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Garcia-Sanz R, Varettoni M, Jiménez C, Ferrero S, Poulain S, San-Miguel JF, Guerrera ML, Drandi D, Bagratuni T, McMaster M, Roccaro AM, Roos-Weil D, Leiba M, Li Y, Qiu L, Hou J, De Larrea CF, Castillo JJ, Dimopoulos M, Owen RG, Treon SP, Hunter ZR. Report of Consensus Panel 3 from the 11th International workshop on Waldenström's Macroglobulinemia: Recommendations for molecular diagnosis in Waldenström's Macroglobulinemia. Semin Hematol 2023; 60:90-96. [PMID: 37099028 DOI: 10.1053/j.seminhematol.2023.03.007] [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: 03/23/2023] [Accepted: 03/23/2023] [Indexed: 04/27/2023]
Abstract
Apart from the MYD88L265P mutation, extensive information exists on the molecular mechanisms in Waldenström's Macroglobulinemia and its potential utility in the diagnosis and treatment tailoring. However, no consensus recommendations are yet available. Consensus Panel 3 (CP3) of the 11th International Workshop on Waldenström's Macroglobulinemia (IWWM-11) was tasked with reviewing the current molecular necessities and best way to access the minimum data required for a correct diagnosis and monitoring. Key recommendations from IWWM-11 CP3 included: (1) molecular studies are warranted for patients in whom therapy is going to be started; such studies should also be done in those whose bone marrow (BM) material is sampled based on clinical issues; (2) molecular studies considered essential for these situations are those that clarify the status of 6q and 17p chromosomes, and MYD88, CXCR4, and TP53 genes. These tests in other situations, and/or other tests, are considered optional; (3) independently of the use of more sensitive and/or specific techniques, the minimum requirements are allele specific polymerase chain reaction for MYD88L265P and CXCR4S338X using whole BM, and fluorescence in situ hybridization for 6q and 17p and sequencing for CXCR4 and TP53 using CD19+ enriched BM; (4) these requirements refer to all patients; therefore, sample should be sent to specialized centers.
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Affiliation(s)
- Ramón Garcia-Sanz
- Hematology Department, University Hospital of Salamanca, Research Biomedical Institute of Salamanca (IBSAL), CIBERONC and Center for Cancer Research-IBMCC (University of Salamanca-CSIC), Salamanca, Spain.
| | - Marzia Varettoni
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Italy
| | - Cristina Jiménez
- Hematology Department, University Hospital of Salamanca, Research Biomedical Institute of Salamanca (IBSAL), CIBERONC and Center for Cancer Research-IBMCC (University of Salamanca-CSIC), Salamanca, Spain
| | - Simone Ferrero
- Unit of Hematology, Department of Biotechnology & Health Sciences, University of Torino, Torino, Italy
| | - Stephanie Poulain
- Laboratory of Hematology, Biology and Pathology Center, CHU of Lille, UMR9020 CNRS-U1277 INSERM, University of Lille, and ONCOLILLE Cancer Institute, CANTHER Laboratory, Lille, France
| | - Jesus F San-Miguel
- Laboratory of Hematology, Biology and Pathology Center, CHU of Lille, Lille, France
| | - Maria L Guerrera
- Hematology department, Clínica Universidad de Navarra, CIMA, IDISNA, CIBERONC, Pamplona, Spain
| | - Daniela Drandi
- Unit of Hematology, Department of Biotechnology & Health Sciences, University of Torino, Torino, Italy
| | - Tina Bagratuni
- Bing Center for Waldenström's Macroglobulinemia, Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | - Mary McMaster
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Aldo M Roccaro
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Damien Roos-Weil
- Clinical Trial Center, Translational Research and Phase I Unit, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Merav Leiba
- Sorbonne Université, Hematology Unit, Pitié-Salpêtrière Hospital, Assitance Publique des Hôpitaux de Paris (AP-HP), Paris, France
| | - Yong Li
- Assuta Ashdod University Hospital, Faculty of Health Science, Ben-Gurion University of the Negev, Negev, Israel
| | - Luigi Qiu
- Department of Medicine, Baylor College of Medicine, Houston, TX
| | - Jian Hou
- National Clinical Research Center for Blood Diseases, Blood Disease Hospital and Institute of Hematology), Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | | | - Jorge J Castillo
- Hematology department, Clínica Universidad de Navarra, CIMA, IDISNA, CIBERONC, Pamplona, Spain
| | - M Dimopoulos
- Bing Center for Waldenström's Macroglobulinemia, Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | - R G Owen
- Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, Barcelona, Spain; St James's University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - S P Treon
- Hematology department, Clínica Universidad de Navarra, CIMA, IDISNA, CIBERONC, Pamplona, Spain
| | - Z R Hunter
- Hematology department, Clínica Universidad de Navarra, CIMA, IDISNA, CIBERONC, Pamplona, Spain
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Buske C, Dreyling M, Alvarez-Larrán A, Apperley J, Arcaini L, Besson C, Bullinger L, Corradini P, Giovanni Della Porta M, Dimopoulos M, D'Sa S, Eich HT, Foà R, Ghia P, da Silva MG, Gribben J, Hajek R, Harrison C, Heuser M, Kiesewetter B, Kiladjian JJ, Kröger N, Moreau P, Passweg JR, Peyvandi F, Rea D, Ribera JM, Robak T, San-Miguel JF, Santini V, Sanz G, Sonneveld P, von Lilienfeld-Toal M, Wendtner C, Pentheroudakis G, Passamonti F. Managing hematological cancer patients during the COVID-19 pandemic: an ESMO-EHA Interdisciplinary Expert Consensus. ESMO Open 2022; 7:100403. [PMID: 35272130 PMCID: PMC8795783 DOI: 10.1016/j.esmoop.2022.100403] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [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: 11/20/2021] [Revised: 01/13/2022] [Accepted: 01/18/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has created enormous challenges for the clinical management of patients with hematological malignancies (HMs), raising questions about the optimal care of this patient group. METHODS This consensus manuscript aims at discussing clinical evidence and providing expert advice on statements related to the management of HMs in the COVID-19 pandemic. For this purpose, an international consortium was established including a steering committee, which prepared six working packages addressing significant clinical questions from the COVID-19 diagnosis, treatment, and mitigation strategies to specific HMs management in the pandemic. During a virtual consensus meeting, including global experts and lead by the European Society for Medical Oncology and the European Hematology Association, statements were discussed and voted upon. When a consensus could not be reached, the panel revised statements to develop consensual clinical guidance. RESULTS AND CONCLUSION The expert panel agreed on 33 statements, reflecting a consensus, which will guide clinical decision making for patients with hematological neoplasms during the COVID-19 pandemic.
