scholarly journals Review paper. Chemobrain in patients suffering from cancer based on the example of multiple myeloma

2017 ◽  
Vol 18 (1) ◽  
pp. 62-69 ◽  
Author(s):  
Magdalena Bury
Keyword(s):  
Multiple Myeloma ◽  
Cancer Treatment ◽  
Cognitive Functioning ◽  
Psychosocial Functioning ◽  
English Literature ◽  
Research Literature ◽  
Cognitive State ◽  
Anti Cancer ◽  
Negative Side Effects ◽  
The Impact

Abstract Introduction: The incidence rate of cancers emphasizes the necessity to investigate not only patients’ somatic ailments but also their psychosocial functioning as well as the need to raise the quality standards of cancer patients. The improvement of the quality of life is one of the major challenges of psycho-oncology, which is the science created in the interface of two disciplines: psychology and medicine. One of the important aspects of psycho-oncologists’ activity is the minimization of negative side-effects related to treatment, such as changes in patients’ cognitive functioning resulting from anti-cancer treatment. Objective: The aim of this work is to provide the reader with the knowledge concerning the phenomenon of chemobrain in a very special group of patients with hemato-oncologic tumour. Few researches related to this topic have confirmed the occurrence of cognitive deficits resulting from the cancer process, taken cytotoxic drugs, other forms of anti-cancer therapy and the activeness of biochemical compounds in patients with multiple myeloma. Methods: The author has done a literary review concerning the topic under study using the Google Scholar and EBSCO databases. The main part of this work consists of references to Polish and English research literature published after 2000. The review includes also classic works from the eighties and nineties of the 20th century. Results: The present work has been divided into several sections. The part devoted to explanation of the term chemobrain describes the evolution of its definition over the years. The second section - ‘Heterogeneity of the phenomenon - causes’ - underlines the influence of biochemical etiological factors, such as the impact of the activity of proinflammatory cytokines on the cognitive state of the patients suffering from tumour. Next part - ‘Chemobrain and multiple myeloma’ is devoted to the clinical characteristics of this cancer and to the descriptions of the selected methods of chemotherapy. The review of researches concerning the deteriorated cognitive functioning of patients with multiple myeloma in relation to the probable aetiology of this disease has been also presented. Conclusions: The review of Polish and English literature concerning the functioning of memory and attention processes in the patients suffering from multiple myeloma can serve as an inspiration for a search for objective biochemical factors conditioning the deterioration of cognitive processes of the patients undergoing anti-cancer treatment.

scholarly journals Delivering Systemic Anti-Cancer Treatment Via Another Route of Administration As an Option to Reduce Exposure to COVID-19 in Patients with Multiple Myeloma in the UK

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 12-13
Author(s):  
Holly Cranmer ◽  
Tanja Podkonjak ◽  
Eugene Benson ◽  
Jonathon Dabora ◽  
Graham H Jackson
Keyword(s):  
Multiple Myeloma ◽  
Cancer Treatment ◽  
Cost Savings ◽  
Route Of Administration ◽  
Treatment Pathway ◽  
Scenario Analyses ◽  
Anti Cancer ◽  
The Uk ◽  
The Impact ◽  
At Home

Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a strain of coronavirus that causes a respiratory illness known as COVID-19. COVID-19 is a pandemic affecting many countries globally.(1) As of 23rd July 2020, there have been 297,146 lab-confirmed cases of COVID-19 in the UK and 45,554 people who tested positive for the virus have died.(2) Patients with multiple myeloma (MM) are at a higher risk of contracting the virus and experiencing more severe outcomes.(3-6) The higher risk is driven by a compromised immune system, the use of immunosuppressive agents and patient characteristics aligning with key risk factors - patients with MM are often elderly and have multiple co-morbidities.(7) In light of the COVID-19 outbreak, NHS England and NICE have issued guidance to modify usual care to reduce patient exposure to COVID-19. For patients with cancer, NICE recommend delivering systemic anti-cancer treatment in different and less immunosuppressive regimens, different locations (ideally at home) or via another (less invasive and/or less resource intensive) route of administration where possible.(8)(9) The objective of this analysis is to explore the impact of switching patients from intravenous (IV) treatments requiring hospital administrations to subcutaneous (SC) or oral alternatives which can be administered at home or in an outpatient setting which reduces the patient's potential exposure to COVID-19. Methods: A decision tree model was developed in Microsoft Excel® (Figure 1). Patients enter the model and are assigned a probability of being treated; those that are treated are then assigned a probability of IV, SC or oral-based therapy. Based on the route of administration, patients are assigned a probability of contracting COVID-19 and, for those patients that do contract the virus, a probability of death from the virus is estimated. The model compares the outcomes from two identical decision trees: one informed by the pre-COVID-19 treatment pathway and one informed by the post-COVID-19 pathway. Model inputs, including COVID-19 inputs (e.g., number of active and diseased COVID-19 cases among patients with MM), have been informed by the literature and clinical opinion. Costs reflected in the model include: treatment of COVID-19, treatment for MM and administration of MM treatments. Scenario analyses explore lower and upper bounds for key inputs. Results are presented from a UK perspective and a 1-year time horizon (from model entry) is considered. Results: Per the model, treating patients with oral therapies is shown to reduce the number of COVID-19 cases and the number of COVID-19 deaths in patients with MM compared with IV- and SC-delivered therapies. These outcomes translate into cost savings driven by costs avoided in treating COVID-19. There was a limited difference in the costs of treating the underlying MM despite the switch. However, there were additional cost savings demonstrated through avoiding expensive and resource intensive administration appointments associated with IV therapies, and to a lesser extent SC therapies. The use of oral therapies has also aided the increase in telemedicine for routine appointments - scenarios exploring this demonstrate further savings. These results are driven by the perceived risk attached to each of the different routes of administration - scenario analyses demonstrated that assuming even the lower bound risk (an assumed additional risk of 10%) for IV therapies vs. oral therapies, a significant number of COVID-19 cases and deaths were avoided, and costs reduced. Conclusions: Changes to the treatment pathway for patients with MM in light of the COVID-19 pandemic aim to reduce the exposure to the virus for these patients. The model demonstrates that simply switching the route of administration can reduce the number of COVID-19 cases and deaths . This has important implications in avoiding severe outcomes, decreasing the spread of the virus and reducing the cost and resource use burden to the healthcare system. In addition, the model reflects potential efficiencies which may extend beyond the COVID-19 pandemic (e.g. telemedicine) to optimize clinical practice for patients with MM in the longer-term. Disclosures Cranmer: Takeda: Current Employment. Podkonjak:Takeda: Current Employment. Benson:Takeda: Current Employment. Dabora:Takeda: Current Employment. Jackson:Merck Sharp and Dohme: Honoraria; Chugai: Honoraria; Amgen: Honoraria; Janssen: Honoraria; Celgene: Honoraria; Takeda: Honoraria; Roche: Honoraria.

scholarly journals P9 A study to investigate the impact of the COVID-19 pandemic on paediatric cancer patients: an international, multicentre, observational cohort study (COVIDPaedsCancer)

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
◽  
Soham Bandyopadhyay
Keyword(s):  
Cohort Study ◽  
Cancer Treatment ◽  
Childhood Cancer ◽  
Multivariate Logistic Regression Analysis ◽  
Global Health Research ◽  
Cancer Outcomes ◽  
Paediatric Cancer ◽  
Cancer Management ◽  
Anti Cancer ◽  
The Impact

Abstract Introduction Childhood cancers are a leading cause of non-communicable disease deaths for paediatric patients around the world. The COVID-19 pandemic may have impacted on global children’s cancer services, which can have consequences for childhood cancer outcomes. The Global Health Research Group on Children’s Non-Communicable Diseases (Global Children’s NCDs) is currently undertaking the first international study to determine the variation in paediatric cancer management during the COVID-19 pandemic, and the short to medium term impacts on childhood cancer outcomes. Methods and analysis This is a multicentre, international, cohort study that will use routinely collected hospital data in a de-identified and anonymised form. Patients will be recruited consecutively into the study, with a 12 -month follow-up period. Patients will be included if they are below the age of 18 years and undergoing anti-cancer treatment for the following cancers: Acute lymphoblastic leukaemia, Burkitt’s Lymphoma, Hodgkin's lymphoma, Wilms Tumour, Sarcoma, Retinoblastoma, Gliomas, Medulloblastomas and Neuroblastomas. Patients must be newly presented or be undergoing active anti-cancer treatment from the 12th March 2020 to the 12th December 2020. The primary objective of the study is to determine 30- and 90-day all-cause mortality rates. This study will examine the factors that influenced these outcomes. Chi-squared analysis will be used to compare mortality between low and middle-income countries and high-income countries. Multilevel, multivariate logistic regression analysis will be undertaken to identify patient-level and hospital-level factors affecting outcomes with adjustment for confounding factors. Ethics and dissemination At the host centre, this study was deemed to be exempt from ethical committee approval due to the use of anonymised registry data. At other centres, participating collaborators have gained local approvals in accordance with their institutional ethical regulations. Collaborators will be encouraged to present the results locally, nationally, and internationally. The results will be submitted for publication in a peer reviewed journal.

