scholarly journals Retrospective examination of lipid-lowering treatment patterns in a real-world high-risk cohort in the UK in 2014: comparison with the National Institute for Health and Care Excellence (NICE) 2014 lipid modification guidelines

BMJ Open ◽  
2017 ◽  
Vol 7 (2) ◽  
pp. e013255 ◽  
Author(s):  
Dylan L Steen ◽  
Irfan Khan ◽  
David Ansell ◽  
Robert J Sanchez ◽  
Kausik K Ray
Keyword(s):  
High Risk ◽  
Real World ◽  
Treatment Patterns ◽  
Lipid Lowering ◽  
Lipid Modification ◽  
The Uk ◽  
Retrospective Examination ◽  
High Risk Cohort

scholarly journals Treatment patterns in patients with Familial hypercholesterolemia: evidence from real-world studies in Germany and the UK

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
I Gouni-Berthold ◽  
D Seshagiri ◽  
R Studer ◽  
A Durand ◽  
S Klebs ◽  
...  
Keyword(s):  
Familial Hypercholesterolemia ◽  
Real World ◽  
Treatment Patterns ◽  
Lipid Lowering ◽  
Clinical Practice Research Datalink ◽  
Private Company ◽  
Statin Monotherapy ◽  
The Mean ◽  
The Uk

Abstract Background Familial hypercholesterolemia (FH) includes a spectrum of disease as per the number and effect of mutations in specific proteins involved in low-density lipoprotein cholesterol (LDL-C) metabolism, together with other genetic factors. Elevated LDL-C levels have been strongly associated with risk of cardiovascular and coronary heart disease, with up to 10-fold risk in patients (pts) with FH than without FH. The aim of lipid-lowering treatments (LLTs) is to reduce the LDL-C levels, although there is limited research describing treatment patterns and LDL-C outcomes in FH pts in routine care. Purpose To characterize the treatment patterns and LDL-C outcomes of FH pts in the real-world setting in Germany (GER) and the UK. Methods We conducted two descriptive, non-interventional and retrospective cohort studies. Pts in GER were identified from General Physician (GP) and Cardiology practices available in electronic medical records database Disease Analyzer (January 1992-June 2020). Pts in the UK were identified from the Clinical Practice Research Datalink linked to the Hospital Episode Statistics admitted pts care and Office of National Statistics datasets. Pts were included if they had diagnosis of FH (index date [ID]) and data available within 6-month before and 3-month after the ID. The first diagnosis of FH in the identification period (GER, 1/07/2015–30/06/2019; UK, 01/01/2010–31/05/2018) was considered the ID. Persistence and adherence to the recorded LLT at ID was analyzed for pts with at least 12 months and 24 months of follow-up. Persistence was measured as the duration (in days) with allowed gap of 60 days and adherence as proportion of days covered (PDC). Results Analysis included 2,105 FH pts from GER and 9,846 from the UK. Data are presented as GER/UK. The mean (SD) age of pts was 60 (15)/52 (14) years, and 60%/61% were females. Hypertension (53%/27%) and depression (31%/38%) were the common comorbidities. At ID, statin monotherapy (29%/68%) was the most commonly prescribed LLT. The use of ezetimibe, fibrates and PCSK9 inhibitors was very low in both countries (Table 1). Of note, LDL-C measurements at ID (−6m/+3m) were available for 31%/73% of pts. In pts with uncontrolled LDL-C (≥55 mg/dL), 34%/64% were receiving statin monotherapy, whereas there was no use of LLT in 62%/29% of pts. During the 24 months follow-up, the mean (SD) persistence and PDC to statins monotherapy was 471 (264)/489 (289) days and 0.65 (0.36)/0.69 (0.46), respectively, with 50%/70% of pts being adherent (PDC ≥0.80). Conclusions In our study, in GER, the rate of LDL-C measurements was low. In both GER and UK, almost all measured patients had LDL-C ≥55mg/dL at ID. Findings indicate low prescriptions of LLTs in GP setting, particularly non-statin LLTs in both countries. The mean adherence (PDC) in GER and the UK was 65% and 69%, respectively within 24 months after ID. Improved LDL-C monitoring and new therapies with potential to lower LDL-C are warranted. FUNDunding Acknowledgement Type of funding sources: Private company. Main funding source(s): Novartis Pharma AG, Basel, Switzerland

scholarly journals Estimating the burden of hyperkalaemia in the UK in high-risk patient populations

