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Koinig KA, Arnold C, Lehmann J, Giesinger J, Köck S, Willenbacher W, Weger R, Holzner B, Ganswindt U, Wolf D, Stauder R. The cancer patient's perspective of COVID-19-induced distress-A cross-sectional study and a longitudinal comparison of HRQOL assessed before and during the pandemic. Cancer Med 2021; 10:3928-3937. [PMID: 33973411 PMCID: PMC8209623 DOI: 10.1002/cam4.3950] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 04/12/2021] [Accepted: 04/16/2021] [Indexed: 12/21/2022] Open
Abstract
Background To permit timely mitigation of adverse effects on overall clinical outcome, it is essential to understand how the pandemic influences distress and health‐related quality of life (HRQOL) in cancer patients during the coronavirus disease 2019 (COVID‐19) pandemic. Methods In this cross‐sectional study, adult cancer patients, without COVID‐19 symptoms, completed a 13‐item questionnaire about the pandemic's impacts on distress and everyday‐life; associations with age, sex, or impaired HRQOL were then assessed by binary logistic regressions. In a subsample of patients with HRQOL assessment available from both before and during the pandemic, we evaluated the pandemic's impact on longitudinal changes in HRQOL reported within 6 months before versus during the COVID‐19 lockdown using McNemar's test, and thresholds for clinical importance. Results We consecutively enrolled 240 patients with solid (50%) or hematological (50%) cancers. Median age was 67 years, 46% were females. The majority ranked heeding their health (80%) and keeping their appointment schedule in hospital (78%) as important. Being younger than 60, or aged 60–70 was independently associated with limitations in everyday life (OR = 3.57, p < 0.001; and 2.05, p = 0.038); female individuals and those with restricted emotional functioning were more distressed by the COVID‐19 situation (OR = 2.47, p = 0.040; and 3.17, p = 0.019); the latter group was also significantly more concerned about being a patient at risk (OR = 2.21, p = 0.029). Interestingly, in a subsample of patients (n = 47), longitudinal comparisons pre‐ versus during the pandemic revealed that HRQOL was not substantially affected by the pandemic. Conclusion Particularly younger and female cancer patients, and those with impaired emotional functioning are distressed by COVID‐19. During the first COVID‐19 lockdown, cancer patients remained predominantly resilient. This analysis highlights the need to mitigate distress situations in vulnerable patients and thereby enhance resilience during pandemics.
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Affiliation(s)
- Karin A Koinig
- Department of Internal Medicine V, Hematology and Oncology, Comprehensive Cancer Center Innsbruck (CCCI), Medical University of Innsbruck, Innsbruck, Austria
| | - Christoph Arnold
- Department of Radiation Oncology, Comprehensive Cancer Center Innsbruck (CCCI), Medical University of Innsbruck, Innsbruck, Austria
| | - Jens Lehmann
- University Hospital of Psychiatry II, Medical University of Innsbruck, Innsbruck, Austria.,OncoTyrol-Center for Personalized Cancer Medicine, Innsbruck, Austria
| | - Johannes Giesinger
- University Hospital of Psychiatry II, Medical University of Innsbruck, Innsbruck, Austria
| | - Stefan Köck
- Department of Internal Medicine V, Hematology and Oncology, Comprehensive Cancer Center Innsbruck (CCCI), Medical University of Innsbruck, Innsbruck, Austria
| | - Wolfgang Willenbacher
- Department of Internal Medicine V, Hematology and Oncology, Comprehensive Cancer Center Innsbruck (CCCI), Medical University of Innsbruck, Innsbruck, Austria.,OncoTyrol-Center for Personalized Cancer Medicine, Innsbruck, Austria
| | - Roman Weger
- Department of Internal Medicine V, Hematology and Oncology, Comprehensive Cancer Center Innsbruck (CCCI), Medical University of Innsbruck, Innsbruck, Austria.,OncoTyrol-Center for Personalized Cancer Medicine, Innsbruck, Austria
| | - Bernhard Holzner
- University Hospital of Psychiatry II, Medical University of Innsbruck, Innsbruck, Austria
| | - Ute Ganswindt
- Department of Radiation Oncology, Comprehensive Cancer Center Innsbruck (CCCI), Medical University of Innsbruck, Innsbruck, Austria
| | - Dominik Wolf
- Department of Internal Medicine V, Hematology and Oncology, Comprehensive Cancer Center Innsbruck (CCCI), Medical University of Innsbruck, Innsbruck, Austria