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Affiliation(s)
- C Buske
- Institute of Experimental Cancer Research, Department of Internal Medicine III, University Hospital Ulm, Ulm, Germany.
| | - M Dreyling
- Department of Medicine III at LMU Hospital, Munich, Germany
| | - A Alvarez-Larrán
- Hematology Department, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - J Apperley
- Centre for Haematology, Imperial College London, Hammersmith Hospital, London, UK
| | - L Arcaini
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - C Besson
- Service d'Hématologie Oncologie, Centre Hospitalier de Versailles, Le Chesnay, France; UVSQ, Inserm, CESP, Villejuif, France
| | - L Bullinger
- Department of Hematology, Oncology, and Tumorimmunology, Campus Virchow Klinikum, Berlin, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - P Corradini
- Hematology Division, University of Milan, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - M Giovanni Della Porta
- Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - M Dimopoulos
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - S D'Sa
- UCLH Centre for Waldenström and Neurohaematology, University College London Hospitals NHS Foundation Trust, London, UK
| | - H T Eich
- Department of Radiation Oncology, University of Muenster, Münster, Germany
| | - R Foà
- Hematology, Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - P Ghia
- Strategic Research Program on Chronic Lymphocytic Leukemia and Laboratory of B Cell Neoplasia, Division of Molecular Oncology, Università Vita-Salute San Raffaele and IRCCS Ospedale San Raffaele, Milan, Italy
| | - M G da Silva
- Department Of Hematology, Portuguese Institute of Oncology, Lisbon, Portugal
| | - J Gribben
- Barts Cancer Institute, Queen Mary University of London, London, UK
| | - R Hajek
- Department of Hematooncology, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - C Harrison
- Clinical Director - Haematology, Haemostasis, Palliative Care, Cellular Pathology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - M Heuser
- Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hanover, Germany
| | - B Kiesewetter
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Vienna, Austria
| | - J J Kiladjian
- Université de Paris, APHP, Hôpital Saint-Louis, Centre d'Investigations Cliniques, Paris, France
| | - N Kröger
- Department of Stem Cell Transplantation, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - P Moreau
- Hematology Department, University Hospital Hotel-Dieu, Nantes, France
| | - J R Passweg
- Hematology Division, Basel University Hospital, Basel, Switzerland
| | - F Peyvandi
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - D Rea
- University Medical Department of Hematology and Immunology, France Intergroupe des Leucémies Myéloïdes Chroniques (Fi-LMC), Hôpital Saint-Louis, Paris, France
| | - J-M Ribera
- Clinical Hematology Department, ICO-Hospital Germans Trias i Pujol, Josep Carreras Research Institute, Universitat Autònoma de Barcelona, Badalona, Spain
| | - T Robak
- Department of Hematology, Medical University of Lodz, Lodz, Poland
| | - J F San-Miguel
- Clínica Universidad de Navarra (CUN), Centro de Investigación Aplicada (CIMA), Instituto de Investigación Sanitaria de Navarra (IDISNA), CIBERONC, Pamplona, Spain
| | - V Santini
- MDS Unit, Hematology, DMSC, AOUC, University of Florence, Florence, Italy
| | - G Sanz
- Hematology Department, Hospital Univesitario y Politecnico La Fe, Valencia; CIBERONC, IS Carlos III, Madrid, Spain
| | - P Sonneveld
- Erasmus MC Cancer Institute, Department of Haematology, Rotterdam, The Netherlands
| | - M von Lilienfeld-Toal
- Department of Hematology and Medical Oncology, University Hospital Jena, Jena, Germany; Leibniz Institute for Natural Product Research and Infection Biology, Hans Knöll Institute, Jena, Germany
| | - C Wendtner
- Munich Clinic Schwabing, Academic Teaching Hospital, Ludwig-Maximilian University, Munich, Germany
| | - G Pentheroudakis
- Scientific and Medical Division, European Society for Medical Oncology, Lugano, Switzerland
| | - F Passamonti
- Department of Medicine and Surgery, University of Insubria, Varese, Italy.
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Treon S, Buske C, Thomas S, Branagan A, Dimopoulos M, Castillo JJ, Garzon F, Tang W, Ronan R, Seyffert S, Garg V, Ali S, Taveras A, Badarau A, Zmajkovicova K, Maier S, Maierhofer B, Matous J. PRELIMINARY CLINICAL DATA FROM A PHASE 1B STUDY OF MAVORIXAFOR AND IBRUTINIB IN PATIENTS WITH WALDENSTRöM MACROGLOBULINEMIA WITH
MYD88
AND
CXCR4
MUTATIONS. Hematol Oncol 2021. [DOI: 10.1002/hon.86_2881] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- S. Treon
- Harvard Medical School Bing Center for Waldenstrom's Macroglobulinemia Boston USA
| | - C. Buske
- University of Ulm Comprehensive Cancer Center and Institute of Experimental Cancer Research Ulm Germany
| | - S. Thomas
- The University of Texas MD Anderson Cancer Center Department of Lymphoma/Myeloma Division of Cancer Medicine Houston USA
| | - A. Branagan
- Massachusetts General Hospital Cancer Center Boston USA
| | - M. Dimopoulos
- University of Athens School of Medicine Department of Clinical Therapeutics National and Kapodistrian Athens Greece
| | - J. J. Castillo
- Harvard Medical School Bing Center for Waldenstrom's Macroglobulinemia Boston USA
| | | | - W. Tang
- X4 Pharmaceuticals Boston USA
| | | | | | - V. Garg
- X4 Pharmaceuticals Boston USA
| | - S. Ali
- X4 Pharmaceuticals Boston USA
| | | | | | | | | | | | - J. Matous
- Colorado Blood Cancer Institute Sarah Cannon Research Institute Denver USA
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Papageorgiou C, Zagouri F, Dimopoulos M, Manios E, Kafouris P, Tousoulis D, Anagnostopoulos C, Toutouzas K. Vascular inflammation and cardiovascular burden in metastatic breast cancer female patients receiving hormonal treatment and CDK 4/6 inhibitors or everolimus. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Chemotherapy regimens for breast cancer treatment can promote vascular dysfunction and lead to high cardiovascular risk.
Purpose
The aim of this study was to investigate the cardiovascular burden and vascular inflammation in metastatic breast cancer patients receiving either CDK 4/6 inhibitors and hormonal treatment or standard everolimus and hormonal treatment.
Methods
22 consecutive female patients with metastatic breast cancer that expressed estrogen and /or progesteron receptor and were HER2-negative were enrolled. Patients with active infection, chronic autoimmune disease and history of chemotherapy for the metastatic disease and/or adjuvant chemotherapy during the past 3 years were excluded. All subjects received hormonal treatment and of those, 10 received everolimus and 12 received therapy with CDK 4/6 inhibitors. The two groups were matched for age, history of hypertension, diabetes, dyslipidemia, smoking and all were free of major cardiovascular events for the past 6 months. Regional wall thickness (RWT) and left ventricle mass (LVM) measurements by transthoracic echocardiographic study were obtained followed by 24 hour ambulatory blood pressure monitoring, and 18F-fluorodeoxyglucose positron-emission tomography/computed tomography imaging. Radiotracer uptake in the aortic wall (ascending, arch, descending, abdominal), was quantified as tissue-to-background ratio (TBR).Each patient was assessed for the aforementioned parameters before the initiation and after 6 months of treatment.
Results
At follow up, patients assigned to CDK4/6 treatment demonstrated increased measurements of 24 hour systolic blood pressure (SBP) (p=0.004), daytime SBP(p=0.004) and night time SBP (p=0.012) (Group effect). The 24 hour mean arterial pressure measurements were also higher in CDK 4/6 population, in comparison to everolimus that displayed firm values. (Group effect- p=0.035, Interaction effect-p=0.023).Additionally, 24 hour diastolic blood pressure recordings in CDK 4/6 therapy were higher opposed to everolimus that remained consistent (Interaction effect- p=0.010). In CDK 4/6 group, TBR aorta measurements also increased significantly, whereas TBR values in everolimus remained stable. (Interaction effect-p=0.049). Both therapeutic regimens displayed statistically significant damaging effect with regards to the following variables: Night-time SBP (p=0.032), RWT (p<0.001), and LVM (p<0.001).
