DLBCL is increasingly being recognized as a heterogeneous disease with distinct molecular subtypes. This has challenged the rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) treatment paradigm in recent years, as several DLBCL subtypes have inferior survival after standard R-CHOP therapy. So how do you choose? In this review the authors conclude with proposed clinical management scenarios in which DA-R-EPOCH may be preferred, including some for patient populations in which the use of R-CHOP vs. DA-R-EPOCH is controversial.

For patients being prescribed isotretinoin, there used to be three risk categories: women of reproductive potential, women not of reproductive potential, and males. The new risk classifications are two: those who can become pregnant and those who cannot. This change was based on stakeholder feedback that gender-specific language can be a barrier to access for patients who do not identify with the previous gender-specific patient categories.

A study published in Morbidity & Mortality Weekly Report (MMWR) argues that immunosuppressed patients and people with compromised immune systems need more than two vaccine doses to achieve adequate protection against COVID-19. After two vaccine doses, immunocompromised patients saw 77% vaccine effectiveness against hospitalization, versus 90% for immunocompetent individuals.

Only 8 of 35 studies could be included in the meta-analysis. Combined, these indicate a 25% risk reduction for physical distancing, 53% for mask-wearing, and 53% for hand washing. The accompanying BMJ editorial explores the possible reasons for the findings and the oddity that so little quality research is available on such an important topic.

This study involved 566 men and women between the ages of 28 and 97 years, who were patients in a preventive cardiology practice. The PULS Cardiac Test measures multiple protein biomarkers, including hepatocyte growth factor, soluble Fas, and IL-16, and uses the results to calculate a five-year risk score for new ACS. All factors more than doubled their prior above the norm level. The 5-year ACS PULS risk score more than doubled as a result.

The Journal of Clinical Oncology has a heartfelt account of one family’s struggle to access medical records after the death of a child from a brain tumor. Closing down online access to medical records is a common practice at hospitals and healthcare clinics following the death of a patient, often to the pain of family members who still have questions and seek answers.