Exploring older people's experiences of the interpersonal care relationship between nurses and patients during hospitalization in the pandemic period: A qualitative study.

AIM: This article presents the findings of a qualitative study focusing on the experiences of people aged over 70 years in the interpersonal nurse-patient care relationship in hospital settings during and after the COVID-19 pandemic. The aim was to analyse different aspects of this relationship, including nurses' behaviour and caring attitudes, the person-centred model of care, patients' involvement in their own care and communication in the hospital context. DESIGN: An exploratory qualitative study was conducted on the basis of an interpretative framework. METHODS: Six focus groups were conducted. A total of 34 participants were purposively recruited from three nursing homes in Spain, Italy and Portugal. Specific inclusion criteria were used to select participants. RESULTS: Five main categories were identified. Analysis revealed the importance of empathy and sensitivity in caring relationships, as well as the need for personalized and patient-centred care. The importance of effective communication and recognition of ageist behaviour by professionals was highlighted. In addition, independent of the pandemic, situational factors in the hospital environment were identified that influence the interpersonal care relationship. CONCLUSIONS: The study highlights the need to promote a person-centred model of care that takes into account the specific preferences and needs of older people. This is achieved by identifying elements of the interpersonal nurse-patient relationship. In addition to highlighting the disparity of opinion regarding an active or passive role in self-care and decision making, the importance of addressing ageism and improving communication is emphasized. WHAT PROBLEM DID THE STUDY ADDRESS?: The importance of the patient-nurse relationship in hospital care has been highlighted in previous studies. Critical elements of the patient care experience have been identified as empathy and effective communication. Ageism in healthcare has been recognized as a potential barrier to patient-centred care. WHAT WERE THE KEY FINDINGS?: The main findings highlight the importance of empathy and personalized care, emphasize the importance of effective communication and address ageist behaviours in the nurse-patient relationship. WHERE AND WHO WILL THE RESEARCH IMPACT?: By highlighting the need for person-centred care and improved communication strategies, particularly in the context of caring for older patients during and after the COVID-19 pandemic, this research will have an impact on healthcare professionals, policy makers and carers. REPORTING METHOD: The COREQ guideline was used. PATIENT OR PUBLIC CONTRIBUTION: This study adopted a collaborative approach to ensure that patient perspectives were integrated into the research process. We organized regular focus groups. Patients were actively involved in shaping the research questions, refining the study design and interpreting the emerging findings. Their valuable input helped us to understand the nuances of their experience and to prioritize the aspects that were critical to their well-being. In addition, their insights guided the development of practical recommendations aimed at improving the interpersonal care relationship between nurses and patients in hospital settings, ensuring that their voices were heard and reflected in the proposed interventions. This patient-centred approach fostered a sense of empowerment among the participants. It reinforced the notion that their experiences and opinions are integral to shaping healthcare practice.

Numerical Study of the Plastic Zone at the Crack Front in Cylindrical Aluminum Specimens Subjected to Tensile Loads.

Cylindrical specimens are of great interest in analyzing mechanical elements' behavior and investigating phenomena with biaxial loads. It is necessary to identify the behavior of the crack front along the thickness to interpret these results, which are usually based on the hypothesis of a straight crack and the observation of the outer face of the crack front. Based on the work carried out on compact tension type specimens, this work proposes adapting this methodology to cylindrical specimens, adapting the previous finite element models. Cylindrical specimens provide an asymmetric behavior influenced by the radius, where the CT (compact tensile) specimen can be considered the extreme infinite radius case. Combinations of the load level and radius values help us simulate the crack's behavior under intermediate hypotheses between a plane crack theory and a three-dimensional one. The plastic strain around the crack front will be analyzed as a function of the thickness and the load level applied. The results allow us to validate the numerical methodology and establish the differentiated behaviors of the plastic zones close to the outer and inner radii.

Corrigendum: Personalized monitoring of circulating tumor DNA with a specific signature of trackable mutations after chimeric antigen receptor T-cell therapy in follicular lymphoma patients.

