https://mnclhd.intersearch.com.au/mnclhdjspui/handle/123456789/15 2026-05-23T08:25:24Z https://mnclhd.intersearch.com.au/mnclhdjspui/handle/123456789/492 Title: Pathogenesis and management of immune dysfunction secondary to B cell haematological malignancies Authors: Crassini, K.; Gibson, J. Abstract: Malignancies of the B-lymphocyte lineage are among the most diagnosed haematological malignancies in clinical practice. In our community, multiple myeloma (MM) and its precursor condition monoclonal gammopathy of undetermined significance are the commonest, accounting for ~12% of diagnoses, followed by chronic lymphocytic leukaemia (CLL) and its precursor condition monoclonal B lymphocytosis, ~9%. Along with diffuse large B cell lymphoma, follicular lymphoma and marginal zone lymphoma, these conditions comprise around a third of all haematological malignancies diagnosed. Infection remains an important cause of mortality and morbidity in the management of patients with these conditions. This is in part treatment-related but also reflective of disease-related immune dysfunction. Infectious complications account for up to 50% of early mortality in patients with myeloma and up to 50% of all mortality in patients with CLL. A variety of strategies are available to decrease the morbidity and mortality of infectious complications; however, practices vary between countries and often between treating physicians. Treatment options have evolved significantly over the last decade, with the introduction of monoclonal antibodies, small molecule inhibitors, second- and third-generation immunomodulatory agents and CAR-T cell therapy. Much of the data that inform clinical practice in infection management predates current therapeutic approaches. This is in part because of the rapid development of new therapies but also reflective of the long natural history of many of these diseases and the need for prolonged periods of observation. In this article, we review the aspects of disease and treatment that contribute to immune dysfunction in MM, CLL and B-cell non-Hodgkin lymphoma and review the current strategies used to manage immune dysfunction and infection. Keywords: CLL; acquired immune deficiency; immune dysfunction; myeloma; non-Hodgkin lymphoma. 2024-01-01T00:00:00Z https://mnclhd.intersearch.com.au/mnclhdjspui/handle/123456789/422 Title: Poor outcomes for trial-ineligible patients receiving polatuzumab for relapsed/refractory diffuse large B-cell lymphoma in routine care: An Australian Lymphoma and Related Diseases Registry project Authors: Shaw, B.; Chung, E.; Wellard, C.; Yoo, E.; Bennett, R.; Birks, C.; Johnston, A.; Cheah, C. Y.; Hamad, N.; Simpson, J.; Barraclough, A.; Ku, M.; Viiala, N.; Ratnasingam, S.; Armytage, T.; Cochrane, T.; Chong, G.; Lee, D.; Manos, K.; Keane, C.; Wallwork, S.; Opat, S.; Hawkes, E. A. Abstract: Polatuzumab vedotin (Pola) is an approved therapy in combination with rituximab and bendamustine for relapsed or refractory diffuse large B-cell lymphoma (RR-DLBCL) based on positive results of the landmark phase II randomised G029365 trial. However, trial results for many approved novel therapies in RR-DLBCL have not been replicated in routine care cohorts, as RR-DLBCL patient populations are heterogeneous and trial eligibility is increasingly restrictive. We evaluated outcomes from pola ± bendamustine and rituximab in patients with RR-DLBCL enrolled in a compassionate access program with no alternative treatment options identified via the Australasian Lymphoma and Related Diseases Registry according to their eligibility for the original phase II published study. Of 58 eligible patients, 74% met the criteria deeming them ineligible for the G029365 original study at the time of pola's commencement. Median progression-free survival and overall survival in our cohort were 2.3 and 3.5 months, respectively. In contrast to the landmark trial cohort, more of our patients ceased therapy prior to completion, the majority due to progressive disease and only 8/58 received any subsequent treatment. Dismal outcomes in this Australian real-world population demonstrate trial eligibility is challenging to meet, and newer treatments can be difficult to deliver in routine care. Clinically applicable results from therapeutic studies require trial cohorts to reflect representative clinical populations wherever possible, and more research is required to address the benefit of novel agents in the increasing majority who are ineligible for modern studies. 2024-02-01T00:00:00Z https://mnclhd.intersearch.com.au/mnclhdjspui/handle/123456789/395 Title: 'Real-world' Australian experience of pomalidomide for relapsed and refractory myeloma Authors: Scott, A.; Weber, N.; Tiley, C.; Taylor, K.; Taper, J.; Harrison, S.; Chan, K. L.; Stark, R.; Lee, C.; Morris, K.; Ho, P. J.; Dodds, A.; Ramanathan, S.; Ramakrishna, R.; Watson, A. M.; Auguston, B.; Kwok, F.; Quach, H.; Warburton, P.; Rowlings, P.; Mollee, P. Abstract: No abstract available. 2018-06-01T00:00:00Z https://mnclhd.intersearch.com.au/mnclhdjspui/handle/123456789/250 Title: Increasing access to screening for blood-borne viruses and sexually transmissible infections for Aboriginal and Torres Strait Islander Australians: evaluation of the Deadly Liver Mob program's 'cascade of care' across nine sites in New South Wales, Australia Authors: Cama, E.; Beadman, K.; Beadman, M.; Smith, K-A.; Christian, J.; Jackson, A. C.; Tyson, B.; Anderson, C.; Smyth, L.; Heslop, J.; Gahan, G.; Tawil, V.; Sheaves, F.; Maher, L.; Page, J.; Tilley, D.; Ryan, A.; Grant, K.; Donovan, B.; Stevens, A.; Slattery, T.; Pearce, K.; John-Leader, F.; Walden, A.; Lenton, J.; Corwley, M.; Treloar, C. Abstract: Background: Aboriginal and Torres Strait Islander Australians are disproportionately impacted by blood-borne viruses (BBVs) and sexually transmissible infections (STIs). Stigma remains one of the key barriers to testing and treatment for BBVs and STIs, particularly among Aboriginal and Torres Strait Islander people. The Deadly Liver Mob (DLM) is a peer-delivered incentivised health promotion program by and for Aboriginal and Torres Strait Islander Australians. The program aims to increase access to BBV and STI education, screening, treatment, and vaccination for Aboriginal and Torres Strait Islander Australians in recognition of the systemic barriers for First Nations people to primary care, including BBV- and STI-related stigma, and institutional racism. This paper presents routinely collected data across nine sites on the 'cascade of care' progression of Aboriginal and Torres Strait Islander clients through the DLM program: hepatitis C education, screening, returning for results, and recruitment of peers. Methods: Routinely collected data were collated from each of the DLM sites, including date of attendance, basic demographic characteristics, eligibility for the program, recruitment of others, and engagement in the cascade of care. Results: Between 2013 and 2020, a total of 1787 Aboriginal and Torres Strait Islander clients were educated as part of DLM, of which 74% went on to be screened and 42% (or 57% of those screened) returned to receive their results. The total monetary investment of the cascade of care progression was approximately $56,220. Data highlight the positive impacts of the DLM program for engagement in screening, highlighting the need for culturally sensitive, and safe programs led by and for Aboriginal and Torres Strait Islander people. However, the data also indicate the points at which clients 'fall off' the cascade, underscoring the need to address any remaining barriers to care. Conclusions: The DLM program shows promise in acting as a 'one stop shop' in addressing the needs of Aboriginal and Torres Strait Islander people in relation to BBVs and STIs. Future implementation could focus on addressing any potential barriers to participation in the program, such as co-location of services and transportation. Keywords: Aboriginal and Torres Strait Islander people; Blood-borne viruses; Health promotion; Hepatitis C; Sexually transmissible infections. 2023-09-01T00:00:00Z