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Tomlinson B, Chow E. The maximum dose of atorvastatin and simvastatin as well as rosuvastatin should be restricted in East Asians. Hong Kong Med J 2024; 30:184-185. [PMID: 38605565 DOI: 10.12809/hkmj2311348] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2024] Open
Affiliation(s)
- B Tomlinson
- Faculty of Medicine, Macau University of Science and Technology, Macau SAR, China
| | - E Chow
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China
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2
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Metheny LL, Sobecks R, Cho C, Fu P, Margevicius S, Wang J, Ciarrone L, Kopp S, Convents RD, Majhail N, Caimi PF, Otegbeye F, Cooper BW, Gallogly M, Malek E, Tomlinson B, Gerds AT, Hamilton B, Giralt S, Perales MA, de Lima M. A multicenter study of posttransplantation low-dose inotuzumab ozogamicin to prevent relapse of acute lymphoblastic leukemia. Blood Adv 2024; 8:1384-1391. [PMID: 38170741 PMCID: PMC10945150 DOI: 10.1182/bloodadvances.2023011514] [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: 08/23/2023] [Revised: 11/15/2023] [Accepted: 12/09/2023] [Indexed: 01/05/2024] Open
Abstract
ABSTRACT The curative potential of allogeneic hematopoietic transplantation (allo-HCT) in patients with acute lymphoblastic leukemia (ALL) is hampered by relapse. Inotuzumab ozogamicin (INO) is an anti-CD22 monoclonal antibody bound to calicheamicin, which has significant activity against ALL. We hypothesized that low-dose INO would be safe and feasible after allo-HCT. Therefore, we conducted a phase 1 study to determine the dose and safety in this setting. Patients were eligible if they were aged 16 to 75 years, had undergone allo-HCT for CD22+ ALL, were in complete remission (CR) after allo-HCT, had high risk of recurrence, were between day 40 and 100 after allo-HCT with adequate graft function, and did not have a history of sinusoidal obstruction syndrome (SOS). The objectives of this trial were to define INO maximum tolerated dose (MTD), to determine post-allo-HCT INO safety, and to measure 1-year progression-free survival (PFS). The trial design followed a "3+3" model. The treatment consisted of INO given on day 1 of 28-day cycles. Dose levels were 0.3 mg/m2, 0.4 mg/m2, 0.5 mg/m2, and 0.6 mg/m2. Median age was 44 years (range, 17-66 years; n = 18). Disease status at transplantation was first CR (n = 14) or second CR or beyond (n = 4). Preparative regimen was of reduced intensity in 72% of patients who received transplantation. Most common toxicity was thrombocytopenia. There were no instances of SOS; the MTD was 0.6 mg/m2. One-year nonrelapse mortality was 5.6%. With a median follow-up of 18.1 months (range, 8.6-59 months) 1-year post-allo-HCT PFS and overall survival is 89% and 94%, respectively. Low-dose INO has a favorable safety profile and was associated with high rates of 1-year PFS. This trial was registered at www.clinicaltrials.gov as #NCT03104491.
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Affiliation(s)
- Leland L. Metheny
- Hematology and Cell Therapy Division, Seidman Cancer Center, University Hospitals, Cleveland, OH
- Case Comprehensive Cancer Center, Cleveland, OH
| | - Ronald Sobecks
- Case Comprehensive Cancer Center, Cleveland, OH
- Blood and Marrow Transplant, Cleveland Clinic Foundation, Cleveland, OH
| | - Christina Cho
- Adult Bone Marrow Transplantation Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Medicine, Weill Cornell Medical College, New York, NY
| | - Pingfu Fu
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH
| | - Seunghee Margevicius
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH
| | - Jiasheng Wang
- Hematology and Cell Therapy Division, Seidman Cancer Center, University Hospitals, Cleveland, OH
- Case Comprehensive Cancer Center, Cleveland, OH
| | - Lisa Ciarrone
- Hematology and Cell Therapy Division, Seidman Cancer Center, University Hospitals, Cleveland, OH
| | - Shelby Kopp
- Hematology and Cell Therapy Division, Seidman Cancer Center, University Hospitals, Cleveland, OH
| | - Robin D. Convents
- Hematology and Cell Therapy Division, Seidman Cancer Center, University Hospitals, Cleveland, OH
| | - Navneet Majhail
- Case Comprehensive Cancer Center, Cleveland, OH
- Blood and Marrow Transplant, Cleveland Clinic Foundation, Cleveland, OH
| | - Paolo F. Caimi
- Case Comprehensive Cancer Center, Cleveland, OH
- Blood and Marrow Transplant, Cleveland Clinic Foundation, Cleveland, OH
| | | | - Brenda W. Cooper
- Hematology and Cell Therapy Division, Seidman Cancer Center, University Hospitals, Cleveland, OH
- Case Comprehensive Cancer Center, Cleveland, OH
| | - Molly Gallogly
- Hematology and Cell Therapy Division, Seidman Cancer Center, University Hospitals, Cleveland, OH
- Case Comprehensive Cancer Center, Cleveland, OH
| | - Ehsan Malek
- Hematology and Cell Therapy Division, Seidman Cancer Center, University Hospitals, Cleveland, OH
- Case Comprehensive Cancer Center, Cleveland, OH
| | - Benjamin Tomlinson
- Hematology and Cell Therapy Division, Seidman Cancer Center, University Hospitals, Cleveland, OH
- Case Comprehensive Cancer Center, Cleveland, OH
| | - Aaron T. Gerds
- Case Comprehensive Cancer Center, Cleveland, OH
- Blood and Marrow Transplant, Cleveland Clinic Foundation, Cleveland, OH
| | - Betty Hamilton
- Case Comprehensive Cancer Center, Cleveland, OH
- Blood and Marrow Transplant, Cleveland Clinic Foundation, Cleveland, OH
| | - Sergio Giralt
- Adult Bone Marrow Transplantation Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Medicine, Weill Cornell Medical College, New York, NY
| | - Miguel-Angel Perales
- Adult Bone Marrow Transplantation Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Medicine, Weill Cornell Medical College, New York, NY
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Sekeres MA, Montesinos P, Novak J, Wang J, Jeyakumar D, Tomlinson B, Mayer J, Jou E, Robak T, Taussig DC, Dombret H, Merchant A, Shaik N, O'Brien T, Roh W, Liu X, Ma W, DiRienzo CG, Chan G, Cortes JE. Glasdegib plus intensive or non-intensive chemotherapy for untreated acute myeloid leukemia: results from the randomized, phase 3 BRIGHT AML 1019 trial. Leukemia 2023; 37:2017-2026. [PMID: 37604981 PMCID: PMC10539167 DOI: 10.1038/s41375-023-02001-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 07/25/2023] [Accepted: 08/08/2023] [Indexed: 08/23/2023]
Abstract
This is the primary report of the randomized, placebo-controlled phase 3 BRIGHT AML 1019 clinical trial of glasdegib in combination with intensive chemotherapy (cytarabine and daunorubicin) or non-intensive chemotherapy (azacitidine) in patients with untreated acute myeloid leukemia. Overall survival (primary endpoint) was similar between the glasdegib and placebo arms in the intensive (n = 404; hazard ratio [HR] 1.05; 95% confidence interval [CI]: 0.782-1.408; two-sided p = 0.749) and non-intensive (n = 325; HR 0.99; 95% CI: 0.768-1.289; two-sided p = 0.969) studies. The proportion of patients who experienced treatment-emergent adverse events was similar for glasdegib versus placebo (intensive: 99.0% vs. 98.5%; non-intensive: 99.4% vs. 98.8%). The most common treatment-emergent adverse events were nausea, febrile neutropenia, and anemia in the intensive study and anemia, constipation, and nausea in the non-intensive study. The addition of glasdegib to either cytarabine and daunorubicin or azacitidine did not significantly improve overall survival and the primary efficacy endpoint for the BRIGHT AML 1019 phase 3 trial was not met. Clinical trial registration: ClinicalTrials.gov: NCT03416179.
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Affiliation(s)
- Mikkael A Sekeres
- Division of Hematology, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA.
| | - Pau Montesinos
- Hospital Universitari i Politècnic La Fe, Valencia, Spain
- CIBERONC, Instituto Carlos III, Madrid, Spain
| | - Jan Novak
- Department of Internal Medicine and Hematology, University Hospital Kralovske Vinohrady, Prague, Czech Republic
- Department of Haematology, 3rd Faculty of Medicine, Charles University and Faculty Hospital Kralovske Vinohrady, Prague, Czech Republic
| | - Jianxiang Wang
- Department of Clinical Hematology, Institute of Hematology and Blood Diseases Hospital, Tianjin, China
| | - Deepa Jeyakumar
- University of California, Irvine, Chao Family Comprehensive Cancer Center, Orange, CA, USA
| | - Benjamin Tomlinson
- Division of Hematology, University Hospitals of Cleveland Seidman Cancer Center, Case Western Reserve University, Cleveland, OH, USA
| | - Jiri Mayer
- Department of Internal Medicine Hematology and Oncology, University Hospital Brno and Masaryk University, Brno, Czech Republic
| | - Erin Jou
- Department of Hematology/Oncology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, USA
| | - Tadeusz Robak
- Department of Hematology, Medical University of Lodz, Lodz, Poland
| | | | - Hervé Dombret
- Institut de Recherche Saint-Louis, Hôpital Saint-Louis Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Akil Merchant
- Division of Hematology and Cellular Therapy, Cedars Sinai Cancer, Los Angeles, CA, USA
| | | | | | - Whijae Roh
- Pfizer Oncology, Pfizer Inc, San Diego, CA, USA
| | - Xueli Liu
- Pfizer Oncology, Pfizer Inc, San Diego, CA, USA
| | - Wendy Ma
- Pfizer Oncology, Pfizer Inc, San Diego, CA, USA
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Wang J, Tomlinson B, Lazarus HM. Update on Small Molecule Targeted Therapies for Acute Myeloid Leukemia. Curr Treat Options Oncol 2023:10.1007/s11864-023-01090-3. [PMID: 37195589 DOI: 10.1007/s11864-023-01090-3] [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] [Accepted: 03/27/2023] [Indexed: 05/18/2023]
Abstract
OPINION STATEMENT The search for effective therapies for the highly heterogenous disease acute myeloid leukemia (AML) has remained elusive. While cytotoxic therapies can induce complete remission and even, at times, long-term survival, this approach is associated with significant toxic effects to visceral organs and worsening of immune dysfunction and marrow suppression leading to death. Sophisticated molecular studies have revealed defects within the AML cell that can be exploited by utilizing small molecule agents to target these defects, often dubbed "target therapy." Several medications have already established new standards of care for many patients with AML, including FDA-approved agents that inhibitor IDH1, IDH2, FLT3, and BCL-2. Emerging small molecules hold additional to add to the armamentarium of AML treatment options including MCL-1 inhibitors, TP53 inhibitors, menin inhibitors, and E-selectin antagonists. Moreover, the increasing options also mean that future combinations of these agents need to be explored, including with cytotoxic drugs and other newer emerging strategies such as immunotherapies for AML. Recent investigations continue to show that overcoming many of the challenges of treating AML finally is on the horizon.
