Two chemotherapy cycles swapped for an antibody, and fewer infections with it

The edition in brief

In the AIEOP-BFM ALL 2017 trial, 709 children with newly diagnosed high-risk B-cell acute lymphoblastic leukaemia were randomised after consolidation to two cycles of blinatumomab or two cycles of conventional chemotherapy. At a planned interim analysis with median follow-up 2.9 years, estimated four-year event-free survival was 83.0% (95% CI 77.4 to 87.4) with blinatumomab against 70.3% (63.8 to 75.9) with chemotherapy, hazard ratio 0.51 (0.35 to 0.73), P = 0.0002. Treatment-related infection occurred in 23.9% against 69.4%, and life-threatening adverse events in 0.5% against 4.7%. Neurotoxic events were more common with blinatumomab (12.0% vs 3.2%); grade 2 or higher cytokine release syndrome occurred in 1.1%. The Neo-MILK stepped-wedge cluster-randomised trial across 15 German level I neonatal units enrolled 1,627 very low birth weight infants. Structured lactation counselling with donor milk banking raised exclusive mother's own milk feeding at discharge by 11 percentage points (95% CI 3.0 to 19.0) from a 43% baseline, with no change in complications or length of stay, and no significant effect in infants under 1,000 g. A meta-analysis of 160 studies and 16,639 NICU parents found psychotherapy and emotional support had the most consistent effect on anxiety (Hedges' g −1.66), stress and depression. Pooled data from four randomised cohorts favoured TZ84-based over HM175-based hepatitis A vaccines on seroconversion at one month (odds ratio 3.05) with comparable adverse events. Across 50 studies, ADHD affected 33% of children with neurofibromatosis type 1.