Skip to main content
Top
Published in:

01-12-2024 | Research

The association between an inflammation-based nutritional tool (Glasgow Prognostic Score) and length of hospital stay in patients with haematological cancer

Authors: Anqi Song, Beiwen Ni, Molian Tang, Yiquan Zhou, Xiaomin Zhang, Zhiqi Chen, Lijing Shen, Renying Xu

Published in: Supportive Care in Cancer | Issue 12/2024

Login to get access

Abstract

Background

This is a retrospective study to identify if Glasgow Prognostic Score (GPS) is associated with length of hospital stay (LOS) in haematological cancer.

Methods

The participants were adult inpatients at a single centre in between 2018 and 2022. Serum levels of CRP and albumin were measured at admission. GPS was calculated as follows: point “0” as CRP < 10 mg/L and albumin ≥ 35 g/L; point “2” as CRP ≥ 10 mg/L and albumin < 35 g/L; point “1” as either CRP ≥ 10 mg/L or albumin < 35 g/L. Patients with point “0” were classified as low risk whilst point “2” as high risk. LOS was defined as the interval between the admission and discharge date.

Results

As a result, the average age was 59.6 ± 12.6 years and the average LOS was 6.0 days (IQR = 2 days, 11 days). Of 1621 patients, 8.8% of them were high risk. GPS was associated with LOS (β = 2.7 days; 95% CI = 0.8 days, 4.6 days; p trend < 0.001) after full adjustment. Each point of GPS was associated with 1.9 days (95% CI = 1.4 days, 2.4 days) longer in LOS with full adjustment. The association was more prominent in younger patients (< 65 years), patients with leukaemia and myelodysplastic syndrome, and those with normal body weight status (18.5–24 kg/m2), compared with their counterparts.

