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Martín García-Sancho A, Baile M, Rodríguez G, Dlouhy I, Sancho JM, Jarque I, González-Barca E, Salar A, Espeso M, Grande C, Bergua J, Montes-Moreno S, Redondo A, Enjuanes A, Campo E, López-Guillermo A, Caballero D. Lenalidomide in combination with R-ESHAP in patients with relapsed or refractory diffuse large B-cell lymphoma: A phase 2 study from GELTAMO. Br J Haematol 2023; 203:202-211. [PMID: 37485564 DOI: 10.1111/bjh.18989] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 06/18/2023] [Accepted: 07/10/2023] [Indexed: 07/25/2023]
Abstract
Diffuse large B-cell lymphoma (DLBCL) patients with relapsed or refractory (RR) disease have poor outcomes with current salvage regimens. We conducted a phase 2 trial to analyse the safety and efficacy of adding lenalidomide to R-ESHAP (LR-ESHAP) in patients with RR DLBCL. Subjects received 3 cycles of lenalidomide 10 mg/day on days 1-14 of every 21-day cycle, in combination with R-ESHAP at standard doses. Responding patients underwent autologous stem-cell transplantation (ASCT). The primary endpoint was the overall response rate (ORR) after 3 cycles. Centralized cell-of-origin (COO) classification was performed. Forty-six patients were included. The ORR after LR-ESHAP was 67% (35% of patients achieved complete remission). Patients with primary refractory disease (n = 26) had significantly worse ORR than patients with non-refractory disease (54% vs. 85%, p = 0.031). No differences in response rates according to the COO were observed. Twenty-eight patients (61%) underwent ASCT. At a median follow-up of 41 months, the estimated 3-year PFS and OS were 42% and 48%, respectively. The most common grade ≥3 adverse events were thrombocytopenia (70% of patients), neutropenia (67%) and anaemia (35%). There were no treatment-related deaths during LR-ESHAP cycles. In conclusion, LR-ESHAP is a feasible salvage regimen with promising efficacy results for patients with RR DLBCL.
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Affiliation(s)
- A Martín García-Sancho
- Hematology Department, Hospital Universitario de Salamanca-IBSAL, CIBERONC, Universidad de Salamanca, Salamanca, Spain
| | - M Baile
- Hematology Department, Hospital Universitario de Salamanca-IBSAL, CIBERONC, Universidad de Salamanca, Salamanca, Spain
| | - G Rodríguez
- Hematology Department, Hospital Universitario Virgen del Rocío/Virgen Macarena, Sevilla, Spain
| | - I Dlouhy
- Hematology Department, Hospital Clinic, Barcelona, Spain
| | - J M Sancho
- Hematology Department, Hospital Germans Trias i Pujol/ICO-IJC, Badalona, Spain
| | - I Jarque
- Hematology Department, Hospital Universitari i Plotècnic La Fe, CIBERONC, Valencia, Spain
| | - E González-Barca
- Institut Català d'Oncologia-Hospitalet, IDIBELL, Universitat de-Barcelona, Barcelona, Spain
| | - A Salar
- Hematology Department, Hospital del Mar, Barcelona, Spain
| | - M Espeso
- Hematology Department, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - C Grande
- Hematology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - J Bergua
- Hematology Department, Hospital San Pedro de Alcántara, Cáceres, Spain
| | - S Montes-Moreno
- Pathology Department, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - A Redondo
- Hematology Department, Hospital Virgen del Puerto, Plasencia, Spain
| | - A Enjuanes
- Unidad de Genómica del IDIBAPS, Barcelona, Spain
| | - E Campo
- Pathology Department, Hospital Clinic, Barcelona, Spain
| | | | - D Caballero
- Hematology Department, Hospital Universitario de Salamanca-IBSAL, CIBERONC, Universidad de Salamanca, Salamanca, Spain
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2
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Muniesa C, Gallardo F, García-Doval I, Estrach MT, Combalia A, Morillo-Andújar M, De la Cruz Vicente F, Machan S, Moya-Martínez C, Rovira R, Sanchez-Gonzalez B, Acebo E, Amutio E, Peñate Y, Losada-Castillo MC, García-Muret MP, Iznardo H, Román-Curto C, Cañueto J, de Misa RF, Flórez A, Izu R, Torres-Navarro I, Zayas A, Pérez-Paredes G, Blanes M, Yanguas JI, Pérez-Ferriols A, Callejas-Charavia M, Ortiz-Romero PL, Pérez-Gil A, Prieto-Torres L, González-Barca E, Servitje O. Brentuximab vedotin in the treatment of cutaneous T-cell lymphomas: data from the Spanish Primary Cutaneous Lymphoma Registry. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)00634-7] [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: 11/03/2022]
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3
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Parody R, Sánchez-Ortega I, Mussetti A, Patiño B, Arnan M, Pomares H, González-Barca E, Mercadal S, Boqué C, Maluquer C, Carro I, Peña M, Clapés V, Verdesoto S, Bustamante G, Oliveira AC, Baca C, Cabezudo E, Talarn C, Escoda L, Ortega S, García N, Isabel González-Medina M, Sánchez-Salmerón M, Fusté C, Villa J, Carreras E, Domingo-Domènech E, Sureda A. A real-life overview of a hematopoietic cell transplant program throughout a four-year period, including prospective registry, exclusion causes and final donor selection. Bone Marrow Transplant 2021; 57:176-182. [PMID: 34711917 DOI: 10.1038/s41409-021-01506-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 10/04/2021] [Accepted: 10/13/2021] [Indexed: 12/11/2022]
Abstract
Traceability of patients who are candidates for Hematopoietic cell transplant (HCT) is crucial to ensure HCT program quality. Continuous knowledge of both a detailed registry from a HCT program and final exclusion causes can contribute to promoting a real-life vision and optimizing patient and donor selection. We analyzed epidemiological data reported in a 4 year-monocentric prospective registry, which included all patients presented as candidates for autologous (Auto) and/or allogeneic (Allo) HCT. A total of 543 patients were considered for HCT: 252 (42.4%) for Allo and 291 (57.6%) for Auto. A total of 98 (38.9%) patients were excluded from AlloHCT due to basal disease progression more commonly (18.2%). Seventy-six (30.2%) patients had an HLA identical sibling, whereas 147 (58.3%) patients had only Haplo. UD research was performed in 106 (42%) cases, significantly more often in myeloid than lymphoid malignancies (57% vs 28.7%, p < 0.001) but 61.3% were finally canceled, due to donor or disease causes in 72.4%. With respect to Auto candidates, a total of 60 (20.6%) patients were finally excluded; progression was the most common cause (12%). Currently, Haplo is the most frequent donor type. The high cancellation rate of UD research should be revised to optimize further donor algorithms.
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Affiliation(s)
- R Parody
- Clinical Hematology Department, Institut Català d'Oncologia-Hospitalet, Barcelona, Spain. .,Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), University of Barcelona, Barcelona, Spain.