Conclusion
Chemotherapy with novel CDK 4/6 inhibitors and hormonal treatment can lead to increased vascular inflammation, and higher blood pressure values compared to the combination of everolimus and hormonal treatment in female patients with HR-positive HER2-negative metastatic breast cancer. Moreover, both treatment strategies promote remodelling of the left ventricle by means of increased RWT and mass. Further research and longitudinal studies in this field are required to validate the above findings.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- C Papageorgiou
- Alexandra University Hospital, Department of Clinical Therapeutics, Athens, Greece
| | - F Zagouri
- Alexandra University Hospital, Department of Clinical Therapeutics, Athens, Greece
| | - M Dimopoulos
- Alexandra University Hospital, Department of Clinical Therapeutics, Athens, Greece
| | - E Manios
- Alexandra University Hospital, Department of Clinical Therapeutics, Athens, Greece
| | - P Kafouris
- Academy of Athens Biomedical Research Foundation, Athens, Greece
| | - D Tousoulis
- Hippokration General Hospital, Athens, Greece
| | | | - K Toutouzas
- Hippokration General Hospital, Athens, Greece
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Dimopoulos M, Weisel K, Moreau P, Jr L, White D, Miguel J, Sonneveld P, Engelhardt M, Jenner M, Corso A, Dürig J, Pavic M, Salomo M, Casal E, Jiang R, Nguyen T, Peluso T, Richardson P. POMALIDOMIDE, BORTEZOMIB, DEXAMETHASONE AFTER 1 PRIOR LINE OF THERAPY IN RELAPSED OR REFRACTORY MULTIPLE MYELOMA: SUBANALYSIS OF OPTIMMISM BY AGE, PRIOR TRANSPLANT, AND HIGH-RISK CYTOGENETICS. Hematol Transfus Cell Ther 2020. [DOI: 10.1016/j.htct.2020.10.454] [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: 10/23/2022] Open
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6
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Terpos E, Symeonidis A, Delimpasi S, Zamagni E, Katodritou E, Rivolti E, Kyrtsonis M, Fotiou D, Kanellias N, Migkou M, Roussou M, Gavriatopoulou M, Hatjiharissi E, Cavo M, Dimopoulos M. Efficacy and safety of daratumumab with dexamethasone in patients with relapsed/refractory multiple myeloma and severe renal impairment: results of the phase 2 dare study. Hematol Transfus Cell Ther 2020. [DOI: 10.1016/j.htct.2020.09.043] [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: 10/23/2022] Open
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7
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Papadimitriou K, Ntanasis-Stathopoulos I, Tsakirakis N, Gavriatopoulou M, Kostopoulos I, Kastritis E, Orologas-Stavrou N, Dimopoulos M, Tsitsilonis O, Terpos E. Peripheral blood immune profiling of multiple myeloma patients at diagnosis: correlations with circulating plasma cells. Hematol Transfus Cell Ther 2020. [DOI: 10.1016/j.htct.2020.09.045] [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: 10/23/2022] Open
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8
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Anastasiou M, Antonopoulos AS, Oikonomou E, Zagouri F, Siasos G, Vogiatzi G, Tsalamandris S, Mistakidi CV, Psaltopoulou T, Bamias A, Dimopoulos M, Tousoulis D. P1573Chemotherapy-induced vasotoxicity in patients undergoing therapy for breast cancer. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Cardiotoxicity is a well-known adverse effect of anthracycline and HER-2 monoclonal antibodies, however the vascular effects of these agents remain less-well studied.
Purpose
To explore the effects of breast chemotherapy on vascular function.
Methods
A total of 57 female patients undergoing breast diagnosed with breast cancer and scheduled for anthracycline-based and HER-2 chemotherapy were included in this study. At baseline, at 3, 6 and 12 months, patients underwent assessment of cardiac function by transthoracic echocardiography, endothelial function assessment by brachial flow mediated dilation (FMD) and assessment of arterial stiffness by carotid-radial pulse wave velocity (PWV) and augmentation index (Aix).
Results
There was a significant decrease in left ventricular ejection fraction (LVEF) overtime compared to baseline (A). This was paralleled by a significant decrease in brachial FMD at 6 months (B) and a significant increase in PWV compared to baseline (C). There was no significant change in Aix compared to baseline levels (D). Chemotherapy-induced cardiotoxicity (expressed by the change in LVEF) was not associated with either the change in FMD or PWV at 6 months.
Conclusions
Breast chemotherapy-induced cardiotoxicity is paralleled by vasotoxicity, which is manifested as endothelial dysfunction and increased arterial stiffness. Systemic vasotoxicity is not directly related to cardiotoxicity, suggesting that monitoring of both cardiac and vascular function could be useful in identifying early signs of cardiovascular toxicity.
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Affiliation(s)
- M Anastasiou
- Hippokration General Hospital, 1st Cardiology Department, Athens Medical School, Athens, Greece
| | - A S Antonopoulos
- Hippokration General Hospital, 1st Cardiology Department, Athens Medical School, Athens, Greece
| | - E Oikonomou
- Hippokration General Hospital, 1st Cardiology Department, Athens Medical School, Athens, Greece
| | - F Zagouri
- Hippokration General Hospital, 1st Cardiology Department, Athens Medical School, Athens, Greece
| | - G Siasos
- Hippokration General Hospital, 1st Cardiology Department, Athens Medical School, Athens, Greece
| | - G Vogiatzi
- Hippokration General Hospital, 1st Cardiology Department, Athens Medical School, Athens, Greece
| | - S Tsalamandris
- Hippokration General Hospital, 1st Cardiology Department, Athens Medical School, Athens, Greece
| | - C V Mistakidi
- Hippokration General Hospital, 1st Cardiology Department, Athens Medical School, Athens, Greece
| | - T Psaltopoulou
- Hippokration General Hospital, 1st Cardiology Department, Athens Medical School, Athens, Greece
| | - A Bamias
- Hippokration General Hospital, 1st Cardiology Department, Athens Medical School, Athens, Greece
| | - M Dimopoulos
- Hippokration General Hospital, 1st Cardiology Department, Athens Medical School, Athens, Greece
| | - D Tousoulis
- Hippokration General Hospital, 1st Cardiology Department, Athens Medical School, Athens, Greece
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9
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Vassilakopoulos T, Papageorgiou S, Michail M, Angelopoulou M, Kourti G, Kalpadakis C, Kotsopoulou M, Leonidopoulou T, Konstantinidou P, Kotsianidis I, Boutsis D, Michali E, Sachanas S, Terpos E, Karianakis G, Poziopoulos C, Vadikolia C, Pigaditou A, Vrakidou E, Anargyrou K, Symeonidis A, Stefanoudaki E, Hadjiharissi E, Papaioannou M, Gainaru G, Tsirogianni M, Katodritou E, Karmiris T, Variami E, Pappa V, Dimopoulos M, Roussou P, Panayitidis P, Konstantopoulos K, Pangalis G. PROGNOSTIC FACTORS (PFs) IN PRIMARY MEDIASTINAL LARGE B-CELL LYMPHOMA (PMLBCL) TREATED WITH RITUXIMAB-CHOP (RCHOP) ± RADIOTHERAPY (RT). Hematol Oncol 2019. [DOI: 10.1002/hon.76_2630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- T.P. Vassilakopoulos
- Dept of Haematology; National & Kapodistrian University of Athens; Athens Greece
| | - S.G. Papageorgiou
- 2nd Department of Internal Medicine and Research Institute; University General Hospital "Attikon"; Haidari Greece
| | - M. Michail
- Hematology; General Hospital of Nicosia; Nicosia Cyprus
| | - M.K. Angelopoulou
- Dept of Haematology; National & Kapodistrian University of Athens; Athens Greece
| | - G. Kourti
- 3rd Dept of Internal Medicine; National and Kapodistrian University of Athens; Athens Greece
| | - C. Kalpadakis
- Dept of Haematology; University of Crete; Heraclion Crete Greece
| | - M. Kotsopoulou
- Dept of Haematology; Metaxa Anticancer Hospital; Piraeus Greece
| | | | - P. Konstantinidou
- Dept of Haematology; Theagenion Anticancer Hospital; Thessaloniki Greece
| | - I. Kotsianidis
- Dept of Haematology; Democritus University of Thrace; Alexandroupolis Greece
| | - D. Boutsis
- Dept of Haematology; Navy Hospital Athens; Athens Greece
| | - E. Michali
- Dept of Haematology; Athens General Hospital, “Gennimatas; Athens Greece
| | - S. Sachanas
- Dept of Haematology; Athens Medical Center, Psychikon Branch; Athens Greece
| | - E. Terpos
- Dept of Therapeutics; National and Kapodistrian University of Athens; Athens Greece