Conclusion

GPS was associated with LOS in Chinese patients with haematological cancer, indicating GPS could be a useful tool to predict outcome.
Appendix
Available only for authorised users
Literature
1.
go back to reference McMillan DC (2008) An inflammation-based prognostic score and its role in the nutrition-based management of patients with cancer. Proc Nutr Soc 67:257–262PubMedCrossRef McMillan DC (2008) An inflammation-based prognostic score and its role in the nutrition-based management of patients with cancer. Proc Nutr Soc 67:257–262PubMedCrossRef
2.
go back to reference Ryan AM, Power DG, Daly L et al (2016) Cancer-associated malnutrition, cachexia and sarcopenia: the skeleton in the hospital closet 40 years later. Proc Nutr Soc 75:199–211PubMedCrossRef Ryan AM, Power DG, Daly L et al (2016) Cancer-associated malnutrition, cachexia and sarcopenia: the skeleton in the hospital closet 40 years later. Proc Nutr Soc 75:199–211PubMedCrossRef
3.
go back to reference McMillan DC, Watson WS, O’Gorman P et al (2001) Albumin concentrations are primarily determined by the body cell mass and the systemic inflammatory response in cancer patients with weight loss. Nutr Cancer 39:210–213PubMedCrossRef McMillan DC, Watson WS, O’Gorman P et al (2001) Albumin concentrations are primarily determined by the body cell mass and the systemic inflammatory response in cancer patients with weight loss. Nutr Cancer 39:210–213PubMedCrossRef
4.
go back to reference Gabay C, Kushner I (1999) Acute-phase proteins and other systemic responses to inflammation. N Engl J Med 340:448–454PubMedCrossRef Gabay C, Kushner I (1999) Acute-phase proteins and other systemic responses to inflammation. N Engl J Med 340:448–454PubMedCrossRef
5.
go back to reference Elahi MM, McMillan DC, McArdle CS et al (2004) Score based on hypoalbuminemia and elevated C-reactive protein predicts survival in patients with advanced gastrointestinal cancer. Nutr Cancer 48:171–173PubMedCrossRef Elahi MM, McMillan DC, McArdle CS et al (2004) Score based on hypoalbuminemia and elevated C-reactive protein predicts survival in patients with advanced gastrointestinal cancer. Nutr Cancer 48:171–173PubMedCrossRef
6.
go back to reference Brown DJ, Milroy R, Preston T et al (2007) The relationship between an inflammation-based prognostic score (Glasgow Prognostic Score) and changes in serum biochemical variables in patients with advanced lung and gastrointestinal cancer. J Clin Pathol 60:705–708PubMedCrossRef Brown DJ, Milroy R, Preston T et al (2007) The relationship between an inflammation-based prognostic score (Glasgow Prognostic Score) and changes in serum biochemical variables in patients with advanced lung and gastrointestinal cancer. J Clin Pathol 60:705–708PubMedCrossRef
7.
go back to reference Read JA, Choy ST, Beale PJ et al (2006) Evaluation of nutritional and inflammatory status of advanced colorectal cancer patients and its correlation with survival. Nutr Cancer 55:78–85PubMedCrossRef Read JA, Choy ST, Beale PJ et al (2006) Evaluation of nutritional and inflammatory status of advanced colorectal cancer patients and its correlation with survival. Nutr Cancer 55:78–85PubMedCrossRef
8.
go back to reference Kim ES, Kim SY, Koh M et al (2018) C-reactive protein binds to integrin α2 and Fcγ receptor I, leading to breast cell adhesion and breast cancer progression. Oncogene 37:28–38PubMedCrossRef Kim ES, Kim SY, Koh M et al (2018) C-reactive protein binds to integrin α2 and Fcγ receptor I, leading to breast cell adhesion and breast cancer progression. Oncogene 37:28–38PubMedCrossRef
9.
go back to reference Crumley AB, McMillan DC, Mckernan M et al (2006) Evaluation of an inflammation-based prognostic score in patients with inoperable gastro-oesophageal cancer. Br J Cancer 94:637–641PubMedPubMedCentralCrossRef Crumley AB, McMillan DC, Mckernan M et al (2006) Evaluation of an inflammation-based prognostic score in patients with inoperable gastro-oesophageal cancer. Br J Cancer 94:637–641PubMedPubMedCentralCrossRef
10.
go back to reference Forrest LM, McMillan DC, McArdle CS et al (2005) A prospective longitudinal study of performance status, an inflammation-based score (GPS) and survival in patients with inoperable non-small-cell lung cancer. Br J Cancer 92:1834–1836PubMedPubMedCentralCrossRef Forrest LM, McMillan DC, McArdle CS et al (2005) A prospective longitudinal study of performance status, an inflammation-based score (GPS) and survival in patients with inoperable non-small-cell lung cancer. Br J Cancer 92:1834–1836PubMedPubMedCentralCrossRef