| | - I Sánchez-Ortega
- Clinical Hematology Department, Institut Català d'Oncologia-Hospitalet, Barcelona, Spain.,EBMT medical Office; 3. Hospital Moisès Broggi, S.Joan d'Espí, Barcelona, Spain
| | - A Mussetti
- Clinical Hematology Department, Institut Català d'Oncologia-Hospitalet, Barcelona, Spain.,Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), University of Barcelona, Barcelona, Spain
| | - B Patiño
- Clinical Hematology Department, Institut Català d'Oncologia-Hospitalet, Barcelona, Spain
| | - M Arnan
- Clinical Hematology Department, Institut Català d'Oncologia-Hospitalet, Barcelona, Spain
| | - H Pomares
- Clinical Hematology Department, Institut Català d'Oncologia-Hospitalet, Barcelona, Spain
| | - E González-Barca
- Clinical Hematology Department, Institut Català d'Oncologia-Hospitalet, Barcelona, Spain.,Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), University of Barcelona, Barcelona, Spain
| | - S Mercadal
- Clinical Hematology Department, Institut Català d'Oncologia-Hospitalet, Barcelona, Spain.,Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), University of Barcelona, Barcelona, Spain
| | - C Boqué
- Clinical Hematology Department, Institut Català d'Oncologia-Hospitalet, Barcelona, Spain.,Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), University of Barcelona, Barcelona, Spain
| | - C Maluquer
- Clinical Hematology Department, Institut Català d'Oncologia-Hospitalet, Barcelona, Spain.,Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), University of Barcelona, Barcelona, Spain
| | - I Carro
- Clinical Hematology Department, Institut Català d'Oncologia-Hospitalet, Barcelona, Spain.,Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), University of Barcelona, Barcelona, Spain
| | - M Peña
- Clinical Hematology Department, Institut Català d'Oncologia-Hospitalet, Barcelona, Spain.,Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), University of Barcelona, Barcelona, Spain
| | - V Clapés
- Clinical Hematology Department, Institut Català d'Oncologia-Hospitalet, Barcelona, Spain.,H. Comarcal d'Alt Penedés, Vilafranca del Penedés, Barcelona, Spain
| | - S Verdesoto
- Clinical Hematology Department, Institut Català d'Oncologia-Hospitalet, Barcelona, Spain.,EBMT medical Office; 3. Hospital Moisès Broggi, S.Joan d'Espí, Barcelona, Spain
| | - G Bustamante
- Clinical Hematology Department, Institut Català d'Oncologia-Hospitalet, Barcelona, Spain.,EBMT medical Office; 3. Hospital Moisès Broggi, S.Joan d'Espí, Barcelona, Spain
| | - A C Oliveira
- Clinical Hematology Department, Institut Català d'Oncologia-Hospitalet, Barcelona, Spain.,Hospital Sant Camil - St. Pere de Ribes, Barcelona, Spain
| | - C Baca
- Clinical Hematology Department, Institut Català d'Oncologia-Hospitalet, Barcelona, Spain.,H General de Igualada, Barcelona, Spain
| | - E Cabezudo
- EBMT medical Office; 3. Hospital Moisès Broggi, S.Joan d'Espí, Barcelona, Spain
| | - C Talarn
- Institut Català d'Oncologia-Hospital Universitari de Tarragona Joan XXIII, Tarragona, Spain
| | - L Escoda
- Institut Català d'Oncologia-Hospital Universitari de Tarragona Joan XXIII, Tarragona, Spain
| | - S Ortega
- Banc de Sang i Teixits, Barcelona, Barcelona, Spain
| | - N García
- Banc de Sang i Teixits, Barcelona, Barcelona, Spain
| | | | - Mar Sánchez-Salmerón
- Clinical Hematology Department, Institut Català d'Oncologia-Hospitalet, Barcelona, Spain
| | - C Fusté
- REDMO, Fundació Josep Carreras, Barcelona, Spain
| | - J Villa
- REDMO, Fundació Josep Carreras, Barcelona, Spain
| | - E Carreras
- REDMO, Fundació Josep Carreras, Barcelona, Spain
| | - E Domingo-Domènech
- Clinical Hematology Department, Institut Català d'Oncologia-Hospitalet, Barcelona, Spain.,Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), University of Barcelona, Barcelona, Spain
| | - A Sureda
- Clinical Hematology Department, Institut Català d'Oncologia-Hospitalet, Barcelona, Spain.,Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), University of Barcelona, Barcelona, Spain
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4
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González-Barca E, Gato L, Esteve A, Sanz‐Pamplona R, Tomás L, Rodriguez M, Martín García‐Sancho A, Córdoba R, Monter A, Bastos M, Bergua Burgues JM, Sayas MJ, Viguria Alegria MC, Sánchez Blanco JJ, Roig M, Luzardo Henriquez HD, Oña R, Cabezudo E, Infante MS, Queizan JA, Blanco Nuñez O, Mozos A, Climent F, Piris MA. CHARACTERIZATION OF THE ONCOGENIC PHENOTYPE IN EXTRANODAL NATURAL KILLER/T‐CELL LYMPHOMA, NASAL TYPE THROUGH GENE EXPRESSION PROFILE. SPANISH LYMPHOMA GROUP GELTAMO. Hematol Oncol 2021. [DOI: 10.1002/hon.139_2880] [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: 11/10/2022]
Affiliation(s)
- E González-Barca
- Institut Català d’Oncologia Hospital Duran i Reynals, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL) Universitat de Barcelona, Hematology L’Hospitalet de Llobregat Barcelona Spain
| | - L Gato
- Fundación Jiménez Díaz, CIBERONC, Pathology Madrid Spain
| | - A Esteve
- nsititut Català d'Oncologia, Unit of Biomarkers and Susceptibility, Oncology Data Analytics Program (ODAP) Medical Oncology Department, B‐ARGO Badalona, Badalona Barcelona Spain
| | - R Sanz‐Pamplona
- Catalan Institute of Oncology (ICO), Oncobell Program, Bellvitge Biomedical Research Institute (IDIBELL) and CIBERESP, Unit of Biomarkers and Susceptibility Oncology Data Analytics Program (ODAP), L'Hospitalet de Llobregat Barcelona Spain
| | - L Tomás
- Fundación Jiménez Díaz, CIBERONC, Pathology Madrid Spain
| | - M Rodriguez
- Fundación Jiménez Díaz, CIBERONC, Pathology Madrid Spain
| | | | - R Córdoba
- Fundación Jimenez Díaz, Hematology Madrid Spain
| | - A Monter
- Hospital de la Santa Creu i Sant Pau, Hematology Barcelona Spain
| | - M Bastos
- Gregorio Marañón General University Hospital (HGUGM), Hematology Madrid Spain
| | | | - M. J Sayas
- Hospital Universitario Dr Peset, Hematology Valencia Spain
| | | | | | - M Roig
- Hospital La Fe, Hematology Valencia Spain
| | | | - R Oña
- MD Anderson Cancer Center, Hematology Madrid Spain
| | - E Cabezudo
- Insititut Català d'Oncologia, Hospital Moises Broggi, Hematology, San Juan Despí Barcelona Spain
| | - M. S Infante
- Hospital Infanta Leonor, Hematology Madrid Spain
| | - J. A Queizan
- Hospital General de Segovia, Hematology Segovia Spain
| | - O Blanco Nuñez
- Hospital Universitario de Salamanca, IBSAL, Pathology Salamanca Spain
| | - A Mozos
- Hospital de la Santa Creu i Sant Pau, Pathology Barcelona Spain
| | - F Climent
- Hospital Universitario de Bellvitge, Institut d'Investigaciò Biomédica de Bellvitge IDIBELL Pathology, Hospitalet de LLobregat Barcelona Spain
| | - M. A Piris
- Fundación Jiménez Díaz, Pathology Madrid Spain
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5
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Bobillo S, Abrisqueta P, Sánchez-González B, Giné E, Romero S, Alcoceba M, González-Barca E, González de Villambrosía S, Sancho JM, Gómez P, Bento L, Montoro J, Montes S, López A, Bosch F. Posttransplant monomorphic Burkitt’s lymphoma: clinical characteristics and outcome of a multicenter series. Ann Hematol 2018; 97:2417-2424. [DOI: 10.1007/s00277-018-3473-8] [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] [Received: 04/17/2018] [Accepted: 08/06/2018] [Indexed: 10/28/2022]
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6
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Sancho J, Gual F, Fernández-Álvarez R, González-García E, Grande C, Gutiérrez N, Peñarrubia M, Batlle-López A, González-Barca E, Guinea J, Gimeno E, Peñalver F, Fuertes M, Gayoso J, Hernández-Rivas J, Moraleda J, García O, Martín A. R-COMP VS R-CHOP AS FIRST-LINE THERAPY FOR DIFFUSE LARGE B-CELL LYMPHOMA IN PATIENTS OLDER THAN 60 YEARS: RESULTS FROM A RANDOMIZED PHASE 2 STUDY FROM THE SPANISH GELTAMO GROUP. Hematol Oncol 2017. [DOI: 10.1002/hon.2438_47] [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: 11/12/2022]
Affiliation(s)
- J. Sancho
- Hematology; ICO-IJC-Hospital Germans Trias i Pujol; Badalona Spain
| | - F. Gual
- Cardiology; Hospital Germans Trias i Pujol; Badalona Spain
| | | | | | - C. Grande
- Hematology; Hospital 12 de Octubre; Madrid Spain
| | - N. Gutiérrez
- Hematology; Hospital Universitario de Salamanca; Salamanca Spain
| | - M. Peñarrubia
- Hematology; Hospital Clínico Universitario de Valladolid; Valladolid Spain
| | | | - E. González-Barca
- Hematology; ICO-Hospital Durán i Reynals, Hospitalet de Llobregat; Spain
| | - J. Guinea
- Hematology; Ho'spital Universitario de araba; Vitoria Spain
| | - E. Gimeno
- Hematology; Hospital del Mar; Barcelona Spain
| | - F. Peñalver
- Hematology; Hospital Universitario Fundación de Alcorcón; Alcorcón Spain
| | - M. Fuertes
- Hematology; Hospital Clínico Universitario Lozano Blesa; Zaragoza Spain
| | - J. Gayoso
- Hematology; Hospital Gregorio Marañón; Madrid Spain
| | | | - J. Moraleda
- Hematology; Hospital Virgen de la Arrixaca; Murcia Spain
| | - O. García
- Hematology; ICO-IJC-Hospital Germans Trias i Pujol; Badalona Spain
| | - A. Martín
- Hematology; Hospital Universitario de Salamanca; Salamanca Spain
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7
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Baptista M, Tapia G, Muñoz-Marmol A, Muncunill J, Montoto S, Gribben J, Calaminici M, Martinez A, Gonzalez-Farre B, López-Guillermo A, González-Barca E, Terol M, Miralles P, Alcoceba M, Vall-Llovera F, Briones J, Abrisqueta P, Abella E, Provencio M, García-Ballesteros C, Moraleda J, Sancho J, Ribera J, Mate J, Navarro J. APPLICATION OF CELL-OF-ORIGIN SUBTYPES DETERMINED BY DIGITAL GENE EXPRESSION IN HIV-RELATED DIFFUSE LARGE B-CELL LYMPHOMAS. Hematol Oncol 2017. [DOI: 10.1002/hon.2438_11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- M. Baptista
- Department of Hematology; ICO-Hospital Universitari Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute, Universitat Autònoma de Barcelona; Badalona Spain
| | - G. Tapia
- Department of Pathology; Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona; Badalona Spain
| | - A. Muñoz-Marmol
- Department of Pathology; Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona; Badalona Spain
| | - J. Muncunill
- Department of Hematology; ICO-Hospital Universitari Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute, Universitat Autònoma de Barcelona; Badalona Spain
| | - S. Montoto
- Department of Haemato-Oncology, Barts Cancer Institute; Queen Mary University of London; London UK
| | - J. Gribben
- Department of Haemato-Oncology, Barts Cancer Institute; Queen Mary University of London; London UK
| | - M. Calaminici
- Department of Haemato-Oncology, Barts Cancer Institute; Queen Mary University of London; London UK
| | - A. Martinez