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
P McEwan ◽  
L Hoskin ◽  
K Badora ◽  
D Sugrue ◽  
G James ◽  
...  
Keyword(s):  
Clinical Practice ◽  
High Risk ◽  
Patient Outcomes ◽  
Real World ◽  
High Risk Patient ◽  
Incidence Rates ◽  
Funding Source ◽  
Eligible Population ◽  
Increased Risk ◽  
The Uk

Abstract Background Patients with chronic kidney disease (CKD), heart failure (HF), resistant hypertension (RHTN) and diabetes are at an increased risk of hyperkalaemia (HK) which can be potentially life-threatening, as a result of cardiac arrhythmias, cardiac arrest leading to sudden death. In these patients, renin-angiotensin-aldosterone system inhibitors (RAASi), are used to manage several cardiovascular and renal conditions, and are associated with an increased risk of HK. Assessing the burden of HK in real-world clinical practice may concentrate relevant care on those patients most in need, potentially improving patient outcomes and efficiency of the healthcare system. Purpose To assess the burden of HK in a real-world population of UK patients with at least one of: RHTN, Type I or II diabetes, CKD stage 3+, dialysis, HF, or in receipt of a prescription for RAASi. Methods Primary and secondary care data for this retrospective study were obtained from the UK Clinical Practice Research Datalink (CPRD) and linked Hospital Episode Statistics (HES). Eligible patients were identified using READ codes defining the relevant diagnosis, receipt of indication-specific medication, or, in the case of CKD, an estimated glomerular filtration rate (eGFR) ≤60 ml/min/1.73m2 within the study period (01 January 2008 to 30 June 2018) or in the five-year lookback period (2003–2007). The index date was defined as 01 January 2008 or first diagnosis of an eligible condition or RAASi prescription, whichever occurred latest. HK was defined as K+ ≥5.0 mmol/L; thresholds of ≥5.5 mmol/L and ≥6.0 mmol/L were explored as sensitivity analyses. Incidence rates of HK were calculated with 95% confidence intervals (CI). Results The total eligible population across all cohorts was 931,460 patients. RHTN was the most prevalent comorbidity (n=317,135; 34.0%) and dialysis the least prevalent (n=4,415; 0.5%). The majority of the eligible population were prescribed RAASi during follow-up (n=754,523; 81.0%). At a K+ threshold of ≥5.0 mmol/L, the dialysis cohort had the highest rate of HK (501.0 events per 1,000 patient-years), followed by HF (490.9), CKD (410.9), diabetes (355.0), RHTN (261.4) and the RAASi cohort (211.2) (Figure 1). This pattern was still observed at alternative threshold definitions of HK. Conclusion This large real-world study of UK patients demonstrates the burden of hyperkalaemia in high-risk patient populations from the UK. There is a need for effective prevention and treatment of HK, particularly in patients with CKD, dialysis or HF where increased incidence rates are observed which in turn will improve patient outcomes and healthcare resource usage. Figure 1. Rates of HK by condition Funding Acknowledgement Type of funding source: Private company. Main funding source(s): AstraZeneca

scholarly journals Real World Assessment of Treatment Patterns and Outcomes Among Multiple Myeloma Patients across Different Risk Stratification Criteria in the United States: A Retrospective Cohort Study

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 1640-1640
Author(s):  
Motiur Rahman ◽  
Christopher Kim ◽  
Jazmine Mateus ◽  
Alissa Keegan
Keyword(s):  
High Risk ◽  
Risk Stratification ◽  
Real World ◽  
Treatment Initiation ◽  
Treatment Patterns ◽  
Community Practice ◽  
Newly Diagnosed ◽  
The Us ◽  
Standard Risk