11.
go back to reference Forrest LM, McMillan DC, McArdle CS et al (2004) Comparison of an inflammation-based prognostic score (GPS) with performance status (ECOG) in patients receiving platinum-based chemotherapy for inoperable non-small-cell lung cancer. Br J Cancer 90:1704–1706PubMedPubMedCentralCrossRef Forrest LM, McMillan DC, McArdle CS et al (2004) Comparison of an inflammation-based prognostic score (GPS) with performance status (ECOG) in patients receiving platinum-based chemotherapy for inoperable non-small-cell lung cancer. Br J Cancer 90:1704–1706PubMedPubMedCentralCrossRef
12.
go back to reference Maziarz RT, Slater SS (2021) Blood and marrow transplant handbook: comprehensive guide for patient care. In: Maziarz RT (ed) Overview of hematopoietic cell transplantation and cellular therapy. Springer Nature, Switzerland 1–9 Maziarz RT, Slater SS (2021) Blood and marrow transplant handbook: comprehensive guide for patient care. In: Maziarz RT (ed) Overview of hematopoietic cell transplantation and cellular therapy. Springer Nature, Switzerland 1–9
13.
go back to reference Nakamura N, Ninomiya S, Matsumoto T et al (2019) Prognostic impact of skeletal muscle assessed by computed tomography in patients with acute myeloid leukemia. Ann Hematol 98:351–359PubMedCrossRef Nakamura N, Ninomiya S, Matsumoto T et al (2019) Prognostic impact of skeletal muscle assessed by computed tomography in patients with acute myeloid leukemia. Ann Hematol 98:351–359PubMedCrossRef
14.
go back to reference Jung J, Lee E, Shim H et al (2021) Prediction of clinical outcomes through assessment of sarcopenia and adipopenia using computed tomography in adult patients with acute myeloid leukemia. Int J Hematol 114:44–52PubMedCrossRef Jung J, Lee E, Shim H et al (2021) Prediction of clinical outcomes through assessment of sarcopenia and adipopenia using computed tomography in adult patients with acute myeloid leukemia. Int J Hematol 114:44–52PubMedCrossRef
15.
go back to reference Ando T, Fujisawa S, Teshigawara H et al (2019) Impact of treatment-related weight changes from diagnosis to hematopoietic stem-cell transplantation on clinical outcome of acute myeloid leukemia. Int J Hematol 109:673–683PubMedCrossRef Ando T, Fujisawa S, Teshigawara H et al (2019) Impact of treatment-related weight changes from diagnosis to hematopoietic stem-cell transplantation on clinical outcome of acute myeloid leukemia. Int J Hematol 109:673–683PubMedCrossRef
16.
go back to reference The European Society for Clinical Nutrition and Metabolism (2019) Basics in clinical nutrition. GALEN, Prague The European Society for Clinical Nutrition and Metabolism (2019) Basics in clinical nutrition. GALEN, Prague
17.
go back to reference Scott HR, McMillan DC, Forrest LM et al (2002) The systemic inflammatory response, weight loss, performance status and survival in patients with inoperable non-small cell lung cancer. Br J Cancer 87:264–267PubMedPubMedCentralCrossRef Scott HR, McMillan DC, Forrest LM et al (2002) The systemic inflammatory response, weight loss, performance status and survival in patients with inoperable non-small cell lung cancer. Br J Cancer 87:264–267PubMedPubMedCentralCrossRef
18.
go back to reference McMillan DC, Elahi MM, Sattar N et al (2001) Measurement of the systemic inflammatory response predicts cancer-specific and non-cancer survival in patients with cancer. Nutr Cancer 41:64–69PubMedCrossRef McMillan DC, Elahi MM, Sattar N et al (2001) Measurement of the systemic inflammatory response predicts cancer-specific and non-cancer survival in patients with cancer. Nutr Cancer 41:64–69PubMedCrossRef
19.
go back to reference Yang J, Wezeman M, Zhang M et al (2007) Human C-reactive protein binds activating Fcgamma receptors and protects myeloma tumor cells from apoptosis. Cancer Cell 12:252–265PubMedCrossRef Yang J, Wezeman M, Zhang M et al (2007) Human C-reactive protein binds activating Fcgamma receptors and protects myeloma tumor cells from apoptosis. Cancer Cell 12:252–265PubMedCrossRef
20.
