SummaryIn the positron emission tomography (PET) era, traditional prognostic factors may not apply for patients with relapsed/refractory (R/R) diffuse large B cell lymphoma (DLBCL) undergoing autologous stem cell transplantation (ASCT). Moreover, little is known about prognostic factors in patients transplanted for transformed indolent lymphoma (TIL). We conducted a retrospective study of 143 patients with R/R DLBCL and TIL who were transplanted in the last decade and had a post-salvage PET scan. We examined prognostic factors in both groups, and constructed a prognostic score for DLBCL patients. For patients with DLBCL, postsalvage PET response was an important prognostic factor. Advanced age and symptomatic relapse were also significantly associated with outcome. A simple score could stratify patients into three risk groups with 4-year post-ASCT overall survival of 84%, 59%, and 10%, and 4-year progression-free survival of 67%, 41% and 0% (P < 0Á0001 for both). However, none of those factors (including PET response to salvage) appeared relevant for patients with TIL, despite their comparable overall outcome. Our prognostic score for DLBCL patients undergoing ASCT may be useful for prognostication, for stratification in clinical trials, and to motivate the design of new strategies for patients in the high-risk group, who may not derive benefit from standard ASCT.

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Background Most falls among community-dwelling older adults occur while walking. Simple walking tests that require little resources, and can be interpreted quickly are advocated as useful screening tools for fall prone patients. Objective To investigate two clinically feasible walking tests, consisting of straight- and curved-path walking and examine their associations with history of prior falls and fall-related outcomes among community-living older adults. Design A cross-sectional analysis was performed on baseline data from a longitudinal cohort study. Setting Participants were recruited through primary care practices. Participants Participants included 428 primary care patients ≥65 years of age at risk for mobility decline. Participants had a median age of 76.5 years, 67.8% were women, and 82.5% were white. Methods Straight-path walking performance was measured as the time needed to walk a 4 meter straight path at usual pace from standstill using a stopwatch (timed to 0.1 second). Curved-path walking performance was timed while participants walked from standstill in a figure-of-8 pattern around two cones placed 5 feet apart. Main Outcome Measurements Multivariable negative binomial regression analyses were performed to assess the relationship between straight-path walking or curved-path walking and self-reported history of number of falls. For fall-related injuries, and fall-related hospitalizations, logistic regression models were used. Results In the fully adjusted model, an increase of 1 second in straight path walking time was associated with 26% greater rate of falls (RR=1.26, 95% CI: 1.10–1.45). An increase in curved-path walking time was associated with 8% greater rate of falls (RR=1.08, CI: 1.03–1.14). Neither walk test was associated with history of fall-related injuries or hospitalizations. Conclusions Poor performance on straight- and curved-path walking performance was associated with a history of greater fall rates in the prior year, but not with a history of fall-related injuries or hospitalizations. This information helps inform how prior fall history is related to performance on walking tests in the primary care setting.

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