Comment: How does the patient affect the treatment?
Jonathan Kell
pp 3-3
Let’s face it – we are all getting older, even the young ones among us. As well as gaining a certain maturity, this results in a few more aches and discomforts; a few more challenges on the stairs to the ward on the top floor.
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Fifty shades of grey – blood cancers, risk and avoidable disparities
Sophia Skyers, Campbell Kerr and Audrey Finney
pp 4-4
We are all equal’ – so the saying goes. the available evidence, however, brings into sharp focus that, in terms of health and health outcomes, this statement could not be further from the truth. By any criteria with which you choose to examine it, and accepting the well-known axiom ‘prevention is better than cure’, combined influences shape health and well-being: the milieu in which we lead our daily lives, our ability to access economic resources, the way in which information is conceived, transmitted and received, as well as the extent to which it is trusted, access to social support networks and access to effective and timely treatments all have an impact on our health outcomes.
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Defining treatment strategies in the older, frailer patient with multiple myeloma
Gordon Cook and Graham Jackson
pp 5-7
The incidence and prevalence of cancer among older adults is expected to increase dramatically over the next 30 years, in large parts because the elderly population in many parts of the world is growing. It is estimated that 70% of cancers will occur in patients older than 65 years by 2030, and the decision to treat older adults with cancer should not be based on chronological age alone.
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Case study masterclass: Recurrent Hodgkin’s lymphoma in pregnancy
Carlos P Carrasco and Lucy Mackillop
pp 8-9
Elsa,a 36-year-old woman,living with her daughter Catherine* and husband Steve*, was expecting a second child. She was anxious about this unplanned pregnancy, both because her daughter’s delivery (caesarean section) eight years previously had been difficult and because Elsa was a Hodgkin’s lymphoma survivor (she was now five years in remission). Just prior to Elsa’s scheduled 20-week fetal anomaly scan in her second pregnancy, she was rushed into the emergency department vomiting blood. The gastroenterology team performed an endoscopy, which revealed a large gastric mass. This was biopsied and the sample revealed it was cancerous – the Hodgkin’s lymphoma had recurred.
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Searching for lifesavers
Corinna McShane
pp 10-10
For many people with a blood cancer or blood disorder, a donation of blood stem cells is their best chance of staying alive. Tragically, however, many patients cannot benefit from this procedure due to a lack of registered donors.
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Venetoclax for 17p deletion chronic lymphocytic leukaemia
Faouzi Djebbari and Anna Schuh
pp 11-14
In the UK, chronic lymphocytic leukaemia (CLL) has an annual incidence of around 3,400 cases and is responsible for around 1,000 deaths per year. Despite significant progressin recent years, CLL remains a largely incurable disease. The addition of rituximab to the chemotherapy backbone fludarabine and cyclophosphamide led, for the first time, to an improvement in overall survival and a change in the natural history of the disease; however, the FCR regimen is associated with significant side effects and 25% of patients relapse within two years from therapy.
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Case study masterclass: answers
Carlos P Carrasco and Lucy Mackillop
pp 15-15
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