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Frank PP, Lu MXE, Sasse EC. Educational and Emotional Needs of Patients with Myelodysplastic Syndromes: An AI Analysis of Multi-Country Social Media. Adv Ther 2023; 40:159-173. [PMID: 36136244 PMCID: PMC9510575 DOI: 10.1007/s12325-022-02277-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 07/19/2022] [Indexed: 01/25/2023]
Abstract
INTRODUCTION Myelodysplastic syndromes (MDS) comprise a heterogeneous group of myeloid malignancies characterized by high symptom burden and limited treatment options. A central challenge to caring for patients with MDS is assessing their needs throughout the different phases of the disease. Patients and caregivers frequently consult online sources to address informational and emotional support needs. METHODS We conducted a social listening analysis of publicly available online forums to identify unmet needs of patients with MDS and their caregivers in the USA, the UK, Spain, Canada, France, and China. We used artificial intelligence (AI) and natural language processing (NLP) to group categories of posts into seven overarching motivations for online engagement (Clinical, Emotional, Treatments, Transplant, Education and Logistics, Physical, and Diet and Lifestyle). RESULTS Posts from the USA and China commonly discussed clinical topics such as MDS diagnosis, disease monitoring, and progression. Posts from Canada and France were frequently about treatments and treatment options. Emotional concerns were key drivers of posts from Canada, Spain, and the UK. Additionally, we also identified topics associated with negative language at key phases during the treatment experience where patients and caregivers exhibited increased online engagement, revealing educational and emotional support gaps at the time of diagnosis, when patients are deciding between treatment options, and when treatment options fail. CONCLUSION In this research, based on social media listening analyzed using AI and NLP, potential information gaps and unmet needs among patients with MDS were identified. Addressing these gaps through targeted patient education and guidance to emotional support options during these phases could reduce the disease burden and emotional distress experienced by patients with MDS.
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Affiliation(s)
- Pauline P. Frank
- Novartis Oncology, Global Medical Affairs, Novartis Pharma AG, Novartis Campus, Fabrikstrasse 18, 4002 Basel, Switzerland
| | | | - Emma C. Sasse
- Novartis Oncology, Global Medical Affairs, Novartis Pharma AG, Novartis Campus, Fabrikstrasse 18, 4002 Basel, Switzerland
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Morelli E, Mulas O, Caocci G. Patient-Physician Communication in Acute Myeloid Leukemia and Myelodysplastic Syndrome. Clin Pract Epidemiol Ment Health 2021; 17:264-270. [PMID: 35444710 PMCID: PMC8985469 DOI: 10.2174/1745017902117010264] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 08/09/2021] [Accepted: 08/17/2021] [Indexed: 11/22/2022]
Abstract
Introduction An effective communication is an integral part of the patient-physician relationship. Lack of a healthy patient-physician relationship leads to a lower level of patient satisfaction, scarce understanding of interventions and poor adherence to treatment regimes. Patients need to be involved in the therapeutic process and the assessment of risks and perspectives of the illness in order to better evaluate their options. Physicians, in turn, must convey and communicate information clearly in order to avoid misunderstandings and consequently poor medical care. The patient-physician relationship in cancer care is extremely delicate due to the complexity of the disease. In cancer diagnosis, the physician must adopt a communicative approach that considers the psychosocial factors, needs and patient's preferences for information,which in turn all contribute to affect clinical outcomes. Search Strategy and Methods This review was conducted using the Preferred Reporting Items for Systematic and Meta-analyses (PRISMA) statement. We included studies on the importance of physician-patient communication in Acute Myeloid Leukaemia and Myelodysplastic Syndrome care. We searched PubMed, Web of Sciences, Scopus, Google scholar for studies published from December 1 st , 2020 up to March 1 st , 2021. Using MeSH headings, we search for the terms "Physician and patient communication AND Acute Myeloid leukemia" or "Myelodysplastic syndrome" or "Doctor" or "Clinician", as well as variations thereof . Purpose of the Review This review examines the progress in communication research between patient and physician and focuses on the impact of communication styles on patient-physician relationshipin hematologic cancers, including Acute Myeloid Leukaemia and Myelodysplastic Syndromes.
