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Tivey A, Shotton R, Eyre TA, Lewis D, Stanton L, Allchin R, Walter H, Miall F, Zhao R, Santarsieri A, McCulloch R, Bishton M, Beech A, Willimott V, Fowler N, Bedford C, Goddard J, Protheroe S, Everden A, Tucker D, Wright J, Dukka V, Reeve M, Paneesha S, Prahladan M, Hodson A, Qureshi I, Koppana M, Owen M, Ediriwickrema K, Marr H, Wilson J, Lambert J, Wrench D, Burney C, Knott C, Talbot G, Gibb A, Lord A, Jackson B, Stern S, Sutton T, Webb A, Wilson M, Thomas N, Norman J, Davies E, Lowry L, Maddox J, Phillips N, Crosbie N, Flont M, Nga E, Virchis A, Camacho RG, Swe W, Pillai A, Rees C, Bailey J, Jones S, Smith S, Sharpley F, Hildyard C, Mohamedbhai S, Nicholson T, Moule S, Chaturvedi A, Linton K. Ibrutinib as first-line therapy for mantle cell lymphoma: a multicenter, real-world UK study. Blood Adv 2024; 8:1209-1219. [PMID: 38127279 PMCID: PMC10912842 DOI: 10.1182/bloodadvances.2023011152] [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: 07/14/2023] [Revised: 11/07/2023] [Accepted: 11/14/2023] [Indexed: 12/23/2023] Open
Abstract
ABSTRACT During the COVID-19 pandemic, ibrutinib with or without rituximab was approved in England for initial treatment of mantle cell lymphoma (MCL) instead of immunochemotherapy. Because limited data are available in this setting, we conducted an observational cohort study evaluating safety and efficacy. Adults receiving ibrutinib with or without rituximab for untreated MCL were evaluated for treatment toxicity, response, and survival, including outcomes in high-risk MCL (TP53 mutation/deletion/p53 overexpression, blastoid/pleomorphic, or Ki67 ≥ 30%). A total of 149 patients from 43 participating centers were enrolled: 74.1% male, median age 75 years, 75.2% Eastern Cooperative Oncology Group status of 0 to 1, 36.2% high-risk, and 8.9% autologous transplant candidates. All patients received ≥1 cycle ibrutinib (median, 8 cycles), 39.0% with rituximab. Grade ≥3 toxicity occurred in 20.3%, and 33.8% required dose reductions/delays. At 15.6-month median follow-up, 41.6% discontinued ibrutinib, 8.1% due to toxicity. Of 104 response-assessed patients, overall (ORR) and complete response (CR) rates were 71.2% and 20.2%, respectively. ORR was 77.3% (low risk) vs 59.0% (high risk) (P = .05) and 78.7% (ibrutinib-rituximab) vs 64.9% (ibrutinib; P = .13). Median progression-free survival (PFS) was 26.0 months (all patients); 13.7 months (high risk) vs not reached (NR) (low risk; hazard ratio [HR], 2.19; P = .004). Median overall survival was NR (all); 14.8 months (high risk) vs NR (low risk; HR, 2.36; P = .005). Median post-ibrutinib survival was 1.4 months, longer in 41.9% patients receiving subsequent treatment (median, 8.6 vs 0.6 months; HR, 0.36; P = .002). Ibrutinib with or without rituximab was effective and well tolerated as first-line treatment of MCL, including older and transplant-ineligible patients. PFS and OS were significantly inferior in one-third of patients with high-risk disease and those unsuitable for post-ibrutinib treatment, highlighting the need for novel approaches in these groups.
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Affiliation(s)
- Ann Tivey
- The University of Manchester, Manchester, United Kingdom
- The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Rohan Shotton
- The University of Manchester, Manchester, United Kingdom
- The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Toby A. Eyre
- Oxford University Hospitals NHS Trust, Oxford, United Kingdom
| | - David Lewis
- Plymouth Hospitals NHS Trust, Plymouth, United Kingdom
| | | | - Rebecca Allchin
- University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - Harriet Walter
- University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - Fiona Miall
- University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - Rui Zhao
- Torbay Hospital, Torquay, United Kingdom
| | | | - Rory McCulloch
- Gloucestershire Hospitals NHS Foundation Trust, Gloucester, United Kingdom
| | - Mark Bishton
- University of Nottingham, Nottingham, United Kingdom
| | - Amy Beech
- Nottingham University Hospitals, Nottingham, United Kingdom
| | | | - Nicole Fowler
- Royal Cornwall Hospital NHS Trust, Truro, United Kingdom
| | | | - Jack Goddard
- Sheffield Teaching Hospitals, Sheffield, United Kingdom
| | - Sam Protheroe
- Stockport NHS Foundation Trust, Stockport, United Kingdom
| | | | - David Tucker
- Royal Cornwall Hospital NHS Trust, Truro, United Kingdom
| | - Josh Wright
- Sheffield Teaching Hospitals, Sheffield, United Kingdom
| | - Vasavi Dukka
- Stockport NHS Foundation Trust, Stockport, United Kingdom
| | - Miriam Reeve
- Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | - Shankara Paneesha
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Mahesh Prahladan
- East Suffolk and North Essex NHS Foundation Trust, Colchester, United Kingdom
| | - Andrew Hodson
- East Suffolk and North Essex NHS Foundation Trust, Colchester, United Kingdom
| | - Iman Qureshi
- University Hospital Coventry and Warwickshire NHS Foundation Trust, Coventry, United Kingdom
| | - Manasvi Koppana
- East Suffolk and North Essex NHS Foundation Trust, Colchester, United Kingdom
| | - Mary Owen
- Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | | | - Helen Marr
- Newcastle Teaching Hospitals NHS Foundation Trust, Newcastle, United Kingdom
| | - Jamie Wilson
- St Richard's Hospital, Chichester, United Kingdom
| | - Jonathan Lambert
- University College Hospital NHS Foundation Trust, London, United Kingdom
| | - David Wrench
- Guy's and St.Thomas' NHS Foundation Trust, London, United Kingdom
| | - Claire Burney
- University Hospitals Bristol NHS Trust, Bristol, United Kingdom
| | - Chloe Knott
- University Hospitals Bristol NHS Trust, Bristol, United Kingdom
| | - Georgina Talbot
- University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, United Kingdom
| | - Adam Gibb
- The Christie NHS Foundation Trust, Manchester, United Kingdom
| | | | | | - Simon Stern
- Epsom and St Helier University Hospitals NHS Trust, Carshalton, United Kingdom
| | - Taylor Sutton
- Gateshead Health NHS Foundation Trust, Gateshead, United Kingdom
| | - Amy Webb
- Harrogate and District NHS Foundation Trust, Harrogate, United Kingdom
| | - Marketa Wilson
- Harrogate and District NHS Foundation Trust, Harrogate, United Kingdom
| | - Nicky Thomas
- Harrogate and District NHS Foundation Trust, Harrogate, United Kingdom
| | - Jane Norman
- Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Elizabeth Davies
- Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Lisa Lowry
- Somerset NHS Foundation Trust, Taunton and Bridgwater, United Kingdom
| | - Jamie Maddox
- South Tees Hospitals NHS Foundation Trust, Middlesborough, United Kingdom
| | - Neil Phillips
- University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, United Kingdom
| | | | - Marcin Flont
- York and Scarborough Teaching Hospitals NHS Foundation, York, United Kingdom
| | - Emma Nga
- Airedale NHS Foundation Trust, Keighley, United Kingdom
| | - Andres Virchis
- The Royal Free London NHS Foundation Trust, London, United Kingdom
| | | | - Wunna Swe
- Calderdale and Huddersfield NHS Foundation Trust, Huddersfield, United Kingdom
| | - Arvind Pillai
- Countess of Chester Hospital NHS Foundation Trust, Chester, United Kingdom
| | - Clare Rees
- Frimley Health NHS Foundation Trust, Frimley, United Kingdom
| | - James Bailey
- Hull University Teaching Hospitals NHS Trust, Hull, United Kingdom
| | - Steve Jones
- Sherwood Forest Hospitals, Nottinghamshire, United Kingdom
| | - Susan Smith
- Sherwood Forest Hospitals, Nottinghamshire, United Kingdom
| | - Faye Sharpley
- The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Catherine Hildyard
- Milton Keynes University Hospital NHS Foundation Trust, Milton Keynes, United Kingdom
| | - Sajir Mohamedbhai
- University College Hospital NHS Foundation Trust, London, United Kingdom
| | - Toby Nicholson
- St Helens and Knowsley NHS Foundation Trust, Merseyside, United Kingdom
| | - Simon Moule
- Frimley Health NHS Foundation Trust, Frimley, United Kingdom
| | - Anshuman Chaturvedi
- The University of Manchester, Manchester, United Kingdom
- The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Kim Linton
- The University of Manchester, Manchester, United Kingdom
- The Christie NHS Foundation Trust, Manchester, United Kingdom
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2
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McGettrick P, Tinago W, O'Brien J, Miles S, Lawler L, Garcia-Leon A, Mahon N, Lambert J, Sheehan G, Landay A, Sabin CA, Cotter AG, Mallon PWG. Distinct Inflammatory Phenotypes are associated with subclinical and clinical Cardiovascular disease in People living with HIV. J Infect Dis 2024:jiae007. [PMID: 38214571 DOI: 10.1093/infdis/jiae007] [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: 08/15/2023] [Revised: 12/28/2023] [Accepted: 01/05/2023] [Indexed: 01/13/2024] Open
Abstract
Despite inflammation being implicated in cardiovascular disease (CVD) in people with HIV (PWH), considerable heterogeneity within populations of PWH exists. Stratifying CVD risk based on inflammatory phenotype could play an important role. Using principal component analyses and unsupervised hierarchical clustering, we examined 38 biomarkers to identify inflammatory phenotypes in two independent cohorts of PWH. We identified three distinct inflammatory clusters present in both cohorts that associated with altered risk of both subclinical CVD (cohort 1) and prevalent clinical CVD (cohort 2) after adjusting for CVD risk factors. These data support precision medicine approaches to enhance CVD risk assessment in PWH.
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Affiliation(s)
- P McGettrick
- Centre for Experimental Pathogen Host Research, University College Dublin, Ireland
- Department of Infectious Diseases, Mater Misericordiae University Hospital, Dublin, Ireland
| | - W Tinago
- Centre for Experimental Pathogen Host Research, University College Dublin, Ireland
| | - J O'Brien
- Department of Radiology, University Hospital Limerick, Ireland
| | - S Miles
- Centre for Experimental Pathogen Host Research, University College Dublin, Ireland
| | - L Lawler
- Department of Radiology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - A Garcia-Leon
- Centre for Experimental Pathogen Host Research, University College Dublin, Ireland
| | - N Mahon
- Department of Cardiology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - J Lambert
- Department of Infectious Diseases, Mater Misericordiae University Hospital, Dublin, Ireland
| | - G Sheehan
- Department of Infectious Diseases, Mater Misericordiae University Hospital, Dublin, Ireland
| | - A Landay
- Department of Internal Medicine, Rush University Medical Center, Chicago, United States of America
| | - C A Sabin
- Institute for Global Health, University College London, London, United Kingdom
| | - A G Cotter
- Department of Infectious Diseases, Mater Misericordiae University Hospital, Dublin, Ireland
| | - P W G Mallon
- Centre for Experimental Pathogen Host Research, University College Dublin, Ireland
- Department of Infectious Diseases, St. Vincent's University Hospital, Dublin, Ireland
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3
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Rampotas A, Carter-Brzezinski L, Somervaille TCP, Forryan J, Panitsas F, Harrison C, Witherall R, Innes AJ, Wallis L, Butt NM, Psaila B, Mead AJ, Carter M, Godfrey AL, Laing H, Garg M, Francis S, Ewing J, Teh CH, Cowen HB, Dyer P, McConville C, Wadelin F, Sahra A, McGregor A, Kulakov E, McLornan DP, Lambert J. Outcomes and characteristics of nonmelanoma skin cancers in patients with myeloproliferative neoplasms on ruxolitinib. Blood 2024; 143:178-182. [PMID: 37963262 DOI: 10.1182/blood.2023022345] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 11/01/2023] [Accepted: 11/01/2023] [Indexed: 11/16/2023] Open
Abstract
ABSTRACT Nonmelanoma skin cancers (NMSCs) in ruxolitinib-treated patients with myeloproliferative neoplasms behave aggressively, with adverse features and high recurrence. In our cohort, mortality from metastatic NMSC exceeded that from myelofibrosis. Vigilant skin assessment, counseling on NMSC risks, and prospective ruxolitinib-NMSC studies are crucial.
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Affiliation(s)
- Alex Rampotas
- Haematology Department, University College London Hospital NHS Foundation Trust, London, United Kingdom
| | - Luke Carter-Brzezinski
- Cancer Research UK Manchester Institute, Manchester, United Kingdom
- Haematology Department, The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Tim C P Somervaille
- Cancer Research UK Manchester Institute, Manchester, United Kingdom
- Haematology Department, The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - James Forryan
- Haematology Department, University College London Hospital NHS Foundation Trust, London, United Kingdom
| | - Fotios Panitsas
- Haematology Department, Laikon University Hospital of Athens, Athens, Greece
| | - Claire Harrison
- Haematology Department, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - Ruth Witherall
- Haematology Department, Royal Cornwall Hospitals NHS Foundation Trust, Treliske, United Kingdom
| | - Andrew J Innes
- Haematology Department, Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Louise Wallis
- Haematology Department, University Hospitals Dorset NHS Foundation Trust, Bournemouth, United Kingdom
| | - Naumann M Butt
- Haematology Department, The Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, United Kingdom
| | - Bethan Psaila
- Department of Haematology and NIHR Biomedical Research Centre, OUH NHS Foundation Trust, Oxford, United Kingdom
| | - Adam J Mead
- Department of Haematology and NIHR Biomedical Research Centre, OUH NHS Foundation Trust, Oxford, United Kingdom
| | - Matthew Carter
- Haematology Department, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Anna L Godfrey
- Haematology Department, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Heather Laing
- University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - Mamta Garg
- University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - Sebastian Francis
- Haematology Department, Sheffield Teaching Hospitals NHS Trust, Sheffield, United Kingdom
| | - Joanne Ewing
- Haematology Department, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Chun Huat Teh
- Haematology Department, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | - Hannah Bibi Cowen
- Haematology Department, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - Peter Dyer
- Haematology Department, University Hospitals of North Midlands, Stoke-on-Trent, United Kingdom
| | - Conall McConville
- Department of Haematology, Altnagelvin Area Hospital, North West Cancer Centre, Derry, United Kingdom
| | - Frances Wadelin
- Haematology Department, Nottingham University Hospital NHS Foundation Trust, Nottingham, United Kingdom
| | - Ali Sahra
- Haematology Department, King's College London Hospital NHS Foundation Trust, London, United Kingdom
| | - Andrew McGregor
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, United Kingdom
| | - Elizabeth Kulakov
- Dermatology Department, University College London Hospital NHS Foundation Trust, London, United Kingdom
| | - Donal P McLornan
- Haematology Department, University College London Hospital NHS Foundation Trust, London, United Kingdom
| | - Jonathan Lambert
- Haematology Department, University College London Hospital NHS Foundation Trust, London, United Kingdom
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4
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Hess G, Dreyling M, Oberic L, Gine E, Zinzani PL, Linton K, Vilmar A, Jerkeman M, Chen JMH, Ohler A, Stilgenbauer S, Thieblemont C, Lambert J, Zilioli VR, Sancho JM, Jimenez-Ubieto A, Fischer L, Eyre TA, Keeping S, Park JE, Wu JJ, Nunes A, Reitan J, Wade SW, Salles G. Indirect treatment comparison of brexucabtagene autoleucel (ZUMA-2) versus standard of care (SCHOLAR-2) in relapsed/refractory mantle cell lymphoma. Leuk Lymphoma 2024; 65:14-25. [PMID: 37840282 DOI: 10.1080/10428194.2023.2268228] [Citation(s) in RCA: 1] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 10/02/2023] [Indexed: 10/17/2023]
Abstract
The SCHOLAR-2 retrospective study highlighted poor overall survival (OS) with standard of care (SOC) regimens among patients with relapsed/refractory (R/R) mantle cell lymphoma (MCL) who failed a covalent Bruton tyrosine kinase inhibitor (BTKi). In the ZUMA-2 single-arm trial, brexucabtagene autoleucel (brexu-cel; autologous anti-CD19 CAR T-cell therapy) demonstrated high rates of durable responses in patients with R/R MCL who had previous BTKi exposure. Here, we compared OS in ZUMA-2 and SCHOLAR-2 using three different methods which adjusted for imbalances in prognostic factors between populations: inverse probability weighting (IPW), regression adjustment (RA), and doubly robust (DR). Brexu-cel was associated with improved OS compared to SOC across all unadjusted and adjusted comparisons. Hazard ratios (95% confidence intervals) were 0.38 (0.23, 0.61) for IPW, 0.45 (0.28, 0.74) for RA, and 0.37 (0.23, 0.59) for DR. These results suggest a substantial survival benefit with brexu-cel versus SOC in patients with R/R MCL after BTKi exposure.