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Affiliation(s)
- Jiasheng Wang
- Division of Hematology, Department of Medicine, Seidman Cancer Center, University Hospitals Cleveland Medical Center, Case Western Reserve University, 11000 Euclid Avenue, Cleveland, OH, 44106, USA
| | - Benjamin Tomlinson
- Division of Hematology, Department of Medicine, Seidman Cancer Center, University Hospitals Cleveland Medical Center, Case Western Reserve University, 11000 Euclid Avenue, Cleveland, OH, 44106, USA.
| | - Hillard M Lazarus
- Division of Hematology, Department of Medicine, Seidman Cancer Center, University Hospitals Cleveland Medical Center, Case Western Reserve University, 11000 Euclid Avenue, Cleveland, OH, 44106, USA
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Tomlinson B, de Lima M, Cogle CR, Thompson MA, Grinblatt DL, Pollyea DA, Komrokji RS, Roboz GJ, Savona MR, Sekeres MA, Abedi M, Garcia-Manero G, Kurtin SE, Maciejewski JP, Patel JL, Revicki DA, George TI, Flick ED, Kiselev P, Louis CU, DeGutis IS, Nifenecker M, Erba HP, Steensma DP, Scott BL. Transplant Referral Patterns for Patients with Newly Diagnosed Higher-Risk Myelodysplastic Syndromes and Acute Myeloid Leukemia at Academic and Community Sites in the Connect® Myeloid Disease Registry: Potential Barriers to Care. Transplant Cell Ther 2023:S2666-6367(23)01243-5. [PMID: 37086851 DOI: 10.1016/j.jtct.2023.04.011] [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: 02/23/2023] [Accepted: 04/14/2023] [Indexed: 04/24/2023]
Abstract
BACKGROUND Hematopoietic stem cell transplantation (HCT) is indicated for patients with higher-risk (HR) myelodysplastic syndromes (MDS) and acute myeloid leukemia (AML). Age, performance status, patient frailty, comorbidities, and non-clinical factors (eg, cost, distance to site) are all recognized as important clinical factors that can influence HCT referral patterns and patient outcomes. However, the proportion of eligible patients referred for HCT in routine clinical practice is largely unknown. OBJECTIVE This study aimed to assess patterns of consideration for HCT among patients with HR-MDS and AML enrolled in the Connect® Myeloid Disease Registry, at community/government (CO/GOV)- or academic (AC)-based sites, as well as to identify factors associated with transplant referral rates. STUDY DESIGN We assessed patterns of consideration for, and completion of, HCT among patients with HR-MDS and AML enrolled between December 12, 2013 and March 6, 2020 in the Connect® Myeloid Disease Registry at 164 CO/GOV and AC sites. Registry sites recorded whether patients were considered for transplant at baseline and at each follow-up visit. The following answers were possible: "considered potentially eligible", "not considered potentially eligible", or "not assessed". Sites also recorded whether patients subsequently underwent HCT at each follow-up visit. Comparison of transplant consideration rates between CO/GOV and AC sites was performed using multivariable logistic regression analysis with covariates for age and comorbidity. RESULTS Among the 778 patients with HR-MDS or AML enrolled in the Registry, patients at CO/GOV sites (27.9%) were less likely to be considered potentially eligible for HCT than patients at AC sites (43.9%; (P < .0001). Multivariable logistic regression analysis with factors for age (<65 versus ≥65 years) and ACE-27 comorbidity grade (<2 versus ≥2) demonstrated that patients at CO/GOV sites were significantly less likely to be considered potentially eligible for transplant than those at AC sites (odds ratio: 1.6, 95% confidence interval [CI], 1.1-2.4, P = .0155). Of patients considered eligible for transplant, 45.1% (65/144) and 35.7% (41/115) of patients at CO/GOV and AC sites, respectively, underwent transplantation (P = .12). Approximately half of all patients at CO/GOV (50.1%) and AC (45.4%) sites were not considered potentially eligible for HCT; the most common reasons were age at CO/GOV sites (71.5%) and comorbidities at AC sites (52.1%). Across all sites, 17.4% of patients across all sites were reported as not assessed (and thus not considered) for transplant by their treating physician (20.7% at CO/GOV and 10.7% at AC sites; P = .0005). CONCLUSIONS These findings suggest many patients with HR-MDS and AML who may be candidates for HCT are not receiving assessment or consideration for transplant in clinical practice. In addition, treatment at CO/GOV sites and age are still significant barriers to ensuring all potentially eligible patients are assessed for HCT.
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Affiliation(s)
- Benjamin Tomlinson
- Seidman Cancer Center, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio.
| | - Marcos de Lima
- Department of Hematology, Ohio State University, Columbus, Ohio
| | | | | | | | | | | | - Gail J Roboz
- Weill Cornell College of Medicine, New York, New York
| | - Michael R Savona
- Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Mikkael A Sekeres
- Sylvester Comprehensive Cancer Center, University of Miami, Miami, Florida
| | - Mehrdad Abedi
- University of California Davis, Sacramento, California
| | | | | | | | - Jay L Patel
- University of Utah and ARUP Laboratories, Salt Lake City, Utah
| | | | - Tracy I George
- University of Utah and ARUP Laboratories, Salt Lake City, Utah
| | | | | | | | | | | | | | | | - Bart L Scott
- Fred Hutchinson Cancer Research Center, Seattle, Washington
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6
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Wang J, Sanati F, Firoozmand A, Fu P, Kolk M, Reese-Koc J, de Lima M, Boughan K, Cooper B, Caimi P, Gallogly M, Otegbeye F, Tomlinson B, Metheny L. Phase I study of intra-osseous co-transplantation of a single-unit cord blood and mesenchymal stromal cells with reduced intensity conditioning regimens. Front Oncol 2023; 13:1186532. [PMID: 37207167 PMCID: PMC10191226 DOI: 10.3389/fonc.2023.1186532] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 04/24/2023] [Indexed: 05/21/2023] Open
Abstract
Cord blood (CB) is a valuable graft source for patients undergoing allogeneic hematopoietic cell transplant (HCT) who lack human leukocyte antigen (HLA)-matched donors. However, single-unit CB-HCT is limited by the insufficient cell dose and slow engraftment. To overcome these limitations, we combined a single-unit CB with third-party healthy donors' bone marrow (BM) derived mesenchymal stromal cells (MSCs) to improve engraftment and injected intra-osseously (IO) to enhance homing. In this phase I clinical trial, six patients with high-risk hematologic malignancies were enrolled and received allogeneic HCT using reduced intensity conditioning regimens. The primary objective was to determine the engraftment rate at day 42. The median age of enrolled patients was 68 years, and only one patient was in complete remission at the time of HCT. The median CB total nucleated cell dose was 3.2x107/kg. No serious adverse events were reported. Two patients had early deaths due to persistent disease and multi-drug resistant bacterial infection, respectively. Of the remaining four evaluable patients, all had successful neutrophil engraftment in a median of 17.5 days. No grade 3 or higher acute graft-versus-host disease (GvHD) was observed, and only one patient developed moderate-extensive chronic GvHD. In conclusion, IO co-transplantation of a single-unit CB and MSCs was feasible and resulted in a reasonable engraftment rate in these very high-risk patients.
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Affiliation(s)
- Jiasheng Wang
- Department of Hematology/Oncology, University Hospitals Seidman Cancer Center, Cleveland, OH, United States
- *Correspondence: Jiasheng Wang,
| | - Farhad Sanati
- Department of Hematology/Oncology, University Hospitals Seidman Cancer Center, Cleveland, OH, United States
| | - Amin Firoozmand
- Department of Hematology/Oncology, University Hospitals Seidman Cancer Center, Cleveland, OH, United States
| | - Pingfu Fu
- Case Western Reserve University, Cleveland, OH, United States
| | - Merle Kolk
- Adult Hematologic Malignancies & Stem Cell Transplantation Service, University Hospitals Seidman Cancer Center, Cleveland, OH, United States
| | - Jane Reese-Koc
- Case Western Reserve University, Cleveland, OH, United States
| | - Marcos de Lima
- Division of Hematology, Ohio State University, Columbus, OH, United States
| | - Kirsten Boughan
- Department of Hematology/Oncology, Louis Stokes Veterans Affairs Medical Center, Cleveland, OH, United States
| | - Brenda Cooper
- Adult Hematologic Malignancies & Stem Cell Transplantation Service, University Hospitals Seidman Cancer Center, Cleveland, OH, United States
| | - Paolo Caimi
- Blood and Marrow Transplant, Cleveland Clinic Foundation, Cleveland, OH, United States
| | - Molly Gallogly
- Adult Hematologic Malignancies & Stem Cell Transplantation Service, University Hospitals Seidman Cancer Center, Cleveland, OH, United States
| | - Folashade Otegbeye
- Clinical Research Division, Fred Hutchison Cancer Center, Seattle, WA, United States
| | - Benjamin Tomlinson
- Adult Hematologic Malignancies & Stem Cell Transplantation Service, University Hospitals Seidman Cancer Center, Cleveland, OH, United States
| | - Leland Metheny
- Adult Hematologic Malignancies & Stem Cell Transplantation Service, University Hospitals Seidman Cancer Center, Cleveland, OH, United States
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Stabellini N, Tomlinson B, Cullen J, Shanahan J, Waite K, Montero AJ, Barnholtz-Sloan JS, Hamerschlak N. Sex differences in adults with acute myeloid leukemia and the impact of sex on overall survival. Cancer Med 2022; 12:6711-6721. [PMID: 36419242 PMCID: PMC10067038 DOI: 10.1002/cam4.5461] [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: 09/08/2022] [Revised: 10/17/2022] [Accepted: 11/11/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND There is a male predominance of acute myeloid leukemia (AML) incidence, but survival data are conflicting. The objective of this study is to carry out a comprehensive analysis of sex differences in AML, and to investigate the impact of sex disparities in survival. METHODS The cohort included patients ≥18 years diagnosed with AML (2010-2022). Demographics, treatment patterns, treatment adverse events, and survival were analyzed. The population was described and compared by sex, and sex-based risks and associations were obtained via Cox proportional-hazards regression. RESULTS In total, 1020 AML patients were analyzed (57.4% males), with lower risk of death for females (aHR = 0.41, 95% CI 0.26-0.66). Among females, BMT (aHR = 0.51, 95% CI 0.27-0.97), hospitalization record (aHR = 0.65, 95%CI 0.45-0.93), and higher appointment completion rates (aHR = 0.98, 95% CI 0.98-0.98) were associated with lower risk of death. Overall, and similarly in males, higher age at diagnosis (aHR = 1.03, 95% CI 1.02-1.04) and a TP53 mutation (aHR = 2.24, 95% CI 1.69-2.97) were associated with higher risk of death. CONCLUSION Sex differences exist in both AML incidence and overall survival. Treatment and health care factors should be addressed by caregivers and public policies developed to reduce mortality rates and mitigate existing sex differences.