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Affiliation(s)
- Emanuela Morelli
- Hematology and CTMO, Businco Hospital, ARNAS “G. Brotzu”, Cagliari, Italy
| | - Olga Mulas
- Hematology and CTMO, Businco Hospital, ARNAS “G. Brotzu”, Cagliari, Italy
| | - Giovanni Caocci
- Hematology and CTMO, Businco Hospital, ARNAS “G. Brotzu”, Cagliari, Italy
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3
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Giesinger JM, La Nasa G, Sparano F, Angermeyer M, Morelli E, Mulas O, Efficace F, Caocci G. Health-Related Quality of Life Assessment in Patients with Myelodysplastic Syndromes: Evidence from Randomized Clinical Trials. Clin Pract Epidemiol Ment Health 2021; 17:307-314. [PMID: 35444708 PMCID: PMC8985474 DOI: 10.2174/1745017902117010307] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 09/02/2021] [Accepted: 11/18/2021] [Indexed: 11/22/2022]
Abstract
Myelodysplastic syndromes (MDS) are characterized by ineffective hematopoiesis and blood cytopenia with a variable risk of progression to acute myeloid leukemia. The main goal of therapy for the large majority of patients is to improve health-related quality of life (HRQoL). Its rigorous assessment is now recommended in international MDS guidelines. Our review provides an overview of HRQoL results from randomized controlled trials (RCTs) in MDS patients. The literature search undertaken in PubMed identified 10 RCTs with HRQoL endpoints (all secondary) published between August 2008 and September 2020. These RCTs have helped to better understand the impact of therapies from the patient perspective and have generated valuable information that can be used to further support clinical decisions. However, the number of RCTs in MDS patients, including HRQoL endpoints, is still low. Given the importance of symptom relief and HRQoL improvement in the treatment of MDS patients, the assessment of the patient perspective in future RCTs is highly recommended to keep expanding the knowledge of the impact of new MDS therapies.
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Health-Related Quality of Life Outcomes in Patients with Myelodysplastic Syndromes with Ring Sideroblasts Treated with Luspatercept in the MEDALIST Phase 3 Trial. J Clin Med 2021; 11:jcm11010027. [PMID: 35011768 PMCID: PMC8745777 DOI: 10.3390/jcm11010027] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 12/10/2021] [Accepted: 12/18/2021] [Indexed: 11/20/2022] Open
Abstract
Patients with myelodysplastic syndromes (MDS) often experience chronic anemia and long-term red blood cell transfusion dependence associated with significant burden on clinical and health-related quality of life (HRQoL) outcomes. In the MEDALIST trial (NCT02631070), luspatercept significantly reduced transfusion burden in patients with lower-risk MDS who had ring sideroblasts and were refractory to, intolerant to, or ineligible for prior treatment with erythropoiesis-stimulating agents. We evaluated the effect of luspatercept on HRQoL in patients enrolled in MEDALIST using the EORTC QLQ-C30 and the QOL-E questionnaire. Change in HRQoL was assessed every 6 weeks in patients receiving luspatercept with best supportive care (+ BSC) and placebo + BSC from baseline through week 25. No clinically meaningful within-group changes and between-group differences across all domains of the EORTC QLQ-C30 and QOL-E were observed. On one item of the QOL-E MDS-specific disturbances domain, patients treated with luspatercept reported marked improvements in their daily life owing to the reduced transfusion burden, relative to placebo. Taken together with previous reports of luspatercept + BSC reducing transfusion burden in patients from baseline through week 25 in MEDALIST, these results suggest luspatercept may offer a treatment option for patients that reduces transfusion burden while providing stability in HRQoL.