scholarly journals Celecoxib Analogues for Cancer Treatment: An Update on OSU-03012 and 2,5-Dimethyl-Celecoxib

Biomolecules ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1049
Author(s):  
Cyril Sobolewski ◽  
Noémie Legrand
Keyword(s):  
Cancer Treatment ◽  
Metabolic Diseases ◽  
Catalytic Site ◽  
Antitumor Effects ◽  
Anti Cancer ◽  
Cox 2 ◽  
Cox 2 Inhibitors ◽  
The Impact ◽  
Important Enzyme ◽  
Specific Inhibitors

Cyclooxygenase-2 (COX-2) is an important enzyme involved in prostaglandins biosynthesis from arachidonic acid. COX-2 is frequently overexpressed in human cancers and plays a major tumor promoting function. Accordingly, many efforts have been devoted to efficiently target the catalytic site of this enzyme in cancer cells, by using COX-2 specific inhibitors such as celecoxib. However, despite their potent anti-tumor properties, the myriad of detrimental effects associated to the chronic inhibition of COX-2 in healthy tissues, has considerably limited their use in clinic. In addition, increasing evidence indicate that these anti-cancerous properties are not strictly dependent on the inhibition of the catalytic site. These findings have led to the development of non-active COX-2 inhibitors analogues aiming at preserving the antitumor effects of COX-2 inhibitors without their side effects. Among them, two celecoxib derivatives, 2,5-Dimethyl-Celecoxib and OSU-03012, have been developed and suggested for the treatment of viral (e.g., recently SARS-CoV-2), inflammatory, metabolic diseases and cancers. These molecules display stronger anti-tumor properties than celecoxib and thus may represent promising anti-cancer molecules. In this review, we discuss the impact of these two analogues on cancerous processes but also their potential for cancer treatment alone or in combination with existing approaches.

scholarly journals The impact of COVID 19 pandemic on pattern of cancer mortality in Najran, Saudi Arabia: a single-cancer center experience

2021 ◽  
Author(s):  
Ahmed M Badheeb ◽  
Mohamed A Badheeb ◽  
Hamdi A Alhakimi
Keyword(s):  
Hepatocellular Carcinoma ◽  
Saudi Arabia ◽  
Cancer Treatment ◽  
Cancer Patients ◽  
Cancer Mortality ◽  
Cancer Center ◽  
Anti Cancer ◽  
Before And After ◽  
The Difference ◽  
The Impact

Abstract Background: The aim of this paper is to compare the patterns and determinants of cancer mortality in Najran region before and after the COVID-19 epidemics. The association between cancer mortality and each of age, sex, site of cancer, stage, and the 30-days survival rate after the last dose of chemotherapy were assessed.Materials & Methods: Adult cancer patients who died of cancer in King Khalid Hospital in Najran Saudi Arabia, were included in this retrospective observational study. We compared mortality patterns in a period of 6 months in 2020 (March to August) with the corresponding period of 2019.Results: 50 dead adult cancer patients were included, 24 in 2019 and 26 in 2020. Among them, 21% vs 42% were younger than 65 years of age; 61% vs 62% were males, for the years 2019 & 2020 respectively. The top three killers in 2019 were colorectal, gastro-esophageal cancers, and hepatocellular carcinoma, while in 2020 were colorectal, hepatocellular carcinoma, and lymphomas. About 16.7% of patients died within 30 days of receiving anti-cancer treatment in 2019 in comparison with 7.7% in 2020. The difference in the 30-days mortality after receiving anti-cancer treatment was not statistically significant between 2019 and 2020 (p = 0.329).Conclusion: The Year 2020, the time of the COVID-19pandemic, was not associated with a significant increase in short-term mortality among patients with malignancy in Najran, Saudi Arabia. Our results generally reflect the crucial role of strict preventive national measures in saving lives and warrants further exploration.

scholarly journals Chemotherapy-Related Differences in Cognitive Functioning and Their Biological Predictors in Patients with Multiple Myeloma