| | | | - C. Poziopoulos
- Dept of Haematology; Metropolitan Hospital; Piraeus Greece
| | - C. Vadikolia
- Dept of Haematology; 424 Army Hospital; Thessaloniki Greece
| | - A. Pigaditou
- Dept of Haematology; Athens Medical Center; Marousi Greece
| | - E. Vrakidou
- Dept of Haematology; HyGEIA Hospital; Athens Greece
| | - K. Anargyrou
- Dept of Haematology; 251 Air Force Hospital; Athens Greece
| | - A. Symeonidis
- Dept of Haematology; University of Patras; Patras Greece
| | | | - E. Hadjiharissi
- 1st Dept of Internal Medicine; AHEPA University Hospital; Thessaloniki Greece
| | - M. Papaioannou
- 1st Dept of Internal Medicine; AHEPA University Hospital; Thessaloniki Greece
| | - G. Gainaru
- Dept of Haematology; HYGEIA Hospital; Athens Greece
| | - M. Tsirogianni
- Dept of Haematology; AGIOS SAVVAS Anticancer Hospital; Athens Greece
| | - E. Katodritou
- Dept of Haematology; Theagenion Anticancer Hospital; Thessaloniki Greece
| | - T. Karmiris
- Dept of Haematology; Evangelismos Hospital; Athens Greece
| | - E. Variami
- 1st Dept of Internal Medicine; National & Kapodistrian University of Athens; Athens Greece
| | - V. Pappa
- 2nd Department of Internal Medicine and Research Institute; University General Hospital "Attikon"; Haidari Greece
| | - M. Dimopoulos
- Dept of Therapeutics; National and Kapodistrian University of Athens; Athens Greece
| | - P. Roussou
- 3rd Dept of Internal Medicine; National and Kapodistrian University of Athens; Athens Greece
| | - P. Panayitidis
- 1st Propedeutic Dept of Internal Medicine; National & Kapodistrian University of Athens; Athens Greece
| | - K. Konstantopoulos
- Dept of Haematology; National & Kapodistrian University of Athens; Athens Greece
| | - G.A. Pangalis
- Dept of Haematology; Athens Medical Center, Psychikon Branch; Athens Greece
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Bamias A, Gibbs E, Khoon Lee C, Davies L, Dimopoulos M, Zagouri F, Veillard AS, Kosse J, Santaballa A, Mirza MR, Tabaro G, Vergote I, Bloemendal H, Lykka M, Floquet A, Gebski V, Pujade-Lauraine E. Bevacizumab with or after chemotherapy for platinum-resistant recurrent ovarian cancer: exploratory analyses of the AURELIA trial. Ann Oncol 2018; 28:1842-1848. [PMID: 28481967 DOI: 10.1093/annonc/mdx228] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background In the open-label randomized phase III AURELIA trial, adding bevacizumab to chemotherapy for platinum-resistant ovarian cancer (PROC) significantly improved progression-free survival and response rate versus chemotherapy alone, but not overall survival (OS). We explored the effect of bevacizumab use after disease progression (PD) in patients randomized to chemotherapy alone. Patients and methods In AURELIA, 361 women with PROC were randomized to chemotherapy alone or with bevacizumab. Patients initially randomized to chemotherapy were offered bevacizumab after PD. Post hoc analyses assessed efficacy and safety in three subgroups: chemotherapy alone, chemotherapy followed by bevacizumab after PD, and chemotherapy plus bevacizumab at randomization. Results Of the 182 patients randomized to chemotherapy alone, 72 (40%) received bevacizumab after PD and 110 (60%) never received bevacizumab. There were no significant differences in patient and disease characteristics between these subgroups at baseline or the time of PD. Compared with patients never receiving bevacizumab, the risk of death was significantly reduced in patients receiving bevacizumab either upfront with chemotherapy [hazard ratio (HR) = 0.68, 95% confidence interval (CI) 0.52-0.90] or after PD (HR = 0.60, 95% CI 0.43-0.86). The tolerability of bevacizumab was similar with administration upfront or after PD. Conclusions Post-PD bevacizumab use may have confounded OS results in AURELIA. In these exploratory analyses of non-randomized subgroups, bevacizumab use, either with chemotherapy or after PD on chemotherapy alone, improved OS compared with no bevacizumab. Combining bevacizumab with chemotherapy at first appearance of platinum resistance maximises the likelihood of patients receiving this active treatment for PROC. ClinicalTrials.gov: NCT00976911.
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Affiliation(s)
- A Bamias
- HECOG and Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - E Gibbs
- NHMRC Clinical Trials Centre, University of Sydney, Camperdown, Australia
| | - C Khoon Lee
- NHMRC Clinical Trials Centre, University of Sydney, Camperdown, Australia
| | - L Davies
- NHMRC Clinical Trials Centre, University of Sydney, Camperdown, Australia
| | - M Dimopoulos
- HECOG and Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - F Zagouri
- HECOG and Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - A-S Veillard
- NHMRC Clinical Trials Centre, University of Sydney, Camperdown, Australia
| | - J Kosse
- AGO and Department of Gynaecology, Sana Klinikum Offenbach, Offenbach, Germany
| | - A Santaballa
- GEICO and Medical Oncology Department, University Hospital and Polytechnic, Valencia, Spain
| | - M R Mirza
- NSGO and Department of Oncology, Rigshospitalet Copenhagen University Hospital, Copenhagen, Denmark
| | - G Tabaro
- MITO and USCC/Dir. Scientifica, Centro di Riferimento Oncologico, CRO-IRCCS, Aviano, Italy
| | - I Vergote
- BGOG and Division of Gynaecological Oncology, Department of Obstetrics and Gynaecology, University Hospital Leuven, Leuven, Belgium
| | - H Bloemendal
- DGOG and Department of Internal Medicine/Oncology, Meander Medical Center, Amersfoort, The Netherlands
| | - M Lykka
- HECOG and Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - A Floquet
- GINECO and Medical Oncology and Genetics Department, Institut Bergonié, Bordeaux
| | - V Gebski
- NHMRC Clinical Trials Centre, University of Sydney, Camperdown, Australia
| | - E Pujade-Lauraine
- GINECO and Paris Descartes University, AP-HP Central Paris University Hospitals, Paris, France
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Bolli N, Biancon G, Moarii M, Gimondi S, Li Y, de Philippis C, Maura F, Sathiaseelan V, Tai YT, Mudie L, O’Meara S, Raine K, Teague JW, Butler AP, Carniti C, Gerstung M, Bagratuni T, Kastritis E, Dimopoulos M, Corradini P, Anderson K, Moreau P, Minvielle S, Campbell PJ, Papaemmanuil E, Avet-Loiseau H, Munshi NC. Analysis of the genomic landscape of multiple myeloma highlights novel prognostic markers and disease subgroups. Leukemia 2017. [DOI: 10.1038/leu.2017.344] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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12
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Koutsoukos K, Zagouri F, Tzannis K, Karavasilis V, Samantas E, Aravantinos G, Koutras A, Gkerzelis I, Chamylos E, Kostouros E, Lykka M, Tsironis G, Dimitriadis I, Liontos M, Fountzilas G, Dimopoulos M, Bamias A. Efficacy and safety of the combination of bevacizumab (BEV) and temsirolimus (TEM) in patients with metastatic renal cancer (mRCC) after first-line anti-VEGF treatment: A Hellenic Cooperative Oncology group (HeCOG) phase II trial. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw373.51] [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: 11/13/2022] Open
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13
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Liontos M, Gavalas N, Tzanis K, Trachana SP, Kostouros E, Zagouri F, Koutsoukos K, Lykka M, Tsironis G, Dimitriadis I, Terpos E, Dimopoulos M, Bamias A. Prognostic and predictive significance of VEGF and TNF&agr; levels in ascites of patients with epithelial ovarian cancer. Correlation with lymphocytes subpopulations. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw374.16] [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: 11/14/2022] Open
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14
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Laubach J, Garderet L, Mahindra A, Gahrton G, Caers J, Sezer O, Voorhees P, Leleu X, Johnsen HE, Streetly M, Jurczyszyn A, Ludwig H, Mellqvist UH, Chng WJ, Pilarski L, Einsele H, Hou J, Turesson I, Zamagni E, Chim CS, Mazumder A, Westin J, Lu J, Reiman T, Kristinsson S, Joshua D, Roussel M, O'Gorman P, Terpos E, McCarthy P, Dimopoulos M, Moreau P, Orlowski RZ, Miguel JS, Anderson KC, Palumbo A, Kumar S, Rajkumar V, Durie B, Richardson PG. Management of relapsed multiple myeloma: recommendations of the International Myeloma Working Group. Leukemia 2015; 30:1005-17. [DOI: 10.1038/leu.2015.356] [Citation(s) in RCA: 175] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Revised: 09/11/2015] [Accepted: 09/24/2015] [Indexed: 11/09/2022]