[This corrects the article DOI: 10.3389/fimmu.2023.1188818.].

Personalized monitoring of circulating tumor DNA with a specific signature of trackable mutations after chimeric antigen receptor T-cell therapy in follicular lymphoma patients.

Background: CART therapy has produced a paradigm shift in the treatment of relapsing FL patients. Strategies to optimize disease surveillance after these therapies are increasingly necessary. This study explores the potential value of ctDNA monitoring with an innovative signature of personalized trackable mutations. Method: Eleven FL patients treated with anti-CD19 CAR T-cell therapy were included. One did not respond and was excluded. Genomic profiling was performed before starting lymphodepleting chemotherapy to identify somatic mutations suitable for LiqBio-MRD monitoring. The dynamics of the baseline mutations (4.5 per patient) were further analyzed on 59 cfDNA follow-up samples. PET/CT examinations were performed on days +90, +180, +365, and every six months until disease progression or death. Results: After a median follow-up of 36 months, all patients achieved a CR as the best response. Two patients progressed. The most frequently mutated genes were CREBBP, KMT2D and EP300. Simultaneous analysis of ctDNA and PET/CT was available for 18 time-points. When PET/CT was positive, two out of four ctDNA samples were LiqBio-MRD negative. These two negative samples corresponded to women with a unique mesenteric mass in two evaluations and never relapsed. Meanwhile, 14 PET/CT negative images were mutation-free based on our LiqBio-MRD analysis (100%). None of the patients had a negative LiqBio-MRD test by day +7. Interestingly, all durably responding patients had undetectable ctDNA at or around three months after infusion. Two patients presented discordant results by PET/CT and ctDNA levels. No progression was confirmed in these cases. All the progressing patients were LiqBio-MRD positive before progression. Conclusion: This is a proof-of-principle for using ctDNA to monitor response to CAR T-cell therapy in FL. Our results confirm that a non-invasive liquid biopsy MRD analysis may correlate with response and could be used to monitor response. Harmonized definitions of ctDNA molecular response and pinpointing the optimal timing for assessing ctDNA responses are necessary for this setting. If using ctDNA analysis, we suggest restricting follow-up PET/CT in CR patients to a clinical suspicion of relapse, to avoid false-positive results.

Haploidentical vs. HLA-matched donor hematopoietic stem-cell transplantation for pediatric patients with acute lymphoblastic leukemia in second remission: A collaborative retrospective study of the Spanish Group for Bone Marrow Transplantation in Children (GETMON/GETH) and the Spanish Childhood Relapsed ALL Board (ReALLNet).

Introduction: Studies addressing the role of haploidentical as alternative to HLA-matched donors for stem cell transplantation (SCT) often include patients with diverse hematological malignancies in different remission statuses. Methods: We compared outcomes of children with acute lymphoblastic leukemia (ALL) undergoing SCT in second complete remission (CR2) from haploidentical (n = 25) versus HLA-matched donor (n = 51). Results: Patients were equally distributed across both groups according to age, immunophenotype, time to and site of relapse, relapse risk-group allocation, and minimal residual disease (MRD) before SCT. Incidence of graft failure, acute graft versus host disease (GVHD), and other early complications did not differ between both groups. We found no differences in overall survival (58.7% versus 59.5%; p = .8), leukemia free survival (LFS) (48% versus 36.4%; p = .5), event free survival (40% versus 34.4%; p = .69), cumulative incidence (CI) of subsequent relapse (28% versus 40.9%; p = .69), treatment related mortality (24% versus 23.6%; p = .83), CI of cGVHD (4.5% versus 18.7%; p = .2), and chronic GVHD-free and leukemia-free survival (44% versus 26.3%; p = .3) after haploidentical donor SCT. Chronic GVHD (HR = 0.09; p=.02) had protective impact, and MRD ≥ 0.01% before SCT (HR = 2.59; p=.01) had unfavorable impact on LFS. Discussion: These results support the role of haploidentical donor SCT in children with ALL in CR2.

Real-life disease monitoring in follicular lymphoma patients using liquid biopsy ultra-deep sequencing and PET/CT.

