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      Philadelphia-negative chronic myeloproliferative neoplasm follow-up: when the phone rings. Changes during the COVID-19 pandemic and patient satisfaction. Experience in 30 health centers in Spain

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      Annals of Hematology
      Springer Berlin Heidelberg
      COVID-19, Ph-MPN, Follow-up, Telemedicine, Patient satisfaction, Spain

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          Abstract

          The SARS-CoV-2 pandemic has favored the expansion of telemedicine. Philadelphia-negative chronic myeloproliferative neoplasms (Ph-MPN) might be good candidates for virtual follow-up. In this study, we aimed to analyze the follow-up of patients with Ph-MPN in Spain during COVID-19, its effectiveness, and acceptance among patients. We present a multicenter retrospective study from 30 centers. Five hundred forty-one patients were included with a median age of 67 years (yr). With a median follow-up of 19 months, 4410 appointments were recorded. The median of visits per patient was 7 and median periodicity was 2.7 months; significantly more visits and a higher frequency of them were registered in myelofibrosis (MF) patients. 60.1% of visits were in-person, 39.5% were by telephone, and 0.3% were videocall visits, with a predominance of telephone visits for essential thrombocythemia (ET) and polycythemia vera (PV) patients over MF, as well as for younger patients (< 50 yr). The proportion of phone visits significantly decreased after the first semester of the pandemic. Pharmacological modifications were performed only in 25.7% of the visits, and, considering overall management, ET patients needed fewer global treatment changes. Telephone contact effectiveness reached 90% and only 5.4% required a complementary in-person appointment. Although 56.2% of the cohort preferred in-person visits, 90.5% of our patients claimed to be satisfied with follow-up during the pandemic, with an 83% of positive comments. In view of our results, telemedicine has proven effective and efficient, and might continue to play a complementary role in Ph-MPN patients’ follow-up.

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          Virtually Perfect? Telemedicine for Covid-19

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            Telehealth for global emergencies: Implications for coronavirus disease 2019 (COVID-19)

            The current coronavirus (COVID-19) pandemic is again reminding us of the importance of using telehealth to deliver care, especially as means of reducing the risk of cross-contamination caused by close contact. For telehealth to be effective as part of an emergency response it first needs to become a routinely used part of our health system. Hence, it is time to step back and ask why telehealth is not mainstreamed. In this article, we highlight key requirements for this to occur. Strategies to ensure that telehealth is used regularly in acute, post-acute and emergency situations, alongside conventional service delivery methods, include flexible funding arrangements, training and accrediting our health workforce. Telehealth uptake also requires a significant change in management effort and the redesign of existing models of care. Implementing telehealth proactively rather than reactively is more likely to generate greater benefits in the long-term, and help with the everyday (and emergency) challenges in healthcare.
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              Philadelphia chromosome-negative classical myeloproliferative neoplasms: revised management recommendations from European LeukemiaNet

              This document updates the recommendations on the management of Philadelphia chromosome-negative myeloproliferative neoplasms (Ph-neg MPNs) published in 2011 by the European LeukemiaNet (ELN) consortium. Recommendations were produced by multiple-step formalized procedures of group discussion. A critical appraisal of evidence by using Grades of Recommendation, Assessment, Development and Evaluation (GRADE) methodology was performed in the areas where at least one randomized clinical trial was published. Seven randomized controlled trials provided the evidence base; earlier phase trials also informed recommendation development. Key differences from the 2011 diagnostic recommendations included: lower threshold values for hemoglobin and hematocrit and bone marrow examination for diagnosis of polycythemia vera (PV), according to the revised WHO criteria; the search for complementary clonal markers, such as ASXL1, EZH2, IDH1/IDH2, and SRSF2 for the diagnosis of myelofibrosis (MF) in patients who test negative for JAK2V617, CALR or MPL driver mutations. Regarding key differences of therapy recommendations, both recombinant interferon alpha and the JAK1/JAK2 inhibitor ruxolitinib are recommended as second-line therapies for PV patients who are intolerant or have inadequate response to hydroxyurea. Ruxolitinib is recommended as first-line approach for MF-associated splenomegaly in patients with intermediate-2 or high-risk disease; in case of intermediate-1 disease, ruxolitinib is recommended in highly symptomatic splenomegaly. Allogeneic stem cell transplantation is recommended for transplant-eligible MF patients with high or intermediate-2 risk score. Allogeneic stem cell transplantation is also recommended for transplant-eligible MF patients with intermediate-1 risk score who present with either refractory, transfusion-dependent anemia, blasts in peripheral blood > 2%, adverse cytogenetics, or high-risk mutations. In these situations, the transplant procedure should be performed in a controlled setting.
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                Author and article information

