Background: Oncological health care services are challenged by the increasing number of cancer survivors, long-term follow-up care, and fragmentation of care. Digital care platforms are potential tools to deliver affordable, patient-centered oncological care. Previous reviews evaluated only one feature of a digital care platform or did not evaluate the effect on enhancement of information, self-efficacy, continuity of care, or patient- and health care provider–reported experiences. Additionally, they have not focused on the barriers and facilitators for implementation of a digital care platform in oncological care. Objective: The aim of this systematic review was to collect the best available evidence of the effect of a digital care platform on quality of care parameters such as enhancement of available information, self-efficacy, continuity of care, and patient- and health care provider–reported experiences. Additionally, barriers and facilitators for implementation of digital care platforms were analyzed. Methods: The PubMed (Medline), Embase, CINAHL, and Cochrane Library databases were searched for the period from January 2000 to May 2020 for studies assessing the effect of a digital care platform on the predefined outcome parameters in oncological patients and studies describing barriers and facilitators for implementation. Synthesis of the results was performed qualitatively. Barriers and facilitators were categorized according to the framework of Grol and Wensing. The Mixed Methods Appraisal Tool was used for critical appraisal of the studies. Results: Seventeen studies were included for final analysis, comprising 8 clinical studies on the effectiveness of the digital care platform and 13 studies describing barriers and facilitators. Usage of a digital care platform appeared to enhance the availability of information and self-efficacy. There were no data available on the effect of a digital care platform on the continuity of care. However, based on focus group interviews, digital care platforms could potentially improve continuity of care by optimizing the exchange of patient information across institutes. Patient-reported experiences such as satisfaction with the platform were considerably positive. Most barriers for implementation were identified at the professional level, such as the concern for increased workload and unattended release of medical information to patients. Most facilitators were found at the patient and innovation levels, such as improved patient-doctor communication and patient empowerment. There were few barriers and facilitators mentioned at the economic and political levels. Conclusions: The use of digital care platforms is associated with better quality of care through enhancement of availability of information and increased self-efficacy for oncological patients. The numerous facilitators identified at the patient level illustrate that patients are positive toward a digital care platform. However, despite these favorable results, robust evidence concerning the effectiveness of digital care platforms, especially from high-quality studies, is still lacking. Future studies should therefore aim to further investigate the effectiveness of digital care platforms, and the barriers and facilitators to their implementation at the economic and political levels.

Background: With the global rise in chronic health conditions, health care is transforming, and patient empowerment is being emphasized to improve treatment outcomes and reduce health care costs. Patient-centered innovations are needed. We focused on patients with chronic myeloid leukemia (CML), a chronic disease with a generally good long-term prognosis because of the advent of tyrosine kinase inhibitors. However, both medication adherence by patients and guideline adherence by physicians are suboptimal, unnecessarily jeopardizing treatment outcomes. Objective: The aim of this study was to develop a patient-centered innovation for patients with CML using a design thinking methodology. Methods: The 5 phases of design thinking (ie, empathize, define, ideate, prototype, and test) were completed, and each phase started with the patient. Stakeholders and end users were identified and interviewed, and observations in the care system were made. Using tools in human-centered design, problems were defined and various prototypes of solutions were generated. These were evaluated by patients and stakeholders and then further refined. Results: The patients desired (1) insights into their own disease; (2) insights into the symptoms experienced, both in terms of knowledge and comprehension; and (3) improvements in the organization of care delivery. A web-based platform, CMyLife, was developed and pilot-tested. It has multiple features, all targeting parts of the bigger solution, including a website with reliable information and a forum, a guideline app, personal medical records with logs of symptoms and laboratory results (including a molecular marker and linked to the guideline app), tailored feedback based on the patients’ symptoms and/or results, screen-to-screen consulting, delivery of medication, and the collection of blood samples at home. Conclusions: The multifeatured innovation, CMyLife, was developed in a multidisciplinary way and with active patient participation. The aim of developing CMyLife was to give patients the tools to monitor their results, interpret these results, and act on them. With this tool, they are provided with the know-how to consider their results in relation to their personal care process. Whether CMyLife achieves its goal and the evaluation of the added value will be the focus of future studies. CML could become the first malignancy for which patients are able to monitor and manage their disease by themselves.

