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Safety, tolerability and efficacy of granulocyte colony-stimulating factor (G-CSF) for mobilization of hematopoietic stem and progenitor cells (HSPCs) from healthy donors have been conclusively demonstrated. This explicitly includes, albeit for smaller cohorts and shorter observation periods, biosimilar G-CSFs. HSPC donation is non-remunerated, its sole reward being "warm glow", hence harm to donors must be avoided with maximal certitude. To ascertain, therefore, long-term physical and mental health effects of HSPC donation, a cohort of G-CSF mobilized donors was followed longitudinally.We enrolled 245 healthy volunteers in this bi-centric long-term surveillance study. 244 healthy volunteers began mobilization with twice-daily Sandoz biosimilar filgrastim and 242 underwent apheresis after G-CSF mobilization. Physical and mental health were followed up over a period of 5-years using the validated SF-12 health questionnaire.Baseline physical and mental health of HSPC donors was markedly better than in a healthy reference population matched for ethnicity, sex and age. Physical, but not mental health was sharply diminished at the time of apheresis, likely due to side effects of biosimilar G-CSF, however had returned to pre-apheresis values by the next follow-up appointment after 6 months. Physical and mental health slightly deteriorated over time with kinetics reflecting the known effects of aging. Hence, superior physical and mental health compared to the general healthy non-donor population was maintained over time.HSPC donors are of better overall physical and mental health than the average healthy non-donor. Superior well-being is maintained over time, supporting the favorable risk-benefit assessment of volunteer HSPC donation. Trial registration National Clinical Trial NCT01766934.

Cancer care has been profoundly impacted by the global pandemic of severe acute respiratory syndrome coronavirus 2 disease (coronavirus disease 2019, COVID-19), resulting in unprecedented challenges. Supportive care is an essential component of cancer treatment, seeking to prevent and manage chemotherapy complications such as febrile neutropenia, anaemia, thrombocytopenia/bleeding, thromboembolic events and nausea/vomiting, all of which are common causes of hospitalisation. These adverse events are an essential consideration under routine patient management, but particularly so during a pandemic, a setting in which clinicians aim to minimise patients' risk of infection and need for hospital visits. Professional medical oncology societies have been providing updated guidelines to support health care professionals with the management, treatment and supportive care needs of their patients with cancer under the threat of COVID-19. This paper aims to review the recommendations made by the most prominent medical oncology societies for devising and modifying supportive care strategies during the pandemic., Highlights • Cancer care has been profoundly impacted by the global pandemic of COVID-19, resulting in unprecedented challenges. • Oncology societies have updated guidelines for the supportive care needs of patients with cancer under the threat of COVID-19. • This paper reviews recommendations from prominent oncology societies for providing supportive care during the pandemic.

Background The aim was to explore the patients’ emotional experience of receiving a diagnosis of IPF. Methods Market research was conducted with an independent agency. Patients with IPF were asked to record a personal account of their experience on a hand-held camera. Face to face interviews with patients were conducted in their home. Carers were also interviewed to add an alternative perspective. Results The sample included 13 male and 3 female patients with IPF. Patients with lung function impairment of all severities were included, five patients were treated with oxygen therapy and another had received a lung transplant. There was a national spread geographically throughout England. There is a fine balance to providing information and patients can benefit from an individually tailored approach. Too much information at the start can be overwhelming. Too little information can leave the individual uncertain about how to deal with their future. Gaps that were identified focused on the practicalities of living with IPF, including social care. There was a high expectation for their physician to explain the trigger for developing IPF. Patients felt a blame culture exists, whereby others felt that IPF is self-inflicted, like COPD, particularly when a patient was taking oxygen therapy. Patients may be left with feelings of anger at missed opportunities and concern for lost years of intervention and appropriate palliative care support. Conclusions The diagnosis of IPF is a devastating one, which can be challenging to manage. Carers, patient groups and expert support at diagnosis were found to be invaluable to patients during this time.

Background Our aim was to understand the emotions patients experience in IPF, from initial symptoms to IPF specialist management. Methods Market research was conducted with an independent agency. Patients with IPF were asked to record a personal account of their experience on a hand-held camera. Face to face interviews with patients were conducted in their home. Carers were also interviewed to add an alternative perspective. Results The sample included 13 male and 3 female patients with IPF. Patients with lung function impairment of all severities were included, five patients were treated with oxygen therapy and another had received a lung transplant. Many patients had a very active lifestyle before developing IPF, leading to a high degree of frustration with the limitations imposed on their physical ability. A protracted time to diagnosis of a rare lung disease while symptoms progressed often led to distrust with their primary healthcare physician. Lack of expert knowledge about the condition often resulted in variable handling of the situation, with patients often finding themselves involved in a type of ‘role-reversal’ whereby they informed their primary healthcare physician about their own condition. IPF specialists were perceived as their “guardian angels”. Despite being given a terminal diagnosis, patients felt reassured that they were receiving appropriate management for their condition. This stemmed from the perception that specialists treating them had appropriate knowledge and a feeling they were supported by the specialist team. Conclusions As with other rare diseases, patients appear to gain most reassurance from HCP’s with a clear understanding of their condition. This highlights the benefit of expert multidisciplinary teams for IPF.