go back to reference Dupire S, Wemeau M, Debarri H et al (2012) Prognostic value of PINI index in patients with multiple myeloma. Eur J Haematol 88:306–313PubMedCrossRef Dupire S, Wemeau M, Debarri H et al (2012) Prognostic value of PINI index in patients with multiple myeloma. Eur J Haematol 88:306–313PubMedCrossRef
21.
go back to reference Zhang Y, Chen S, Chen H et al (2023) A comprehensive analysis of Glasgow Prognostic Score (GPS)/the modified Glasgow Prognostic Score (mGPS) on immune checkpoint inhibitor efficacy among patients with advanced cancer. Cancer Med 12:38–48PubMedCrossRef Zhang Y, Chen S, Chen H et al (2023) A comprehensive analysis of Glasgow Prognostic Score (GPS)/the modified Glasgow Prognostic Score (mGPS) on immune checkpoint inhibitor efficacy among patients with advanced cancer. Cancer Med 12:38–48PubMedCrossRef
22.
go back to reference Filliatre-Clement L, Broseus J, Muller M et al (2019) Serum albumin or body mass index: which prognostic factor for survival in patients with acute myeloblastic leukaemia? Hematol Oncol 37:80–84PubMedCrossRef Filliatre-Clement L, Broseus J, Muller M et al (2019) Serum albumin or body mass index: which prognostic factor for survival in patients with acute myeloblastic leukaemia? Hematol Oncol 37:80–84PubMedCrossRef
23.
go back to reference Heppt MV, Heinzerling L, Kahler KC et al (2017) Prognostic factors and outcomes in metastatic uveal melanoma treated with programmed cell death-1 or combined PD-1/cytotoxic T-lymphocyte antigen-4 inhibition. Eur J Cancer 82:56–65PubMedCrossRef Heppt MV, Heinzerling L, Kahler KC et al (2017) Prognostic factors and outcomes in metastatic uveal melanoma treated with programmed cell death-1 or combined PD-1/cytotoxic T-lymphocyte antigen-4 inhibition. Eur J Cancer 82:56–65PubMedCrossRef
24.
go back to reference Li X, Zhang Y, Zhao W et al (2015) The Glasgow Prognostic Score as a significant predictor of diffuse large B cell lymphoma treated with R-CHOP in China. Ann Hematol 94:57–63PubMedCrossRef Li X, Zhang Y, Zhao W et al (2015) The Glasgow Prognostic Score as a significant predictor of diffuse large B cell lymphoma treated with R-CHOP in China. Ann Hematol 94:57–63PubMedCrossRef
25.
go back to reference Hao X, Wei Y, Wei X et al (2017) Glasgow Prognostic Score is superior to other inflammation-based scores in predicting survival of diffuse large B-cell lymphoma. Oncotarget 8:76740–76748PubMedPubMedCentralCrossRef Hao X, Wei Y, Wei X et al (2017) Glasgow Prognostic Score is superior to other inflammation-based scores in predicting survival of diffuse large B-cell lymphoma. Oncotarget 8:76740–76748PubMedPubMedCentralCrossRef
26.
go back to reference Witte HM, Bonorden B, Riecke A et al (2020) The Glasgow Prognostic Score at diagnosis is a predictor of clinical outcome in patients with multiple myeloma undergoing autologous haematopoietic stem cell transplantation. Cancers (Basel) 20:12 Witte HM, Bonorden B, Riecke A et al (2020) The Glasgow Prognostic Score at diagnosis is a predictor of clinical outcome in patients with multiple myeloma undergoing autologous haematopoietic stem cell transplantation. Cancers (Basel) 20:12
27.
go back to reference Kyle UG, Genton L, Pichard C (2005) Hospital length of stay and nutritional status. Curr Opin Clin Nutr Metab Care 8:397–402PubMedCrossRef Kyle UG, Genton L, Pichard C (2005) Hospital length of stay and nutritional status. Curr Opin Clin Nutr Metab Care 8:397–402PubMedCrossRef
28.
go back to reference Petrella F, Radice D, Casiraghi M et al (2016) Glasgow Prognostic Score class 2 predicts prolonged intensive care unit stay in patients undergoing pneumonectomy. Ann Thorac Surg 102:1898–1904PubMedCrossRef Petrella F, Radice D, Casiraghi M et al (2016) Glasgow Prognostic Score class 2 predicts prolonged intensive care unit stay in patients undergoing pneumonectomy. Ann Thorac Surg 102:1898–1904PubMedCrossRef
30.
go back to reference Li YJ, Jiang WQ, Huang JJ et al (2013) The Glasgow Prognostic Score (GPS) as a novel and significant predictor of extranodal natural killer/T-cell lymphoma, nasal type. Am J Hematol 88:394–399PubMedCrossRef Li YJ, Jiang WQ, Huang JJ et al (2013) The Glasgow Prognostic Score (GPS) as a novel and significant predictor of extranodal natural killer/T-cell lymphoma, nasal type. Am J Hematol 88:394–399PubMedCrossRef
31.