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Oliva EN, Platzbecker U, Fenaux P, Garcia-Manero G, LeBlanc TW, Patel BJ, Kubasch AS, Sekeres MA. Targeting health-related quality of life in patients with myelodysplastic syndromes - Current knowledge and lessons to be learned. Blood Rev 2021; 50:100851. [PMID: 34088518 DOI: 10.1016/j.blre.2021.100851] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 05/10/2021] [Accepted: 05/13/2021] [Indexed: 12/12/2022]
Abstract
Using a range of health-related quality of life (HRQoL) instruments, most - but not all - studies of myelodysplastic syndromes (MDS) have reported that lower hemoglobin levels and red blood cell transfusion dependency are associated with worse HRQoL. In addition, some MDS treatments may significantly improve HRQoL, particularly among those patients who respond to therapy; however, the majority of these studies were underpowered for this secondary endpoint. Furthermore, decreased HRQoL has been associated with worse survival outcomes, and HRQoL scores can be used to refine classical prognostic systems. Despite the subjective nature of HRQoL, the importance and validity of measuring it in trials and clinical practice are increasingly being recognized, but properly validated MDS-specific instruments are required. We describe what is currently known about HRQoL in patients with MDS, and the limitations of measuring HRQoL, and we provide some recommendations to improve the measurement of this outcome in future trials.
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Affiliation(s)
- Esther N Oliva
- Grande Ospedale Metropolitano Bianchi Melacrino Morelli, Reggio Calabria, Italy.
| | - Uwe Platzbecker
- Department of Hematology, Cellular Therapy and Hemostaseology, Leipzig University Hospital, Leipzig, Germany.
| | - Pierre Fenaux
- Service d'Hématologie Séniors, Hôpital Saint-Louis, Université Paris 7, Paris, France.
| | | | | | | | - Anne Sophie Kubasch
- Department of Hematology, Cellular Therapy and Hemostaseology, Leipzig University Hospital, Leipzig, Germany.
| | - Mikkael A Sekeres
- Sylvester Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA.
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Verhoef MJ, de Nijs EJM, Ootjers CS, Fiocco M, Fogteloo AJ, Heringhaus C, Marijnen CAM, Horeweg N, der Linden YMV. End-of-Life Trajectories of Patients With Hematological Malignancies and Patients With Advanced Solid Tumors Visiting the Emergency Department: The Need for a Proactive Integrated Care Approach. Am J Hosp Palliat Care 2020; 37:692-700. [PMID: 31867978 PMCID: PMC7361664 DOI: 10.1177/1049909119896533] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Purpose: Patients with hematological malignancies (HM) have more unpredictable disease trajectories compared to patients with advanced solid tumors (STs) and miss opportunities for a palliative care approach. They often undergo intensive disease-directed treatments until the end of life with frequent emergency department (ED) visits and in-hospital deaths. Insight into end-of-life trajectories and quality of end-of-life care can support arranging appropriate care according to patients’ wishes. Method: Mortality follow-back study to compare of end-of-life trajectories of HM and ST patients who died <3 months after their ED visit. Five indicators based on Earle et al. for quality of end-of-life care were assessed: intensive anticancer treatment <3 months, ED visits <6 months, in-hospital death, death in the intensive care unit (ICU), and in-hospice death. Results: We included 78 HM patients and 420 ST patients, with a median age of 63 years; 35% had Eastern Cooperative Oncology Group performance status 3-4. At the ED, common symptoms were dyspnea (22%), pain (18%), and fever (11%). After ED visit, 91% of HM patients versus 76% of ST patients were hospitalized (P = .001). Median survival was 17 days (95% confidence interval [CI]: 15-19): 15 days in HM patients (95% CI: 10-20) versus 18 days in ST patients (95% CI: 15-21), P = .028. Compared to ST patients, HM patients more often died in hospital (68% vs 30%, P < .0001) and in the ICU or ED (30% vs 3%, P < .0001). Conclusion: Because end-of-life care is more aggressive in HM patients compared to ST patients, a proactive integrated care approach with early start of palliative care alongside curative care is warranted. Timely discussions with patients and family about advance care planning and end-of-life choices can avoid inappropriate care at the end of life.