- Department of Pathology, Hospital Clinic, Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS); University of Barcelona; Barcelona Spain
| | - B. Gonzalez-Farre
- Department of Pathology, Hospital Clinic, Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS); University of Barcelona; Barcelona Spain
| | - A. López-Guillermo
- Department of Hematology, Hospital Clinic, Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS); University of Barcelona; Barcelona Spain
| | - E. González-Barca
- Department of Hematology; ICO-Hospital Duran i Reynals, L'Hospitalet de Llobregat; Spain
| | - M. Terol
- Department of Hematology and Oncology; Hospital Clínic Universitari de València; Valencia Spain
| | - P. Miralles
- Department of Infectious Diseases; Hospital Gregorio Marañón; Madrid Spain
| | - M. Alcoceba
- Department of Hematology; Hospital Universitario de Salamanca; Salamanca Spain
| | - F. Vall-Llovera
- Servicio de Hematología Clínica; Hospital Universitari Mutúa de Terrassa; Terrassa Spain
| | - J. Briones
- Department of Hematology, Hospital de la Santa Creu i Sant Pau; Josep Carreras Leukaemia Research Institute; Barcelona Spain
| | - P. Abrisqueta
- Department of Hematology; Hospital Vall d'Hebrón; Barcelona Spain
| | - E. Abella
- Department of Hematology; Hospital del Mar; Barcelona Spain
| | - M. Provencio
- Department of Medical Oncology; Hospital Universitario Puerta De Hierro; Majadahonda Spain
| | | | - J. Moraleda
- Department of Hematology; Hospital Clinico Universitario Virgen de la Arrixaca; Murcia Spain
| | - J. Sancho
- Department of Hematology; ICO-Hospital Universitari Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute, Universitat Autònoma de Barcelona; Badalona Spain
| | - J. Ribera
- Department of Hematology; ICO-Hospital Universitari Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute, Universitat Autònoma de Barcelona; Badalona Spain
| | - J. Mate
- Department of Pathology; Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona; Badalona Spain
| | - J. Navarro
- Department of Hematology; ICO-Hospital Universitari Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute, Universitat Autònoma de Barcelona; Badalona Spain
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Mercadal S, Vidal N, López-Parra M, Ibañez M, Caldú R, Bobillo S, Barceló I, García E, Martinez P, Cacabelos P, Dlouhy I, Sancho J, Muntañola A, Gómez L, Erro E, Gállego J, Salar A, Caballero A, Solé M, Huertas N, Estela J, Baron M, Barbero N, González-Barca E, Graus F, Velasco R. Initial management of primary central nervous system lymphoma in Spain in the last decade. The experience of the GELTAMO and Spanish neuro-oncology groups. Hematol Oncol 2017. [DOI: 10.1002/hon.2439_107] [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)
- S. Mercadal
- Hematology; Catalan Institute of Oncology. Hospital Duran i Reynals., L'Hospitalet de Llobregat; Barcelona Spain
| | - N. Vidal
- Pathology; Hospital de Bellvitge, L'Hospitalet de Llobregat; Barcelona Spain
| | - M. López-Parra
- Hematology; Hospital Universitario de Salamanca; Salamanca Spain
| | - M. Ibañez
- Neurology; Hospital Universitario i Politècnic La Fe; Valencia Spain
| | - R. Caldú
- Neurology; Hospital Universitario Miguel Servet; Zaragoza Spain
| | - S. Bobillo
- Hematology; Hospital Vall d'Hebrón; Barcelona Spain
| | - I. Barceló
- Neurology; Hospital Universitario Son Espases; Palma de Mallorca Spain
| | - E. García
- Neurology; Hospital Universitario Virgen de la Arrixaca; Murcia Spain
| | - P. Martinez
- Hematology; Hospital Universitario Doce de Octubre; Madrid Spain
| | - P. Cacabelos
- Neurology; Complejo hospitalario Santiago Compostela; Santiago Compostela Spain
| | - I. Dlouhy
- Hematology; Hospital Clínic; Barcelona Spain
| | - J. Sancho
- Hematology; ICO. Hospital Germans Trias i Pujol; Badalona Spain
| | - A. Muntañola
- Hematology; Hospital Mutua de Terrassa; Terrassa Spain
| | - L. Gómez
- Neurology; Hospital Quirón; Madrid Spain
| | - E. Erro
- Neurology; Hospital de Navarra; Pamplona Spain
| | - J. Gállego
- Neurology; Clínica Universitaria de Navarra; Pamplona Spain
| | - A. Salar
- Hematology; Hospital del Mar; Barcelona Spain
| | - A. Caballero
- Hematology; Hospital de Sant Pau; Barcelona Spain
| | - M. Solé
- Hematology; Hospital Virgen del Rocío; Sevilla Spain
| | - N. Huertas
- Neurology; Hospiatl Severo Ochoa; Leganés Spain
| | - J. Estela
- Neurology; Hospital Parc Taulí; Sabadell Spain
| | - M. Baron
- Neurology; Hospital Fundación Alcorcón; Alcorcón Spain
| | - N. Barbero
- Neurology; Hospital Rey Juan Carlos; Móstoles Spain
| | - E. González-Barca
- Hematology; Catalan Institute of Oncology. Hospital Duran i Reynals., L'Hospitalet de Llobregat; Barcelona Spain
| | - F. Graus
- Hematology; Hospital Clínic; Barcelona Spain
| | - R. Velasco
- Neurology; Hospital de Bellvitge, L'Hospitalet de Llobregat; Barcelona Spain
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9
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Martín A, Baile M, Rodríguez G, Dlouhy I, Sancho J, Jarque I, González-Barca E, Salar A, Espeso M, Grande C, Bergua J, Montes-Moreno S, López-Guillermo A, Campo E, Caballero D. Lenalidomide in combination with R-ESHAP in patients with relapsed or refractory diffuse large B-cell lymphoma: A phase 2 study from the Spanish group GELTAMO. Hematol Oncol 2017. [DOI: 10.1002/hon.2439_93] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- A. Martín
- Hematology; Hospital Universitario de Salamanca and IBSAL; Salamanca Spain
| | - M. Baile
- Hematology; Hospital Universitario de Salamanca and IBSAL; Salamanca Spain
| | - G. Rodríguez
- Hematology; UGC HH.UU. Virgen del Rocío / Virgen Macarena; Sevilla Spain
| | - I. Dlouhy
- Hematology; Hospital Clinic; Barcelona Spain
| | - J.M. Sancho
- Hematology; Hospital Germans Trias i Pujol / ICO-IJC, Barcelona; Badalona Spain
| | - I. Jarque
- Hematology; Hospital Universitario La Fe; Valencia Spain
| | - E. González-Barca
- Hematology; Hospital Duran i Reynals / ICO-IDIBELL, Hospitalet de Llobregat; Barcelona Spain
| | - A. Salar
- Hematology; Hospital del Mar; Barcelona Spain
| | - M. Espeso
- Hematology; Hospital Regional Universitario de Málaga; Málaga Spain
| | - C. Grande
- Hematology; Hospital Universitario 12 de Octubre; Madrid Spain
| | - J. Bergua
- Hematology; Hospital San Pedro de Alcántara; Cáceres Spain
| | - S. Montes-Moreno
- Pathology; Hospital Universitario Marqués de Valdecilla; Santander Spain
| | | | - E. Campo
- Pathology; Hospital Clinic; Barcelona Spain
| | - D. Caballero
- Hematology; Hospital Universitario de Salamanca and IBSAL; Salamanca Spain
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10
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Bobillo S, Abrisqueta P, Sánchez-González B, Giné E, Romero S, Alcoceba M, González-Barca E, González de Villambrosía S, Sancho J, Castellví J, López A, Bosch F. Post-transplant monomorphic Burkitt's lymphoma: Clinical characteristics and outcome of a multicenter series. Hematol Oncol 2017. [DOI: 10.1002/hon.2439_100] [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: 11/10/2022]
Affiliation(s)
- S. Bobillo
- Department of Hematology; Vall d'Hebron University Hospital; Barcelona Spain
| | - P. Abrisqueta
- Department of Hematology; Vall d'Hebron University Hospital; Barcelona Spain
| | | | - E. Giné
- Department of Hematology; Hospital Clinic; Barcelona Spain
| | - S. Romero
- Department of Hematology; Hospital La Fe; València Spain
| | - M. Alcoceba
- Department of Hematology; Hospital Universitario de Salamanca; Salamanca Spain
| | - E. González-Barca
- Department of Hematology, Institut Català d'Oncologia; Hospital Duran y Reynals, L'Hospitalet de Llobregat; Spain
| | | | - J.M. Sancho
- Department of Hematology; ICO-IJC-University Hospital Germans Trias y Pujol; Badalona Spain
| | - J. Castellví
- Department of Pathology; Vall d'Hebron University Hospital; Barcelona Spain
| | - A. López
- Department of Hematology; Vall d'Hebron University Hospital; Barcelona Spain
| | - F. Bosch
- Department of Hematology; Vall d'Hebron University Hospital; Barcelona Spain
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11
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Velasco R, Mercadal S, Vidal N, Bruna J, González-Barca E, López-Guillermo A, Graus F. OS08.9 Management of Primary Central Nervous System Lymphoma in Spain in the last decade: a case series of the Spanish Group of Neuro-Oncology and GELTAMO. Neuro Oncol 2017. [DOI: 10.1093/neuonc/nox036.059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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12
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González-Barca E, Canales M, Salar A, Ferreiro-Martínez JJ, Ferrer-Bordes S, García-Marco JA, Sánchez-Blanco JJ, García-Frade J, Peñalver J, Bello-López JL, Sancho JM, Caballero D. Central nervous system prophylaxis with intrathecal liposomal cytarabine in a subset of high-risk patients with diffuse large B-cell lymphoma receiving first line systemic therapy in a prospective trial. Ann Hematol 2016; 95:893-9. [PMID: 27025508 PMCID: PMC4853453 DOI: 10.1007/s00277-016-2648-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Accepted: 03/17/2016] [Indexed: 10/26/2022]
Abstract
The dissemination in the central nervous system (CNS) is an uncommon but fatal complication occurring in patients with diffuse large B-cell lymphoma (DLBCL). Standard prophylaxis has been demonstrated to reduce CNS relapse and improve survival rates. Intrathecal (IT) liposomal cytarabine allows maintaining elevated drug levels in the cerebrospinal fluid for an extended period of time. Data on the efficacy and safety of liposomal cytarabine as CNS prophylaxis in patients with DLBCL are still insufficient. The objective of the present study was to evaluate the effectiveness and safety of the prophylaxis with IT liposomal cytarabine in prevention of CNS relapse in high-risk patients with DLBCL who were included in a trial of first line systemic therapy with 6 cycles of dose-dense R-CHOP every 14 days. Twenty-four (18.6 %) out of 129 patients were identified to have risk factors for CNS involvement, defined as follows: >30 % bone marrow infiltration, testes infiltration, retroperitoneal mass ≥10 cm, Waldeyer ring, or bulky cervical nodes involvement. Liposomal cytarabine (50 mg) was administered by lumbar puncture the first day of the 1st, 2nd, and 6th cycle of R-CHOP14 scheme. Among 70 IT infusions, grade 3-4 adverse events reported were headache (one patient) and nausea/vomiting (one patient). With a median follow-up of 40.1 months, no CNS involvement by DLBCL was observed in any patient. In conclusion, IT liposomal cytarabine is safe, feasible, and effective for CNS prophylaxis, causing few associated risks and little discomfort to patients with DLBCL.
