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Lewis CS, Joy G, Jensen P, Barraclough A, Franco N, Talaulikar D, Hawkes EA, El-Galaly TC, Villa D, Dickinson M, Seymour JF, Cheah CY. Primary gastric diffuse large B-cell lymphoma: A multicentre retrospective study. Br J Haematol 2024. [PMID: 38632873 DOI: 10.1111/bjh.19470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Revised: 04/03/2024] [Accepted: 04/04/2024] [Indexed: 04/19/2024]
Abstract
Primary gastric diffuse large B-cell lymphoma (PG-DLBCL) accounts for the majority of extra-nodal DLBCL. Even so, literature is lacking on early, localised presentations. We studied a cohort of patients with stage I disease, diagnosed between 2006 and 2018, from six centres between Australia, Canada and Denmark. Our goal was to characterise outcomes, review treatment and investigate the role of interim positron emission tomography (iPET). Thirty-seven eligible patients were identified. The median duration of follow-up was 42.2 months. All received chemoimmunotherapy with 91.9% (n = 34) given rituximab, cyclophosphamide, doxorubicin, vincristine and prednisolone (R-CHOP). 35.1% (n = 13) underwent consolidative radiotherapy. Eighteen patients were H. pylori positive and 11 had the documentation of H. pylori eradication therapy. The 4-year progression-free survival and overall survival of R-CHOP was 88% (95% CI: 71-95) and 91% (95% CI: 75-97) respectively. All patients who achieved a partial metabolic response or complete metabolic response on iPET went on to achieve complete response at the end of treatment. R-CHOP-based therapy with iPET assessment appears to offer favourable outcomes, with radiotherapy and H. pylori eradication therapy implemented on a case-by-case basis.
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Affiliation(s)
- Cameron S Lewis
- Department of Haematology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
- Department of Haematology, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Greta Joy
- Centre for Lymphoid Cancer, British Columbia Cancer, Vancouver, British Columbia, Canada
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Paw Jensen
- Department of Hematology, Clinical Cancer Research Center, Aalborg University Hospital, Aalborg, Denmark
| | - Allison Barraclough
- Department of Haematology, Austin Health, Melbourne, Victoria, Australia
- Department of Haematology, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - Nunzio Franco
- Department of Haematology, ACT Pathology, Canberra Health Services, Canberra, Australian Capital Territory, Australia
| | - Dipti Talaulikar
- Department of Haematology, ACT Pathology, Canberra Health Services, Canberra, Australian Capital Territory, Australia
- College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Eliza A Hawkes
- Department of Haematology, Austin Health, Melbourne, Victoria, Australia
- School of Public Health and Preventative Medicine, Monash University, Melbourne, Victoria, Australia
| | - Tarec Christoffer El-Galaly
- Department of Hematology, Clinical Cancer Research Center, Aalborg University Hospital, Aalborg, Denmark
- Department of Hematology, Odense University Hospital, Odense, Denmark
- Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institute, Stockholm, Sweden
| | - Diego Villa
- Centre for Lymphoid Cancer, British Columbia Cancer, Vancouver, British Columbia, Canada
| | - Michael Dickinson
- Department of Haematology, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, Victoria, Australia
- University of Melbourne, Melbourne, Victoria, Australia
| | - John F Seymour
- Department of Haematology, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, Victoria, Australia
- University of Melbourne, Melbourne, Victoria, Australia
| | - Chan Y Cheah
- Department of Haematology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
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2
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Shaw B, Chung E, Wellard C, Yoo E, Bennett R, Birks C, Johnston A, Cheah CY, Hamad N, Simpson J, Barraclough A, Ku M, Viiala N, Ratnasingam S, Armytage T, Cochrane T, Chong G, Lee D, Manos K, Keane C, Wallwork S, Opat S, Hawkes EA. Poor outcomes for trial-ineligible patients receiving polatuzumab for relapsed/refractory diffuse large B-cell lymphoma in routine care: An Australian Lymphoma and Related Diseases Registry project. EJHaem 2024; 5:325-332. [PMID: 38633125 PMCID: PMC11020125 DOI: 10.1002/jha2.870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 02/01/2024] [Accepted: 02/06/2024] [Indexed: 04/19/2024]
Abstract
Polatuzumab vedotin (Pola) is an approved therapy in combination with rituximab and bendamustine for relapsed or refractory diffuse large B-cell lymphoma (RR-DLBCL) based on positive results of the landmark phase II randomised G029365 trial. However, trial results for many approved novel therapies in RR-DLBCL have not been replicated in routine care cohorts, as RR-DLBCL patient populations are heterogeneous and trial eligibility is increasingly restrictive. We evaluated outcomes from pola ± bendamustine and rituximab in patients with RR-DLBCL enrolled in a compassionate access program with no alternative treatment options identified via the Australasian Lymphoma and Related Diseases Registry according to their eligibility for the original phase II published study. Of 58 eligible patients, 74% met the criteria deeming them ineligible for the G029365 original study at the time of pola's commencement. Median progression-free survival and overall survival in our cohort were 2.3 and 3.5 months, respectively. In contrast to the landmark trial cohort, more of our patients ceased therapy prior to completion, the majority due to progressive disease and only 8/58 received any subsequent treatment. Dismal outcomes in this Australian real-world population demonstrate trial eligibility is challenging to meet, and newer treatments can be difficult to deliver in routine care. Clinically applicable results from therapeutic studies require trial cohorts to reflect representative clinical populations wherever possible, and more research is required to address the benefit of novel agents in the increasing majority who are ineligible for modern studies.
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Affiliation(s)
- Briony Shaw
- Department of HaematologyMonash HealthClaytonAustralia
- School of Public Health and Preventive Medicine, Monash UniversityMelbourneAustralia
| | - Eliza Chung
- School of Public Health and Preventive Medicine, Monash UniversityMelbourneAustralia
| | - Cameron Wellard
- School of Public Health and Preventive Medicine, Monash UniversityMelbourneAustralia
| | - Edward Yoo
- Department of HaematologySir Charles Gairdner HospitalPerthAustralia
| | - Rory Bennett
- Department of HaematologyPeter MacCallum Cancer CentreMelbourneAustralia
| | | | - Anna Johnston
- Department of Clinical HaematologyRoyal Hobart HospitalHobartAustralia
| | - Chan Y Cheah
- Department of HaematologySir Charles Gairdner HospitalPerthAustralia
- Medical School, University of Western AustraliaNedlandsAustralia
| | - Nada Hamad
- Department of HaematologySt Vincent's HospitalSydneyAustralia
- School of Clinical Medicine, Faculty of Medicine and HealthUNSW SydneyAustralia
- School of MedicineUniversity of Notre Dame AustraliaSydneyAustralia
| | - Jock Simpson
- Department of HaematologyPort Macquarie Base HospitalPort MacquarieAustralia
| | | | - Matthew Ku
- Department of HaematologySt Vincent's HospitalMelbourneAustralia
- Faculty of MedicineUniversity of MelbourneMelbourneAustralia
| | - Nicholas Viiala
- Department of HaematologyLiverpool HospitalSydneyAustralia
- South West Sydney Clinical Campus, School of Clinical Medicine, Faculty of Medicine and HealthUNSW SydneyAustralia
| | - Sumita Ratnasingam
- Department of Clinical HaematologyUniversity Hospital GeelongGeelongAustralia
| | | | - Tara Cochrane
- Department of HaematologyGold Coast University HospitalGold CoastAustralia
- Griffith UniversityGold CoastAustralia
| | - Geoffrey Chong
- Department of Medical OncologyGrampians HealthBallaratAustralia
| | - Denise Lee
- Department of HaematologyEastern HealthMelbourneAustralia
| | - Kate Manos
- Department of HaematologyFlinders Medical CentreAdelaideAustralia
| | - Colm Keane
- Department of HaematologyPrincess Alexandra HospitalBrisbaneAustralia
| | | | - Stephen Opat
- Department of HaematologyMonash HealthClaytonAustralia
- School of Public Health and Preventive Medicine, Monash UniversityMelbourneAustralia
| | - Eliza A. Hawkes
- School of Public Health and Preventive Medicine, Monash UniversityMelbourneAustralia
- Department of Medical Oncology and Clinical HaematologyOlivia Newton‐John Cancer Research Institute at Austin HealthHeidelbergAustralia
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3
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Binkley MS, Flerlage JE, Savage KJ, Akhtar S, Steiner R, Zhang XY, Dickinson M, Prica A, Major A, Hendrickson PG, Hopkins D, Ng A, Casulo C, Baron J, Roberts KB, Al Kendi J, Balogh A, Ricardi U, Torka P, Specht L, De Silva R, Pickard K, Blazin LJ, Henry M, Smith CM, Halperin D, Brady J, Brennan B, Senchenko MA, Reeves M, Hoppe BS, Terezakis S, Talaulikar D, Picardi M, Kirova Y, Fergusson P, Hawkes EA, Lee D, Doo NW, Barraclough A, Cheah CY, Ku M, Hamad N, Mutsando H, Gilbertson M, Marconi T, Viiala N, Maurer MJ, Eichenauer DA, Hoppe RT. International Prognostic Score for Nodular Lymphocyte-Predominant Hodgkin Lymphoma. J Clin Oncol 2024:JCO2301655. [PMID: 38531001 DOI: 10.1200/jco.23.01655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 09/20/2023] [Accepted: 01/11/2024] [Indexed: 03/28/2024] Open
Abstract
PURPOSE Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is a rare cancer, and large international cooperative efforts are needed to evaluate the significance of clinical risk factors and immunoarchitectural patterns (IAPs) for all stages of pediatric and adult patients with NLPHL. METHODS Thirty-eight institutions participated in the Global nLPHL One Working Group retrospective study of NLPHL cases from 1992 to 2021. We measured progression-free survival (PFS), overall survival (OS), transformation rate, and lymphoma-specific death rate. We performed uni- and multivariable (MVA) Cox regression stratified by management to select factors for the lymphocyte-predominant international prognostic score (LP-IPS) validated by five-fold cross-validation. RESULTS We identified 2,243 patients with a median age of 37 years (IQR, 23-51). The median follow-up was 6.3 years (IQR, 3.4-10.8). Most had stage I to II (72.9%) and few B symptoms (9.9%) or splenic involvement (5.4%). IAP was scored for 916 (40.8%). Frontline management included chemotherapy alone (32.4%), combined modality therapy (30.5%), radiotherapy alone (24.0%), observation after excision (4.6%), rituximab alone (4.0%), active surveillance (3.4%), and rituximab and radiotherapy (1.1%). The PFS, OS, transformation, and lymphoma-specific death rates at 10 years were 70.8%, 91.6%, 4.8%, and 3.3%, respectively. On MVA, IAPs were not associated with PFS or OS, but IAP E had higher risk of transformation (hazard ratio [HR], 1.81; P < .05). We developed the LP-IPS with 1 point each for age ≥45 years, stage III-IV, hemoglobin <10.5 g/dL, and splenic involvement. Increasing LP-IPS was significantly associated with worse PFS (HR, 1.52) and OS (HR, 2.31) and increased risk of lymphoma-specific death (HR, 2.63) and transformation (HR, 1.41). CONCLUSION In this comprehensive study of all ages of patients with NLPHL, we develop the LP-IPS to identify high-risk patients and inform upcoming prospective clinical trials evaluating de-escalation of therapy for patients with low LP-IPS scores (<2).
