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Older People Taking More Risks With Food Safety
People over the age of 60 are more likely than younger people to take risks with "use by" dates, according to new research findings published by the Food Standards Agency.
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Donor Stem Cell Transplantation Associated With Survival Benefit For Patients With Leukemia
An analysis of previous studies indicates that allogeneic stem cell transplantation (SCT) (stem cells from a compatible donor) is associated with significant overall and relapse-free survival benefit among adult patients with intermediate- and poor-risk but not good-risk acute myeloid leukemia in first complete remission, compared with nonallogeneic SCT therapies, according to an article in the June 10 issue of JAMA.
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Calif. Senate Advances Bill To Ban Health Insurance 'Gender Rating'
The California Senate last week approved a bill (S.B. 54) that would prohibit health insurance companies from charging different rates for individual insurance policies based on gender, the San Francisco Chronicle reports (Buchanan, San Francisco Chronicle, 5/15). The state Assembly last Monday voted 48-29 in favor of a similar measure (A.B. 119). Insurance companies maintain that the practice, known as gender rating, is justified because younger women typically seek health care services more frequently than men. According to a report by the National Women"s Law Center, women can pay up to 20% more than men for the same individual coverage. Federal law already prohibits employers that offer health plans from charging different rates based on gender, and ten states have similar laws that apply to individual plans. However, the remaining 40 states allow the practice.State Sen. Mark Leno (D) authored the Senate legislation after San Francisco filed a lawsuit against the state seeking to outlaw gender rating. The lawsuit is on hold pending the outcome of the two bills (Buchanan, San Francisco Chronicle, 5/14).
Oncology

Donor Stem Cell Transplantation Associated With Survival Benefit For Patients With Leukemia

An analysis of previous studies indicates that allogeneic stem cell transplantation (SCT) (stem cells from a compatible donor) is associated with significant overall and relapse-free survival benefit among adult patients with intermediate- and poor-risk but not good-risk acute myeloid leukemia in first complete remission, compared with nonallogeneic SCT therapies, according to an article in the June 10 issue of JAMA. The optimal curative treatment of acute myeloid leukemia (AML) in first complete remission (CR1) is uncertain. While more than 70 percent of younger adult patients with newly diagnosed AML will enter a CR1 after initial (induction) chemotherapy, a substantial number subsequently experience disease relapse, according to background information in the article. "Allogeneic SCT after myeloablative conditioning [high-dose radiation and/or chemotherapy given to destroy normal and cancerous cells in the bone marrow prior to infusion of donor stem cells] is a curative treatment option for younger patients with AML in CR1. However, concerns regarding allogeneic SCT-related toxicity, and questions regarding its benefit, limit its use for patients who have attained an initial remission," the authors write. John Koreth, M.B.B.S., D.Phil., of the Dana Farber Cancer Institute, Boston, and colleagues conducted a meta-analysis to quantify relapse-free survival (RFS) and overall survival benefit of allogeneic SCT for AML in CR1 overall, and also for good-, intermediate-, and poor-risk AML. The researchers conducted a search for articles on trials evaluating allogeneic SCT vs. nonallogeneic SCT therapies (autologous [donor and recipient are the same person] SCT, consolidation chemotherapy, or both) for AML in CR1. The researchers identified 24 trials that met criteria for inclusion in the analysis, which included 6,007 patients (5,951 patients in RFS analyses and 5,606 patients in overall survival analyses); 3,638 patients were analyzed by cytogenetic (abnormalities in the composition of the chromosomes) risk (547, 2,499, and 592 with good-, intermediate-, and poor-risk AML, respectively). "Our primary finding is that the totality of the prospective trial data indicates statistically significant RFS and overall survival benefit with allogeneic SCT for adult AML in CR1. This conclusion is supported by a variety of sensitivity and subgroup analyses ò€¦. Additionally, our analyses indicate that allogeneic SCT benefit likely varies by AML cytogenetic risk. We document significant RFS and overall survival benefit for allogeneic SCT in intermediate- and poor-risk AML, and a lack of significant RFS or overall survival benefit for good-risk AML," the authors write. "While enrollment in therapeutic trials is to be encouraged, our findings provide evidence to guide clinical decision making and future trial design." JAMA 2009;301[22]:2349-2361. Journal of the American Medical Association


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