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MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Antibodies, Monoclonal, Murine-Derived/administration & dosage
- Antimetabolites, Antineoplastic/administration & dosage
- Antineoplastic Combined Chemotherapy Protocols/administration & dosage
- Cyclophosphamide/administration & dosage
- Cytarabine/administration & dosage
- Doxorubicin/administration & dosage
- Female
- Follow-Up Studies
- Humans
- Injections, Spinal
- Lymphoma, Large B-Cell, Diffuse/diagnosis
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large B-Cell, Diffuse/mortality
- Male
- Middle Aged
- Post-Exposure Prophylaxis/methods
- Prednisone/administration & dosage
- Prospective Studies
- Risk Factors
- Rituximab
- Survival Rate
- Vincristine/administration & dosage
- Young Adult
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Affiliation(s)
- E González-Barca
- Institut Català d'Oncologia. IDIBELL., Hospital Duran i Reynals, Av. Gran Vía 199-203, 08908, L'Hospitalet de Llobregat, Barcelona, Spain.
| | - M Canales
- Hospital Universitario La Paz, Madrid, Spain
| | - A Salar
- Hospital del Mar, Barcelona, Spain
| | | | | | | | | | | | - J Peñalver
- Fundación Hospital de Alcorcón, Madrid, Spain
| | - J L Bello-López
- Complexo Hospitalario de Santiago, Santiago de Compostela, Spain
| | - J M Sancho
- Institut Català d'Oncologia - Hospital Germans Trias i Pujol, Badalona, Spain
| | - D Caballero
- Hospital Clínico Universitario de Salamanca, Salamanca, Spain
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13
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Bonanad S, De la Rubia J, Gironella M, Pérez Persona E, González B, Fernández Lago C, Arnan M, Zudaire M, Hernández Rivas JA, Soler A, Marrero C, Olivier C, Altés A, Valcárcel D, Hernández MT, Oiartzabal I, Fernández Ordoño R, Arnao M, Esquerra A, Sarrá J, González-Barca E, González J, Calvo X, Nomdedeu M, García Guiñón A, Ramírez Payer A, Casado A, López S, Durán M, Marcos M, Cruz-Jentoft AJ. Development and psychometric validation of a brief comprehensive health status assessment scale in older patients with hematological malignancies: The GAH Scale. J Geriatr Oncol 2015; 6:353-61. [PMID: 26139300 DOI: 10.1016/j.jgo.2015.03.003] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [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: 10/27/2014] [Revised: 03/24/2015] [Accepted: 03/31/2015] [Indexed: 12/27/2022]
Abstract
OBJECTIVES The purpose of this study was to develop a new brief, comprehensive geriatric assessment scale for older patients diagnosed with different hematological malignancies, the Geriatric Assessment in Hematology (GAH scale), and to determine its psychometric properties. MATERIALS AND METHODS The 30-item GAH scale was designed through a multi-step process to cover 8 relevant dimensions. This is an observational study conducted in 363 patients aged≥65years, newly diagnosed with different hematological malignancies (myelodysplasic syndrome/acute myeloblastic leukemia, multiple myeloma, or chronic lymphocytic leukemia), and treatment-naïve. The scale psychometric validation process included the analyses of feasibility, floor and ceiling effect, validity and reliability criteria. RESULTS Mean time taken to complete the GAH scale was 11.9±4.7min that improved through a learning-curve effect. Almost 90% of patients completed all items, and no floor or ceiling effects were identified. Criterion validity was supported by reasonable correlations between the GAH scale dimensions and three contrast variables (global health visual analogue scale, ECOG and Karnofsky), except for comorbidities. Factor analysis (supported by the scree plot) revealed nine factors that explained almost 60% of the total variance. Moderate internal consistency reliability was found (Cronbach's α: 0.610), and test-retest was excellent (ICC coefficients, 0.695-0.928). CONCLUSION Our study suggests that the GAH scale is a valid, internally reliable and a consistent tool to assess health status in older patients with different hematological malignancies. Future large studies should confirm whether the GAH scale may be a tool to improve clinical decision-making in older patients with hematological malignancies.
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Affiliation(s)
- S Bonanad
- Hematology Department, H. U. La Fe, Av. Fernando Abril Martorell, 106, 46026 Valencia, Spain.
| | - J De la Rubia
- Hematology Department, H. U. La Fe, Av. Fernando Abril Martorell, 106, 46026 Valencia, Spain
| | - M Gironella
- Hematology Department, H. U. Vall d'Hebrón, Passeig de la Vall d'Hebron, 119-129, 08035 Barcelona, Spain
| | - E Pérez Persona
- Hematology Department, H. U. Txagorritxu, c/ Jose Atxotegi, s/n, 01009 Vitoria-Gasteiz, Álava, Spain
| | - B González
- Hematology Department, H. U. de Canarias, Ctra. Ofra, s/n, 38320 San Cristóbal de La Laguna, Santa Cruz de Tenerife, Spain
| | - C Fernández Lago
- Hematology Department, C.H.U. A Coruña, As Xubias, 84, 15006, A Coruña, Spain
| | - M Arnan
- Hematology Department, Catalan Institute of Oncology, IDIBELL, Hospital Duran i Reynals, Avinguda Granvia de l'Hospitalet, 199-203 08908 l'Hospitalet de Llobregat, Barcelona, Spain
| | - M Zudaire
- Hematology Department, C.H. de Navarra, Av. Pío XII, 36, 31008 Pamplona, Navarra, Spain
| | - J A Hernández Rivas
- Hematology Department, H.U. Infanta Leonor, Avenida Gran Vía del Este, 80, 28031 Madrid, Spain
| | - A Soler
- Hematology Department, C.S. Parc Taulí, Parc Taulí, 1, 08208 Sabadell, Barcelona, Spain
| | - C Marrero
- Hematology Department, H. Ntra. Sra. de La Candelaria, Carretera del Rosario, 145, 38010 Santa Cruz de Tenerife, Spain
| | - C Olivier
- Hematology Department, C.H. de Segovia, c/ de Miguel Servet, s/n, Segovia, Spain
| | - A Altés
- Hematology Department, H. Sant Joan de Déu, Passeig de Sant Joan de Déu, 2, 08950 Esplugues de Llobregat, Barcelona, Spain
| | - D Valcárcel
- Hematology Department, H. U. Vall d'Hebrón, Passeig de la Vall d'Hebron, 119-129, 08035 Barcelona, Spain
| | - M T Hernández
- Hematology Department, H. U. de Canarias, Ctra. Ofra, s/n, 38320 San Cristóbal de La Laguna, Santa Cruz de Tenerife, Spain
| | - I Oiartzabal
- Hematology Department, H. U. Txagorritxu, c/ Jose Atxotegi, s/n, 01009 Vitoria-Gasteiz, Álava, Spain
| | - R Fernández Ordoño
- Hematology Department, H.U. Infanta Leonor, Avenida Gran Vía del Este, 80, 28031 Madrid, Spain
| | - M Arnao
- Hematology Department, H.U. de La Ribera, Carretera Corbera, km 1, 46600 Alzira, Valencia, Spain
| | - A Esquerra
- Hematology Department, C.S. Parc Taulí, Parc Taulí, 1, 08208 Sabadell, Barcelona, Spain
| | - J Sarrá
- Hematology Department, Catalan Institute of Oncology, IDIBELL, Hospital Duran i Reynals, Avinguda Granvia de l'Hospitalet, 199-203 08908 l'Hospitalet de Llobregat, Barcelona, Spain
| | - E González-Barca
- Hematology Department, Catalan Institute of Oncology, IDIBELL, Hospital Duran i Reynals, Avinguda Granvia de l'Hospitalet, 199-203 08908 l'Hospitalet de Llobregat, Barcelona, Spain
| | - J González
- Hematology Department, H.U. Virgen del Rocío, Avenida Manuel Siurot, s/n, 41013 Sevilla, Spain
| | - X Calvo
- Hematology Department, Hospital Clínic de Barcelona, Carrer Villarroel, 170, 08036 Barcelona, Spain
| | - M Nomdedeu
- Hematology Department, Hospital Clínic de Barcelona, Carrer Villarroel, 170, 08036 Barcelona, Spain
| | - A García Guiñón
- Hematology Department, H.U. Arnau de Vilanova, Avenida Alcalde Rovira Roure, 80, 25198 Lleida, Spain
| | - A Ramírez Payer
- Hematology Department, H.U. Central de Asturias, Calle Carretera de Rubín, s/n, 33011 Oviedo, Spain
| | - A Casado
- U. Autónoma de Madrid, Dynamic Science S.L., c/Azcona, 31, 28028 Madrid, Spain
| | - S López
- Celgene S.L.U., Paseo de Recoletos, 37, 28004 Madrid, Spain
| | - M Durán
- Celgene S.L.U., Paseo de Recoletos, 37, 28004 Madrid, Spain
| | - M Marcos
- Celgene S.L.U., Paseo de Recoletos, 37, 28004 Madrid, Spain
| | - A J Cruz-Jentoft
- Geriatric Department, H.U. Ramón y Cajal, Ctra. de Colmenar Viejo, km. 9,100, 28034 Madrid, Spain
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14
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Mercadal S, Climent F, Domingo-Doménech E, Oliveira A, Romagosa V, de Sevilla AF, González-Barca E. Clinical Characteristics and Risk of Relapse for Patients with Stage I-II Diffuse Large B-cell Lymphoma Treated in First Line with Immunochemotherapy. Clin Med Insights Blood Disord 2013; 6:23-7. [PMID: 25512717 PMCID: PMC4222304 DOI: 10.4137/cmbd.s12713] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Diffuse large b-cell lymphoma (DLBCL) is an aggressive and potentially curable lymphoma that presents itself as stage I–II in 30% of all cases. It is known that in these localized stages, 15–20% of patients treated without rituximab eventually relapse, but less data exist regarding rituximab era. We have analyzed clinico-pathological features and risk of relapse in 98 patients with I–II stage DLBCL in complete response (CR) or unconfirmed CR (CRu) after first-line treatment consisting of immunochemotherapy. Twelve patients (12.2%) eventually relapsed. Late relapse, more than two years after diagnosis, occurred in three patients, and early relapse, less than two years after diagnosis, was documented in nine patients. Median time from diagnosis to relapse was 0.61 years for patients with early relapse and 3.66 years for patients with late relapse. The second CR rate obtained was similar in the late and in early relapsing patients, being 33% versus 44% (p = 0.072), respectively. Three-year overall survival (OS) was 22% for early relapsing patients and 33% for late relapsing patients (p = 0.65). In conclusion, patients who are diagnosed with stage I-II DLBCL and achieve a CR/CRu with first line immunochemotherapy have a good prognosis. However, a proportion of patients relapse, and this is less frequent in patients treated with first line with immunochemotherapy. These patients have a poor prognosis.