go back to reference Esfahani A, Ghoreishi Z, Abedi MM et al (2014) Nutritional assessment of patients with acute leukemia during induction chemotherapy: association with hospital outcomes. Leuk Lymphoma 55:1743–1750PubMedCrossRef Esfahani A, Ghoreishi Z, Abedi MM et al (2014) Nutritional assessment of patients with acute leukemia during induction chemotherapy: association with hospital outcomes. Leuk Lymphoma 55:1743–1750PubMedCrossRef
32.
go back to reference Jeejeebhoy KN, Keller H, Gramlich L et al (2015) Nutritional assessment: comparison of clinical assessment and objective variables for the prediction of length of hospital stay and readmission. Am J Clin Nutr 101:956–965PubMedCrossRef Jeejeebhoy KN, Keller H, Gramlich L et al (2015) Nutritional assessment: comparison of clinical assessment and objective variables for the prediction of length of hospital stay and readmission. Am J Clin Nutr 101:956–965PubMedCrossRef
33.
go back to reference Beghetto MG, Luft VC, Mello ED et al (2009) Accuracy of nutritional assessment tools for predicting adverse hospital outcomes. Nutr Hosp 24:56–62PubMed Beghetto MG, Luft VC, Mello ED et al (2009) Accuracy of nutritional assessment tools for predicting adverse hospital outcomes. Nutr Hosp 24:56–62PubMed
34.
go back to reference de Luis DA, Izaola O, Cuellar L et al (2006) Nutritional assessment: predictive variables at hospital admission related with length of stay. Ann Nutr Metab 50:394–398PubMedCrossRef de Luis DA, Izaola O, Cuellar L et al (2006) Nutritional assessment: predictive variables at hospital admission related with length of stay. Ann Nutr Metab 50:394–398PubMedCrossRef
35.
go back to reference Dixon MR, Haukoos JS, Udani SM et al (2003) Carcinoembryonic antigen and albumin predict survival in patients with advanced colon and rectal cancer. Arch Surg 138:962–966PubMedCrossRef Dixon MR, Haukoos JS, Udani SM et al (2003) Carcinoembryonic antigen and albumin predict survival in patients with advanced colon and rectal cancer. Arch Surg 138:962–966PubMedCrossRef
36.
go back to reference Fuhrman MP, Charney P, Mueller CM (2004) Hepatic proteins and nutrition assessment. J Am Diet Assoc 104:1258–1264PubMedCrossRef Fuhrman MP, Charney P, Mueller CM (2004) Hepatic proteins and nutrition assessment. J Am Diet Assoc 104:1258–1264PubMedCrossRef
37.
go back to reference Jensen GL (2006) Inflammation as the key interface of the medical and nutrition universes: a provocative examination of the future of clinical nutrition and medicine. JPEN J Parenter Enteral Nutr 30:453–463PubMedCrossRef Jensen GL (2006) Inflammation as the key interface of the medical and nutrition universes: a provocative examination of the future of clinical nutrition and medicine. JPEN J Parenter Enteral Nutr 30:453–463PubMedCrossRef
38.
go back to reference Jensen GL, Mirtallo J, Compher C et al (2010) Adult starvation and disease-related malnutrition: a proposal for etiology-based diagnosis in the clinical practice setting from the International Consensus Guideline Committee. JPEN J Parenter Enteral Nutr 34:156–159PubMedCrossRef Jensen GL, Mirtallo J, Compher C et al (2010) Adult starvation and disease-related malnutrition: a proposal for etiology-based diagnosis in the clinical practice setting from the International Consensus Guideline Committee. JPEN J Parenter Enteral Nutr 34:156–159PubMedCrossRef
39.
go back to reference Wieland A, Kerbi R, Berghold A et al (2003) C-reactive protein (CRP) as tumor marker in pediatric and adolescent patients with Hodgkin disease. Med Pediatr Oncol 41:21–25PubMedCrossRef Wieland A, Kerbi R, Berghold A et al (2003) C-reactive protein (CRP) as tumor marker in pediatric and adolescent patients with Hodgkin disease. Med Pediatr Oncol 41:21–25PubMedCrossRef
40.
go back to reference Legouffe E, Rodriguez C, Picot MC et al (1998) C-reactive protein serum level is a valuable and simple prognostic marker in non Hodgkin’s lymphoma. Leuk Lymphoma 31:351–357PubMedCrossRef Legouffe E, Rodriguez C, Picot MC et al (1998) C-reactive protein serum level is a valuable and simple prognostic marker in non Hodgkin’s lymphoma. Leuk Lymphoma 31:351–357PubMedCrossRef
41.
go back to reference Herishanu Y, Perry C, Braunstein R et al (2007) Early-mid treatment C-reactive protein level is a prognostic factor in aggressive non-Hodgkin’s lymphoma. Eur J Haematol 79:150–154PubMedCrossRef Herishanu Y, Perry C, Braunstein R et al (2007) Early-mid treatment C-reactive protein level is a prognostic factor in aggressive non-Hodgkin’s lymphoma. Eur J Haematol 79:150–154PubMedCrossRef
