bluuebunny/crossref_metadata_2025_split huggingface dataset:
Understanding the information needs of lymphoma and CLL patients: A comparison of Asia-Pacific and Europe.
Authors: Bates Cherie D. , Watson Amanda , Warwick Lorna 
Published: June 2023

e18884 Background: Effective communication between healthcare providers and patients has improved patient outcomes and satisfaction. This study aims to evaluate the impact of healthcare provider-patient communication on patient satisfaction and outcomes in patients diagnosed with lymphoma and chronic lymphocytic leukaemia (CLL). The study utilises data from the Lymphoma Coalition (LC) 2020 Global Patient Survey (GPS) to compare the information experiences of patients in the Asia-Pacific (APAC) and European regions diagnosed with lymphoma and CLL. Methods: We analysed a subset of patients from APAC region (n = 3021) and the European region (n = 4343) and examined the demographic characteristics of both groups. Statistical analyses, including chi-square tests and logistic regression, were performed using IBM SPSS v27 software to assess patients' information experiences. Results: The findings of this study reveal that patients in APAC experienced a lower likelihood of receiving sufficient information at the time of diagnosis and expressed challenges in comprehending treatment options and managing treatment-related side effects. Notably, compared to patients in Europe, patients in APAC reported a greater need for information related to self-care (42% vs 14%) and treatment options (68% vs 50%). Conclusions: This study highlights APAC patients with lymphoma & CLL require more information, reflective of their health literacy levels, from their healthcare professionals. It is recommended that healthcare providers provide tailored information to improve patient outcomes and satisfaction. [Table: see text]
Beyond the binary: Analysis of esophageal cancer hospitalizations in the transgender population, a national inpatient sample study.
Authors: Yadukumar Lekha , Singh Yuvaraj , Dasu Neethi , Khalid Yaser , Gogtay Maya 
Published: June 2023

e18888 Background: Transgenders are individuals with a gender identity that differs from their sex at the time of birth. Over > 1.6 million adults identify themselves as transgender in the US, of which 39% are women and 36% are men. While gender differences in cancer prevalence have been well established between men and women, very few studies evaluate the prevalence of cancer in patients who identify as transgender people. We aimed to evaluate the trends of esophageal cancer admission hospitalizations in the transgender population compared to the general population. Methods: This was a retrospective analysis of the data obtained from the Nationwide Inpatient Sample database. Data were sampled from 2015 to 2020 utilizing the ICD-10 codes of esophageal cancer and patients( > 18 years) who identified as transgender. The primary outcome was in-hospital mortality. Secondary outcomes were the length of stay (LOS) and total costs in the hospital, respectively. A multivariate logistic regression analysis was used to estimate the odds ratio. Results: A total of 212,425 patients with esophageal cancer were admitted between 2015- 2020, of which 97,950 were transgender. The mean age was 33 vs. 34 years in the general population. Both groups were predominantly Caucasian (65% vs. 68%), followed by African Americans (15.2% vs. 5.2%). Median household income (MHI) in transgender people was commonly in the lower quartile (27.8%). In cisgender patients, 37% had a MHI in the 26th-50th followed by 26% in the 76th-100th percentile. Inpatient mortality in transgender patients with esophageal cancer was OR = 5.1[1.8-8.3] (p < 0.05). The average LOS was higher in the transgender population by 2.15 days [1.1-3.1](p < 0.05). Increased LOS in teaching hospitals by 1.3 days [1.08- 1.59] (p < 0.001) and larger hospitals by 1.4 days [0.51- 2.28] (p < 0.001) was observed. The total cost of admission was significantly different in teaching hospitals ($27,774, p < 0.001). Conclusions: We found a significant difference between the inpatient outcomes of transgender and the general population. Despite the markedly low representation of transgender people in the national cancer registries, they experienced an increased mean length of stay and mortality compared to cisgenders with esophageal cancer. Further investigation is required to determine the cause of disparity in healthcare utilization amongst the gender-diverse population. [Table: see text]
Adverse events during chimeric antigen receptor T-cell (CAR-T) therapy for hematologic malignancies (HM): Real-world, US patient experience.
Authors: Kish Jonathan , Liu Rachael , Vennam Srinivasa , Lussier Courtney , Pfeffer Daniel , Nayak Pratibha 
Published: June 2023