2021 ◽  
Vol 11 (9) ◽  
pp. 1166
Author(s):  
Magdalena Bury-Kamińska ◽  
Aneta Szudy-Szczyrek ◽  
Aleksandra Nowaczyńska ◽  
Olga Jankowska-Łęcka ◽  
Marek Hus ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Cognitive Functioning ◽  
Cognitive Processes ◽  
Elisa Test ◽  
Cognitive State ◽  
Biological Factors ◽  
Main Research ◽  
Tnf Α ◽  
Treatment Stage ◽  
Research Questions

The paper presents a study on the changes in cognitive functioning in patients undergoing chemotherapy with diagnosed multiple myeloma (MM). The aim of the study was to answer the following two main research questions: Does the treatment stage differentiate the functioning of cognitive processes in patients with diagnosed MM and to what extent? Is it possible to treat biological factors (TNF-α, IL-6, IL-10, and BDNF) as predictors of patients’ cognitive functioning? The patients were examined twice, before the treatment and after 4–6 cycles of chemotherapy. Selected neuropsychological research methods as well as experimental and clinical trials were employed to diagnose the patients’ general cognitive state, attention, memory, and executive functions. The level of biological factors was assessed with the ELISA test. The results show that the patients’ cognitive functioning was worse before the treatment than during the cytostatic therapy. It was also possible to predict the cognitive state of patients suffering from multiple myeloma based on a selected biological parameter (neurotrophin BDNF).

scholarly journals Cognitive Functioning in Patients with Pediatric-Onset Multiple Sclerosis, an Updated Review and Future Focus

Children ◽  
2019 ◽  
Vol 6 (2) ◽  
pp. 21 ◽  
Author(s):  
Joy B. Parrish ◽  
Emily Fields
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Functioning ◽  
Psychosocial Functioning ◽  
Functional Outcomes ◽  
Daily Living ◽  
Demyelinating Diseases ◽  
Future Studies ◽  
Preventative Measures ◽  
The Impact ◽  
Pediatric Onset

Pediatric-onset multiple sclerosis (POMS) is relatively rare, but as technology and neuroimaging advance, an increasing number of cases are identified, and our understanding of how multiple sclerosis (MS) impacts the developing brain improves. There are consistent findings in the literature highlighting the impact of MS and other demyelinating diseases on cognitive functioning and cognitive development. We also have a better understanding of how POMS impacts psychosocial functioning and functional outcomes in daily living. This paper hopes to review findings associated with cognitive and psychosocial functioning in patients with POMS, as well as explore more recent advances in the field and how they relate to cognitive and psychosocial outcomes. We also discuss the ongoing need for future studies with a focus on better understanding deficits and disease correlates, but also preventative measures and potential rehabilitation.

scholarly journals 1608P The impact of COVID-19 on the delivery of systemic anti-cancer treatment at Guy’s Cancer Centre

2021 ◽  
Vol 32 ◽  
pp. S1149
Author(s):  
S. Dolly ◽  
B. Russell ◽  
C.L. Moss ◽  
E. Tsotra ◽  
C. Gousis ◽  
...  
Keyword(s):  
Cancer Treatment ◽  
Cancer Centre ◽  
Anti Cancer ◽  
The Impact

scholarly journals Clinical Outcomes of COVID-19 in Hematological Malignancies in Jordan : Tertiary Cancer Center Experience

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 5039-5039
Author(s):  
Hazim Ababneh ◽  
Fadwa Alqadi ◽  
Mohammad ma'Akoseh ◽  
Khalid Halahleh ◽  
Layan abo Abed ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Clinical Outcomes ◽  
Hematological Malignancies ◽  
Polymerase Chain Reaction Test ◽  
High Morbidity ◽  
Icu Admission ◽  
Increased Risk ◽  
Anti Cancer ◽  
The Impact