In the present study, we screened 84 Follicular Lymphoma patients for somatic mutations suitable as liquid biopsy MRD biomarkers using a targeted next-generation sequencing (NGS) panel. We found trackable mutations in 95% of the lymph node samples and 80% of the liquid biopsy baseline samples. Then, we used an ultra-deep sequencing approach with 2 · 10-4 sensitivity (LiqBio-MRD) to track those mutations on 151 follow-up liquid biopsy samples from 54 treated patients. Positive LiqBio-MRD at first-line therapy correlated with a higher risk of progression both at the interim evaluation (HRINT 11.0, 95% CI 2.10-57.7, p = 0.005) and at the end of treatment (HREOT, HR 19.1, 95% CI 4.10-89.4, p < 0.001). Similar results were observed by PET/CT Deauville score, with a median PFS of 19 months vs. NR (p < 0.001) at the interim and 13 months vs. NR (p < 0.001) at EOT. LiqBio-MRD and PET/CT combined identified the patients that progressed in less than two years with 88% sensitivity and 100% specificity. Our results demonstrate that LiqBio-MRD is a robust and non-invasive approach, complementary to metabolic imaging, for identifying FL patients at high risk of failure during the treatment and should be considered in future response-adapted clinical trials.

Psychological impact during COVID-19 lockdown in children and adolescents with previous mental health disorders.

OBJECTIVE: During the COVID-19 pandemic, authorities confined adults, adolescents and children to their homes. Recent articles warn of possible long-term consequences on mental health, especially for those who suffer from underlying psychiatric conditions and for vulnerable sections of the population. The present study explores the psychological impact of the COVID-19 quarantine on outpatients at the Centre of Child and Adolescent Mental Health (CAMHS), which is based in Barcelona. METHODS: A total of 441 caregivers answered an online ad-hoc survey on their sociodemographic and economic situation, perceived stress, and clinical changes and coping strategies observed in their children during lockdown. The Chi-square test was used to compare the response percentages for each behaviour or symptom between age, gender and diagnostic groups. Variance and post-hoc test were also analyzed, as was the Pearson correlation. RESULTS: The use of electronic devices has significantly increased. There has also been an increase in symptoms such as attentional problems, fatigue and irritability, among others. Differences were found between age and gender groups. The diagnostic groups most affected by confinement were Autism Spectrum Disorders and Conduct Disorders. The survey also discovered a relationship between the loss of family income, parental stress and increased symptoms in children. CONCLUSION: Confinement has increased externalizing symptoms and behaviours as well as COVID-19 related concerns, somatic problems and anxieties. It is important to observe the fluctuation of symptoms and how young people adapt to the pandemic in order to reach a better understanding of the situation and devise new strategies to reduce the psychological impact of the pandemic.

Exploration and Bibliometric Mapping of Scientific Production on Quality of Life, Social Impact, and Security in Love Relationships in Patients with Dental Prostheses.

AIM: To explore and conduct a bibliometric mapping of scientific production on quality of life, social impact, and security in love relationships in patients with dental prostheses. MATERIALS AND METHODS: This study is a bibliometric, retrospective, observational analysis of scientific publications indexed in Scopus from 2017 to 2022. The search was conducted on March 8, 2023, using the MESH thesaurus and a defined search strategy. Fifty-two relevant studies were identified and exported to the SciVal program for further analysis. Various bibliometric indicators were used to analyze scientific production, including number of citations, publication, authorship, institution and collaboration, journal quartile, country of origin, h-index, CiteScore 2020, SCImago Journal Rank (SJR), Field Weighted Citation Impact (FWCI), and Source Normalized Impact per Paper (SNIP). RESULTS: Most of the articles (39) were in the highest quality quartiles (Q1 and Q2). Brazil produced a total of 15 scientific publications with a domain-weighted impact of 0.65, while Germany produced a total of 11 publications with a domain-weighted impact of 3.15. The results show that international collaboration (32.7%) and national collaboration (38.5%) are more frequent. The most influential author is Daniel Ralph Reißmann with a total of 72 publications followed by Oliver Schierz with 27 publications. German institutions (University of Hamburg, Leipzig University, and Ludwig Maximilian University of Munich) lead in scientific productivity. The Journal of Prosthetic Dentistry (Q1) has the highest number of articles (7) and a citation-to-publication ratio of 14.7. CONCLUSION: Scientific production on quality of life in patients with dental prostheses is still scarce, although its dissemination is mainly in high-impact scientific journals. CLINICAL SIGNIFICANCE: This study provided a deeper understanding of how dental prostheses affect people's lives. This can provide practitioners with valuable information to make clinical treatment decisions to improve quality of life. In addition, it can guide future studies to deepen the understanding of this topic in the clinical setting.