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Affiliation(s)
- Mary-Joanne Verhoef
- Center of Expertise Palliative Care, Leiden University Medical Center, Leiden, the Netherlands
| | - Ellen J M de Nijs
- Center of Expertise Palliative Care, Leiden University Medical Center, Leiden, the Netherlands
| | - Claudia S Ootjers
- Department of Hematology, Leiden University Medical Center, Leiden, the Netherlands
| | - Marta Fiocco
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands.,Mathematical Institute, Leiden University, Leiden, the Netherlands
| | - Anne J Fogteloo
- Department of Internal Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Christian Heringhaus
- Department of Emergency Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Corrie A M Marijnen
- Department of Radiation Oncology, Leiden University Medical Center, the Netherlands
| | - Nanda Horeweg
- Department of Radiation Oncology, Leiden University Medical Center, the Netherlands
| | - Yvette M van der Linden
- Center of Expertise Palliative Care, Leiden University Medical Center, Leiden, the Netherlands.,Department of Radiation Oncology, Leiden University Medical Center, the Netherlands
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Moreno-Alonso D, Porta-Sales J, Monforte-Royo C, Trelis-Navarro J, Sureda-Balarí A, Fernández De Sevilla-Ribosa A. Palliative care in patients with haematological neoplasms: An integrative systematic review. Palliat Med 2018; 32:79-105. [PMID: 29130387 DOI: 10.1177/0269216317735246] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Palliative care was originally intended for patients with non-haematological neoplasms and relatively few studies have assessed palliative care in patients with haematological malignancies. AIM To assess palliative care interventions in managing haematological malignancies patients treated by onco-haematology departments. DESIGN Integrative systematic review with data extraction and narrative synthesis (PROSPERO #: CRD42016036240). DATA SOURCES PubMed, CINAHL, Cochrane, Scopus and Web-of-Science were searched for articles published through 30 June 2015. Study inclusion criteria were as follows: (1) published in English or Spanish and (2) containing data on palliative care interventions in adults with haematological malignancies. RESULTS The search yielded 418 articles; 99 met the inclusion criteria. Six themes were identified: (1) end-of-life care, (2) the relationship between onco-haematology and palliative care departments and referral characteristics, (3) clinical characteristics, (4) experience of patients/families, (5) home care and (6) other themes grouped together as 'miscellany'. Our findings indicate that palliative care is often limited to the end-of-life phase, with late referral to palliative care. The symptom burden in haematological malignancies patients is more than the burden in non-haematological neoplasms patients. Patients and families are generally satisfied with palliative care. Home care is seldom used. Tools to predict survival in this patient population are lacking. CONCLUSION Despite a growing interest in palliative care for haematological malignancies patients, the evidence base needs to be strengthened to expand our knowledge about palliative care in this patient group. The results of this review support the need to develop closer cooperation and communication between the palliative care and onco-haematology departments to improve patient care.
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Affiliation(s)
- Deborah Moreno-Alonso
- 1 Palliative Care Service, Institut Catala d' Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Josep Porta-Sales
- 1 Palliative Care Service, Institut Catala d' Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Cristina Monforte-Royo
- 2 Nursing, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, Spain
| | - Jordi Trelis-Navarro
- 1 Palliative Care Service, Institut Catala d' Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Anna Sureda-Balarí
- 3 Clinical Haematology Service, Institut Catala d' Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain
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Nickolich M, El-Jawahri A, LeBlanc TW. Palliative and End-of-Life Care in Myelodysplastic Syndromes. Curr Hematol Malig Rep 2017; 11:434-440. [PMID: 27704467 DOI: 10.1007/s11899-016-0352-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
A growing literature demonstrates that MDS is associated with significant impairments in overall quality of life. Given the poor prognosis for many patients with MDS, and the considerable morbidities associated with this disease, there is a critical need to address palliative and end-of-life care needs in this population. However, palliative and end-of-life care issues are under-represented in the MDS literature. In this article, we highlight a growing body of literature that demonstrates unmet palliative and end-of-life care needs in hematologic malignancies, including MDS, and highlight opportunities for further research and quality improvement initiatives to address unmet needs in MDS care.
