of 21.5 cases per year (R2 = 0.236, SD = 5.7, range = 9 – 29). 74.7% were male and the average age of diagnosis was 53.8 years (SD = 18.62, range = 3 – 90). 40 different primary sites were identified, with the most common being lymph nodes of multiple regions (32.9%). Extranodal primary sites were rare but documented. Charlson-Deyo comorbidity scores varied: Score 0 = 61.6%, Score 1 = 8.4%, Score 2 = 4.2%, Score ≥ 3 = 25.7%. Incidence for race was highest among Whites (69.2%), followed by Blacks (25.3%), then Asians (3.4%). 8.4% of patients were of Hispanic ethnicity. A greater percentage of patients were in the top income quartile (33.8%), compared to the second (19.7%), third (23.9%), and fourth (22.5%). Most patients were either insured privately or by Medicare (73.9%), whereas 8.9% were uninsured. Most were treated at academic facilities (54.7%), and many were treated at facilities in the Eastern United States (47.5%). 19.1% of patients had metastases at diagnosis, most often in distant lymph nodes (6.1%). Conclusions: This study provides insight into the demographics of patients diagnosed with DLBCL in HHV8+ MCD. This cancer showed a nearly 3-fold male preponderance and primarily affected Whites, mirroring existing trends in DLBCL overall. About one fifth of patients presented with metastasis at diagnosis. Interestingly, patient Charlson-Deyo scores displayed a bimodal distribution, with 87.3% of patients having a Score of either 0 or ≥3. The top income quartile was most affected, but patients were more evenly distributed among the bottom three. Further investigation is needed to better define the role of demographics in shaping diagnostic, therapeutic, and outcome discrepancies in those with DLBCL in HHV8+ MCD.
High dose methotrexate (MTX) treatment: Value of post treatment MTX level monitoring and risk factors for acute kidney injury.
Authors: Snyder Rose , Urazov Anna , Deh Mayukh , Kulkarni Ajinkya , Chen Pin-Jung , Raju Gagan , Tanni Miss , Xu Yiqing 
Published: June 2023

e19539 Background: High-dose methotrexate therapy is an effective treatment for primary central nervous system (CNS) lymphoma and other tumors. Methotrexate (MTX) is an antimetabolite which penetrates blood brain barrier when administered intravenously at high doses. Defective or delayed clearance of MTX may lead to toxicities, especially acute kidney injury (AKI) in 2-13% of patients. We developed a protocol to mitigate side effects by checking MTX levels every 24 hours, administering leucovorin or glucarpidase rescue, and hydration with urine alkalization. This study examines the risk factors for developing AKI after high dose MTX administration. Methods: Patients who began treatment with high dose methotrexate in 2020 and 2021 were eligible. We collected data on demographics, diagnosis, methotrexate levels, laboratory levels at baseline and after treatment, toxicities, interventions and outcomes. Results: 26 patients were included, who received 112 cycles of treatments (median 3.5, range 1-10). Median age was 62 years (range 25-83) and 57% were male. 20 patients experienced elevated MTX levels. Among the 112 cycles, MTX levels were elevated at 24h, 48h and 72h in 22 (19.6%), 16 (14.3%), and 45 (40.2%) of the cycles respectively, which trigged an increase in the rescue leucovorin dose and hydration dose in 26 (23.2%) and 16 (14.3%) cycles, respectively. AKI was recorded in 20 cycles (17.9%), with 17 (85%) being grade 1 (ULN – 1.5 x ULN), and 3 (2.7%) being grade 2 (1.5-3x ULN). In 20 cycles with AKI, 9 (45%) had grade 1 elevated creatinine level pretreatment; 8 (88.9%) of them remained grade1 without increase > 0.2. The development of AKI occurred in all MTX dose levels, without a difference in frequency. 57% of cycles with elevated 24h MTX level, and 13% of cycles with delayed clearance > 4 days, were associated with AKI. 75% of cycles with AKI had delayed clearance (avg 7 days). Two patients required glucarpidase rescue treatment, based on elevated 24-36 h MTX level and grade 1-2 AKI; one of these patients permanently discontinued MTX. Conclusions: Among 26 patients who received a total of 112 cycles of high dose MTX treatment, 11 developed AKI in 20 cycles, mostly grade 1 with spontaneous recovery. MTX level elevation at 24 hours predicted the development of AKI. Elevated baseline creatinine or MTX dose range is not a risk factor for AKI.