Corrigendum: Personalized monitoring of circulating tumor DNA with a specific signature of trackable mutations after chimeric antigen receptor T-cell therapy in follicular lymphoma patients.

[This corrects the article DOI: 10.3389/fimmu.2023.1188818.].

A 10-year Scientometric Analysis of the Characteristics of the Worldwide Publication on the Toxic Effects of Fluoride.

AIM: To perform a 10-year scientometric analysis of the characteristics of the worldwide publication on the toxic effects of fluoride. MATERIALS AND METHODS: A bibliometric study of the worldwide scientific production on the toxic effects of fluoride during the years 2011-2020 was performed. All metadata from the Scopus database were evaluated. These were then exported to SciVal (Elsevier) for analysis of quantity, collaboration, and impact indicators. RESULTS: We found that the "Biological Trace Element Research" was the most productive journal with 22 published manuscripts and that the most productive universities on the systemic toxic effects of fluoride on the body were Shanxi Agricultural University, Guizhou Medical University, and Huazhong University of Science and Technology with 31, 11, and 10 manuscripts, respectively. In addition, it was found that most of the world scientific production on the toxic effects of fluoride was published in Q1 level journals (top 25%). CONCLUSION: Finally, it was concluded that most of the total production on this topic was published in high-impact Q1 journals, with China being the leading country in terms of number and impact of publications. Finally, there was evidence of collaboration between the United States, China, and India, being the countries that led in co-authorship by country. CLINICAL SIGNIFICANCE: This research is of clinical importance as it allows the identification of the most productive institutions, authors, and countries in this field. In this way, strategic alliances can be established to enhance the development of research.

A Novel Methodology to Obtain the Mechanical Properties of Membranes by Means of Dynamic Tests.

A new, non-destructive methodology is proposed in this work in order to determine the mechanical properties of membrane using vibro-acoustic tests. This procedure is based on the dynamic analysis of the behavior of the membrane. When the membrane is subjected to a sound excitation it responds by vibrating based on its modal characteristics and this modal parameter is directly related to its mechanical properties. The paper is structured in two parts. First, the theoretical bases of the test are presented. The interaction between the sound waves and the membrane (mechano-acoustic coupling) is complex and requires meticulous study. It was broadly studied by means of numerical simulations. A summary of this study is shown. Aspects, such as the position of the sound source, the measuring points, the dimensions of the membrane, the frequency range, and the magnitudes to be measured, among others, were evaluated. The validity of modal analysis curve-fitting techniques to extract the modal parameter from the data measures was also explored. In the second part, an experimental test was performed to evaluate the validity of the method. A membrane of the same material with three different diameters was measured with the aim of estimating the value of the Young's modulus. The procedure was applied and satisfactory results were obtained. Additionally, the experiment shed light on aspects that must be taken account in future experiments.

Integral Valorization of Two-Phase Olive Mill Solid Waste (OMSW) and Related Washing Waters by Anaerobic Co-digestion of OMSW and the Microalga Raphidocelis subcapitata Cultivated in These Effluents.