42.
go back to reference Cao Y, Shi YX, Chen JO et al (2012) Serum C-reactive protein as an important prognostic variable in patients with diffuse large B cell lymphoma. Tumour Biol 33:1039–1044PubMedCrossRef Cao Y, Shi YX, Chen JO et al (2012) Serum C-reactive protein as an important prognostic variable in patients with diffuse large B cell lymphoma. Tumour Biol 33:1039–1044PubMedCrossRef
43.
go back to reference Senjo H, Onozawa M, Hidaka D et al (2022) High CRP-albumin ratio predicts poor prognosis in transplant ineligible elderly patients with newly diagnosed acute myeloid leukemia. Sci Rep 12:8885PubMedPubMedCentralCrossRef Senjo H, Onozawa M, Hidaka D et al (2022) High CRP-albumin ratio predicts poor prognosis in transplant ineligible elderly patients with newly diagnosed acute myeloid leukemia. Sci Rep 12:8885PubMedPubMedCentralCrossRef
44.
go back to reference Toomey D, Redmond HP, Bouchier-Hayes D (1995) Mechanisms mediating cancer cachexia. Cancer 76:418–2426CrossRef Toomey D, Redmond HP, Bouchier-Hayes D (1995) Mechanisms mediating cancer cachexia. Cancer 76:418–2426CrossRef
45.
go back to reference August DA, Huhmann MB (2009) A.S.P.E.N. clinical guidelines: nutrition support therapy during adult anticancer treatment and in hematopoietic cell transplantation. J Parenter Enter Nutr 33:472–500CrossRef August DA, Huhmann MB (2009) A.S.P.E.N. clinical guidelines: nutrition support therapy during adult anticancer treatment and in hematopoietic cell transplantation. J Parenter Enter Nutr 33:472–500CrossRef
46.
go back to reference Gupta D, Vashi PG, Lammersfeld CA et al (2011) Role of nutritional status in predicting the length of stay in cancer: a systematic review of the epidemiological literature. Ann Nutr Metab 59:96–106PubMedCrossRef Gupta D, Vashi PG, Lammersfeld CA et al (2011) Role of nutritional status in predicting the length of stay in cancer: a systematic review of the epidemiological literature. Ann Nutr Metab 59:96–106PubMedCrossRef
47.
go back to reference Crysandt M, Kramer M, Ehninger G et al (2016) A high BMI is a risk factor in younger patients with de novo acute myelogenous leukemia. Eur J Haematol 97:17–24PubMedCrossRef Crysandt M, Kramer M, Ehninger G et al (2016) A high BMI is a risk factor in younger patients with de novo acute myelogenous leukemia. Eur J Haematol 97:17–24PubMedCrossRef
48.
go back to reference Wenzell CM, Gallagher EM, Earl M et al (2013) Outcomes in obese and overweight acute myeloid leukemia patients receiving chemotherapy dosed according to actual body weight. Am J Hematol 88:906–909PubMedCrossRef Wenzell CM, Gallagher EM, Earl M et al (2013) Outcomes in obese and overweight acute myeloid leukemia patients receiving chemotherapy dosed according to actual body weight. Am J Hematol 88:906–909PubMedCrossRef
49.
go back to reference Reese J, Deakyne SJ, Blanchard A et al (2015) Rate of preventable early unplanned intensive care unit transfer for direct admissions and emergency department admissions. Hosp Pediatr 5:27–34PubMedCrossRef Reese J, Deakyne SJ, Blanchard A et al (2015) Rate of preventable early unplanned intensive care unit transfer for direct admissions and emergency department admissions. Hosp Pediatr 5:27–34PubMedCrossRef
Metadata
Title
The association between an inflammation-based nutritional tool (Glasgow Prognostic Score) and length of hospital stay in patients with haematological cancer
Authors
Anqi Song
Beiwen Ni
Molian Tang
Yiquan Zhou
Xiaomin Zhang
Zhiqi Chen
Lijing Shen
Renying Xu
Publication date
01-12-2024
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 12/2024
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-024-09021-0
SPONSORED

Recent advances in the use of CAR T-cell therapies in relapsed/refractory diffuse large B-cell lymphoma and follicular lymphoma

In this webinar, Professor Martin Dreyling and an esteemed international panel of CAR T-cell therapy experts discuss the latest data on the safety, efficacy, and clinical impact of CAR T-cell therapies in the treatment of r/r DLBCL and r/r FL.

Please note, this webinar is not intended for healthcare professionals based in the US and UK.

Sponsored by:
  • Novartis Pharma AG
Chaired by: Prof. Martin Dreyling
Developed by: Springer Healthcare
Watch now