Citations

Abstract Objective: To define the incidence of donor-derived infection (DDI) in recipients of solid organ transplant (SOT) from donors with positive blood cultures and to assess the impact of shorter versus longer duration of targeted preemptive antibiotic therapy (PAT). Design: Retrospective, single-center, cohort study. Setting: Mayo Clinic Arizona. Patients: Recipients transplanted between 1/1/2019 and 7/1/2024 who received an organ from a donor with positive blood cultures. Methods: The primary outcome was incidence of DDI. Secondary outcomes included duration of PAT and incidence of donor blood culture contamination. Results: Among 199 SOT recipients from 167 unique donors with positive blood cultures, two recipients developed confirmed DDI within 30 days of SOT. Both cases were gram negative bacillary bacteremia not treated in donors and occurred immediately posttransplant prior to adequate recipient PAT. Six-month graft survival and recipient survival were 96.5% and 97.5% respectively. 139 recipients (69.8%) received PAT for a median duration of 7 days. There was no difference in rate of infections between recipients provided with ≤7 days versus 8–14 days of PAT for donor blood cultures; however, recipients who received 8–14 days had more Clostridioides difficile infections (CDIs) within 60 days of SOT (7.7% vs 1.5% ≤ 7 days, P = .040) and were more often discharged on intravenous antibiotics (32.3% vs 11.3%, P < .001). Conclusion: We observed a low rate of DDI following receipt of organs from donors with positive blood cultures. DDI occurred in cases without adequate donor/recipient treatment. Longer durations of targeted PAT resulted in more CDI and intravenous antibiotics on discharge.

Abstract Introduction: Attending to survivorship including distress in the contexts of social drivers (SDH) is critical but lacking. In response, this novel research on Black CaP survivors (CaPS) aims to measure SDH distresses and assess utility of a digital intervention to inform survivorship studies, practice and outcomes. Method: Informed by the Science of Survivorship, and our pilot study with multisectoral stakeholders, we assessed SDH and acceptability/utility of a digital Survivorship Care (SC) Toolkit. SCToolkit is a digitized whole-person care with guidance from multisectoral stakeholders e.g., clinicians and survivors. SCToolkit includes: ASCO informed treatment summary template for diagnostics, treatments, side effects, care team, genetics, and comorbidities, and patient active guide on survivorship concerns, provider communication, health advisories, survivorship care booklet, SDH FINDHELP resource, and survivorship videos. SCToolkit was delivered via survivors’ personal REDCap file, and can be uploaded to their EMR patient portal for easy-to-use survivorship roadmap accessible on smartphones, laptops, and computers. Motivational Interviewing was provided via Zoom to facilitate digital efficacy and SCToolkit use. Descriptive analyses were conducted using SAS. Citation Format: Kimlin Ashing, Floyd Willis, Christopher Williams, John McCall, Gaole Song, Douglas Adu-Fokuo, Erika Galdamez, Fornati Bedell, Cassandra N. Moore, EWAN COBRAN, Che Ngufor, Kathleen J. Yost, Timethia J. Bonner, Getachew Dagne, Arnold Merriweather, Ernest T. Kaninjing, Rotimi Oladapo, Roxana S. Dronca, Folakemi T. Odedina. Examining contextual distress and utility of a digital survivorship care toolkit [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2026; Part 1 (Regular Abstracts); 2026 Apr 17-22; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2026;86(7 Suppl):Abstract nr 880.