This study evaluates the comprehensive valorization of the byproducts derived from the two-phase olive oil elaboration process [i.e., olive washing water (OWW), olive oil washing water (OOWW), and olive mill solid waste (OMSW)] in a closed-loop process. Initially, the microalga Raphidocelis subcapitata was grown using a mixture of OWW and OOWW as the culture medium, allowing phosphate, nitrate, sugars, and soluble chemical oxygen demand removal. In a second step, the microalgal biomass grown in the mixture of washing waters was used as a co-substrate together with OMSW for an anaerobic co-digestion process. The anaerobic co-digestion of the combination of 75% OMSW-25% R. subcapitata enhanced the methane yield by 7.0 and 64.5% compared to the anaerobic digestion of the OMSW and R. subcapitata individually. This schedule of operation allowed for integration of all of the byproducts generated from the two-phase olive oil elaboration process in a full valorization system and the establishment of a circular economy concept for the olive oil industry.

An image processing tool for the detection of anthracycline-induced cardiotoxicity by evaluating the myocardial metabolic activity in [18F]FDG PET/CT.

PURPOSE: Chemotherapy-induced cardiotoxicity is one of the main complications during and after cancer treatment. While echocardiography is the most used technique in clinical practice to evaluate left ventricular (LV) dysfunction, a multimodal approach is preferred for the early detection of anthracycline-induced cardiotoxicity. In this paper, an image processing tool allowing the qualitative and quantitative analysis of myocardial metabolic activity by [18F]fluorodeoxyglucose (FDG) positron emission tomography computed tomography (PET/CT) images, acquired routinely during and after cancer treatment, is presented. METHODS: The methodology is based on cardiac single photon emission computed tomography image processing protocols used in clinical practice. LV polar maps are created, and quantitative regional values are calculated. The tool was validated in a study group of 24 patients with Hodgkin or non-Hodgkin lymphoma (HL and NHL, respectively) treated with anthracyclines. Staging, interim and end-of-treatment [18F]FDG PET/CT images were acquired and the presented tool was used to extract the quantitative metrics of LV metabolic activity. RESULTS: Results show an overall increase of metabolic activity in the interim PET image acquired while on treatment compared to staging PET, which then decreased in the end-of-treatment scan. Positive correlation coefficients between staging and interim scans, and negative correlation coefficients between interim and end-of-treatment scans also support this finding. Metabolic changes occur predominantly in the septal region. CONCLUSION: The proposed methodology and presented software solution provides the capability to assess quantitatively myocardial metabolism acquired by routine [18F]FDG PET/CT scanning during cancer treatment for evaluating anthracycline-induced cardiotoxicity. The [18F]FDG PET/CT septal-lateral uptake ratio is proposed as a new quantitative measure of myocardial metabolism.

Evaluation and modelling of methane production from corn stover pretreated with various physicochemical techniques.

Lignocellulosic by-products from agricultural crops represent an important raw material for anaerobic digestion and clean renewable, which is a key component of the circular economy. Lignocellulose is recalcitrant to biodegradation and pretreatments are required to increase methane yield during anaerobic digestion. In this work, the efficacy of different physicochemical pretreatments was compared using corn stover biomass as substrate. Anaerobic digestion of untreated and pretreated corn stover was performed in batch mode at mesophilic temperature (38°C) and organic matter solubilization of pretreated substrates was also investigated. The highest organic matter solubilization occurred in autoclave pretreatment (soluble chemical oxygen demand = 5630 ± 42 mg O2 L-1). However, the highest methane yield was obtained using alkaline pretreatment (367 ± 35 mL CH4 g-1 VSadded). Alkaline pretreatment increased methane yield by 43.3% compared to untreated control (256 ± 15 mL CH4 g-1 VSadded). Two mathematical models (i.e. first-order kinetics and transfer function) were utilized to fit the experimental data with the aim of assessing anaerobic biodegradation and to obtain the kinetic constants in all cases studied. Both models adequately fit the experimental results. The kinetic constant, k, of the first-order model increased by 92.8% when stover was pretreated with sulphuric acid compared with control. The transfer function model revealed that the maximum methane production rate, Rm, was obtained for the sulphuric acid treatment, which was 63.5% higher compared to control.