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Affiliation(s)
- Nickolas Stabellini
- Graduate Education Office, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.,Department of Hematology-Oncology, University Hospitals Seidman Cancer Center, Cleveland, Ohio, USA.,Faculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, Brazil.,Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Benjamin Tomlinson
- Department of Hematology-Oncology, University Hospitals Seidman Cancer Center, Cleveland, Ohio, USA
| | - Jennifer Cullen
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.,Case Comprehensive Cancer Center, Cleveland, Ohio, USA
| | - John Shanahan
- Cancer Informatics, Seidman Cancer Center at University Hospitals of Cleveland, Cleveland, Ohio, USA
| | - Kristin Waite
- Division of Cancer Epidemiology and Genetics (DCEG), Trans-Divisional Research Program (TDRP), National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Alberto J Montero
- Department of Hematology-Oncology, University Hospitals Seidman Cancer Center, Cleveland, Ohio, USA
| | - Jill S Barnholtz-Sloan
- Division of Cancer Epidemiology and Genetics (DCEG), Trans-Divisional Research Program (TDRP), National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA.,Center for Biomedical Informatics and Information Technology (CBIIT), National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Nelson Hamerschlak
- Oncohematology Department, Hospital Israelita Albert Einstein, São Paulo, Brazil
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Otegbeye F, Cooper B, Caimi P, Zamborsky K, Reese-Koc J, Hillian A, Hernandez-Collazo Y, Lee G, Boughan K, Tomlinson B, Gallogly M, Metheny L, Bajor D, Selfridge J, Saltzman J, Lazarus HM, de Lima M, Wald DN. A Phase I study to determine maximum tolerated dose of ex vivo expanded natural killer cells derived from unrelated, HLA-disparate adult donors. Transplant Cell Ther 2022; 28:250.e1-250.e8. [PMID: 35172204 PMCID: PMC9489303 DOI: 10.1016/j.jtct.2022.02.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 02/02/2022] [Accepted: 02/09/2022] [Indexed: 11/27/2022]
Abstract
The administration of allogeneic natural killer (NK) cells following a lymphodepleting chemotherapy regimen is emerging as a well-tolerated therapeutic approach in the management of various malignancies. Contrary to the expected complications of allogeneic T cell therapy, there remains no evidence of graft-versus-host disease (GVHD) mediated by NK cells in numerous clinical trials. On the contrary, preclinical and clinical studies suggest that NK cells do not induce GVHD and in fact may prevent its development following allogeneic hematopoietic cell transplantation (HCT). In this study, we sought to determine the maximum tolerated dose of non-HLA-matched donor NK cells derived from peripheral blood and ex vivo expanded using a novel feeder cell platform. In a single-center Phase I clinical trial using a 3 × 3 design, 9 subjects each received 2 infusions of NK cells 2 weeks apart following a preparative regimen of cyclophosphamide (60 mg/kg i.v.) and fludarabine (25 mg/m2/day i.v for 5 days). No exogenous cytokines were administered. NK cells were administered at 3 dose levels: 1 × 107/kg, 2.5 × 107/kg, and 5 × 107/kg. Three subjects had myelodysplastic syndrome (MDS) or acute myelogenous leukemia (AML), and the other 6 subjects had colorectal carcinoma. Recipients were monitored over a 4-week period for GVHD as well as other adverse events and for persistence of donor NK cells in systemic circulation. Disease assessment was started at 28 days following the first NK cell infusion and continued until postinfusion day 100 or disease progression. In all 9 study subjects, there was no occurrence of GVHD and no dose-limiting toxicities that would warrant cohort expansion at any of the 3 planned cell dose levels. Low-level donor NK cell persistence was observed up to 4 weeks after the first NK cell infusion at all dose levels. The best observed response was a complete response with incomplete platelet recovery in a MDS subject who experienced disease relapse after prior allogeneic HCT. Other responses were stable disease in 1 subject with MDS and 2 subjects with colorectal cancer up to postinfusion day 100. This off-the-shelf, third-party NK cell product can be administered safely without inducing GVHD and exhibits in vivo persistence promoted by preparative lymphodepletion alone. The observed clinical responses could be enhanced by administration of exogenous cytokine support, as well as complementary approaches that promote NK cell function in the tumor microenvironment.
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Buzzell N, Blash S, Miner K, Hevy M, Tomlinson B, Syme R, Gavin W. 86 Creating homozygous offspring using oviductal sperm deposition with poor quality cryopreserved semen from a transgenic founder goat. Reprod Fertil Dev 2021; 34:280. [PMID: 35231215 DOI: 10.1071/rdv34n2ab86] [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: 11/23/2022] Open
Affiliation(s)
| | - S Blash
- LFB USA Inc., Framingham, MA, USA
| | - K Miner
- LFB USA Inc., Framingham, MA, USA
| | - M Hevy
- LFB USA Inc., Framingham, MA, USA
| | | | - R Syme
- LFB USA Inc., Framingham, MA, USA
| | - W Gavin
- LFB USA Inc., Framingham, MA, USA
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10
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Gu X, Tohme R, Tomlinson B, Sakre N, Hasipek M, Durkin L, Schuerger C, Grabowski D, Zidan AM, Radivoyevitch T, Hong C, Carraway H, Hamilton B, Sobecks R, Patel B, Jha BK, Hsi ED, Maciejewski J, Saunthararajah Y. Decitabine- and 5-azacytidine resistance emerges from adaptive responses of the pyrimidine metabolism network. Leukemia 2021; 35:1023-1036. [PMID: 32770088 PMCID: PMC7867667 DOI: 10.1038/s41375-020-1003-x] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 07/13/2020] [Accepted: 07/22/2020] [Indexed: 01/10/2023]
Abstract
Mechanisms-of-resistance to decitabine and 5-azacytidine, mainstay treatments for myeloid malignancies, require investigation and countermeasures. Both are nucleoside analog pro-drugs processed by pyrimidine metabolism into a deoxynucleotide analog that depletes the key epigenetic regulator DNA methyltranseferase 1 (DNMT1). Here, upon serial analyses of DNMT1 levels in patients' bone marrows on-therapy, we found DNMT1 was not depleted at relapse. Showing why, bone marrows at relapse exhibited shifts in expression of key pyrimidine metabolism enzymes in directions adverse to pro-drug activation. Further investigation revealed the origin of these shifts. Pyrimidine metabolism is a network that senses and regulates deoxynucleotide amounts. Deoxynucleotide amounts were disturbed by single exposures to decitabine or 5-azacytidine, via off-target depletion of thymidylate synthase and ribonucleotide reductase respectively. Compensating pyrimidine metabolism shifts peaked 72-96 h later. Continuous pro-drug exposures stabilized these adaptive metabolic responses to thereby prevent DNMT1-depletion and permit exponential leukemia out-growth as soon as day 40. The consistency of the acute metabolic responses enabled exploitation: simple treatment modifications in xenotransplant models of chemorefractory leukemia extended noncytotoxic DNMT1-depletion and leukemia control by several months. In sum, resistance to decitabine and 5-azacytidine originates from adaptive responses of the pyrimidine metabolism network; these responses can be anticipated and thus exploited.
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Affiliation(s)
- Xiaorong Gu
- Department of Translational Hematology & Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Rita Tohme
- Department of Translational Hematology & Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Benjamin Tomlinson
- Department of Hematology and Oncology, University Hospitals, Cleveland, OH, USA
| | - Nneha Sakre
- Department of Translational Hematology & Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Metis Hasipek
- Department of Translational Hematology & Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Lisa Durkin
- Department of Clinical Pathology, Tomsich Pathology Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Caroline Schuerger
- Department of Translational Hematology & Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Dale Grabowski
- Department of Translational Hematology & Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Asmaa M Zidan
- Department of Translational Hematology & Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Tomas Radivoyevitch
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA
| | - Changjin Hong
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA
| | - Hetty Carraway
- Department of Hematology and Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Betty Hamilton
- Department of Hematology and Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Ronald Sobecks
- Department of Hematology and Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Bhumika Patel
- Department of Hematology and Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Babal K Jha
- Department of Translational Hematology & Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Eric D Hsi
- Department of Clinical Pathology, Tomsich Pathology Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Jaroslaw Maciejewski
- Department of Translational Hematology & Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
- Department of Hematology and Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Yogen Saunthararajah
- Department of Translational Hematology & Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA.
- Department of Hematology and Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA.
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11
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Gyurkocza B, Nath R, Choe H, Seropian SE, Stiff P, Agura E, Abhyankar S, Litzow MR, Tomlinson B, Abboud C, Chen GL, Hari P, Orozco JJ, Sabloff M, Al-Kadhimi Z, Van Besien K, Silverman M, Foran J, Schuster MW, Kebriaei P, Levy MY, Lazarus HM, Giralt SA, Liang Q, Berger MS, Reddy V, Pagel JM. Targeted Radioimmunotherapy with Anti-CD45 Iodine (131I) Apamistamab [Iomab-B] in Older Patients with Active, Relapsed or Refractory (R/R) Acute Myeloid Leukemia Results in Successful and Timely Engraftment Not Related to the Radiation Dose Delivered. Transplant Cell Ther 2021. [DOI: 10.1016/s2666-6367(21)00086-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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12
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Patel S, Copley M, Boughan KM, Caimi P, Cooper B, Gallogly M, Kurian M, Malek E, Metheny L, O’Brien T, Otegbeye F, Saade E, Tomlinson B, de Lima M. Clostridioides Difficile Infection Prophylaxis in Allogeneic Stem Cell Transplant Recipients. Transplant Cell Ther 2021. [DOI: 10.1016/s2666-6367(21)00463-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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13
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Jurdi NE, Nock N, Fu P, Cao S, Cotton JM, Ali N, Ravi G, Pinto R, Galloway E, Kolke S, Cooper B, Tomlinson B, Malek E, Lance C, Kolk MJ, Ferrari N, Lee R, de Lima M, Caimi PF, Metheny L. Physical Activity and Sleep Measures Using a Fitness Tracking Device during Hematopoietic Cell Transplantation: A Pilot Study. Transplant Cell Ther 2021; 27:502.e1-502.e6. [PMID: 33827757 DOI: 10.1016/j.jtct.2021.02.015] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 01/13/2021] [Accepted: 02/16/2021] [Indexed: 11/19/2022]
Abstract
Patients undergoing hematopoietic cell transplantation (HCT) experience decline in their physical activity during their transplant admission. There is limited experience with prospective monitoring of transplant recipients. We therefore measured physical activity and sleep patterns of subjects undergoing autologous and allogeneic HCT. Eighty-three patients were consented for this study. Sixty-three patients competed the study and had their physical activity prospectively assessed using the fitness-tracking device Fitbit HR. Outcomes included adherence, physical activity, readmission, hematopoietic engraftment, and 100-day survival. Sixty percent of patients (n = 37) underwent autologous HCT, and 40% (n = 26) underwent allogenic HCT. Both groups had a comparable number of steps at admission to the hospital. The number of daily steps during the study period was lower in the allogeneic group (2159 versus 3008, P = .07), as was the minimum number of steps recorded over the transplant admission (allogeneic HCT = 395 versus autologous HCT = 848, P = .01). Patients undergoing allogeneic HCT were less active on the day before discharge (1956 steps versus 3183 steps, P = .08). In multivariate analysis, physical activity was not associated with HCT-related outcomes. Patients undergoing HCT experience significant decline in their physical activity during their transplant admission that does not recover by the time of discharge. This effect can be objectively measured using fitness tracking devices.
