News in brief: Positive daratumumab combination therapy results continue in MM; Trade-off with increased shelf-life of frozen platelets; Physician communication challenged by diagnostic multitasking


Positive daratumumab combination therapy results continue in MM

Daratumumab plus lenalidomide and dexamethasone (DRd) continues to improve progression-free survival in newly diagnosed multiple myeloma patients who are ineligible for stem-cell transplants, according to the latest MAIA results.

The study has been monitoring DRd’s effectiveness in 737 patients across the Asia-Pacific, North America, Europe and Middle East versus lenalidomide and dexamethasone alone for median 56.2 months.

So far, patients on the triple therapy have not reached median progression free survival, while the control group met it at 34.4 months (hazard ratio [HR]: 0.53, P < 0.0001), the authors wrote in Lancet Oncology. Neither group has reached median overall survival, however (HR: 0.68, P = 0.0013).

No new safety concerns have arisen, with the most common (> 15%) grade 3 or higher treatment-related adverse events being neutropenia, pneumonia, anaemia and lymphopenia, the authors wrote.

Serious adverse events and deaths occurred in 77% and 4% of DRd patients versus 70% and 3% of control patients respectively.

The authors concluded their results “support the frontline use of daratumumab plus lenalidomide and dexamethasone for patients with multiple myeloma who are ineligible for transplantation”.


Cryopreservation of platelets means a trade-off with increased shelf-life

Cryopreservation significantly changes the immune phenotype of platelets which may increase the potential for adverse transfusion events, Australian Red Cross Lifeblood research shows.

A study compared the factors associated with platelet immune function in pre-freeze and post-thaw samples from buffy-coat derived platelets cryopreserved at -80℃.

It found cryopreserved platelets exhibited lower supernatant concentrations of many biological response modifiers (BRMs) including IL-1β, OX40L, IL-13, IL-27, and CD40L which have previously been associated with adverse reactions.

“Our data suggests that cryopreservation induces the release of specific (BRMs) and receptors, but not others, as a result of platelet degranulation or potentially, thaw-induced damage, or lysis of the cellular membrane,” the study authors said.

As well, cryopreservation altered the abundance of surface receptors involved with leukocyte interaction and pathogen- and damage-associated molecular patterns (PAMP/DAMP) recognition.

Cryopreservation also altered toll-like receptor (TLR) abundance on the surface membrane compared to pre-freeze platelets.

Read more in Transfusion


Physician communication challenged by diagnostic multitasking

Patient communication tends to be less satisfactory in specialties in which physicians must use diagnostic reasoning during patient encounters, an Australian study has found.

Physicians have more ‘cognitive busyness’ and must mentally multitask more than specialists such as surgeons whose encounters are more focused on procedures, according to according to Queensland researchers who analysed communication ratings for 67 doctors across various specialties.

They said their findings suggested that patient communication may be relegated to a secondary task and the news of an adverse finding may be less well accepted from physicians than from a procedural specialist who was not distracted by cognitive multitasking.

Possible solutions included having separate consultations for making and conveying a diagnosis or taking a break during a consultation before delivering the diagnosis, they suggested in Internal Medicine Journal.

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