Eliminating hepatitis C on the Balearic Islands, Spain: a protocol for an intervention study to test and link people who use drugs to treatment and care.

INTRODUCTION: The hepatitis C virus (HCV) is a highly infectious and deadly disease, affecting some 58 million people worldwide. Of the 1.13 million people living in the Balearic Islands, Spain, about 1350 individuals have untreated HCV. Of these, about 1120 (83%) are estimated to be people who use drugs (PWUD), who are one of the key at-risk groups for HCV infection globally. Carrying out micro-elimination approaches focused on this population is crucial to achieve the WHO goal of eliminating HCV by 2030. Thus, the primary objective of this study is to validate a model of care that simplifies the screening and linkage to HCV care pathways for PWUD on the Balearic Islands. METHODS AND ANALYSIS: This intervention study will be implemented across 17 sites, in 4 different settings: addiction service centres (n=12), non-governmental organisation centres (n=3), a mobile methadone unit and a prison, with an estimated 3725 participants. Together with the healthcare staff at each centre, the intervention protocols will be adapted, focusing on four phases: recruitment and testing; linkage to care; treatment for those who test positive; and monitoring of sustained virological response 12 weeks after treatment and reinfection. The primary outcomes will be the number of tested and treated individuals and the secondary outcomes will include individuals lost at each step in the cascade of care. Descriptive analysis and multivariable logistic regression of the data will be undertaken. ETHICS AND DISSEMINATION: The Hospital Clínic Barcelona, Spain, Ethics Committee approved this study on 18 February 2021 (HCB/2020/2018). Findings will be disseminated through peer-reviewed publications, conference presentations and social media. The results of this study could provide a model for targeting PWUD for HCV testing and treatment in the rest of Spain and in other settings, helping to achieve the WHO HCV elimination goal.

SEGHI Study: Defining the Best Surveillance Strategy in Hodgkin Lymphoma after First-Line Treatment.

The optimal strategy for early surveillance after first complete response is unclear in Hodgkin lymphoma. Thus, we compared the various follow-up strategies in a multicenter study. All the included patients had a negative positron emission tomography/computed tomography at the end of induction therapy. From January 2007 to January 2018, we recruited 640 patients from 15 centers in Spain. Comparing the groups in which serial imaging were performed, the clinical/analytical follow-up group was exposed to significantly fewer imaging tests and less radiation. With a median follow-up of 127 months, progression-free survival at 60 months of the entire series was 88% and the overall survival was 97%. No significant differences in survival or progression-free survival were found among the various surveillance strategies. This study suggests that follow-up approaches with imaging in Hodgkin lymphoma provide no benefits for patient survival, and we believe that clinical/analytical surveillance for this group of patients could be the best course of action.

Body Expression-Based Intervention Programs for Persons with Intellectual Disabilities: A Systematic Review.

The benefits of physical exercise on human health are widely known. However, the level of physical activity in the majority of the population is considered insufficient. People with intellectual disabilities (ID), in particular, show this lack of physical activity to a greater extent. It has been noted that the promotion of activities focused on corporal expression (CE) stimulates the motivation to carry out physical exercise in this population group. The aim of this study was to carry out a systematic review of the last ten years of CE programs carried out in people with ID. The criteria established in the PRISMA statement were followed in the literature search. The databases consulted were Scopus, Web of Science, Pubmed, PsycInfo and Elton B. Stephens Company (EBSCO). Eight exclusion criteria were established for the selection of articles. For the analysis of the selected research, three quality criteria for interventions were established. Subsequently, a summary table with the characteristics of each study was made. In conclusion, it can be stated that CE programs in people with ID report benefits at both physical and psychosocial levels. It is necessary to extend this approach for the promotion of healthy physical activity that advocates social inclusion.

Clinical course and risk factors for mortality from COVID-19 in patients with haematological malignancies.