e18891 Background: CAR-T therapy represents the most significant advancement in the treatment of HM in the past 5 years. Life-threatening complications such as cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) may occur leading to significant morbidity and mortality. We aimed to describes the frequency of CRS and ICANS and the time to onset of each post CAR-T therapy administration in real-world, U.S. patients. Methods: Patients (pts) with HM who received any FDA-approved CAR-T therapy were identified from a U.S. EMR database containing de-identified healthcare data for > 40M patients from > 500 hospitals and 30 healthcare systems (including academic centers). Confirmation of CAR-t treatment was based on ≥1 procedure code for general administration of CAR-T therapy (e.g., XW033C3, introduction of engineered autologous chimeric antigen receptor t-cell immunotherapy into peripheral vein) or a specific approved CAR-T (I.e., XW033K7, introduction of idecabtagene vicleucel immunotherapy into peripheral vein) between 2017 and 2022. Diagnosis of CRS or any ICAN was based ≥1 related ICD-10 diagnosis code (e.g., CRS = D89.83X). Frequency of occurrence of CRS, symptoms of CRS, ICANS symptoms, and severity of CRS or ICANS is described (severity based on validated clinical algorithm). Time to CRS and ICANS was calculated as the interval from CAR-T administration to first reported diagnosis, respectively. Results: 212 pts met the study criteria including 77 b-cell lymphoma, 64 multiple myeloma, 47 follicular lymphoma, 13 mantle cell lymphoma and 11 acute lymphoblastic leukemia pts. The majority were male (54.7%); median age was 60 years. Overall, 100 (47.2%) pts were diagnosed with CRS (any grade) while 82 (38.7%) pts experienced any ICAN symptoms. The top three CRS symptoms were fever (57.5%), hypotension (31.1%) and tachycardia (21.2%). The top three ICANS symptoms were obtundation (18.4%), confusion (12.7%), and delirium (12.7%). Of CRS pts, 25.0% experienced severe symptoms, including renal insufficiency (10.0%), atrial fibrillation (9.0%), ventricular tachycardia (7.0%), and cardiac failure (2.0%). The median time to development of CRS was 2 days (range 0-23 days). Of pts. experiencing ICANS, 72.0% experienced any mild symptom and 53.7% experienced any severe symptom, including obtundation (47.6%), aphasia (13.4%), and seizures (1.2%). The median time to development of ICANS post CAR-T therapy was 6 days (range 0-26 days). Conclusions: Our study is the first real-world, U.S. evaluation of the frequency and time to toxicities associated with CAR-t therapy across multiple hematologic malignancies. While well-described in RCTs these data highlight the need for the continued development of clinical and therapeutic approaches to minimize their impact on the effectiveness of CAR-T.
COVID-19 vaccination in patients with cancer: Results from survey based observational study.
Authors: Polimera Hyma Vani , Pomerantz Lauren Danielle , Guare Emma , Zhu Junjia , Joshi Monika 
Published: June 2023

e18897 Background: COVID‐19 (C19) disproportionately affects those with comorbid medical conditions, leading to significantly higher mortality rate. Cancer(ca) is a well-studied risk factor for developing severe C19 disease. However, ca patients (pts) were largely excluded from clinical trials evaluating the safety and efficacy of 3 FDA-approved C19 vaccines (vax). We aim to study this highly vulnerable pts’ behavior and outcomes regarding C19 vax. Methods: A prospective and observational single center study. Adult ca pts (18-89 years) seen in clinics from Nov 2021-Sept 2022 were randomly interviewed using telephone surveys after a verbal consent. Type of ca and therapy data were collected from pts’ medical records. The survey included C19 disease status, vax status positive (vax+) or negative (vax-), reason for vax status, s.e, impact on ca Rx or ca progression. Our primary objectives were to assess the rate of vaccination in the adult ca pts and identify barriers to vaccination. Secondary objectives were determining factors associated with vax acceptance vs. hesitancy, identifying s.e of C19 vax, and effect of C19 vax on clinical outcomes in ca pts. Results: N = 170 [Males 82 (48.2%) and females 88 (51.8%)]. The median age was 65 years. Among 170 pts, 58.2% had solid malignancy, 40% had hematologic malignancy, and 1.8% had both solid and hematologic malignancy. Refer to Table 1 for outcomes data. Overall, 146 (85.9%) pts received C19 vax. C19 infection positive (C19+) in 49 (28.8%) pts. Of them 9 (18.4%) pts required hospitalization. The vax rate of prior C19+ pts was 73.5% compared to 90.9% in C19 infection negative (C19-) pts (p = 0.0013). Demographic factors were not significantly associated with vaccine uptake. A total of 50% pts developed s.e from vax. However only one patient (0.68%) reported a delay in ca treatment due to C19 vax and believed that vax affected the ca outcome. Conclusions: Our results demonstrate that majority of the ca pts were vaccinated against C19 and tolerated it well, with minimal side effects. Prior C19 infection significantly decreased vax uptake. Vaccination did not have notable adverse effect on ca outcomes. Oncologists should discuss the importance of C19 vax in the context of ca to avoid misconceptions and hesitancy. Clinical trial information: NCT04953065 . [Table: see text]
A powerful random forest-based pipeline for accurately identifying the structural variants on panel sequencing data.
Authors: Zhuang Guiwu , Chen Yu-Long , Tang Hongzhen , Wang Wei , Wang Peng , Gao Edmond , Fang Shencun 
Published: June 2023