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Affiliation(s)
- Michael Sargent Binkley
- Department of Radiation Oncology, Stanford School of Medicine, Stanford University, Stanford, CA
| | - Jamie E Flerlage
- Department of Oncology, St Jude Children's Research Hospital, Memphis, TN
| | | | - Saad Akhtar
- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Raphael Steiner
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | | | - Anca Prica
- Princess Margaret Cancer Centre, Toronto, Canada
| | | | | | - David Hopkins
- Department of Haematology, Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom
| | - Andrea Ng
- Dana-Farber Cancer Institute, Boston, MA
| | | | | | | | | | | | | | - Pallawi Torka
- Roswell Park Comprehensive Cancer Center, Buffalo, NY
| | - Lena Specht
- Copenhagen University Hospital, Copenhagen, Denmark
| | - Ravindu De Silva
- Norfolk and Norwich University Hospital, Norfolk, United Kingdom
| | - Keir Pickard
- Newcastle upon Tyne Hospitals, Newcastle upon Tyne, United Kingdom
| | - Lindsay J Blazin
- Division of Hematology/Oncology, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN
| | | | | | - Daniel Halperin
- University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - Jessica Brady
- Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | | | - Maria Anatolevna Senchenko
- Oncology and Immunology, Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Moscow, Russian Federation
| | - Marie Reeves
- Royal Manchester Children's Hospital, Manchester, United Kingdom
| | - Bradford S Hoppe
- University of Florida, Gainesville, FL
- Mayo Clinic, Jacksonville, FL
| | | | - Dipti Talaulikar
- Canberra Health Services, Canberra, Australia
- College of Health and Medicine, Australian National University, Canberra, Australia
| | - Marco Picardi
- Department of Clinical Medicine and Surgery, AOU Federico II, Naples, Italy
| | | | | | - Eliza A Hawkes
- Olivia Newton-John Cancer Research Centre at Austin Health, Melbourne, Australia
- Lymphoma and Related Diseases Registry, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Denise Lee
- Austin Hospital, Eastern Health, Melbourne, Australia
| | - Nicole Wong Doo
- Lymphoma and Related Diseases Registry, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Department of Haematology, Concord Hospital, Concord Clinical School, University of Sydney, Sydney, Australia
| | | | - Chan Y Cheah
- Department of Haematology, Sir Charles Gairdner Hospital, Perth, Australia
- Medical School, University of Western Australia, Perth, Australia
| | - Matthew Ku
- Department of Haematology, St Vincent's Hospital, Melbourne, Australia
- University of Melbourne, Melbourne, Australia
| | - Nada Hamad
- Department of Haematology, St Vincent's Hospital Sydney, Sydney, Australia
- Faculty of Medicine and Health, School of Clinical Medicine, UNSW Sydney, Sydney, Australia
- School of Medicine, University of Notre Dame, Sydney, Australia
| | - Howard Mutsando
- Faculty of Medicine and Health, School of Clinical Medicine, UNSW Sydney, Sydney, Australia
- University of Queensland Rural Clinical School, Toowoomba, Australia
| | | | | | - Nicholas Viiala
- Department of Haematology, Liverpool Hospital, Liverpool, Australia
- South West Sydney Clinical School, UNSW Medicine, Liverpool, Australia
| | - Matthew J Maurer
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN
| | - Dennis A Eichenauer
- Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf, University Hospital Cologne, German Hodgkin Study Group, Cologne, Germany
| | - Richard T Hoppe
- Department of Radiation Oncology, Stanford School of Medicine, Stanford University, Stanford, CA
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4
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Barraclough A, Agrawal S, Talaulikar D, Chong G, Yoo E, Cheah CY, Franco N, Nguyen B, Mutsando H, Tahir F, Trotman J, Huang J, Keane C, Lincoln M, Cochrane T, Johnston AM, Dickinson M, Opat S, McQuilten ZK, Wood EM, St George G, Hawkes EA. Impact and utility of follicular lymphoma GELF criteria in routine care: an Australasian Lymphoma Alliance study. Haematologica 2024. [PMID: 38450504 DOI: 10.3324/haematol.2023.284538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Indexed: 03/08/2024] Open
Abstract
Follicular Lymphoma (FL) treatment initiation is largely determined by tumor burden and symptoms. In the pre-rituximab era, the Group d'Etude des Lymphomes Folliculaires (GELF) developed widely adopted criteria to identify high tumor burden FL patients to harmonize clinical trial populations. The utilization of GELF criteria (GELFc) in routine therapeutic decision-making is poorly described. This multicenter retrospective study evaluated patterns of GELFc at presentation and GELFc utilization in therapeutic decision-making in newly diagnosed, advanced stage rituximab-era FL. Associations between GELFc, treatment given, and patient survival were analyzed in 300 eligible cases identified between 2002-2019. 163 (54%) had ≥1 GELFc at diagnosis. The presence or cumulative number of GELFc did not predict PFS in patients undergoing watch-and-wait (WW) or those receiving systemic treatment. Of interest, in patients with ≥1 GELFc, 16/163 (10%) underwent initial watch-and-wait (comprising 22% of the watchand- wait cohort). In those receiving systemic therapy +/- radiotherapy, 74/215 (34%) met no GELFc. Our data suggest clinicians are using adjunctive measures to make decisions regarding treatment initiation in a significant proportion of patients. By restricting FL clinical trial eligibility only to those meeting GELFc, reported outcomes may not be applicable to a significant proportion of patients treated in routine care settings.
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Affiliation(s)
- Allison Barraclough
- Olivia Newton John Cancer Research and Wellness Centre, Austin Health, Victoria, Australia; Fiona Stanley Hospital, Western Australia
| | - Shivam Agrawal
- Olivia Newton John Cancer Research and Wellness Centre, Austin Health, Victoria, Australia; Prince of Wales Hospital, New South Wales
| | - Dipti Talaulikar
- Canberra Health Services, Australian Capital Territory, Australia; College of Health and Medicine, Australian National University, Australian Capital Territory
| | - Geoffrey Chong
- Olivia Newton John Cancer Research and Wellness Centre, Austin Health, Victoria, Australia; Ballarat Regional Integrated Cancer Centre, Ballarat Health Services, Victoria
| | - Edward Yoo
- Fiona Stanley Hospital, Western Australia, Australia; Sir Charles Gairdner Hospital, Western Australia
| | - Chan Y Cheah
- Sir Charles Gairdner Hospital, Western Australia, Australia; Medical School, University of Western Australia, Western Australia
| | - Nunzio Franco
- Canberra Health Services, Australian Capital Territory, Australia; College of Health and Medicine, Australian National University, Australian Capital Territory
| | | | - Howard Mutsando
- Toowoomba Hospital, Queensland, Australia; University of Queensland Rural Clinical School, Queensland
| | - Fatima Tahir
- Concord Repatriation General Hospital, University of Sydney, New South Wales
| | - Judith Trotman
- Concord Repatriation General Hospital, University of Sydney, New South Wales
| | - Jing Huang
- School of Clinical Sciences at Monash Health, Monash University, Victoria
| | | | | | - Tara Cochrane
- Gold Coast University Hospital, Queensland, Australia; School of Medicine, Griffith University, Queensland
| | | | - Michael Dickinson
- Peter MacCallum Cancer Centre and The Royal Melbourne Hospital, Victoria
| | - Stephen Opat
- School of Clinical Sciences at Monash Health, Monash University, Victoria, Australia; School of Public Health and Preventive Medicine, Monash University, Victoria
| | - Zoe K McQuilten
- School of Clinical Sciences at Monash Health, Monash University, Victoria, Australia; School of Public Health and Preventive Medicine, Monash University, Victoria
| | - Erica M Wood
- School of Clinical Sciences at Monash Health, Monash University, Victoria, Australia; School of Public Health and Preventive Medicine, Monash University, Victoria
| | - Gayathri St George
- School of Public Health and Preventive Medicine, Monash University, Victoria
| | - Eliza A Hawkes
- Olivia Newton John Cancer Research and Wellness Centre, Austin Health, Victoria, Australia; School of Public Health and Preventive Medicine, Monash University, Victoria.
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5
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Barraclough A, Hawkes EA. Tribulations of trials in aggressive lymphoma. Blood 2023; 142:2232-2234. [PMID: 38153771 DOI: 10.1182/blood.2023022382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2023] Open
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Abstract
Diffuse large B-cell lymphoma (DLBCL) is the most common lymphoma and a heterogeneous B-cell disease. The majority of patients with newly diagnosed disease are cured with first-line combination immunochemotherapy treatment however, those who experience treatment failure have dismal outcomes. Antibody therapies and immunotherapy have provided the single most major advance in the treatment of DLBCL in the last 4 decades. Rituximab, the first immunotherapy, and a monoclonal antibody targeting CD20, improved DLBCL overall survival when added to chemotherapy 2 decades ago. Since then, the advent of further "naked" monoclonal antibodies that target malignant B-cells or stimulate the immune system to kill cancer, as well as antibody-drug conjugates and bispecific antibodies have all entered the DLBCL armamentarium; with 5 antibody therapy approvals in the last 6 years alone. Here we review the literature on antibodies and immunotherapies for DLBCL and the future directions involving this successful group of drugs.
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Affiliation(s)
- Allison Barraclough
- Fiona Stanley Hospital, Perth, Australia; University of Melbourne, Melbourne, Victoria, Australia
| | - Eliza A Hawkes
- University of Melbourne, Melbourne, Victoria, Australia; Olivia Newton John Cancer Research & Wellness Centre, Austin Health, Melbourne, Victoria, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
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7
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Barraclough A, England JT, Villa D, Wight J, Hapgood G, Conn J, Doo NW, Li EW, Gilbertson M, Shaw B, Bishton MJ, Saeed M, Ratnasingam S, Abeyakoon C, Chong G, Wai SH, Ku M, Lee HP, Fleming K, Tam C, Douglas G, Cheah CY, Ng ZY, Rolfe T, Mills AK, Hamad N, Cashman H, Gleeson M, Narayana M, Hawkes EA. Outcomes in grade 3B follicular lymphoma: an international study led by the Australasian Lymphoma Alliance. Haematologica 2023; 108:2444-2453. [PMID: 36815381 PMCID: PMC10483350 DOI: 10.3324/haematol.2022.281375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 02/16/2023] [Indexed: 02/24/2023] Open
Abstract
Grade (G) 3B follicular lymphoma (FL) is a rare FL subtype which exists on a histological continuum between 'lowgrade' (Grade 1, 2 and 3A FL) and diffuse large B-cell lymphoma (DLBCL) appearing to share features with each. Clinical characteristics and outcomes are poorly understood due to lack of adequate representation in prospective trials and large-scale analyses. We analyzed 157 G3BFL cases from 18 international centers, and two comparator groups; G3AFL (n=302) and DLBCL (n=548). Composite histology with DLBCL or low-grade FL occurred in approximately half of the G3BFL cases. With a median of 5 years follow-up, the overall survival and progression-free survival of G3BFL patients was better than that of DLBCL patients (P<0.001 and P<0.001, respectively); however, G3BFL patients were younger (P<0.001) with better performance status (P<0.001), less extranodal disease (P<0.001) and more frequently had normal lactate dehydrogenase (P<0.001) at baseline. The overall and progression-free survival of patients with G3BFL and G3AFL were similar (P=0.83 and P=0.80, respectively). After frontline immunochemotherapy, 24% of G3BFL relapsed; relapse rates were 63% in the DLBCL cohort and 19% in the low-grade FL cohort. Eight percent of relapses occurred beyond 5 years. In this G3BFL cohort, the revised International Prognostic Index successfully delineated risk groups, but the Follicular Lymphoma International Prognostic Index did not. We conclude that patients with immunochemotherapy-treated G3BFL have similar survival outcomes to those with G3AFL, yet a favorable baseline profile and distinctly superior prognosis compared to patients with DLBCL.
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Affiliation(s)
- Allison Barraclough
- Fiona Stanley Hospital, Department of Haematology, Perth, Australia; University of Melbourne, Melbourne
| | - James T England
- University of British Columbia and BC Cancer Centre for Lymphoid Cancer, Vancouver, Canada; Princess Margaret Cancer Centre, Toronto
| | - Diego Villa
- University of British Columbia and BC Cancer Centre for Lymphoid Cancer, Vancouver
| | - Joel Wight
- University of Melbourne, Melbourne, Australia; Townsville University Hospital, Department of Haematology, Townsville
| | - Greg Hapgood
- Princess Alexandra Hospital, Department of Haematology, Brisbane
| | - Jason Conn
- Princess Alexandra Hospital, Department of Haematology, Brisbane
| | | | | | - Michael Gilbertson
- Monash Health, Department of Haematology, Melbourne, Australia; School of Clinical Sciences, Monash University, Melbourne
| | - Briony Shaw
- Monash Health, Department of Haematology, Melbourne
| | - Mark J Bishton
- Nottingham City Hospital, Department of Haematology, Nottingham
| | - Malik Saeed
- Nottingham City Hospital, Department of Haematology, Nottingham
| | | | | | - Geoff Chong
- University of Melbourne, Melbourne, Australia; Ballarat Regional Integrated Cancer Centre, Ballarat Health Services, Melbourne, Australia; Department of Medical Oncology and Haematology, Olivia Newton-John Cancer Research and Wellness Centre, Austin Health, Melbourne
| | - Shin Hnin Wai
- Department of Medical Oncology and Haematology, Olivia Newton-John Cancer Research and Wellness Centre, Austin Health, Melbourne, Australia; The Northern Hospital, Department of Haematology, Melbourne
| | - Matthew Ku
- University of Melbourne, Melbourne, Australia; St Vincent's Hospital Melbourne, Department of Haematology, Melbourne
| | - Hui-Peng Lee
- Flinders Medical Centre, Department of Haematology, Adelaide
| | - Kathryn Fleming
- Flinders Medical Centre, Department of Haematology, Adelaide
| | - Constantine Tam
- University of Melbourne, Melbourne, Australia; Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Department of Haematology, Melbourne
| | - Genevieve Douglas
- Department of Medical Oncology and Haematology, Olivia Newton-John Cancer Research and Wellness Centre, Austin Health, Melbourne
| | - Chan Y Cheah
- Sir Charles Gairdner Hospital, Department of Haematology, Perth, Australia; University of Western Australia, Medical School, Perth
| | - Zi Yun Ng
- Sir Charles Gairdner Hospital, Department of Haematology, Perth
| | | | | | - Nada Hamad
- St Vincent's Hospital Sydney, Department of Haematology, Sydney, Australia; School of Clinical Medicine, University of New South Wales, Sydney, Australia; School of Medicine, University of Notre Dame, Sydney
| | - Helen Cashman
- St Vincent's Hospital Sydney, Department of Haematology, Sydney
| | - Mary Gleeson
- Guy's and St. Thomas' NHS Foundation Trust, Department of Haematology, London
| | | | - Eliza A Hawkes
- Department of Medical Oncology and Haematology, Olivia Newton-John Cancer Research and Wellness Centre, Austin Health, Melbourne, Australia; Transfusion Research Unit, Monash University, Melbourne.
