Graft-versus-host disease (GVHD) is a complication of hematopoietic cell transplantation (HCT) that has a low chance of complete remission and a substantial effect on morbidity and mortality. To better understand how to improve the field of GVHD research, management, and care, the cGVHD Eurograft Initiative organised a European community advisory board of patient advocates, with the assistance of the Lymphoma Coalition, to identify unmet needs. We present the results of this project in this Viewpoint, which identify unmet GVHD needs from the patient advocates' perspectives and provide five key actionable themes to improve GVHD management and care. The identified themes were: the need for reliable and tailored information, increased patient empowerment, access to professional dedicated care, optimal emotional support, and attention to the financial implications of GVHD, with improved communication as an overarching theme. This first step in patient-centred research opens the way to future collaborative initiatives by merging stakeholder perspectives to strive for better care and outcomes after HCT by addressing the most pertinent patient needs.
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http://dx.doi.org/10.1016/S2352-3026(24)00357-0 | DOI Listing |
Neurology
April 2025
School of Law, University of Virginia, Charlottesville.
This consensus position statement of the American Academy of Neurology, American Epilepsy Society, and Epilepsy Foundation of America updates prior 1994 and 2007 position statements on seizures, driver licensure, and medical reporting. Key consensus positions include the following: (1) in the United States, national driving standards promulgated through a system such as the Uniform Law Commission would reduce confusion and improve adherence with state driving standards; (2) state licensing criteria for medical conditions should be promulgated by regulations and guidelines based on enabling legislation rather than in statutes themselves and should be developed by medical advisory boards working in collaboration with departments of motor vehicles; (3) licensing criteria should be equitable, nondiscriminatory, objective, and compatible with comparable risks in other populations; (4) a minimum seizure-free interval of 3 months should ordinarily be required before driving in all cases and should be extended in individual cases based on review of favorable and unfavorable features by medical advisory boards; (5) individuals with exclusively provoked seizures attributable to provoking factors that are unlikely to reoccur in the future may not require a seizure-free interval before resuming driving; (6) individuals with previously well-controlled epilepsy who experience seizures due to short-term interruptions of antiseizure medications in the setting of hospitalization or practitioner-directed medication-titration may not require a seizure-free interval before driving once previously effective levels of antiseizure medications have been resumed; (7) patients and practitioners should pause driving during tapering and following discontinuation of an antiseizure medication if another such medication is not introduced; (8) individuals whose cognition or coordination is impaired due to medications used to prevent seizures should refrain from driving; (9) health care practitioners should be allowed but not mandated to report drivers who pose an elevated risk; but (10) neither a decision to report a patient suspected of being at elevated risk nor a decision declining to report a patient suspected of being at elevated risk should be subject to legal liability; (11) nations, states, and municipalities should provide alternative methods of transportation and accommodations for individuals whose driving privileges are restricted due to medical conditions.
View Article and Find Full Text PDFEuropace
March 2025
Clinical Cardiac Academic Group, Genetic and Cardiovascular Sciences Institute, City-St George's University of London, London, UK.
Atrial fibrillation (AF) is one of the most common cardiac diseases and a complicating comorbidity for multiple associated diseases. Many clinical decisions regarding AF are currently based on the binary recognition of AF being present or absent with the categorical appraisal of AF as continued or intermittent. Assessment of AF in clinical trials is largely limited to the time to (first) detection of an AF episode.
View Article and Find Full Text PDFAnn Surg Oncol
March 2025
Department of Cardiothoracic Surgery, Mayo Clinic Arizona, Phoenix, AZ, USA.
Background: Treatment of non-small cell lung cancer (NSCLC) remains challenging; 5-year survival is as low as 24% for resectable disease. However, the outlook for stage IA NSCLC is favorable, with 5-year survival exceeding 74% and with surgery often being curative. Despite this positive prognosis, low socioeconomic status has been shown to correlate with nonstandard treatment and worse overall survival specifically in stage IA.
View Article and Find Full Text PDFInt J Hematol
March 2025
Department of Hematology, Hokkaido University Faculty of Medicine, Sapporo, Japan.
In the randomized, double-blind, phase 3 GRAPHITE study (NCT03657160), anti-αβ integrin antibody vedolizumab showed greater efficacy than placebo for prevention of lower-gastrointestinal (GI) acute graft-versus-host disease (aGVHD) after unrelated allogenic hematopoietic stem cell transplantation (allo-HSCT). This post hoc analysis assessed the efficacy and safety of vedolizumab versus placebo for lower-GI aGVHD prevention in Japanese and non-Japanese patients, when added to standard GVHD prophylaxis (calcineurin inhibitor + methotrexate/mycophenolate mofetil + / - anti-thymocyte globulin [ATG]). The analysis included 35 (18 vedolizumab-treated, 17 placebo-treated) Japanese and 298 (150 vedolizumab-treated, 148 placebo-treated) non-Japanese patients.
View Article and Find Full Text PDFRadiol Med
March 2025
Radiotherapy and Radiosurgery Department, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.
Aim: Despite the widespread use of immunotherapy (IO) and targeted therapy (TT) in clinical practice, data on toxicity in combination with SBRT are lacking, largely based on retrospective studies and case reports. The present survey, conducted within the AIRO Oligometastatic Study Group, was developed for radiation oncologists to investigate the current clinical practice in Italy regarding hypofractionated SBRT (defined as a dose/fraction ≥ 5 Gy) in cancer patients using IO and TT.
Methods: The online survey, composed of 19 questions, was developed using the cloud-based platform SurveyMonkey® and was sent to all registered AIRO members using the association's mailing list and was administered online and in anonymous form.
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