e18898 Background: Numerous studies have reported that the identification of structural variants (SVs) can provide ideal targets for cancer targeting therapy. However, on the one hand, the current algorithms exhibited different performances in detecting different types and sizes of SVs; on the other hand, the whole-genome/exome sequencing for detecting SVs is costly, and only a portion of SVs can be used to guide the clinical treatment of cancer patients. Therefore, developing a powerful, highly accurate, and cost-effective pipeline to detect SVs for clinical application is urgently required. Methods: Based on simulated sequencing data, four common SV detection tools (Delly, Lumpy, SvABA, and Manta) were used to select the best performance one. This tool will be used for detecting SVs in panel sequencing data. Then, Integrative Genomics Viewer (IGV) was used to annotate these SVs as true positive (TP) and false positive (FP) SVs. These annotated TP and FP SVs were used as input in the random forest classifier (RFC) to train a model for predicting the true or false positive SVs. Two independent testing cohorts and standards were used to validate this constructed pipeline. In addition, IHC/FISH experiments were performed to further validate these predicted TP SVs. Results: In the simulation data, the detection tool with the highest SVs identification sensitivity was Delly. By Delly, a total of 1,303 SVs in 384 tumor samples were detected. Based on annotated TP and FP SVs, an RFC model was constructed in the training cohort, which predicted 334 and 560 TP and FP SVs, respectively. The accuracy rates (AR) were 99.85% and 100% of TP and FP SVs, respectively. The predicted TP and FP SVs by constructed pipeline also showed a high accuracy rate in cohort 1 (98.96% and 99.24% of TP and FP SVs, respectively), cohort 2 (98.48% and 100% of TP and FP SVs, respectively), and standards (the mean accuracy rate was 90%). Finally, based on these TP SVs predicted by the constructed pipeline, FISH/IHC experiment results further verified the robustness of this pipeline (the man accuracy rate was 95.83%). Conclusions: The constructed random forest-based pipeline can robustly and accurately identify SVs based on panel sequencing data, which will be helpful for clinical decision-making.
Assessing the willingness to participate in future clinical trials.
Authors: Shaver Amy L. , Nikita Nikita , Banks Joshua , El Khoury Christiane , Melillo Rebecca J. , Song Yawei , Lu-Yao Grace L. , Leader Amy 
Published: June 2023