Abstract Background: Despite the development of highly active novel agents, high risk (HR) multiple myeloma (MM) patients continue to demonstrate relatively poor prognosis. Limited data is published on how treatment patterns with risk stratification systems have changed over time. Moreover, real world studies using electronic health records (EHRs) have not evaluated the performance of risk stratification systems with real world outcomes. This study aims to evaluate the ability to implement three different risk stratification systems - international staging system (ISS), revised ISS (R-ISS), and high-risk chromosomal abnormalities (HRCA, defined as presence of del(17)p, t(4;14) and/or t(4;16)) [Palumbo et al. 2015] - to characterize treatment patterns and associated outcomes [real world overall survival (rwOS) and real world progression free survival (rwPFS)] among newly diagnosed MM (NDMM) patients in the US community practice. Methods: This study used Flatiron Enhanced MM EHR de-identified database (New York, NY). Newly diagnosed MM patients (≥ 18 years) were diagnosed from January 2015 through June 2020 (cohort 1 - for studying treatment distribution) with follow-up through December 2020, and from January 2015 through December 2018 (cohort 2 - for rwOS and rwPFS), with follow-up through December 2020. Patients with malignancies other than MM were excluded. Proportion of rwOS was measured from treatment initiation until death, and median rwPFS was measured from treatment initiation until death, progression, or start of new line of therapy using Kaplan-Meier method. Results: A total of 1,979 and 1,382 patients were eligible in cohorts 1 and 2, respectively. In both the cohorts, approximately 18% (cohort 1: N=367, cohort 2: N=248), 41% (cohort 1: N=805, cohort 2: N=566), and 37% (cohort 1: N=738, cohort 2: N=508) were HR patients according to the R-ISS, ISS, and HRCA criteria, respectively. Approximately half of the HR patients were ≥70 years old (52% for R-ISS III and ISS III, and 47% for HRCA), with chronic kidney disease stage ≥3 by eGFR for 54% R-ISS III and ISS III, and 34% high risk CA, and ECOG score ≥2 for 18% R-ISS III, 19% ISS III, and 14% HRCA patients. Triplets were the most frequent treatment regimens (62% for R-ISS III and II, and 66% for R-ISS I; 59% for ISS III, and 65% for ISS II and I; 65% for HRCA and 61% for standard risk CA(SRCA) with proteasome inhibitors (PIs) / immunomodulatory agents (IMiDs) / dexamethasone being most common regimen across all the risk stratification criteria. Quadruplet agent use was higher in R-ISS III and ISS III categories (6.8% vs. 3.3% for R-ISS III vs. I; 6.3% vs. 2.8% for ISS III vs. I). The median rwPFS in HR patients were shorter than the lower risk subgroups (R-ISS III: 8.8 months [95% CI 7.1 - 11.0], R-ISS II: 12.1 months [95% CI 10.7 - 13.6], R-ISS I: 23.5 months [95% CI 13.8 - .]; ISS III: 10.4 months [95% CI 8.5 - 11.5], ISS II: 12.7 months [95% CI 10.7 - 14.3], ISS I: 16 months [95% CI 12.2 - 19.5]; HRCA: 10.1 months [95% CI 8.8 - 12.1], SRCA: 13.1 months [95% CI 11.3 - 14.8]). The 2-year rwOS was lower in the HR subgroups (R-ISS III: 0.65 [95% CI 0.59 - 0.70], R-ISS II: 0.79 [95% CI 0.76 - 0.81], R-ISS I: 0.91 [95% CI 0.85 - 0.95]; ISS III: 0.68 [95% CI 0.64 - 0.72], ISS II: 0.81 [95% CI 0.77 - 0.84], ISS I: 0.89 [95% CI 0.85 - 0.92]; HRCA: 0.75 [95% CI 0.71 - 0.79], SRCA: 0.79 [95% CI 0.76 - 0.81]). Discussion: This study found that median rwPFS and 2-year rwOS proportions were consistently lower among HR patients compared to the standard risk individuals. The majority of the HR patients were older, with decreased levels of physical functioning and worse indicators of end-organ damage including renal function, anemia, and hypercalcemia. Most patients received triplets with frequent use of PIs likely for aggressive disease control among HR patients. Some HR patients received more quads than lower risk patients suggesting treatment intensification, but HR patients also received stem cell transplants at a lower rate. Although a smaller proportion of patients have all the data collected needed for R-ISS classification, the consistent findings across treatment outcomes suggest that R-ISS is implementable in real world studies and has a greater discriminatory ability than ISS or HRCA alone. Overall, this study suggests that HR patients have relatively poor outcomes which calls for the study of risk-adapted implementation of novel therapies among this patient population in the US community practice settings. Figure 1 Figure 1. Disclosures Rahman: Amgen Inc.: Current Employment, Current holder of stock options in a privately-held company. Kim: Amgen: Current Employment, Current equity holder in publicly-traded company. Mateus: Amgen Inc.: Current Employment, Other: Work at Amgen as a contract employee through DOCS. Keegan: Amgen Inc.: Current Employment, Current holder of stock options in a privately-held company.

