Burkitt lymphoma in the modern era: real-world outcomes and prognostication across 30 US cancer centers.

We examined adults with untreated Burkitt lymphoma (BL) from 2009 to 2018 across 30 US cancer centers. Factors associated with progression-free survival (PFS) and overall survival (OS) were evaluated in univariate and multivariate Cox models. Among 641 BL patients, baseline features included the following: median age, 47 years; HIV+, 22%; Eastern Cooperative Oncology Group (ECOG) performance status (PS) 2 to 4, 23%; >1 extranodal site, 43%; advanced stage, 78%; and central nervous system (CNS) involvement, 19%. Treatment-related mortality was 10%, with most common causes being sepsis, gastrointestinal bleed/perforation, and respiratory failure. With 45-month median follow-up, 3-year PFS and OS rates were 64% and 70%, respectively, without differences by HIV status. Survival was better for patients who received rituximab vs not (3-year PFS, 67% vs 38%; OS, 72% vs 44%; P < .001) and without difference based on setting of administration (ie, inpatient vs outpatient). Outcomes were also improved at an academic vs community cancer center (3-year PFS, 67% vs 46%, P = .006; OS, 72% vs 53%, P = .01). In multivariate models, age ≥ 40 years (PFS, hazard ratio [HR] = 1.70, P = .001; OS, HR = 2.09, P < .001), ECOG PS 2 to 4 (PFS, HR = 1.60, P < .001; OS, HR = 1.74, P = .003), lactate dehydrogenase > 3× normal (PFS, HR = 1.83, P < .001; OS, HR = 1.63, P = .009), and CNS involvement (PFS, HR = 1.52, P = .017; OS, HR = 1.67, P = .014) predicted inferior survival. Furthermore, survival varied based on number of factors present (0, 1, 2 to 4 factors) yielding 3-year PFS rates of 91%, 73%, and 50%, respectively; and 3-year OS rates of 95%, 77%, and 56%, respectively. Collectively, outcomes for adult BL in this real-world analysis appeared more modest compared with results of clinical trials and smaller series. In addition, clinical prognostic factors at diagnosis identified patients with divergent survival rates.

An informational reference on anthrax for first responders.

Anthrax was widely discussed in the media several years ago during the American Anthrax attacks. Despite a less-ened interest in the subject today, anthrax still poses a threat to the United States government and its people. This article looks at publically available data and resources in an effort to combine current information into one easy to ready docu-ment. It can be used as an informational reference for first responders when learning about the anthrax threat.

An informational reference on anthrax for first responders.

Anthrax was widely discussed in the media several years ago during the American Anthrax attacks. Despite a lessened interest in the subject today, anthrax still poses a threat to the United States government and its people. This article looks at publically available data and resources in an effort to combine current information into one easy to ready document. It can be used as an informational reference for first responders when learning about the anthrax threat.

School-Based Bullying and Teen Dating Violence Prevention Laws: Overlapping or Distinct?

The most recent legislative attempts to curb violence in schools have been school-based dating violence prevention laws. In the previous decade, there was an increase in legislation designed to prevent bullying in schools; these laws now exist in 50 states. However, most anti-bullying laws provide an expansive definition of bullying that includes any type of peer aggression, harassment, or teen dating violence (TDV). Having several different state and federal laws aimed at curtailing multiple forms of aggression may produce confusion about appropriate intervention and disciplinary responses, requiring school districts to develop parallel sets of policies, educational curricula, intervention approaches, and reporting requirements for overlapping behaviors that can be simultaneously peer aggression, bullying, harassment, and TDV. We conducted a systematic search of applicable laws and systematically coded those we identified for relevant content (i.e., definitions, covered locales, protected groups, and personnel, procedural, preventive, and disclosure elements). Anti-bullying laws were typically more detailed than dating violence laws. TDV laws were more likely to target TDV and control intimate behavior and to provide for education about healthy relationships. Both types of laws often mandated trainings; specified reportable behaviors; discussed sanctions, recommendations, and interventions; and mentioned counseling, specially trained staff persons, or designated specialists. Both anti-bullying and TDV laws also sometimes directed reporting of aggregate incident rates and impacts of prevention efforts. Neither type of law tended to specify school and community resources or prevention approaches. Results inform discussion of the merits of different approaches to school-based violence prevention laws.