Epidemiology and prognostic factors of hepatosplenic T-cell lymphoma (HSTL): An analysis of NCDB (National Cancer Database).
Authors: Albagoush Sara , Masih Durva , Cichon Gregory , Cogua Laura , Silberstein Peter T. , Ermann Daniel Arthur 
Published: June 2023

e19544 Background: Hepatosplenic T-cell lymphoma (HSTCL) is a rare T-cell malignancy, associated with rapid disease progression and generally poor outcomes. To date, few studies have been performed that examine outcomes expected survival outcomes and clinical features of this disease. We aimed to perform a large retrospective study with a focus on disease characteristics and overall survival outcomes. Methods: Utilizing the National Cancer Database (NCDB), we identified 434 patients with HSTCL 2004-2020. Patients were selected by ICD-0-3 histology code 9716. Kaplan-Meier curves and survival tables were created to calculate 1-, 5-year survival probabilities for variables including ages, race, sex, facility type, age, insurance, primary site, stage, and adjuvant therapy. Log-rank and cox regression analysis was used to compare the groups within each variable. Results: The cohort consisted of 68.9% male patients and 67.4% Caucasian patients with a median age of diagnosis of 50 years old. The most common type of insurance was private insurance 49.5% then Medicare 24%, Medicaid 16.4% and not insured 5.8% with median distance of 16.1 miles from hospital where they received care. Most patients (56.8%) were treated at academic/ research facilities, followed by comprehensive community cancer programs 22.8%. Mostly located in metro areas (85.5%) with median household income > $ 46000 (43.5%). More cases diagnosed since 2013. The most common primary anatomical site was spleen 91.7% followed by lymph nodes. Stage IV was the most common stage 77.2%t. Overall, 1-, 5- year survival probabilities for patients with HSTCL were 47.4% and 25.4% respectively. Median overall survival time is 11.24 months (95% CI 9.592-12.888). Female patients had better survival outcomes than males with median survival 20.6 months and 9.5 months, respectively. Academic/research centers (12.65 months) and Medicaid (14.98 months) followed by private insurance (11.79 months) had better survival outcomes. As stage increased, overall survival probabilities decreased; stage 1 median survival 12.71 months, stage 4 (11.24 months). Spleen (12.35 months) had better survival outcomes compared to lymph nodes. With regards to treatment modalities, patient who underwent bone marrow transplant (81.64 months) followed by surgery of primary site (14.92 months) followed by multiple agent chemotherapy (11.27 months) had better survival rates compared to all other treatment modalities. Conclusions: This is the largest and most comprehensive study to date on the epidemiology and prognostic factors of Hepatosplenic T cell Lymphoma. The result of our analysis brings up several interesting trends including females had significantly longer survival when compared to males with the same disease. Other major factors influencing survival are facility type, age, sex, race, insurance status, stage, adjuvant therapy and primary site.
Clinical outcomes of patients with multiple myeloma following disease progression after BCMA-targeted CAR T-cell therapy.
Authors: Subramanian Naveen G. , Garcia Pleitez Hector , Pasvolsky Oren , Kalariya Nilesh , Patel Krina K. , Ferreri Christopher J. 
Published: June 2023

e20002 Background: While BCMA-targeted CAR T therapies have yielded unprecedented efficacy in patients with multiple myeloma, most patients (pts) experience disease relapse. Treatment after progression on CAR T has become an unmet need given the limited novel treatment options available. We evaluated clinical outcomes for pts relapsing after BCMA CAR T. Methods: This was a single-center retrospective analysis including pts who had been treated with a BCMA-targeted CAR T therapy prior to 12/31/22 and then had disease progression. Data for all subsequent lines of therapy were collected, and best response to therapy was graded as per IMWG criteria. Statistics were descriptive in nature. Results: Thirty pts treated with BCMA CAR T (14 trial, 16 commercial) relapsed. The cohort of median age 61 had notable disease characteristics of 40% with high-risk FISH and 30% with extramedullary disease (EMD). The median number of prior lines of therapy (LOT) was 5, with 80% triple-class refractory and 47% penta-refractory. Patients treated with late BCMA CAR T (≥ 4 prior LOT; n=20) had higher rates of EMD (40% v 10%), triple-class refractory (90% v 60%), and penta-refractory disease (55% v 30%) compared to pts who received early CAR T (< 4 prior LOT; n=10). At data cutoff, 4 pts died without receiving subsequent therapy and 1 pt was pending start of their first regimen. The remaining 25 pts received 58 salvage therapies, of which 54 regimens were evaluable for response. The overall response rate (ORR) for all regimens was 46%. Median overall survival (OS) was not reached, and the 6 and 12-month OS rates were 83% and 77% respectively. ORR and median progression free survival (PFS) stratified by the specific type of salvage therapy are shown in the table. Patients who received a regimen consisting only of agents they had received in a prior LOT had an ORR of 57% and median PFS of 3.6 months. Patients who received early CAR T had a higher ORR to all subsequent salvage therapies (59% v 33%), longer median PFS (4.6 months v 1.6 months), and higher 12-month OS (90% v 70%). Conclusions: For pts with progression after BCMA CAR T, treatment with another BCMA CAR T or transplant had more favorable outcomes. Retreatment with prior therapies resulted in disease control for a fair number of patients, which can serve as a bridge to another novel therapy. The pts treated with early CAR T had more favorable post-progression outcomes than late CAR T, yet 70% of pts who received late CAR T were alive at 1 year post-progression. [Table: see text]
A perilous and complicated situation in hospitals: Vitamin D deficiency in multiple myeloma patients—A nationwide cross-sectional study.