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Affiliation(s)
- Najla El Jurdi
- University Hospitals Seidman Cancer Center, Cleveland, Ohio
| | - Nora Nock
- Case Western Reserve University, Cleveland, Ohio
| | - Pingfu Fu
- Case Western Reserve University, Cleveland, Ohio
| | - Shufen Cao
- Case Western Reserve University, Cleveland, Ohio
| | - Joel M Cotton
- University Hospitals Seidman Cancer Center, Cleveland, Ohio
| | - Naveed Ali
- University Hospitals Seidman Cancer Center, Cleveland, Ohio; Case Western Reserve University, Cleveland, Ohio
| | - Gayathri Ravi
- University Hospitals Seidman Cancer Center, Cleveland, Ohio; Case Western Reserve University, Cleveland, Ohio
| | - Raisa Pinto
- University Hospitals Seidman Cancer Center, Cleveland, Ohio; Case Western Reserve University, Cleveland, Ohio
| | - Erin Galloway
- University Hospitals Seidman Cancer Center, Cleveland, Ohio
| | - Samantha Kolke
- University Hospitals Seidman Cancer Center, Cleveland, Ohio
| | - Brenda Cooper
- University Hospitals Seidman Cancer Center, Cleveland, Ohio; Case Western Reserve University, Cleveland, Ohio
| | - Benjamin Tomlinson
- University Hospitals Seidman Cancer Center, Cleveland, Ohio; Case Western Reserve University, Cleveland, Ohio
| | - Ehsan Malek
- University Hospitals Seidman Cancer Center, Cleveland, Ohio; Case Western Reserve University, Cleveland, Ohio
| | | | - Merle J Kolk
- University Hospitals Seidman Cancer Center, Cleveland, Ohio
| | - Nicole Ferrari
- University Hospitals Seidman Cancer Center, Cleveland, Ohio
| | - Richard Lee
- University Hospitals Seidman Cancer Center, Cleveland, Ohio; Case Western Reserve University, Cleveland, Ohio
| | - Marcos de Lima
- University Hospitals Seidman Cancer Center, Cleveland, Ohio; Case Western Reserve University, Cleveland, Ohio
| | - Paolo F Caimi
- University Hospitals Seidman Cancer Center, Cleveland, Ohio; Case Western Reserve University, Cleveland, Ohio
| | - Leland Metheny
- University Hospitals Seidman Cancer Center, Cleveland, Ohio; Case Western Reserve University, Cleveland, Ohio.
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14
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Jajosky AN, Sadri N, Meyerson HJ, Oduro KA, Kelkar A, Fitzgerald B, Tomlinson B, Moore EM, Beck RC. Clonal cytopenia of undetermined significance (CCUS) with dysplasia is enriched for MDS-type molecular findings compared to CCUS without dysplasia. Eur J Haematol 2021; 106:500-507. [PMID: 33386622 DOI: 10.1111/ejh.13574] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 09/23/2020] [Revised: 12/17/2020] [Accepted: 12/21/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Although morphologic dysplasia is not typically considered a feature of CCUS, we have consistently observed low-level bone marrow (BM) dysplasia among CCUS patients. We sought to determine whether sub-diagnostic BM dysplasia in CCUS patients is associated with other clinico-pathologic findings of myelodysplastic syndrome (MDS). METHODS We identified 49 CCUS patients, 25 with sub-diagnostic dysplasia (CCUS-D), and 24 having no dysplasia (CCUS-ND). We compared the clinical, histologic, and laboratory findings of CCUS-D and CCUS-ND patients to 49 MDS patients, including blood cell counts, BM morphology, flow cytometry, cytogenetics, and results of next-generation sequencing. RESULTS No statistically significant differences were observed between CCUS-D and CCUS-ND patients in the degree of cytopenias, BM cellularity, myeloid-to-erythroid ratio, or the presence of flow cytometric abnormalities. However, compared to CCUS-ND, CCUS-D patients exhibited increased mutations in myeloid malignancy-associated genes, including non-TET2/DNMT3A/ASXL1 variants, spliceosome (SF3B1, SRSF2, ZRSR2, or U2AF1) variants, and IDH2/RUNX1/CBL variants. CCUS-D patients were also enriched for higher variant allele frequencies and co-mutation of TET2/DNMT3A/ASXL1 with other genes. CONCLUSIONS CCUS-D patients exhibit a molecular (but not clinical) profile more similar to MDS patients than CCUS-ND, suggesting CCUS-D may represent a more immediate precursor to MDS and may warrant closer clinical follow-up.
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Affiliation(s)
- Audrey N Jajosky
- Department of Pathology and Laboratory Medicine, University Hospitals of Cleveland/Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Navid Sadri
- Department of Pathology and Laboratory Medicine, University Hospitals of Cleveland/Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Howard J Meyerson
- Department of Pathology and Laboratory Medicine, University Hospitals of Cleveland/Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Kwadwo A Oduro
- Department of Pathology and Laboratory Medicine, University Hospitals of Cleveland/Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Ashwin Kelkar
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Brynn Fitzgerald
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Benjamin Tomlinson
- Division of Hematology and Oncology, Department of Medicine, University Hospitals of Cleveland/Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Erika M Moore
- Department of Pathology and Laboratory Medicine, University Hospitals of Cleveland/Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Rose C Beck
- Department of Pathology and Laboratory Medicine, University Hospitals of Cleveland/Case Western Reserve University School of Medicine, Cleveland, OH, USA
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15
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Abou-Ismail MY, Ravi G, Fu P, Cao S, Vuyyala S, Caimi P, Kolk M, Ferrari N, Boughan K, Cooper B, Gallogly M, Otegbeye F, Tomlinson B, de Lima M, Metheny L. Correction: History of drug use in allogeneic hematopoietic cell transplant recipients. Bone Marrow Transplant 2020; 56:756. [PMID: 33087878 DOI: 10.1038/s41409-020-01085-w] [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: 11/09/2022]
Affiliation(s)
- Mouhamed Yazan Abou-Ismail
- University Hospitals Seidman Cancer Center, Cleveland, OH, USA.,Case Western Reserve University, Cleveland, OH, USA
| | - Gayathri Ravi
- University Hospitals Seidman Cancer Center, Cleveland, OH, USA.,Case Western Reserve University, Cleveland, OH, USA
| | - Pingfu Fu
- Case Western Reserve University, Cleveland, OH, USA
| | - Shufen Cao
- Case Western Reserve University, Cleveland, OH, USA
| | | | - Paolo Caimi
- University Hospitals Seidman Cancer Center, Cleveland, OH, USA.,Case Western Reserve University, Cleveland, OH, USA
| | - Merle Kolk
- University Hospitals Seidman Cancer Center, Cleveland, OH, USA
| | - Nicole Ferrari
- University Hospitals Seidman Cancer Center, Cleveland, OH, USA
| | - Kirsten Boughan
- University Hospitals Seidman Cancer Center, Cleveland, OH, USA.,Case Western Reserve University, Cleveland, OH, USA
| | - Brenda Cooper
- University Hospitals Seidman Cancer Center, Cleveland, OH, USA.,Case Western Reserve University, Cleveland, OH, USA
| | - Molly Gallogly
- University Hospitals Seidman Cancer Center, Cleveland, OH, USA.,Case Western Reserve University, Cleveland, OH, USA
| | - Folashade Otegbeye
- University Hospitals Seidman Cancer Center, Cleveland, OH, USA.,Case Western Reserve University, Cleveland, OH, USA
| | - Benjamin Tomlinson
- University Hospitals Seidman Cancer Center, Cleveland, OH, USA.,Case Western Reserve University, Cleveland, OH, USA
| | - Marcos de Lima
- University Hospitals Seidman Cancer Center, Cleveland, OH, USA.,Case Western Reserve University, Cleveland, OH, USA
| | - Leland Metheny
- University Hospitals Seidman Cancer Center, Cleveland, OH, USA. .,Case Western Reserve University, Cleveland, OH, USA.
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16
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Dharmavaram G, Cao S, Sundaram S, Ayyappan S, Boughan K, Gallogly M, Malek E, Metheny L, Tomlinson B, Otegbeye F, Lazarus HM, Cooper B, Fu P, Lima M, Caimi PF. Aggressive lymphoma subtype is a risk factor for venous thrombosis. Development of lymphoma - specific venous thrombosis prediction models. Am J Hematol 2020; 95:918-926. [PMID: 32311162 DOI: 10.1002/ajh.25837] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Revised: 03/19/2020] [Accepted: 04/13/2020] [Indexed: 01/27/2023]
Abstract
Venous thromboembolic events (VTE) are a frequent complication of lymphoma. We conducted a retrospective analysis to compare VTE risk in diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma (FL). Subjects were randomly assigned to training and validation sets to identify risk factors of VTE and evaluate risk model performance, including the Khorana score. A group of 790 patients were diagnosed from 2002 to 2014 (DLBCL = 542, FL = 248). Median follow- up was 49 months. We observed 106 VTE, with higher incidence in DLBCL (5-year cumulative incidence = 16.3% vs 3.8% in FL patients). Five-year OS for patients with VTE was 51.4% vs 73.1% in patients without VTE (P < .001). Baseline VTE risk factors identified in the training cohort included lymphoma subtype, previous VTE, ECOG performance status ≥2, decreased albumin, increased calcium, elevated WBC, absolute lymphocyte count or monocyte count, and presence of bulky disease. Addition of new variables to the Khorana score improved its performance measured by Akaike information criterion and Concordance index. A new risk model including lymphoma subtype, albumin, WBC count, and bulky disease was validated in time-based ROC analyses. These findings were confirmed in the validation cohort. Lymphoma subtypes have different VTE risk. The effect of lymphoma subtype was independent from disease burden and the use of systemic therapy. The Khorana risk-score was validated in time to event analyses, and a more robust lymphoma-specific VTE risk score is proposed. These findings suggest lymphoma patients with highest VTE risk can be identified with baseline parameters.