Real-World Treatment Patterns and Outcomes of Proteasome Inhibitor (PI: Bortezomib [V], Carfilzomib [K], or Ixazomib [I])-Lenalidomide/Dexamethasone (Rd)-Triplets By Prior Lenalidomide-Exposure in Patients with Relapsed/Refractory Multiple Myeloma (RRMM) Engaged in Routine Care in the United States (US)

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 47-48
Author(s):  
Larysa Sanchez ◽  
Dasha Cherepanov ◽  
Dorothy Romanus ◽  
Aditya Raju ◽  
Marlo Blazer ◽  
...  
Keyword(s):  
High Risk ◽  
Real World ◽  
Research Funding ◽  
Small Sample Size ◽  
The United States ◽  
Treatment Patterns ◽  
Small Sample ◽  
Prior Exposure ◽  
Bone Lesions ◽  
Front Line

BACKGROUND: PIs combined with an Rd backbone are the most commonly used triplet combination regimens in patients (pts) with RRMM in the US. The hallmark trials supporting the efficacy of these regimens were predominantly in pts without prior exposure to lenalidomide (R).1,2 Real-world analyses have shown that R-based regimens are increasingly used in the front-line setting.3-5 Thus, real-world treatment patterns in pts with prior R exposure and the real-world comparative effectiveness of PI-Rd triplets in this population with RRMM needs further elucidation. METHODS: A retrospective cohort of RRMM pts initiating IRd, KRd, or VRd in line of therapy (LOT) ≥2 were followed between 7/2007-9/2018 in Optum's deidentified national electronic health records database. RRMM pts were defined as those initiating LOT ≥2 between 1/2014 and 9/2018 and were categorized as having or not having prior exposure to R (R-exposed; no-prior-R) in any prior LOT. Index regimen was the first use of I-/K-/or V-Rd. LOTs were defined via an algorithm developed with MM specialists to proxy the definition of a LOT in RCTs & in accordance with NCCN MM Guidelines.6 Baseline data included: CRAB (hyperCalcemia, Renal insufficiency, Anemia, and Bone lesions); high risk cytogenetics (defined as del[17p], 1q21 gain, t[4;14], or t[14;16]); Charlson Comorbidity Index (CCI) score; and modified frailty score using age and CCI score. Median duration of therapy (DOT) and time-to-next-treatment (TTNT) (a proxy for PFS; defined as time from index regimen start to subsequent LOT or death) were estimated using Kaplan-Meier methods and compared using covariate-adjusted Cox proportional hazard models (FIGURE). Observations were censored at time of loss to follow-up (f/u)/end of study period (9/30/2018). RESULTS: Of 650 pts included, 397 were R-exposed (IRd, n=112; KRd, n=115; VRd, n=170); 253 had no-prior-R (IRd, n=29; KRd, n=62; VRd, n=162). R-exposed pts, overall, were treated in later LOTs (LOT2: 55% v 78%) and had a longer median time from diagnosis to index LOT (26.7 v 13.4 months) than no-prior-R pts; this differed between treatment cohorts (TABLE). In R-exposed pts, more pts with symptomatic relapse (≥1 CRAB symptom, 87%) or high-risk cytogenetics (30%) received KRd than IRd (75% & 23%) or VRd (74% & 16%) (TABLE). More pts treated with IRd were ≥75 years old: 42% (IRd) v 36% (VRd) / 21% (KRd). In R-exposed pts, 35.3% of those receiving VRd in LOT ≥2 had prior V-IMID-based and 53.5% had IMID-based therapy (ie, IMID with no PI nor monoclonal antibody) in LOT1; >98% of LOT1 IMID use was R, across groups. In R-exposed pts, 56.5% of those receiving KRd had prior V-IMID-based and 16.5% had IMID-based therapy in LOT1; in IRd pts in LOT ≥2, 29.5% and 43.8% had prior V-IMID-based and IMID-based therapy in LOT1. In unadjusted analysis, at a median f/u of 11, 11.9, and 14.8 months for I-, K-, and V-Rd, median TTNT for R-exposed pts: 12.3 months (IRd), 7.8 months (KRd), and 13.9 months (VRd) (P=0.50); HRs for TTNTLOT stratified: 0.84 (IRd v KRd), 0.96 (IRd v VRd), 1.15 (KRd v VRd), and median regimen DOTs: 8.4 months (IRd), 7.5 months (KRd), and 9.5 months (VRd) (P=0.75). In no-prior-R pts, HRs for TTNTLOT stratified were significant for IRd v KRd (HR=0.33) and KRd v VRd (HR=1.62) (P<0.01, both); IRd v VRd (HR=0.53; P=0.11). In adjusted analysis, there were no significant differences for R-exposed pts by PI-Rd regimens for TTNT (FIGURE), nor for regimen DOT. For no-prior-R pts, adjusted HR for TTNT was significant for I- v K-Rd (HR=0.36; P=0.03) and for regimen DOT was significant for I- v V-Rd (HR=0.34; P=0.03). CONCLUSIONS: In this real-world study, the majority of pts received a PI-Rd combination after prior VRd or Rd in front-line. After controlling for baseline characteristics, including prior PI-exposure, PI-Rd triplets were comparable in TTNT in R-exposed pts treated in LOTs ≥2. TTNT was significantly longer for I- v K-Rd in pts with no-prior-R, although this is limited by small sample size. Published studies indicate that individualized treatment recommendations may improve real-world outcomes, such as IRd v KRd in frail pts which was associated with significantly longer TTNT.6 Prior-R exposure, in our analysis, does not appear to influence the relative PI-triplet regimen effectiveness in LOTs ≥2. With increasing use of R in earlier LOTs, understanding real-world treatment patterns and subsequent PI-Rd effectiveness in consequent LOTs is key for optimizing RRMM pt management. Disclosures Cherepanov: Millennium Pharmaceuticals, Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited: Current Employment. Romanus:Takeda: Current Employment. Raju:Xcenda: Current Employment, Other: Xcenda received research funding from Takeda. Blazer:Xcenda: Current Employment, Other: Xcenda received research funding from Takeda. Farrelly:Xcenda: Current Employment, Other: Xcenda received research funding from Takeda. Stull:Takeda: Current Employment. Ailawadhi:Phosplatin: Research Funding; Celgene: Honoraria; Amgen: Research Funding; Takeda: Honoraria; Janssen: Research Funding; Pharmacyclics: Research Funding; Cellectar: Research Funding; BMS: Research Funding; Medimmune: Research Funding.

