Publications by authors named "Jeroen Janssen"

Background: Digital mental health interventions could sustainably and scalably prevent and reduce loneliness in older adults. We designed an app containing 29 text-based games and a questionnaire-administering chatbot to stimulate intergenerational contact.

Objective: This study aims to evaluate the feasibility of a social gaming app in reducing loneliness among older adults by evaluating recruitment strategies, data collection procedures, and gameplay activity.

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Bariatric surgery is increasingly performed to treat severe obesity. As a result of anatomical and physiological changes in the gastrointestinal tract, the pharmacokinetics (PK) of oral drugs can be altered, affecting their efficacy and safety. This includes the class of tyrosine kinase inhibitors (TKIs) which are used to treat chronic myeloid leukemia (CML).

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  • Haematology patients experiencing high-risk neutropenia are susceptible to bloodstream infections linked to mucosal barrier injuries, particularly during episodes of fever.
  • A study involving 416 neutropenic haematology patients identified risk factors for these infections, noting that certain conditions like low MASCC scores and specific fungal colonizations significantly increased risk.
  • Findings revealed that while low citrulline levels at fever onset correlated with candidaemia, they did not indicate the likelihood of bacterial infections; moreover, quinolone antibiotics appeared beneficial.
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Given the selection of elderly patients with AML in first complete remission (CR1) the advantage of consolidation with allogeneic hematopoietic cell transplantation (HCT) over chemotherapy is still unclear. Newly diagnosed AML patients in CR1 aged 60-75 years were registered and a donor search initiated. After one consolidation cycle, patients with a matched donor were randomized to HCT with fludarabine/lowdose total body irradiation and cyclosporine/mycophenolate mofetil immunosuppression or conventional non-HCT.

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Historically, dose selection of anticancer drugs has mainly been based on establishing the maximum tolerated dose in phase 1 clinical trials with a traditional 3 plus 3 design. In the era of targeted therapies and immune-modulating agents, this approach does not necessarily lead to selection of the most favourable dose. This strategy can introduce potentially avoidable toxicity or inconvenience for patients.

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Background: Teamwork in the operating room is of paramount importance to provide high-quality patient care. It has been shown that increased team member familiarity predicts improved teamwork. A complicating factor is the often-changing composition of the operating room teams.

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Precise and reliable predictive parameters to accurately identify chronic myeloid leukemia (CML) patients who can successfully discontinue their tyrosine kinase inhibitor (TKI) treatment are lacking. One promising parameter is depth of molecular response measured by BCR::ABL1 digital PCR (dPCR). The aim of this study was to validate a previously described prediction cutoff of 0.

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Limited data is available on the health-related quality of life (HRQoL) and symptoms of patients with chronic myeloid leukemia (CML) who are in treatment-free remission (TFR). We herein report HRQoL results from the EURO-SKI trial. Patients who had been on tyrosine kinase inhibitors (TKIs) therapy for at least 3 years and achieved MR4 for at least 1 year were enrolled from 11 European countries, and the EORTC QLQ-C30 and the FACIT-Fatigue questionnaires were used to assess HRQoL and fatigue respectively.

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  • - Asciminib specifically targets the unique myristoyl pocket of BCR::ABL1, proving effective against chronic myeloid leukemia (CML) that has mutations resistant to other treatments, particularly in heavily pretreated patients.
  • - In a phase I study of 48 patients with the T315I mutation, 62.2% reached a BCR::ABL1 level of ≤1% and nearly 49% achieved a major molecular response, demonstrating significant antileukemic activity over a two-year period.
  • - Common severe side effects included increased lipase and low platelet counts, but the overall risk-benefit profile supports asciminib as a viable treatment for T315I-mutated CML-CP
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  • - The EURO-SKI study, the largest clinical trial on stopping tyrosine kinase inhibitors (TKIs) for chronic myeloid leukemia, involved 728 patients and found that 61% maintained major molecular response (MMR) at 6 months and 46% at 36 months.
  • - Key factors influencing MMR maintenance included the length of TKI treatment and the patient's deep molecular remission duration before stopping treatment, along with the type of leukemia transcript.
  • - For patients experiencing late MMR losses, factors like TKI treatment duration, the presence of blasts in blood, and platelet counts at diagnosis were significant predictors of outcomes during the 36-month follow-up.
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  • * The DAstop2 study examined patients who previously failed a treatment-free remission (TFR) attempt, re-treating them with dasatinib for two years and assessing their ability to stop TKIs again.
  • * Results showed that 61%, 56%, and 46% of patients maintained TFR at 6, 12, and 24 months after attempting a second stop, demonstrating that this approach is safe and effective for many patients.
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Measurable residual disease (MRD) measured in the bone marrow (BM) of acute myeloid leukemia (AML) patients after induction chemotherapy is an established prognostic factor. Hemodilution, stemming from peripheral blood (PB) mixing within BM during aspiration, can yield false-negative MRD results. We prospectively examined hemodilution by measuring MRD in BM aspirates obtained from three consecutive 2 mL pulls, along with PB samples.