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Affiliation(s)
- S Mercadal
- Department of Hematology, L'Hospitalet, Barcelona, Spain
| | - F Climent
- Department of Pathology, L'Hospitalet, Barcelona, Spain
| | | | - A Oliveira
- Department of Hematology, L'Hospitalet, Barcelona, Spain
| | - V Romagosa
- Department of Pathology, L'Hospitalet, Barcelona, Spain
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15
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Cortés Romera M, Gámez Cenzano C, Caresia Aróztegui A, Martín-Comín J, González-Barca E, Ricart Brulles Y, Palacios Abufón A, Robles Barba J, Rodríguez-Bel L, Rossi Seoane S, Fernández de Sevilla A. Utility of the PET–CT in the evaluation of early response to treatment in the diffuse large B-cell lymphoma. Preliminary results. Rev Esp Med Nucl Imagen Mol 2012. [DOI: 10.1016/j.remnie.2012.05.004] [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: 11/15/2022]
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16
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Gudiol C, Bodro M, Simonetti A, Tubau F, González-Barca E, Cisnal M, Domingo-Domenech E, Jiménez L, Carratalà J. Changing aetiology, clinical features, antimicrobial resistance, and outcomes of bloodstream infection in neutropenic cancer patients. Clin Microbiol Infect 2012; 19:474-9. [PMID: 22524597 DOI: 10.1111/j.1469-0691.2012.03879.x] [Citation(s) in RCA: 172] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Recent changes in the management of patients with haematological malignancies might have influenced the aetiology, characteristics, antimicrobial resistance and outcomes of bloodstream infection (BSI) during neutropenia. We compared 272 episodes of BSI in adult neutropenic patients with cancer prospectively collected from January 1991 to December 1996 (first period), when quinolone prophylaxis was used, with 283 episodes recorded from January 2006 to March 2010 (second period), when antibacterial prophylaxis was stopped. Patients in the second period were significantly older and were more likely to have graft-versus-host disease and a urinary catheter in place, whereas the presence of a central venous catheter, parenteral nutrition, corticosteroids and antifungal and quinolone prophylaxis, were more frequent in the first period. More patients in the first period had mucositis and soft-tissue infection as the origin of BSI, but an endogenous source was more common during the second. Gram-positive BSI was more frequent in the first period (64% versus 41%; p <0.001), mainly due to coagulase-negative staphylococci and viridans group streptococci. In the second period gram-negative BSI increased (28% versus 49%; p <0.001), quinolone susceptibilities were recovered, but multidrug-resistant gram-negative BSI also increased (1% versus 6%; p <0.001). Although patients in the second period were more likely to need admission to the intensive-care unit, overall case-fatality rate was similar in the two periods (19% versus 15%). The aetiology of BSI in neutropenic patients with cancer has shifted from gram-positive to gram-negative organisms. Multidrug resistance among gram-negative bacilli is emerging as a therapeutic challenge. Overall case-fatality rate remains high.
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Affiliation(s)
- C Gudiol
- Infectious Disease Service, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Hospital Universitari de Bellvitge, University of Barcelona, Barcelona, Spain.
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17
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Cortés Romera M, Gámez Cenzano C, Caresia Aróztegui AP, Martín-Comín J, González-Barca E, Ricart Brulles Y, Palacios Abufón A, Robles Barba J, Rodríguez-Bel L, Rossi Seoane S, Fernández de Sevilla A. Utility of the PET-CT in the evaluation of early response to treatment in the diffuse large B-cell lymphoma. Preliminary results. Rev Esp Med Nucl Imagen Mol 2011; 31:135-41. [PMID: 21944191 DOI: 10.1016/j.remn.2011.05.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2011] [Revised: 05/19/2011] [Accepted: 05/23/2011] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To assess the role of FDG-PET/CT performed after the first cycles of chemotherapy in the prediction of response to treatment in patients with diffuse large B-cell lymphoma. METHODS Twenty patients (mean age: 48 years) were included, 16 initial staging and 4 relapse. All patients underwent PET/CT at 3 times: 1) Baseline, 2) After 1-3 cycles of chemotherapy (early response assessment), and 3) End of treatment (evaluation of final response). Early PET/CT findings were correlated to the end-treatment PET/CT and follow-up. The evaluation of the response was established according to the decrease in uptake of the lesions (SUVmax). In the early assessment, a good response indicator (GRI) was obtained when the lesion disappeared or had more than 50% reduction in SUVmax. At the end of the treatment, a complete metabolic response (CMR) was determined in negative PET scans. Follow-up was superior to 19 months and final outcome was established as progression/relapse or no evidence of disease (NED). RESULTS At the early treatment evaluation, 16/16 patients of initial staging (100%) and 2/4 of relapse (50%) achieved GRI. At the end of treatment evaluation, 14/16 patients of initial staging with GRI achieved CMR and 1/16 PMR: 14 were alive with NED in the follow-up while 1 relapsed. In the second group, 2/2 patients with GRI achieved CMR (100%): 1 continued with NED in the follow-up and another relapsed. CONCLUSION FDG-PET/CT after the first cycles of chemotherapy is useful to monitor treatment due to its high negative predictive value (87.5%), using it to modify treatment early in the non-responders.
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Affiliation(s)
- M Cortés Romera
- Unitat PET, Institut de Diagnòstic per la Imatge (IDI), Hospital Universitari de Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.
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18
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Calvo-Villas JM, Martín A, Conde E, Pascual A, Heras I, Varela R, de la Rubia J, Ramirez MJ, Díez-Martín JL, Panizo C, Rodríguez-Salazar MJ, Pascual MJ, Donato EM, González-Barca E, Caballero MD. Effect of addition of rituximab to salvage chemotherapy on outcome of patients with diffuse large B-cell lymphoma relapsing after an autologous stem-cell transplantation. Ann Oncol 2010; 21:1891-1897. [PMID: 20231299 DOI: 10.1093/annonc/mdq035] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND We have investigated if rituximab-based salvage regimens improve response rates and survival of patients with diffuse large B-cell lymphoma (DLBCL) relapsing after an autologous stem-cell transplantation (ASCT). PATIENTS AND METHODS We have retrospectively analyzed 82 patients with DLBCL who received salvage therapy for relapse or progression after ASCT. Patients were divided into two groups, according to whether rituximab-based salvage regimens were given (n = 42, 'R-' group) or not (n = 40, 'R+' group) after ASCT. RESULTS Patients in the R+ group had better complete remission (CR) (55% versus 21.4%, P = 0.006) and overall response (OR) (75% versus 40.4%, P = 0.001) rates, and better 3-year event-free survival (EFS) (37% versus 9%, P = 0.002) and overall survival (OS) (50% versus 20%, P = 0.005) than patients in the R- group. Patients retreated with rituximab had better CR (42.9% versus 21.4%, P = 0.032) and OR (66.7% versus 40.4%, P = 0.019) rates, and better OS (36.2% versus 20% at 3 years, P = 0.05) and EFS (36.2% versus 9% at 3 years, P = 0.05) than patients who received chemotherapy alone at relapse after ASCT. CONCLUSIONS The addition of rituximab to salvage chemotherapy improves response rates and EFS in patients with relapsed DLBCL after ASCT. These patients may benefit from rituximab retreatment, although larger prospective studies are needed to confirm these results.
