Introduction: Non-responsive or relapsed lymphoma patients may benefit from salvage chemotherapy or high-dose chemotherapy followed by autologous stem cell transplantation (ASCT), an effective treatment, particularly in non-Hodgkin's and Hodgkin's lymphoma. This study aimed to investigate recurrence in these patients and identify associated risk factors. Methods: A retrospective cohort study analyzed outcomes of lymphoma patients undergoing ASCT at Omid Hospital (2016-2020). Comprehensive data on demographics, treatment, underlying disease, recurrence, and pre-transplantation laboratory parameters were collected from hospital records. Follow-up from transplantation to February 2021 allowed for survival and recurrence evaluation using Kaplan-Meier and Cox regression. The study included patients without concurrent plasma cell disorders or other hematological malignancies for a focused lymphoma treatment outcome analysis. Results: Forty-nine lymphoma patients underwent ASCT (21 HL, 42.9%; 28 NHL, 57.1%). Gender distribution was similar (30 males, 61.2%; 19 females, 38.8%; P=0.774). Mean age at transplantation was 38.8 ± 11.15 years (P=0.519 between groups). Recurrence occurred in 14 patients (7 in each group; P=0.523), with a mean recurrence-free survival (RFS) of 25.2 months (95% CI: 21.44-28.96). HL patients had a lower mean RFS and a higher recurrence hazard ratio (HR: 1.25, 95% CI: 0.420-3.76), though not statistically significant (P=0.683). In NHL, older age significantly correlated with recurrence (P=0.030). While male gender and older age were associated with lower survival, only advanced age in NHL significantly predicted decreased survival (HR: 1.167, 95% CI: 1.102-1.197). Conclusions: Male HL patients showed diminished survival and an elevated hazard ratio (not statistically significant). Advanced age significantly predicted reduced survival in NHL patients. Pre-transplant laboratory markers did not significantly predict survival.

Background: The increasing complexity of cancer care and rapid advancements indigital technologies have led to the emergence of smart cancer hospitals as innovativesolutions to contemporary healthcare challenges.Objective: This review aims to provide a comprehensive overview of the essentialarchitectural, technological, and operational requirements for designing and operatingsmart cancer hospitals.Methods: A synthesis of recent literature and global case studies was conducted toidentify core elements defining smart cancer hospitals, focusing on technology integration,adaptable architectural design, environmental considerations, IT infrastructure,and multidisciplinary care.Results: Smart cancer hospitals incorporate advanced technologies such as artificialintelligence, the Internet of Things (IoT), big data analytics, and telemedicineto enhance diagnostic accuracy, treatment efficiency, and patient experience. Modularand adaptable designs enable rapid technological updates and spatial flexibility.Sustainable architectural elements contribute to improved patient outcomes andstaff well-being. Robust IT infrastructure ensures secure, interoperable clinical dataexchange. Integration of multidisciplinary collaboration areas, palliative care, andpsychosocial support fosters holistic, patient-centered care.Conclusion: This review outlines critical components necessary for creating future-ready smart cancer hospitals that combine technological advancement withhuman-centered care. These insights aim to assist architects, healthcare providers,and policymakers in developing oncology facilities responsive to evolving cancer careneeds.

Modern medicine, despite its numerous benefits, often places oncologists in complex clinical scenarios. These situations require intricate choices to ensure patients receive optimal treatment. Advanced cancer patients, especially in borderline situations of expected benefit or increased risk of complications, face unique challenges.1 Overtreatment and undertreatment represent the two extremes of the therapeutic spectrum, both of which signify suboptimal management of cancer patients. These concepts vary significantly across different medical disciplines, healthcare providers, and patients, as there is no universally accepted definition.2 Oncologists undertake complex decision-making processes following detailed discussions with patients and their families, aiming to find the optimal balance in the therapeutic strategy. The question arises: Is it appropriate to recommend a new line of treatment for all cancer patients in the same manner, including elderly advanced cancer patients with comorbidities? As a palliative medicine specialist working in a government hospital in a developing country, when I consult with elderly advanced cancer patients who are resistant to the first-line available treatment, a primary concern for both patients and their relatives is whether to initiate a new, costly treatment with potentially unknown or limited efficacy, as recommended by the oncologist. From an ethical perspective, in some cases, the recommended treatment by oncologists may not be appropriate. This can be evaluated by considering the four fundamental principles of ethics: autonomy, beneficence, non-maleficence, and justice.