Authors: Lakhanpal Manisha Rakesh , Chelikam Nikhila , Manjani Divesh , Lahori Simmy , Akella Sai Anusha , Shivashankar Prashanth Gumpu , Shah Shlok Vimal , Ali Abdirazak , Toor Varneet , Singh Aryak , Gujarathi Rahul , Manjani Lokesh , Patel Urvish , Adiga Avinash , Kukreja Geetika 
Published: June 2023

e20010 Background: For the year 2019, the United States age-adjusted rate of new Multiple Myeloma (MM) cases was 6.8 per 100,000 people and the age-adjusted death rate was 3 per 100,000 people. Vitamin D Deficiency (VDD) and associated complications are very common in MM patients. Aim of our study was to evaluate the prevalence and risk of VDD in patients with MM and VDD associated disability and mortality in the VDD patients. Methods: We performed a cross-sectional retrospective analysis of Nationwide Inpatient Sample data 2016-2018. Adults hospitalizations with MM were identified using ICD 10 code. Hospitalized patients were grouped into patients with VDD and without VDD. We ran chi square, unpaired-t test and mixed-effect survey logistic regression analysis to find out odds ratio and 95%CI showing outcomes of VDD in MM patients. Results: We found 330,175 hospitalizations with MM. Of these 11,480 were noted to be patients with VDD with higher prevalence (0.64% vs 0.37%) of and strong association (aOR:1.41, 95%CI:1.35-1.47) with MM in comparison without MM. Amongst MM, females [1.50, 1.49-1.51], black race [1.23, 1.22-1.24], urban teaching hospitals [1.22, 1.22-1.23], and hospitals in mid-west region [1.30, 1.29- 1.32] had higher prevalence odds of VDD compared with males, white race population, rural hospitals and hospitals in northeast region. (p<0.0001) Patients with VDD had higher prevalence and strong association with higher morbidity [5.1% vs 3.9%, 1.24,1.14-1.36; c-value=0.67], severe/extreme disability [77.2% vs 73.3%, 1.26, 1.20-1.33; c-value=0.73], and discharge to locations other than home [51.15% vs 45.69%, 1.29, 1.23-1.34; c-value=0.69] in comparison without VDD. (p<0.0001) [Table]. Conclusions: Significant poor outcomes warrant early identification of VDD and role of same hospitalization vitamin D replacement amongst MM patients with higher risk. [Table: see text]
External validation of venous thromboembolism risk prediction models in patients with multiple myeloma in a community setting: A retrospective cohort study.
Authors: Ramasamy Chidambaram , Sekar Abinesh , Shanmugavel Geetha Harinivaas , Kumar Madhan Srinivasan , Syed Masood Pasha , Seetharaman Kala , Siddiqui Ahmad Daniyal , Abraham George M. 