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Affiliation(s)
- Georg Hess
- Department of Hematology, Oncology and Pneumology, Comprehensive Cancer Center, University Medical School of the Johannes Gutenberg-University, Mainz, Germany
| | | | - Lucie Oberic
- Department of Hematology, University Hospital Centre Toulouse, Service d'Hématologie, Toulouse, France
| | - Eva Gine
- GELTAMO, Hematology Department, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Pier Luigi Zinzani
- IRCCS Azienda Ospedaliero-Universitaria di Bologna Istituto di Ematologia "Seràgnoli", Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy
| | - Kim Linton
- The Manchester Cancer Research Center, Manchester, UK
| | | | - Mats Jerkeman
- Department of Oncology, Skane University Hospital and Lund University, Lund, Sweden
| | | | - Anke Ohler
- Department of Hematology, Oncology and Pneumology, Comprehensive Cancer Center, University Medical School of the Johannes Gutenberg-University, Mainz, Germany
| | | | | | - Jonathan Lambert
- Department of Haematology, University College London Hospitals NHS Foundation Trust, London, UK
| | | | - Juan-Manuel Sancho
- GELTAMO, Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Badalona, Spain
| | | | - Luca Fischer
- Medizinische Klinik III, LMU Klinikum, Munich, Germany
| | | | | | | | - James J Wu
- Kite, a Gilead Company, Santa Monica, CA, USA
| | - Ana Nunes
- Kite, a Gilead Company, Santa Monica, CA, USA
| | | | - Sally W Wade
- Wade Outcomes Research & Consulting, Salt Lake City, UT, USA
| | - Gilles Salles
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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5
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Eyre TA, Bishton MJ, McCulloch R, O'Reilly M, Sanderson R, Menon G, Iyengar S, Lewis D, Lambert J, Linton KM, McKay P. Diagnosis and management of mantle cell lymphoma: A British Society for Haematology Guideline. Br J Haematol 2024; 204:108-126. [PMID: 37880821 DOI: 10.1111/bjh.19131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 09/13/2023] [Accepted: 09/15/2023] [Indexed: 10/27/2023]
Affiliation(s)
- Toby A Eyre
- Department of Haematology, Cancer and Haematology Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Mark J Bishton
- Department of Haematology, Nottingham University Hospitals NHS Foundation Trust, Oxford, UK
- Translational Medical Sciences, University of Nottingham, Nottingham, UK
| | - Rory McCulloch
- Department of Haematology, Gloucestershire Hospitals NHS Foundation Trust, Gloucester, UK
| | - Maeve O'Reilly
- Department of Haematology, University College London Hospitals, London, UK
| | - Robin Sanderson
- Department of Haematology, King's College Hospital, London, UK
| | - Geetha Menon
- Department of Cellular Pathology, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Sunil Iyengar
- Department of Haematology, The Royal Marsden Hospital, London, UK
| | - David Lewis
- Department of Haematology, Derriford Hospital, Plymouth, UK
| | - Jonathan Lambert
- Department of Haematology, University College London Hospitals, London, UK
| | - Kim M Linton
- Department of Haematology, The Christie NHS Foundation Trust, Manchester, UK
| | - Pamela McKay
- Beatson West of Scotland Cancer Centre, Glasgow, UK
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6
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Lannon-Boran C, Hannigan C, Power JM, Lambert J, Kelly M. The effect of mindfulness-based intervention on cognitively unimpaired older adults' cognitive function and sleep quality: a systematic review and meta-analysis. Aging Ment Health 2024; 28:23-35. [PMID: 37485984 DOI: 10.1080/13607863.2023.2228255] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 05/30/2023] [Indexed: 07/25/2023]
Abstract
Objective: This systematic review and meta-analysis aimed to investigate the effect of mindfulness-based intervention (MBI) on cognitively unimpaired older adults' cognitive function and sleep quality.Method: Studies published in English since 2010 were considered for inclusion. Databases searched were PubMed, Embase, Web of Science, and PsycInfo. We included randomized controlled trials (RCTs) with adults over 55 with no known cognitive impairment, that recorded cognitive outcomes and/or sleep quality pre- and post-intervention, and that implemented Mindfulness-Based Stress Reduction (MBSR), or an MBI closely based on MBSR protocol.Results: Seven RCTs fit the inclusion criteria, with 276 participants in MBI groups and 287 in controls. Four studies investigated mindfulness and cognitive function, two investigated mindfulness and sleep quality, and one investigated mindfulness, cognitive function, and sleep quality. Some studies were not reported in sufficient detail to be included in meta-analyses. Results of meta-analyses showed no significant differences between MBI groups vs controls on cognitive measures of executive function, free recall, and delayed recall. Meta-analysis revealed that MBI significantly improved sleep quality compared to controls.Conclusion: Given that poor sleep quality is strongly linked to increased risk of cognitive decline, further research investigating sleep quality's role in the mindfulness-cognitive function relationship in cognitively unimpaired older adults is recommended.
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Affiliation(s)
- Colm Lannon-Boran
- Department of Psychology, National College of Ireland, Dublin, Ireland
- Department of Psychology, Maynooth University, Kildare, Ireland
| | - Caoimhe Hannigan
- Department of Psychology, National College of Ireland, Dublin, Ireland
| | | | - Jonathan Lambert
- School of Computing, National College of Ireland, Dublin, Ireland
| | - Michelle Kelly
- Department of Psychology, National College of Ireland, Dublin, Ireland
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7
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McLornan DP, Godfrey AL, Green A, Frewin R, Arami S, Brady J, Butt NM, Cargo C, Ewing J, Francis S, Garg M, Harrison C, Innes A, Khan A, Knapper S, Lambert J, Mead A, McGregor A, Neelakantan P, Psaila B, Somervaille TCP, Woodley C, Nangalia J, Cross NCP, McMullin MF. Diagnosis and evaluation of prognosis of myelofibrosis: A British Society for Haematology Guideline. Br J Haematol 2024; 204:127-135. [PMID: 37932932 DOI: 10.1111/bjh.19164] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 10/02/2023] [Accepted: 10/08/2023] [Indexed: 11/08/2023]
Affiliation(s)
- Donal P McLornan
- Department of Haematology, University College London Hospitals, London, UK
| | - Anna L Godfrey
- Haematopathology and Oncology Diagnostics Service, Department of Haematology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Anna Green
- Department of Histopathology, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - Rebecca Frewin
- Department of Haematology, Gloucestershire Hospitals NHS Foundation Trust, Gloucester, UK
| | - Siamak Arami
- Department of Haematology, London Northwest Healthcare University NHS Trust, London, UK
| | - Jessica Brady
- Department of Clinical Oncology, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - Nauman M Butt
- Department of Haematology, The Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, UK
| | - Catherine Cargo
- Department of Haematology, Leeds Teaching Hospitals NHS Foundation Trust, Leeds, UK
| | - Joanne Ewing
- Department of Haematology, University Hospitals Birmingham Trust, Birmingham, UK
| | - Sebastian Francis
- Department of Haematology, Sheffield Teaching Hospital NHS Foundation Trust, Sheffield, UK
| | - Mamta Garg
- Department of Haematology, University Hospitals Leicester NHS Trust, Leicester, UK
| | - Claire Harrison
- Department of Haematology, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - Andrew Innes
- Department of Haematology, Imperial College, London, UK
| | - Alesia Khan
- Department of Haematology, Leeds Teaching Hospitals NHS Foundation Trust, Leeds, UK
| | - Steve Knapper
- Department of Haematology, Cardiff University, Cardiff, UK
| | - Jonathan Lambert
- Department of Haematology, University College London Hospitals, London, UK
| | - Adam Mead
- MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
- Department of Haematology, Churchill Hospital, Oxford University NHS Trust, Oxford, UK
| | - Andrew McGregor
- Department of Haematology, Freeman Hospital, Newcastle upon Tyne, UK
| | - Pratap Neelakantan
- Department of Haematology, Royal Berkshire NHS Foundation Trust, Berkshire, UK
| | - Bethan Psaila
- MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
- Department of Haematology, Churchill Hospital, Oxford University NHS Trust, Oxford, UK
| | - Tim C P Somervaille
- Cancer Research UK Manchester Institute and The Christie NHS Foundation Trust, Manchester, UK
| | - Claire Woodley
- Department of Haematology, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - Jyoti Nangalia
- Wellcome Sanger Institute, University of Cambridge, Cambridge, UK
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8
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McLornan DP, Psaila B, Ewing J, Innes A, Arami S, Brady J, Butt NM, Cargo C, Cross NCP, Francis S, Frewin R, Garg M, Godfrey AL, Green A, Khan A, Knapper S, Lambert J, McGregor A, McMullin MF, Nangalia J, Neelakantan P, Woodley C, Mead A, Somervaille TCP, Harrison CN. The management of myelofibrosis: A British Society for Haematology Guideline. Br J Haematol 2024; 204:136-150. [PMID: 38037886 DOI: 10.1111/bjh.19186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 10/03/2023] [Accepted: 10/20/2023] [Indexed: 12/02/2023]
Affiliation(s)
- Donal P McLornan
- Department of Haematology, University College London Hospitals, London, UK
| | - Bethan Psaila
- MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
- Department of Haematology, Churchill Hospital, Oxford University NHS Trust, Oxford, UK
| | - Joanne Ewing
- Department of Haematology, University Hospitals Birmingham Trust, London, UK
| | - Andrew Innes
- Department of Haematology, Imperial College, London, UK
| | - Siamak Arami
- Department of Haematology, London Northwest Healthcare University NHS Trust, London, UK
| | - Jessica Brady
- Department of Clinical Oncology, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - Nauman M Butt
- Department of Haematology, The Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, UK
| | - Catherine Cargo
- Department of Haematology, Leeds Teaching Hospitals NHS Foundation Trust, Leeds, UK
| | | | - Sebastian Francis
- Department of Haematology, Sheffield Teaching Hospital NHS Foundation Trust, Sheffield, UK
| | - Rebecca Frewin
- Department of Haematology, Gloucestershire Hospitals NHS Foundation Trust, Gloucester, UK
| | - Mamta Garg
- Department of Haematology, University Hospitals Leicester NHS Trust, Leicester, UK
| | - Anna L Godfrey
- Haematopathology & Oncology Diagnostics Service, Department of Haematology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Anna Green
- Department of Histopathology, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - Alesia Khan
- Department of Haematology, Leeds Teaching Hospitals NHS Foundation Trust, Leeds, UK
| | - Steve Knapper
- Department of Haematology, Cardiff University, Cardiff, UK
| | - Jonathan Lambert
- Department of Haematology, University College London Hospitals, London, UK
| | | | | | - Jyoti Nangalia
- Wellcome Sanger Institute, University of Cambridge, Cambridge, UK
| | - Pratap Neelakantan
- Department of Haematology, Royal Berkshire NHS Foundation Trust, London, UK
| | - Claire Woodley
- Department of Haematology, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - Adam Mead
- MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
- Department of Haematology, Churchill Hospital, Oxford University NHS Trust, Oxford, UK
| | - Tim C P Somervaille
- Cancer Research UK Manchester Institute & The Christie NHS Foundation Trust, Manchester, UK
| | - Claire N Harrison
- Department of Haematology, Guy's and St. Thomas' NHS Foundation Trust, London, UK
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9
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Rampotas A, Sockel K, Panitsas F, Theuser C, Bornhauser M, Hernani R, Hernandez-Boluda JC, Esquirol A, Avenoso D, Tsirigotis P, Robin M, Czerw T, Helbig G, Roddie C, Lambert J, McLornan DP. Adoptive Immunotherapy via Donor Lymphocyte Infusions following Allogeneic Hematopoietic Stem Cell Transplantation for Myelofibrosis: A Real-World, Retrospective Multicenter Study. Transplant Cell Ther 2023; 29:687.e1-687.e7. [PMID: 37633414 DOI: 10.1016/j.jtct.2023.08.020] [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: 04/06/2023] [Revised: 08/14/2023] [Accepted: 08/18/2023] [Indexed: 08/28/2023]
Abstract
Allogeneic hematopoietic cell transplantation (allo-HCT) remains the sole curative option for myelofibrosis (MF). Relapse remains a significant problem, however, occurring in up to 20% to 30% of cases. Donor lymphocyte infusion (DLI) represents a potentially effective strategy for relapse prevention and management, but the optimal timing based on measurable residual disease/chimerism analyses and the choice of regimen remain undetermined. We performed a retrospective real-world analysis of a multicenter cohort of MF allo-HCT recipients from 8 European transplantation centers who received DLI between 2005 and 2022. Response was assessed using International Working Group-Myeloproliferative Neoplasms Research and Treatment-defined response criteria, and survival endpoints were estimated using the Kaplan-Meier estimator and log-rank test. The study included 28 patients with a median age of 58 years and a Karnofsky Performance Status of >80. The majority of patients had Dynamic International Prognostic Scoring System-plus intermediate-2 or high-risk disease at the time of allo-HCT. In vivo T cell depletion was used in 20 patients (71.2%), with 19 of the 20 receiving antithymocyte globulin. The indication for DLI was either "preemptive" (n = 15), due to a decrease in recipient chimerism (n = 13) or molecular relapse (n = 2), or "therapeutic" (n = 13) for clinician-defined hematologic/clinical relapse. No patient received DLI prophylactically. The median time of DLI administration was 23.4 months post allo-HCT. Of the 16 patients receiving multiple DLIs, 12 were part of a planned escalating dose regimen. The median follow-up from the time of first DLI was 55.4 months. The responses to DLI were complete response in 9 patients, partial response in 1 patient, and clinical improvement in 6 patients. Chimerism levels improved in 16 patients, and stable disease was reported in 5 patients. No response or progression was reported in 7 patients. DLI-induced acute graft-versus-host disease (aGVHD) was reported in 11 patients (39%), with grade III-IV aGVHD in 7 (25%). The median overall survival from the time of first DLI was 62.6 months, and the cumulative incidence of relapse/progression after first DLI was 30.8% at 6 months. This study highlights that good response rates can be achieved with DLI even after frank relapse in some patients in a cohort in which other treatment options are very limited. More prospective studies are warranted to identify the optimal DLI regimen and timing to improve patient outcomes.