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15
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Mohty M, Terpos E, Mateos M, Palumbo A, Lejniece S, Beksac M, Bekadja M, Legiec W, Dimopoulos M, Stankovic S, Durán M, De Stefano V, Kochkareva Y, Laane E, Berthou C, Salwender H, Masliak Z, Pe eli nas V, Willenbacher W, Silva J, Louw V, Nemet D, Borbényi Z, Abadi U, Pedersen R, Ernel P, Potamianou A, Couturier C, Olie R, Feys C, Thoret-Bauchet F, Boccadoro M. Frontline therapy for multiple myeloma (MM) in real-world clinical practice: Results from the third interim analysis of the multinational, non-interventional, observational EMMOS study. Clinical Lymphoma Myeloma and Leukemia 2015. [DOI: 10.1016/j.clml.2015.07.321] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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16
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Dimopoulos M, Cheung M, Roussel M, Liu T, Gamberi B, Kolb B, Derigs H, Eom H, Belhadj K, Lenain P, van der Jagt R, Rigaudeau S, Hall R, Jaccard A, Tosikyan A, Karlin L, Bensinger W, Schots R, Chen G, Marek J, Ervin-Haynes A, Facon T. Continuous Lenalidomide and Low-Dose Dexamethasone for the Treatment of Patients with Newly Diagnosed Multiple Myeloma and Renal Impairment in the First Trial. Clinical Lymphoma Myeloma and Leukemia 2015. [DOI: 10.1016/j.clml.2015.07.339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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17
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Buske C, Leblond V, Dimopoulos M, Kimby E, Jäger U, Dreyling M. Waldenström's macroglobulinaemia: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2013; 24 Suppl 6:vi155-9. [DOI: 10.1093/annonc/mdt298] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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18
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Moreau P, San Miguel J, Ludwig H, Schouten H, Mohty M, Dimopoulos M, Dreyling M. Multiple myeloma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2013; 24 Suppl 6:vi133-7. [PMID: 23956208 DOI: 10.1093/annonc/mdt297] [Citation(s) in RCA: 173] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Affiliation(s)
- P Moreau
- Department of Haematology, University Hospital, Nantes, France
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Fountzilas G, Gogas H, Pavlidis N, Eleftheraki A, Skarlos D, Koutras A, Timotheadou E, Papandreou C, Pectasides D, Dimopoulos M. Dose-Dense Sequential Adjuvant Chemotherapy With Epirubicin, Paclitaxel and CMF Versus Epirubicin, Cmf and Weekly Docetaxel or Paclitaxel Followed by Trastuzumab for One Year in Patients With Early Breast Cancer. Ann Oncol 2012. [DOI: 10.1093/annonc/mds392] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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20
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Richardson PG, Delforge M, Beksac M, Wen P, Jongen JL, Sezer O, Terpos E, Munshi N, Palumbo A, Rajkumar SV, Harousseau JL, Moreau P, Avet-Loiseau H, Lee JH, Cavo M, Merlini G, Voorhees P, Chng WJ, Mazumder A, Usmani S, Einsele H, Comenzo R, Orlowski R, Vesole D, Lahuerta JJ, Niesvizky R, Siegel D, Mateos MV, Dimopoulos M, Lonial S, Jagannath S, Bladé J, Miguel JS, Morgan G, Anderson KC, Durie BGM, Sonneveld P, Sonneveld P. Management of treatment-emergent peripheral neuropathy in multiple myeloma. Leukemia 2012; 26:595-608. [PMID: 22193964 DOI: 10.1038/leu.2011.346] [Citation(s) in RCA: 189] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Peripheral neuropathy (PN) is one of the most important complications of multiple myeloma (MM) treatment. PN can be caused by MM itself, either by the effects of the monoclonal protein or in the form of radiculopathy from direct compression, and particularly by certain therapies, including bortezomib, thalidomide, vinca alkaloids and cisplatin. Clinical evaluation has shown that up to 20% of MM patients have PN at diagnosis and as many as 75% may experience treatment-emergent PN during therapy. The incidence, symptoms, reversibility, predisposing factors and etiology of treatment-emergent PN vary among MM therapies, with PN incidence also affected by the dose, schedule and combinations of potentially neurotoxic agents. Effective management of treatment-emergent PN is critical to minimize the incidence and severity of this complication, while maintaining therapeutic efficacy. Herein, the state of knowledge regarding treatment-emergent PN in MM patients and current management practices are outlined, and recommendations regarding optimal strategies for PN management during MM treatment are provided. These strategies include early and regular monitoring with neurological evaluation, with dose modification and treatment discontinuation as indicated. Areas requiring further research include the development of MM-specific, patient-focused assessment tools, pharmacogenomic analysis of patient DNA, and trials to assess the efficacy of pharmacological interventions.
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Mitro P, Kirsch P, Gajek J, Zysko D, Mazurek W, Ruiz GA, Chirife R, Tentori C, Nogues M, Grancelli H, Nur-Mammadova G, Mustafaev I, Gajek J, Zysko D, Mazurek W, Sredniawa B, Cebula S, Musialik-Lydka A, Kowalczyk J, Sliwinska A, Sedkowska A, Wozniak A, Kalarus Z, Pietrucha AZ, Wojewodka-Zak E, Bzukala I, Wnuk M, Mroczek-Czernecka D, Konduracka E, Piwowarska W, Peppes V, Kontomerkos D, Parisi T, Dimopoulos M, Antoniou A, Freitas JP, Santos RM, Boomsma F, Maciel MJ, Iacoviello M, Forleo C, Guida P, Ciccone MM, D'andria V, Sorrentino S, Panunzio M, Favale S, Candeias R, Silva J, Santos A, Marques N, Jesus I, Gomes V, Gajek J, Zysko D, Mazurek W, Olendrzynski LUK, Kramarz EK, Kubik LK, Zysko D, Gajek J, Mazurek W, Tahir T, Rose S, Garratt C, Clarke B, Cooper P, Fitzpatrick A, Petkar S, Fuca G, Dinelli M, Gianfranchi L, Corbucci G, Alboni P, Leiria TLL, Kus T, Godin B, Ayala-Paredes F, Lemieux A, Sturmer ML, Stanczyk A, Gatzoulis K, Karystinos G, Gialernios T, Sotiropoulos H, Sideris S, Dilaveris P, Arsenos P, Stefanadis C, Maggi R, Kohno R, Abe H, Otsuji Y. Poster Session 4: Syncope. Europace 2009. [DOI: 10.1093/europace/euq238] [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: 11/14/2022] Open
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22
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Dimopoulos M, Terpos E, Comenzo RL, Tosi P, Beksac M, Sezer O, Siegel D, Lokhorst H, Kumar S, Rajkumar SV, Niesvizky R, Moulopoulos LA, Durie BGM. International myeloma working group consensus statement and guidelines regarding the current role of imaging techniques in the diagnosis and monitoring of multiple Myeloma. Leukemia 2009; 23:1545-56. [PMID: 19421229 DOI: 10.1038/leu.2009.89] [Citation(s) in RCA: 304] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Several imaging technologies are used for the diagnosis and management of patients with multiple myeloma (MM). Conventional radiography, computed tomography (CT), magnetic resonance imaging (MRI) and nuclear medicine imaging are all used in an attempt to better clarify the extent of bone disease and soft tissue disease in MM. This review summarizes all available data in the literature and provides recommendations for the use of each of the technologies. Conventional radiography still remains the 'gold standard' of the staging procedure of newly diagnosed and relapsed myeloma patients. MRI gives information complementary to skeletal survey and is recommended in MM patients with normal conventional radiography and in all patients with an apparently solitary plasmacytoma of bone. Urgent MRI or CT (if MRI is not available) is the diagnostic procedure of choice to assess suspected cord compression. Bone scintigraphy has no place in the routine staging of myeloma, whereas sequential dual-energy X-ray absorptiometry scans are not recommended. Positron emission tomography/CT or MIBI imaging are also not recommended for routine use in the management of myeloma patients, although both techniques may be useful in selected cases that warrant clarification of previous imaging findings, but such an approach should ideally be made within the context of a clinical trial.
