scholarly journals COVID-19-Vaccination Prioritization in Patients with Cancer

2021 ◽  
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
B Cell ◽  
Cancer Patients ◽  
Hematological Malignancies ◽  
Performance Status ◽  
Poor Performance ◽  
Poor Performance Status ◽  
Patients With Cancer ◽  
Cell Responses

In patients with cancer, SARS-CoV-2 (COVID-19) can contribute to increasing morbidity and mortality and decreased survival was found in patients with hematological and intrathoracic malignancies, poor performance status, comorbidities, and increased age. Patients with hematological malignancies who were treated with stem cell transplantation and anti-CD-20 antibody demonstrated lower rates of seroconversion, compared to COVID-19-infected-cancer patients. Patients with hematological malignancies might have substantially compromised B-cell and T-cell responses.

scholarly journals Prioritization of Covid-19 Vaccination in Patients with Cancer

2021 ◽  
Vol 6 (3) ◽  
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
B Cell ◽  
Cancer Patients ◽  
Hematological Malignancies ◽  
Performance Status ◽  
Poor Performance ◽  
Poor Performance Status ◽  
Patients With Cancer ◽  
Cell Responses

In patients with cancer, SARS-CoV-2 (COVID-19) can contribute to increasing morbidity and mortality and decreased survival was found in patients with hematological and intrathoracic malignancies, poor performance status, comorbidities, and increased age. Patients with hematological malignancies who were treated with stem cell transplantation and anti-CD-20 antibody demonstrated lower rates of seroconversion, compared to COVID-19-infected-cancer patients. Patients with hematological malignancies might have substantially compromised B-cell and T-cell responses.

scholarly journals COVID-19 and cancer registries: learning from the first peak of the SARS-CoV-2 pandemic

2021 ◽  
Author(s):  
Alvin J. X. Lee ◽  
Karin Purshouse
Keyword(s):  
Risk Factors ◽  
Performance Status ◽  
Poor Performance ◽  
Cancer Registries ◽  
Adverse Outcomes ◽  
Smoking History ◽  
Poor Performance Status ◽  
International Studies ◽  
Patients With Cancer ◽  
Increased Risk

AbstractThe SARS-Cov-2 pandemic in 2020 has caused oncology teams around the world to adapt their practice in the aim of protecting patients. Early evidence from China indicated that patients with cancer, and particularly those who had recently received chemotherapy or surgery, were at increased risk of adverse outcomes following SARS-Cov-2 infection. Many registries of cancer patients infected with SARS-Cov-2 emerged during the first wave. We collate the evidence from these national and international studies and focus on the risk factors for patients with solid cancers and the contribution of systemic anti-cancer treatments (SACT—chemotherapy, immunotherapy, targeted and hormone therapy) to outcomes following SARS-Cov-2 infection. Patients with cancer infected with SARS-Cov-2 have a higher probability of death compared with patients without cancer. Common risk factors for mortality following COVID-19 include age, male sex, smoking history, number of comorbidities and poor performance status. Oncological features that may predict for worse outcomes include tumour stage, disease trajectory and lung cancer. Most studies did not identify an association between SACT and adverse outcomes. Recent data suggest that the timing of receipt of SACT may be associated with risk of mortality. Ongoing recruitment to these registries will enable us to provide evidence-based care.

scholarly journals Poor Prognosis of Diffuse Large B-Cell Lymphoma with Hepatitis C Infection

2021 ◽  
Vol 11 (9) ◽  
pp. 844
Author(s):  
Yu-Fen Tsai ◽  
Yi-Chang Liu ◽  
Ching-I Yang ◽  
Tzer-Ming Chuang ◽  
Ya-Lun Ke ◽  
...  
Keyword(s):  
Hepatitis C ◽  
B Cell ◽  
Cell Lymphoma ◽  
Performance Status ◽  
Poor Performance ◽  
B Cell Lymphoma ◽  
Liver Involvement ◽  
Poor Performance Status ◽  
Large B Cell Lymphoma ◽  
Large B Cell

Background: Hepatitis C virus (HCV) in diffuse large B-cell lymphoma (DLBCL) is associated with a higher prevalence and distinctive clinical characteristics and outcomes. Methods: A retrospective analysis of adult DLBCL patients from 2011 to 2015 was studied. Results: A total of 206 adult DLBCL were enrolled with 22 (10.7%) HCV-positive patients. Compared to HCV-negative patients, the HCV-positive group had a poor performance status (p = 0.011), lower platelet count (p = 0.029), and higher spleen and liver involvement incidences (liver involvement, p = 0.027, spleen involvement, p = 0.026), and they received fewer cycles of chemotherapy significantly due to morbidity and mortality (p = 0.048). Overall survival was shorter in HCV-positive DLBCL (25.3 months in HCV-positive vs. not reached (NR), p = 0.049). With multivariate analysis, poor performance status (p < 0.001), advanced stage (p < 0.001), less chemotherapy cycles (p < 0.001), and the presence of liver toxicity (p = 0.001) contributed to poor OS in DLBCL. Among HCV-positive DLBCL, the severity of liver fibrosis was the main risk factor related to death. Conclusion: Inferior survival of HCV-positive DLBCL was observed and associated with poor performance status, higher numbers of complications, and intolerance of treatment, leading to fewer therapy. Therefore, anti-HCV therapy, such as direct-acting antiviral agents, might benefit these patients in the future.