BACKGROUND: The impact of coronavirus disease 2019 (COVID-19) in haematological patients (HP) has not been comprehensively reported. METHODS: We analysed 39 patients with SARS-CoV-2 infection and haematological malignancies. Clinical characteristics and outcomes were compared to a matched control group of 53 non-cancer patients with COVID-19. Univariate and multivariate analyses were carried out to assess the risk factors associated with poor outcome. RESULTS: The most frequent haematological diseases were lymphoma (30%) and multiple myeloma (30%). Eighty-seven % HP developed moderate or severe disease. Patients with haematological malignancies had a significantly higher mortality rate compared to non-cancer patients (35.9% vs 13.2%; P = .003 (odds ratio 6.652). The worst outcome was observed in chronic lymphocytic leukaemia patients. Only age >70 years and C reactive protein >10 mg/dl at admission were associated with higher risk of death (odds ratio 34.86, P = .003 and 13.56,P = .03). Persistent viral sheddind was detected in 5 HP. Active chemotherapy, viral load at diagnosis and COVID-19 therapy were not predictors of outcome. CONCLUSION: Mortality of COVID-19 is significantly higher in patients with haematological malignancies compared to non-cancer patients. The impact of persistent viral shedding must be considered in order to re-start therapies and maintain infectious control measures.

Autologous stem cell transplantation may be curative for patients with follicular lymphoma with early therapy failure without the need for immunotherapy.

OBJECTIVE/BACKGROUND: Patients with follicular lymphoma (FL) with early therapy failure (ETF) within 2 years of frontline therapy have poor overall survival (OS). We recently reported the results of autologous stem cell transplantation (ASCT) in patients from the Grupo Español de Linfomas y Trasplantes de Médula Ósea (GELTAMO) registry treated with rituximab prior to ASCT and with ETF after first-line immunochemotherapy, leading to 81% 5-year OS since ASCT. We explored whether ASCT is also an effective option in the pre-rituximab era-that is, in patients treated in induction and rescued only with chemotherapy. METHODS: ETF was defined as relapse/progression within 2 years of starting first-line therapy. We identified two groups: the ETF cohort (n = 87) and the non-ETF cohort (n = 47 patients receiving ASCT but not experiencing ETF following first-line therapy). RESULTS: There was a significant difference in 5-year progression-free survival between the ETF and non-ETF cohorts (43% vs. 57%, respectively; p = .048). Nevertheless, in patients with ETF with an interval from first relapse after primary treatment to ASCT of <1 year, no differences were observed in 5-year progression-free survival (48% vs. 66%, respectively; p = .44) or in 5-year OS (69% vs. 77%, p = .4). Patients in the ETF cohort transplanted in complete remission showed a plateau in the OS curves, at 56%, beyond 13.7 years of follow-up. CONCLUSION: ASCT may be a curative option for ETF in patients who respond to rescue chemotherapy, without the need for immunotherapy or other therapies, and should be considered as an early consolidation, especially in patients with difficult access to rituximab.

Life expectancy of follicular lymphoma patients in complete response at 30 months is similar to that of the Spanish general population.

The use of immunochemotherapy has improved the outcome of follicular lymphoma (FL). Recently, complete response at 30 months (CR30) has been suggested as a surrogate for progression-free survival. This study aimed to analyse the life expectancy of FL patients according to their status at 30 months from the start of treatment in comparison with the sex and age-matched Spanish general population (relative survival; RS). The training series comprised 263 patients consecutively diagnosed with FL in a 10-year period who needed therapy and were treated with rituximab-containing regimens. An independent cohort of 693 FL patients from the Grupo Español de Linfomas y Trasplante Autólogo de Médula Ósea (GELTAMO) group was used for validation. In the training cohort, 188 patients were in CR30, with a 10-year overall survival (OS) of 53% and 87% for non-CR30 and CR30 patients, respectively. Ten-year RS was 73% and 100%, showing no decrease in life expectancy for CR30 patients. Multivariate analysis indicated that the FL International Prognostic Index was the most important variable predicting OS in the CR30 group. The impact of CR30 status on RS was validated in the independent GELTAMO series. In conclusion, FL patients treated with immunochemotherapy who were in CR at 30 months showed similar survival to a sex- and age-matched Spanish general population.