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Affiliation(s)
- M Dimopoulos
- Department of Therapeutics, Alexandra Hospital, Athens, Greece.
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23
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Zagouri F, Bamias A, Papakostas P, Karadimou A, Bournakis E, Dimopoulos M, Fountzilas G, Papadimitriou C. 0187 Weekly docetaxel with or without gemcitabine as second line chemotherapy in paclitaxel pretreated patients with metastatic breast cancer: A randomised phase II study conducted by the Hellenic Co-operative oncology group. Breast 2009. [DOI: 10.1016/s0960-9776(09)70210-3] [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] Open
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24
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Edwards BJ, Gounder M, McKoy J, Raisch D, Farrugia M, Cesar M, Marx R, Ruggiero S, Dimopoulos M, Bennett C. Bisphosphonate use and osteonecrosis of the jaw: Pharmacovigilance and reporting of this serious adverse event from the Research on Adverse Drug Events and Reports (RADAR) project. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.6519] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
6519 Background: Two years after zoledronate, received FDA approval, four dental professionals treated 107 cases of osteonecrosis of the jaw (ONJ). We review the timeline and source for initial recognition of ONJ and the comprehensiveness of dissemination of information on this adverse drug event. Methods: Data sources included primary case series from dental professionals; published case reports, clinical trials, and cases reported to the manufacturers or the FDA. Exposure adjusted incidence rates estimates were derived from manufacturer sponsored and investigator initiated review of claims data from large cancer centers. Safety notifications were disseminated by the manufacturers, regulatory authorities, and academic investigators. Results: Between 2001 and 2003, 107 patients with ONJ received care from dental professionals. In late 2003, and 2004 peer-reviewed case series were published. By 2006, safety databases maintained by the FDA, the manufacturer, and the RADAR project included information on 2,270, 1,178, and 368 cases of ONJ, respectively. In 2004 and 2005, incidence estimates of 0.8 and 22 ONJ cases per 1,000 person-years of intravenous bisphosphonate therapy were reported by the manufacturer and academic investigators. From 2003 to 2006, safety information from manufacturers, national regulatory authorities, case series, and clinical guidelines were disseminated. Conclusions: Recognition and reporting of ONJ occurred two years after FDA approval of zoledronate, dissemination of safety information occurred in the third year, and publications were disseminated from year three to year five. The life-cycle for identification and information dissemination for this serious adverse drug reaction was short and comprehensive. [Table: see text] [Table: see text]
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Affiliation(s)
- B. J. Edwards
- Research on Adverse Drug Events and Reports (RADAR); Bone Health and Osteoporosis Center, Feinberg School, Chicago, IL; Feinberg School of Medicine, Chicago, IL; VA Midwest Center for Health Services, Chicago, IL; Botsford General Hospital, Farmington Hills, MI; Nova Southwestern University College of Dental Med, Fort Lauderdale, FL; Miller School of Medicine, University of Miami, Miami, FL; Long Island Jewish Medical Center, New Hyde Park, NY; Medical School, University of Athens, Athens, Greece; VA
| | - M. Gounder
- Research on Adverse Drug Events and Reports (RADAR); Bone Health and Osteoporosis Center, Feinberg School, Chicago, IL; Feinberg School of Medicine, Chicago, IL; VA Midwest Center for Health Services, Chicago, IL; Botsford General Hospital, Farmington Hills, MI; Nova Southwestern University College of Dental Med, Fort Lauderdale, FL; Miller School of Medicine, University of Miami, Miami, FL; Long Island Jewish Medical Center, New Hyde Park, NY; Medical School, University of Athens, Athens, Greece; VA
| | - J. McKoy
- Research on Adverse Drug Events and Reports (RADAR); Bone Health and Osteoporosis Center, Feinberg School, Chicago, IL; Feinberg School of Medicine, Chicago, IL; VA Midwest Center for Health Services, Chicago, IL; Botsford General Hospital, Farmington Hills, MI; Nova Southwestern University College of Dental Med, Fort Lauderdale, FL; Miller School of Medicine, University of Miami, Miami, FL; Long Island Jewish Medical Center, New Hyde Park, NY; Medical School, University of Athens, Athens, Greece; VA
| | - D. Raisch
- Research on Adverse Drug Events and Reports (RADAR); Bone Health and Osteoporosis Center, Feinberg School, Chicago, IL; Feinberg School of Medicine, Chicago, IL; VA Midwest Center for Health Services, Chicago, IL; Botsford General Hospital, Farmington Hills, MI; Nova Southwestern University College of Dental Med, Fort Lauderdale, FL; Miller School of Medicine, University of Miami, Miami, FL; Long Island Jewish Medical Center, New Hyde Park, NY; Medical School, University of Athens, Athens, Greece; VA
| | - M. Farrugia
- Research on Adverse Drug Events and Reports (RADAR); Bone Health and Osteoporosis Center, Feinberg School, Chicago, IL; Feinberg School of Medicine, Chicago, IL; VA Midwest Center for Health Services, Chicago, IL; Botsford General Hospital, Farmington Hills, MI; Nova Southwestern University College of Dental Med, Fort Lauderdale, FL; Miller School of Medicine, University of Miami, Miami, FL; Long Island Jewish Medical Center, New Hyde Park, NY; Medical School, University of Athens, Athens, Greece; VA
| | - M. Cesar
- Research on Adverse Drug Events and Reports (RADAR); Bone Health and Osteoporosis Center, Feinberg School, Chicago, IL; Feinberg School of Medicine, Chicago, IL; VA Midwest Center for Health Services, Chicago, IL; Botsford General Hospital, Farmington Hills, MI; Nova Southwestern University College of Dental Med, Fort Lauderdale, FL; Miller School of Medicine, University of Miami, Miami, FL; Long Island Jewish Medical Center, New Hyde Park, NY; Medical School, University of Athens, Athens, Greece; VA
| | - R. Marx
- Research on Adverse Drug Events and Reports (RADAR); Bone Health and Osteoporosis Center, Feinberg School, Chicago, IL; Feinberg School of Medicine, Chicago, IL; VA Midwest Center for Health Services, Chicago, IL; Botsford General Hospital, Farmington Hills, MI; Nova Southwestern University College of Dental Med, Fort Lauderdale, FL; Miller School of Medicine, University of Miami, Miami, FL; Long Island Jewish Medical Center, New Hyde Park, NY; Medical School, University of Athens, Athens, Greece; VA
| | - S. Ruggiero
- Research on Adverse Drug Events and Reports (RADAR); Bone Health and Osteoporosis Center, Feinberg School, Chicago, IL; Feinberg School of Medicine, Chicago, IL; VA Midwest Center for Health Services, Chicago, IL; Botsford General Hospital, Farmington Hills, MI; Nova Southwestern University College of Dental Med, Fort Lauderdale, FL; Miller School of Medicine, University of Miami, Miami, FL; Long Island Jewish Medical Center, New Hyde Park, NY; Medical School, University of Athens, Athens, Greece; VA