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Affiliation(s)
- Gouri Dharmavaram
- School of MedicineCase Western Reserve University Cleveland Ohio USA
| | - Shufen Cao
- Department of Population and Quantitative Health SciencesCase Western Reserve University Cleveland Ohio USA
| | - Suchitra Sundaram
- Department of MedicineRoswell Park Cancer Institute Buffalo New York USA
| | - Sabarish Ayyappan
- Division of Hematology, Oncology and Bone & Marrow TransplantationUniversity of Iowa Iowa City Iowa USA
| | - Kirsten Boughan
- Hematologic Malignancies and Stem Cell Transplant Program, Division of Hematology and OncologyUniversity Hospitals Seidman Cancer Center, Cleveland, Ohio and Case Comprehensive Cancer Center Cleveland Ohio USA
| | - Molly Gallogly
- Hematologic Malignancies and Stem Cell Transplant Program, Division of Hematology and OncologyUniversity Hospitals Seidman Cancer Center, Cleveland, Ohio and Case Comprehensive Cancer Center Cleveland Ohio USA
| | - Ehsan Malek
- Hematologic Malignancies and Stem Cell Transplant Program, Division of Hematology and OncologyUniversity Hospitals Seidman Cancer Center, Cleveland, Ohio and Case Comprehensive Cancer Center Cleveland Ohio USA
| | - Leland Metheny
- Hematologic Malignancies and Stem Cell Transplant Program, Division of Hematology and OncologyUniversity Hospitals Seidman Cancer Center, Cleveland, Ohio and Case Comprehensive Cancer Center Cleveland Ohio USA
| | - Benjamin Tomlinson
- Hematologic Malignancies and Stem Cell Transplant Program, Division of Hematology and OncologyUniversity Hospitals Seidman Cancer Center, Cleveland, Ohio and Case Comprehensive Cancer Center Cleveland Ohio USA
| | - Folashade Otegbeye
- Hematologic Malignancies and Stem Cell Transplant Program, Division of Hematology and OncologyUniversity Hospitals Seidman Cancer Center, Cleveland, Ohio and Case Comprehensive Cancer Center Cleveland Ohio USA
| | - Hillard M. Lazarus
- Hematologic Malignancies and Stem Cell Transplant Program, Division of Hematology and OncologyUniversity Hospitals Seidman Cancer Center, Cleveland, Ohio and Case Comprehensive Cancer Center Cleveland Ohio USA
| | - Brenda Cooper
- Hematologic Malignancies and Stem Cell Transplant Program, Division of Hematology and OncologyUniversity Hospitals Seidman Cancer Center, Cleveland, Ohio and Case Comprehensive Cancer Center Cleveland Ohio USA
| | - Pingfu Fu
- Department of Population and Quantitative Health SciencesCase Western Reserve University Cleveland Ohio USA
| | - Marcos Lima
- Hematologic Malignancies and Stem Cell Transplant Program, Division of Hematology and OncologyUniversity Hospitals Seidman Cancer Center, Cleveland, Ohio and Case Comprehensive Cancer Center Cleveland Ohio USA
| | - Paolo F. Caimi
- Hematologic Malignancies and Stem Cell Transplant Program, Division of Hematology and OncologyUniversity Hospitals Seidman Cancer Center, Cleveland, Ohio and Case Comprehensive Cancer Center Cleveland Ohio USA
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17
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Reid E, Suneja G, Ambinder RF, Ard K, Baiocchi R, Barta SK, Carchman E, Cohen A, Crysler OV, Gupta N, Gustafson C, Hall A, Johung KL, Klopp A, LaCasce AS, Lin C, Mehta A, Menon MP, Morgan D, Nathwani N, Noy A, Ratner L, Rizza S, Rudek MA, Sanchez J, Taylor J, Tomlinson B, Wang CCJ, Yendamuri S, Dwyer MA, Freedman-Cass DA. AIDS-Related Kaposi Sarcoma, Version 2.2019, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw 2020; 17:171-189. [PMID: 30787130 DOI: 10.6004/jnccn.2019.0008] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
As treatment of HIV has improved, people living with HIV (PLWH) have experienced a decreased risk of AIDS and AIDS-defining cancers (non-Hodgkin's lymphoma, Kaposi sarcoma, and cervical cancer), but the risk of Kaposi sarcoma in PLWH is still elevated about 500-fold compared with the general population in the United States. The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for AIDS-Related Kaposi Sarcoma provide diagnosis, treatment, and surveillance recommendations for PLWH who develop limited cutaneous Kaposi sarcoma and for those with advanced cutaneous, oral, visceral, or nodal disease.
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Affiliation(s)
| | | | | | - Kevin Ard
- 4Massachusetts General Hospital Cancer Center
| | - Robert Baiocchi
- 5The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute
| | | | | | - Adam Cohen
- 8Huntsman Cancer Institute at the University of Utah
| | | | | | - Chelsea Gustafson
- 11Robert H. Lurie Comprehensive Cancer Center of Northwestern University
| | | | | | - Ann Klopp
- 13The University of Texas MD Anderson Cancer Center
| | | | - Chi Lin
- 15Fred & Pamela Buffett Cancer Center
| | - Amitkumar Mehta
- 16University of Alabama at Birmingham Comprehensive Cancer Center
| | - Manoj P Menon
- 17Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance
| | | | | | - Ariela Noy
- 20Memorial Sloan Kettering Cancer Center
| | - Lee Ratner
- 21Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine
| | | | | | | | - Jeff Taylor
- 24HIV + Aging Research Project - Palm Springs
| | - Benjamin Tomlinson
- 25Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute
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- 28National Comprehensive Cancer Network
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18
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Ali N, Tomlinson B, Metheny L, Goldstein SC, Fu P, Cao S, Caimi P, Patel RD, Varela JC, Andrade L, Balls JW, Baer L, Smith M, Smith T, Nelson M, de Lima M, Mori S. Conditioning regimen intensity and low-dose azacitidine maintenance after allogeneic hematopoietic cell transplantation for acute myeloid leukemia. Leuk Lymphoma 2020; 61:2839-2849. [DOI: 10.1080/10428194.2020.1789630] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Naveed Ali
- Stem Cell Transplant Program, University Hospitals of Cleveland Seidman Cancer Center, Case Western Reserve University, Cleveland, OH, USA
| | - Benjamin Tomlinson
- Stem Cell Transplant Program, University Hospitals of Cleveland Seidman Cancer Center, Case Western Reserve University, Cleveland, OH, USA
| | - Leland Metheny
- Stem Cell Transplant Program, University Hospitals of Cleveland Seidman Cancer Center, Case Western Reserve University, Cleveland, OH, USA
| | - Steven C. Goldstein
- Department of Blood and Marrow Transplant, AdventHealth Hospital, Orlando, FL, USA
| | - Pingfu Fu
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Shufen Cao
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Paolo Caimi
- Stem Cell Transplant Program, University Hospitals of Cleveland Seidman Cancer Center, Case Western Reserve University, Cleveland, OH, USA
| | - Rushang D. Patel
- Department of Blood and Marrow Transplant, AdventHealth Hospital, Orlando, FL, USA
| | - Juan Carlos Varela
- Department of Blood and Marrow Transplant, AdventHealth Hospital, Orlando, FL, USA
| | - Luisa Andrade
- Stem Cell Transplant Program, University Hospitals of Cleveland Seidman Cancer Center, Case Western Reserve University, Cleveland, OH, USA
| | - Jason W. Balls
- Department of Blood and Marrow Transplant, AdventHealth Hospital, Orlando, FL, USA
| | - Linda Baer
- Stem Cell Transplant Program, University Hospitals of Cleveland Seidman Cancer Center, Case Western Reserve University, Cleveland, OH, USA
| | - Megan Smith
- Department of Blood and Marrow Transplant, AdventHealth Hospital, Orlando, FL, USA
| | - Tori Smith
- Department of Blood and Marrow Transplant, AdventHealth Hospital, Orlando, FL, USA
| | - Megan Nelson
- Department of Blood and Marrow Transplant, AdventHealth Hospital, Orlando, FL, USA
| | - Marcos de Lima
- Stem Cell Transplant Program, University Hospitals of Cleveland Seidman Cancer Center, Case Western Reserve University, Cleveland, OH, USA
| | - Shahram Mori
- Department of Blood and Marrow Transplant, AdventHealth Hospital, Orlando, FL, USA
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19
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Ueda M, Stefan T, Stetson L, Ignatz-Hoover JJ, Tomlinson B, Creger RJ, Cooper B, Lazarus HM, de Lima M, Wald DN, Caimi PF. Phase I Trial of Lithium and Tretinoin for Treatment of Relapsed and Refractory Non-promyelocytic Acute Myeloid Leukemia. Front Oncol 2020; 10:327. [PMID: 32211336 PMCID: PMC7076174 DOI: 10.3389/fonc.2020.00327] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 02/25/2020] [Indexed: 11/13/2022] Open
Abstract
Glycogen synthase kinase-3 (GSK3) inhibitors induce differentiation and growth inhibition of acute myeloid leukemia (AML) cells. Our pre-clinical studies showed GSK3 inhibition leads to sensitization of AML cells to tretinoin-mediated differentiation. We conducted a phase I trial of lithium, a GSK3 inhibitor, plus tretinoin for relapsed, refractory non-promyelocytic AML. Nine patients with median (range) age 65 (42–82) years were enrolled. All subjects had relapsed leukemia after prior therapy, with a median (range) of 3 (1–3) prior therapies. Oral lithium carbonate 300 mg was given 2–3 times daily and adjusted to meet target serum concentration (0.6 to 1.0 mmol/L); tretinoin 22.5 or 45 mg/m2/day (two equally divided doses) was administered orally on days 1–7 and 15–21 of a 28-day cycle. Four patients attained disease stability with no increase in circulating blasts for ≥4 weeks. Median (range) survival was 106 days (60–502). Target serum lithium concentration was achieved in all patients and correlated with GSK3 inhibition in leukemic cells. Immunophenotypic changes associated with myeloid differentiation were observed in five patients. The combination treatment led to a reduction in the CD34+ CD38– AML stem cell population both in vivo and in vitro. The combination of lithium and tretinoin is well-tolerated, induces differentiation of leukemic cells, and may target AML stem cells, but has limited clinical activity in the absence of other antileukemic agents. The results of this clinical trial suggest GSK3 inhibition can result in AML cell differentiation and may be a novel therapeutic strategy in this disease, particularly in combination with other antileukemic agents. Lithium is a weak GSK3 inhibitor and future strategies in AML treatment will probably require more potent agents targeting this pathway or combinations with other antileukemic agents. This trial is registered at ClinicalTrials.gov NCT01820624.