scholarly journals Real-World Use of Pomalidomide and Dexamethasone in Double Refractory Multiple Myeloma: A Multicentre UK Experience

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 3312-3312
Author(s):  
Nicola Maciocia ◽  
Andrew Melville ◽  
Paul Michael Maciocia ◽  
Simon Cheesman ◽  
Faye Sharpley ◽  
...  
Keyword(s):  
High Risk ◽  
Renal Impairment ◽  
Real World ◽  
Research Funding ◽  
Patient Characteristics ◽  
Older Age ◽  
Neutropenic Sepsis ◽  
Equity Ownership ◽  
Grade 3 ◽  
The Uk

Abstract Introduction. The outlook for myeloma patients who relapse after or become refractory to bortezomib and IMiDs is poor, with limited therapeutic options and a median survival (OS) of 9 months. In the phase 3 MM-003 study, pomalidomide plus low-dose dexamethasone resulted in a significant PFS (median 4 vs 1.9 months) and OS (median 13.1 vs 8.1 months) benefit, compared to high-dose dexamethasone. Information on real-world outcomes of pomalidomide therapy is limited. We carried out a retrospective analysis of patients receiving pomalidomide in the UK, to compare outcomes and tolerability with published clinical trial data, and focus on high risk subgroups. Methods. All patients treated with pomalidomide at 5 major UK centres between August 2013 and March 2016 were identified from chemotherapy records, and clinical data including toxicity and survival from patient records. Disease response and adverse FISH were defined as per IMWG. Survival was estimated using Kaplan-Meier, and correlations made using log-rank methods. Key subgroups: eGFR <45ml/min, adverse genetics, and older age were assessed. Results. A total of 85 patients were identified. Of these, 70 (82%) had measurable disease (IMWG criteria) and received ≥1 cycle so were included in response analyses. Baseline patient characteristics are reported in Table 1. 96.5% of patients were refractory to one or more IMiDs, and 72.9% were refractory to both IMiDs and bortezomib. 92.9% were refractory to their last treatment. The median dose of pomalidomide was 4mg (2-4). Grade 3-4 non-haematological toxicities occurred in 42.4%: pneumonia (16.5%), neutropenic sepsis (8.2%), and acute kidney injury (7.1%), were most common. Grade 3-4 neutropenia occurred in 38% and thrombocytopenia in 24%. Seven patients died on treatment, 6 during the first cycle (2 PD and sepsis, 2 neutropenic sepsis, 1 PD and AKI, 2 pneumonia). In the 70 patients assessable for response, ORR was 52.9% (5.7% VGPR, 47.1% PR, 38.6% SD). Median duration of response (DoR) was 4 months. With median follow-up of 13 months, median PFS was 5 months (95%CI 3.6-6.4), and median OS 13 months (95%CI 10.8-15.2). Patients with renal failure (eGFR <45ml/min) had PFS and OS that were similar to those with eGFR ≥45ml/min ((HR=0.95, 95%CI 0.49-1.82, and HR=1.22, 0.59-2.53). Patients with adverse FISH (44%) had similar outcomes to those with standard FISH (ORR 45.8 vs 50%, median PFS 6 vs 5 months (HR=0.86, 95%CI 0.44-1.67, and median OS 10 vs 8 months, HR=1.223, 0.55-2.68). Patients aged >65yrs had similar outcomes to younger patients,(ORR 54.1 vs 51.5%, median PFS and OS comparable between groups). Rates of toxicity were also not influenced by renal impairment, adverse genetics, or older age. The most important predictors of PFS and OS were depth and durability of response. PFS was 6 months for patients achieving PR, 4 months for SD and 1 month for PD, while OS was 18 months in patients achieving PR, 13 months for SD and 3 months for PD. For patients with DoR >4 months, PFS was 11 months and OS 23 months. In contrast, in patients whose DoR was < 4 months or who did not respond, OS was 9 months. Conclusions. Our real-world data on the characteristics and outcomes of patients receiving pomalidomide for relapsed/refractory myeloma in the UK reflect results of published clinical trials. The ORR of 52.9% in our cohort is higher than in MM-003 and MM-010, but PFS (5 months) and OS (13 months) were remarkably similar. Rates of haematological toxicity and infections are low, confirming the good tolerability of pomalidomide in this patient group. Depth and sustainability of response were important predictors of survival: achievement of PR was associated with improved PFS and OS, while patients who achieved SD still derived a survival benefit. Patients who maintained a response for at least 4 months had an estimated survival of nearly 2 years. No difference in response, survival or tolerability was seen in key subgroups, including those with moderate renal impairment, adverse cytogenetics and older age. Our findings confirm the efficacy of pomalidomide in these heavily pre-treated patients and add to the evidence for the benefit of pomalidomide in high risk patient groups. Table Patient characteristics and comparison with MM003 trial Table. Patient characteristics and comparison with MM003 trial Figure 1 PFS and OS for the edited group of 70 patients Figure 1. PFS and OS for the edited group of 70 patients Disclosures Maciocia: Autolus: Equity Ownership, Patents & Royalties: TRBC1 and 2 Targeting for the Diagnosis and Treatment of T-cell Malignancies. Ramasamy:Celgene: Honoraria, Research Funding. Jenner:Novartis: Consultancy, Honoraria; Takeda: Consultancy, Honoraria, Other: Travel support; Amgen: Consultancy, Honoraria, Other: Travel support; Celgene: Consultancy, Honoraria, Research Funding; Janssen: Consultancy, Honoraria, Other: Travel support, Research Funding. Schey:Celgene, Takeda: Honoraria; Celgene, Johnson & Johnson: Speakers Bureau; Celgene: Consultancy. Yong:Autolus Ltd: Equity Ownership, Patents & Royalties: APRIL based chimeric antigen receptor; Janssen: Research Funding.

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