Abstract Introduction: The COVID-19 infection has a devastating clinical outcome among individuals with immunocompromised states, particularly those with malignancies. The impact of the coronavirus pandemic on patients with hematological malignancies in low and middle-income countries is not well studied. Herein, we sought to report the clinical outcomes of the COVID-19 infection in patients with hematological malignancies treated at a single institution. Methods: Electronic medical record charts of patients diagnosed with hematological malignancies (leukemia, lymphoma, and multiple myeloma) were reviewed. Patients who were diagnosed with laboratory-confirmed SARS-CoV-2 infection by Real-Time Polymerase Chain Reaction test between April 2020 and October 2020 were identified as the subjects of this study. The demographic data, including tumor characteristics, laboratory results, anti-cancer treatments, patient outcomes (need for hospitalization, ICU admission, complications, and mortality), were extracted and analyzed. Results: We identified 89 patients diagnosed with hematological malignancies who were infected with COVID-19 during the eligibility period. The median age at the time of diagnosis was 54 years (range, 19-80 years). Fifty-two patients (58%) were male, and 37 patients (42%) were female. Of the 89 cases, 41 patients (46%) were diagnosed with lymphoma, 27 patients (30%) had leukemia, 21 patients (24%) had multiple myeloma. 84 patients (94%) received prior anti-cancer treatment, such as: chemotherapy (n=47, 53%), immunotherapy (n= 4, 4%), chemoimmunotherapy (n=26, 29%), and tyrosine kinase inhibitors (n=3, 3%). At the time of COVID-19 diagnosis, 52 patients (58%) had active malignancy, while 37 patients (42%) were in remission. Fifty-nine patients (66%) had comorbidities, with hypertension (n=32, 36%) being the most commonly reported comorbidity, followed by diabetes mellitus (n=25, 28%) and ischemic heart disease (n=8, 9%). The most encountered presentations were: fever (n=32, 36%) followed by cough (n=31, 35%), shortness of breath (n=21, 23%), aches (n=6, 7%), fatigue (n=6, 7%), and ageusia (n=6, 7%). Forty subjects (45%) were hospitalized, 11 patients (12%) were eventually admitted to the intensive care unit (ICU). Notably, the hospitalization and ICU admission rates were higher among the people aged more than 53 years (n= 24, 59%; n=9, 82%, respectively). Among the 89 patients, complications were recognized in 36% of the patients (n=32), with sepsis (n=12, 13%), acute kidney injury (n=11, 12%), and cardiovascular complications (n=3, 3%) being the most prevalent complications. The median time interval between the date of COVID-19 diagnosis and the last follow-up date was 3 months (range, 2 days-6.4 months). At the time of the last follow-up, 64 patients (72%) remained alive, and 25 patients (28%) succumbed to COVID-related complications. Conclusion: The COVID-19 infection has deteriorated clinical outcomes among patients with hematological malignancies, which could be attributed to the high incidence of infections, increased risk of hospitalizations/ICU admissions, and other COVID-related complications. Such high morbidity and mortality rates necessitate future studies to outline the potential risk factors for COVID-related complications and modifications in the plan of care, including evaluation of the effect of vaccination on the outcome of these patients. Disclosures No relevant conflicts of interest to declare.

scholarly journals The Impact of COVID-19 on the Delivery of Systemic Anti-Cancer Treatment at Guy’s Cancer Centre

Cancers ◽  
2022 ◽  
Vol 14 (2) ◽  
pp. 266
Author(s):  
Beth Russell ◽  
Charlotte Moss ◽  
Eirini Tsotra ◽  
Charalampos Gousis ◽  
Debra Josephs ◽  
...  
Keyword(s):  
Cancer Treatment ◽  
Clinical Decision Making ◽  
Stage Iv ◽  
Clinical Decision ◽  
Study Data ◽  
Real World Data ◽  
Cancer Centre ◽  
Treatment Type ◽  
Anti Cancer ◽  
The Impact

Background: This study aimed to assess the outcome of cancer patients undergoing systemic anti-cancer treatment (SACT) at our centre to help inform future clinical decision-making around SACT during the COVID-19 pandemic. Methods: Patients receiving at least one episode of SACT for solid tumours at Guy’s Cancer Centre between 1 March and 31 May 2020 and the same period in 2019 were included in the study. Data were collected on demographics, tumour type/stage, treatment type (chemotherapy, immunotherapy, biological-targeted) and SARS-CoV2 infection. Results: A total of 2120 patients received SACT in 2020, compared to 2449 in 2019 (13% decrease). From 2019 to 2020, there was an increase in stage IV disease (62% vs. 72%), decrease in chemotherapy (42% vs. 34%), increase in immunotherapy (6% vs. 10%), but similar rates of biologically targeted treatments (37% vs. 38%). There was a significant increase in 1st and 2nd line treatments in 2020 (68% vs. 81%; p < 0.0001) and reduction in 3rd and subsequent lines (26% vs. 15%; p = 0.004) compared to 2019. Of the 2020 cohort, 2% patients developed SARS-CoV2 infections. Conclusions: These real-world data from a tertiary Cancer Centre suggest that despite the challenges faced due to the COVID-19 pandemic, SACT was able to be continued without any significant effects on the mortality of solid-tumour patients. There was a low rate (2%) of SARS-CoV-2 infection which is comparable to the 1.4%-point prevalence in our total cancer population.

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