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Affiliation(s)
- J M Calvo-Villas
- Department of Hematology, Hospital Doctor José Molina Orosa, Arrecife de Lanzarote.
| | - A Martín
- Department of Hematology, Complejo Asistencial de Zamora, Zamora
| | - E Conde
- Department of Hematology, Hospital Marqués de Valdecilla, Santander
| | - A Pascual
- Department of Hematology, Hospital Clinico Universitario San Carlos, Madrid
| | - I Heras
- Department of Hematology, Hospital Morales Meseguer, Murcia
| | - R Varela
- Department of Hematology, Hospital Juan Canalejo, La Coruña
| | | | - M J Ramirez
- Department of Hematology, Hospital General de Jerez, Jerez de la Frontera
| | | | - C Panizo
- Department of Hematology, Clínica Universitaria de Navarra, Pamplona
| | | | - M J Pascual
- Department of Hematology, Hospital Carlos Haya, Malaga
| | - E M Donato
- Department of Hematology, Hospital General de Castellón, Castellón
| | - E González-Barca
- Department of Hematology, Institut Catalá d'Oncología-Hospital Duran i Reynals, L'Hospitalet de Llobregat
| | - M D Caballero
- Department of Hematology, Hospital Clínico Universitario, Salamanca, Spain
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Oliveira AC, Domingo-Domenech E, Arnan M, Gallardo D, Puig I, González-Barca E. All-trans retinoic acid-induced myositis in a case of acute promyelocytic leukaemia. Int J Lab Hematol 2008; 30:254-5. [PMID: 18205843 DOI: 10.1111/j.1751-553x.2007.00933.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Domingo-Domènech E, de Sanjosé S, González-Barca E, Romagosa V, Domingo-Clarós A, Gil-Vernet S, Figueras J, Manito N, Otón B, Petit J, Grañena A, Fernández de Sevilla A. Post-transplant lymphomas: a 20-year epidemiologic, clinical and pathologic study in a single center. Haematologica 2001; 86:715-21. [PMID: 11454526] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023] Open
Abstract
BACKGROUND AND OBJECTIVES To study the incidence, clinical presentation, pathologic features and outcome of post-transplant lymphomas (PTL) during the past 20 years. DESIGN AND METHODS We undertook a descriptive study of all biopsy-proven cases of PTL diagnosed in our hospital from 1979 through 1999. The average annual incidence rate of PTL was analyzed at 5-year intervals from 1979 to 1999. Risk ratios were estimated by comparing the incidence of PTL among transplanted patients with that of lymphoma observed in the general population of the region. Survival analysis was performed at the univariate level using the Kaplan Meier technique and at the multivariate level by Cox hazard models. RESULTS Seventeen of 1,860 transplanted patients developed a PTL (0.9%). The risk of PTL was calculated to be almost 8-fold higher than the risk of lymphoma in the general population. The risk was highest among those who had received a heart transplant (RR=35.6). The mean time between transplant and the diagnosis of PTL was 31 +/- 29 months. Of all PTL, 88% were of B-cell origin and 53% of the cases tested were Epstein-Barr virus (EBV)-positive. The median survival was 24 months. The majority of patients with allograft involvement died within the 2 months following diagnosis (hazard ratio 5.3; 95% CI 1.4-20.7). INTERPRETATION AND CONCLUSIONS Organ transplantation is a major risk factor for the development of lymphoma, a disease with a particularly bad prognosis when it develops at the site of the allograft. Early diagnosis and more specific treatment may improve PTL survival.
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Affiliation(s)
- E Domingo-Domènech
- Department of Clinical Hematology, Institut Català d'Oncologia, Barcelona, Spain.
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González-Barca E, Carratalá J, Mykietiuk A, Fernández-Sevilla A, Gudiol F. Predisposing Factors and Outcome of Staphylococcus aureus Bacteremia in Neutropenic Patients with Cancer. Eur J Clin Microbiol Infect Dis 2001. [DOI: 10.1007/s100960000431] [Citation(s) in RCA: 6] [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: 10/27/2022]
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González-Barca E, Carratalà J, Mykietiuk A, Fernández-Sevilla A, Gudiol F. Predisposing factors and outcome of Staphylococcus aureus bacteremia in neutropenic patients with cancer. Eur J Clin Microbiol Infect Dis 2001; 20:117-9. [PMID: 11305464 DOI: 10.1007/pl00011241] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Staphylococcus aureus caused 30 of 438 (7%) cases of bacteremia in neutropenic patients with cancer during a 10-year study period. Acute leukemia as an underlying disease and severe oral mucositis were more frequent among patients with Staphylococcus aureus bacteremia (57% vs. 33%, P = 0.01, and 32% vs. 12%, P = 0.006, respectively) than among the 151 patients who had gram-negative bacteremia during the same study period. The most frequent source of Staphylococcus aureus bacteremia was the venous catheter (35% vs. 1%; P = 0.00001). Septic metastases were more frequent in patients with Staphylococcus aureus bacteremia (14% vs. 4%, P = 0.03). Attributable mortality was 10% and overall mortality 23%. Staphylococcus aureus bacteremia remains a significant cause of morbidity and mortality in neutropenic patients with cancer.
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Affiliation(s)
- E González-Barca
- Department of Hematology, Institut Catalá d'Oncología, Hospital Duran i Reynals, Ciutat Sanitaria i Universitària de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.
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González-Barca E, Fernández de Sevilla A, Domingo-Claros A, Romagosa V, Martín-Henao GA, De Sanjose S, Carmona M, Petit J, García J, Grañena A. Autologous stem cell transplantation (ASCT) with immunologically purged progenitor cells in patients with advanced stage follicular lymphoma after early partial or complete remission: toxicity, follow-up of minimal residual disease and survival. Bone Marrow Transplant 2000; 26:1051-6. [PMID: 11108302 DOI: 10.1038/sj.bmt.1702660] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The role of autologous stem cell transplant (ASCT) in indolent lymphomas is a controversial issue. From 1994 to 1999, we performed ASCT with immunologically purged progenitor cells in 15 patients with advanced stage follicular lymphoma (FL) after early partial or complete remission. Results of the purging strategy and follow-up of minimal residual disease after transplant were analyzed with PCR amplification of bcl-2/IgH rearrangement for the t(14;18) translocation. A comparison of transplanted patients with a group of controls was carried out to evaluate differences in progression-free survival and overall survival. Eighty percent of patients received one chemotherapy regimen before ASCT and were in first remission. All the patients received cyclophosphamide plus hyperfractionated total body irradiation as the conditioning regimen. Nine patients were transplanted with bone marrow (BM) and six with peripheral blood progenitor cells (PBPC). Engraftment was delayed in one patient transplanted with BM. Two patients died during the transplant procedure. Ten of 12 evaluable patients were PCR positive in the BM for bcl-2 rearrangement at diagnosis. Six of them (60%) were still positive after chemotherapy, and one patient was transplanted with a positive hematopoietic product after purging. With a median follow-up of 27 months, six of eight evaluable patients still remain PCR negative in the BM. With a median follow-up of 4.7 years from diagnosis, progression-free survival was 83% (95% CI: 63-100). The risk of disease progression of non-transplanted patients was 19.2 times higher than that of transplanted patients (P = 0.01), but no differences were found in overall survival. Regarding patients in first remission, the risk of relapse was 12.6 times higher in non-transplanted than in transplanted patients (P = 0.04). This procedure seems to offer a good chance to achieve a PCR-negative state and prolonged freedom from recurrence. According to these results, prospective randomized trials are warranted.
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Affiliation(s)
- E González-Barca
- Department of Clinical Hematology, Hospital Duran i Reynals, Institut Catalá d'Oncologìa, Barcelona, Spain
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Marron A, Carratalà J, González-Barca E, Fernández-Sevilla A, Alcaide F, Gudiol F. Serious complications of bacteremia caused by Viridans streptococci in neutropenic patients with cancer. Clin Infect Dis 2000; 31:1126-30. [PMID: 11073739 DOI: 10.1086/317460] [Citation(s) in RCA: 116] [Impact Index Per Article: 4.8] [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: 11/12/1999] [Revised: 02/23/2000] [Indexed: 11/03/2022] Open
Abstract
We prospectively studied 485 episodes of bacteremia in neutropenic patients with cancer. Viridans streptococci caused a total of 88 episodes (18%). Ten (11%) of these 88 cases were associated with serious complications: acute respiratory distress syndrome (ARDS) plus septic shock (5 cases), ARDS (3), and septic shock (2). Streptococcus mitis was the species most frequently isolated (7 of 10 episodes). Four viridans streptococci showed a diminished susceptibility to penicillin (MICs ranged from 0.25 to 4 microg/mL), and 5 strains were resistant to ceftazidime (MICs ranged from 2 to >32 microg/mL). Patients with viridans streptococcal bacteremia (VSB) who developed serious complications were compared with patients with VSB without complications. Severe oral mucositis (70% vs. 32.5%, respectively; P=.036), high-dose chemotherapy with cyclophosphamide (60% vs. 25%, respectively; P=.043), and allogeneic bone marrow transplantation (40% vs. 10%, respectively; P=.040) were the only variables found to be significantly associated with the development of complications. Neither a specific species of viridans streptococci nor resistance to penicillin was associated with the occurrence of complications. The mortality rate was higher in case patients than in control patients (80% vs. 17.5%, respectively; P<.001). Serious complications associated with VSB occur mainly in patients receiving high-dose chemotherapy with cyclophosphamide before allogeneic bone marrow transplantation who develop severe oral mucositis; these complications are associated with a high mortality rate.