Obesity is a persistent public health issue, often resulting in metabolic complications such as insulin resistance (IR). The secretion of pro-inflammatory cytokines from adipose tissue (AT) is increased during obesity, contributing to the impairment of systemic insulin sensitivity. While interventions in animal models have shown that reducing inflammation restores insulin sensitivity, human studies reducing systemic inflammation have produced inconsistent results. We recently demonstrated that three months of high-dose (4 g/daily) ω-3PUFA (fish oil, FO) supplementation improved insulin sensitivity, and decreased systemic and AT inflammation in individuals with obesity (BMI ≥ 30 kg/m2). Given recent studies highlighting the involvement of microRNA (miRNA) in inflammatory cytokine production, we investigated the effect of ω-3PUFA supplementation on AT miRNA expression in this cohort. AT biopsies were collected before and after ω-3PUFA supplementation. miRNA was processed on the Affymetrix miRNA 4.0 GeneChip and analyzed using existing inflammatory gene sets sourced from MSigDB. Unbiased, differentially expressed miRNA analysis identified miR-4498 and miR-5689 as significantly increased after three months of ω-3PUFA supplementation. Real-time PCR confirmed bioinformatic analysis findings. Our study reports the modulation of miRNA in AT, reductions in systemic and AT markers of inflammation, and the improvement of IR post ω-3PUFA supplementation. Further research is needed to elucidate the link between miR-4498, miR-5689, and whole-body insulin sensitivity.

OBJECTIVE: Accurate assessment of skin and skin changes across diverse populations is critical for patient health. To promote the knowledge and skills nurses need in practice to identify skin changes, nurse educators must include content on assessment of diverse skin tones in nursing education programs. This study’s objective was to develop and pilot education modules about the assessment of diverse skin tones to be part of an undergraduate nursing course. METHODS: In this quality improvement project, modules highlighted the importance of skin assessment and appropriate techniques for assessing erythema, pallor, cyanosis, and jaundice on diverse skin tones. Undergraduate nursing students completed a questionnaire evaluating the modules and their learning experience. RESULTS: The majority of students (≥70%) agreed or highly agreed that the modules were interesting, informative, engaging, and increased their knowledge. Comments to open-ended questions supported their evaluation ratings. CONCLUSIONS: Undergraduate nursing students positively received education modules on assessing patients with diverse skin tones. Students perceived the modules as having the potential to enhance their learning and assessment skills to prevent and detect skin changes associated with pressure injury. The modules serve as an example of a strategy to integrate education content about diverse skin tones into nursing curricula.

Background: A critical component of conducting systematic reviews or meta-analyses is assessing the methodological quality and bias of included studies. Several methodological quality assessment tools have been developed; however, these tools may not be relevant to observational sports medicine research, which carries numerous unique nuances and biases. Purpose: To develop the Sport Publication Observational Research Tool (SPORT), which evaluates and scores the methodological quality of observational sports medicine research. Study Design: Consensus statement. Methods: SPORT was developed through a modified Delphi approach involving members from the Herodicus Society and The FORUM. All active members were invited to participate in the process aimed at building consensus on SPORT content and scoring. After finalizing SPORT, a power analysis led to the independent selection of 55 observational clinical sports medicine studies, which were scored twice by 4 reviewers of varying training levels. Interrater and intrarater reliability for SPORT was assessed using intraclass correlation coefficients (ICCs). The distribution and percentiles for total SPORT score across the 55 studies were calculated. SPORT was also compared with the methodological index for non-randomized studies (MINORS), a commonly utilized quality assessment tool. Results: A total of 51 members participated and achieved 100%, 100%, 98.0%, and 98.0% completion rates for rounds 1 through 4, respectively. The final SPORT included 19 subscores related to methodological quality and bias and achieved 94% consensus approval. Mean SPORT completion time was 6 minutes and 19 seconds per study, which varied significantly by reviewer training level. The subscore "peer review" demonstrated unacceptable reliability and was removed. The remaining 18 subscores exhibited ICC ranges of 0.599 to 0.955 for interrater reliability and 0.530 to 0.936 for intrarater reliability. Total SPORT score demonstrated excellent agreement, for interrater (ICC, 0.967) and intrarater reliability (ICC, 0.966). Median SPORT score across the 55 studies was 20.0 and skewed toward lower scores. There was a moderate significant correlation between SPORT and MINORS ( r [53] = 0.575; P < .001). Conclusion: An objective tool to assess the methodologic quality of observational sports medicine research (SPORT) was successfully developed through a modified Delphi approach with numerous content experts in the field. This tool may be useful in assessing the methodological quality of primary observational sports medicine studies included in systematic reviews and meta-analyses.