| | - M. Dimopoulos
- Research on Adverse Drug Events and Reports (RADAR); Bone Health and Osteoporosis Center, Feinberg School, Chicago, IL; Feinberg School of Medicine, Chicago, IL; VA Midwest Center for Health Services, Chicago, IL; Botsford General Hospital, Farmington Hills, MI; Nova Southwestern University College of Dental Med, Fort Lauderdale, FL; Miller School of Medicine, University of Miami, Miami, FL; Long Island Jewish Medical Center, New Hyde Park, NY; Medical School, University of Athens, Athens, Greece; VA
| | - C. Bennett
- Research on Adverse Drug Events and Reports (RADAR); Bone Health and Osteoporosis Center, Feinberg School, Chicago, IL; Feinberg School of Medicine, Chicago, IL; VA Midwest Center for Health Services, Chicago, IL; Botsford General Hospital, Farmington Hills, MI; Nova Southwestern University College of Dental Med, Fort Lauderdale, FL; Miller School of Medicine, University of Miami, Miami, FL; Long Island Jewish Medical Center, New Hyde Park, NY; Medical School, University of Athens, Athens, Greece; VA
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Durie BGM, Harousseau JL, Miguel JS, Bladé J, Barlogie B, Anderson K, Gertz M, Dimopoulos M, Westin J, Sonneveld P, Ludwig H, Gahrton G, Beksac M, Crowley J, Belch A, Boccadaro M, Turesson I, Joshua D, Vesole D, Kyle R, Alexanian R, Tricot G, Attal M, Merlini G, Powles R, Richardson P, Shimizu K, Tosi P, Morgan G, Rajkumar SV. Erratum: International uniform response criteria for multiple myeloma. Leukemia 2007. [DOI: 10.1038/sj.leu.2404582] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Durie BGM, Harousseau JL, Miguel JS, Bladé J, Barlogie B, Anderson K, Gertz M, Dimopoulos M, Westin J, Sonneveld P, Ludwig H, Gahrton G, Beksac M, Crowley J, Belch A, Boccadaro M, Turesson I, Joshua D, Vesole D, Kyle R, Alexanian R, Tricot G, Attal M, Merlini G, Powles R, Richardson P, Shimizu K, Tosi P, Morgan G. Erratum: International uniform response criteria for multiple myeloma. Leukemia 2006. [DOI: 10.1038/sj.leu.2404428] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Kountourakis P, Psyrri A, Scorilas A, Kowalski D, Camp R, Markakis S, Dimopoulos M. 326 POSTER Prognostic significance of human kallikrein 7 protein expression levels in ovarian cancer by using automated quantitative analysis. EJC Suppl 2006. [DOI: 10.1016/s1359-6349(06)70331-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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28
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Durie BGM, Harousseau JL, Miguel JS, Bladé J, Barlogie B, Anderson K, Gertz M, Dimopoulos M, Westin J, Sonneveld P, Ludwig H, Gahrton G, Beksac M, Crowley J, Belch A, Boccadaro M, Cavo M, Turesson I, Joshua D, Vesole D, Kyle R, Alexanian R, Tricot G, Attal M, Merlini G, Powles R, Richardson P, Shimizu K, Tosi P, Morgan G, Rajkumar SV. International uniform response criteria for multiple myeloma. Leukemia 2006; 20:1467-73. [PMID: 16855634 DOI: 10.1038/sj.leu.2404284] [Citation(s) in RCA: 2017] [Impact Index Per Article: 112.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
New uniform response criteria are required to adequately assess clinical outcomes in myeloma. The European Group for Blood and Bone Marrow Transplant/International Bone Marrow Transplant Registry criteria have been expanded, clarified and updated to provide a new comprehensive evaluation system. Categories for stringent complete response and very good partial response are added. The serum free light-chain assay is included to allow evaluation of patients with oligo-secretory disease. Inconsistencies in prior criteria are clarified making confirmation of response and disease progression easier to perform. Emphasis is placed upon time to event and duration of response as critical end points. The requirements necessary to use overall survival duration as the ultimate end point are discussed. It is anticipated that the International Response Criteria for multiple myeloma will be widely used in future clinical trials of myeloma.
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Affiliation(s)
- B G M Durie
- Aptium Oncology, Inc., Cedars-Sinai Outpatient Cancer Center, Los Angeles, CA 90048, USA.
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Berenson J, Shirina N, Chen YM, Dimopoulos M. Survival in patients with multiple myeloma receiving zoledronic acid: Stratification by baseline bone alkaline phosphatase levels. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.7505] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
7505 Background: Zoledronic acid is indicated for the treatment of bone metastases in patients with multiple myeloma and has been demonstrated to reduce the risk of skeletal morbidity. However, it is unknown whether there is a survival benefit secondary to the reduction in skeletal complications. To assess the effect of zoledronic acid on survival in patients with multiple myeloma, we conducted a retrospective analysis of a subset of patients in a large, randomized, controlled trial. Methods: Survival data were analyzed for multiple myeloma patients (n = 209) treated with zoledronic acid 4 mg (n = 107) or pamidronate 90 mg (n = 102) who had at least 1 post-baseline safety evaluation and information on baseline bone alkaline phosphatase (BALP) levels (a marker of bone metabolism). Patients were retrospectively stratified by baseline BALP levels according to the following criteria: low BALP (< 146 U/L) and high BALP (≥ 146 U/L). Survival data were analyzed over 25 months on study. Results: The overall survival rate at 25 months was significantly higher in patients treated with zoledronic acid compared with pamidronate (76% versus 63%; P = .038, Cox regression). Among patients who had a low baseline BALP level, the survival rates were similar for both treatment groups. However, among patients with a high baseline BALP level, zoledronic acid treatment significantly improved survival at study end compared with pamidronate (82% versus 55%; P = .048, log-rank test). Conclusions: This exploratory analysis suggests that zoledronic acid treatment may improve survival compared with pamidronate, and this effect was observed primarily in patients who had a high baseline BALP level, indicating more aggressive osteolytic disease. [Table: see text]
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Affiliation(s)
- J. Berenson
- University of Athens School of Medicine; Institute for Myeloma & Bone Cancer Research, West Hollywood, CA; Novartis Oncology, East Hanover, NJ
| | - N. Shirina
- University of Athens School of Medicine; Institute for Myeloma & Bone Cancer Research, West Hollywood, CA; Novartis Oncology, East Hanover, NJ
| | - Y. M. Chen
- University of Athens School of Medicine; Institute for Myeloma & Bone Cancer Research, West Hollywood, CA; Novartis Oncology, East Hanover, NJ
| | - M. Dimopoulos
- University of Athens School of Medicine; Institute for Myeloma & Bone Cancer Research, West Hollywood, CA; Novartis Oncology, East Hanover, NJ