Complement C5 inhibitor eculizumab has a great impact on the treatment of patients with paroxysmal nocturnal hemoglobinuria (PNH). However, this treatment success has a major drawback: a substantially increased susceptibility for life-threatening Neisseria meningitidis infections. Therefore, N meningitidis vaccination is strongly advised before initiating complement C5–blocking therapy. In this study, we show that the multicomponent N meningitidis serogroup B (4CMenB) vaccination of PNH patients treated with eculizumab results in a significant increase in anti–N meningitidis serogroup B (MenB) plasma immunoglobulin G (IgG) levels. Anti-MenB IgG was able to bind to the bacterial surface and initiate complement activation; however, inhibition of the membrane attack complex formation completely blocked whole blood–mediated killing of MenB. This would suggest that, despite 4CMenB vaccination, PNH patients taking C5 inhibitors are not sufficiently protected against MenB infection, which is in line with the fact that vaccinated PNH patients still experience meningococcal infections.

Patients with hematological malignancies (HM) or undergoing hematopoietic cell transplantation (HCT) face high risk of bloodstream infections (BSI) during febrile neutropenia. Rising antimicrobial resistance (AMR), especially among Gram-negative (GN) bacteria, challenges effective empirical antibiotic therapy (EAT) selection. This ECIL-10 systematic review updates European resistance epidemiology since the 2011 ECIL-4 guidelines publication to inform clinical recommendations. We conducted a systematic review (ID: CRD42025638003) of bacterial epidemiology and resistance in HM/HCT patients across Europe, from June 2011 to September 2024 using PubMed, Embase, and Web of Science according to PRISMA guidelines. We included studies reporting BSI or colonization rates and resistance patterns, including extended-spectrum beta-lactamase-producing/third-generation cephalosporin-resistant (ESBL/3GCR), fluoroquinolone-resistant (FQ-R) carbapenem-resistant (CR), and multidrug-resistant (MDR) for GN bacteria; methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) for Gram-positive (GP) bacteria. Two reviewers independently extracted data with ECDC/EARS-Net surveillance 2011 and 2022 data providing supporting analysis. We examined fluoroquinolone prophylaxis (FQ-P) impact on BSI rate and resistance. Analysis included 40 studies (33,387 patients/febrile episodes from observational studies and 21,402 patients from one meta-analysis) across 12 European countries. BSI prevalence averaged 30% (range, 15-59%), with 42% GN and 51% GP distribution. Median resistance rates among GN BSI were: 55% for FQ-R, 30% for ESBL/3GCR, 13% for both CR and MDR. CR reached 26% in P. aeruginosa (PsA) and 38% in K. pneumoniae (KPn). Among GP BSI resistance was 3% for MRSA and 1% for VRE. Colonization studies demonstrated 20% ESBL/3GCR and 5% CR rates. We identified a southeastern European resistance gradient and significant temporal increase in ESBL/3GCR, CR KPn, and MDR PsA, confirmed in ECDC/EAR-Net analysis. FQ-P reduced overall and GN BSI incidence but increased FQ-R and ESBL/3GCR GN infections in adults. In children, FQ-P reduced BSI in leukemia but not in HCT and data on resistance were inconclusive. ECIL-10 proposed resistance reporting aligned with ESCMID/IDSA guidelines. AMR presents an escalating challenge in febrile neutropenic HM/HCT patients with geographical variability and increasing resistance trends. These findings strongly support the need for updated guidelines, antimicrobial stewardship programs, rapid diagnostics implementation, and prospective studies to optimize effective empirical therapy strategies.

Health-related quality of life (HRQOL) assessment is important to facilitate decisions in the current treatment landscape of chronic myeloid leukemia (CML). Therefore, the availability of a validated HRQOL questionnaire, specifically developed for CML patients treated with tyrosine kinase inhibitors (TKIs), may enhance quality of research in this area. We performed an international study including 782 CML patients to assess the validity of the EORTC QLQ-CML 24 questionnaire, and to generate HRQOL reference values to facilitate interpretation of results in future studies. Internal consistency, assessed with Cronbach’s alpha coefficients, ranged from 0.66 to 0.83. In the confirmatory factor analysis, all standardized factor loadings exceeded the threshold of 0.40 (range 0.49–0.97), confirming the hypothesized scale structure. Reference values stratified by age and sex were also generated. Our findings support the use of the EORTC QLQ-CML 24, in conjunction with the EORTC QLQ-C30, as a valuable measure to assess HRQOL in CML patients.