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Affiliation(s)
- Alexandros Rampotas
- Department of Haematology and Cell Therapy, University College London Hospital NHS Foundation Trust, London, United Kingdom.
| | - Katja Sockel
- Medical Clinic and Policlinic I, University Hospital Dresden, TU Dresden, Germany
| | - Fotios Panitsas
- Department of Haematology, Laikon University Hospital, Athens, Greece
| | - Catrin Theuser
- Medical Clinic and Policlinic I, University Hospital Dresden, TU Dresden, Germany
| | - Martin Bornhauser
- Medical Clinic and Policlinic I, University Hospital Dresden, TU Dresden, Germany
| | - Rafael Hernani
- Haematology Department, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | | | - Albert Esquirol
- Department of Haematology, Hospital de la Santa creu i Sant Pau and Universitat Autonoma de Barcelona, Spain
| | - Daniele Avenoso
- Department of Haematology, King's College Hospital NHS Foundation Trust, London, United Kingdom
| | | | - Marie Robin
- Service d'Hématologie-Greffe, Hôpital Saint-Louis, APHP, Université de Paris Cité, Paris, France
| | - Tomasz Czerw
- Department of Haematology and Bone Marrow Transplantation, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice, Poland
| | - Grzegorz Helbig
- Department of Hematology and Bone Marrow Transplantation, Medical University of Silesia, Katowice, Poland
| | - Claire Roddie
- Department of Haematology and Cell Therapy, University College London Hospital NHS Foundation Trust, London, United Kingdom
| | - Jonathan Lambert
- Department of Haematology and Cell Therapy, University College London Hospital NHS Foundation Trust, London, United Kingdom
| | - Donal P McLornan
- Department of Haematology and Cell Therapy, University College London Hospital NHS Foundation Trust, London, United Kingdom
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10
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Mardones ML, Lambert J, Wiedenmann J, Davies TW, Levy O, D'Angelo C. Artificial light at night (ALAN) disrupts behavioural patterns of reef corals. Mar Pollut Bull 2023; 194:115365. [PMID: 37579595 DOI: 10.1016/j.marpolbul.2023.115365] [Citation(s) in RCA: 1] [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] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/27/2023] [Accepted: 07/30/2023] [Indexed: 08/16/2023]
Abstract
Increasing levels of Artificial Light At Night (ALAN) alter the natural diel cycles of organisms at global scale. ALAN constitutes a potential threat to the light-dependent functioning of symbiotic scleractinian corals, the habit-founders of warm, shallow water reefs. Here, we show that ALAN disrupts the natural diel tentacle expansion and contraction behaviour, a key mechanism for prey capture and nutrient acquisition in corals. We exposed four symbiotic scleractinian coral species to different ALAN treatments (0.4-2.5 μmol quanta m-2 s-1). Exposure to ALAN levels of 1.2 μmol quanta m-2 s-1 and above altered the normal tentacle expansion response in diurnal species (Stylophora pistillata and Duncanopsammia axifuga). The tentacle expansion pattern of nocturnal species (Montastraea cavernosa and Lobophyllia hemprichii) was less affected, which may indicate a greater capacity to tolerate ALAN exposure. The results of this work suggest that ALAN has the potential to affect nutrient acquisition mechanisms of symbiotic corals which may in turn result in changes in the coral community structure in shallow water reefs in ALAN-exposed areas.
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Affiliation(s)
- M L Mardones
- Coral Reef Laboratory, University of Southampton, European Way, Southampton, UK
| | - J Lambert
- Coral Reef Laboratory, University of Southampton, European Way, Southampton, UK
| | - J Wiedenmann
- Coral Reef Laboratory, University of Southampton, European Way, Southampton, UK
| | - T W Davies
- School of Biological and Marine Sciences, University of Plymouth, Plymouth, UK
| | - O Levy
- Mina and Everard Goodman Faculty of Life Sciences, Bar-Ilan University, Israel; Israel The H. Steinitz Marine Biology Laboratory, The Interuniversity Institute for Marine Sciences of Eilat, Israel
| | - C D'Angelo
- Coral Reef Laboratory, University of Southampton, European Way, Southampton, UK.
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11
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Gonzalez-Cantero A, Boehncke WH, De Sutter J, Zamorano JL, Lambert J, Puig L. Statins and psoriasis: Position statement by the Psoriasis Task Force of the European Academy of Dermatology and Venerology. J Eur Acad Dermatol Venereol 2023; 37:1697-1705. [PMID: 37259959 DOI: 10.1111/jdv.19191] [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: 02/19/2023] [Accepted: 04/26/2023] [Indexed: 06/02/2023]
Abstract
BACKGROUND Psoriasis is associated with an increased mortality risk, with cardiovascular disease being the leading excess cause (in a dose-response manner with psoriasis severity). Statins have demonstrated a reduction in all-cause mortality with no excess of adverse events among the general population. The underuse of interventions in cardiovascular prevention, such as statins, for patients with psoriasis may be the result of an insufficient evaluation. OBJECTIVES To provide the dermatologist with a tool for systematizing the treatment of dyslipidemia in psoriasis, which generally escapes the scope of dermatological practice, and to facilitate decision-making about the referral and treatment of patients. METHODS The Psoriasis Task Force of the European Academy of Dermatology and Venereology performed this two-phase study to achieve a consensus and create recommendations on the use of statin therapy in patients with psoriasis. The first phase included a systematic review to identify a list of outline concepts and recommendations according to guidelines. The second phase consisted in a two-round Delphi study to evaluate those recommendations not literally taken from guidelines. RESULTS A list of 47 concepts and recommendations to be followed by dermatologists involved in the treatment of patients with moderate-severe psoriasis was created. It included six main concepts about cardiovascular risk and psoriasis, six items related with the role of low-density lipoprotein cholesterol (LDL-c) and the benefits of statin treatment in psoriasis patients, eight recommendations about how cardiovascular risk should be assessed, three on the role of non-invasive cardiovascular imaging, three on LDL-c thresholds, eight key points related to statin prescription, 10 on statin treatment follow-up and three on patient referral to another specialist. CONCLUSIONS The application of this position statement (close final list of concepts and recommendations) will help dermatologists to manage dyslipidemia and help psoriasis patients to reduce their cardiovascular risk.
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Affiliation(s)
- A Gonzalez-Cantero
- Department of Dermatology, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Faculty of Medicine, Universidad Francisco de Vitoria, Madrid, Spain
| | - W H Boehncke
- Division of Dermatology and Venereology, Geneva University Hospitals, Geneva, Switzerland
| | - J De Sutter
- Department of Cardiology, AZ Maria Middelares, Ghent, Belgium
| | - J L Zamorano
- Departamento de Cardiología, Hospital Universitario Ramón y Cajal (IRYCIS), Madrid, Spain
| | - J Lambert
- Department of Dermatology, Ghent University Hospital, Ghent, Belgium
| | - L Puig
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
- School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
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12
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Hammoudi N, Lehmann-Che J, Lambert J, Amoyel M, Maggiori L, Salfati D, Tran Minh ML, Baudry C, Asesio N, Poirot B, Lourenco N, Corte H, Allez M, Aparicio T, Gornet JM. Prognosis and molecular characteristics of IBD-associated colorectal cancer: Experience from a French tertiary-care center. Dig Liver Dis 2023; 55:1280-1287. [PMID: 36872200 DOI: 10.1016/j.dld.2023.02.011] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 02/10/2023] [Accepted: 02/16/2023] [Indexed: 03/07/2023]
Abstract
BACKGROUND Little is known about the prognosis of colorectal cancer associated with inflammatory bowel disease (CRC-IBD) in a real-world cohort in France. METHODS We conducted a retrospective observational study including all patients presenting CRC-IBD in a French tertiary center. RESULTS Among 6510 patients, the rate of CRC was 0.8% with a median delay of 19.5 years after IBD diagnosis (median age 46 years, ulcerative colitis 59%, initially localized tumor 69%). There was a previous exposure to immunosuppressants (IS) in 57% and anti-TNF in 29% of the cases. A RAS mutation was observed in only 13% of metastatic patients. OS of the whole cohort was 45 months. OS and PFS of synchronous metastatic patients was 20.4 months and 8.5 months respectively. Among the patients with localized tumor those previously exposed to IS had a better PFS (39 months vs 23 months; p = 0.05) and OS (74 vs 44 months; p = 0.03). The IBD relapse rate was 4%. No unexpected chemotherapy side-effect was observed CONCLUSIONS: OS of CRC-IBD is poor in metastatic patients although IBD is not associated with under-exposure or increased toxicity to chemotherapy. Previous IS exposure may be associated with a better prognosis.
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Affiliation(s)
- N Hammoudi
- Université de Paris, INSERM U1160, EMiLy, Institut de Recherche Saint-Louis, Paris, France; Gastroenterology Department, AP-HP, Hôpital Saint-Louis / Lariboisière, Paris, France
| | - J Lehmann-Che
- Department of molecular oncology, Hôpital Saint-Louis, Université Paris Cité, Paris, France
| | - J Lambert
- Department of biostatistics, Hôpital Saint-Louis, APHP, Paris University, Paris, France. Hôpital Saint-Louis, Paris - France
| | - M Amoyel
- Gastroenterology Department, AP-HP, Hôpital Saint-Louis / Lariboisière, Paris, France
| | - L Maggiori
- Department of digestive surgery, Hôpital Saint-Louis, APHP, Université Paris Cité, Paris, France
| | - D Salfati
- Gastroenterology Department, AP-HP, Hôpital Saint-Louis / Lariboisière, Paris, France
| | - M L Tran Minh
- Gastroenterology Department, AP-HP, Hôpital Saint-Louis / Lariboisière, Paris, France
| | - C Baudry
- Gastroenterology Department, AP-HP, Hôpital Saint-Louis / Lariboisière, Paris, France
| | - N Asesio
- Gastroenterology Department, AP-HP, Hôpital Saint-Louis / Lariboisière, Paris, France
| | - B Poirot
- Department of molecular oncology, Hôpital Saint-Louis, Université Paris Cité, Paris, France
| | - N Lourenco
- Gastroenterology Department, AP-HP, Hôpital Saint-Louis / Lariboisière, Paris, France
| | - H Corte
- Department of digestive surgery, Hôpital Saint-Louis, APHP, Université Paris Cité, Paris, France
| | - M Allez
- Université de Paris, INSERM U1160, EMiLy, Institut de Recherche Saint-Louis, Paris, France; Gastroenterology Department, AP-HP, Hôpital Saint-Louis / Lariboisière, Paris, France
| | - T Aparicio
- Université de Paris, INSERM U1160, EMiLy, Institut de Recherche Saint-Louis, Paris, France; Gastroenterology Department, AP-HP, Hôpital Saint-Louis / Lariboisière, Paris, France
| | - J M Gornet
- Gastroenterology Department, AP-HP, Hôpital Saint-Louis / Lariboisière, Paris, France.
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13
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Gousset S, Torta DM, Mouraux A, Lambert J, van den Broeke EN. Pinprick-induced gamma-band oscillations are not a useful electrophysiological marker of pinprick hypersensitivity in humans. Clin Neurophysiol 2023; 153:102-110. [PMID: 37473484 DOI: 10.1016/j.clinph.2023.06.018] [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: 02/25/2023] [Revised: 06/07/2023] [Accepted: 06/16/2023] [Indexed: 07/22/2023]
Abstract
OBJECTIVE This study aimed to investigate scalp gamma-band oscillations (GBOs) induced by mechanical stimuli activating skin nociceptors before and after the induction of mechanical hypersensitivity using high-frequency electrical stimulation (HFS) of the skin. METHODS In twenty healthy volunteers, we recorded the electroencephalogram during robot-controlled mechanical pinprick stimulation (512 mN) applied at the right ventral forearm before and after HFS. RESULTS HFS induced a significant increase in mechanical pinprick sensitivity, but this increased pinprick sensitivity was, at the group level, not accompanied by a significant increase in GBOs. Visual inspection of the individual data revealed that possible GBOs were present in eight out of twenty participants (40%) and the frequency of these GBOs varied substantially across participants. CONCLUSIONS Based on the low number of participants showing GBOs we question the (clinical) utility of mechanically-induced GBOs as an electrophysiological marker of pinprick hypersensitivity in humans. SIGNIFICANCE Mechanical pinprick-induced scalp GBOs are not useful for evaluating mechanical pinprick hypersensitivity in humans.
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Affiliation(s)
- S Gousset
- Institute of Neuroscience, Université Catholique de Louvain (UCL), B-1200 Brussels, Belgium
| | - D M Torta
- Health Psychology Group, University of Leuven (KUL), Leuven, Belgium
| | - A Mouraux
- Institute of Neuroscience, Université Catholique de Louvain (UCL), B-1200 Brussels, Belgium
| | - J Lambert
- Institute of Neuroscience, Université Catholique de Louvain (UCL), B-1200 Brussels, Belgium
| | - E N van den Broeke
- Institute of Neuroscience, Université Catholique de Louvain (UCL), B-1200 Brussels, Belgium; Health Psychology Group, University of Leuven (KUL), Leuven, Belgium.