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8
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Barraclough A, Hawkes E, Sehn LH, Smith SM. Diffuse large B-cell lymphoma. Hematol Oncol 2023. [PMID: 37435781 DOI: 10.1002/hon.3202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 05/29/2023] [Accepted: 06/07/2023] [Indexed: 07/13/2023]
Abstract
Large B-cell lymphoma, the prototype of aggressive non-Hodgkin lymphomas, is both the most common lymphoma and accounts for the highest global burden of lymphoma-related deaths. For nearly 4 decades, the goal of treatment has been "cure", first based on CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone), and subsequently with rituximab plus CHOP. However, there is significant clinical, pathologic, and biologic heterogeneity, and not all patients are cured. Understanding and incorporating this biologic heterogeneity into treatment decisions unfortunately is not yet standard of care. Despite this gap, we now have significant advances in frontline, relapsed, and refractory settings. The POLARIX trial shows, for the first time, improved progression-free survival in a prospective randomized phase 3 setting. In the relapsed and refractory settings, there are now many approved agents/regimens, and several bispecific antibodies poised to join the arsenal of options. While chimeric antigen receptor T-cell therapy is discussed in detail elsewhere, it has quickly become an excellent option in the second-line setting and beyond. Unfortunately, special populations such as older adults continue to have poor outcomes and be underrepresented in trials, although a new generation of trials aim to address this disparity. This brief review will highlight the key issues and advances that offer improved outcomes to an increasing portion of patients.
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Affiliation(s)
- Allison Barraclough
- Department of Haematology, Fiona Stanley Hospital, Perth, Western Australia, Australia
- University of Melbourne, Medical School, Melbourne, Victoria, Australia
| | - Eliza Hawkes
- Olivia Newton John Cancer Research Centre, Austin Health, Melbourne, Victoria, Australia
- Monash University School of Public Health & Preventive Medicine, Melbourne, Victoria, Australia
| | - Laurie H Sehn
- BC Cancer Centre for Lymphoid Cancer, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Sonali M Smith
- The University of Chicago Medicine, Section of Hematology/Oncology, The University of Chicago, Chicago, Illinois, USA
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9
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Nguyen J, Wellard C, Chung E, Cheah CY, Dickinson M, Doo NW, Keane C, Talaulikar D, Berkahn L, Morgan S, Hamad N, Cochrane T, Johnston AM, Forsyth C, Opat S, Barraclough A, Mutsando H, Ratnasingam S, Giri P, Wood EM, McQuilten ZK, Hawkes EA. Clinical characteristics of Australian treatment-naïve patients with classical Hodgkin lymphoma from the lymphoma and related diseases registry. Eur J Haematol 2023; 110:386-395. [PMID: 36539351 DOI: 10.1111/ejh.13915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 12/03/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022]
Abstract
Comprehensive clinical characteristics of Australian patients with classical Hodgkin Lymphoma (cHL) have not previously been systematically collected and described. We report real-world data of 498 eligible patients from the first 5 years of the Lymphoma and Related Diseases Registry (LaRDR), including baseline characteristics, histologic subtype, and treatment patterns in first-line therapy. Patient demographics and distribution of histopathological subtypes of cHL are similar to reported international cohorts. Doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) was the most common therapy for both early and advanced-stage disease, and 48% of patients with the early-stage disease received radiotherapy. Treatment patterns are consistent with international guidelines. In comorbid patients ≥60 years of age with advanced-stage disease, there is greater variation in treatment. In patients with a recorded response, the objective response rate (ORR) was 96% in early-stage disease, and 88% in advanced-stage disease. Early progression-free survival data suggest Australian patients with cHL have good outcomes, similar to other international studies.
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Affiliation(s)
| | - Cameron Wellard
- Monash University School of Public Health & Preventive Medicine, Melbourne, Victoria, Australia
| | - Eliza Chung
- Monash University School of Public Health & Preventive Medicine, Melbourne, Victoria, Australia
| | - Chan Y Cheah
- Sir Charles Gairdner Hospital and Medical School, University of Western Australia, Western Australia, Australia
| | - Michael Dickinson
- Peter MacCallum Cancer Centre; Royal Melbourne Hospital, and the Sir Peter MacCallum Department of Oncology at the University of Melbourne, Melbourne, Victoria, Australia
| | - Nicole Wong Doo
- Concord Repatriation General Hospital; Concord Clinical School, University of Sydney, Concord, New South Wales, Australia
| | - Colm Keane
- Princess Alexandra Hospital, Queensland, Australia
| | - Dipti Talaulikar
- Canberra Health Services, The Australian National University, Australian Capital Territory, Australia
| | | | | | - Nada Hamad
- St Vincent's Hospital Sydney, Sydney, New South Wales, Australia
| | - Tara Cochrane
- Gold Coast University Hospital, Griffith University, Southport, Queensland, Australia
| | | | | | | | | | | | | | | | - Erica M Wood
- Monash University School of Public Health & Preventive Medicine, Melbourne, Victoria, Australia
| | - Zoe K McQuilten
- Monash University School of Public Health & Preventive Medicine, Melbourne, Victoria, Australia
| | - Eliza A Hawkes
- Monash University School of Public Health & Preventive Medicine, Melbourne, Victoria, Australia.,Olivia Newton John Cancer Research Institute at Austin Health, Victoria, Australia
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10
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Manos K, Chong G, Keane C, Lee ST, Smith C, Churilov L, McKendrick J, Renwick W, Blombery P, Burgess M, Nelson NE, Fancourt T, Hawking J, Lin W, Scott AM, Barraclough A, Wight J, Grigg A, Fong CY, Hawkes EA. Immune priming with avelumab and rituximab prior to R-CHOP in diffuse large B-cell lymphoma: the phase II AvR-CHOP study. Leukemia 2023; 37:1092-1102. [PMID: 36906715 DOI: 10.1038/s41375-023-01863-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 02/19/2023] [Accepted: 02/27/2023] [Indexed: 03/13/2023]
Abstract
Immune evasion, due to abnormal expression of programmed-death ligands 1 and 2 (PD-L1/PD-L2), predicts poor outcomes with chemoimmunotherapy in diffuse large B-cell lymphoma (DLBCL). Immune checkpoint inhibition (ICI) has limited efficacy at relapse but may sensitise relapsed lymphoma to subsequent chemotherapy. ICI delivery to immunologically intact patients may thus be the optimal use of this therapy. In the phase II AvR-CHOP study, 28 patients with treatment-naive stage II-IV DLBCL received sequential avelumab and rituximab priming ("AvRp;" avelumab 10 mg/kg and rituximab 375 mg/m2 2-weekly for 2 cycles), R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisolone for 6 cycles) and avelumab consolidation (10 mg/kg 2-weekly for 6 cycles). Grade 3/4 immune-related adverse events occurred in 11%, meeting the primary endpoint of a grade ≥3 irAE rate of <30%. R-CHOP delivery was not compromised but one patient ceased avelumab. Overall response rates (ORR) after AvRp and R-CHOP were 57% (18% CR) and 89% (all CR). High ORR to AvRp was observed in primary mediastinal B-cell lymphoma (67%; 4/6) and molecularly-defined EBV-positive DLBCL (100%; 3/3). Progression during AvRp was associated with chemorefractory disease. Two-year failure-free and overall survival were 82% and 89%. An immune priming strategy with AvRp, R-CHOP and avelumab consolidation shows acceptable toxicity with encouraging efficacy.
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Affiliation(s)
- Kate Manos
- Olivia Newton John Cancer Research Institute at Austin Health, Heidelberg, VIC, Australia
| | - Geoffrey Chong
- Ballarat Regional Integrated Cancer Centre, Ballarat Central, VIC, Australia
| | - Colm Keane
- Princess Alexandra Hospital, Woolloongabba, QLD, Australia
| | - Sze-Ting Lee
- Olivia Newton John Cancer Research Institute at Austin Health, Heidelberg, VIC, Australia
| | - Charmaine Smith
- Olivia Newton John Cancer Research Institute at Austin Health, Heidelberg, VIC, Australia
| | - Leonid Churilov
- Melbourne Medical School, University of Melbourne, Parkville, VIC, Australia
| | | | | | - Piers Blombery
- Peter MacCallum Cancer Centre, East Melbourne, VIC, Australia
| | | | | | - Tineke Fancourt
- Olivia Newton John Cancer Research Institute at Austin Health, Heidelberg, VIC, Australia
| | - Joanne Hawking
- Olivia Newton John Cancer Research Institute at Austin Health, Heidelberg, VIC, Australia
| | - Wendi Lin
- Olivia Newton John Cancer Research Institute at Austin Health, Heidelberg, VIC, Australia
| | - Andrew M Scott
- Olivia Newton John Cancer Research Institute at Austin Health, Heidelberg, VIC, Australia
| | | | - Joel Wight
- Townsville University Hospital, Douglas, QLD, Australia
| | - Andrew Grigg
- Olivia Newton John Cancer Research Institute at Austin Health, Heidelberg, VIC, Australia
| | - Chun Yew Fong
- Olivia Newton John Cancer Research Institute at Austin Health, Heidelberg, VIC, Australia
| | - Eliza A Hawkes
- Olivia Newton John Cancer Research Institute at Austin Health, Heidelberg, VIC, Australia.
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11
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Keane C, Hamad N, Barraclough A, Lee YY, Talaulikar D, Ku M, Wight J, Tatarczuch M, Swain F, Gregory GP. Diagnosis and management of primary central nervous system lymphoma: a Consensus Practice Statement from the Australasian Lymphoma Alliance. Intern Med J 2021; 52:1624-1632. [PMID: 34927329 DOI: 10.1111/imj.15658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 10/24/2021] [Accepted: 12/05/2021] [Indexed: 11/28/2022]
Abstract
Primary central nervous system lymphoma is a clinicopathological disease entity that accounts for 1 % of all non-Hodgkin lymphoma (NHL). Advanced patient age, adverse disease biology and complexities of diagnosis and treatment render outcomes markedly inferior to systemic NHL. Despite this, an increasing evidence base including limited randomised controlled clinical trial data is informing optimal therapeutic strategies with methotrexate-based induction chemotherapy schedules and intensified consolidation in selected patients. This practice statement represents an evidence-based review of the literature and has been devised to assist healthcare professionals in the diagnosis and management of this disease. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- C Keane
- Division of Cancer Services, Princess Alexandra Hospital, Brisbane, Australia.,University of Queensland, Brisbane, Australia
| | - N Hamad
- Department of Haematology, St Vincent's Hospital Sydney, Australia.,School of Medicine, Sydney, University of Notre Dame, Australia.,St Vincent's Clinical School, Sydney, University of New South, UK
| | - A Barraclough
- Department of Haematology, Fiona Stanley Hospital, Western Australia, Australia
| | - Y Y Lee
- Radiation Oncology, Division of Cancer Services, Princess Alexandra Hospital, Queensland, Australia
| | - D Talaulikar
- Department of Haematology, Canberra Hospital, ACT, Australia
| | - M Ku
- Department of Clinical Haematology, St Vincent's Hospital Melbourne, Fitzroy, Australia.,University of Melbourne, Victoria, Australia
| | - J Wight
- Department of Haematology, Townsville Hospital, Australia
| | - M Tatarczuch
- Monash Haematology, Monash Health, Clayton, Australia.,School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
| | - F Swain
- Division of Cancer Services, Princess Alexandra Hospital, Australia
| | - G P Gregory
- Monash Haematology, Monash Health, Clayton, Australia.,School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
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12
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Boyle S, Tobin JWD, Perram J, Hamad N, Gullapalli V, Barraclough A, Singaraveloo L, Han MH, Blennerhassett R, Nelson N, Johnston AM, Talaulikar D, Karpe K, Bhattacharyya A, Cheah CY, Subramoniapillai E, Bokhari W, Lee C, Hawkes EA, Jabbour A, Strasser SI, Chadban SJ, Brown C, Mollee P, Hapgood G. Management and Outcomes of Diffuse Large B-cell Lymphoma Post-transplant Lymphoproliferative Disorder in the Era of PET and Rituximab: A Multicenter Study From the Australasian Lymphoma Alliance. Hemasphere 2021; 5:e648. [PMID: 34651103 PMCID: PMC8505336 DOI: 10.1097/hs9.0000000000000648] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 09/08/2021] [Indexed: 11/26/2022] Open
Abstract
There are limited data on post-transplant lymphoproliferative disorder (PTLD) in the era of positron emission tomography (PET) and rituximab (R). Furthermore, there is limited data on the risk of graft rejection with modern practices in reduction in immunosuppression (RIS). We studied 91 patients with monomorphic diffuse large B-cell lymphoma PTLD at 11 Australian centers: median age 52 years, diagnosed between 2004 and 2017, median follow-up 4.7 years (range, 0.5-14.5 y). RIS occurred in 88% of patients. For patients initially treated with R-monotherapy, 45% achieved complete remission, rising to 71% with the addition of rituximab, cyclophosphamide, doxorubicin, vincristine, prednisolone (R-CHOP) for those not in complete remission. For patients initially treated with R-CHOP, the complete remission rate was 76%. There was no difference in overall survival (OS) between R-monotherapy and R-chemotherapy patients. There was no difference in OS for patients with systemic lymphoma (n = 68) versus central nervous system (CNS) involvement (n = 23) (3-y OS 72% versus 73%; P = 0.78). Treatment-related mortality was 7%. End of treatment PET was prognostic for patients with systemic lymphoma with longer OS in the PET negative group (3-y OS 91% versus 57%; P = 0.01). Graft rejection occurred in 9% (n = 4 biopsy-proven; n = 4 suspected) during the entire follow-up period with no cases of graft loss. RIS and R-based treatments are safe and effective with a low likelihood of graft rejection and high cure rate for patients achieving complete remission with CNS or systemic PTLD.