                Contributors
                sanosorio2000@gmail.com
                Journal
                Ann Hematol
                Ann Hematol
                Annals of Hematology
                Springer Berlin Heidelberg (Berlin/Heidelberg )
                0939-5555
                1432-0584
                23 November 2022
                : 1-10
                Affiliations
                [1 ]GRID grid.410526.4, ISNI 0000 0001 0277 7938, Hematology Department, , Gregorio Marañón General University Hospital, ; Madrid, Spain
                [2 ]GRID grid.411083.f, ISNI 0000 0001 0675 8654, Hematology Department, , Vall d’Hebron University Hospital, ; Barcelona, Spain
                [3 ]GRID grid.411375.5, ISNI 0000 0004 1768 164X, Hematology Department, , Virgen Macarena University Hospital, ; Seville, Spain
                [4 ]GRID grid.414792.d, ISNI 0000 0004 0579 2350, Hematology Department, , Lucus Augusti University Hospital, ; Lugo, Spain
                [5 ]Hematology Department, University Hospital Complex, Albacete, Spain
                [6 ]Hematology Department, La Ribera Alzira University Hospital, Valencia, Spain
                [7 ]GRID grid.410458.c, ISNI 0000 0000 9635 9413, Hematology Department, , Hospital Clinic of Barcelona, ; Barcelona, Spain
                [8 ]GRID grid.419651.e, ISNI 0000 0000 9538 1950, Hematology Department, , Fundación Jiménez-Díaz University Hospital, ; Madrid, Spain
                [9 ]GRID grid.411289.7, ISNI 0000 0004 1770 9825, Hematology Department, , Dr Peset University Hospital, ; Valencia, Spain
                [10 ]GRID grid.411171.3, ISNI 0000 0004 0425 3881, Hematology Department, , Móstoles University Hospital, ; Madrid, Spain
                [11 ]GRID grid.413563.6, ISNI 0000 0001 2331 2267, Hematology Department, , San Cecilio de Granada University Hospital, ; Granada, Spain
                [12 ]Hematology Department, Grupo Recoletas Hospital (Campo Grande, Zamora, Palencia Y Segovia), Palencia, Spain
                [13 ]GRID grid.411106.3, ISNI 0000 0000 9854 2756, Hematology Department, , Miguel Servet University Hospital, ; Saragossa, Spain
                [14 ]GRID grid.413937.b, ISNI 0000 0004 1770 9606, Hematology Department, , Arnau de Vilanova Hospital, ; Valencia, Spain
                [15 ]Hematology Department, Asistential Complex of Palencia, Palencia, Spain
                [16 ]GRID grid.411171.3, ISNI 0000 0004 0425 3881, Hematology Department, , Henares University Hospital, ; Madrid, Spain
                [17 ]GRID grid.81821.32, ISNI 0000 0000 8970 9163, Hematology Department, , La Paz University Hospital, ; Madrid, Spain
                [18 ]GRID grid.411372.2, ISNI 0000 0001 0534 3000, Hematology Department, , Clínico Virgen de La Arrixaca University Hospital, ; Murcia, Spain
                [19 ]GRID grid.411052.3, ISNI 0000 0001 2176 9028, Hematology Department, , Central University Hospital of Asturias, ; Oviedo, Spain
                [20 ]Hematology Department, Galdakao-Usansolo Hospital, Bizkaia, Spain
                [21 ]GRID grid.411171.3, ISNI 0000 0004 0425 3881, Hematology Department, , Sureste University Hospital, ; Madrid, Spain
                [22 ]Hematology Department, La Fe University and Polytechnic Hospital, Valencia, Spain
                [23 ]GRID grid.411164.7, ISNI 0000 0004 1796 5984, Hematology Department, , Son Espases University Hospital, ; Palma de Mallorca, Spain
                [24 ]GRID grid.414875.b, ISNI 0000 0004 1794 4956, Hematology Department, , Mutua Terrassa University Hospital, ; Barcelona, Spain
                [25 ]GRID grid.411347.4, ISNI 0000 0000 9248 5770, Hematology Department, , “IRYCIS” Ramón Y Cajal University Hospital, ; Madrid, Spain
                [26 ]Hematology Department, Príncipe de, Asturias University Hospital, Alcalá de Henares, Spain
                [27 ]GRID grid.411308.f, Hematology Department, , Clinic University Hospital, ; Valencia, Spain
                [28 ]GRID grid.411250.3, ISNI 0000 0004 0399 7109, Hematology Department, , Doctor Negrín University Hospital, ; Gran Canaria, Spain
                [29 ]GRID grid.411220.4, ISNI 0000 0000 9826 9219, Hematology Department, , Canarias University Hospital, ; Tenerife, Spain
                [30 ]GRID grid.411171.3, ISNI 0000 0004 0425 3881, Hematology Department, , San Carlos Clinic University Hospital, ; Madrid, Spain
                Author information
                http://orcid.org/0000-0002-9277-8148
                http://orcid.org/0000-0002-6745-0490
                Article
                5044
                10.1007/s00277-022-05044-x
                9686214
                36422672
                3fcf3093-fd4f-4b7b-b251-1a159ccca0a0
                © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2022, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

                This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

                History
                : 18 September 2022
                : 8 November 2022
                Categories
                Original Article

                Hematology
                covid-19,ph-mpn,follow-up,telemedicine,patient satisfaction,spain
                Hematology
                covid-19, ph-mpn, follow-up, telemedicine, patient satisfaction, spain

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