Published: June 2023

e20027 Background: Newly diagnosed Multiple Myeloma (MM) patients have a 10 to 20 times higher risk of developing venous thromboembolism (VTE) than the general population. Three risk prediction models have been recently established to ascertain the degree of VTE risk: SAVED (Surgery, Asian race, VTE history, Elderly and Dexamethasone), IMPEDE VTE (Immunomodulatory drugs (IMiD), BMI, Pelvic fracture, Erythropoietin stimulating agent, Dexamethasone/Doxorubicin, Asian Ethnicity, VTE history, Tunneled line, Existing thromboprophylaxis) and PRISM scores (Prior VTE, Race, IMiD, Surgery, Metaphase Cytogenetics). Our primary objective was to assess the external validity of three VTE risk prediction models in a community hospital setting. Methods: All consecutive newly diagnosed MM treated at Saint Vincent Hospital from 1/1/2012 to 12/22/2022 were included in our analysis. Patients receiving therapeutic anticoagulation for other indications or a diagnosis of VTE within 6 months prior to MM diagnosis were excluded. Variables were collected by retrospective chart review at the time of MM treatment initiation. Model discrimination was assessed by calculating the area under the receiver operating characteristic curve (AUROC). Logistic regression was used to calculate the odds ratio (OR) of VTE occurrence with candidate variables in the risk prediction model. Results: The 160 patients with newly diagnosed MM and available data on VTE occurrence were included. The median age of our cohort at treatment initiation was 74 years (range 31-96); 55% were male, and 75% were Caucasians. IMiD-based induction regimen was used in 68.1 % of patients. The median SAVED score was 1 (IQR:0-2), IMPEDE VTE was 4 (IQR: 2-6), and PRISM score was 2 (IQR: 0-2). The most common thromboprophylactic agent used was aspirin (53.8%). The median time to VTE from induction was 4.8 months. The cumulative incidence of VTE at 12 months was 13.1%. Each 1-point increase in the score was associated with a significantly higher chance of VTE occurrence across all three models (Table). Factors significantly associated with the development of VTE were prior VTE history (OR:2.28, 95% CI:1.31-3.97,p = 0.003) and age greater than 80 years (OR:4.03, 95% CI:1.47-11.02,p = 0.006). Conclusions: Our findings suggest that all three PRISM (AUROC = 0.70), SAVED (AUROC = 0.72), and IMPEDE VTE (AUROC = 0.73) scores could statistically predict VTE outcomes in our patient population. The inclusion of more parameters in the IMPEDE VTE score may have led to its outperformance in risk stratification. [Table: see text]
Trends in presentation, treatment, and survival in young multiple myeloma patients age 50 and under from 2000-2021.
Authors: Kumar Anupama Deepa , Quan Michelle Alyssa , Costello Caitlin , Aaron Rosenberg 
Published: June 2023

e20028 Background: Multiple myeloma (MM) is a disease predominantly of older adults with an average age of 69 at diagnosis. Limited data is available on the diagnostic details and outcomes of MM patients ≤50 years old, and particularly how these trends have changed over the past two decades. We present data from one of the largest retrospective cohorts of younger MM patients. Methods: This retrospective review identified 213 MM patients by pooling two datasets: 88 MM patients aged ≤50 years at first stem cell transplant (SCT) between 1/1/2000-6/1/2021 at University of California (UC), San Diego; and 125 MM patients age ≤50 years old at diagnosis between 1/1/2014-7/1/2021 at UC Davis. Demographics, diagnostic details, treatment, response, and overall survival (OS) data were collected. Results: The pooled dataset included 209 patients with MM and 4 with plasma cell leukemia. The median age was 45, with 58 (27%) Hispanic and 37 (17%) Black patients. In 89 patients with available data, 23% were R-ISS-1, 58% were R-ISS-2, and 19% were R-ISS 3. Overall, 14% of patients had high-risk cytogenetics [ t(4;14), del17p, or t(14;16]] . Patients diagnosed and treated in 2000-2010 were more likely to have received doublet or cytotoxic chemotherapy for induction therapy, while 80% of patients in 2010-2021 received triplet-based therapies. Responses to induction improved across decades, with 23% of patients in the earlier cohort vs 49% patients in the later cohort achieving a very good partial response (VGPR) or better. Eighty-five percent of patients received a SCT, the majority being autologous with only 13 upfront or salvage allogeneic SCTs in the earlier and 1 in the later cohort. The median OS for the entire cohort is 168 months, 171 months in the early cohort, and not reached in 2011-2021 cohort. Conclusions: We present retrospective data of a large and diverse cohort of California MM patients ≤50 years old, with nearly 50% of patients from underrepresented populations spanning over 2 decades. We found similar diagnostic features and risk group to those reported in the general MM population. Noticeable improvements in treatment responses were seen in the later decade with the introduction of modern therapies. A median OS of 14 years for the entire cohort over 20 years offers a glimpse into the hopeful promise for extended survival of younger patients as more effective therapies lead to deeper and more durable responses. [Table: see text]