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Chronic myeloid leukemia (CML) is a hematologic neoplasm characterized by the expression of the BCR::ABL1 oncoprotein, a constitutively active tyrosine kinase, resulting in uncontrolled growth and proliferation of cells in the myeloid lineage. Targeted therapy using tyrosine kinase inhibitors (TKIs) such as imatinib, nilotinib, dasatinib, bosutinib, ponatinib and asciminib has drastically improved the life expectancy of CML patients. However, treatment resistance occurs in 10-20% of CML patients, which is a multifactorial problem that is only partially clarified by the presence of TKI inactivating mutations.

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The safety and efficacy of sabatolimab, a novel immunotherapy targeting T-cell immunoglobulin domain and mucin domain-3 (TIM-3), was assessed in combination with hypomethylating agents (HMAs) in patients with HMA-naive revised International Prognostic System Score (IPSS-R) high- or very high-risk myelodysplastic syndromes (HR/vHR-MDS) or chronic myelomonocytic leukemia (CMML). Sabatolimab + HMA had a safety profile similar to that reported for HMA alone and demonstrated durable clinical responses in patients with HR/vHR-MDS. These results support the ongoing evaluation of sabatolimab-based combination therapy in MDS, CMML, and acute myeloid leukemia.

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Background: Digital loneliness interventions for older adults are promising, yet conclusive evidence is lacking due to a lack of randomized controlled trials (RCTs) and difficulties with recruitment. Process evaluation of performed RCTs is essential to inform future interventions. Still, it is rarely carried out, resulting in an overly optimistic view of the impact of eHealth interventions on loneliness in older adults and options to conduct such research entirely remotely.

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Objectives: Acquired missense mutations in the BCR::ABL1 kinase domain (KD) may cause tyrosine kinase inhibitor (TKI) treatment failure. Based on mutation-specific in vitro derived IC50-values, alternative TKI may be selected. We assessed clinical practice of BCR::ABL1 KD mutation testing, clinical response in relation to IC50-values, and clinical outcome of tested patients.

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Insight into real-world treatment-related toxic effects reported by patients has the potential to improve care, benchmark trials, and fill knowledge gaps, especially in patients with chronic myeloid leukaemia, which is treated in the majority of patients continually with tyrosine-kinase inhibitors (TKIs). The aim of our systematic review was to investigate the content validity of instruments that elicit TKI-related toxic effects reported by patients with chronic myeloid leukaemia in the real world. We searched PubMed and Embase from Jan 1, 2017 to Oct 21, 2022.

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  • Graft-versus-host disease (GvHD) is a major complication in allogeneic hematopoietic stem cell transplants, and this study compares the effectiveness of two treatments, anti-thymocyte globulin (ATG) and post-transplant cyclophosphamide (PTCy), in patients who received transplants using matched unrelated donors (MUD) with non-myeloablative conditioning (NMC).
  • The study included 185 adult patients and found that acute GvHD occurred in 48% of those treated with ATG compared to only 21% in those treated with PTCy, indicating that PTCy is more effective at reducing acute GvHD risk.
  • Both treatments had similar
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Objective: The operating room is a highly complex environment, where patient care is delivered by interprofessional teams. Unfortunately, issues with communication and teamwork occur, potentially leading to patient harm. A shared mental model is one prerequisite to function effectively as a team, and consists of task- and team-related knowledge.

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In order to improve molecular response for a discontinuation attempt in chronic myeloid leukemia (CML) patients in chronic phase, who had not achieved at least a molecular response <0.01% BCR-ABL1 (MR) after at least 2 years of imatinib therapy, we prospectively evaluated whether they could attain MR after a switch to a combination of nilotinib and 9 months of pegylated interferon-α2b (PegIFN). The primary endpoint of confirmed MR at month 12 (a BCR-ABL1 level ≤ 0.

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Asciminib is approved for patients with Philadelphia chromosome-positive chronic-phase chronic myeloid leukemia (CML-CP) who received ≥2 prior tyrosine kinase inhibitors or have the T315I mutation. We report updated results of a phase 1, open-label, nonrandomized trial (NCT02081378) assessing the safety, tolerability, and antileukemic activity of asciminib monotherapy 10-200 mg once or twice daily in 115 patients with CML-CP without T315I (data cutoff: January 6, 2021). After ≈4-year median exposure, 69.

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