e18899 Background: Sidney Kimmel Cancer Center at Jefferson in Philadelphia, PA conducts a bi-annual survey to identify and describe their catchment area. Since patient participation is critical to the future of cancer clinical trials yet less than 6.3% of cancer patients participate nationally, the most recent survey included questions related to willingness to participate in future clinical trials. Survey items included the willingness to participate in future clinical trials and offer insight into reasons to and not to participate. Methods: A cross-sectional study was conducted among adult residents in southeastern Pennsylvania and New Jersey from July 2022 to August 2022 and included 2,744 respondents. Survey questions were included to elucidate reasons for or against willingness to participate, cancer attitudes or beliefs, health literacy, and numeracy. Characteristics were summarized with frequency counts and percentages. Frequency counts were weighted. Weights were calculated by iteratively adjusting the marginal values of select demographic characteristics to match the population totals of each surveyed county based on population totals obtained from American Community Survey data. Results: The weighted sample represented the 3,889,048 residents of the catchment area. Survey respondents self-identified as Hispanic (9.3%), non-Hispanic (NH) White (57.8%), NH Black (19.0%), and NH Other (14.0%). Only 50.8% of the population expressed willingness to participate in a future clinical trial. Over 50% of Hispanics, NH Backs, and NH Whites were willing to participate in future trials (Table). Those who did were more likely to be married (51.4%) and NH White (61.1%), see table. When asked the reason for future participation the strongest response was the possibility of learning more about my health or medical condition (67.4%). The weakest reason was similar between both my family (12.4%) and my doctor (14.2%) who would want me to participate. The strongest reason against participation is “worry about experiencing side effects” (52.6%). Conclusions: The results shed light on the need to ask catchment members when designing recruitment methods. Future endeavors involving community engagement and education may improve willingness to participate. [Table: see text]
Incidence of solid malignancies (SM) among patients with Waldenström macroglobulinemia (WM): Analysis of the SEER database (2000-2019).
Authors: Taneja Alankrita , Mishra Rahul , Arun Kumar Sumukh , Iyer Ajay , Hillengass Jens 
Published: June 2023

e18902 Background: WM is an indolent disease with a median survival of ~ 16 years following diagnosis. We aimed to study the incidence of various SM among patients with WM, which can help in their targeted surveillance. Methods: We used SEER 17 registry to identify adult [ > 20 years(y)] patients(pts) with an index diagnosis (dx) of WM between 2000- 2019. We included ICD-O-3 codes 9671/3 (Lymphoplasmacytic lymphoma) and 9761/ (Waldenstrom macroglobulinemia) to identify index dx. Only first of the two codes was used if both were mentioned for same pt. Pts were grouped based on age at WM dx ≤60y (young) and > 60y (old) for analysis. We used ICD-O-3/WHO 2008 codes assigned to site of SM to identify subsequent diagnosis ( > 2months after index diagnosis) of SM. We included the first SM site, for pts with > 1 subsequent SM. We analyzed SM sites with > 15 patients. We excluded patients with diagnosis made from death certificate or autopsy. Follow up period was till December 2019. Demographics and treatment details were extracted using SEER Stat v 8.4.0.1 software. Statistical analyses were performed using R 4.2.2. Chi-squared test was used to calculate difference between categorical variables. Kaplan Meier method and log rank test were used to estimate overall survival (OS). Results: We identified 8099 patients with a dx of WM, of which 794 (9.8%) had subsequent SM. WM and SM were diagnosed at median (IQR) ages of 70 (62-76)y and 74 (67-81)y, with a median gap of 41 (20-79) months. Majority of WM survivors with SM were males (517/794, 65.1%), white (91.4%) and old ( > 60y) (79.2%) at WM diagnosis. Ten SM sites, each with > 15 pts were identified (Table). Most common site of SM in young WM females was breast, while it was lung and bronchus(LB) in the older group. In males, prostate, and LB were two most common sites in each age-groups. 1% of older male patients developed breast cancer. (Table1) Of note, thyroid was a common site, 9.3% of SM, in young WM female cohort. Cecum and most of brain cancers were noted among pts with old age at WM dx. Overall survival was poorest for LB. Conclusions: There was a 10% incidence of SM in WM survivors during 2000-2019. LB cancer carried worst OS among WM survivors and was the most prevalent, second to gender specific cancer, among patients with relatively younger onset WM. [Table: see text]
Effect of COVID-19 on mortality in patients admitted for DVT/PE with pre-existing cancer diagnosis at the beginning of the COVID-19 pandemic: A national inpatient sample study.
Authors: Campbell Andrew , Abuhelwa Ziad , Hamouda Danae M. 
Published: June 2023