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Affiliation(s)
- A Marron
- Service of Infectious Diseases, Ciutat Sanitària i Universitària de Bellvitge, Institut Català d'Oncologia, University of Barcelona, Spain
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Domènech E, Villén E, González-Barca E, Querol S, García J, Rueda F. Serum-free culture conditions for the generation of dendritic cells from cord blood CD34+ hematopoietic progenitors: phenotypic and functional analysis. Haematologica 2000; 85:989-90. [PMID: 10980642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
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González-Barca E, Fernández-Sevilla A, Carratalá J, Salar A, Peris J, Grañena A, Gudiol F. Prognostic factors influencing mortality in cancer patients with neutropenia and bacteremia. Eur J Clin Microbiol Infect Dis 1999; 18:539-44. [PMID: 10517190 DOI: 10.1007/s100960050345] [Citation(s) in RCA: 65] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The purpose of this study was to identify risk factors for mortality in neutropenic patients with cancer and bacteremia. A consecutive sample of 438 neutropenic patients (granulocyte count <0.5 x 10(9)/l) with cancer and bacteremia was studied to identify the clinical characteristics associated with mortality at the onset of bacteremia. The mean age of the subjects was 48 years (range, 15-87 years). Most cases of bacteremia (77%) were hospital-acquired and occurred in patients with acute leukemia (48%). Gram-positive organisms caused 233 (53%) episodes of bacteremia, gram-negative organisms caused 151 (34%) episodes, and 48 (11%) episodes were polymicrobial. The overall mortality within 30 days of the onset of bacteremia was 24.4%. The variables found to be independently associated with increased mortality using logistic regression techniques were as follows: shock at the onset of bacteremia (OR, 10; 95% CI, 4.2-23.8), pneumonia (OR,4.4; 95% CI, 1.9-10), uncontrolled cancer (OR,4.3; 95% CI, 1.5-12.7), and absence of prophylaxis with norfloxacin (OR,2.4; 95% CI, 1.3-4.5). The prognostic factors ascertained in this study may help to identify those patients at higher risk of death. Medical intervention addressing some of these factors may improve the outcome of bacteremia in neutropenic patients with cancer.
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Affiliation(s)
- E González-Barca
- Department of Hematology, Institut Catalá d'Oncología, Hospital Duran i Reynals, Ciutat Sanitaria i Universitària de Bellvitge, Barcelona, Spain.
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González-Barca E, Grañena A, Fernández-Sevilla A, Moreno V, Salar A, Rueda F, García J. Low-dose subcutaneous interleukin-2 in patients with minimal residual lymphoid neoplasm disease. Eur J Haematol Suppl 1999; 62:231-8. [PMID: 10227456 DOI: 10.1111/j.1600-0609.1999.tb01752.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Interleukin-2 (IL-2) is a cytokine that became available for clinical use with the development of recombinant DNA technology. Patients with resistant or relapsed lymphoid neoplasm have been treated with high-dose IL-2 with some responses. The aim of the present study is to determine whether there may be a biological justification for the use of low dose subcutaneous (s.c.) IL-2 as maintenance therapy in patients with lymphoid neoplasm in complete remission with high risk of relapse. We treated 15 patients with sc IL-2, 4.5 Million International Units (MIU) daily, 5 days per week for 12 consecutive weeks, in the outpatient clinic. This therapy was well tolerated and could be administered in an outpatient regimen. It increased the eosinophil count (p = 0.009), but the number of granulocytes, monocytes, T-lymphocytes and B-lymphocytes did not change. The number of natural killer (NK) cells increased from 11% to 35% of all lymphocytes during IL-2 therapy (p = 0.0006). Effector lymphokine-activated killer activity (eLAK) also increased from 6x10(-3) Lytic Units (LU)/ml to 80x10(-3) LU/ml (p = 0.02). All these changes reached a "plateau" after the 4th week of therapy. The increase in the number of NK cells correlated strongly with the increase in eLAK activity (r = 0.96, p<0.0001). Disease-free survival was determined in 14 patients who completed the treatment and compared with historical controls. Patients treated with IL-2 had the same relapse risk (median time to relapse 11.1 months, 95% confidence interval 5.5-16.6) as did controls (median time to relapse 9.7 months, 95% confidence interval 1-27.7) (p = 0.9). Low dose s.c. IL-2 stimulated NK proliferation, which generated cytotoxic activity in vivo in patients with lymphoid neoplasms. However, these patients did not have a lower risk of disease relapse compared to historical controls.
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Affiliation(s)
- E González-Barca
- Department of Hematology, Institut Catalá d'Oncología, Hospital Duran i Reynals, Ciutat Sanitaria i Universitària de Bellvitge, Barcelona, Spain
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Martín-Henao GA, Picón M, Limón A, Carmona M, Amill B, Azqueta C, López R, González-Barca E, Grañena A, Brunet S, García J. Immunomagnetic bone marrow (BM) and peripheral blood progenitor cell (PBPC) purging in follicular lymphoma (FL). Bone Marrow Transplant 1999; 23:579-87. [PMID: 10217189 DOI: 10.1038/sj.bmt.1701612] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Twenty-nine B cell follicular lymphoma (FL) patients had their BM (n = 12) or PBPC (n = 17) purged using a panel of monoclonal antibodies and immunomagnetic beads (IMB). The median recovery of nucleated cells (NC) and CD34+ cells was 59.3% (40.5-74) and 56.1% (30.8-82.9) in BM and 77.2% (64.7-88.3) and 73.5% (61.5-98.6) in PBPC (P<0.0005). A median of >1.62 and >1.02 log of target cell depletion was achieved as judged by flow cytometry analysis in BM and PBPC, respectively. Of 29% of initial harvests that had a bcl2 PCR-amplified signal, 37.5% became PCR negative in the final purged products. Absorbed cells containing IMB-target cell complexes gave bcl2 rearrangement signal in 20% of samples in which the start and final purged components were negative. Twenty-three of 26 patients receiving an autologous purged product are evaluable for engraftment. Median time to reach an ANC >0.5x10(9)/l and platelet count >20x10(9)/l was 21 (11-43) and 41 days (13-70) for BM (n = 9) and 14 (10-31) and 14 (8-37) for PBPC (n = 14) autografted patients (P = 0.01 and 0.001). One patient did not engraft and was rescued with a back-up BM. These data demonstrate that this indirect immunomagnetic technique is able to achieve a high grade of lymphoma cell depletion in BM and PBPC and that these purged products are capable of rapid engraftment after autologous transplantation.
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Affiliation(s)
- G A Martín-Henao
- Department of Cryobiology and Cell Therapy, Cancer Research Institute, Barcelona, Spain
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Salar A, Fernández de Sevilla A, Romagosa V, Domingo-Claros A, González-Barca E, Grañena A. [Peripheral T-cell lymphomas without primary skin involvement. An anatomicoclinical study of 29 consecutive cases]. Med Clin (Barc) 1999; 112:255-6. [PMID: 10220752] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
BACKGROUND To analyze peripheral non-cutaneous T-cell lymphomas (NC-TCL) and to test the significance of the IPI. PATIENTS AND METHODS Twenty-nine consecutive patients diagnosed with NC-TCL according to the REAL classification. RESULTS At diagnosis were common: B symptoms (21%), stage III/IV (55%), high LDH level (55%) and extranodal involvement (79%). Twelve (48%) patients achieved complete remission. The IPI identified groups of patients with different response to therapy and survival. CONCLUSIONS NC-TCL with high or high-intermediate IPI had a short survival if treated with CHOP.
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Affiliation(s)
- A Salar
- Servicio de Hematología Clínica, Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona.
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Marín D, González-Barca E, Domingo E, Berlanga J, Grañena A. Noninvasive mechanical ventilation in a patient with respiratory failure after hematopoietic progenitor transplantation. Bone Marrow Transplant 1998; 22:1123-4. [PMID: 9877278 DOI: 10.1038/sj.bmt.1701487] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Respiratory failure requiring orotracheal intubation (OTI) and mechanical ventilation (MV) is almost always a fatal complication in patients who undergo hematopoietic progenitor transplantation (HPT). We present the case of a woman who suffered respiratory failure with bilateral infiltrates on a chest X-ray taken on day +14 following autologous bone marrow transplantation. We managed the patient satisfactorily with noninvasive ventilation, avoiding OTI. We believe that patients with non-progressive pulmonary lesions and without multiple system organ failure, may be correctly managed with noninvasive positive-pressure ventilation (NPPV).
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Affiliation(s)
- D Marín
- Clinical Hematology Service, Ciutat Sanitaria i Universitaria de Bellvitge, Hospital Duran i Reynals, Institut Catalá d'Oncologia, Barcelona, Spain
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Salar A, Carratalà J, Zurita A, González-Barca E, Grañena A. Bacteremia caused by CDC group IV c-2 in a patient with acute leukemia. Haematologica 1998; 83:670-2. [PMID: 9718879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Human infection due to CDC group IV c-2, a gram negative bacillous, are rare. We describe a case of nosocomial bacteremia caused by this organism in a neutropenic patient with acute lymphoblastic leukemia and include a literature review of CDC group IV c-2 infection in patients with hematologic malignancies.
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Salar A, Fernández de Sevilla A, Romagosa V, Domingo-Claros A, González-Barca E, Pera J, Climent J, Grañena A. Diffuse large B-cell lymphoma: is morphologic subdivision useful in clinical management? Eur J Haematol Suppl 1998; 60:202-8. [PMID: 9580245 DOI: 10.1111/j.1600-0609.1998.tb01023.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The diffuse large B-cell lymphoma category of the REAL classification encompasses different morphologic lymphoma subtypes in a single entity. The aim of this study is to determine the influence of the morphologic subdivision within this category with respect to clinical features and response to treatment. From January 1993 to October 1996, 132 patients were diagnosed de novo with diffuse large B-cell lymphoma in our institution. All cases were classified according to the REAL and the Updated Kiel classifications, and immunohistochemical study was performed in all of them. Sixty-three per cent of patients received chemotherapy with a curative approach. Of the 105 assessable patients, 80 cases (74%) were classified as centroblastic (CB) and 25 cases (26%) as immunoblastic (IB), according to the updated Kiel classification. These 2 subsets of lymphomas did not differ with respect to major clinical features and laboratory parameters. Both groups had a similar complete response rate with a uniform therapeutic approach and the overall 2-yr survival did not show statistical differences (49% in CB vs. 45% in IB). In conclusion, for clinicians, morphologic subdivision of the diffuse large B-cell lymphoma category into CB and IB subtypes has little clinical and prognostic significance.