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Affiliation(s)
- Masumi Ueda
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, United States.,Department of Medicine, Division of Medical Oncology, University of Washington, Seattle, WA, United States
| | - Tammy Stefan
- Department of Pathology, Case Western Reserve University, Cleveland, OH, United States
| | - Lindsay Stetson
- Department of Pathology, Case Western Reserve University, Cleveland, OH, United States
| | - James J Ignatz-Hoover
- Department of Pathology, Case Western Reserve University, Cleveland, OH, United States
| | - Benjamin Tomlinson
- Stem Cell Transplant and Hematologic Malignancies Program, University Hospitals Seidman Cancer Center, Cleveland, OH, United States.,Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, United States
| | - Richard J Creger
- Stem Cell Transplant and Hematologic Malignancies Program, University Hospitals Seidman Cancer Center, Cleveland, OH, United States.,Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, United States
| | - Brenda Cooper
- Stem Cell Transplant and Hematologic Malignancies Program, University Hospitals Seidman Cancer Center, Cleveland, OH, United States.,Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, United States
| | - Hillard M Lazarus
- Stem Cell Transplant and Hematologic Malignancies Program, University Hospitals Seidman Cancer Center, Cleveland, OH, United States.,Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, United States
| | - Marcos de Lima
- Stem Cell Transplant and Hematologic Malignancies Program, University Hospitals Seidman Cancer Center, Cleveland, OH, United States.,Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, United States
| | - David N Wald
- Department of Pathology, Case Western Reserve University, Cleveland, OH, United States.,Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, United States
| | - Paolo F Caimi
- Stem Cell Transplant and Hematologic Malignancies Program, University Hospitals Seidman Cancer Center, Cleveland, OH, United States.,Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, United States
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20
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Ali N, Tomlinson B, Patel RD, Metheny L, Varela J, Otegbeye F, Boughan KM, Goldstein SC, Baer LK, Balls JW, Ahmed N, Smith M, Brister L, Edgar C, Nelson MM, Smith T, de Lima M, Mori S. Role of Post-Allogeneic Hematopoietic Stem Cell Transplantation Low-Dose Azacitidine for Prevention of Relapse in Patients with Acute Myeloid Leukemia and Myelodysplastic Syndrome: A Retrospective Analysis. Biol Blood Marrow Transplant 2020. [DOI: 10.1016/j.bbmt.2019.12.643] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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21
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Gyurkocza B, Nath R, Stiff PJ, Agura E, Litzow MR, Tomlinson B, Choe H, Abhyankar S, Seropian SE, Chen GL, Hari P, Al-Kadhimi Z, Foran J, Orozco JJ, van Besien K, Sabloff M, Kebriaei P, Abboud C, Levy MY, Lazarus HM, Giralt SA, Berger MS, Reddy V, Pagel JM. Targeted Conditioning with Anti-CD45 Iodine (131I) Apamistamab [Iomab-B] Leads to High Rates of Allogeneic Transplantation and Successful Engraftment in Older Patients with Active, Relapsed or Refractory (rel/ref) AML after Failure of Chemotherapy and Targeted Agents: Preliminary Midpoint Results from the Prospective, Randomized Phase 3 Sierra Trial. Biol Blood Marrow Transplant 2020. [DOI: 10.1016/j.bbmt.2019.12.575] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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22
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Caimi P, Reese JS, Otegbeye F, Schneider D, Bakalarz KL, Boughan KM, Cooper B, Galloway E, Gallogly M, Kruger W, Worden A, Kadan M, Lopes FBTP, Sharma A, Malek E, Metheny L, Tomlinson B, Wald D, Sekaly RP, Orentas R, Dropulic B, de Lima M. On Site Manufacture of AntiCD19 CAR-T Cells. Responses in Subjects with Rapidly Progressive Refractory Lymphomas. Biol Blood Marrow Transplant 2020. [DOI: 10.1016/j.bbmt.2019.12.478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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23
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Ahmed N, Caimi P, Reese JS, Otegbeye F, Patel S, Schneider D, Boughan KM, Cooper B, Gallogly M, Kruger W, Worden A, Kadan M, Lopes FBTP, Sharma A, Malek E, Metheny L, Tomlinson B, Wald D, Sekaly RP, Orentas R, Dropulic B, de Lima M. Prophylactic Tocilizumab in Patients with Relapsed Refractory Lymphoma Treated with Anti CD19 Chimeric Antigen Receptor T-Cell Therapy. Biol Blood Marrow Transplant 2020. [DOI: 10.1016/j.bbmt.2019.12.447] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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24
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Metheny L, Sobecks RM, Majhail NS, Caimi P, Otegbeye F, Cooper B, Gallogly M, Malek E, Tomlinson B, Gerds AT, Hamilton BK, de Lima M. Inotuzumab Ozogamicin Post-Transplant for Acute Lymphoblastic Leukemia. Biol Blood Marrow Transplant 2020. [DOI: 10.1016/j.bbmt.2019.12.636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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25
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Covut F, Boughan KM, Cooper B, Caimi P, Tomlinson B, Otegbeye F, Driscoll JJ, de Lima M, Malek E. Equivocal Significance of Prior Malignancies to Predict Overall Survival of Multiple Myeloma Patients after Autologous Hematopoietic Cell Transplant. Biol Blood Marrow Transplant 2020. [DOI: 10.1016/j.bbmt.2019.12.457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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26
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Ali N, Cooper B, Tomlinson B, Metheny L, Caimi P, Boughan K, Gallogly M, Otegbeye F, Malek E, Lazarus H, Creger R, de Lima M. Treatment-related mortality following autologous hematopoietic stem cell transplantation is unaffected by timing of G-CSF administration. Bone Marrow Transplant 2020; 55:1697-1700. [PMID: 32024994 DOI: 10.1038/s41409-020-0812-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Revised: 11/17/2019] [Accepted: 01/22/2020] [Indexed: 11/09/2022]
Affiliation(s)
- Naveed Ali
- Stem cell Transplant Program, University Hospitals of Cleveland Seidman Cancer Center, Case Western Reserve University, Cleveland, OH, USA
| | - Brenda Cooper
- Stem cell Transplant Program, University Hospitals of Cleveland Seidman Cancer Center, Case Western Reserve University, Cleveland, OH, USA
| | - Benjamin Tomlinson
- Stem cell Transplant Program, University Hospitals of Cleveland Seidman Cancer Center, Case Western Reserve University, Cleveland, OH, USA
| | - Leland Metheny
- Stem cell Transplant Program, University Hospitals of Cleveland Seidman Cancer Center, Case Western Reserve University, Cleveland, OH, USA
| | - Paolo Caimi
- Stem cell Transplant Program, University Hospitals of Cleveland Seidman Cancer Center, Case Western Reserve University, Cleveland, OH, USA
| | - Kirsten Boughan
- Stem cell Transplant Program, University Hospitals of Cleveland Seidman Cancer Center, Case Western Reserve University, Cleveland, OH, USA
| | - Molly Gallogly
- Stem cell Transplant Program, University Hospitals of Cleveland Seidman Cancer Center, Case Western Reserve University, Cleveland, OH, USA
| | - Folashade Otegbeye
- Stem cell Transplant Program, University Hospitals of Cleveland Seidman Cancer Center, Case Western Reserve University, Cleveland, OH, USA
| | - Ehsan Malek
- Stem cell Transplant Program, University Hospitals of Cleveland Seidman Cancer Center, Case Western Reserve University, Cleveland, OH, USA
| | - Hillard Lazarus
- Stem cell Transplant Program, University Hospitals of Cleveland Seidman Cancer Center, Case Western Reserve University, Cleveland, OH, USA
| | - Richard Creger
- Stem cell Transplant Program, University Hospitals of Cleveland Seidman Cancer Center, Case Western Reserve University, Cleveland, OH, USA
| | - Marcos de Lima
- Stem cell Transplant Program, University Hospitals of Cleveland Seidman Cancer Center, Case Western Reserve University, Cleveland, OH, USA.
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27
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Perales MA, Tomlinson B, Zhang MJ, St Martin A, Beitinjaneh A, Gibson J, Hogan W, Kekre N, Lazarus H, Marks D, McGuirk J, Romee R, Solh M, Wagner JE, Weisdorf DJ, de Lima M, Eapen M. Alternative donor transplantation for acute myeloid leukemia in patients aged ≥50 years: young HLA-matched unrelated or haploidentical donor? Haematologica 2020; 105:407-413. [PMID: 31101756 PMCID: PMC7012481 DOI: 10.3324/haematol.2018.215202] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [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: 12/21/2018] [Accepted: 05/16/2019] [Indexed: 11/18/2022] Open
Abstract
We sought to study whether survival after haploidentical transplantation is comparable to that after matched unrelated donor transplantation for 822 patients aged 50-75 years with acute myeloid leukemia in first or second complete remission. One hundred and ninety-two patients received grafts from haploidentical donors (sibling 25%; offspring 75%) and 631 patients from matched unrelated donors aged 18-40 years. Patients’ and disease characteristics of the two groups were similar except that recipients of matched unrelated donor transplantation were more likely to have poor risk cytogenetics and more likely to receive myeloablative conditioning regimens. Time from documented remission to transplant did not differ by donor type. Five-year overall survival was 32% and 42% after haploidentical and matched unrelated donor transplant, respectively (P=0.04). Multivariable analysis showed higher mortality (hazard ratio 1.27, P=0.04) and relapse (hazard ratio 1.32, P=0.04) after haploidentical transplantation, with similar non-relapse mortality risks. Chronic graft-versus-host disease was higher after matched unrelated donor compared to haploidentical transplantation when bone marrow was the graft (hazard ratio 3.12, P<0.001), but when the graft was peripheral blood, there was no difference in the risk of chronic graft-versus-host disease between donor types. These data support the view that matched unrelated donor transplant with donors younger than 40 years is to be preferred.
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Affiliation(s)
- Miguel-Angel Perales
- Adult Bone Marrow Transplant Services, Department of Medicine, Memorial Sloan-Kettering Cancer Center, and Department of Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Benjamin Tomlinson
- Seidman Cancer Center, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Mei-Jie Zhang
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.,Division of Biostatistics, Institute for Health and Society, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Andrew St Martin
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Amer Beitinjaneh
- UM Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA
| | - John Gibson
- Institute of Haematology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - William Hogan
- Bone Marrow Transplant Program, Mayo Clinic, Rochester, MN, USA
| | - Natasha Kekre
- Blood and Marrow Transplant Program, The Ottawa Hospital, Ottawa, ON, Canada
| | - Hillard Lazarus
- University Hospitals Bristol National Health Service Foundation Trust, Bristol, UK
| | - David Marks
- University Hospitals Bristol National Health Service Foundation Trust, Bristol, UK
| | - Joseph McGuirk
- Division of Hematologic Malignancies and Cellular Therapy, University of Kansas Medical Center, Kansas City, KS, USA
| | - Rizwan Romee
- Division of Hematologic Malignancies and Transplantation, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Melhem Solh
- The Blood and Marrow Transplant Program at Northside Hospital, Atlanta, GA, USA
| | - John E Wagner
- BMT Program, University of Minnesota Masonic Children's Hospital, Minneapolis, MN, USA
| | | | - Marcos de Lima
- The Blood and Marrow Transplant Program at Northside Hospital, Atlanta, GA, USA
| | - Mary Eapen
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
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28
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Tomlinson B, Raess PW, Beck RC, Moore EM. Erythroblastic sarcoma with rare PDGFRA rearrangement responding to tyrosine kinase inhibitor therapy. Br J Haematol 2020; 188:e98-e100. [PMID: 31951668 DOI: 10.1111/bjh.16379] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Benjamin Tomlinson
- Seidman Cancer Center, Case Comprehensive Cancer Center, Cleveland, OH, USA
| | - Philipp W Raess
- Department of Pathology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Rose C Beck
- Department of Pathology, Oregon Health & Science University, Portland, OR, USA
| | - Erika M Moore
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
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29
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Reid E, Suneja G, Ambinder RF, Ard K, Baiocchi R, Barta SK, Carchman E, Cohen A, Gupta N, Johung KL, Klopp A, LaCasce AS, Lin C, Makarova-Rusher OV, Mehta A, Menon MP, Morgan D, Nathwani N, Noy A, Palella F, Ratner L, Rizza S, Rudek MA, Taylor J, Tomlinson B, Wang CCJ, Dwyer MA, Freedman-Cass DA. Cancer in People Living With HIV, Version 1.2018, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw 2019; 16:986-1017. [PMID: 30099375 DOI: 10.6004/jnccn.2018.0066] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
People living with HIV (PLWH) are diagnosed with cancer at an increased rate over the general population and generally have a higher mortality due to delayed diagnoses, advanced cancer stage, comorbidities, immunosuppression, and cancer treatment disparities. Lack of guidelines and provider education has led to substandard cancer care being offered to PLWH. To fill that gap, the NCCN Guidelines for Cancer in PLWH were developed; they provide treatment recommendations for PLWH who develop non-small cell lung cancer, anal cancer, Hodgkin lymphoma, and cervical cancer. In addition, the NCCN Guidelines outline advice regarding HIV management during cancer therapy; drug-drug interactions between antiretroviral treatments and cancer therapies; and workup, radiation therapy, surgical management, and supportive care in PLWH who have cancer.