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14
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Lourenço A, Lee N, Charlwood F, Lambert J, Vera-Sánchez JA, Hussein M, Shipley D, Romano F, Lowe M, Clarke M, Lorentini S, Mazal A, Pettingell J, Palmans H, Thomas R. A portable primary-standard level graphite calorimeter for absolute dosimetry in clinical pencil beam scanning proton beams. Phys Med Biol 2023; 68:175005. [PMID: 37414003 DOI: 10.1088/1361-6560/ace50f] [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: 12/06/2022] [Accepted: 07/06/2023] [Indexed: 07/08/2023]
Abstract
Objective. To report the use of a portable primary standard level graphite calorimeter for direct dose determination in clinical pencil beam scanning proton beams, which forms part of the recommendations of the proposed Institute of Physics and Engineering in Medicine (IPEM) Code of Practice (CoP) for proton therapy dosimetry.Approach. The primary standard proton calorimeter (PSPC) was developed at the National Physical Laboratory (NPL) and measurements were performed at four clinical proton therapy facilities that use pencil beam scanning for beam delivery. Correction factors for the presence of impurities and vacuum gaps were calculated and applied, as well as dose conversion factors to obtain dose to water. Measurements were performed in the middle of 10 × 10 × 10 cm3homogeneous dose volumes, centred at 10.0, 15.0 and 25.0 g·cm-2depth in water. The absorbed dose to water determined with the calorimeter was compared to the dose obtained using PTW Roos-type ionisation chambers calibrated in terms of absorbed dose to water in60Co applying the recommendations in the IAEA TRS-398 CoP.Main results.The relative dose difference between the two protocols varied between 0.4% and 2.1% depending on the facility. The reported overall uncertainty in the determination of absorbed dose to water using the calorimeter is 0.9% (k= 1), which corresponds to a significant reduction of uncertainty in comparison with the TRS-398 CoP (currently with an uncertainty equal or larger than 2.0% (k= 1) for proton beams).Significance. The establishment of a purpose-built primary standard and associated CoP will considerably reduce the uncertainty of the absorbed dose to water determination and ensure improved accuracy and consistency in the dose delivered to patients treated with proton therapy and bring proton reference dosimetry uncertainty in line with megavoltage photon radiotherapy.
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Affiliation(s)
- A Lourenço
- Medical Radiation Science Group, National Physical Laboratory, Teddington TW11 0LW, United Kingdom
- Department of Medical Physics and Biomedical Engineering, University College London, London WC1E 6BT, United Kingdom
| | - N Lee
- Medical Radiation Science Group, National Physical Laboratory, Teddington TW11 0LW, United Kingdom
| | - F Charlwood
- Christie Medical Physics and Engineering, The Christie NHS Foundation Trust, Manchester M20 4BX, United Kingdom
| | - J Lambert
- Rutherford Cancer Centre South Wales, Newport NP10 8FZ, United Kingdom
| | - J A Vera-Sánchez
- Centro de Protonterapia Quirónsalud, E-28223 Pozuelo de Alarcón, Madrid, Spain
| | - M Hussein
- Medical Radiation Science Group, National Physical Laboratory, Teddington TW11 0LW, United Kingdom
- Department of Medical Physics and Biomedical Engineering, University College London, London WC1E 6BT, United Kingdom
| | - D Shipley
- Medical Radiation Science Group, National Physical Laboratory, Teddington TW11 0LW, United Kingdom
| | - F Romano
- Istituto Nazionale di Fisica Nucleare, Sezione di Catania, Via S Sofia 64, I-95123, Catania, Italy
| | - M Lowe
- Christie Medical Physics and Engineering, The Christie NHS Foundation Trust, Manchester M20 4BX, United Kingdom
| | - M Clarke
- Christie Medical Physics and Engineering, The Christie NHS Foundation Trust, Manchester M20 4BX, United Kingdom
| | - S Lorentini
- Protontherapy Department, Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy
| | - A Mazal
- Centro de Protonterapia Quirónsalud, E-28223 Pozuelo de Alarcón, Madrid, Spain
| | - J Pettingell
- Rutherford Cancer Centre North East, Bedlington NE22 7FD, United Kingdom
| | - H Palmans
- Medical Radiation Science Group, National Physical Laboratory, Teddington TW11 0LW, United Kingdom
- Medical Physics Group, MedAustron Ion Therapy Center, A-2700 Wiener Neustadt, Austria
| | - R Thomas
- Medical Radiation Science Group, National Physical Laboratory, Teddington TW11 0LW, United Kingdom
- University of Surrey, Faculty of Engineering and Physical Science, Guildford GU2 7XH, United Kingdom
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15
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Paulou F, Wegrzyn J, Rossel JB, Gonvers E, Antoniadis A, Kägi M, Wolmarans MR, Lambert J, Albrecht E. Analgesic efficacy of selective tibial nerve block versus partial local infiltration analgesia for posterior pain after total knee arthroplasty: a randomized, controlled, triple-blinded trial. Anaesth Crit Care Pain Med 2023; 42:101223. [PMID: 37030393 DOI: 10.1016/j.accpm.2023.101223] [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: 02/12/2023] [Revised: 02/28/2023] [Accepted: 03/19/2023] [Indexed: 04/08/2023]
Abstract
BACKGROUND The adductor canal block provides pain relief on the anterior aspect of the knee after arthroplasty. Pain on the posterior aspect may be treated either by partial local infiltration analgesia of the posterior capsule or by a tibial nerve block. This randomized, controlled, triple-blinded trial tests the hypothesis that a tibial nerve block would provide superior analgesia compared to posterior capsule infiltration in patients scheduled for total knee arthroplasty under spinal anesthesia with an adductor canal block. METHODS Sixty patients were randomized to receive either infiltration of the posterior capsule by the surgeon with ropivacaine 0.2%, 25 mL, or a tibial nerve block with 10 mL of ropivacaine 0.5%. Sham injections were performed to guarantee proper blinding. The primary outcome was intravenous morphine consumption at 24 h. Secondary outcomes included intravenous morphine consumption, pain scores at rest and on movement, and different functional outcomes, measured at up to 48 h. When necessary, longitudinal analyses were performed with a mixed-effects linear model. RESULTS The median (interquartile range) of cumulative intravenous morphine consumption at 24 h was 12 mg (4-16) and 8 mg (2-14) in patients having the infiltration or the tibial nerve block respectively (p = 0.20). Our longitudinal model showed a significant interaction between group and time in favor of the tibial nerve block (p = 0.015). No significant differences were present between groups in the other above-mentioned secondary outcomes. CONCLUSION A tibial nerve block does not provide superior analgesia when compared to infiltration. However, a tibial nerve block might be associated with a slower increase in morphine consumption over time.
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Affiliation(s)
- F Paulou
- Department of Anaesthesia, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland
| | - J Wegrzyn
- Department of Orthopaedic Surgery, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland
| | - J B Rossel
- Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - E Gonvers
- Department of Anaesthesia, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland
| | - A Antoniadis
- Department of Orthopaedic Surgery, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland
| | - M Kägi
- Department of Orthopaedic Surgery, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland
| | - M R Wolmarans
- Department of Anaesthesia, Norfolk and Norwich University Hospital, Norwich, United Kingdom
| | - J Lambert
- Department of Orthopaedic Surgery, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland
| | - E Albrecht
- Department of Anaesthesia, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland.
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16
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Lambert J, Demeestere J, Dewachter B, Cockmartin L, Wouters A, Symons R, Boomgaert L, Vandewalle L, Scheldeman L, Demaerel P, Lemmens R. Performance of Automated ASPECTS Software and Value as a Computer-Aided Detection Tool. AJNR Am J Neuroradiol 2023; 44:894-900. [PMID: 37500286 PMCID: PMC10411841 DOI: 10.3174/ajnr.a7956] [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: 03/06/2023] [Accepted: 06/14/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND AND PURPOSE ASPECTS quantifies early ischemic changes in anterior circulation stroke on NCCT but has interrater variability. We examined the agreement of conventional and automated ASPECTS and studied the value of computer-aided detection. MATERIALS AND METHODS We retrospectively collected imaging data from consecutive patients with acute ischemic stroke with large-vessel occlusion undergoing thrombectomy. Five raters scored conventional ASPECTS on baseline NCCTs, which were also processed by RAPID software. Conventional and automated ASPECTS were compared with a consensus criterion standard. We determined the agreement over the full ASPECTS range as well as dichotomized, reflecting thrombectomy eligibility according to the guidelines (ASPECTS 0-5 versus 6-10). Raters subsequently scored ASPECTS on the same NCCTs with assistance of the automated ASPECTS outputs, and agreement was obtained. RESULTS For the total of 175 cases, agreement among raters individually and the criterion standard varied from fair to good (weighted κ = between 0.38 and 0.76) and was moderate (weighted κ = 0.59) for the automated ASPECTS. The agreement of all raters individually versus the criterion standard improved with software assistance, as did the interrater agreement (overall Fleiss κ = 0.15-0.23; P < .001 and .39 to .55; P = .01 for the dichotomized ASPECTS). CONCLUSIONS Automated ASPECTS had agreement with the criterion standard similar to that of conventional ASPECTS. However, including automated ASPECTS during the evaluation of NCCT in acute stroke improved the agreement with the criterion standard and improved interrater agreement, which could, therefore, result in more uniform scoring in clinical practice.
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Affiliation(s)
- J Lambert
- From the Departments of Radiology (J.L., B.D., L.C., R.S., L. B., P.D.)
- Departments of Imaging and Pathology (J.L., B.D., P.D.)
- Neuroscience (J.D., A.W., L.V., L.S., R.L.)
| | - J Demeestere
- Neurology (J.D., L.V., L.S., R.S.), University Hospitals Leuven, Leuven, Belgium
- Experimental Neurology (J.D., A.W., L.V., L.S., R.L.), Laboratory of Neurobiology, Katholieke Universiteit Leuven, University of Leuven, Leuven, Belgium
| | - B Dewachter
- From the Departments of Radiology (J.L., B.D., L.C., R.S., L. B., P.D.)
- Departments of Imaging and Pathology (J.L., B.D., P.D.)
| | - L Cockmartin
- From the Departments of Radiology (J.L., B.D., L.C., R.S., L. B., P.D.)
| | - A Wouters
- Neuroscience (J.D., A.W., L.V., L.S., R.L.)
- Experimental Neurology (J.D., A.W., L.V., L.S., R.L.), Laboratory of Neurobiology, Katholieke Universiteit Leuven, University of Leuven, Leuven, Belgium
| | - R Symons
- From the Departments of Radiology (J.L., B.D., L.C., R.S., L. B., P.D.)
- Imelda Hospital (R.S.), Bonheiden, Belgium
| | - L Boomgaert
- From the Departments of Radiology (J.L., B.D., L.C., R.S., L. B., P.D.)
| | - L Vandewalle
- Neurology (J.D., L.V., L.S., R.S.), University Hospitals Leuven, Leuven, Belgium
- Neuroscience (J.D., A.W., L.V., L.S., R.L.)
- Experimental Neurology (J.D., A.W., L.V., L.S., R.L.), Laboratory of Neurobiology, Katholieke Universiteit Leuven, University of Leuven, Leuven, Belgium
| | - L Scheldeman
- Neurology (J.D., L.V., L.S., R.S.), University Hospitals Leuven, Leuven, Belgium
- Neuroscience (J.D., A.W., L.V., L.S., R.L.)
- Experimental Neurology (J.D., A.W., L.V., L.S., R.L.), Laboratory of Neurobiology, Katholieke Universiteit Leuven, University of Leuven, Leuven, Belgium
| | - P Demaerel
- From the Departments of Radiology (J.L., B.D., L.C., R.S., L. B., P.D.)
- Departments of Imaging and Pathology (J.L., B.D., P.D.)
| | - R Lemmens
- Neurology (J.D., L.V., L.S., R.S.), University Hospitals Leuven, Leuven, Belgium
- Neuroscience (J.D., A.W., L.V., L.S., R.L.)
- Experimental Neurology (J.D., A.W., L.V., L.S., R.L.), Laboratory of Neurobiology, Katholieke Universiteit Leuven, University of Leuven, Leuven, Belgium
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Hess G, Dreyling M, Oberic L, Gine E, Luigi Zinzani P, Linton K, Vilmar A, Jerkeman M, Chen JMH, Ohler A, Stilgenbauer S, Thieblemont C, Lambert J, Ruggero Zilioli V, Sancho JM, Jimenez Ubieto A, Fischer L, Eyre TA, Keeping S, Park JE, Wu JJ, Siddiqi R, Reitan J, Wade S, Salles G. Real-world experience among patients with relapsed/refractory mantle cell lymphoma after Bruton tyrosine kinase inhibitor failure in Europe: The SCHOLAR-2 retrospective chart review study. Br J Haematol 2023; 202:749-759. [PMID: 36257914 PMCID: PMC10812379 DOI: 10.1111/bjh.18519] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [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: 06/14/2022] [Revised: 09/30/2022] [Accepted: 10/05/2022] [Indexed: 11/30/2022]
Abstract
Mantle cell lymphoma (MCL) after relapse is associated with poor prognosis. No standard of care exists and available evidence for treatments is limited, particularly in patients who fail Bruton tyrosine kinase inhibitor (BTKi) therapy. This multicentre retrospective chart review study, SCHOLAR-2, addresses this knowledge gap and reports on data collected from 240 patients with relapsed/refractory MCL in Europe who were treated with BTKi-based therapy between July 2012 and July 2018, and had experienced disease progression while on BTKi therapy or discontinued BTKi therapy due to intolerance. The median overall survival (OS) from initiation of first BTKi therapy was 14.6 months (95% confidence interval [CI] 11.6-20.0) in the overall cohort, 5.5 months (95% CI 3.9-8.2) in 91 patients without post-BTKi therapy, and 23.8 months (95% CI 18.9-30.1) in 149 patients who received post-BTKi therapy (excluding chimeric antigen receptor T-cell treatment). In the latter group, patients received a median of one (range, one to seven) line of post-BTKi therapy, with lenalidomide-containing regimens and bendamustine plus rituximab being the most frequently administered; the median OS from initiation of first post-BTKi therapy was 9.7 months (95% CI 6.3-12.7). These results provide a benchmark for survival in patients with R/R MCL receiving salvage therapy after BTKi failure.
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Affiliation(s)
- Georg Hess
- Department of Hematology, Oncology and Pneumology, Comprehensive Cancer Center, University Medical School of the Johannes Gutenberg-University, Mainz, Germany
| | | | | | - Eva Gine
- GELTAMO, Hematology Department, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Pier Luigi Zinzani
- IRCCS Azienda Ospedaliero-Universitaria di Bologna Istituto di Ematologia “Seràgnoli”, Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy
| | - Kim Linton
- The Manchester Cancer Research Center, Manchester, United Kingdom
| | | | - Mats Jerkeman
- Department of Oncology, Skane University Hospital and Lund University, Lund, Sweden
| | | | - Anke Ohler
- Department of Hematology, Oncology and Pneumology, Comprehensive Cancer Center, University Medical School of the Johannes Gutenberg-University, Mainz, Germany
| | | | | | - Jonathan Lambert
- University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | | | - Juan-Manuel Sancho
- GELTAMO, Institut Català d’Oncologia, Hospital Germans Trias i Pujol, Badalona, Spain
| | | | - Luca Fischer
- Medizinische Klinik III, LMU Klinikum, Munich, Germany
| | | | | | | | | | | | | | - Sally Wade
- Wade Outcomes Research & Consulting, Salt Lake City, USA
| | - Gilles Salles
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, USA
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Blombery P, Pazhakh V, Albuquerque AS, Maimaris J, Tu L, Briones Miranda B, Evans F, Thompson ER, Carpenter B, Proctor I, Curtin JA, Lambert J, Burns SO, Lieschke GJ. Biallelic deleterious germline SH2B3 variants cause a novel syndrome of myeloproliferation and multi-organ autoimmunity. EJHaem 2023; 4:463-469. [PMID: 37206266 PMCID: PMC10188477 DOI: 10.1002/jha2.698] [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] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 04/01/2023] [Accepted: 04/15/2023] [Indexed: 05/21/2023]
Abstract
SH2B3 is a negative regulator of multiple cytokine receptor signalling pathways in haematopoietic tissue. To date, a single kindred has been described with germline biallelic loss-of-function SH2B3 variants characterized by early onset developmental delay, hepatosplenomegaly and autoimmune thyroiditis/hepatitis. Herein, we described two further unrelated kindreds with germline biallelic loss-of-function SH2B3 variants that show striking phenotypic similarity to each other as well as to the previous kindred of myeloproliferation and multi-organ autoimmunity. One proband also suffered severe thrombotic complications. CRISPR-Cas9 gene editing of zebrafish sh2b3 created assorted deleterious variants in F0 crispants, which manifest significantly increased number of macrophages and thrombocytes, partially replicating the human phenotype. Treatment of the sh2b3 crispant fish with ruxolitinib intercepted this myeloproliferative phenotype. Skin-derived fibroblasts from one patient demonstrated increased phosphorylation of JAK2 and STAT5 after stimulation with IL-3, GH, GM-CSF and EPO compared to healthy controls. In conclusion, these additional probands and functional data in combination with the previous kindred provide sufficient evidence for biallelic homozygous deleterious variants in SH2B3 to be considered a valid gene-disease association for a clinical syndrome of bone marrow myeloproliferation and multi-organ autoimmune manifestations.