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Affiliation(s)
- A Salar
- Department of Clincal Haematology, Institut Català d'Oncologia and Hospital Príncipes de España (Ciudad Sanitaria y Universitaria de Bellvitge), Barcelona, Spain.
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Salar A, Fernández de Sevilla A, Romagosa V, Domingo-Claros A, González-Barca E, de Sanjosé S, Pera J, Servitje O, Grañena A. Distribution and incidence rates of lymphoid neoplasms according to the REAL classification in a single institution. A prospective study of 940 cases. Eur J Haematol 1997; 59:231-7. [PMID: 9338621 DOI: 10.1111/j.1600-0609.1997.tb00982.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Recently, a new classification system for lymphoid neoplasms, known as the REAL classification, has been proposed. Our aim is to know the distribution of lymphoid neoplasms according to this schema and compare it with the Updated Kiel classification. We also estimate incidence rates of lymphoid neoplasms in our area. From January 1993 to November 1996, 940 patients were diagnosed of lymphoid neoplasm in our center. Histologic material was prospectively classified according to both the REAL and the Updated Kiel classifications. According to the REAL classification, distribution of all cases of lymphoid neoplasms was as follows: 73.6% B-cell neoplasm, 9.4% T-cell neoplasms, 9.6% Hodgkin's disease and 7.4% unclassifiable. Considering only non-Hodgkin's lymphomas (NHL), 87.2% of cases could be categorized according to the REAL and 77.7% with the Updated Kiel classification. These figures differed due to unrecognized categories in the Kiel schema. Annual incidence rate per 100,000 inhabitants was 20.1 for lymphoid neoplasms, and NHL alone was 9.0. In conclusion, the REAL classification allowed us to categorize more cases of NHL than did the Updated Kiel classification, fundamentally because of the inclusion of some recently described entities.
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Affiliation(s)
- A Salar
- Department of Clinical Hematology, Hospital Príncipes de España (Ciudad Sanitaria y Universitaria de Bellvitge), Barcelona, Spain.
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González-Barca E, Querol S, Grañena A, Sarra J, Sirchia G, García J. Umbilical cord blood transplantation from unrelated donors in an adult weighing 90 kilograms. Role of immunosuppression in engraftment. Bone Marrow Transplant 1997; 20:333-6. [PMID: 9285549 DOI: 10.1038/sj.bmt.1700880] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
A 40-year-old male weighing 90 kilograms was diagnosed with acute myeloblastic leukaemia M5a which was resistant to chemotherapy. Neither a related nor an unrelated HLA-compatible bone marrow donor could be found. A unit of cord blood was found with an HLA compatibility of four out of six loci, and was infused after conditioning with cyclophosphamide, total body irradiation and antilymphocyte globulin. The infused cord blood had 0.98 x 10(7) nucleated cells per kilogram. On day 35 after infusion the patient was considered to have graft failure. A second unit of cord blood was found, and after 3 days of antilymphocyte globulin, it was infused (day 41). The course was complicated by severe hypoxia and bilateral interstitial pulmonary infiltrates, and the patient was treated with high doses of methylprednisolone. On day 58 the leukocyte count increased to 3 x 10(9)/l, and there was total chimerism of the first cord blood unit infused. Two weeks later leukocyte counts decreased progressively and the patient died of a disseminated fungal infection. We discuss the importance of the number of nucleated cells per kilogram of body weight infused, and the role of intensive immunosuppression in engraftment of cord blood transplantations in adults.
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Affiliation(s)
- E González-Barca
- Servicio de Hematología Clínica, Hospital Duran y Reynals, Institut Catalá d'Oncología, Ciudad Sanitaria Bellvitge, Barcelona, Spain
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González-Barca E, Ardanuy C, Carratalá J, Sanchez A, Fernández-Sevilla A, Grañena A. Fatal myofascial necrosis due to imipenem-resistant Aeromonas hydrophila. Scand J Infect Dis 1997; 29:91-2. [PMID: 9112306 DOI: 10.3109/00365549709008672] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
We report the case of a fatal myofascial necrosis caused by an imipenem-resistant Aeromonas hydrophila in a patient with a history of aplastic anemia. He presented with fever and left thigh tenderness. The CT scan was consistent with cellulitis and, after cultures were obtained, empirical treatment with imipenem and amikacin was started. Two days later, necrotic bullae appeared on his thigh, and cultures showed Aeromonas hydrophila which was imipenem-resistant. Although surgical debridement was performed and ciprofloxacin was initiated, the patient died.
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Affiliation(s)
- E González-Barca
- Department of Hematology, Hospital Duran i Reynals, Barcelona, Spain
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Domingo A, González-Barca E, Castellsagué X, Fernandez-Sevilla A, Grañena A, Crespo N, Ferrán C. Expression of adhesion molecules in 113 patients with B-cell chronic lymphocytic leukemia: relationship with clinico-prognostic features. Leuk Res 1997; 21:67-73. [PMID: 9029188 DOI: 10.1016/s0145-2126(96)00076-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The B-cell chronic lymphocytic leukemia (B-CLL) is a heterogeneous disease, its clinical and biological behavior possibly being influenced by surface molecules expressed in B-lymphocytes. These molecules mediate cell adhesion, mobility and homing. Expression of surface adhesion molecules of the integrin family (CD11a/CD18 or LFA-1, CD11c/CD18), of the immunoglobulin-related family (CD54), of the selectin family (CD62L or LAM-1) and the lymphocyte homing receptor (CD44) were analyzed in peripheral cells from 113 B-CLL patients. The association with three prognosis-related parameters (Rai stage, bone marrow pattern and doubling time) was determined. The study included only patients with B-CLL lymphocytes of typical morphology, which always expressed CD5 and CD23. Low expression of integrins, particularly CD18, was associated with advanced disease (Rai stages III-IV) and diffuse bone marrow pattern, even after adjusting for other prognosis-related variables. Expression of CD54 was associated independently with rapid doubling time (less than 12 months). The association persisted after adjusting for stage and bone marrow pattern; CD44 was expressed in all patients. No correlations were found between expression of CD62L and the prognostic variables analyzed. In conclusion, CD54 expression and low CD18 expression are both significantly associated with poor prognostic features.
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Affiliation(s)
- A Domingo
- Department of Haematology, Ciudad Sanitaria y Universitaria Bellvitge, Barcelona, Spain
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González-Barca E, Granena A. [Interleukin 2: a step forward in the treatment of cancer]. Med Clin (Barc) 1996; 107:578-80. [PMID: 9064382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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González-Barca E, Fernández-Sevilla A, Carratalá J, Grañena A, Gudiol F. Prospective study of 288 episodes of bacteremia in neutropenic cancer patients in a single institution. Eur J Clin Microbiol Infect Dis 1996; 15:291-6. [PMID: 8781879 DOI: 10.1007/bf01695660] [Citation(s) in RCA: 81] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Trends in causative organisms and sources of infection were studied in a series of 288 episodes of bacteremia in neutropenic cancer patients observed in a single institution from 1986 to 1993. The incidence of bacteremia increased significantly from 20 episodes per 1000 admissions in 1986 to 50 episodes per 1000 admissions in 1993 (p = 0.00001). Over the study period, a continuous increment in gram-positive bacteremia, which reached 81% of episodes in 1993 (p = 0.000001), was observed. Conversely, the incidence of gram-negative bacteremia remained stable. Coagulase-negative staphylococci and viridans group streptococci were the most commonly isolated pathogens. Bacteremia caused by coagulase-negative staphylococci increased from 3 episodes per 1000 admissions to 19 episodes per 1000 admissions (p = 0.0001), and viridans group streptococci bacteremia increased from 0 episodes per 1000 admissions to 19 episodes per 1000 admissions (p = 0.000001). The upward trend in gram-positive bacteremia appeared to be related to a significant increase in both intravascular catheters (p = 0.003) and oral mucositis (p = 0.003) as sources of infection. Specific strategies to prevent chemotherapy-induced mucositis and catheter-related bacteremia merit further investigations.
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Affiliation(s)
- E González-Barca
- Service of Hematology, Hospital Duran i Reynals, Ciutat Sanitaria i Universitaria de Bellvitge, Barcelona, Spain
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González-Barca E, Domingo A, Fernández de Sevilla A, Grañena A. [Clinical course of severe acquired aplastic anemia to myelodysplastic syndrome and acute leukosis]. Med Clin (Barc) 1995; 105:224-6. [PMID: 7658741] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Survival of patients with severe acquired aplastic anemia has improved dramatically during the past decade mainly due to the use of new treatments. The long-term follow-up of these patients has allowed to observe an increased incidence of late malignant hematological complications such as myelodysplastic syndromes and leukemia, which raises the question whether they are just different forms of presentation of the same disease. We report two cases of severe acquired aplastic anemia with long-time survival, one of them developed a myelodysplastic syndrome and the other one a myelodysplastic syndrome followed by an acute leukemia. We discuss the factors associated with a high risk to develop myelodysplastic syndrome and acute leukemia, and its repercussions in therapy.
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Affiliation(s)
- E González-Barca
- Servicio de Hematología, Ciudad Sanitaria y Universitaria de Bellvtge, Barcelona
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