Abstract Introduction: Among Non-Hodgkin lymphomas (NHL), DLBCL is the most prevalent subtype (~30% of diagnoses). First-line (1L) chemoimmunotherapy cures many patients (pts), but 30-40% will relapse. Prognostic and predictive biomarkers are needed to identify pts refractory to 1L therapy or at high risk of relapse, enabling timely intervention and improved outcomes. This study evaluated tumor-informed WGS-based longitudinal ctDNA monitoring in a real-world DLBCL cohort. Methods: We retrospectively analyzed ctDNA data from 49 pts with DLBCL. Plasma samples were collected before, during, and at the end of 1L therapy (EOT, defined as ± 21 days from the last infusion (preferred when available) or ± 14 days from post-treatment PET imaging) and during surveillance/subsequent treatments. A WGS-based tumor-informed assay (Signatera™ Genome, Natera, Inc.) was used for ctDNA detection and quantification. The association of ctDNA dynamics with event-free survival (EFS) was evaluated using Cox regression analysis, restricted to pts completing at least 5 cycles of 1L therapy. Results: The median age of the cohort was 62 years (range: 56-74), and median follow-up was 22 months (range: 14-30). Pre-treatment ctDNA-positivity rate was 100% (31/31). A total of 19 pts achieved ctDNA clearance during 1L therapy (early clearance within 3 cycles, n=5; late clearance between cycle 4 and EOT, n=14). Pts with no clearance or ctDNA-positivity at EOT (n=7) had significantly inferior EFS compared to those achieving ctDNA clearance (HR 8.04, 95%CI: 1.87-34.62, p=0051). On further stratifying the clearance group and comparing with no clearances, pts with early clearance had superior outcomes (HR 13.22, 95%CI: 1.48-1741.94, p=0.0166), relative to late clearances (HR 5.65, 95%CI 1.46–25.16, p=0.0129). Notably, all 5 pts with early ctDNA clearance remained serially negative and relapse-free. Of the 49 pts, 9 proceeded to chimeric antigen receptor T-cell therapy (CAR-T). Among 6 of these pts with available ctDNA results pre and post therapy, all 3 who stayed ctDNA-positive after CAR-T relapsed (1.3, 2, and 4.5 months post-infusion); 1 pt with pre- and post-CAR-T ctDNA-negativity and 2 pts with ctDNA clearance post-CAR-T remained relapse-free for 9.6, 15.9, and 22.4 months, respectively. Taken together, the PPV and NPV for a single ctDNA time point post CAR-T infusion were 100% for predicting long-term clinical outcomes. Conclusions: Our data support longitudinal ctDNA monitoring as a valuable prognostic and predictive biomarker in DLBCL. ctDNA clearance, particularly early clearance within the first 3 cycles of 1L therapy, is associated with improved pt outcomes. Longitudinal ctDNA monitoring and dynamics can enable identification of high-risk pts who do not clear ctDNA and may benefit from earlier referral for CAR-T. Furthermore, ctDNA monitoring pre- and post-CAR-T infusion is predictive of treatment response and can identify pts at high risk of relapse.

