Objectives To evaluate clinical and financial impact of pharmacist interventions in an ambulatory adult hematology–oncology department. Methods All cancer patients receiving a first injectable immuno- and/or chemotherapy regimen were included in this prospective study over a one-year period. The clinical impact of pharmacist interventions made by two clinical pharmacists was rated using the Clinical Economic and Organizational tool. Financial impact was calculated through cost savings and cost avoidance. Main results: Five hundred and fifty-eight patients were included. A total of 1970 pharmacist interventions were performed corresponding to a mean number of 3.5 pharmacist interventions/patient. The clinical impact of pharmacist interventions was classified as negative, null, minor, moderate, major and lethal in 0, 84 (4%), 1353 (68%), 385 (20%), 148 (8%) and 0 cases, respectively. The overall cost savings were €175,563. One hundred and nine (6%) of all pharmacist interventions concerned immuno- or chemotherapy regimen for cost savings of €148,032 (84% of the total amount of cost savings). The cost avoidance was €390,480. Cost avoidance results were robust to sensitivity analyses with cost of preventable adverse drug event as main driver of the model. When the cost of employing a pharmacist was subtracted from the average yearly cost savings plus cost avoidance per pharmacist, this yielded a net benefit of €223,021. The cost–benefit ratio of the clinical pharmacist was €3.7 for every €1 invested. Principal conclusions: To have two full-time clinical pharmacists in a 55-bed ambulatory adult hematology–oncology department is both clinically and financially beneficial.

Purpose Daratumumab is the first anti-CD38 monoclonal antibody of the class approved for recurrent and refractory multiple myeloma. Grade 3 and 4 Infusion-Related Reactions (IRRs) are frequent during the first and second infusions. Due to the risks associated with severe IRRs, daratumumab is systematically administered over a period of 3.5 hours. The main objective of this study was to evaluate the safety of a 90-minute daratumumab infusion from the third infusion. Patients and methods All patients who had received two or more doses of daratumumab in monotherapy or in combination with standard infusion rates were included. We excluded patients enrolled in clinical trials. For the rapid infusion protocol, 20% of the dose was administered over 30 minutes and the remaining 80% over 60 minutes. Results From April 1 to May 31, 2019, 25 patients received 53 90-minute infusions of daratumumab. Premedication included corticosteroids, antipyretics, antihistamines, and if necessary a leukotriene receptor antagonist. No grade 3 or grade 4 IRRs were observed. Conclusion From the third infusion, we found that a rapid administration of daratumumab (90 vs 210 minutes) was well tolerated and safe. It would be interesting to test this regimen from the second infusion.

RÉSUMÉDix grandes a\oses(A/osa alosa) sont équipées d'émetteurs radio en Loire moyenne, à l'époque de leur migration anadrome. Le marquage a lieu 15 à 20 km en aval du seuil de St LAURENT-des-EAUX, un des premiers obstacles sérieux rencontrés sur cet axe de migration.Le suivi des poissons montre que la technique du radio-pistage peut être appliquée à cette espèce pourtant très sensible aux manipulations. Au-delà de ce test de fiabilité, les résultats confirment l'influence déterminante du facteur température sur la progression des aloses en rivière (inhibition au-dessous d'un seuil proche de 12°C). On constate de même qu'une forte crue peut perturber momentanément leur remontée.En l'absence de ces conditions hydrologiques défavorables, les données recueillies permettent également l'évaluation d'une vitesse moyenne de progression (20 km/j) sur parcours sans obstacle.Enfin, la plupart des aloses marquées ayant été arrêtées par le seuil on observe leur comportement de repli et de regroupement en aval de celui-ci. SUMMARY RADIO-TRACKING OF ATLANTIC SHADS IN THE RIVER LOIRETen Atlantic shads (Alosa alosa) were tagged with radio transmitters during their spawning migration in the middle River Loire. Radio-tagging occurred 15-20 km downstream of the weir of St LAURENT-des-EAUX, one of the first disturbing obstacles in the river to upstream migrants.Radio telemetry can be successfully used to monitor the behavior of shad despite the apparent sensitivity of this speciesto handling. Radio-tracking resultsdemonstratedthat water température had a pronounced effect on shadswimming speed (migrations were inhibited at times when températures fell below 12 degrees C). Peakflow rates in the river produced a similar effect on migratory behavior. In the absence of thèse adverse hydrological conditions, radio-tagged shad migrated upstream at an average rate of 20 km/day until they encountered the weir. Most of the tagged fish were impeded by this structure. The behavioral response (downstream movement, schooling) of shad blocked by the weir was noted.

The study demonstrated that pomalidomide-dexamethasone regimen has a long-term favorable safety-efficacy profile in RRMM patients. The survival benefit is substantial even in patients with stable disease.

RÉSUMÉThe length of this delay in migration has been function of the évolution of température except for two salmons for which a stress resufting from tagging was involved.