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Affiliation(s)
- Myles Nickolich
- Divisions of Hematology, Medical Oncology, and Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | | | - Thomas W LeBlanc
- Duke Cancer Institute, Duke University School of Medicine, Durham, NC, USA. .,DUMC, Box 2715, Durham, NC, 27710, USA.
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9
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Transfusion Thresholds, Quality of Life, and Current Approaches in Myelodysplastic Syndromes. Anemia 2016; 2016:8494738. [PMID: 27195147 PMCID: PMC4853931 DOI: 10.1155/2016/8494738] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Accepted: 04/04/2016] [Indexed: 11/17/2022] Open
Abstract
Hemoglobin thresholds and triggers for blood transfusions have changed over the years moving from a higher to a lower level. This review article summarizes the current evidence of transfusion thresholds in the hospitalized as well as in the outpatient setting and particularly in myelodysplasia. Fatigue is the main reported symptom in this group of patients and current clinical trials are looking for a more liberal approach of red cell transfusion and the effect on quality of life as opposed to the restrictive strategy used in the critical care setting. Practical considerations, the cost effectiveness of this strategy in addition to the possible complications, and the use of quality of life questionnaires have also been reviewed.
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Niscola P, Mandelli F, Efficace F. Improving accuracy of prognosis in patients with myelodysplastic syndromes using self-reported quality of life data. Opportunities for a new research agenda in developing prognostic models. Expert Rev Hematol 2016; 9:415-7. [DOI: 10.1586/17474086.2016.1164030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
| | - Franco Mandelli
- Data Center and Health Outcomes Research Unit, Italian Group for Adult Hematologic Diseases (GIMEMA), Rome, Italy
| | - Fabio Efficace
- Data Center and Health Outcomes Research Unit, Italian Group for Adult Hematologic Diseases (GIMEMA), Rome, Italy
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Chisolm S, Salkeld E, Houk A, Huber J. Partnering in medical education: rare disease organizations bring experts and a patient voice to the conversation. Expert Opin Orphan Drugs 2014. [DOI: 10.1517/21678707.2014.966687] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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12
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Efficace F, Gaidano G, Breccia M, Criscuolo M, Cottone F, Caocci G, Bowen D, Lübbert M, Angelucci E, Stauder R, Selleslag D, Platzbecker U, Sanpaolo G, Jonasova A, Buccisano F, Specchia G, Palumbo GA, Niscola P, Wan C, Zhang H, Fenu S, Klimek V, Beyne-Rauzy O, Nguyen K, Mandelli F. Prevalence, severity and correlates of fatigue in newly diagnosed patients with myelodysplastic syndromes. Br J Haematol 2014; 168:361-70. [DOI: 10.1111/bjh.13138] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Accepted: 07/29/2014] [Indexed: 11/25/2022]
Affiliation(s)
- Fabio Efficace
- Data Centre and Health Outcomes Research Unit; Italian Group for Adult Haematological Diseases (GIMEMA); Rome Italy
| | - Gianluca Gaidano
- Division of Haematology; Department of Translational Medicine; Amedeo Avogadro University of Eastern Piedmont; Novara Italy
| | - Massimo Breccia
- Department of Haematology; University of Rome “La Sapienza”; Rome Italy
| | - Marianna Criscuolo
- Department of Haematology; University of Rome “Cattolica S. Cuore”; Rome Italy
| | - Francesco Cottone
- Data Centre and Health Outcomes Research Unit; Italian Group for Adult Haematological Diseases (GIMEMA); Rome Italy
| | - Giovanni Caocci
- Department of Medical Sciences; University of Cagliari; Cagliari Italy
| | - David Bowen
- St James's Institute of Oncology; Leeds Teaching Hospitals, Bexley Wing; Leeds UK
| | - Michael Lübbert
- Department of Internal Medicine I; University of Freiburg Medical Centre; Freiburg Germany