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Affiliation(s)
- Piers Blombery
- Clinical HaematologyPeter MacCallum Cancer Centre/Royal Melbourne HospitalMelbourneVictoriaAustralia
- University of MelbourneMelbourneVictoriaAustralia
| | - Vahid Pazhakh
- Clinical HaematologyPeter MacCallum Cancer Centre/Royal Melbourne HospitalMelbourneVictoriaAustralia
- Australian Regenerative Medicine InstituteMonash UniversityClaytonVictoriaAustralia
| | | | - Jesmeen Maimaris
- Institute of Immunity and TransplantationUniversity College LondonLondonUK
- Department of ImmunologyRoyal Free London NHS Foundation TrustLondonUK
| | - Lingge Tu
- Australian Regenerative Medicine InstituteMonash UniversityClaytonVictoriaAustralia
| | | | - Florence Evans
- Institute of Immunity and TransplantationUniversity College LondonLondonUK
| | - Ella R. Thompson
- Clinical HaematologyPeter MacCallum Cancer Centre/Royal Melbourne HospitalMelbourneVictoriaAustralia
- University of MelbourneMelbourneVictoriaAustralia
| | - Ben Carpenter
- Department of HaematologyUniversity College London Hospitals NHS Foundation TrustLondonUK
| | - Ian Proctor
- Department of HaematologyUniversity College London Hospitals NHS Foundation TrustLondonUK
| | - Julie A. Curtin
- Haematology DepartmentChildren's Hospital at WestmeadWestmeadNew South WalesAustralia
| | - Jonathan Lambert
- Department of HaematologyUniversity College London Hospitals NHS Foundation TrustLondonUK
- Department of HaematologyUCL Cancer InstituteUniversity College LondonLondonUK
| | - Siobhan O. Burns
- Institute of Immunity and TransplantationUniversity College LondonLondonUK
- Department of ImmunologyRoyal Free London NHS Foundation TrustLondonUK
| | - Graham J. Lieschke
- Clinical HaematologyPeter MacCallum Cancer Centre/Royal Melbourne HospitalMelbourneVictoriaAustralia
- Australian Regenerative Medicine InstituteMonash UniversityClaytonVictoriaAustralia
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Chapelle V, Lambert J, Deom T, Tessier E, Amouroux D, Silvestre F. Early-life exposure to methylmercury induces reversible behavioral impairments and gene expression modifications in one isogenic lineage of mangrove rivulus fish Kryptolebias marmoratus. Aquat Toxicol 2023; 258:106474. [PMID: 36893699 DOI: 10.1016/j.aquatox.2023.106474] [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] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 02/28/2023] [Accepted: 03/02/2023] [Indexed: 06/18/2023]
Abstract
Methylmercury (MeHg) is a ubiquitous bioaccumulative neurotoxicant present in aquatic ecosystems. It is known to alter behaviors, sensory functions and learning abilities in fish and other vertebrates. Developmental and early-life stages exposure to MeHg can lead to brain damage with immediate consequences on larvae behavior, but may also induce long term effects in adults after a detoxification period. However, very little is known about developmental origin of behavioral impairment in adults due to early exposure to MeHg. The aim of this study is to assess whether early-life MeHg exposure induces immediate and/or delayed effects on behaviors, related genes expression and DNA methylation (one of epigenetic mechanisms). To reach this goal, newly hatched larvae of mangrove rivulus fish, Kryptolebias marmoratus, were exposed to two sub-lethal concentrations of MeHg (90 μg/L and 135 µg/L) for 7 days, and immediate and delayed effects were assessed respectively in 7 dph (days post-hatching) and 90 dph fish. This species naturally produces isogenic lineages due to its self-fertilizing reproduction system, which is unique among vertebrates. It allows to study how environment stressors can influence organism's phenotype while minimizing genetic variability. As results, both MeHg exposures are associated with a decreased foraging efficiency and thigmotaxis, and a dose-dependent reduction in larvae locomotor activity. Regarding molecular analysis in larvae whole bodies, both MeHg exposures induced significant decreased expression of DNMT3a, MAOA, MeCP2 and NIPBL, and significant increase of GSS, but none of those genes underwent methylation changes in targeted CpGs. None of significant behavioral and molecular impairments observed in 7-dph larvae were found in 90-dph adults, which highlight a distinction between immediate and delayed effects of developmental MeHg exposure. Our results suggest implications of aminergic system and its neurotransmitters, redox/methylation trade-off and possibly other epigenetic mechanisms in MeHg neurotoxicity underlying behavioral alterations in rivulus.
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Affiliation(s)
- V Chapelle
- Laboratory of Evolutionary and Adaptive Physiology, Institute of Life, Earth, and the Environment, University of Namur, 61 Rue de Bruxelles, 5000, Namur, Belgium.
| | - J Lambert
- Laboratory of Evolutionary and Adaptive Physiology, Institute of Life, Earth, and the Environment, University of Namur, 61 Rue de Bruxelles, 5000, Namur, Belgium
| | - T Deom
- Laboratory of Evolutionary and Adaptive Physiology, Institute of Life, Earth, and the Environment, University of Namur, 61 Rue de Bruxelles, 5000, Namur, Belgium
| | - E Tessier
- Université de Pau et des Pays de L'Adour, E2S UPPA, CNRS, Institut des Sciences Analytiques et de Physicochimie pour l'Environnement et les Matériaux, Pau, France
| | - D Amouroux
- Université de Pau et des Pays de L'Adour, E2S UPPA, CNRS, Institut des Sciences Analytiques et de Physicochimie pour l'Environnement et les Matériaux, Pau, France
| | - F Silvestre
- Laboratory of Evolutionary and Adaptive Physiology, Institute of Life, Earth, and the Environment, University of Namur, 61 Rue de Bruxelles, 5000, Namur, Belgium
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20
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Thakker C, Booth HL, Lambert J, Morgan S, Checkley AM. Investigating eosinophilia. BMJ 2023; 380:e070295. [PMID: 36737076 DOI: 10.1136/bmj-2022-070295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Clare Thakker
- Hospital for Tropical Diseases, University College London Hospitals NHS Foundation Trust, London, UK
- University College London, London, UK
| | - Helen L Booth
- University College London Hospitals NHS Foundation Trust, London, UK
| | - Jonathan Lambert
- University College London Hospitals NHS Foundation Trust, London, UK
- UCL Cancer Institute, University College London, London, UK
| | - Sarah Morgan
- Camden Directorate, North Central London Integrated Care Board, London, UK
- Hampstead Group Practice, London, UK
| | - Anna M Checkley
- Hospital for Tropical Diseases, University College London Hospitals NHS Foundation Trust, London, UK
- London School of Hygiene and Tropical Medicine, London, UK
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21
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Garbincius J, Luongo T, Lambert J, Mangold A, Murray E, Hildebrand A, Jadiya P, Elrod J. Manipulation of cardiomyocyte MCU expression reveals distinct consequences of mitochondrial calcium uptake in early versus late adaptation to sustained stress. J Mol Cell Cardiol 2022. [DOI: 10.1016/j.yjmcc.2022.08.150] [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: 01/02/2023]
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22
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Soenen R, Stove C, Capobianco A, De Schutter H, Dobbelaere M, Mahjor T, Follens M, Lambert J, Grine L. 146 Promising tools to facilitate the implementation of TDM of biologics in clinical practice. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.156] [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: 11/19/2022]
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23
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Lambert J, Maracani A, Scorrano L. Slc25a12 regulates Opa1 oligomeric assembly and cristae maintenance which is implicated in cardiac pathophysiology. J Mol Cell Cardiol 2022. [DOI: 10.1016/j.yjmcc.2022.08.019] [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: 01/01/2023]
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24
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Amerikanou R, Lambert J, Alimam S. Myeloproliferative neoplasms in adolescents and young adults. Best Pract Res Clin Haematol 2022; 35:101374. [DOI: 10.1016/j.beha.2022.101374] [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] [Received: 07/26/2022] [Revised: 08/05/2022] [Accepted: 08/11/2022] [Indexed: 11/02/2022]
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25
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O'Reilly MA, Sanderson R, Wilson W, Iyengar S, Lambert J, McCulloch R, Eyre TA. Addendum to British Society for Haematology Guideline for the management of mantle cell lymphoma, 2018 (Br. J. Haematol. 2018; 182: 46-62): Risk assessment of potential CAR T candidates receiving a covalent Bruton tyrosine kinase inhibitor for relapsed/refractory disease. Br J Haematol 2022; 199:40-44. [PMID: 35894253 DOI: 10.1111/bjh.18378] [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] [Received: 06/07/2022] [Revised: 07/09/2022] [Accepted: 07/11/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Maeve A O'Reilly
- Department of Haematology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Robin Sanderson
- Department of Haematology, Kings college Hospital, London, UK
| | - William Wilson
- UCL Cancer Trials Centre, University College London, London, UK
| | - Sunil Iyengar
- Department of Haematology, Royal Marsden Hospital, London, UK
| | - Jonathan Lambert
- Department of Haematology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Rory McCulloch
- Department of Haematology, Gloucestershire Hospitals NHS Foundation Trust, Gloucester, UK
| | - Toby A Eyre
- Department of Haematology, Oxford University NHS Trust, Oxford, UK
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Miglianico M, Thériault R, Lavoie B, Labelle P, Joussemet M, Veilleux M, Lambert J, Bertrand-Dubois D. Pratiques cliniques inspirées par la recherche en psychologie positive. Psychologie Française 2022. [DOI: 10.1016/j.psfr.2022.06.004] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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27
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Lambert J. Tick Borne Infections in the EU:A New Epidemic in the Face of Global Warming. Ir Med J 2022; 115:594. [PMID: 35696127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- J Lambert
- Mater Misericordiae University Hospital, Eccles St, Dublin 7
- Rotunda Hospital Dublin, Parnell Square E, Rotunda, Dublin 1
- UCD School of Medicine, Belfield, Dublin 4
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Reich K, Iversen L, Puig L, Lambert J, Mrowietz U, Kaplan Saday K, Warren RB. Long‐term efficacy and safety of brodalumab in moderate‐to‐severe plaque psoriasis: a post hoc pooled analysis of AMAGINE‐2 and ‐3. J Eur Acad Dermatol Venereol 2022; 36:1275-1283. [DOI: 10.1111/jdv.18068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 02/23/2022] [Indexed: 11/30/2022]
Affiliation(s)
- K. Reich
- Translational Research in Inflammatory Skin Diseases Institute for Health Services Research in Dermatology and Nursing University Medical Center Hamburg‐Eppendorf Hamburg Germany
| | - L. Iversen
- Department of Dermatology Aarhus University Hospital Aarhus Denmark
| | - L. Puig
- Department of Dermatology Hospital de la Santa Creu i Sant Pau Autonomous University of Barcelona Barcelona Spain
| | - J. Lambert
- Department of Dermatology Ghent University Ghent Belgium
| | - U. Mrowietz
- Department of Dermatology University Medical Center Schleswig‐Holstein Kiel Germany
| | | | - R. B. Warren
- Dermatology Centre Salford Royal NHS Foundation Trust Manchester NIHR Biomedical Research Centre University of Manchester United Kingdom
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Lambert J, Leutenegger AL, Janno AS, Baudot A. Suivi temporel de clusters identifiés à partir de réseaux de patients. Rev Epidemiol Sante Publique 2022. [DOI: 10.1016/j.respe.2022.01.023] [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] Open
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Bryne A, Lambert J, Yellon D, Walker M, Sivabalasingham S, Ghosh AK. Cardio-oncology Issues in Lymphoma Patients. Isr Med Assoc J 2022; 24:159-164. [PMID: 35347928] [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] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Advances in Lymphoma management have resulted in significant improvements in patient outcomes over the last 50 years. Despite these developments, cardiotoxicity from lymphoma treatments remains an important cause of mortality and morbidity in this cohort of patients. We outlined the most common cardiotoxicities associated with lymphoma treatments and their respective investigation and management strategies, including the role of cardiac pre-assessment and late effects monitoring.