e18903 Background: Coagulopathy and thrombosis are commonly associated with both cancer and Coronavirus Disease 2019 (COVID-19) infection. Thus, it is thought that cancer patients with COVID-19 carry an even higher risk for thrombosis than each disease individually. Cohort studies using the COVID-19 and Cancer Consortium (CCC19) registry data have identified risk factors for development of in-hospital VTE and PE in patients with cancer and COVID-19, however the risk of in-hospital mortality and length of stay in this population remains unknown. Using newly-available data from the National Inpatient Sample in 2020, we compared rates of in-hospital mortality and length of stay between patients with and without COVID-19 infection admitted for DVT and PE with known diagnosis of cancer. Methods: The National Inpatient Sample was analyzed to identify all adult admissions with primary diagnosis of DVT and PE and secondary diagnosis of solid tumor or hematologic malignancy from April to December 2020. These patients were then stratified based on secondary diagnoses of COVID-19 infection. Rates of inpatient mortality and hospital length of stay were compared to non-COVID patients. The cases for COVID-19 infection, thrombotic events, and cancer were selected based on ICD-10 (International Classification of Disease) codes. ICD-10 codes used for solid tumor malignancies included breast, lung, prostate, colon, pancreas, liver, and rectal cancer. ICD-10 codes for hematologic malignancy included leukemia, lymphoma, and multiple myeloma. Chi square tests were utilized to check the significance of association between mortality, LOS and COVID-19 infection in the population admitted for DVT and PE. Results: There were a total of 13,856 patients admitted for DVT/PE with secondary diagnosis of solid tumor or hematologic malignancy from April to December 2020. Among this population, 80 patients (mean age 61 years) also had a secondary diagnosis of COVID-19 infection. Overall in-hospital death rate for cancer patients with DVT/PE was 5.2% (n = 720). Less than 1% (n = 5) of those patients had a secondary diagnosis of COVID-19 infection (P = 0.8547). Mean LOS with COVID-19 diagnosis was 4 days (95% CI 2.7 - 5.3) and without COVID diagnosis was 4.75 days (95% CI 4.5 - 5, P = 0.4483), showing no statistically significant difference. Conclusions: There was no statistically significant difference of mortality or LOS between COVID-19 and non-COVID-19 infected patients admitted for DVT or PE with secondary diagnosis of malignancy.
Estimated value-based pricing for blood-based colorectal cancer screening test versus multi-target stool DNA test.
Authors: Kisiel John B. , Fendrick A. Mark , Borah Bijan J. , Ebner Derek W. , Ozbay A. Burak , Vahdat Vahab , Estes Chris , Limburg Paul J. 
Published: June 2023

e18911 Background: Stool-based colorectal cancer (CRC) screening with the multi-target stool DNA (mt-sDNA) test is a guideline endorsed strategy for average-risk individuals age ≥45 years and provides a reference for value-based pricing (VBP); maximum price at which a willingness-to-pay threshold is reached. Blood-based tests (BT) are an emerging screening option. Using recent reported BT performance data from the ECLIPSE study (Guardant Health, Inc.)1, the potential VBP of BT compared with multi-target stool DNA (mt-sDNA) was analyzed. Methods: Using the validated CRC-AIM model, we simulated a cohort of 2 million average-risk individuals who received screening with BT at 1, 2, or 3-year intervals or triennial mt-sDNA between the ages of 45-75 years. For BT, CRC sensitivity, advanced adenoma sensitivity, and specificity were based on reported clinical trial data (83%, 13%, and 90%, respectively). Adherence assumptions for BT and mt-sDNA screening were modeled at perfect (100%) or real-world mt-sDNA adherence (RWE). Key outcomes were life-years gained (LYG) per 1000 individuals vs no screening, and VBP of BT vs mt-sDNA ($895 vs $508) was assessed at a willingness-to-pay (WTP) threshold of $50,000 per quality-adjusted life-year. Results: The triennial mt-sDNA was more effective and less costly vs BT at all intervals with both perfect and RWE adherence at the current price. Compared with mt-sDNA screening, LYG of screening with BT was lower (320 vs. 241-314) and the VBP should be at most $49 and $11 and no-cost at the 1-, 2-, and 3-year intervals, respectively (Table), when perfect adherence is assumed. With RWE adherence, the LYG with mt-sDNA was 306 compared to 229-284 with BT across all intervals. To be comparable to RWE triennial mt-sDNA screening, the maximum VBP for BT would need to be $13 at the 1-year interval and no cost for 2- and 3-year interval. Conclusions: Compared to annual, biannual, and triennial BT, triennial mt-sDNA was more effective at all intervals and 44% to 102% less costly. The maximum price of BT should not exceed $49 to be considered a cost-effective option compared to mt-sDNA when WTP is 50,000. [Table: see text]