BACKGROUND: Classical Hodgkin lymphoma (cHL) is a clinicopathologically unique, aggressive lymphoma arising from germinal center B-cells and is one of the most curable hematological malignancies. This study aimed to determine the clinical course, treatment regimens, response rates, and survival data of patients diagnosed with cHL in a tertiary center. METHODS: A retrospective review was conducted to include patients with a diagnosis of cHL from 2013 to 2017. Data of demographic and clinical characteristics, treatment regimens, and outcomes were collected and analyzed. RESULTS: We recruited 94 patients with a median age of 27.0 [interquartile range (IQR), 12] years. Most of the patients were male (61.7%) and 73.4% were ethnic Malay. Nodular sclerosis was the most common histology (77.6%), followed by mixed cellularity (6.4%) and others (16%). The median follow-up time was 28.0 (IQR, 32) months. All patients received chemotherapy but only 13.8% received radiotherapy as consolidation. The doxorubicin-bleomycin-vinblastine-dacarbazine regimen was the most common (85.1%), followed by the escalated bleomycin-etoposide-doxorubicin-cyclophosphamide-vincristineprednisolone-procarbazine regimen (14.9%). Following treatment, 76.1% of patients achieved complete response. The 2-year overall survival (OS) and progression-free survival (PFS) of the entire cohort were 96.5% and 71.1%, respectively. The 2-year OS and PFS for advanced-stage disease were 93.9% and 62.8%, compared to 100% and 82.7% for early-stage disease, respectively (P=0.252 and P=0.052, respectively). CONCLUSION: This study provides insight into the clinical presentation and treatment outcomes among patients with cHL in Malaysia. A longer study duration is required to identify OS and PFS benefits and treatment-related complications for different chemotherapeutic regimens.
B-Lymphocytes ; Cohort Studies ; Diagnosis ; Disease-Free Survival ; Drug Therapy ; Follow-Up Studies ; Germinal Center ; Hematologic Neoplasms ; Hodgkin Disease ; Humans ; Lymphoma ; Malaysia ; Male ; Radiotherapy ; Retrospective Studies ; Sclerosis ; Tertiary Care Centers

Increasing incidence of Venous Thromboembolism (VTE) has complicated treatment courses for hospitalised patients. Despite recommendation to support deep vein thrombosis (DVT) risk assessment and appropriate use of prophylaxis in medical inpatients, it is either neglected or prescribed unnecessarily by the clinicians. This study aimed to assess and compare the appropriateness of DVT prophylaxis prescribing between usual care versus a pharmacist-driven DVT Risk Alert Tool (DRAT) intervention among hospitalised medical patients.

Introudction: Suboptimal care transition post-discharge may potentially increase subsequent healthcare system utilization. Transition of care is a service approach to support continuum of patient care after discharge. Objectives: This study aimed to compare the effect of pharmacist-assisted transition of care versus standard care models towards healthcare resource utilization among medical ward patients. Methods: A cluster randomized controlled study was conducted among medical ward patients in a Malaysian secondary hospital from July to December 2019. Intervention group received pharmacist-assisted discharge medication reconciliation, bedside discharge medication delivery with counselling and a timely post-discharge callback. Control group followed standard discharge process with medication collection at ambulatory pharmacy without post-discharge phone calls. Study endpoints included pharmacy first refill persistency, resolution on unintended discharge medication discrepancies and 30-days all-cause rehospitalization. Results: A total of 168 patients with 84 patients in each arm were recruited. Intervention resulted a higher pharmacy first refill persistency (70.2% versus 50.0%, p<0.05), indicating a lowering in subsequent unscheduled refill rate. Under intervention, consistent rate of resolution from discrepancies (100.0%, IQR 0 versus 100.0%, IQR 67; p<0.05) was demonstrated that corresponded to medication cost-savings of RM6.80 per prescription over control. Unplanned rehospitalization was not significantly different between groups (p>0.05) but towards a trend of 10% reduction after intervention. Conclusion Pharmacist-led transition care model demonstrated promising effect towards a reduction in healthcare resource use compared to standard care. Future studies for its standardization across institutions are warranted to facilitate service expansion.
Patient Transfer