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Affiliation(s)
- Alex Bryne
- Royal Surrey County Hospital, Guildford, England
| | - Jonathan Lambert
- Barts Heart Centre, St. Bartholomew's Hospital West Smithfield, London, United Kingdom
| | - Derek Yellon
- Hatter Cardiovascular Institute, University College London, London, United Kingdom
| | - Malcolm Walker
- Hatter Cardiovascular Institute, University College London, London, United Kingdom
| | | | - Arjun K Ghosh
- Barts Heart Centre, St. Bartholomew's Hospital West Smithfield, London, United Kingdom
- Hatter Cardiovascular Institute, University College London, London, United Kingdom
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Van Loon A, Mortelmans D, Siozopoulou V, Ogunjimi B, Jansens H, Lambert J, Aerts O. A first case of “Covid toes” from a viral vector‐based COVID‐19 vaccine. J Eur Acad Dermatol Venereol 2022; 36:e400-e402. [DOI: 10.1111/jdv.17948] [Citation(s) in RCA: 2] [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: 10/16/2021] [Accepted: 01/18/2022] [Indexed: 11/28/2022]
Affiliation(s)
- A. Van Loon
- Department of Dermatology University Hospital Antwerp (UZA) and Research group Immunology, Infla‐Med Centre of Excellence, University of Antwerp Antwerp Belgium
| | - D. Mortelmans
- Department of Dermatology University Hospital Antwerp (UZA) and Research group Immunology, Infla‐Med Centre of Excellence, University of Antwerp Antwerp Belgium
| | - V. Siozopoulou
- Department of Pathology University Hospital Antwerp (UZA) and University of Antwerp Antwerp Belgium
| | - B. Ogunjimi
- Department of Pediatrics University Hospital Antwerp (UZA) and University of Antwerp Antwerp Belgium
| | - H. Jansens
- Department of Laboratory Medicine University Hospital Antwerp (UZA) and University of Antwerp Antwerp Belgium
| | - J. Lambert
- Department of Dermatology University Hospital Antwerp (UZA) and Research group Immunology, Infla‐Med Centre of Excellence, University of Antwerp Antwerp Belgium
| | - O. Aerts
- Department of Dermatology University Hospital Antwerp (UZA) and Research group Immunology, Infla‐Med Centre of Excellence, University of Antwerp Antwerp Belgium
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Cook H, Lambert J, Thomas R, Palmans H, Hussein M, Clark CH, Royle G, Pettingell J, Lourenço A. Development of a heterogeneous phantom to measure range in clinical proton therapy beams. Phys Med 2022; 93:59-68. [PMID: 34968893 DOI: 10.1016/j.ejmp.2021.11.006] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 11/16/2021] [Accepted: 11/20/2021] [Indexed: 11/24/2022] Open
Abstract
PURPOSE In particle therapy, determination of range by measurement or calculation can be a significant source of uncertainty. This work investigates the development of a bespoke Range Length Phantom (RaLPh) to allow independent determination of proton range in tissue. This phantom is intended to be used as an audit device. METHOD RaLPh was designed to be compact and allows different configurations of tissue substitute slabs, to facilitate measurement of range using radiochromic film. Fourteen RaLPh configurations were tested, using two types of proton fluence optimised water substitutes, two types of bone substitute, and one lung substitute slabs. These were designed to mimic different complex tissue interfaces. Experiments were performed using a 115 MeV mono-energetic scanning proton beam to investigate the proton range for each configuration. Validation of the measured film ranges was performed via Monte Carlo simulations and ionisation chamber measurements. The phantom was then assessed as an audit device, by comparing film measurements with Treatment Planning System (TPS) predicted ranges. RESULTS Varying the phantom slab configurations allowed for measurable range differences, and the best combinations of heterogeneous material gave agreement between film and Monte Carlo on average within 0.2% and on average within 0.3% of ionisation chamber measurements. Results against the TPS suggest a material density override is currently required to enable the phantom to be an audit device. CONCLUSION This study found that a heterogeneous phantom with radiochromic film can provide range verification as part of a dedicated audit for clinical proton therapy beams.
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Affiliation(s)
- H Cook
- Department of Medical Physics and Biomedical Engineering, University College London, London WC1E 6BT, United Kingdom; Medical Radiation Science, National Physical Laboratory, Teddington, TW11 0LW, United Kingdom.
| | - J Lambert
- Medical Physics Department, The Rutherford Cancer Centre South Wales, Newport NP10 8FZ, United Kingdom
| | - R Thomas
- Medical Radiation Science, National Physical Laboratory, Teddington, TW11 0LW, United Kingdom
| | - H Palmans
- Medical Radiation Science, National Physical Laboratory, Teddington, TW11 0LW, United Kingdom; Medical Physics Group, MedAustron Ion Therapy Center, A-2700 Wiener Neustadt, Austria
| | - M Hussein
- Medical Radiation Science, National Physical Laboratory, Teddington, TW11 0LW, United Kingdom
| | - C H Clark
- Department of Medical Physics and Biomedical Engineering, University College London, London WC1E 6BT, United Kingdom; Medical Radiation Science, National Physical Laboratory, Teddington, TW11 0LW, United Kingdom; Radiotherapy Physics, University College London Hospital, NW1 2BU, United Kingdom; Radiotherapy Trials Quality Assurance Group (RTTQA), Mount Vernon Cancer Centre, HA6 2RN, United Kingdom
| | - G Royle
- Department of Medical Physics and Biomedical Engineering, University College London, London WC1E 6BT, United Kingdom
| | - J Pettingell
- Medical Physics Department, The Rutherford Cancer Centre South Wales, Newport NP10 8FZ, United Kingdom
| | - A Lourenço
- Department of Medical Physics and Biomedical Engineering, University College London, London WC1E 6BT, United Kingdom; Medical Radiation Science, National Physical Laboratory, Teddington, TW11 0LW, United Kingdom
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van Ee I, Deprez E, Egeberg A, Augustin M, Conrad C, Corazza V, Donati L, Lambert J, Lăpădatu R, Meyer A, Paul C, Penzer-Hick R, Stephen K, van der Zon J, Bewley A. Freedom from disease in psoriasis: a Delphi consensus definition by patients, nurses and physicians. J Eur Acad Dermatol Venereol 2021; 36:403-412. [PMID: 34816508 PMCID: PMC9303201 DOI: 10.1111/jdv.17829] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 07/07/2021] [Accepted: 11/03/2021] [Indexed: 12/22/2022]
Abstract
Background Physician‐reported clinical outcome and quality of life (QoL) measures are currently used to assess outcomes and direct treatment of plaque psoriasis. However, people with psoriasis may have different criteria for judging treatment success. Objectives To build a unified consensus on the definition of ‘freedom from disease’ from a European stakeholder group, including people with psoriasis, dermatologists and nurses. Methods The modified Delphi consensus methodology was used to define ‘freedom from disease’, with a consensus group consisting of people with psoriasis, nurses and dermatologists. This methodology involved people with psoriasis during the entire process and consisted of a 15‐member Facilitating Consensus Panel to drive the programme content and a larger Voting Consensus Panel to vote on defining ‘freedom from disease’. The Facilitating Panel agreed on disease domains, and aspects of each domain were put forward to the Voting Consensus Panel to establish relative importance. Following two voting rounds, a meeting was held to agree on a final consensus statement. Results The Facilitating Panel consisted of six patient advocacy group representatives, three specialist nurses and six dermatologists. Voting rounds 1 and 2 were completed by 166 and 130 respondents from the Voting Consensus Panel, respectively. The outputs from both rounds of voting were similar, focusing on normality of living, symptom control, and a relationship of mutual respect and trust between the individual with psoriasis and their healthcare professional. The consensus statement emphasizes that ‘freedom from disease’ is multifaceted and includes the following domains ‘management of clinical symptoms’, ‘psychosocial elements’, ‘QoL and well‐being’, ‘treatment’ and ‘healthcare team support’. ‘Freedom from disease’ means all aspects are addressed. Conclusions Freedom from disease in psoriasis is a multicomponent concept including five main domains. This diverse and multifaceted patient perspective will help us to improve understanding of the outcomes of treatment interventions in people with psoriasis.
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Affiliation(s)
- I van Ee
- Psoriasispatiënten Nederland (PN), Nijkerk, The Netherlands
| | - E Deprez
- Ghent University Hospital, Ghent, Belgium
| | - A Egeberg
- Department of Dermatology, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - M Augustin
- IVDP Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - C Conrad
- Lausanne University Hospital CHUV, Lausanne, Switzerland
| | - V Corazza
- Fondazione Natalino Corazza Onlus Psoriasis & Co, Bologna, Italy
| | - L Donati
- Fondazione Natalino Corazza Onlus Psoriasis & Co, Bologna, Italy
| | - J Lambert
- Ghent University Hospital, Ghent, Belgium
| | - R Lăpădatu
- Associaţia Pacienţilor cu Afecţiuni Autoimune (APAA), Bucharest, Romania
| | - A Meyer
- Deutscher Psoriasis Bund e.V. (DPB), Hamburg, Germany
| | - C Paul
- Paul Sabatier University, Toulouse, France.,Centre Hospitalier Universitaire, Toulouse, France
| | | | | | - J van der Zon
- Psoriasispatiënten Nederland (PN), Nijkerk, The Netherlands
| | - A Bewley
- Barts Health NHS Trust & Queen Mary University, London, UK
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Patch S, Nguyen C, Cohilis M, Lambert J, Souris K, Janssens G, Labarbe R, Ono S, Lynch T. Thermoacoustic Range Verification During Pencil Beam Delivery of a Clinical Plan to an Abdominal Imaging Phantom. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1407] [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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Grine L, Hilhorst N, Michels N, Abbeddou S, De Henauw S, Lambert J. 243 Interim Results of the MANGO Trial: Modified Intermittent Fasting in Psoriasis. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.08.248] [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: 11/29/2022]
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Bose P, Verstovsek S, Kremyanskaya M, Mascarenhas J, Talpaz M, Harrison C, Rampai R, Patriarca A, Gupta V, Granacher N, Somervaille T, Schiller G, Drummond M, Foltz L, Lambert J, Prejzner W, Colak G, Keller P, Shao J, Luptakova K, Hoffman R, Vannucchi A. MPN-328: Pelabresib (CPI-0610) Improved Anemia Associated with Myelofibrosis: Interim Results from the Ongoing MANIFEST Phase 2 Study. Clinical Lymphoma Myeloma and Leukemia 2021. [DOI: 10.1016/s2152-2650(21)01832-2] [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] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Soenen R, Grine L, Schots L, Lanssens S, Temmerman L, Thomas D, Lambert J. LB814 Therapeutic drug monitoring: The way towards individualized Secukinumab dosing in Psoriasis. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.07.075] [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: 10/20/2022]
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38
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Nicholas O, Saplaouros A, Lambert J, Fegan G, Hugtenburg R, Gwynne S. PO-1241 Optimising splenic dose with PBT and VMAT for distal oesophageal cancer. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07692-1] [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: 10/20/2022]
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39
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Patch S, Nguyen C, Labarbe R, Janssens G, Lambert J, Cohilis M, Souris K, Ono S, Lynch T. OC-0205 Thermoacoustic Range Verification During Delivery of a Clinical Plan to a Abdominal Imaging Phantom. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06820-1] [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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40
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Westeel V, Bourdon M, Cortot AB, Debieuvre D, Toffart AC, Acquadro M, Arnould B, Lambert J, Cotte FE, Gaudin AF, Lemasson H. Management of lung cancer patients' quality of life in clinical practice: a Delphi study. ESMO Open 2021; 6:100239. [PMID: 34388690 PMCID: PMC8363823 DOI: 10.1016/j.esmoop.2021.100239] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 06/18/2021] [Accepted: 07/19/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The assessment of health-related quality of life (HRQoL) has seen exponential growth in oncology clinical trials. However, the measurement of HRQoL has yet to be optimised in routine clinical practice. This study aimed at exploring the operationalisation of HRQoL in clinical practice with the goal of reaching a consensus from a panel of physicians. MATERIALS AND METHODS Physicians involved in the management of lung cancer patients in France were recruited to participate in a Delphi study. The study involved three rounds of iterated queries to gain consensus on management aspects of HRQoL, including timing of discussion on HRQoL, which specific domains of HRQoL should be discussed, and what was the most appropriate method of assessment. The threshold adopted for consensus was at least 70% agreement among physicians. A scientific committee reviewed results following each round of the Delphi study. RESULTS A representative panel of 60 physicians participated in this study. Consensus was obtained for HRQoL management at all time points in the patient care pathway. Panellists agreed that HRQoL discussions should occur during routine visits and hospitalisation. The involvement of patients' relatives was also recognised as important, except when discussing side-effects and involvement of a multidisciplinary team. There was a lack of consensus on a systematic assessment for all patients at each visit and no consensus on how HRQoL should be measured in clinical practice. CONCLUSIONS HRQoL discussions are considered an integral part in the management of lung cancer patients, and are deemed key to success in patient-physician interaction. Further research is required to harmonise how best to implement HRQoL assessment.
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Affiliation(s)
- V Westeel
- Unité de Méthodologie et de Qualité de Vie en Cancérologie, Centre Hospitalier Universitaire de Besançon, UMR1098, Université de Franche-Comté, Besançon, France
| | - M Bourdon
- Institut de Cancérologie de l'Ouest, Nantes, Angers, France; UMR INSERM 1246 SPHERE, Université de Nantes, Université de Tours, Tours, France
| | - A B Cortot
- University of Lille, Centre Hospitalier Universitaire de Lille, CNRS, Inserm, Institut Pasteur de Lille, UMR9020-UMR-S 1277-Canther, Lille, France
| | - D Debieuvre
- GHRMSA-Hôpital Emile Muller, Mulhouse, France
| | - A-C Toffart
- Centre Hospitalier Universitaire de Grenoble Alpes, Grenoble, France
| | - M Acquadro
- Patient Centred Outcomes, ICON plc, Lyon, France
| | - B Arnould
- Patient Centred Outcomes, ICON plc, Lyon, France
| | - J Lambert
- Patient Centred Outcomes, ICON plc, Lyon, France.
| | - F-E Cotte
- Bristol-Myers Squibb, Rueil-Malmaison, France
| | - A-F Gaudin
- Bristol-Myers Squibb, Rueil-Malmaison, France
| | - H Lemasson
- Bristol-Myers Squibb, Rueil-Malmaison, France
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Abstract
Antiphospholipid syndrome (APS) and myeloproliferative neoplasms (MPN) are associated with an increased risk of thrombosis. The optimal management of patients with coexistent APS and MPN has not been defined. A single centre and systematic literature review of patients with coexistent APS and MPN was performed. Cases were divided into two groups based on whether they met international consensus criteria for APS. Of the 12 studies identified, eight were excluded (leaving five of a total 54 patients), as although antiphospholipid antibodies (aPL) were documented, the diagnosis of APS was not conclusively demonstrated. Another ten patients with definite APS were identified at our centre. Fifteen patients (ten females, five males) were therefore included in this analysis (eleven definite APS and four highly likely), median age 44 (range: 13-71) years. Nine had polycythaemia vera and six, essential thrombocythaemia. Thirteen of the 15 patients (86.7%) had thrombotic APS (seven with initial venous events and six arterial) and two (13.3%) had obstetric APS. Nine patients were single-positive, and six double-positive for aPL. None were triple aPL-positive. Four patients at our centre had recurrent thrombotic/obstetric events, including while on anticoagulation/antiplatelet treatment.
