Medicare item for genome-wide microarray testing in MM

A new MBS item for genome-wide microarray testing (GWMA) for people with multiple myeloma will be introduced from 1 November. Item 73391 will allow for the diagnosis and monitoring of multiple myeloma, as a complementary service to fluorescence in-situ hybridisation (FISH) testing currently provided under item 73290.

The item is expected to benefit 13,500 patients, and was recommended by the Medicare Services Advisory Committee (MSAC) in 2019, based on its conclusion that GWMA was faster (2-4 days turnaround time rather than 18 days for karyotyping), more accurate, detected more genetic variations, and had a lower failure rate than karyotyping.

Childhood cancer casts long shadow over survivors’ QOL

The ‘new normal’ for childhood cancer survivors is significantly lower quality of life than those of their peers who did not experience haematological or solid cancers.

An Australian and New Zealand study of 182 parents of children <16 years and more than five years from their diagnosis, found parents of cancer survivors were more likely to report their children were sad and lonely.

Parents also reported their children experienced 3.2 late effects relating to their cancer and/or treatment including dental problems (43.4%), fatigue (38.3%), problems relating to immunity (37.7%), memory and learning problems (33.7%) and emotional difficulties (30.3%).

The study found children who received treatments other than surgery (i.e., chemotherapy, radiotherapy, transplant) and who experienced more late effects were significantly associated with worse parent-reported child HRQoL.

Lower parent resilience was also associated with child sadness and loneliness.

The findings suggest psychosocial functioning of young survivors may be an area of ongoing vulnerability years after treatment completion.

“Accordingly, improving patient and parent HRQoL should be a goal of survivorship care.”

Read more in Pediatric Blood & Cancer

Improved prediction of PICC thrombosis in cancer patients

Patients with active cancer have longer peripherally inserted central catheter (PICC) durations (70 v 18 days) and higher PICC thrombosis rates than patients without cancer (7% vs 0.7%).

The Australian findings, from a retrospective single centre case-control audit of 249 participants, confirm PICC thrombosis in cancer patients as an area of clinical need.

The study also evaluated the utility of the Khorana risk score (KRS) which predicts VTE in cancer and the Michigan Risk Score (MRS) specific for PICC thrombosis.

It found that adding thrombocytosis to the MRS improved its ability to predict PICC thrombosis (AUC 0.72) – resulting in a low risk group comprising 48% of cancer patients with a low rate of PICC thrombosis (1.4%).

“Prospective validation of this modified MRS as a risk assessment model for PICC thrombosis would be invaluable to clinical practice,” the study concluded.

Read more in the Internal Medicine Journal