Factors associated with self-perceived burden to the primary caregiver in older patients with hematologic malignancies: an exploratory study

Objective: Although cancer patients frequently experience self-perceived burden to others, this perception has not been enough studied. The aim of this study was to investigate the prevalence of selfperceived burden to the primary caregiver (SPB-PC) and associated factors in an older patient population with hematologic malignancies at the time of chemotherapy initiation. Methods: In total, 166 consecutive patients with hematologic malignancies aged ≥65 years were recruited at the time of chemotherapy initiation. Patients’ SPB-PC was assessed using a 100-mm visual analogue scale (VAS). Characteristics potentially associated with SPB-PC, including sociodemographic and medical characteristics, physical functioning status (Karnofsky performance score, activities of daily living (ADL)/instrumental ADL), symptoms (fatigue, pain, nausea, quality of life), psychological distress (Hospital Anxiety and Depression Scale (HADS)), perceived cognitive function (Functional Assessment of Cancer Therapy Cognitive (FACT-Cog) Scale), and patients’/primary caregivers’ personal relationship characteristics (family tie, support), were assessed. Results: Thirty-five percent of patients reported moderate to severe SPB-PC (VAS ≥ 50 mm). Patients’ SPB-PC was associated with lower Karnofsky performance (β = 0.135, p = 0.058) and ADL (β = 0.148, p = 0.037) scores, and higher HADS (β = 0.283, p<0.001) and FACT-Cog perceived cognitive impairments subscale (β = 0.211, p = 0.004) scores. The proportion of explained variance was 23.5%. Conclusions: Health care professionals should be aware that about one third of older cancer patients experience moderate to severe SPB-PC at the time of chemotherapy initiation. They should adapt their support of patients who report such a feeling

Kinetics of early and late molecular recurrences after first-line imatinib cessation in chronic myeloid leukemia: updated results from the STIM2 trial

Discontinuation of tyrosine kinase inhibitors in chronic phase chronic myeloid leukemia is feasible in clinical practice based on recently published international recommendations. Nevertheless, factors predictive of molecular recurrence have not been fully elucidated and long-term follow-up of patients enrolled in clinical studies are required in order to update knowledge on discontinuation attempts particularly in terms of the safety and durability of treatment-free remission (TFR). In the current study, we updated results from the STIM2 study in the light of the consensual criterion of molecular recurrence reported in different international recommendations. Among the 199 patients included in the perprotocol study, 108 patients lost a major molecular response. With a median follow-up of 40.8 months (5.5-111 months), the probability of treatment-free remission was 43.4% [36.3-50.4] at 5 years, 40.9% [32.8-47.3] at 7 years and 34.5% [25.6- 43.3] at 9 years. Molecular recurrence occurred between 0 to 6 months, 6 to 24 months and after 24 months in 75 patients (69%), 15 patients (14%) and 18 patients (17%), respectively. Notably, the kinetics of molecular recurrence differed significantly between these three subgroups with a median time from loss of MR4 (BCR::ABL1 IS≤0.01%) to loss of major molecular response of 1, 7 and 22 months, respectively. Predictive factors of molecular recurrence differed according to the time of occurrence of the molecular recurrence. Durations of imatinib treatment and deep molecular response as well as BCR::ABL1/ABL1 levels at cessation of tyrosine kinase inhibitor treatment, as quantified by reverse transcriptase droplet digital polymerase chain reaction, are involved in molecular recurrence occurring up to 24 months but not beyond. (ClinicalTrial. gov Identifier NCT#0134373)

Contribution à une meilleure évaluation et prise en charge clinique de la vulnérabilité cognitive chez le patient âgé présentant une affection cancéreuse

La vulnérabilité cognitive est très fréquente chez les patients âgés présentant une affection oncologique et peut avoir des répercussions importantes sur leur prise en charge médicale et leur survie. De plus, la vulnérabilité cognitive peut également impacter le bien-être physique et psychologique des personnes âgées. Le caractère hétérogène de la vulnérabilité cognitive entrave bien souvent son évaluation et sa prise en charge. Toutefois, peu d’études ont, à l’heure actuelle, porté spécifiquement sur la vulnérabilité cognitive chez le patient âgé au début d’un traitement oncologique.Cette thèse a investigué ce sujet au travers d’une étude empirique répondant aux objectifs suivants: (1) l’évaluation au début d’un traitement oncologique des vulnérabilités gériatriques, et en particulier de la vulnérabilité cognitive, du patient âgé et leurs impacts sur la survie globale et (2) l’évaluation au début d’un traitement oncologique du désir de recevoir une aide psychologique et son implication clinique chez le patient âgé.Les résultats des deux premiers chapitres (1) montrent que la vulnérabilité cognitive au début d’un traitement oncologique est un prédicteur indépendant de la survie globale chez les patients âgés. Les résultats du troisième chapitre (2) indiquent que si quatre patients âgés sur dix présentent de la détresse ou une vulnérabilité cognitive au début d’un traitement oncologique, seule une personne sur dix souhaite recevoir une aide psychologique pour faire face à ses difficultés.Les résultats de ce travail de thèse soulignent l’importance d’évaluer la vulnérabilité cognitive pour guider la décision thérapeutique chez le patient âgé. Ces résultats suggèrent également qu’il serait bénéfique de proposer des interventions de soutien aux patients âgés afin de remédier à leur manque d’intérêt pour les services de santé mentale dans le but de réduire la morbidité et mortalité associées à la vulnérabilité cognitive. Enfin, ce travail de thèse souligne l’importance de continuer à développer et à améliorer les méthodes d’évaluation et d’intervention de la vulnérabilité cognitive chez le patient âgé.Doctorat en Sciences psychologiques et de l'éducationinfo:eu-repo/semantics/nonPublishe

Onco-haematology geriatry: impact of cognitive disorders

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Geriatric vulnerabilities and their impact on survival in older patients at the initiation of cancer treatment: major impact of cognition.

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Desire for Formal Psychological Support among Cancer Patients and their Caregivers: Age and Gender Influences

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Carl Obenland and the painted portrait

Die Arbeit beschäftigt sich mit dem schwäbischen Porträtmaler Carl Obenland (1908-2008) und seinem kommerziellen Erfolg in seiner Heimat im Zeitalter der Fotografie. Aufgrund seines hohen handwerklichen Könnens und seiner konservativen Einstellung fand er seine Klientel vor allem in der gehobenen Mittelschicht der Vor- und Nachkriegszeit. Dieses Phänomen besitzt einen historischen Hintergrund.The publication deals with the Swabian painter Carl Obenland (1908-2008) and his commerical success in his home region in the age of photography. Due to the high standard of his artistic skills and his conservative attitude he found his clientele in the upper middle class of the pre- and postwar periods. This phenomenon is based on a historic background

G8 or Multimodal Geriatric Assessment (MGA) for the screening of older patients with malignant hemopathies?

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G8 as a screening tool for older patients with malignant hemopathies: A surrogate for CGA?

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G8 as a screening tool for older patients with malignant hemopathies: A surrogate for CGA?

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