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Affiliation(s)
- Zara Sayar
- Haemostasis Research Unit, Department of Haematology, University College London, London, UK
| | - Susanna Nallamilli
- Haemostasis Research Unit, Department of Haematology, University College London, London, UK.,Department of Haematology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Maria Efthymiou
- Haemostasis Research Unit, Department of Haematology, University College London, London, UK.,Department of Haematology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Jonathan Lambert
- Department of Haematology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Hannah Cohen
- Haemostasis Research Unit, Department of Haematology, University College London, London, UK.,Department of Haematology, University College London Hospitals NHS Foundation Trust, London, UK
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42
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Mahil S, Yates M, Langan S, Yiu Z, Tsakok T, Dand N, Mason K, McAteer H, Meynell F, Coker B, Vincent A, Urmston D, Vesty A, Kelly J, Lancelot C, Moorhead L, Bachelez H, Bruce I, Capon F, Contreras C, Cope A, De La Cruz C, Di Meglio P, Gisondi P, Hyrich K, Jullien D, Lambert J, Marzo‐Ortega H, McInnes I, Naldi L, Norton S, Puig L, Sengupta R, Spuls P, Torres T, Warren R, Waweru H, Weinman J, Griffiths C, Barker J, Brown M, Galloway J, Smith C. Risk-mitigating behaviours in people with inflammatory skin and joint disease during the COVID-19 pandemic differ by treatment type: a cross-sectional patient survey. Br J Dermatol 2021; 185:80-90. [PMID: 33368145 PMCID: PMC9214088 DOI: 10.1111/bjd.19755] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND Registry data suggest that people with immune-mediated inflammatory diseases (IMIDs) receiving targeted systemic therapies have fewer adverse coronavirus disease 2019 (COVID-19) outcomes compared with patients receiving no systemic treatments. OBJECTIVES We used international patient survey data to explore the hypothesis that greater risk-mitigating behaviour in those receiving targeted therapies may account, at least in part, for this observation. METHODS Online surveys were completed by individuals with psoriasis (globally) or rheumatic and musculoskeletal diseases (RMDs) (UK only) between 4 May and 7 September 2020. We used multiple logistic regression to assess the association between treatment type and risk-mitigating behaviour, adjusting for clinical and demographic characteristics. We characterized international variation in a mixed-effects model. RESULTS Of 3720 participants (2869 psoriasis, 851 RMDs) from 74 countries, 2262 (60·8%) reported the most stringent risk-mitigating behaviour (classified here under the umbrella term 'shielding'). A greater proportion of those receiving targeted therapies (biologics and Janus Kinase inhibitors) reported shielding compared with those receiving no systemic therapy [adjusted odds ratio (OR) 1·63, 95% confidence interval (CI) 1·35-1·97]. The association between targeted therapy and shielding was preserved when standard systemic therapy was used as the reference group (OR 1·39, 95% CI 1·23-1·56). Shielding was associated with established risk factors for severe COVID-19 [male sex (OR 1·14, 95% CI 1·05-1·24), obesity (OR 1·37, 95% CI 1·23-1·54), comorbidity burden (OR 1·43, 95% CI 1·15-1·78)], a primary indication of RMDs (OR 1·37, 95% CI 1·27-1·48) and a positive anxiety or depression screen (OR 1·57, 95% CI 1·36-1·80). Modest differences in the proportion shielding were observed across nations. CONCLUSIONS Greater risk-mitigating behaviour among people with IMIDs receiving targeted therapies may contribute to the reported lower risk of adverse COVID-19 outcomes. The behaviour variation across treatment groups, IMIDs and nations reinforces the need for clear evidence-based patient communication on risk-mitigation strategies and may help inform updated public health guidelines as the pandemic continues.
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43
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Bahti A, Telfah A, Lambert J, Hergenröder R, Suter D. Optimal control pulses for subspectral editing in low field NMR. J Magn Reson 2021; 328:106993. [PMID: 34029798 DOI: 10.1016/j.jmr.2021.106993] [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] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 03/14/2021] [Accepted: 04/26/2021] [Indexed: 06/12/2023]
Abstract
Low field NMR is an inexpensive and low footprint technique to obtain physical, chemical, electronic and structural information on small molecules, but suffers from poor spectral dispersion, especially when applied to the analysis of mixtures. Subspectral editing employing optimal control pulses is a suitable approach to cope with the severe signal superpositions in complex mixture spectra at low field. In this contribution, the use of optimal control pulses is demonstrated to be feasible at a field strength as low as 0.5 T. The optimal control pulse shapes were calculated using the Krotov algorithm. Downsizing the complexity of the algorithm from exponential to polynomial is shown to be possible by using a system approach with each system corresponding to a (small) molecule. In this way compound selective excitation pulses can be calculated. The signals of substructures of the cyclopentenone molecule were excited using optimal control pulses calculated by the Krotov algorithm demonstrating the feasibility of subspectral editing. Likewise, for a mixture of benzoic acid and alanine, editing of the signals of either benzoic acid or alanine employing optimal control pulses was shown to be possible. The obtained results are very promising and can be extended to the targeted analysis of complex mixtures such as biofluids or metabolic samples at low field strengths opening access for benchtop NMR to point of care settings.
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Affiliation(s)
- A Bahti
- Leibniz-Institut für Analytische Wissenschaften - ISAS - e.V., 44139 Dortmund, Germany; Experimental Physics III, TU Dortmund University, 44227 Dortmund, Germany.
| | - A Telfah
- Leibniz-Institut für Analytische Wissenschaften - ISAS - e.V., 44139 Dortmund, Germany
| | - J Lambert
- Leibniz-Institut für Analytische Wissenschaften - ISAS - e.V., 44139 Dortmund, Germany
| | - R Hergenröder
- Leibniz-Institut für Analytische Wissenschaften - ISAS - e.V., 44139 Dortmund, Germany.
| | - D Suter
- Experimental Physics III, TU Dortmund University, 44227 Dortmund, Germany
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44
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Mahil SK, Yates M, Yiu ZZN, Langan SM, Tsakok T, Dand N, Mason KJ, McAteer H, Meynell F, Coker B, Vincent A, Urmston D, Vesty A, Kelly J, Lancelot C, Moorhead L, Bachelez H, Capon F, Contreras CR, De La Cruz C, Di Meglio P, Gisondi P, Jullien D, Lambert J, Naldi L, Norton S, Puig L, Spuls P, Torres T, Warren RB, Waweru H, Weinman J, Brown MA, Galloway JB, Griffiths CM, Barker JN, Smith CH. Describing the burden of the COVID-19 pandemic in people with psoriasis: findings from a global cross-sectional study. J Eur Acad Dermatol Venereol 2021; 35:e636-e640. [PMID: 34145643 PMCID: PMC8447018 DOI: 10.1111/jdv.17450] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- S K Mahil
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK.,NIHR Biomedical Research Centre at Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK
| | - M Yates
- NIHR Biomedical Research Centre at Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK.,Centre for Rheumatic Diseases, King's College London, London, UK
| | - Z Z N Yiu
- Dermatology Centre, Salford Royal NHS Foundation Trust, The University of Manchester, Manchester Academic Health Science Centre, NIHR Manchester Biomedical Research Centre, Manchester, UK
| | - S M Langan
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK.,Faculty of Epidemiology, and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - T Tsakok
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK.,NIHR Biomedical Research Centre at Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK
| | - N Dand
- Department of Medical and Molecular Genetics, School of Basic and Medical Biosciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.,Health Data Research UK, London, UK
| | - K J Mason
- Centre for Rheumatic Diseases, King's College London, London, UK.,School of Medicine, Keele University, Keele, UK
| | - H McAteer
- The Psoriasis Association, Northampton, UK
| | - F Meynell
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK.,NIHR Biomedical Research Centre at Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK
| | - B Coker
- NIHR Biomedical Research Centre at Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK
| | - A Vincent
- NIHR Biomedical Research Centre at Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK
| | - D Urmston
- The Psoriasis Association, Northampton, UK
| | - A Vesty
- The Psoriasis Association, Northampton, UK
| | - J Kelly
- Dermatology Centre, Salford Royal NHS Foundation Trust, The University of Manchester, Manchester Academic Health Science Centre, NIHR Manchester Biomedical Research Centre, Manchester, UK
| | - C Lancelot
- International Federation of Psoriasis Associations (IFPA), Bromma, Sweden
| | - L Moorhead
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK
| | - H Bachelez
- Department of Dermatology, AP-HP Hôpital Saint-Louis, Paris, France.,INSERM U1163, Imagine Institute for Human Genetic Diseases, Université de Paris, Paris, France
| | - F Capon
- NIHR Biomedical Research Centre at Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK.,Department of Medical and Molecular Genetics, School of Basic and Medical Biosciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - C R Contreras
- Catedra de Dermatologia, Hospital de Clinicas, Facultad de Ciencias Medicas, Universidad Nacional de Asuncion, San Lorenzo, Paraguay
| | | | - P Di Meglio
- NIHR Biomedical Research Centre at Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK.,St John's Institute of Dermatology, School of Basic & Medical Biosciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - P Gisondi
- Section of Dermatology and Venereology, University of Verona, Verona, Italy
| | - D Jullien
- Department of Dermatology, Edouard Herriot Hospital, Hospices Civils de Lyon, University of Lyon, Lyon, France.,Groupe de Recherche sur le Psoriasis (GrPso) de la Société Française de Dermatologie, Paris, France
| | - J Lambert
- Department of Dermatology, Ghent University, Ghent, Belgium
| | - L Naldi
- Centro Studi GISED, Bergamo, Italy
| | - S Norton
- Psychology Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - L Puig
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - P Spuls
- Department of Dermatology, Amsterdam Public Health/Infection and Immunology, Amsterdam University Medical Centers, Location AMC, Amsterdam, The Netherlands
| | - T Torres
- Department of Dermatology, Centro Hospitalar do Porto, Porto, Portugal
| | - R B Warren
- Dermatology Centre, Salford Royal NHS Foundation Trust, The University of Manchester, Manchester Academic Health Science Centre, NIHR Manchester Biomedical Research Centre, Manchester, UK
| | - H Waweru
- International Federation of Psoriasis Associations (IFPA), Bromma, Sweden
| | - J Weinman
- School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - M A Brown
- NIHR Biomedical Research Centre at Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK.,Centre for Rheumatic Diseases, King's College London, London, UK
| | - J B Galloway
- Centre for Rheumatic Diseases, King's College London, London, UK.,Dermatology Centre, Salford Royal NHS Foundation Trust, The University of Manchester, Manchester Academic Health Science Centre, NIHR Manchester Biomedical Research Centre, Manchester, UK
| | - C M Griffiths
- Dermatology Centre, Salford Royal NHS Foundation Trust, The University of Manchester, Manchester Academic Health Science Centre, NIHR Manchester Biomedical Research Centre, Manchester, UK
| | - J N Barker
- NIHR Biomedical Research Centre at Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK.,St John's Institute of Dermatology, School of Basic & Medical Biosciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - C H Smith
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK.,NIHR Biomedical Research Centre at Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK
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45
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Connellan D, Diffley K, McCabe J, Cotter A, McGinty T, Sheehan G, Ryan K, Cullen W, Lambert J, Callaly E, Kyne L. 484 CHANGING PRACTICES OF DECISION MAKING REGARDING DO-NOT-ATTEMPT-CARDIOPULMONARY-RESUSCITATION ORDERS AMID THE COVID-19 PANDEMIC. Age Ageing 2021. [PMCID: PMC8344931 DOI: 10.1093/ageing/afab117.07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
The COVID-19 pandemic has brought the decision-making process regarding cardiopulmonary resuscitation into focus. This study aims to analyse Do-Not-Attempt CPR (DNACPR) documentation in older hospitalised patients before and during the COVID-19 pandemic.
Methods
This was a retrospective repeated cross-sectional study. Data including co-morbidities and resuscitation status was collected on 300 patients with COVID-19 hospitalised from March 1st to May 31 s t 2020. DNACPR documentation rates in patients aged ≥65 years with a diagnosis of COVID-19 were compared to those without COVID-19 admitted during the same period. Pre-COVID-19 pandemic DNACPR documentation rates were also examined. Factors associated with DNACPR order instatement during the first wave of the COVID-19 pandemic were identified.
Results
Of 300 COVID-19-positive patients, 28% had a DNACPR order documented during their admission. 50% of DNAR orders were recorded within 24 hours of a positive swab result for SARS-CoV-2. Of 131 patients aged 65 years or over within the cohort admitted with COVID-19, 60.3% had a DNACPR order compared to 25.4% of 130 patients ≥65 without COVID-19 (p < 0.0001). During a comparable time period pre-pandemic, 15.4% of 130 older patients had a DNACPR order in place (p < 0.0001). Independent associations with DNACPR order documentation included increasing age (Odds Ratio [O.R.] 1.12; 95% CI 1.05-1.21); nursing home resident status (O.R. 3.57; 95% CI 1.02-12.50); frailty (O.R. 3.34; 95% CI 1.16-9.61) and chronic renal impairment (O.R. 5.49; 1.34-22.47). The case-fatality-rate of older patients with COVID-19 was 29.8% versus 5.4% without COVID-19. Of older COVID-19-positive patients, 39.2% were referred to palliative care services and 70.2% survived.
Conclusion
The COVID-19 pandemic has prompted more widespread and earlier decision-making regarding resuscitation status. Although case-fatality-rates were higher for older hospitalised patients with COVID-19, many older patients survived the illness. Advance care planning should be prioritised in all patients and should remain clinical practice despite the pandemic.
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Affiliation(s)
- D Connellan
- Mater Misericordiae University Hospital, Eccles Street, Dublin 7; School of Medicine, University College Dublin, Belfield, Dublin 4
| | - K Diffley
- Mater Misericordiae University Hospital, Eccles Street, Dublin 7; School of Medicine, University College Dublin, Belfield, Dublin 4
| | - J McCabe
- Mater Misericordiae University Hospital, Eccles Street, Dublin 7; School of Medicine, University College Dublin, Belfield, Dublin 4
| | - A Cotter
- Mater Misericordiae University Hospital, Eccles Street, Dublin 7; School of Medicine, University College Dublin, Belfield, Dublin 4
| | - T McGinty
- Mater Misericordiae University Hospital, Eccles Street, Dublin 7; School of Medicine, University College Dublin, Belfield, Dublin 4
| | - G Sheehan
- Mater Misericordiae University Hospital, Eccles Street, Dublin 7; School of Medicine, University College Dublin, Belfield, Dublin 4
| | - K Ryan
- Mater Misericordiae University Hospital, Eccles Street, Dublin 7; School of Medicine, University College Dublin, Belfield, Dublin 4
| | - W Cullen
- Mater Misericordiae University Hospital, Eccles Street, Dublin 7; School of Medicine, University College Dublin, Belfield, Dublin 4
| | - J Lambert
- Mater Misericordiae University Hospital, Eccles Street, Dublin 7; School of Medicine, University College Dublin, Belfield, Dublin 4
| | - E Callaly
- Mater Misericordiae University Hospital, Eccles Street, Dublin 7; School of Medicine, University College Dublin, Belfield, Dublin 4
| | - L Kyne
- Mater Misericordiae University Hospital, Eccles Street, Dublin 7; School of Medicine, University College Dublin, Belfield, Dublin 4
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46
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Bommier C, Ruggiu M, Monegier A, Zucca E, Thieblemont C, Lambert J. ENDPOINTS IN MARGINAL ZONE LYMPHOMAS: A SYSTEMATIC REVIEW REVEALS WIDE HETEROGENEITY ACROSS TRIALS AND CALLS FOR STANDARDIZATION. Hematol Oncol 2021. [DOI: 10.1002/hon.27_2881] [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)
- C Bommier
- Hôpital Saint Louis Onco‐hematology department U1153 Inserm ‐ ECSTRRA Team Paris France
| | - M Ruggiu
- Hôpital Saint Louis Hematopoietic stem cell transplant Paris France
| | - A Monegier
- Hôpital Saint Louis, Statistics and Bioinformatics Paris France
| | - E Zucca
- Ospedale Regionale di Bellinzona e Valli, IELSG Bellinzona Switzerland
| | | | - J Lambert
- Hôpital Saint Louis, Statistics and Bioinformatics Inserm U1153 ECSTRRA Team Paris France
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47
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Lambert JLW, Segaert S, Ghislain PD, Hillary T, Nikkels A, Willaert F, Lambert J, Speeckaert R. Practical recommendations for systemic treatment in psoriasis according to age, pregnancy, metabolic syndrome, mental health, psoriasis subtype and treatment history (BETA-PSO: Belgian Evidence-based Treatment Advice in Psoriasis; part 1). J Eur Acad Dermatol Venereol 2021; 34:1654-1665. [PMID: 32735076 PMCID: PMC7496083 DOI: 10.1111/jdv.16684] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [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: 02/02/2020] [Accepted: 05/15/2020] [Indexed: 12/18/2022]
Abstract
Background Impressive progress in new therapeutic options has been made for psoriasis. Treatments include topical steroids, phototherapy, conventional, synthetic disease‐modifying drugs and an expanding list of biologics. Objective The primary objective of this work was to collect evidence for the creation of practice guidelines for systemic treatment of psoriasis (BETA‐PSO: Belgian Evidence‐based Treatment Advice in Psoriasis). Methods Evidence‐based recommendations were formulated using a quasi‐Delphi methodology after a systematic search of the literature and a consensus procedure involving 8 psoriasis experts. Results In this part, the use of systemic treatment in different age groups, during pregnancy, in metabolic syndrome, in patients with mental health problems, in different psoriasis subtypes and in previously systemically treated patients treatment is discussed. Conclusion Guidance on therapeutic choice in specific clinical situations in psoriasis is provided in order to facilitate the decision‐making in clinical practice.