| | - Reinhard Stauder
- Department of Internal Medicine V, Hematology and Oncology, Comprehensive Cancer Center Innsbruck (CCCI), Medical University of Innsbruck, Innsbruck, Austria
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Fauser J, Köck S, Gunsilius E, Chott A, Peer A, Ditlbacher A, Fritsche G, Joannidis M, Wolf D, Pircher A. Death of unknown cause? Post-mortem diagnosis of fulminant course of an EBV-associated secondary hemophagocytic lymphohistiocytosis. Memo 2021; 14:287-291. [PMID: 33824685 PMCID: PMC8015738 DOI: 10.1007/s12254-021-00701-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 03/02/2021] [Indexed: 11/04/2022]
Abstract
HLH is a life-threatening disease, which is characterized by a dysregulated immune response with uncontrolled T cell and macrophage activation. The often fulminant course of the disease needs a fast diagnostic work-up to initiate as soon as possible the appropriate therapy. We present herein the case of a 71-year-old patient with rapidly progressive hyperinflammatory syndrome, which post mortem resulted in the diagnosis of EBV-associated HLH. With this case report, we intend to highlight the relevance of the HScore in the diagnosis of HLH, to create a greater awareness for EBV as a trigger of HLH, and to demonstrate the importance of treating EBV-associated HLH as early as possible.
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Affiliation(s)
- Josia Fauser
- Department of Hematology and Oncology, Internal Medicine V, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria
| | - Stefan Köck
- Department of Hematology and Oncology, Internal Medicine V, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria
| | - Eberhard Gunsilius
- Department of Hematology and Oncology, Internal Medicine V, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria
| | - Andreas Chott
- Institute of Pathology and Microbiology, Wilheminenspital, Vienna, Austria
| | - Andreas Peer
- Division of Intensive Care and Emergency Medicine, Department of Internal Medicine, Medical University of Innsbruck, Innsbruck, Austria
| | - Adelheid Ditlbacher
- Division of Intensive Care and Emergency Medicine, Department of Internal Medicine, Medical University of Innsbruck, Innsbruck, Austria
| | - Gernot Fritsche
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Michael Joannidis
- Division of Intensive Care and Emergency Medicine, Department of Internal Medicine, Medical University of Innsbruck, Innsbruck, Austria
| | - Dominik Wolf
- Department of Hematology and Oncology, Internal Medicine V, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria
| | - Andreas Pircher
- Department of Hematology and Oncology, Internal Medicine V, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria
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Mildner F, Sopper S, Amann A, Pircher A, Pall G, Köck S, Naismith E, Wolf D, Gamerith G. Systematic review: Soluble immunological biomarkers in advanced non-small-cell lung cancer (NSCLC). Crit Rev Oncol Hematol 2020; 153:102948. [PMID: 32645684 DOI: 10.1016/j.critrevonc.2020.102948] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 03/27/2020] [Accepted: 03/30/2020] [Indexed: 01/05/2023] Open
Abstract
In the highly dynamic field of advanced malignancies, biomarkers from liquid samples are urgently needed to improve treatment tailoring. However, the heterogenic data lack direct comparison of assays, vectors and relevant validations are rarely found. Therefore, we classified the available studies based on three categories: Measured vectors, applied technique and detected biomarker. High blood tumor mutational burden and low baseline levels of soluble programmed cell death 1 ligand 1 (PD-L1) appear to predict treatment responses to immunotherapy. A high PD-1+ CD4+ T-cell count was associated with poor overall survival, PD-1+CD8+ T-cells connect to a favorable outcome. Circulating tumor cells expressing PD-L1 were mainly associated with poor overall survival and treatment failure. CONCLUSION: Measurement of immunological factors as liquid biomarkers is feasible and has shown promising results. The use of coherent nomenclatures, cross-platform assay comparisons and validations through appropriate powered clinical trials are urgently required to push this auspicious field.