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Affiliation(s)
- Stephen Boyle
- Department of Haematology, Princess Alexandra Hospital, Brisbane, Queensland, Australia
- University of Queensland, Brisbane, Queensland, Australia
| | - Joshua W. D. Tobin
- University of Queensland, Brisbane, Queensland, Australia
- Department of Haematology, Gold Coast University Hospital, Gold Coast, Queensland, Australia
| | - Jacinta Perram
- Institute of Haematology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Nada Hamad
- Department of Haematology, St Vincent’s Hospital, Sydney, New South Wales, Australia
- Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Veena Gullapalli
- Department of Haematology, St Vincent’s Hospital, Sydney, New South Wales, Australia
| | - Allison Barraclough
- Department of Haematology and Olivia Newton John Cancer Research Institute, The Austin Hospital, Melbourne, Victoria, Australia
| | | | - Min-Hi Han
- Department of Haematology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Richard Blennerhassett
- Department of Haematology, Westmead Hospital, Sydney, New South Wales, Australia
- University of Sydney, Sydney, New South Wales, Australia
| | - Niles Nelson
- Royal Hobart Hospital, Hobart, Tasmania, Australia
| | - Anna M. Johnston
- Royal Hobart Hospital, Hobart, Tasmania, Australia
- University of Tasmania, Hobart, Tasmania, Australia
| | - Dipti Talaulikar
- Department of Haematology, Canberra Hospital, Canberra, Australian Capital Territory, Australia
- Australian National University, Canberra, Australian Capital Territory, Australia
| | - Krishna Karpe
- Department of Renal Medicine, Canberra Hospital, Canberra, Australian Capital Territory, Australia
| | - Abir Bhattacharyya
- Department of Haematology, Westmead Hospital, Sydney, New South Wales, Australia
| | - Chan Yoon Cheah
- Department of Haematology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
- University of Western Australia, Crawley, Western Australia, Australia
| | | | - Waqas Bokhari
- Royal Brisbane Hospital, Brisbane, Queensland, Australia
| | - Cindy Lee
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Eliza A. Hawkes
- Department of Haematology and Olivia Newton John Cancer Research Institute, The Austin Hospital, Melbourne, Victoria, Australia
- Eastern Health, Box Hill, Victoria, Australia
- University of Melbourne, Melbourne, Victoria, Australia
| | - Andrew Jabbour
- Department of Cardiology, St Vincent’s Hospital, Sydney, New South Wales, Australia
| | - Simone I. Strasser
- University of Sydney, Sydney, New South Wales, Australia
- AW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Steven J. Chadban
- University of Sydney, Sydney, New South Wales, Australia
- Department of Renal Medicine, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
- Kidney Node, Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Christina Brown
- Institute of Haematology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
- University of Sydney, Sydney, New South Wales, Australia
| | - Peter Mollee
- Department of Haematology, Princess Alexandra Hospital, Brisbane, Queensland, Australia
- University of Queensland, Brisbane, Queensland, Australia
| | - Greg Hapgood
- Department of Haematology, Princess Alexandra Hospital, Brisbane, Queensland, Australia
- University of Queensland, Brisbane, Queensland, Australia
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13
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Manos K, Khor R, Chong G, Palmer J, MacManus M, Keane C, Scott AM, Shortt J, Ritchie D, Churilov L, Johnston L, Witkowski T, Barraclough A, Lee ST, Lin W, Koldej R, Hawkes E. Abstract CT208: Phase I Dose Escalation Study of Radiotherapy and Durvalumab (MEDI4736) in Relapsed or Refractory Diffuse Large B-cell Lymphoma (DLBCL): The RaDD Study. Cancer Res 2021. [DOI: 10.1158/1538-7445.am2021-ct208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Most DLBCL & FL responds well to first line treatment, yet relapsed disease outcomes are poor. Immune checkpoint inhibition (ICI) with PD/PD1 inhibitors (PD1i) yield high response rates in some lymphomas; though single agent PD1i yields a disappointing ORR of 10% in heavily pre-treated DLBCL, some responses are durable. RT stimulates anti-tumour immunity through several mechanisms and may enhance response to ICI. Concurrent ICI & RT is synergistic in preclinical studies & solid tumours, improving local & distant (abscopal) response. RT to multiple disease sites may broaden the spectrum of tumour antigen release and overcome clonal variation between disease sites to further augment the immune response. A dose-response relationship between RT and antigen release has yet to be established. This phase I dose escalation study aims to determine the safety profile of RT in combination with durvalumab, an anti-PD-L1 monoclonal antibody, in relapsed/refractory DLBCL and FL.
Study Design and Methods: RaDD (NCT03610061) is a phase I dose escalation study to determine the safety profile of escalating dose and number of sites of RT in combination with durvalumab in relapsed/refractory (RR) DLBCL & FL. Eligible patients (pts) have received ≥ 1 prior line of therapy and are ineligible for or relapsed after autologous stem cell transplant (auto-SCT). Pts with active autoimmune disease, CNS involvement, prior allogeneic-SCT or chronic steroid use are excluded. RT dose and site escalation proceeds according to a 3+3 design with 6 dose levels (cohorts 1-6). Treatment comprises external beam RT to target site(s) daily for 5 days (Cohorts 1-5); Cohort 6 receives a further 5 daily fractions (max 30Gy). Durvalumab 1500mg IV commences day 2 of RT and continues 4-weekly until disease progression. Pts can continue until a second radiological progression if clinical benefit is ongoing. The dose limiting toxicity period is 28 days from start of RT.
The primary endpoint is the toxicity, drug pharmacokinetics, maximum tolerated dose (MTD) and recommended phase two dose (RP2D) of simultaneous RT and durvalumab. Secondary endpoints include response rates, progression-free survival and overall survival.
Correlative studies will examine the tumour-immune system interaction; an exploratory PET substudy with novel tracers for durvalumab (89Zr-Durvalumab) & CD8+ T cells (89Zr -Df-IAB22M2C) will also be performed.
Projected enrolment for determination of the MTD and RP2D is 6-30 pts pending toxicity. Recruitment will continue to 36 pts for secondary endpoint analysis. 22 pts are enrolled to date in the main study, with 2 patients enrolled in the PET-substudy.
Acknowledgements: Victorian Cancer Agency (grant funding - TRP16006), Astra Zeneca (durvalumab and funding), Celgene (funding), Imaginab (89Zr -Df-IAB22M2C).
Citation Format: Kate Manos, Richard Khor, Geoffrey Chong, Jodie Palmer, Michael MacManus, Colm Keane, Andrew M. Scott, Jake Shortt, David Ritchie, Leonid Churilov, Laura Johnston, Tom Witkowski, Allison Barraclough, Sze Ting Lee, Wendi Lin, Rachel Koldej, Eliza Hawkes. Phase I Dose Escalation Study of Radiotherapy and Durvalumab (MEDI4736) in Relapsed or Refractory Diffuse Large B-cell Lymphoma (DLBCL): The RaDD Study [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr CT208.
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Affiliation(s)
| | | | - Geoffrey Chong
- 2Olivia Newton-John Cancer Research Institute at Austin Health, Heidelberg, Australia
| | - Jodie Palmer
- 3Olivia Newton-John Cancer Research Institute, Heidelberg, Australia
| | | | - Colm Keane
- 5Princess Alexandra Hospital, Woolloongabba, Australia
| | - Andrew M. Scott
- 2Olivia Newton-John Cancer Research Institute at Austin Health, Heidelberg, Australia
| | | | - David Ritchie
- 7Australian Cancer Research Foundation at Royal Melbourne Hospital, Melbourne, Australia
| | | | | | - Tom Witkowski
- 3Olivia Newton-John Cancer Research Institute, Heidelberg, Australia
| | | | - Sze Ting Lee
- 2Olivia Newton-John Cancer Research Institute at Austin Health, Heidelberg, Australia
| | - Wendi Lin
- 1Austin Health, Heidelberg, Australia
| | - Rachel Koldej
- 7Australian Cancer Research Foundation at Royal Melbourne Hospital, Melbourne, Australia
| | - Eliza Hawkes
- 2Olivia Newton-John Cancer Research Institute at Austin Health, Heidelberg, Australia
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14
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Hawkes EA, Lee ST, Chong G, Gilbertson M, Grigg A, Churilov L, Fancourt T, Keane C, Ritchie D, Koldej R, Agarwal R, Manos K, Smith C, Houdyk K, Hawking J, Barraclough A. IMMUNE PRIMING WITH NIVOLUMAB FOLLOWED BY NIVOLUMAB & RITUXIMAB IN 1
ST
LINE TREATMENT OF FOLLICULAR LYMPHOMA: THE PHASE 2 1
ST
FLOR STUDY. Hematol Oncol 2021. [DOI: 10.1002/hon.81_2879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- E. A. Hawkes
- Olivia Newton‐John Cancer Research and Wellness Centre Medical Oncology and Haematology Melbourne Australia
| | - S. T. Lee
- Austin Health, Molecular Imaging and Therapy Melbourne Australia
| | - G. Chong
- Ballarat Regional Intergrated Cancer Centre Haematology and Oncology Ballarat Australia
| | | | - A. Grigg
- Austin Health Haematology Melbourne Australia
| | - L. Churilov
- Melbourne Brain Centre Florey Institute of Neuroscience and Mental Health Melbourne Australia
| | - T. Fancourt
- Austin Health Anatomical Pathology Melbourne Australia
| | - C. Keane
- Princess Alexandra Hospital Haematology Brisbane Australia
| | - D. Ritchie
- Peter MacCallum Cancer Centre and Royal Melbourne Hospital Haematology Melbourne Australia
| | - R. Koldej
- The Royal Melbourne Hospital ACRF Translational Research Laboratory Melbourne Australia
| | - R. Agarwal
- Austin Health Molecular Diagnostics Melbourne Australia
| | - K. Manos
- Austin Health Haematology Melbourne Australia
| | - C. Smith
- Austin Health Cancer Clinical Trials Centre Melbourne Australia
| | - K. Houdyk
- Austin Health Cancer Clinical Trials Centre Melbourne Australia
| | - J. Hawking
- Austin Health Cancer Clinical Trials Centre Melbourne Australia
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15
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Hawkes EA, Lee ST, Chong G, Gilbertson M, Grigg A, Churilov L, Fancourt T, Keane C, Ritchie D, Koldej R, Agarwal R, Manos K, Smith C, Houdyk K, Hawking J, Barraclough A. Immune priming with nivolumab followed by nivolumab and rituximab in first-line treatment of follicular lymphoma: The phase 2 1st FLOR study. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.7560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
7560 Background: Standard of care immunochemotherapy in front-line (1L) follicular lymphoma (FL) is highly efficacious but not without significant toxicity. High rates of grade 3-5 adverse events (AEs), primarily infection and bone marrow suppression, are experienced in up to 75% of patients. A more tolerable but equally effective approach is required. PD-1 inhibition, in combination with rituximab (R), increases T cell anti-tumour effect & enhances NK cell antibody dependent cell cytotoxicity, with proven efficacy in relapsed FL. The concept of ‘priming’ the immune system with nivolumab (N) prior to tumour-directed therapy has rationale and evidence, but the safety of this approach in 1L FL is not described. Methods: ‘1st FLOR’ (NCT03245021) is an open-label, multi-centre, phase 2, Simon’s 2-stage study of N + R (N = 39). Key eligibility were stage III-IV grade 1-3A FL requiring 1L systemic therapy; ECOG ≤2; adequate organ function. All patients (pts) receive induction N 240mg IV 2-weekly for 4 cycles. Pts with complete response (CR) receive 4 further cycles of 240mg IV N monotherapy then 12 cycles of maintenance N 480mg IV 4-weekly. Pts with < CR had 240mg N plus 375mg/m2 IV R 2-weekly for 4 cycles followed by maintenance N+R (N 480mg 4 weekly for 12 cycles; R 12 weekly for 8 cycles). Primary endpoint (EP) was ≥ G3 toxicity rate during induction. Secondary EPs; response rate by Lugano response criteria, overall toxicity, PFS, OS. Results: Between September 2017 to March 2020, 39 pts were enrolled. Baseline characteristics included median age of 54 (range: 28-79). stage IV disease in 67%, B Symptoms & bulk (≥7cm) in 23% each, intermediate-high risk FLIPI in 74%. The primary EP was met, with only 16 pts (41%) having ≥G3 toxicity at end of induction. Non-immune AEs were predominantly G1-2; most commonly infection (67%) & fatigue (64%). G3-4 Immune-related AEs were infrequent and included pancreatitis plus hepatitis (N = 1), pancreatitis alone (N = 1), rash (N = 1), transaminitis (N = 2), hypocortisolism (N = 1), hyperglycaemia (N = 3) and asymptomatic lipase/amylase increase (N = 3). Median follow-up was 17.5 months (range: 7-39). Overall response rate was 92% (36/39) with CR in 54% (21/39). Median time to CR was 5 months (m) (range: 2-25). Nine pts (23%) discontinued treatment; 7 due to progressive disease (1 pt died of transformed FL), 2 developed constitutional symptoms (1 stable disease, 1 partial response). In 25 evaluable pts, 12m PFS & OS is 72% (CI 51-88) & 96% (CI 80-100). Biomarker analysis is in progress. Conclusions: Immune-priming with single-agent N, then combination N+R in 1L FL is associated with favourable toxicity and high ORR & CR rates potentially providing an alternative to chemotherapy. Acknowledgements: Bristol-myers Squibb provided funding and nivolumab for this study. Clinical trial information: NCT03245021.