| | | | - Reinhard Stauder
- Department of Internal Medicine V (Haematology and Oncology); Innsbruck Medical University; Innsbruck Austria
| | | | - Uwe Platzbecker
- Department of Medicine I; University hospital Dresden “Carl Gustav Carus”; Dresden Germany
| | - Grazia Sanpaolo
- Stem Cell Transplantation Unit; Department of Haematology; IRCCS ‘Casa Sollievo della Sofferenza’ Hospital; San Giovanni Rotondo Italy
| | - Anna Jonasova
- Department of Medicine; Department of Haematology; General University Hospital; Charles University; Prague Czech Republic
| | | | - Giorgina Specchia
- Haematology Section; Department of Emergency and Organ Transplantation; University of Bari; Bari Italy
| | | | | | - Chonghua Wan
- School of Humanities and Management; Guangdong Medical College; Dongguan China
| | - Huiyong Zhang
- Department of Haematology; Affiliated Hospital of Liaoning University of Traditional Chinese Medicine; Shenyang China
| | - Susanna Fenu
- Department of Haematology; S. Giovanni-Addolorata Hospital; Rome Italy
| | - Virginia Klimek
- Department of Medicine; Memorial Sloan-Kettering Cancer Center; New York NY USA
| | | | - Khanh Nguyen
- Department of Leukemia; MD Anderson Cancer Center; Houston TX USA
| | - Franco Mandelli
- Data Centre and Health Outcomes Research Unit; Italian Group for Adult Haematological Diseases (GIMEMA); Rome Italy
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LeBlanc TW, Abernethy AP. Quality of life in higher resolution: the next generation of comparative effectiveness research in malignant hematology. Haematologica 2013; 98:823-4. [PMID: 23729721 DOI: 10.3324/haematol.2013.085787] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Kurtin SE. Myelodysplastic syndromes: the challenge of developing clinical guidelines and supportive care strategies for a rare disease. Clin J Oncol Nurs 2013; 16 Suppl:5-7. [PMID: 22641280 DOI: 10.1188/12.cjon.s1.5-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Myelodysplastic syndromes (MDS) represent a group of clonal myeloid malignancies with variability in clinical presentation and disease trajectory, as well as prognosis and treatment recommendations (Kurtin & Demakos, 2010). MDS is considered to be a rare disease that is most common in adults older than age 70. The disease is characterized by ineffective hematopoiesis, progressive bone marrow failure, and a variable risk of leukemic transformation thought to result from complex interactions between the malignant clone and the bone marrow microenvironment (Kurtin, 2011). This supplement is intended to provide the oncology clinician with an overview of MDS and provide tools for the clinical management and support of patients with MDS.
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Ridgeway JA, Fechter L, Murray C, Borràs N. Update on the science of myelodysplastic syndromes. Clin J Oncol Nurs 2012; 16 Suppl:9-22. [PMID: 22641281 DOI: 10.1188/12.cjon.s1.9-22] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Scientific research is only just beginning to shed light on the pathobiology underlying the various subtypes of myelodysplastic syndromes (MDS), a heterogeneous group of clonal stem cell disorders characterized by cytopenias that can progress to acute myeloid leukemia. Increased understanding of the disease and prognostic implications of specific clinical features has aided in the development of prescribing guidelines and new treatments for MDS. Because oncology nurses have frequent interactions with patients during diagnostic and therapeutic evaluations, an understanding of the science behind disease classification, prognostic scoring, and the goals of treatment for low- and high-risk disease is important to answer questions regarding diagnostic results, treatment outcomes, and adverse event monitoring.
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Affiliation(s)
- Jean A Ridgeway
- Adult Hematologic Malignancies/Stem Cell Transplant Program, University of Chicago Medical Center, Illinois, USA.
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