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30
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Mato A, Barrientos J, Brander D, Pagel J, Gutierrez M, Kadish K, Tomlinson B, Ghosh N, Giafis N, Ipe D, Upasani S, Sundaram M, Ferrante L, Amaya-Chanaga C, Iyengar R, Sharman J. PF383 PROGNOSTIC TESTING AND TREATMENT APPROACHES BASED ON REAL-WORLD CLINICAL EXPERIENCE FROM AN INTERIM ANALYSIS OF THE INFORMCLL REGISTRY OF PATIENTS WITH CHRONIC LYMPHOCYTIC LEUKEMIA. Hemasphere 2019. [DOI: 10.1097/01.hs9.0000559744.42031.cf] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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31
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Caimi P, Reese-Koc J, Otegbeye F, Schneider D, Chamoun K, Boughan K, Cooper B, Galloway E, Gallogly M, Kruger W, Worden A, Kadan M, Malek E, Metheny L, Tomlinson B, Wald D, Sekaly R, Orentas R, Dropulic B, de Lima M. PHASE 1 STUDY OF ANTICD19 CAR-T CELLS WITH TNFα TRANSMEMBRANE DOMAIN AND 41BB, CD3ζ COSTIMULATORY DOMAINS. RESPONSES IN SUBJECTS WITH RAPIDLY PROGRESSIVE LYMPHOMA. Hematol Oncol 2019. [DOI: 10.1002/hon.115_2630] [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: 11/11/2022]
Affiliation(s)
- P.F. Caimi
- Medicine - Hematology and Oncology; University Hospitals Seidman Cancer Center; Cleveland United States
| | - J.S. Reese-Koc
- Medicine - Hematology and Oncology; University Hospitals Seidman Cancer Center; Cleveland United States
| | - F. Otegbeye
- Medicine - Hematology and Oncology; University Hospitals Seidman Cancer Center; Cleveland United States
| | - D. Schneider
- Miltenyi Biotec Company; Lentigen; Gaithersburg United States
| | - K. Chamoun
- Medicine - Hematology and Oncology; University Hospitals Seidman Cancer Center; Cleveland United States
| | - K.M. Boughan
- Medicine - Hematology and Oncology; University Hospitals Seidman Cancer Center; Cleveland United States
| | - B.W. Cooper
- Medicine - Hematology and Oncology; University Hospitals Seidman Cancer Center; Cleveland United States
| | - E. Galloway
- Medicine - Hematology and Oncology; University Hospitals Seidman Cancer Center; Cleveland United States
| | - M.M. Gallogly
- Medicine - Hematology and Oncology; University Hospitals Seidman Cancer Center; Cleveland United States
| | - W. Kruger
- Miltenyi Biotec Company; Lentigen; Gaithersburg United States
| | - A. Worden
- Miltenyi Biotec Company; Lentigen; Gaithersburg United States
| | - M. Kadan
- Miltenyi Biotec Company; Lentigen; Gaithersburg United States
| | - E. Malek
- Medicine - Hematology and Oncology; University Hospitals Seidman Cancer Center; Cleveland United States
| | - L. Metheny
- Miltenyi Biotec Company; Lentigen; Gaithersburg United States
| | - B. Tomlinson
- Medicine - Hematology and Oncology; University Hospitals Seidman Cancer Center; Cleveland United States
| | - D.N. Wald
- Medicine - Hematology and Oncology; University Hospitals Seidman Cancer Center; Cleveland United States
| | - R.P. Sekaly
- Department of Pathology; Case Western Reserve University; Cleveland United States
| | - R. Orentas
- Miltenyi Biotec Company; Lentigen; Gaithersburg United States
| | - B. Dropulic
- Miltenyi Biotec Company; Lentigen; Gaithersburg United States
| | - M. de Lima
- Medicine - Hematology and Oncology; University Hospitals Seidman Cancer Center; Cleveland United States
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32
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Advani AS, Cooper B, Visconte V, Elson P, Chan R, Carew J, Wei W, Mukherjee S, Gerds A, Carraway H, Nazha A, Hamilton B, Sobecks R, Caimi P, Tomlinson B, Malek E, Little J, Miron A, Pink J, Maciejewski J, Unger A, Kalaycio M, de Lima M, Sekeres MA. A Phase I/II Trial of MEC (Mitoxantrone, Etoposide, Cytarabine) in Combination with Ixazomib for Relapsed Refractory Acute Myeloid Leukemia. Clin Cancer Res 2019; 25:4231-4237. [PMID: 30992301 DOI: 10.1158/1078-0432.ccr-18-3886] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 03/01/2019] [Accepted: 04/11/2019] [Indexed: 12/22/2022]
Abstract
PURPOSE The prognosis of patients with relapsed/refractory (R/R) acute myeloid leukemia (AML) remains poor, and novel therapies are needed. The proteasome pathway represents a potential therapeutic target. A phase I trial of the second-generation proteasome inhibitor ixazomib in combination with MEC (mitoxantrone, etoposide, and cytarabine) was conducted in patients with R/R AML. PATIENTS AND METHODS Dose escalation of ixazomib was performed using a standard 3 × 3 design. Gene-expression profiling was performed on pretreatment and posttreatment bone marrow or blood samples. RESULTS The maximum tolerated dose of ixazomib in combination with MEC was 1.0 mg. The dose limiting toxicity was thrombocytopenia. Despite a poor risk population, the response rate [complete remission (CR)/CR with incomplete count recovery (CRi)] was encouraging at 53%. Gene-expression analysis identified two genes, IFI30 (γ-interferon inducible lysosomal thiol reductase) and RORα (retinoic orphan receptor A), which were significantly differentially expressed between responding and resistant patients and could classify CR. CONCLUSIONS These results are encouraging, but a randomized trial is needed to address whether the addition of ixazomib to MEC improves outcome. Gene-expression profiling also helped us identify predictors of response and potentially novel therapeutic targets.
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Affiliation(s)
| | - Brenda Cooper
- University Hospitals of Cleveland Seidman Cancer Center, Cleveland, Ohio
| | | | - Paul Elson
- Cleveland Clinic Department of Quantitative Health Science, Cleveland, Ohio
| | - Ricky Chan
- Case Comprehensive Cancer Center, Cleveland, Ohio
| | - Jennifer Carew
- University of Arizona Cancer Center, Leon Levy Cancer Center, Tucson, Arizona
| | - Wei Wei
- Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio
| | | | - Aaron Gerds
- Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio
| | - Hetty Carraway
- Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio
| | - Aziz Nazha
- Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio
| | - Betty Hamilton
- Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio
| | - Ronald Sobecks
- Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio
| | - Paolo Caimi
- University Hospitals of Cleveland Seidman Cancer Center, Cleveland, Ohio
| | - Benjamin Tomlinson
- University Hospitals of Cleveland Seidman Cancer Center, Cleveland, Ohio
| | - Ehsan Malek
- University Hospitals of Cleveland Seidman Cancer Center, Cleveland, Ohio
| | - Jane Little
- University Hospitals of Cleveland Seidman Cancer Center, Cleveland, Ohio
| | - Alexander Miron
- Case Comprehensive Cancer Center, Cleveland, Ohio.,Department of Genetics and Genome Science, CWRU School of Medicine, Cleveland, Ohio
| | - John Pink
- Case Comprehensive Cancer Center, Cleveland, Ohio
| | | | - Allison Unger
- Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio
| | - Matt Kalaycio
- Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio
| | - Marcos de Lima
- University Hospitals of Cleveland Seidman Cancer Center, Cleveland, Ohio
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33
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Chamoun K, Getz T, Kolk M, de Lima M, Patel S, Metheny L, Caimi P, Malek E, Otegbeye F, Tomlinson B, Gallogly M, Boughan KM, Hou J, Creger R, Cooper B. Oral Vs Intravenous Tacrolimus Post Allogeneic Stem Cell Transplant: A Retrospective Analysis. Biol Blood Marrow Transplant 2019. [DOI: 10.1016/j.bbmt.2018.12.395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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34
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Jurdi NE, Filali-Mouhim A, Salem I, Retuerto M, Dambrosio NM, Lazarus HM, Caimi P, Cooper B, Tomlinson B, Metheny L, Malek E, Otegbeye F, Sekaly RP, Ghannoum M, de Lima M. Transplant Outcomes and Toxicities Are Associated with Changes in Relative Abundance, Diversity and Richness of the Oral and Gastrointestinal Microbiome during Autologous Transplantation for Multiple Myeloma: Results of a Prospective Pilot Study. Biol Blood Marrow Transplant 2019. [DOI: 10.1016/j.bbmt.2018.12.835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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35
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Chamoun K, Covut F, Park M, Caimi P, Metheny L, Tomlinson B, Baer L, Brister L, Lazarus HM, de Lima M, Cooper B. Peri-Transplant Venous Thromboembolism in Patients with Multiple Myeloma. Biol Blood Marrow Transplant 2019. [DOI: 10.1016/j.bbmt.2018.12.821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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36
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El Jurdi N, Cotton JM, Ali N, Galloway E, Pinto R, Kolke S, Cooper B, Tomlinson B, Metheny L, Malek E, Nock N, Kolk M, Lee R, de Lima M, Caimi P. Use of a Fitness Tracking Device to Monitor Physical Activity and Sleep Patterns during Hospitalization for Hematopoietic Stem Cell Transplant: Results of a Prospective Observational Study. Biol Blood Marrow Transplant 2018. [DOI: 10.1016/j.bbmt.2017.12.190] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Malek E, Hoffman G, Creger R, Cooper B, Kolk M, Lazarus HM, Tomlinson B, Caimi P, Metheny L, de Lima M. Optimizing Autologous Stem Cell Transplant for High-Risk Patients with Plasma Cell Dyscrasias. Biol Blood Marrow Transplant 2018. [DOI: 10.1016/j.bbmt.2017.12.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Caimi P, Ali N, Cooper B, Creger R, Malek E, Metheny L, Tomlinson B, Gallogly M, Otegbeye F, Eckmeyer K, Hillian A, Pereira G, Mansur D, de Lima M. Phase I Clinical Trial of Targeted Marrow Irradiation in Combination with Fludarabine and Busulfan for Conditioning of Hematopoietic Cell Transplant in High Risk Patients. Biol Blood Marrow Transplant 2018. [DOI: 10.1016/j.bbmt.2017.12.375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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El Jurdi N, FitzGerald B, Salem I, Dambrosio N, Retuerto M, Caimi P, Cooper B, Tomlinson B, Metheny L, Malek E, Lazarus HM, Otegbeye F, Ghannoum M, de Lima M. Diversity and Abundance Analysis of the Oral and Gastrointestinal Microbiome during Autologous Transplantation for Multiple Myeloma: Interim Results of a Prospective Pilot Study. Biol Blood Marrow Transplant 2018. [DOI: 10.1016/j.bbmt.2017.12.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Shang Q, Tam L, Li H, Wong P, Sanderson J, Yu C, Tomlinson B. P563Reduced left ventricular rotation reserve in patients with psoriatic arthritis - a low-level bicycle Ergometer exercise test. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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41
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Tashkandi H, Moore EM, Tomlinson B, Goebel T, Sadri N. Co-occurrence of type I CALR and two MPL mutations in patient with primary myelofibrosis. Ann Hematol 2017; 96:1417-1418. [PMID: 28502030 DOI: 10.1007/s00277-017-3022-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 05/08/2017] [Indexed: 01/19/2023]
Affiliation(s)
- Hammad Tashkandi
- Department of Pathology and Laboratory Medicine, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Erika M Moore
- Department of Pathology and Laboratory Medicine, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Benjamin Tomlinson
- Department of Hematology and Oncology, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Teresa Goebel
- Department of Hematology and Oncology, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Navid Sadri
- Department of Pathology and Laboratory Medicine, Case Western Reserve University School of Medicine, Cleveland, OH, USA. .,University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Cleveland, OH, 44106, USA.