Abstract Introduction: Primary central nervous system T-cell lymphoma (PCNSTL) is a rare form of PCNSL, comprising 2–8% of cases. Prognostic factors remain undefined, and no standard treatment protocol currently exists. Prior studies have been limited by small sample sizes, incomplete molecular profiling, and poor representation of novel treatment modalities. In this study, we aimed to identify clinicopathologic factors associated with patient (pt) outcomes and delineate the spectrum of treatment regimens used to inform future clinical practice. Methods A multicenter retrospective study was conducted across 15 North American academic institutions. Pts aged ≥18 years with biopsy-confirmed PCNSTL between 2009 and 2025 with no evidence of systemic disease were included. Cases with CNS relapse of systemic T-cell lymphoma were excluded. Baseline characteristics were analyzed using independent t-tests, Fisher's exact tests, or Pearson's chi-square tests. Primary endpoints were overall survival (OS) and progression-free survival (PFS), evaluated by Kaplan–Meier, log-rank tests, and Cox regression. Results: Forty-two pts met inclusion criteria. Median age was 57 (range 19–77), 69% were male, and 79% were white. Most (69%) had ECOG 0–1. No patients had HIV, hepatitis B or C, or a history of solid organ transplant. LDH was elevated at diagnosis in 38%, and 24% had B-symptoms. Mean absolute lymphocyte count at diagnosis was 1.82/µL. The most common histologic subtypes were PTCL-NOS (76%), followed by ALK-negative ALCL (12%) and γδ T-cell lymphoma (5%). All patients had parenchymal brain lesions with 57% having multifocal disease. Additionally, CSF involvement was seen in 21%, vitreoretinal involvement in 3%, and deep brain involvement in 34%. Next-generation sequencing was performed in seven pts (17%), with disease-associated variants identified in three cases. Among these, two pts had mutations in TP53, and one had a mutation in DNMT3A. Cytogenetics were obtained in 7 pts with only one exhibiting a complex karyotype. Only one pt was EBV positive by EBER-ISH. Overall, 79% received HD-MTX-based therapy. First-line treatments were mainly HD-MTX alone (38%), HD-MTX + temozolomide (17%), or vincristine + procarbazine (12%). No patients were treated on clinical trials. Median treatment duration was 78 days and median number of treatment cycles was 4 (range 1–9 cycles). One patient received radiation alone; 5% received radiation with systemic therapy. A steroid pre-phase was used in 60%, with 44% exhibiting a clinical response. Overall response rate to first-line treatment was 63% (13 CR, 12 PR). Imaging alone was used in determining response in all patients. Repeated biopsy was not performed. Twelve patients (29%) underwent consolidative autologous transplant, most commonly with thiotepa/carmustine (TT/BCNU, 69%) or BEAM conditioning (25%). Median duration of follow-up was 10.4 months. Sixty-two percent of pts progressed during the study period, with 7% experiencing extra-CNS relapse. Median PFS was 8.2 months. Improved PFS was associated with &gt;3 cycles of therapy (p=0.03) and transplant with TT/BCNU (p=0.0004). At last follow-up, 43% were in remission and 52% were deceased, mostly due to disease progression (77%). Median OS was 17.6 months. One- and two-year OS rates were 58% and 42%, respectively. OS was associated with Nottingham/Barcelona score &lt;2 (p=0.02), &gt;3 treatment cycles (p=0.0008), response to first-line therapy (p=0.0007), and TT/BCNU-based transplant (p=0.0001). IELSG, Taipei, and MSKCC risk scores were not significantly associated with survival, though IELSG approached significance (p=0.09). Discussion: This study is among the largest cohorts of PCNSTL pts compiled to date. PCNSTL remains rare and heterogenous. Treatment across centers largely mirrors management of B-cell PCNSL with high utilization of HD-MTX regimens and TT/BCNU conditioning autologous transplant. Survival outcomes within our cohort are consistent with those previously reported within the literature. Receipt of &gt;3 cycles of therapy, TT/BCNU conditioning and Nottingham/Barcelona scores were associated with longer survival within our cohort. Limitations of our study include its retrospective design and heterogeneity within pt disease characteristics, treatments utilized and disease assessment intervals. Further exploration into pathophysiology and optimal management of this unique entity is needed.