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Affiliation(s)
- Eliza Anne Hawkes
- Austin Health and Olivia Newton-John Cancer Research Institute, Heidelberg, Australia
| | - Sze Ting Lee
- Austin Health and Olivia Newton-John Cancer Research Institute, Heidelberg, Australia
| | - Geoff Chong
- Ballarat Regional Integrated Cancer Centre, Ballarat, Australia
| | | | | | | | | | - Colm Keane
- Princess Alexandra Hospital, Woolloongabba, Australia
| | - David Ritchie
- Peter MacCallum Cancer Centre & Royal Melbourne Hospital, Melbourne, Australia
| | - Rachel Koldej
- Australian Cancer Research Foundation at Royal Melbourne Hospital, Melbourne, Australia
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16
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Loh Z, Salvaris R, Chong G, Churilov L, Manos K, Barraclough A, Hawkes EA. Evolution of eligibility criteria for diffuse large B-cell lymphoma randomised controlled trials over 30 years. Br J Haematol 2021; 193:741-749. [PMID: 33851428 DOI: 10.1111/bjh.17436] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 02/01/2021] [Indexed: 11/27/2022]
Abstract
Eligibility criteria for randomised control trials (RCT) in diffuse large B-cell lymphoma (DLBCL) may be becoming increasingly strict. In this analysis, 42 first-line phase III RCTs enrolling DLBCL patients since 1990 were identified from PubMed and clinicaltrials.gov. Changes in 31 individual eligibility criteria were assessed using three pre-defined eras [(1) 1993-2005; (2) 2006-2013; and (3) 2014-2020]. The presence of 15/31 criteria increased significantly over time, and the total number of criteria per study also increased over time [median Era 1: 14·5, interquartile range (IQR) 12·6-16·4; Era 2: 21, 18·8-23·3; Era 3: 23, 21-25; P < 0·001]. When each trial's eligibility criteria were applied to 215 consecutive patients from an institutional database treated between 2010 and 2020, a median of 57% (IQR 47-70) of patients were hypothetically eligible for trial enrolment. The median percentage of patients eligible was 68% (56-91), 54% (37-81) and 47% (38-82) for Era 1, 2 and 3 respectively (P = 0·004). Phase III front-line DLBCL trial criteria have become increasingly restrictive over the last three decades, resulting in a diminishing proportion of trial-eligible patients, with less than 50% of our patients eligible for modern-era studies. This potentially impacts generalisability of recent trial results and will likely limit recruitment to ongoing studies.
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Affiliation(s)
- Zoe Loh
- Department of Medical Oncology and Clinical Haematology, Olivia Newton John Cancer Research and Wellness Centre at Austin Health, Heidelberg, Vic., Australia
| | - Ross Salvaris
- Department of Medical Oncology and Clinical Haematology, Olivia Newton John Cancer Research and Wellness Centre at Austin Health, Heidelberg, Vic., Australia.,Department of Haematology, Monash Health, Clayton, Vic., Australia
| | - Geoffrey Chong
- Department of Medical Oncology and Clinical Haematology, Olivia Newton John Cancer Research and Wellness Centre at Austin Health, Heidelberg, Vic., Australia.,Melbourne Medical School, University of Melbourne, Melbourne, Vic., Australia
| | - Leonid Churilov
- Melbourne Medical School, University of Melbourne, Melbourne, Vic., Australia
| | - Kate Manos
- Department of Medical Oncology and Clinical Haematology, Olivia Newton John Cancer Research and Wellness Centre at Austin Health, Heidelberg, Vic., Australia
| | - Allison Barraclough
- Department of Medical Oncology and Clinical Haematology, Olivia Newton John Cancer Research and Wellness Centre at Austin Health, Heidelberg, Vic., Australia
| | - Eliza A Hawkes
- Department of Medical Oncology and Clinical Haematology, Olivia Newton John Cancer Research and Wellness Centre at Austin Health, Heidelberg, Vic., Australia.,Melbourne Medical School, University of Melbourne, Melbourne, Vic., Australia.,Department of Haematology, Eastern Health, Melbourne, Vic., Australia
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Abstract
Grade 3B follicular lymphoma (G3B FL) is rare, accounting for only 5-10% of FLs. Not only has it been routinely excluded from clinical trials, but data published on diagnosis, outcomes, choice of therapies and role of imaging are conflicting. With the advent of increasingly diverse treatment options for low-grade (G1-3A) FL, and the molecular subcategorisation of high-grade B-cell lymphomas, characterisation and treatment of G3B FL is ever more important as extrapolation of data becomes more difficult. New data have emerged exploring unique genetic characteristics, specific features on positron emission tomography imaging, choice of therapy, and outcomes of G3B FL in the current era. The present review will summarise and appraise these new data, and offer recommendations based on current evidence.
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Affiliation(s)
- Allison Barraclough
- Department of Haematology, Austin Health, Melbourne, Vic., Australia.,Department of Haematology, Fiona Stanley Hospital, Perth, WA, Australia
| | - Mark Bishton
- Department of Haematology, Nottingham City Hospital, Nottingham, UK
| | - Chan Y Cheah
- Department of Haematology, Sir Charles Gairdner Hospital, Perth, WA, Australia.,Medical School, University of Western Australia, Perth, WA, Australia
| | - Diego Villa
- Centre for Lymphoid Cancer, British Columbia Cancer and University of British Columbia, Vancouver, BC, Canada
| | - Eliza A Hawkes
- Department of Medical Oncology and Haematology, Olivia Newton-John Cancer Research and Wellness Centre, Austin Health, Melbourne, Vic., Australia.,Department of Medical Oncology and Haematology, Eastern Health, Melbourne, Vic., Australia
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Merli F, Luminari S, Tucci A, Arcari A, Rigacci L, Hawkes E, Chiattone CS, Cavallo F, Cabras G, Alvarez I, Fabbri A, Re A, Puccini B, Barraclough A, Delamain MT, Ferrero S, Usai SV, Ferrari A, Cencini E, Pennese E, Zilioli VR, Marino D, Balzarotti M, Cox MC, Zanni M, Di Rocco A, Lleshi A, Botto B, Hohaus S, Merli M, Sartori R, Gini G, Nassi L, Musuraca G, Tani M, Bottelli C, Kovalchuk S, Re F, Flenghi L, Molinari A, Tarantini G, Chimienti E, Marcheselli L, Mammi C, Spina M. Simplified Geriatric Assessment in Older Patients With Diffuse Large B-Cell Lymphoma: The Prospective Elderly Project of the Fondazione Italiana Linfomi. J Clin Oncol 2021; 39:1214-1222. [PMID: 33577377 DOI: 10.1200/jco.20.02465] [Citation(s) in RCA: 68] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To prospectively validate the use of a simplified geriatric assessment (sGA) at diagnosis and to integrate it into a prognostic score for older patients with diffuse large B-cell lymphoma (DLBCL). METHODS We conducted the prospective Elderly Project study on patients with DLBCL older than 64 years who underwent our Fondazione Italiana Linfomi original geriatric assessment (oGA) (age, Cumulative Illness Rating Scale for Geriatrics, activities of daily living, and instrumental activities of daily living) before treatment. Treatment choice was left to the physician's discretion. The primary end point was overall survival (OS) (ClinicalTrials.gov identifier: NCT02364050). RESULTS We analyzed 1,163 patients (median age 76 years), with a 3-year OS of 65% (95% CI, 62 to 68). Because at multivariate analysis on oGA, age > 80 years retained an independent correlation with OS, we also developed a new, simplified version of the GA (sGA) that classifies patients as fit (55%), unfit (28%), and frail (18%) with significantly different 3-year OS of 75%, 58%, and 43%, respectively. The sGA groups, International Prognostic Index, and hemoglobin levels were independent predictors of OS and were used to build the Elderly Prognostic Index (EPI). Three risk groups were identified: low (23%), intermediate (48%), and high (29%), with an estimated 3-year OS of 87% (95% CI, 81 to 91), 69% (95% CI, 63 to 73), and 42% (95% CI, 36 to 49), respectively. The EPI was validated using an independent external series of 328 cases. CONCLUSION The Elderly Project validates sGA as an objective tool to assess fitness status and defines the new EPI to predict OS of older patients with DLBCL.