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Affiliation(s)
- Finn Mildner
- Internal Medicine V, Hematology and Oncology, Medical University Innsbruck, Anichstraße 35, A- 6020, Innsbruck, Austria; Tiroler Krebsforschung Institut (TKFI), Innrain 66, A-6020, Innsbruck, Austria
| | - Sieghart Sopper
- Internal Medicine V, Hematology and Oncology, Medical University Innsbruck, Anichstraße 35, A- 6020, Innsbruck, Austria; Tiroler Krebsforschung Institut (TKFI), Innrain 66, A-6020, Innsbruck, Austria
| | - Arno Amann
- Internal Medicine V, Hematology and Oncology, Medical University Innsbruck, Anichstraße 35, A- 6020, Innsbruck, Austria; Tiroler Krebsforschung Institut (TKFI), Innrain 66, A-6020, Innsbruck, Austria
| | - Andreas Pircher
- Internal Medicine V, Hematology and Oncology, Medical University Innsbruck, Anichstraße 35, A- 6020, Innsbruck, Austria
| | - Georg Pall
- Internal Medicine V, Hematology and Oncology, Medical University Innsbruck, Anichstraße 35, A- 6020, Innsbruck, Austria
| | - Stefan Köck
- Internal Medicine V, Hematology and Oncology, Medical University Innsbruck, Anichstraße 35, A- 6020, Innsbruck, Austria; Tiroler Krebsforschung Institut (TKFI), Innrain 66, A-6020, Innsbruck, Austria
| | - Erin Naismith
- Internal Medicine V, Hematology and Oncology, Medical University Innsbruck, Anichstraße 35, A- 6020, Innsbruck, Austria
| | - Dominik Wolf
- Internal Medicine V, Hematology and Oncology, Medical University Innsbruck, Anichstraße 35, A- 6020, Innsbruck, Austria; Internal Medicine 3, Oncology, Hematology, Immunoncology, Rheumatology, University Hospital Bonn (UKB), Venusberg-Campus 1, 53127, Bonn, Germany; Tiroler Krebsforschung Institut (TKFI), Innrain 66, A-6020, Innsbruck, Austria
| | - Gabriele Gamerith
- Internal Medicine V, Hematology and Oncology, Medical University Innsbruck, Anichstraße 35, A- 6020, Innsbruck, Austria; Tiroler Krebsforschung Institut (TKFI), Innrain 66, A-6020, Innsbruck, Austria.
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Ženka J, Caisová V, Uher O, Nedbalová P, Kvardová K, Masáková K, Krejčová G, Paďouková L, Jochmanová I, Wolf KI, Chmelař J, Kopecký J, Loumagne L, Mestadier J, D’agostino S, Rohaut A, Ruffin Y, Croize V, Lemaître O, Sidhu SS, Althammer S, Steele K, Rebelatto M, Tan T, Wiestler T, Spitzmueller A, Korn R, Schmidt G, Higgs B, Li X, Shi L, Jin X, Ranade K, Koeck S, Amann A, Gamerith G, Zwierzina M, Lorenz E, Zwierzina H, Kern J, Riva M, Baert T, Coosemans A, Giovannoni R, Radaelli E, Gsell W, Himmelreich U, Van Ranst M, Xing F, Qian W, Dong C, Xu X, Guo S, Shi Q, Quandt D, Seliger B, Plett C, Amberger DC, Rabe A, Deen D, Stankova Z, Hirn A, Vokac Y, Werner J, Krämer D, Rank A, Schmid C, Schmetzer H, Guerin M, Weiss JM, Regnier F, Renault G, Vimeux L, Peranzoni E, Feuillet V, Thoreau M, Guilbert T, Trautmann A, Bercovici N, Amberger DC, Doraneh-Gard F, Boeck CL, Plett C, Gunsilius C, Kugler C, Werner J, Schmohl J, Kraemer D, Ismann B, Rank A, Schmid C, Schmetzer HM, Markota A, Ochs C, May P, Gottschlich A, Gosálvez JS, Karches C, Wenk D, Endres