Abstract Introduction: Circulating tumor DNA (ctDNA) has emerged as a promising biomarker for treatment response monitoring, risk stratification, and early recurrence detection for patients with lymphoma. Tumor-informed ctDNA testing for detecting molecular residual disease (MRD) is seeing early adoption in this setting, demonstrating technical feasibility and clinical need for personalized monitoring tools. However, the prognostic utility of ctDNA across indolent and aggressive subtypes of lymphoma remains poorly understood. Here, we present real-world data on ctDNA detection and clearance dynamics in patients with various lymphoma subtypes, including patients who are newly diagnosed and those in the relapsed/refractory setting receiving chimeric antigen receptor (CAR)-T therapy. Methods: We performed a retrospective, real-world analysis of ctDNA testing in 148 patients with either B-cell (n=129) or T-cell lymphoma (n=19). Among the 129 patients with B-cell lymphoma, 113 patients had aggressive subtypes (n=84 with DLBCL; n=29 with other), and 16 had indolent lymphoma subtypes. ctDNA was analyzed using a tumor-informed 16-plex mPCR-NGS assay (SignateraTM, Natera, Inc.) from September 2020 - May 2025. Plasma samples (n=1,122; median: 7 per patient, range: 1-31) were collected at baseline, during therapy, at end-of-treatment (EOT), and during follow-up per physician's discretion. ctDNA status at baseline and EOT, and clearance kinetics during first-line (1L) induction therapy were correlated with clinical outcomes. Results: The median patient age was 61 years (range: 18.3–84), and median follow-up was 18.7 months (range: 0.6–54.4 months). Disease stage at diagnosis was available for 139 patients: stage I (n=15, 11%), stage II (n=31, 22%), stage III (n=16, 12%), and stage IV (n=77, 55%). Stage was unknown in 9 patients. Overall, ctDNA detection at baseline was 95.7% (90/94), including 100% in patients with indolent B-cell (11/11), and T-cell lymphomas (6/6), and 94.8% (73/77) in patients with aggressive B-cell lymphomas. Across all subtypes, EOT ctDNA status was strongly prognostic for event-free survival (EFS). Patients with ctDNA-positivity at EOT had significantly worse EFS (HR: 7.33, 95%CI: 2.8-19.18, p&lt;0.0001). In aggressive lymphomas, particularly in DLBCL, ctDNA positivity at EOT was associated with a markedly worse prognosis (Aggressive: HR: 7.69, 95%CI: 2.62-22.56, p=0.0002; DLBCL only: HR: 5.74, 95%CI: 1.71-19.23, p&lt;0.01). Among patients with evaluable ctDNA time points relative to 1L therapy (N=60), ctDNA clearance at any time point during treatment correlated with improved EFS. (HR: 18.55, 95%CI: 4.82-71.32, p&lt;0.0001). All patients who did not clear ctDNA relapsed, yielding a positive predictive value of 100% (11/11); the negative predictive value for those who did clear was 88% (43/49). The remaining six patients turned positive during surveillance prior to relapse. Of 15 patients treated with CAR-T cell therapy, 11 had pre- and post-infusion timepoints for ctDNA analysis. Of these, 82% (9/11) were ctDNA-positive prior to CAR-T, and 55% (5/9) achieved post-infusion ctDNA clearance and a complete clinical response, though one became ctDNA-positive and relapsed (13.3 months post-CAR-T), and another suffered non-disease mortality (22.3 months post-CAR-T). In contrast, all 4 patients remaining ctDNA-positive post-CAR-T relapsed or died within a median of 3.3 months (range: 1.3–6.4 months). Two patients persistently ctDNA-negative remain disease-free. Taken together, the PPV and NPV for 12-month EFS following CAR-T therapy using a single ctDNA timepoint were both 100%. Conclusions: This is the first report of the largest, real-world study evaluating the utility of ctDNA across a broad spectrum of heterogeneous lymphoma subtypes in patients receiving various standard of care therapies. ctDNA status at EOT and on-treatment clearance were strong predictors of clinical outcomes across multiple histological subtypes of lymphoma treated with standard-of-care agents including CAR-T cell therapy. The robustness of these findings across biologically distinct subgroups highlight the broad applicability of ctDNA testing for risk stratification and recurrence monitoring for both aggressive and indolent disease. Further prospective studies are needed to validate these findings.