News in brief: PTLD outcomes in the era of PET and rituximab; AMA ‘secession’ move slammed; WA wants cancer centre to rival Peter Mac

PTLD outcomes in the era of PET and rituximab 

Rituximab continues to show safety and efficacy in the largest real-world study of DLBCL patients with PET-staged post-transplant lymphoproliferative disease (PTLD), Australian haematologists stay.

The study, which assessed outcomes for 91 patients diagnosed with DLBCL PTLD across 11 Australian centres between 2004 and 2017, found 45% of those initially treated with rituximab (R) monotherapy achieved complete remission by median 4.7 years’ follow-up.

The figure jumped to 71% after patients not in complete remission received rituximab with cyclophosphamide, doxorubicin, vincristine and prednisolone (R-CHOP), lead author and Princess Alexandra Hospital Haematology Fellow Dr Stephen Boyle and his team wrote in Hemasphere.

Meanwhile, 76% of patients initially on R-CHOP achieved complete-remission, they wrote. Overall survival was similar between rituximab monotherapy and R-CHOP groups and those with systemic lymphoma versus central nervous system involvement (3 year OS:  72% versus 73%, P = 0.78).

While there were no cases of graft loss, rejection occurred in 9% of patients and treatment-related mortality was 7%.

“[Rituximab]-based treatments are safe and effective with a low likelihood of graft rejection and high cure rate for patients achieving complete remission with CNS or systemic PTLD,” the authors concluded.

AMA ‘secession’ move slammed

A move by AMA Victoria to offer cheaper ‘Associate’ membership that does not include membership of the Federal AMA has been condemned by some senior figures as effectively seceding from the national medical union.

The state branch is offering a ‘low cost membership option’ that is 40% cheaper than the full annual membership rates of $1582, and which provides the benefits and services of the AMA Victoria branch.

AMA Victoria told the ABC it had simply created an “additional membership category which offers doctors more choice, flexibility and pricing transparency”.

However Dr Stephen Parnis, a former AMA Victoria President and Vice President of the Federal AMA said the move would undermine the authority of the Federal AMA and also irreparably diminish the resources and policy strength of the AMA at state level

The move was also opposed by Federal AMA president Dr Omar Khorshid, who urged doctors to maintain their full membership while the Federal body sought to resolve its issues with the Victorian arm.

WA wants comprehensive cancer centre to rival Peter Mac

Cancer specialists in Western Australia are lobbying government to set up a comprehensive cancer facility to match those that currently exist in other states such as the Peter MacCallum Cancer Centre in Melbourne

Federal Parliament was told of proposals by Professor Peter Leedman, director of the Harry Perkins Institute of Medical Research in Perth, to develop a Western Australian centre that will bring together world-class multidisciplinary cancer care, translational research and clinical trials for the WA community in one purpose-built iconic modern facility.

Ian Goodenough, Federal Liberal Member for the electorate of Moore said WA was the only mainland Australian state without a current or developing comprehensive cancer centre such as the Chris O’Brien Lifehouse in Sydney.

“Western Australian cancer patients receive excellent clinical care. However, unlike New South Wales and Victoria, there is no single facility dedicated to the treatment of all cancers. This means that cancer patients simply navigate multiple services to get the treatment they deserve. It is fragmented,” he said.

He said the WA facility would cost around $750 million to set up, with funding sourced from the WA state government, the federal government and through corporate philanthropy.

“The benefits of having a comprehensive cancer centre based in Perth include improved patient survival and quality of life through improved access to the latest drugs via clinical trials,” he said.

“Total cancer care will be provided centrally, including diagnosis and treatment, imaging, pathology, surgery, radiotherapy, oncology, immunotherapy, chemotherapy, immunotherapy, exercise and wellness treatments. The facility will also foster world-class translational research that attracts the best clinicians and researchers from across the world.”

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