S, Kobold S, Hilmenyuk T, Klar R, Jaschinski F, Gamerith G, Augustin F, Lorenz E, Manzl C, Hoflehner E, Moser P, Zelger B, Köck S, Amann A, Kern J, Schäfer G, Öfner D, Maier H, Zwierzina H, Sopper S, Prado-Garcia H, Romero-Garcia S, Sandoval-Martínez R, Puerto-Aquino A, Lopez-Gonzalez J, Rumbo-Nava U, Klar R, Hilmenyuk T, Jaschinski F, Coosemans A, Baert T, Van Hoylandt A, Busschaert P, Vergote I, Baert T, Van Hoylandt A, Busschaert P, Vergote I, Coosemans A, Laengle J, Pilatova K, Budinska E, Bencsikova B, Sefr R, Nenutil R, Brychtova V, Fedorova L, Hanakova B, Zdrazilova-Dubska L, Allen C, Ku YC, Tom W, Sun Y, Pankov A, Looney T, Hyland F, Au-Young J, Mongan A, Becker A, Tan JBL, Chen A, Lawson K, Lindsey E, Powers JP, Walters M, Schindler U, Young S, Jaen JC, Yin S, Chen Y, Gullo I, Gonçalves G, Pinto ML, Athelogou M, Almeida G, Huss R, Oliveira C, Carneiro F, Merz C, Sykora J, Hermann K, Hussong R, Richards DM, Fricke H, Hill O, Gieffers C, Pinho MP, Barbuto JAM, McArdle SE, Foulds G, Vadakekolathu JN, Abdel-Fatah TMA, Johnson C, Hood S, Moseley P, Rees RC, Chan SYT, Pockley AG, Rutella S, Geppert C, Hartmann A, Kumar KS, Gokilavani M, Wang S, Merz C, Richards DM, Sykora J, Redondo-Müller M, Heinonen K, Marschall V, Thiemann M, Fricke H, Gieffers C, Hill O, Zhang L, Mao B, Jin Y, Zhai G, Li Z, Wang Z, Qian W, An X, Qiao M, Zhang J, Shi Q, Weber J, Kluger H, Halaban R, Sznol M, Roder H, Roder J, Grigorieva J, Asmellash S, Oliveira C, Meyer K, Steingrimsson A, Blackmon S, Sullivan R, Boeck CL, Amberger DC, Doraneh-Gard F, Sutanto W, Guenther T, Schmohl J, Schuster F, Salih H, Babor F, Borkhardt A, Schmetzer H, Kim Y, Oh I, Park C, Ahn S, Na K, Song S, Choi Y, Fedorova L, Poprach A, Lakomy R, Selingerova I, Demlova R, Pilatova K, Kozakova S, Valik D, Petrakova K, Vyzula R, Zdrazilova-Dubska L, Aguilar-Cazares D, Galicia-Velasco M, Camacho-Mendoza C, Islas-Vazquez L, Chavez-Dominguez R, Gonzalez-Gonzalez C, Prado-Garcia H, Lopez-Gonzalez JS, Yang S, Moynihan KD, Noh M, Bekdemir A, Stellacci F, Irvine DJ, Volz B, Kapp K, Oswald D, Wittig B, Schmidt M, Chavez-Dominguez R, Aguilar-Cazares D, Prado-Garcia H, Islas-Vazquez L, Lopez-Gonzalez JS, Kleef R, Bohdjalian A, McKee D, Moss RW, Saeed M, Zalba S, Debets R, ten Hagen TLM, Javed S, Becher J, Koch-Nolte F, Haag F, Gordon EM, Sankhala KK, Stumpf N, Tseng W, Chawla SP, Suárez NG, Báez GB, Rodríguez MC, Pérez AG, García LC, Fernández DH, Pous JR, Ramírez BS, Jacoberger-Foissac C, Saliba H, Seguin C, Brion A, Frisch B, Fournel S, Heurtault B, Otterhaug T, Håkerud M, Nedberg A, Edwards V, Selbo P, Høgset A, Jaitly T, Dörrie J, Schaft N, Gross S, Schuler-Thurner B, Gupta S, Taher L, Schuler G, Vera J, Rataj F, Kraus F, Grassmann S, Chaloupka M, Lesch S, Heise C, Endres S, Kobold S, Cadilha BML, Dorman K, Heise C, Rataj F, Endres S, Kobold S. Abstracts from the 4th ImmunoTherapy of Cancer Conference. J Immunother Cancer 2017. [PMCID: PMC5374589 DOI: 10.1186/s40425-017-0219-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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