scholarly journals Precision Medicine Tumor Boards: Clinical Applicability of Personalized Treatment Concepts in Ovarian Cancer

Cancers ◽  
2020 ◽  
Vol 12 (3) ◽  
pp. 548 ◽  
Author(s):  
Stefanie Aust ◽  
Richard Schwameis ◽  
Tamara Gagic ◽  
Leonhard Müllauer ◽  
Eva Langthaler ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Precision Medicine ◽  
Cancer Patients ◽  
Median Time ◽  
Performance Status ◽  
Poor Performance ◽  
Pi3k Pathway ◽  
Poor Performance Status ◽  
Clinical Applicability ◽  
Tumor Boards

Background: Treating cancer according to its molecular alterations (i.e., targeted treatment, TT) is the goal of precision medicine tumor boards (PTBs). Their clinical applicability has been evaluated for ovarian cancer patients in this analysis. Methods: All consecutive ovarian cancer patients discussed in a PTB at the Medical University of Vienna, Austria, from April 2015 to April 2019 were included (n = 44). Results: In 38/44 (86%) cases, at least one mutation, deletion or amplification was detected. The most frequently altered genes were p53 (64%), PI3K pathway (18%), KRAS (14%), BRCA1 (11%) and BRCA2 (2%). In 31 patients (70%) a TT was recommended. A total of 12/31 patients (39%) received the recommended therapy. Median time from indication for PTB to TT start was 65 days (15–216). Median time to treatment failure was 2.7 months (0.2–13.2). Clinical benefit rate (CBR) was 42%. Reasons for treatment discontinuation were disease progression (42%), poor performance status (PS > 2; 25%), death (17%) or treatment related side effects (8%). In 61% the TT was not administered—mainly due to PS > 2. Conclusion: Even though a TT recommendation can be derived frequently, clinical applicability remains limited due to poor patients’ general condition after exploitation of standard treatment. However, we observed antitumor activity in a substantial number of heavily pretreated patients.

Initiation of Chemotherapy in Cancer Patients with Poor Performance Status: A Population-Based Analysis

2014 ◽  
Vol 30 (3) ◽  
pp. 166-172 ◽  
Author(s):  
Joan Porter ◽  
Craig Earle ◽  
Clare Atzema ◽  
Ying Liu ◽  
Doris Howell ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Performance Status ◽  
Poor Performance ◽  
Population Based ◽  
Poor Performance Status

Autologous Stem Cell Transplantation (ASCT) for Elderly Patients (≥ 60 Years) with Non-Hodgkin’s Lymphoma (NHL): An Analysis Based on EBMT Registry.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 1888-1888
Author(s):  
Esa Jantunen ◽  
Carmen Canals ◽  
Didier Blaise ◽  
Alessandro Rambaldi ◽  
Herve Tilly ◽  
...  
Keyword(s):  
Stem Cell ◽  
Elderly Patients ◽  
Performance Status ◽  
Poor Performance ◽  
B Cell Lymphoma ◽  
Poor Performance Status ◽  
Significant Prognostic Factor ◽  
Bulky Disease ◽  
Stem Cell Source ◽  
Mantle Cell