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Affiliation(s)
- Francesco Merli
- Hematology Unit, Azienda Unità Sanitaria Locale-IRCCS, Reggio Emilia, Italy
| | - Stefano Luminari
- Hematology Unit, Azienda Unità Sanitaria Locale-IRCCS, Reggio Emilia, Italy.,Department CHIMOMO, University of Modena and Reggio Emilia, Reggio Emilia, Italy
| | - Alessandra Tucci
- Hematology Division, ASST Spedali Civili Brescia, Brescia, Italy
| | - Annalisa Arcari
- Hematology Unit, Ospedale Guglielmo da Saliceto, Piacenza, Italy
| | - Luigi Rigacci
- Haematology Unit, Careggi University Hospital, Firenze, Italy
| | - Eliza Hawkes
- Department of Oncology and Clinical Haematology, Olivia Newton-John Cancer Research Institute at Austin Health, Heidelberg, Melbourne, Australia
| | - Carlos S Chiattone
- Santa Casa Medical School, Sao Paulo, Brazil.,Samaritano Hospital, Sao Paulo, Brazil
| | - Federica Cavallo
- Division of Hematology, Department of Molecular Biotechnologies and Health Sciences, University of Torino/AOU "Città della Salute e della Scienza di Torino," Torino, Italy
| | - Giuseppina Cabras
- Division of Hematology, Ospedale Oncologico Armando Businco, Cagliari, Italy
| | - Isabel Alvarez
- Hematology Unit, Azienda Unità Sanitaria Locale-IRCCS, Reggio Emilia, Italy
| | - Alberto Fabbri
- Unit of Hematology, Azienda Ospedaliera Universitaria Senese and University of Siena, Siena, Italy
| | - Alessandro Re
- Hematology Division, ASST Spedali Civili Brescia, Brescia, Italy
| | | | | | | | - Simone Ferrero
- Division of Hematology, Department of Molecular Biotechnologies and Health Sciences, University of Torino/AOU "Città della Salute e della Scienza di Torino," Torino, Italy
| | - Sara Veronica Usai
- Division of Hematology, Ospedale Oncologico Armando Businco, Cagliari, Italy
| | - Angela Ferrari
- Hematology Unit, Azienda Unità Sanitaria Locale-IRCCS, Reggio Emilia, Italy
| | - Emanuele Cencini
- Unit of Hematology, Azienda Ospedaliera Universitaria Senese and University of Siena, Siena, Italy
| | - Elsa Pennese
- Lymphoma Unit, Department of Hematology, Ospedale Spirito Santo, Pescara, Italy
| | | | - Dario Marino
- Department of Clinical and Experimental Oncology, Medical Oncology 1, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
| | - Monica Balzarotti
- Department of Medical Oncology and Hematology, Humanitas Clinical Research Hospital-IRCCS, Rozzano (MI), Italy
| | | | - Manuela Zanni
- Hematology Unit, Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy
| | - Alice Di Rocco
- Institute of Hematology, Department of Translational and Precision Medicine "Sapienza," University of Roma, Roma, Italy
| | - Arben Lleshi
- Division of Medical Oncology and Immune-related Tumors, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano (PN), Italy
| | - Barbara Botto
- Division of Hematology, Città della Salute e della Scienza Hospital and University, Torino, Italy
| | - Stefan Hohaus
- University Policlinico Gemelli Foundation-IRCCS, Catholic University of the Sacred Heart, Roma, Italy
| | - Michele Merli
- Division of Hematology, Ospedale di Circolo e Fondazione Macchi-ASST Sette Laghi, University of Insubria, Varese, Italy
| | - Roberto Sartori
- Department of Clinical and Experimental Oncology, Oncohematology Unit, Veneto Institute of Oncology, IOV-IRCCS, Castelfranco Veneto (TV), Italy
| | - Guido Gini
- Division of Hematology, Azienda Ospedaliera Universitaria Ospedali Riuniti, Ancona, Italy
| | - Luca Nassi
- Hematology, AOU Maggiore della Carità and University of Eastern Piedmont, Novara, Italy
| | - Gerardo Musuraca
- Hematology Unit, IRCCS-Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) SRL, Meldola (FC), Italy
| | - Monica Tani
- Hematology Unit, Santa Maria delle Croci Hospital, Ravenna, Italy
| | - Chiara Bottelli
- Hematology Division, ASST Spedali Civili Brescia, Brescia, Italy
| | - Sofia Kovalchuk
- Haematology Unit, Careggi University Hospital, Firenze, Italy
| | - Francesca Re
- Hematology and BMT Center, Azienda Ospedaliera Universitaria, Parma, Italy
| | - Leonardo Flenghi
- Hematology, Santa Maria della Misericordia Hospital, Perugia, Italy
| | | | - Giuseppe Tarantini
- Haematology and BMT Unit, Ospedale Monsignor R. Dimiccoli, Barletta, Italy
| | - Emanuela Chimienti
- Division of Medical Oncology and Immune-related Tumors, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano (PN), Italy
| | | | - Caterina Mammi
- Gruppo Amici dell'Ematologia GRADE-Onlus Foundation, Reggio Emilia, Italy
| | - Michele Spina
- Division of Medical Oncology and Immune-related Tumors, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano (PN), Italy
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Ryland GL, Barraclough A, Fong CY, Fleming S, Bajel A, Hofmann O, Westerman D, Grimmond S, Blombery P. Inotuzumab ozogamicin resistance associated with a novel CD22 truncating mutation in a case of B-acute lymphoblastic leukaemia. Br J Haematol 2020; 191:123-126. [PMID: 32648276 DOI: 10.1111/bjh.16949] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Georgina L Ryland
- Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,Centre for Cancer Research, University of Melbourne, Melbourne, VIC, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia
| | - Allison Barraclough
- Department of Clinical Haematology, Austin Health, Heidelberg, VIC, Australia
| | - Chun Yew Fong
- Department of Clinical Haematology, Austin Health, Heidelberg, VIC, Australia.,Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, Australia
| | - Shaun Fleming
- Department of Clinical Haematology, Alfred Hospital, Melbourne, VIC, Australia
| | - Ashish Bajel
- Clinical Haematology, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - Oliver Hofmann
- Centre for Cancer Research, University of Melbourne, Melbourne, VIC, Australia
| | - David Westerman
- Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia.,Clinical Haematology, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - Sean Grimmond
- Centre for Cancer Research, University of Melbourne, Melbourne, VIC, Australia
| | - Piers Blombery
- Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia.,Clinical Haematology, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, VIC, Australia
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20
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Nic Ionmhain UM, Knezevic BR, Barraclough A, Lucas M, Anstey M. What's beneath the surface? Stevens-Johnson syndrome/toxic epidermal necrolysis combined with haemophagocytic lymphohistiocytosis: a case report. Anaesth Intensive Care 2017; 45:125-127. [PMID: 28072947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- U M Nic Ionmhain
- Intensive Care Department, Sir Charles Gairdner Hospital, Perth, Western Australia
| | - B R Knezevic
- Department of Immunology, Sir Charles Gairdner Hospital, Perth, Western Australia
| | - A Barraclough
- Department of Haematology, Sir Charles Gairdner Hospital, Perth, Western Australia
| | - M Lucas
- Department of Immunology, PathWest, Laboratory Medicine, Sir Charles Gairdner Hospital, School of Medicine and Pharmacology, University of Western Australia, School of Pathology and Laboratory Medicine, University of Western Australia, Institute for Immunology and Infectious Diseases, Murdoch University, Perth, Western Australia
| | - M Anstey
- Intensive Care Department, Sir Charles Gairdner Hospital, Perth, Western Australia
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Carr DF, Chung WH, Jenkiins RE, Chaponda M, Nwikue G, Cornejo Castro EM, Antoine DJ, Pirmohamed M, Wuillemin N, Dina D, Eriksson KK, Yerly D, Pavlos R, Mckinnin E, Ostrov D, Peters B, Buus S, Koelle D, Chopra A, Rive C, Redwood A, Restrepo S, Bracey A, Yuan J, Gaudieri S, Carrington M, Haas D, Mallal S, Phillips E, De Boer D, Menheere P, Nieuwhof C, Bons J, Jonsson F, De Chaisemartin L, Granger V, Gillis C, Gouel A, Neukirch C, Dib F, Nicaise PR, Longrois D, Tubach F, Martin S, Bruhns P, Chen KL, Liao SL, Sheen YS, Cho YT, Yang CW, Liau JY, Chu CY, Aguiar R, Lopes A, Fernandes N, Viegas L, Pereira-Barbosa MA, Bünter A, Gupta N, Petkovic TP, Wirth N, Pichler WJ, Hausmann O, Yazicioglu M, Ozdemir PG, Ciplak G, Kaya O, Cooke PJ, Mota I, Gaspar Â, Benito-Garcia F, Chambel M, Morais-Almeida M, Marques L, Alcoceba E, Lara S, Carneiro-Leão L, Botelho C, Dias-Castro E, Cernadas JR, Nicholls K, Lay W, Smith O, Collins C, Unglik G, Spriggs K, Auyeung P, McComish J, Douglass JA, Peter JG, Potter P, Carolino F, De Castro ED, Moreira AS, Abreu C, Gomes E, Cardoso BK, Tomaz E, Correia S, Inácio F, Arnold A, Bear N, Rueter K, Gong G, O’Sullivan M, Muthusamy S, Noble V, Lucas M, Buterleviciute N, Rudzeviciene O, Abreu C, May S, Pongdee T, Park M, Griguola L, Vinikovas A, Kašinskaite S, Kvedariene V, Aktas A, Rahman S, Elbi H, Ozyurt BC, Cavkaytar O, Karaatmaca B, Cetinkaya PG, Esenboga S, Sahiner UM, Sekerel BE, Soyer O, Zubrinich C, Tong B, Patel M, Giles M, O’Hehir R, Puy R, Amaral L, Demir S, Gelincik A, Olgac M, Caskun R, Unal D, Colakoglu B, Buyukozturk S, Matute OV, Bernad A, Gastaminza G, Madamba R, Lacasa C, Goikoetxea MJ, D’Amelio C, Rifón J, Martínez N, Ferrer M, Ribeiro C, Faria E, Frutuoso C, Barros A, Lebre R, Pego A, Bom AT, Ensina LF, Aranda C, Nunes IC, Martins AM, Solé D, Bavbek S, Kendirlinan R, Çerçi P, Tutluer S, Soyyigit S, Sözener ZÇ, Aydin Ö, Gümüsburun R, Almeida M, Sai K, Imatoh T, Nakamura R, Fukazawa C, Hinomura Y, Saito Y, Sousa-Pinto B, Correia C, Gomes L, Gil-Mata S, Araújo L, Delgado L, Sai K, Okamoto-Uchida Y, Kajinami K, Matsunaga K, Aihara M, Wang CW, Su SC, Hung SI, Ho HC, Yang CH, Paulmann M, Dunant A, Mockenhaupt M, Sekula P, Schumacher M, Kardaun S, Naldi L, Bellón T, Creamer D, Haddad C, Sassolas B, Lebrun-Vignes B, Valeyrie-Allanore L, Roujeau JC, Paulmann M, Kremmler C, Mockenhaupt M, Dodiuk-Gad RP, Olteanu C, Feinstein A, Hashimoto R, Alhusayen R, Whyte-Croasdaile S, Finkelstein Y, Burnett M, Sade S, Cartotto R, Jeschke M, Shear NH, Takamura N, Yamane Y, Matsukura S, Nakamura K, Watanabe Y, Yamaguchi Y, Kambara T, Ikezawa Z, Aihara M, Hashimoto R, Chew H, Burnett M, Jeschke M, Knezevic B, Ionmhain UN, Barraclough A, Anstey M, Usui T, Meng X, Farrell J, Whitaker P, Watson J, French N, Park K, Naisbitt D, Neves AC, Cadinha S, Moreira A, Da Silva JPM, Drvar DL, Gulin SJ, Hadzavdic SL, Ceovic R, De Francisco AM, De Vicente Jiménez T, Luque AG, David NR, Galván JMM, Darlenski R, Gulin D, Sikic J, Habek JC, Galic E, Specht P, Staab D, Mayer B, Roehmel J, Solovan C, Chiriac A, Djurinec P, Kostovic K, Bradamante M, Almeida JP, Caiado J, Pedro E, Da Silva PC, Barbosa MP, Bogas G, Blanca-López N, Pérez-Alzate D, Doña I, Agúndez JA, García-Martín E, Cornejo-García JA, Mayorga C, Torres MJ, Canto MG, Blanca M, Aksakal S, Sin AZ, Koç ZP, Günsen FD, Ardeniz Ö, Gökmen ENM, Gülbahar O, Kokuludag A, Pérez-Sánchez N, Salas M, Salas M, Gomez F, Barrionuevo E, Andreu I, Miranda MÁ, Didžiokaite G, Gaidej O, Kašinskaite S, Garcimartin MI, Somoza ML, Bojas G, Cornejo-Garcia JA, Perez FJR, Miranda MA, Jerschow