Background The aim was to explore the ways in which patients with IPF obtain information about their condition. Methods Market research was conducted with an independent agency. Patients with IPF were asked to record a personal account of their experience on a hand-held camera. Face to face interviews with patients were conducted in their home. Carers were also interviewed to add an alternative perspective. Results The sample included 13 male and 3 female patients with IPF. Patients with lung function impairment of all severities were included, five patients were treated with oxygen therapy and another had received a lung transplant. Patients reported finding information from a variety of sources, including primary healthcare professionals, patient information leaflets, the internet, district nurses and support groups. Most valued sources of information were IPF physicians, nurse specialists and patient support groups. Gaps identified by patients were the need for high quality information including, 1) accurate and complete information about IPF, 2) clarity on the difficulty of predicting life expectancy, 3) how to access services and benefits, 4) how palliative care can help, 5) why support groups are beneficial, 6) how to modify lifestyle as capabilities change, 7) how to live and travel with oxygen and 8) how to explain oxygen to others. Conclusions Support groups are under-developed, with great potential to help patients and their carers. Support groups are well placed to provide advice for everyday living that the healthcare community may be unable to offer. There is also a need to improve the standard of written information currently available for patients with IPF.

Objectives According to NHS QOF (Quality and Outcomes Framework) figures, 3.3 million UK citizens have asthma. Previous studies have shown an association of asthma with increased direct and indirect healthcare costs, but similar studies have not been conducted specifically for UK asthma patients. The aim of the current study is to assess the impact of poor asthma control on UK patients treated with ICS + LABA maintenance treatment. Methods Data were from the 2010 and 2011 UK National Health and Wellness Survey (NHWS), an Internet-based questionnaire from a representative sample of UK adults stratified by age and gender. 701 respondents self-reported a diagnosis of asthma without concomitant COPD, chronic bronchitis, or emphysema and were currently being treated with ICS + LABA. Patients Not Well Controlled (NWC) according to ACT (score Results A greater proportion of the 452 NWC patients (64% of the overall sample) go to emergency (21% vs. 14%, p = 0.016) or are hospitalised (13% vs. 8%, p = 0.022), in comparison with the WC; Their mental and physical HR-QoL is lower (SF-12 MCS: 43 vs. 47/100; PCS: 40 vs. 48/100; Health utility: 0.65 vs. 0.74/1.00; all p’s Conclusions Over 60% UK ICS + LABA-treated adult patients are poorly controlled. Poor control is associated with lower HR-QoL, greater healthcare use and productivity impairment, but not with significantly different levels of adherence to WC patients. The recognition of patients remaining symptomatic and utilising healthcare resource whilst treated with ICS + LABA maintenance therapy is an important step to improving their management.

Background Asthma affects 5.4 million people in the UK. We wanted to explore the emotional journey patients with asthma experience during their management. Methods Market research was conducted with an independent agency to investigate the emotional journey patients with asthma experience. Methodologies used to collect this data included patient immersion interviews with ethnographic elements, video diary and the Soulmate™ Duo interview technique. Soulmate TM is a technique where for a proportion of the interview, patients interview each other without a moderator, allowing deeper insight into their experiences to be obtained. A total of 21 patients were interviewed, including partners and families to fully understand the impact of asthma on the individual affected. Results Experience of asthma varies considerably depending on whether symptoms first presented in early childhood or later in life. Patients diagnosed in childhood or infancy were found to normalise their symptoms more and may underestimate the severity of their condition, leading to lower adherence. Those diagnosed in adulthood were found to be more aware of the impact asthma was having upon their life. These patients tend to be regimented about taking medication and develop strategies to help them remember. Patients experience a range of emotional ups and downs throughout the treatment journey. The emotional dynamic was found to change with certain events, from diagnosis to their first asthma exacerbation. The key emotional themes identified with regards to asthma as a disease were feeling; 1) vulnerable and insecure of experiencing an asthma attack at any time, 2) restricted and constrained in terms of what they could do with their life, 3) tired and deflated over a battle that can never be won, 4) calm and relaxed when they did not experience symptoms. Impact on partners of patients with asthma was significant and often unrecognised. Conclusions Patients diagnosed with asthma in childhood are at risk of under-estimating their symptoms and are potentially at greater risk of being mis-managed. These patients need a deeper exploration of their asthma symptoms to optimise their management.