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Affiliation(s)
- J L W Lambert
- Department of Dermatology, Ghent University Hospital, Ghent, Belgium
| | | | - P D Ghislain
- Dermatology, Cliniques Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - T Hillary
- Dermatology, University Hospital Leuven, Leuven, Belgium
| | - A Nikkels
- Dermatology, Centre Hospitalier Universitaire de Liège, Liège, Belgium
| | - F Willaert
- Dermatology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - J Lambert
- Dermatology, University Hospital of Antwerp, Antwerp, Belgium
| | - R Speeckaert
- Department of Dermatology, Ghent University Hospital, Ghent, Belgium
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48
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Rampotas A, Wilson MR, Lomas O, Denny N, Leary H, Ferguson G, McKay P, Ebsworth T, Miller J, Shah N, Martinez-Calle N, Bishton M, Everden A, Tucker D, El-Hassad E, Hennessy B, Doherty D, Prideaux S, Faryal R, Hayat A, Keohane C, Marr H, Gibb A, Pocock R, Lambert J, Lacey R, Elmusharaf N, Clifford R, Eyre TA. Treatment patterns and outcomes of unfit and elderly patients with Mantle cell lymphoma unfit for standard immunochemotherapy: A UK and Ireland analysis. Br J Haematol 2021; 194:365-377. [PMID: 33959947 DOI: 10.1111/bjh.17513] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 02/15/2021] [Revised: 03/30/2021] [Accepted: 04/05/2021] [Indexed: 12/01/2022]
Abstract
Mantle cell lymphoma (MCL) presenting in elderly, unfit patients represents a clinical challenge. Front-line 'attenuated' or low-intensity immunochemotherapy is often employed, although outcomes are relatively unexplored. We report outcomes of attenuated immunochemotherapy in 95 patients with MCL across 19 centres in the UK and Ireland considered unfit for full-dose rituximab-bendamustine or rituximab-cyclophosphamide, doxorubicin, vincristine, prednisolone (R-CHOP). Regimens examined were rituximab-cyclophosphamide, vincristine, prednisolone (R-CVP) (n = 19), dose-attenuated R-CHOP (n = 22), dose attenuated rituximab-bendamustine (n = 24) and rituximab-chlorambucil (n = 30). The primary outcome was progression-free survival (PFS). The secondary outcomes included overall response, overall survival (OS) and toxicity. The median (range) age was 79 (58-89) years and 50% were aged ≥80 years. The median (range) Cumulative Illness Rating Scale-Geriatric score was 6 (0-24). The median PFS for all patients was 15 months [95% confidence interval (CI) 8·7-21·2) and median OS was 31·4 months (95% CI 19·7-43·2). By multivariable analysis (MVA), the only clinical factor associated with an inferior PFS was blastoid morphology [hazard ratio (HR) 2·90, P = 0·01). Notably, higher treatment intensity (R-CHOP/R-bendamustine composite) provided an independently superior PFS compared with R-CVP/R-chlorambucil (MVA HR 0·49, P = 0·02). Factors associated with inferior OS by MVA were Eastern Cooperative Oncology Group Performance Status (HR 2·14, P = 0·04), blastoid morphology (HR 4·08, P = 0·001) and progression of disease at <24 months status (HR 5·68, P < 0·001). Overall, survival after front-line dose-attenuated immunochemotherapy is unsatisfactory. Clinical trials investigating novel agents such as Bruton tyrosine kinase and B-cell lymphoma 2 inhibitors in this specific clinical setting are warranted.
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Affiliation(s)
- Alexandros Rampotas
- Department of Haematology, Oxford University Hospital NHS Foundation Trust, Oxford, UK.,Oxford University Graduate Academic School, Oxford, UK
| | - Matthew R Wilson
- Department of Haematology, Beatson West of Scotland Cancer Centre, Glasgow, UK
| | - Oliver Lomas
- Department of Haematology, Oxford University Hospital NHS Foundation Trust, Oxford, UK.,Department of Haematology, Buckinghamshire Healthcare NHS Trust, Cardiff, UK
| | - Nicholas Denny
- Department of Haematology, Oxford University Hospital NHS Foundation Trust, Oxford, UK.,Oxford University Graduate Academic School, Oxford, UK
| | - Heather Leary
- Department of Haematology, Milton Keynes University Hospital NHS Foundation Trust, Oxford, UK
| | - Graeme Ferguson
- Department of Haematology, Beatson West of Scotland Cancer Centre, Glasgow, UK
| | - Pamela McKay
- Department of Haematology, Beatson West of Scotland Cancer Centre, Glasgow, UK
| | - Tim Ebsworth
- Department of Haematology, University Hospital of Southampton NHS Foundation Trust, Southampton, UK
| | - Jonathan Miller
- Department of Haematology, Norfolk and Norwich University Hospital NHS Foundation Trust, Norwich, UK
| | - Nimish Shah
- Department of Haematology, Norfolk and Norwich University Hospital NHS Foundation Trust, Norwich, UK
| | | | - Mark Bishton
- Department of Haematology, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Angharad Everden
- Department of Haematology, Royal Cornwall Hospital NHS Trust, Truro, UK
| | - David Tucker
- Department of Haematology, Royal Cornwall Hospital NHS Trust, Truro, UK
| | - Ezzat El-Hassad
- Department of Haematology, University Hospital Waterford, Waterford, Republic of Ireland
| | - Brian Hennessy
- Department of Haematology, University Hospital Waterford, Waterford, Republic of Ireland
| | - Dearbhla Doherty
- Department of Haematology, St Vincent's University Hospital, Dublin, Republic of Ireland
| | - Steve Prideaux
- Department of Haematology, Great Western Hospitals NHS Foundation Trust, Swindon, UK
| | - Rehman Faryal
- Department of Haematology, University Hospital Galway, Galway, Republic of Ireland
| | - Amjad Hayat
- Department of Haematology, University Hospital Galway, Galway, Republic of Ireland
| | - Clodagh Keohane
- Department of Haematology, Mercy University Hospital, Cork, Republic of Ireland
| | - Helen Marr
- Department of Haematology, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Adam Gibb
- Department of Medical Oncology, The Christie NHS Foundation Trust, Manchester, UK
| | - Rachael Pocock
- Department of Haematology, University College London Hospital NHS Foundations Trust, London, UK
| | - Jonathan Lambert
- Department of Haematology, University College London Hospital NHS Foundations Trust, London, UK
| | - Rachel Lacey
- Department of Haematology, Royal Berkshire NHS Foundation Trust, London, UK
| | - Nagah Elmusharaf
- Department of Haematology, University Hospital of Wales, Cardiff, UK
| | - Ruth Clifford
- Department of Haematology, University Hospital Limerick, Limerick, Republic of Ireland
| | - Toby A Eyre
- Department of Haematology, Oxford University Hospital NHS Foundation Trust, Oxford, UK
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Luger T, Dirschka T, Eyerich K, Gollnick H, Gupta G, Lambert J, Micali G, Ochsendorf F, Ständer S, Traidl-Hoffmann C. Developments and challenges in dermatology: an update from the Interactive Derma Academy (IDeA) 2019. J Eur Acad Dermatol Venereol 2021; 34 Suppl 7:3-18. [PMID: 33315305 DOI: 10.1111/jdv.17009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 10/09/2020] [Indexed: 01/09/2023]
Abstract
The 2019 Interactive Derma Academy (IDeA) meeting was held in Lisbon, Portugal, 10-12 May, bringing together leading dermatology experts from across Europe, the Middle East and Asia. Over three days, the latest developments and challenges in relation to the pathophysiology, diagnosis, evaluation and management of dermatological conditions were presented, with a particular focus on acne, atopic dermatitis (AD) and actinic keratosis (AK). Interesting clinical case studies relating to these key topics were discussed with attendees to establish current evidence-based best practices. Presentations reviewed current treatments, potential therapeutic approaches and key considerations in the management of acne, AK and AD, and discussed the importance of the microbiome in these conditions, as well as the provision of patient education/support. It was highlighted that active treatment is not always required for AK, depending on patient preferences and clinical circumstances. In addition to presentations, two interactive workshops on the diagnosis and treatment of sexually transmitted infections/diseases (STIs/STDs) presenting to the dermatology clinic, and current and future dermocosmetics were conducted. The potential for misdiagnosis of STIs/STDs was discussed, with dermoscopy and/or reflectance confocal microscopy suggested as useful diagnostic techniques. In addition, botulinum toxin was introduced as a potential dermocosmetic, and the possibility of microbiome alteration in the treatment of dermatological conditions emphasized. Furthermore, several challenges in dermatology, including the use of lasers, the complexity of atopic dermatitis, wound care, use of biosimilars and application of non-invasive techniques in skin cancer diagnosis were reviewed. In this supplement, we provide an overview of the presentations and discussions from the fourth successful IDeA meeting, summarizing the key insights shared by dermatologists from across the globe.
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Affiliation(s)
- T Luger
- Department of Dermatology, University of Münster, Münster, Germany
| | - T Dirschka
- Centroderm Clinic, Wuppertal, Germany.,Faculty of Health, University Witten-Herdecke, Witten, Germany
| | - K Eyerich
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany.,Unit of Dermatology, Department of Medicine, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - H Gollnick
- Department of Dermatology and Venereology, Otto-von-Guericke University, Magdeburg, Germany
| | - G Gupta
- University Department of Dermatology, Edinburgh, UK
| | - J Lambert
- Department of Dermatology, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium
| | - G Micali
- Dermatology Clinic, University of Catania, Catania, Italy
| | - F Ochsendorf
- Department of Dermatology, Frankfurt University Hospital, Frankfurt/Main, Germany
| | - S Ständer
- Center for Chronic Pruritus, Department of Dermatology, University Hospital Münster, Münster, Germany
| | - C Traidl-Hoffmann
- Chair and Institute of Environmental Medicine, UNIKA-T, Technical University of Munich and Helmholtz Zentrum München, Augsburg, Germany
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50
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McCulloch R, Lewis D, Crosbie N, Eyre TA, Bolam S, Arasaretnam A, Creasey T, Goradia H, McMillan A, Dawi S, Harrison S, Miles O, Robinson A, Dutton D, Wilson MR, McKay P, Follows G, Phillips N, Patmore R, Lambert J, Bishton M, Osborne W, Johnston R, Kirkwood AA, Rule S. Ibrutinib for mantle cell lymphoma at first relapse: a United Kingdom real-world analysis of outcomes in 211 patients. Br J Haematol 2021; 193:290-298. [PMID: 33620106 DOI: 10.1111/bjh.17363] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [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: 11/09/2020] [Accepted: 01/13/2021] [Indexed: 01/04/2023]
Abstract
Ibrutinib is an established treatment for relapsed/refractory (R/R) mantle cell lymphoma (MCL) and clinical trial data supports use at second line compared to later relapse. We aimed to investigate outcomes and tolerability for ibrutinib when given second line in a real-world setting. Our multicentre retrospective analysis included 211 R/R MCL patients, median age 73 years, receiving ibrutinib second-line within the United Kingdom's National Health Service. Overall response to ibrutinib was 69% (complete response 27%). The median progression-free survival (PFS) was 17·8 months (95% CI 13·1-22·2) and median overall survival (OS) 23·9 months (95% CI 15·0-32·8). Drug-related adverse event led to dose reduction in 10% of patients and discontinuation in 5%. In patients with progressive disease, accounting for 100 of 152 patients stopping ibrutinib, 43% received further systemic therapy. Post-ibrutinib rituximab, bendamustine and cytarabine (R-BAC) showed a trend toward improved survival compared to alternative systemic treatments (post-ibrutinib median OS 14·0 months, 95% CI 8·1-19·8, vs. 3·6 months, 95% CI 2·6-4·5, P = 0·06). Our study confirms the clinical benefit and good tolerability of ibrutinib at first relapse in a real-world population. Patients progressing on ibrutinib had limited survival but outcomes with R-BAC in select patients were promising.
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Affiliation(s)
- Rory McCulloch
- University Hospitals Plymouth NHS Trust, Plymouth, United Kingdom
| | - David Lewis
- University Hospitals Plymouth NHS Trust, Plymouth, United Kingdom
| | - Nicola Crosbie
- University Hospitals Plymouth NHS Trust, Plymouth, United Kingdom
| | - Toby A Eyre
- Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Simon Bolam
- Taunton and Somerset NHS Foundation Trust, Taunton, United Kingdom
| | - Anita Arasaretnam
- Brighton and Sussex University Hospitals NHS Trust, Brighton, United Kingdom
| | - Thomas Creasey
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle-upon-Tyne, United Kingdom
| | - Harshita Goradia
- Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
| | - Annabel McMillan
- University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Safia Dawi
- Hull University Teaching Hospitals NHS Trust, Hull, United Kingdom
| | - Samuel Harrison
- University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, United Kingdom
| | - Oliver Miles
- Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, United Kingdom
| | - Andrew Robinson
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - David Dutton
- Great Western Hospitals NHS Foundation Trust, Swindon, United Kingdom
| | | | - Pam McKay
- Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom
| | - George Follows
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Neil Phillips
- University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, United Kingdom
| | - Russell Patmore
- Hull University Teaching Hospitals NHS Trust, Hull, United Kingdom
| | - Jonathan Lambert
- University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Mark Bishton
- Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
| | - Wendy Osborne
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle-upon-Tyne, United Kingdom
| | - Rosalynd Johnston
- Brighton and Sussex University Hospitals NHS Trust, Brighton, United Kingdom
| | - Amy A Kirkwood
- Cancer Research UK and UCL Cancer Trials Centre, UCL Cancer Institute, University College London, London, United Kingdom
| | - Simon Rule
- Peninsula Medical School, University of Plymouth, Plymouth, United Kingdom
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