E, Pelletier T, Ren Z, Hudes G, Sanak M, Morales E, Schuster V, Spivack SD, Rosenstreich D, Erzen R, Silar M, Bajrovic N, Rijavec M, Zidarn M, Korosec P, Castro E, Al-Ahmad M, Rodriguez T, Azevedo JP, Tavares B, Regateiro F, Todo-Bom A, Miranda PA, De La Cruz Hoyos B, Abuzeid W, Akbar N, Gibber M, Fried M, Han W, Keskin T, Tamayev R, Spivack SD, Rosenstreich D, Jerschow E, Boni E, Russello M, Mauro M, Neto MF, Brosseron L, Malheiro D, Barreira P, Sprigg D, Trevenen M, Seet J, Trubiano J, Smith W, Jeelall Y, Vale S, Loh R, Mclean-Tooke A, Müller S, Amstutz U, Jörg L, Yawalkar N, Krähenbühl S, Leblanc A, Ribeiro L, Vega A, Rivas RG, Alonso A, Beitia JM, Mateo B, Cárdenas R, Garcia-Dominguez JJ, Pavlos R, Strautins K, James I, Mallal S, Redwood A, Aguiar R, Lopes A, Neves A, Do Céu Machado M, Dalgiç CT, Gökmen ENM, Bulut G, Ardeniz FÖ, Gülbahar O, Sin AZ, Hsu SH, Yang CW, Ye YM, Hur GY, Park HS, Kim SH, Ali S, Hollingsworth PN, Mclean-Tooke APC, Chadly Z, Fredj NB, Aouam K, Romdhane HB, Boughattas NA, Chaabane A, Salazar ML, Pola B, Fiandor A, Ramírez E, Ortega JD, Quirce S, Cabañas R, Baynova K, Labella M, Prados M, Ramonaite A, Bajoriuniene I, Sitkauskiene B, Sakalauskas R, Kwon JW, Park S, Silva D, Leão LC, Castro E, Garcimartin M, De La Torre MV, Pérez FJR, Haroun E, Diez GC, Ónodi-Nagy K, Kinyó Á, Kemény L, Bata-Csörgo Z, Pita JS, Fernandes RA, Moura A, Sousa N, Loureiro C, Pfützner W, Marrouche N, Grattan C, Chen YE, Chen CB, Hsiao YP, Garcimartin MI, Ruano FJ. 7th drug hypersensitivity meeting: part one. Clin Transl Allergy 2016. [PMCID: PMC5009634 DOI: 10.1186/s13601-016-0121-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Oral Abstracts O1 Functionally distinct HMGB1 isoforms correlate with physiological processes in drug-induced SJS/TEN Daniel F. Carr, Wen-Hung Chung, Rosalind E. Jenkiins, Mas Chaponda, Gospel Nwikue, Elena M. Cornejo Castro, Daniel J. Antoine, Munir Pirmohamed O2 Hypersensitivity reactions to beta-lactams, does the t cell recognition pattern influence the clinical picture? Natascha Wuillemin, Dolores Dina, Klara K. Eriksson, Daniel Yerly O3 Specific binding characteristics of HLA alleles associated with nevirapine hypersensitivity Rebecca Pavlos, Elizabeth Mckinnin, David Ostrov, Bjoern Peters, Soren Buus, David Koelle, Abha Chopra, Craig Rive, Alec Redwood, Susana Restrepo, Austin Bracey, Jing Yuan, Silvana Gaudieri, Mary Carrington, David Haas, Simon Mallal, Elizabeth Phillips O4 Do we need to measure total ige for the interpretation of analytical results of ImmunoCAP dnd 3gAllergy specific IgE? Douwe De Boer, Paul Menheere, Chris Nieuwhof, Judith Bons O5 Neutrophil activation in systemic anaphylaxis: results from the multicentric NASA study Friederike Jonsson, Luc De Chaisemartin, Vanessa Granger, Caitlin Gillis, Aurelie Gouel, Catherine Neukirch, Fadia Dib, Pascale Roland Nicaise, Dan Longrois, Florence Tubach, Sylvie Martin, Pierre Bruhns, NASA Study Group O6 Purpuric drug eruptions due to epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) for non-small-cell lung cancer (NSCLC): a clinic-pathological study of 32 cases Kai-Lung Chen, Shu-Ling Liao, Yi-Shuan Sheen, Yung-Tsu Cho, Che-Wen Yang, Jau-Yu Liau, Chia-Yu Chu Poster presentations: Poster Walk 1—Anaphylaxis (P01–P09) P1 Anaphylactic reactions during anaesthesia and the perioperative period Rita Aguiar, Anabela Lopes, Natália Fernandes, Leonor Viegas, M. A. Pereira-Barbosa P2 Anaphylaxis to chlorhexidine: is there a cross-reactivity to alexidine? Antonia Bünter, Nisha Gupta, Tatjana Pecaric Petkovic, Nicole Wirth, Werner J. Pichler, Oliver Hausmann P3 Cefotaxime-induced severe anaphylaxis in a neonate Mehtap Yazicioglu, Pinar G. Ozdemir, Gokce Ciplak, Ozkan Kaya P4 Clinical features and diagnosis of anaphylaxis resulting from exposure to chlorhexidine Peter John Cooke P5 Drug-induced anaphylaxis: five-year single-center survey Inês Mota, Ângela Gaspar, Filipe Benito-Garcia, Marta Chambel, Mário Morais-Almeida P6 Intraoperative severe anaphylactic reaction due to patent blue v dye Luis Marques, Eva Alcoceba, Silvia Lara P7 Kounis syndrome in the setting of anaphylaxis to diclofenac Leonor Carneiro-Leão, Carmen Botelho, Eunice Dias-Castro, Josefina Cernadas P8 Perioperative anaphylaxis audit: Royal Melbourne Hospital Katherine Nicholls, William Lay, Olivia Smith, Christine Collins, Gary Unglik, Kymble Spriggs, Priscilla Auyeung, Jeremy McComish, Jo A. Douglass P9 Recurrent peri-operative anaphylaxis: a perfect storm Jonny G. Peter, Paul Potter Poster Walk 2: DH regions and patient groups (P10–P19) P10 A rare presentation of amoxicillin allergy in a young child Fabrícia Carolino, Eunice Dias De Castro, Josefina R. Cernadas P11 Adverse drug reactions in children: antibiotics or virus? Ana Sofia Moreira, Carmo Abreu, Eva Gomes P12 Allergic reactions in invasive medical procedures Bárbara Kong Cardoso, Elza Tomaz, Sara Correia, Filipe Inácio P13 Antibiotic allergy in children: room for improvement Annabelle Arnold, Natasha Bear, Kristina Rueter, Grace Gong, Michael O’Sullivan, Saravanan Muthusamy, Valerie Noble, Michaela Lucas P14 Drug hypersensitivity reactions in children and results of diagnostic evaluation Neringa Buterleviciute, Odilija Rudzeviciene P15 Nonimmediate cutaneous drug reactions in children: are skin tests required? Ana Sofia Moreira, Carmo Abreu, Eva Gomes P16 Pediatric patients with a history of penicillin allergy and a positive penicillin skin test may not be at an increased risk for multiple drug allergies Sara May, Thanai Pongdee, Miguel Park P17 Proved hypersensitivity to drugs according data of Vilnius University Hospital Santariskiu Klinikos Linas Griguola, Arturas Vinikovas, Simona Kašinskaite, Violeta Kvedariene P18 Self-reported prevalence of drug hypersensitivity reactions among students in Celal Bayar University, Turkey Ayse Aktas, Suheyla Rahman, Huseyin Elbi, Beyhan Cengiz Ozyurt P19 Severe drug hypersensitivity reactions in pediatric age Ozlem Cavkaytar, Betul Karaatmaca, Pinar Gur Cetinkaya, Saliha Esenboga, Umit M. Sahiner, Bulent E. Sekerel, Ozge Soyer Poster Walk 3: Desensitisation (P20–P28) P20 A protocol for desensitisation to valaciclovir Celia Zubrinich, Bianca Tong, Mittal Patel, Michelle Giles, Robyn O’Hehir, Robert Puy P21 A rare case of desensitization to modafinil Josefina Cernadas, Luís Amaral, Fabrícia Carolino P22 A sixteen-day desensitization protocol in delayed type hypersensitivity reactions to oral drugs Semra Demir, Asli Gelincik, Muge Olgac, Raif Caskun, Derya Unal, Bahauddin Colakoglu, Suna Buyukozturk P23 Desensitization to intravenous etoposide using a 12 and a 13-step protocol. Two cases report Olga Vega Matute, Amalia Bernad, Gabriel Gastaminza, Roselle Madamba, Carlos Lacasa, M. J. Goikoetxea, Carmen D’Amelio, Jose Rifón, Nicolas Martínez, Marta Ferrer P24 Drug desensitisation in oncology: the experience of an immunoallergology department for 5 years Carmelita Ribeiro, Emília Faria, Cristina Frutuoso, Anabela Barros, Rosário Lebre, Alice Pego, Ana Todo Bom P25 Filgrastim anaphylaxis: a successful desensitization protocol Luis Amaral, Josefina Cernadas P26 Galsulfase hypersensitivity and desensitization of a mucopolysaccharidosis VI patient Luis Felipe Ensina, Carolina Aranda, Ines Camelo Nunes, Ana Maria Martins, Dirceu Solé P27 Rapid drug desensitization with biologicals: one-center experience with four biologicals Sevim Bavbek, Resat Kendirlinan, Pamir Çerçi, Seda Tutluer, Sadan Soyyigit, Zeynep Çelebi Sözener, Ömür Aydin, Reyhan Gümüsburun P28 Successful desensitization to a high dose of methotrexate in a delayed type hypersensitivity reaction Josefina Cernadas, Leonor Carneiro-Leão, Fabrícia Carolino, Marta Almeida Poster Walk 4: SJS (P29–P38) P29 Assessment of impact of infection on drug-induced severe cutaneous adverse reactions and rhabdomyolysis using the Japanese adverse drug event report database Kimie Sai, Takuya Imatoh, Ryosuke Nakamura, Chisato Fukazawa, Yasushi Hinomura, Yoshiro Saito P30 Characterization of erythema multiforme and severe cutaneous adverse reactions hospitalizations Bernardo Sousa-Pinto, Cláudia Correia, Lídia Gomes, Sara Gil-Mata, Luís Araújo, Luís Delgado P31 Effects of infection on incidence/severity of SJS/TEN and myopathy in Japanese cases analyzed by voluntary case reports Ryosuke Nakamura, Kimie Sai, Takuya Imatoh, Yoshimi Okamoto-Uchida, Koji Kajinami, Kayoko Matsunaga, Michiko Aihara, Yoshiro Saito P32 Efficacy of tumor necrosis factor—a antagonists in Stevens–Johnson syndrome and toxic epidermal necrolysis: a randomized controlled trial and immunosuppressive effects evaluation Chuang-Wei Wang, Shih-Chi Su, Shuen-Iu Hung, Hsin-Chun Ho, Chih-Hsun Yang, Wen-Hung Chung P33 Evolution of drug causality in Stevens–Johnson syndrome and toxic epidermal necrolysis in Europe: analysis of 10 years RegiSCAR-Study Maren Paulmann, Ariane Dunant, Maja Mockenhaupt, Peggy Sekula, Martin Schumacher, Sylvia Kardaun, Luigi Naldi, Teresa Bellón, Daniel Creamer, Cynthia Haddad, Bruno Sassolas, Bénédicte Lebrun-Vignes, Laurence Valeyrie-Allanore, Jean-Claude Roujeau P34 Long-term sequelae in patients with Stevens–Johnson syndrome and toxic epidermal necrolysis: a 5-year analysis Maren Paulmann, Carmen Kremmler, Peggy Sekula, Laurence Valeyrie-Allanore, Luigi Naldi, Sylvia Kardaun, Maja Mockenhaupt P35 Major emotional complications and decreased health related quality of life among survivors of Stevens–Johnson syndrome and toxic epidermal necrolysis Roni P. Dodiuk-Gad, Cristina Olteanu, Anthony Feinstein, Rena Hashimoto, Raed Alhusayen, Sonia Whyte-Croasdaile, Yaron Finkelstein, Marjorie Burnett, Shachar Sade, Robert Cartotto, Marc Jeschke, Neil H. Shear P36 Retrospective analysis of Stevens–Johnson syndrome and toxic epidermal necrolysis in Japanese patients: treatment and outcome Naoko Takamura, Yumiko Yamane, Setsuko Matsukura, Kazuko Nakamura, Yuko Watanabe, Yukie Yamaguchi, Takeshi Kambara, Zenro Ikezawa, Michiko Aihara P37 Severe physical complications among survivors of Stevens–Johnson syndrome and toxic epidermal necrolysis Roni P. Dodiuk-Gad, Cristina Olteanu, Rena Hashimoto, Hall Chew, Raed Alhusayen, Sonia Whyte-Croasdaile, Yaron Finkelstein, Marjorie Burnett, Shachar Sade, Robert Cartotto, Marc Jeschke, Neil H. Shear P38 Stevens–Johnson syndrome/toxic epidermal necrolysis combined with haemophagocytic lymphohistiocytosis: a case report Brittany Knezevic, Una Nic Ionmhain, Allison Barraclough, Michaela Lucas, Matthew Anstey Poster Walk 5: Other organs/unexpected immune reactions (P39–P47) P39 A case report of patient with anti-tuberculosis drug-related severe liver failure Toru Usui, Xiaoli Meng, John Farrell, Paul Whitaker, John Watson, Neil French, Kevin Park, Dean Naisbitt P40 Acute interstitial nephritis induced by ibuprofen Ana Castro Neves, Susana Cadinha, Ana Moreira, J. P. Moreira Da Silva P41 Cetuximab induced acneiform rash—two case reports Daniela Ledic Drvar, Sandra Jerkovic Gulin, Suzana Ljubojevic Hadzavdic, Romana Ceovic P42 Enteropathy associated with losartan Ana