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Tomlinson B, Lazarus HM. Enhancing acute myeloid leukemia therapy - monitoring response using residual disease testing as a guide to therapeutic decision-making. Expert Rev Hematol 2017; 10:563-574. [PMID: 28475434 DOI: 10.1080/17474086.2017.1326811] [Citation(s) in RCA: 16] [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] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Current standards for monitoring the response of acute myeloid leukemia (AML) are based on morphologic assessments of the bone marrow and recovery of peripheral blood counts. A growing experience is being developed to enhance the detection of small amounts of AML, or minimal residual disease (MRD). Areas covered: Available techniques include multi-color flow cytometry (MFC) of leukemia associated immunophenotypes (LAIP), quantitative reverse transcriptase polymerase chain reaction (QRT-PCR) for detecting fusion and mutated genes (RUNX1-RUNX1T1, CBFB-MYH11, and NPM1), overexpression of genes such as WT1, and next generation sequencing (NGS) for MRD. Expert commentary: While MRD monitoring is standard of care in some leukemia subsets such as acute promyelocytic leukemia, this approach for the broader AML population does not universally predict outcomes as some patients may experience relapse in the setting of undetectable leukemia while others show no obvious disease progression despite MRD positivity. However, there are instances where MRD can identify patients at increased risk for relapse that may change recommended therapy. Currently, prospective investigations to define clinically relevant MRD thresholds are ongoing. Risk-adapted trials are needed to best define the use of MRD in the follow up of AML patients after initial induction therapy.
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Affiliation(s)
- Benjamin Tomlinson
- a Department of Medicine , University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center , Cleveland , OH , USA
| | - Hillard M Lazarus
- a Department of Medicine , University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center , Cleveland , OH , USA
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Covut F, Pinto R, Cooper BW, Tomlinson B, Metheny L, Malek E, Lazarus HM, de Lima M, Caimi PF. Nivolumab before and after allogeneic hematopoietic cell transplantation. Bone Marrow Transplant 2017; 52:1054-1056. [PMID: 28346414 DOI: 10.1038/bmt.2017.44] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- F Covut
- Stem Cell Transplant Program, University Hospitals Seidman Cancer Center, Cleveland, OH, USA
| | - R Pinto
- Stem Cell Transplant Program, University Hospitals Seidman Cancer Center, Cleveland, OH, USA
| | - B W Cooper
- Stem Cell Transplant Program, University Hospitals Seidman Cancer Center, Cleveland, OH, USA.,Case Comprehensive Cancer Center, Cleveland, OH, USA
| | - B Tomlinson
- Stem Cell Transplant Program, University Hospitals Seidman Cancer Center, Cleveland, OH, USA.,Case Comprehensive Cancer Center, Cleveland, OH, USA
| | - L Metheny
- Stem Cell Transplant Program, University Hospitals Seidman Cancer Center, Cleveland, OH, USA.,Case Comprehensive Cancer Center, Cleveland, OH, USA
| | - E Malek
- Stem Cell Transplant Program, University Hospitals Seidman Cancer Center, Cleveland, OH, USA.,Case Comprehensive Cancer Center, Cleveland, OH, USA
| | - H M Lazarus
- Stem Cell Transplant Program, University Hospitals Seidman Cancer Center, Cleveland, OH, USA.,Case Comprehensive Cancer Center, Cleveland, OH, USA
| | - M de Lima
- Stem Cell Transplant Program, University Hospitals Seidman Cancer Center, Cleveland, OH, USA.,Case Comprehensive Cancer Center, Cleveland, OH, USA
| | - P F Caimi
- Stem Cell Transplant Program, University Hospitals Seidman Cancer Center, Cleveland, OH, USA.,Case Comprehensive Cancer Center, Cleveland, OH, USA
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Hu M, Tam C, So W, Chan J, Tomlinson B, Ma R. Genetic variants and lipid traits in the Hong Kong Chinese patients with type 2 diabetes. Atherosclerosis 2016. [DOI: 10.1016/j.atherosclerosis.2016.07.729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Chan SW, Xiao Y, Hu M, Yin OQP, Chu TTW, Fok BSP, Lee VHL, Tomlinson B. Associations of the CYP3A5*3
and CYP3A4
*1G
polymorphisms with the pharmacokinetics of oral midazolam and the urinary 6β-hydroxycortisol/cortisol ratio as markers of CYP3A activity in healthy male Chinese. J Clin Pharm Ther 2016; 41:552-8. [PMID: 27511886 DOI: 10.1111/jcpt.12433] [Citation(s) in RCA: 8] [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] [Received: 05/26/2016] [Accepted: 07/16/2016] [Indexed: 01/25/2023]
Affiliation(s)
- S. W. Chan
- Department of Medicine and Therapeutics; Prince of Wales Hospital; The Chinese University of Hong Kong; NT Hong Kong SAR China
| | - Y. Xiao
- Department of Medicine and Therapeutics; Prince of Wales Hospital; The Chinese University of Hong Kong; NT Hong Kong SAR China
| | - M. Hu
- Department of Medicine and Therapeutics; Prince of Wales Hospital; The Chinese University of Hong Kong; NT Hong Kong SAR China
| | - O. Q. P. Yin
- School of Pharmacy; The Chinese University of Hong Kong; Hong Kong SAR China
| | - T. T. W. Chu
- Department of Medicine and Therapeutics; Prince of Wales Hospital; The Chinese University of Hong Kong; NT Hong Kong SAR China
| | - B. S. P. Fok
- Department of Medicine and Therapeutics; Prince of Wales Hospital; The Chinese University of Hong Kong; NT Hong Kong SAR China
| | - V. H. L. Lee
- School of Pharmacy; The Chinese University of Hong Kong; Hong Kong SAR China
| | - B. Tomlinson
- Department of Medicine and Therapeutics; Prince of Wales Hospital; The Chinese University of Hong Kong; NT Hong Kong SAR China
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Ueda M, Lazarus HM, Cooper B, Caimi P, Creger R, Little JA, Baer L, Brister L, Malek E, Metheny L, Tomlinson B, Gerson SL, Oran B, de Lima M. Low-Dose Azacitidine (AZA) for Treatment of Acute Myeloid Leukemia (AML) or Myelodysplastic Syndrome (MDS) Relapse after Allogeneic Hematopoietic Cell Transplant (HCT). Biol Blood Marrow Transplant 2016. [DOI: 10.1016/j.bbmt.2015.11.610] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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47
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Ueda M, Lazarus HM, Tomlinson B, Creger R, Kolk M, de Lima M, Cooper B. Concurrent Use of Blinatumomab and Donor Lymphocyte Infusion (DLI) for Treatment of Relapsed Precursor B Cell Acute Lymphoblastic Leukemia (pre B ALL) after Allogeneic Hematopoietic Cell Transplant (HCT). Biol Blood Marrow Transplant 2016. [DOI: 10.1016/j.bbmt.2015.11.861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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48
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Liu ZM, Ho SC, Chen YM, Tomlinson B, Ho S, To K, Woo J. Effect of whole soy and purified daidzein on ambulatory blood pressure and endothelial function--a 6-month double-blind, randomized controlled trial among Chinese postmenopausal women with prehypertension. Eur J Clin Nutr 2015; 69:1161-8. [PMID: 25782428 DOI: 10.1038/ejcn.2015.24] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [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: 04/09/2014] [Revised: 12/02/2014] [Accepted: 01/29/2015] [Indexed: 12/31/2022]
Abstract
BACKGROUND/OBJECTIVES Although observational studies suggest that soy foods or isoflavones are cardio-protective, clinical trials on whole soy or isoflavone daidzein (one major isoflavone and the precursor of equol) on blood pressure (BP) and endothelial function (EF) are few and have not been specifically conducted among equol producers, a population most likely to benefit from soy treatment. SUBJECTS/METHODS We performed a 6-month double-blind, randomized, placebo-controlled trial to examine the effect of whole soy (soy flour) or purified daidzein on BP and EF in prehypertensive or untreated hypertensive postmenopausal women verified to be equol producers. A total of 270 eligible women were recruited and randomized to either one of the three treatment groups, 40 g soy flour (whole soy group), 40 g low-fat milk powder+63 mg daidzein (daidzein group) or 40 g low-fat milk powder (active control group) daily, each given as a solid beverage powder for 6 months. The primary outcome measures were 24 h ambulatory BP (ABP) and EF assessed by flow-mediated dilation using brachial artery ultrasound. RESULTS A total of 253 subjects completed the study according to protocol. Urinary isoflavones indicated good compliance with the interventions. Intention to treat and per-protocol analysis indicated that there was no significant difference in the 6-month changes or % changes in parameters of ABP and brachial flow-mediated dilation among the three treatment groups. A further subgroup analysis among hypertensive women (n=138) did not alter the conclusions. CONCLUSIONS Whole soy and purified daidzein had no significant effect on BP and vascular function among equol-producing postmenopausal women with prehypertension or untreated hypertension.
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Affiliation(s)
- Z-M Liu
- Division of Geriatrics, Department of Medicine & Therapeutics, the Chinese University of Hong Kong, Hong Kong, China
| | - S C Ho
- Division of Epidemiology, The Jockey Club of School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong, China
| | - Y-M Chen
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - B Tomlinson
- Division of Geriatrics, Department of Medicine & Therapeutics, the Chinese University of Hong Kong, Hong Kong, China
| | - S Ho
- Department of Imaging and Interventional Radiology, the Chinese University of Hong Kong, Hong Kong, China
| | - K To
- School of Pharmacy, the Chinese University of Hong Kong, Hong Kong, China
| | - J Woo
- Division of Geriatrics, Department of Medicine & Therapeutics, the Chinese University of Hong Kong, Hong Kong, China
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Hu M, Fok B, Wo S, Lee V, Zuo Z, Tomlinson B. Influence of farnesoid X receptor and bile acid transporter polymorphisms on the pharmacokinetics of ursodeoxycholic acid. Atherosclerosis 2015. [DOI: 10.1016/j.atherosclerosis.2015.04.411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Hu M, Yang Y, Masuda D, Yamashita S, Tomlinson B. Is there a role for niacin in familial hypercholesterolaemia? Atherosclerosis 2015. [DOI: 10.1016/j.atherosclerosis.2015.04.383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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