Abstract Limited data is available on feasibility and efficacy of ASCT in elderly patients with NHL. Patients: In 2000–2005 15869 NHL patients with ASCT were reported to EBMT database, 3133 (20%) were ≥ 60 years. Only patients with MED-B dataset and those with either diffuse large B-cell lymphoma (DLBCL), mantle cell (MCL) or follicular lymphoma (FL) were subjected to more detailed analysis. This group included 906 elderly NHL patients (median age 63 years, range 60–75) (DLBCL, n = 463; MCL, n = 208; FL, n = 235) who were compared with 3661 patients &lt; 60 years (DLBCL, n = 2149; MCL, n = 435; FL, n = 1077) regarding outcome. Bulky disease was more common in younger patients (26% vs. 15%, p &lt; 0.001) as well as B-symptoms at diagnosis (42% vs. 36%, p = 0.02). Elderly patients had received more often at least two treatment lines before ASCT (70% vs. 59%, p&lt;0.001). The median follow-up for the surviving patients was 14 months. Results: Non-relapse mortality (NRM) was higher in patients ≥ 60 years of age: 3.8% vs.2.3% at 100 days, 6.9% vs. 3.9% at 1 year and 9.4% vs. 5.8% at 3 years (p&lt;0.001). No differences in NRM were observed between patients aged 60–64 years (n = 633) and those aged 65–69 (n = 240). A higher NRM was observed in DLBCL and MCL patients compared to FL patients (p=0.001and p=0.002, respectively). Other variables associated with a higher NRM were an elevated LDH at diagnosis (p=0.04), ≥ 2 treatment lines before ASCT (p&lt;0.001); a poor performance status at ASCT (p&lt;0.001); not being in CR1 at ASCT (chemosensitive disease vs. CR1, p=0.02; chemorefractory disease vs. CR1, p&lt;0.001) and BM as stem cell source (p=0.02). In multivariate analysis, elderly patients showed a higher NRM [RR = 1.6 (CI 1.2–2.1), p=0.001]. In patients with DLBCL, age ≥ 60 years at ASCT was associated with a trend to a higher risk of relapse or progression (p =0.07) and a worse PFS (p=0.008). PFS at 2 years was 69% vs. 79% for patients in CR1 and 52% vs. 60% for patients with sensitive disease at ASCT, respectively. In MCL, elderly patients had worse PFS (p=0.008). PFS at 2 years was 78 vs. 81% for MCL patients in CR1 and 52% vs. 67%, respectively for those patients autografted with sensitive disease. Older age was not a significant prognostic factor either for relapse rate or for PFS in patients with FL. PFS at 2 years was 69% and 81% for FL patients in CR1, and 69% and 69% for FL patients with sensitive disease, respectively. Conclusions: ASCT is feasible in selected NHL patients aged 60–69 years. The outcome is promising taking into account the generally poorer prognosis of lymphomas in elderly population.

What can we do for gastrointestinal cancer patients with poor performance status (PS)?

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 19629-19629
Author(s):  
K. Shitara ◽  
M. Munakata ◽  
O. Muto ◽  
M. Kasai ◽  
Y. Sakata
Keyword(s):  
Cancer Patients ◽  
Tumor Markers ◽  
Gastrointestinal Cancer ◽  
Survival Benefit ◽  
Performance Status ◽  
Poor Performance ◽  
Poor Performance Status ◽  
Ecog Ps ◽  
To Receive ◽  
Measurable Lesion

19629 Background: The prognosis of advanced gastrointestinal cancer patients, especially those with poor PS, is generally dismal. Needless to say, such patients are ineligible for participation in clinical studies. However, there are many patients with poor PS who wish to receive chemotherapy. Methods: From June 2000 to October 2006, a total of 508 patients with advanced cancer, including 304 gastrointestinal cancer patients, were treated by chemotherapy in our hospital. Of these, 110 gastrointestinal cancer patients (gastric=35, colorectal=30, pancreatic=26, biliary tract=11, esophageal=8) had poor PS (ECOG PS 3 = 68 patients, PS 4 = 42 patients). In 103 patients with at least one measurable lesion, a partial response according to RECIST criteria was obtained in 13 patients (12.6%). In 60 patients with ascites (47 patients), pleural effusion (25 patients), or both (12 patients), 11 of the patients (18.3%) achieved decreased fluid accumulation. A decline in tumor markers (>25%) was observed in 28 patients. Improvement in PS was seen in 13 patients (11.8%). As a result, 35 patients (31.8 %, including 9 patients with PS 4) achieved a tumor response, a decrease in accumulated fluid, or a decline in tumor markers, which resulted in a survival benefit compared to the other 75 patients without effect (6.4 months vs. 2.3 months, p<0.001). Alleviation of some symptoms was observed in 28 out of 98 symptomatic patients (30.4%). A better response and/or a decline in tumor markers significantly correlated with alleviation of symptoms (p<0.001). No treatment related death was seen. Conclusions: With regard to response rate, chemotherapy was rarely effective for patients with advanced gastrointestinal cancer with poor PS. However, more than a few patients gained a certain survival benefit and alleviation of symptoms. Thus, chemotherapy may be warranted in cases of patients with advanced gastrointestinal cancer who wish to receive chemotherapy despite the low possibility of response. No significant financial relationships to disclose.

Risk factors for poor performance status in cancer patients: A multivariate analysis in 3,585 patients

2008 ◽  
Vol 26 (15_suppl) ◽  
pp. 9628-9628 ◽  
Author(s):  
R. Nair ◽  
M. Shirodkar ◽  
M. Mallath ◽  
A. D’Cruz ◽  
P. Shukla ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Cancer Patients ◽  
Performance Status ◽  
Poor Performance ◽  
Poor Performance Status
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