Montoro De Francisco, Talía De Vicente Jiménez, Amelia García Luque, Natalia Rosado David, José Mª Mateos Galván P43 Granuloma annulare after therapy with canakinumab Razvigor Darlenski P44 Hypersensitivity eosinophilic myocarditis or acute coronary syndrome? Case report Dario Gulin, Jozica Sikic, Jasna Cerkez Habek, Sandra Jerkovic Gulin, Edvard Galic P45 Piperacillin-induced immune haemolytic anaemia: a severe and frequent complication of antibiotic treatment in patients with cystic fibrosis Philip Specht, Doris Staab, Beate Mayer, Jobst Roehmel P46 Progesterone triggered pemphigus foliaceus: case report Sandra Jerkovic Gulin, Caius Solovan, Anca Chiriac P47 Ramipril: triggered generalized pustular psoriasis Paola Djurinec, Kresimir Kostovic, Mirna Bradamante, Sandra Jerkovic Gulin, Romana Ceovic Poster Walk 6: NSAIDs (P48–P56) P48 Aspirin desensitization in cardiovascular disease—Portuguese experience Jose Pedro Almeida, Joana Caiado, Elisa Pedro, Pedro Canas Da Silva, Manuel Pereira Barbosa P49 Asthma and/or rhinitis to NSAIDs with good tolerance to ASA Gador Bogas, Natalia Blanca-López, Diana Pérez-Alzate, Inmaculada Doña, José Augusto Agúndez, Elena García-Martín, José Antonio Cornejo-García, Cristobalina Mayorga, María José Torres, Gabriela Canto, Miguel Blanca P50 Clinical characteristics of 196 patients with non-steroidal anti-inflammatory drug (NSAIDs) hypersensitivity Sengül Aksakal, Aytül Zerrin Sin, Zeynep Peker Koç, Fatma Düsünür Günsen, Ömür Ardeniz, Emine Nihal Mete Gökmen, Okan Gülbahar, Ali Kokuludag P51 Development of immediate hypersensitivity to several NSAIDs maintaining good tolerance to ASA Natalia Pérez-Sánchez, Natalia Blanca-López, Diana Pérez-Alzate, Gador Bogas, Inmaculada Doña, María Salas, María José Torres, Miguel Blanca, Gabriela Canto P52 Diagnosis of hypersensitivity reactions to paracetamol in a large series of cases Inmaculada Doña, Maria Salas, Francisca Gomez, Natalia Blanca-Lopez, Diana Perez-Alzate, Gador Bogas, Esther Barrionuevo, Maria Jose Torres, Inmaculada Andreu, Miguel Ángel Miranda, Gabriela Canto, Miguel Blanca P53 Hypersensitivity to paracetamol according to the new classification of hypersensitivity to NSAIDs Gabija Didžiokaite, Olesia Gaidej, Simona Kašinskaite, Violeta Kvedariene P54 Ibuprofen and other aryl propionic derivates can induce immediate selective hypersensitivity responses Diana Perez-Alzate, Natalia Blanca-López, Maria Isabel Garcimartin, Inmaculada Doña, Maria Luisa Somoza, Cristobalina Mayorga, Maria Jose Torres, Gador Bojas, Jose Antonio Cornejo-Garcia, Maria Gabriela Canto, Miguel Blanca P55 Subjects developing immediate responses to several NSAIDs can be selective with good tolerance to ASA Natalia Blanca-Lopez, Diana Pérez-Alzate, Francisco Javier Ruano Perez, Inmaculada Doña, Maria Luisa Somoza, Inmaculada Andreu, Miguel Angel Miranda, Cristobalina Mayorga, Maria Jose Torres, Jose Antonio Cornejo-Garcia, Miguel Blanca, Maria Gabriela Canto P56 Utility of low-dose oral aspirin challenges for diagnosis of aspirin exacerbated respiratory disease Elina Jerschow, Teresa Pelletier, Zhen Ren, Golda Hudes, Marek Sanak, Esperanza Morales, Victor Schuster, Simon D. Spivack, David Rosenstreich Poster Walk 7: NSAID 2 (P57–P65) P57 Alternate regulation of cyclooxygenase-2 (COX-2) MRNA expression may predispose patients to aspirin-induced exacerbations Renato Erzen, Mira Silar, Nissera Bajrovic, Matija Rijavec, Mihaela Zidarn, Peter Korosec P58 Anaphylaxis to diclofenac: what about the underlying mechanism? Leonor Carneiro-Leão, Fabrícia Carolino, Luís Amaral, Carmen Botelho, Eunice Dias-Castro, Josefina Cernadas P59 COX-2 inhibitors: are they always a safe alternative in hypersensitivity to nonsteroidal anti-inflammatory drugs? Luis Amaral, Fabricia Carolino, Eunice Castro, Josefina Cernadas P60 Management of patients with history of NSAIDs reactions prior to coronary angioplasty Mona Al-Ahmad, Tito Rodriguez P61 Oral drug challenge with non-steroidal anti-inflammatory drug under spirometric control: clinical series of 110 patients João Pedro Azevedo, Emília Faria, Beatriz Tavares, Frederico Regateiro, Ana Todo-Bom P62 Prevalence and incidence of analgesic hypersensitivity reactions in Colombia Pablo Andrés Miranda, Bautista De La Cruz Hoyos P63 Recent endoscopic sinus surgery lessens reactions during aspirin challenge in patients with aspirin exacerbated respiratory disease Teresa Pelletier, Waleed Abuzeid, Nadeem Akbar, Marc Gibber, Marvin Fried, Weiguo Han, Taha Keskin, Robert Tamayev, Golda Hudes, Simon D. Spivack, David Rosenstreich, Elina Jerschow P64 Safe use of imidazole salycilate in a case of multiple NSAIDs induced urticaria-angioedema Elisa Boni, Marina Russello, Marina Mauro P65 Selective hypersensitivity reactions to ibuprofen—seven years experience Marta Ferreira Neto Poster Walk 8: Epidemiological methods (P66–P72) P66 Allopurinol hypersensitivity: a 7-year review Lise Brosseron, Daniela Malheiro, Susana Cadinha, Patrícia Barreira, J. P. Moreira Da Silva P67 Antibiotic allergy labelling is associated with increased hospital readmission rates in Australia Brittany Knezevic, Dustin Sprigg, Michelle Trevenen, Jason Seet, Jason Trubiano, William Smith, Yogesh Jeelall, Sandra Vale, Richard Loh, Andrew Mclean-Tooke, Michaela Lucas P68 Experts’ opinions on severe cutaneous adverse drug reactions-report of a survey from the 9th international congress on cutaneous adverse drug reactions 2015 Roni P. Dodiuk-Gad, Cristina Olteanu, Wen-Hung Chung, Neil H. Shear P69 HLA-A*31-positive AGEP with carbamazepine use and other severe cutaneous adverse drug reactions (SCARs) detected by electronic medical records screening Sabine Müller, Ursula Amstutz, Lukas Jörg, Nikhil Yawalkar, Stephan Krähenbühl P70 Patients with suspected drug allergy: a specific psychological profile? Eunice Dias-Castro, Ana Leblanc, Laura Ribeiro, Josefina R. Cernadas P71 Use of an electronic device and a computerized mathematic algorithm to detect the allergic drug reactions through the analysis of heart rate variability Arantza Vega, Raquel Gutierrez Rivas, Ana Alonso, Juan Maria Beitia, Belén Mateo, Remedios Cárdenas, Juan Jesus Garcia-Dominguez P72 Variation in ERAP influences risk for HLA-B*57:01 positive abacavir hypersensitivity Rebecca Pavlos, Kaija Strautins, Ian James, Simon Mallal, Alec Redwood, Elizabeth Phillips Poster Walk 9: DRESS/AGEP (P73–P81) P73 A clinical case of DRESS syndrome in a child after administration of amoxicillin-clavulanic acid Rita Aguiar, Anabela Lopes, Ana Neves, Maria Do Céu Machado, M. A. Pereira-Barbosa P74 Acute generalized exanthematous pustulosis (AGEP) induced by mesalazine, reliable and oftenly used drug to treat inflammatory bowel disease Ceyda Tunakan Dalgiç, Emine Nihal Mete Gökmen, Fatma Düsünür Günsen, Gökten Bulut, Fatma Ömür Ardeniz, Okan Gülbahar, Ali Kokuludag, Aytül Zerrin Sin P75 Changes of blood plasmacytoid dendritic cells, myeloid dendritic cells, and basophils during the acute stage of drug reaction with eosinophilia and systemic symptoms (DRESS) and other drug eruptions Shao-Hsuan Hsu, Yung-Tsu Cho, Che-Wen Yang, Kai-Lung Chen, Chia-Yu Chu P76 Characterization of isoniazid/rifampicin-specific t-cell responses in patients with DRESS syndrome Young-Min Ye, Gyu-Young Hur, Hae-Sim Park, Seung-Hyun Kim P77 DRESS syndrome secondary to sulfasalazine with delayed TEN: a case presentation Syed Ali, Michaela Lucas, Peter N. Hollingsworth, Andrew P. C. Mclean-Tooke P78 Drug rash with eosinophilia and systemic symptoms (DRESS) features according to the culprit drug Zohra Chadly, Nadia Ben Fredj, Karim Aouam, Haifa Ben Romdhane, Naceur A. Boughattas, Amel Chaabane P79 Drug reaction with eosinophilia and systemic symptoms induced by allopurinol: not always easy to diagnose Marina Lluncor Salazar, Beatriz Pola, Ana Fiandor, Teresa Bellón, Elena Ramírez, Javier Domínguez Ortega, Santiago Quirce, Rosario Cabañas P80 Drug reaction with eosinophilia and systemic symptoms syndrome induced by two drugs simultaneously: a case report Krasimira Baynova, Marina Labella, Manuel Prados P81 The drug reaction with eosinophilia and systemic symptoms (DRESS) induced by the second-line antituberculosis drugs and Epstein–Barr virus infection Agne Ramonaite, Ieva Bajoriuniene, Brigita Sitkauskiene, Raimundas Sakalauskas Poster Walk 10: Miscellaneous drug hypersensitivity (P82–P91) P82 A case of cycloserine-induced lichenoid drug eruption confirmed with a lymphocatye transformation test Jae-Woo Kwon, Shinyoung Park P83 Allergic reaction to topical eye drops: 5 years’ retrospective study in a drug allergy unit Diana Silva, Leonor Carneiro Leão, Fabricia Carolino, Eunice Castro, Josefina Cernadas P84 Allergy to heparins Diana Perez-Alzate, Natalia Blanca-López, Maria Luisa Somoza Alvarez, Maria Garcimartin, Maria Vazquez De La Torre, Francisco Javier Ruano Pérez, Elisa Haroun, Gabriela Canto Diez P85 Allopurinol-induced adverse drug reactions Katinka Ónodi-Nagy, Ágnes Kinyó, Lajos Kemény, Zsuzsanna Bata-Csörgo P86 Analysis of a population with immediate hypersensitivity to corticosteroids: an 11 year review Joana Sofia Pita, Emília Faria, Rosa Anita Fernandes, Ana Moura, Nuno Sousa, Carmelita Ribeiro, Carlos Loureiro, Ana Todo Bom P87 Anaphylaxis against mivacurium in a 12-months old boy at first-time exposure Wolfgang Pfützner P88 Antihistamine-exacerbated chronic spontaneous urticaria: a paradox? Nadine Marrouche, Clive Grattan P89 Anti-osteoporotic agents-induced cutaneous adverse drug reactions in Asians Yu-En Chen, Chun-Bing Chen, Wen-Hung Chung, Yu-Ping Hsiao, Chia-Yu Chu P90 Diagnosis of allergic reactions to eye drops Maria Vazquez De La Torre, Natalia Blanca-Lopez, Diana Perez-Alzate, Maria Isabel Garcimartin, Francisco Javier Ruano, Maria Luisa Somoza, Elisa Haroun, Gabriela Canto P91 Diagnostic approach in suspected hypersensitivity reactions to corticosteroids Fabrícia Carolino, Eunice Dias De Castro, Josefina R. Cernadas
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Barraclough A, Triplett J, Tuch P. Brachial neuritis with phrenic nerve involvement. J Clin Neurosci 2012; 19:1301-2. [DOI: 10.1016/j.jocn.2011.12.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2011] [Accepted: 12/10/2011] [Indexed: 11/25/2022]
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Affiliation(s)
- Allison Barraclough
- Department of Vascular Surgery, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
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Barraclough A, Cronin A. Contraceptive technologies and consumer choices. Caribb Health 1999; 2:14-6. [PMID: 12349369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
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Sutton RW, Markland J, Barraclough A, Chapman WB. Investigations in the examination and on variations in the composition of milk. Part I. The determination of the Hortvet freezing-point. Analyst 1950. [DOI: 10.1039/an9507500042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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