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Wang M, Knight R, Dimopoulos M, Siegel D, Rajkumar SV, Facon T, Yu Z, Zeldis J, Olesnyckyj M, Weber DM. Comparison of lenalidomide in combination with dexamethasone to dexamethasone alone in patients who have received prior thalidomide in relapsed or refractory multiple myeloma. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.7522] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
7522 Background: Lenalidomide (len), an analog of thalidomide (thal) is a novel, oral immunomodulatory agent that is effective against multiple myeloma (MM). Two randomized, Phase III trials (MM009 and MM010) have recently demonstrated superior responses and overall survival (OS) for patients (pts) treated with len and dexamethasone (dex) in comparison with dex-placebo. This is a prospective subgroup analysis to assess the impact of prior therapy with thal on the sensitivity of MM to subsequent lenalidomide. Methods: We evaluated 692 pts from both trials (MM009 and MM010). The pts had relapsed/refractory MM, were not refractory to dex and were randomized to receive either len (25 mg daily for 3 weeks (wks) every 4 wks) plus dex (40 mg on days 1–4, 9–12, 17–20 every 4 wks for 4 cycles, then 40 mg on days 1–4 every subsequent cycle) or placebo plus dex. Standard criteria were used to evaluate response and TTP. Results: Pooled data from 692 pts showed superior median TTP (48.1 vs 20.1 wks) and OR (59.2% vs 22.5%) in pts treated with len/dex compared to dex-placebo (p <0.001). Although subgroup analysis of pts with prior thal therapy revealed that pts who received len/dex had significantly improved OR, PR CR and median TTP than pts who received dex-placebo, OR, CR and TTP were highest in len/dex pts not previously treated with thal. Multivariate analysis indicates that after controlling for the treatment factor and baseline disease characteristics, whether or not pt had prior exposure to thal is a marginally significant variable to predict TTP. The risk of deep venous thrombosis and pulmonary embolism in these subgroups will be updated on further analysis. Conclusions: Lenalidomide in combination with dexamethasone is more effective than dexamethasone-placebo regardless of prior thalidomide in relapsed/refractory multiple myeloma. [Table: see text] [Table: see text]
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Affiliation(s)
- M. Wang
- UT M. D. Anderson Cancer Center, Houston, TX; Celgene Corporation, Summit, NJ; General Alexandras Hospital, Athens, Greece; Hackensack University Medical Center, Hackensack, NJ; Mayo Clinic, Rochester, MN; Hôpital Claude Huriez, Lillie, France
| | - R. Knight
- UT M. D. Anderson Cancer Center, Houston, TX; Celgene Corporation, Summit, NJ; General Alexandras Hospital, Athens, Greece; Hackensack University Medical Center, Hackensack, NJ; Mayo Clinic, Rochester, MN; Hôpital Claude Huriez, Lillie, France
| | - M. Dimopoulos
- UT M. D. Anderson Cancer Center, Houston, TX; Celgene Corporation, Summit, NJ; General Alexandras Hospital, Athens, Greece; Hackensack University Medical Center, Hackensack, NJ; Mayo Clinic, Rochester, MN; Hôpital Claude Huriez, Lillie, France
| | - D. Siegel
- UT M. D. Anderson Cancer Center, Houston, TX; Celgene Corporation, Summit, NJ; General Alexandras Hospital, Athens, Greece; Hackensack University Medical Center, Hackensack, NJ; Mayo Clinic, Rochester, MN; Hôpital Claude Huriez, Lillie, France
| | - S. V. Rajkumar
- UT M. D. Anderson Cancer Center, Houston, TX; Celgene Corporation, Summit, NJ; General Alexandras Hospital, Athens, Greece; Hackensack University Medical Center, Hackensack, NJ; Mayo Clinic, Rochester, MN; Hôpital Claude Huriez, Lillie, France
| | - T. Facon
- UT M. D. Anderson Cancer Center, Houston, TX; Celgene Corporation, Summit, NJ; General Alexandras Hospital, Athens, Greece; Hackensack University Medical Center, Hackensack, NJ; Mayo Clinic, Rochester, MN; Hôpital Claude Huriez, Lillie, France
| | - Z. Yu
- UT M. D. Anderson Cancer Center, Houston, TX; Celgene Corporation, Summit, NJ; General Alexandras Hospital, Athens, Greece; Hackensack University Medical Center, Hackensack, NJ; Mayo Clinic, Rochester, MN; Hôpital Claude Huriez, Lillie, France
| | - J. Zeldis
- UT M. D. Anderson Cancer Center, Houston, TX; Celgene Corporation, Summit, NJ; General Alexandras Hospital, Athens, Greece; Hackensack University Medical Center, Hackensack, NJ; Mayo Clinic, Rochester, MN; Hôpital Claude Huriez, Lillie, France
| | - M. Olesnyckyj
- UT M. D. Anderson Cancer Center, Houston, TX; Celgene Corporation, Summit, NJ; General Alexandras Hospital, Athens, Greece; Hackensack University Medical Center, Hackensack, NJ; Mayo Clinic, Rochester, MN; Hôpital Claude Huriez, Lillie, France
| | - D. M. Weber
- UT M. D. Anderson Cancer Center, Houston, TX; Celgene Corporation, Summit, NJ; General Alexandras Hospital, Athens, Greece; Hackensack University Medical Center, Hackensack, NJ; Mayo Clinic, Rochester, MN; Hôpital Claude Huriez, Lillie, France
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Kassar M, Yu Z, Bamias A, Markakis S, Kowalski D, Efstathiou E, Camp RL, Rimm DL, Psyrri D, Dimopoulos M. In situ proteomics of biomarker expression in epithelial ovarian cancer. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.5041] [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: 11/20/2022] Open
Affiliation(s)
- M. Kassar
- Yale Univ, New Haven, CT; Univ of Athens, Athens, Greece
| | - Z. Yu
- Yale Univ, New Haven, CT; Univ of Athens, Athens, Greece
| | - A. Bamias
- Yale Univ, New Haven, CT; Univ of Athens, Athens, Greece
| | - S. Markakis
- Yale Univ, New Haven, CT; Univ of Athens, Athens, Greece
| | - D. Kowalski
- Yale Univ, New Haven, CT; Univ of Athens, Athens, Greece
| | - E. Efstathiou
- Yale Univ, New Haven, CT; Univ of Athens, Athens, Greece
| | - R. L. Camp
- Yale Univ, New Haven, CT; Univ of Athens, Athens, Greece
| | - D. L. Rimm
- Yale Univ, New Haven, CT; Univ of Athens, Athens, Greece
| | - D. Psyrri
- Yale Univ, New Haven, CT; Univ of Athens, Athens, Greece
| | - M. Dimopoulos
- Yale Univ, New Haven, CT; Univ of Athens, Athens, Greece
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Kalofonos HP, Aravantinos G, Kosmidis P, Papakostas P, Economopoulos T, Dimopoulos M, Skarlos D, Bamias A, Pectasides D, Chalkidou S, Karina M, Koutras A, Samantas E, Bacoyiannis C, Samelis GF, Basdanis G, Kalfarentzos F, Fountzilas G. Irinotecan or oxaliplatin combined with leucovorin and 5-fluorouracil as first-line treatment in advanced colorectal cancer: a multicenter, randomized, phase II study. Ann Oncol 2005; 16:869-77. [PMID: 15855226 DOI: 10.1093/annonc/mdi193] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Irinotecan (IRI) and oxaliplatin (OXA) are effective in the treatment of colorectal cancer. Previously untreated patients with advanced colorectal carcinoma (CRC) were randomly assigned to receive IRI plus leucovorin (LV)/5-fluorouracil (5-FU), or OXA plus LV/5-FU in order to compare the response rates, time-to-tumor progression, overall survival rates, and toxicity profiles of these two agents. MATERIALS AND METHODS From January 1999 to February 2002, 295 patients were randomized to receive either IRI/LV/5-FU or OXA/LV/5-FU. The treatment schedules consisted of weekly IRI 70 mg/m(2) or OXA 45 mg/m(2) plus LV 200 mg/m(2) followed immediately by intravenous bolus 5-FU 450 mg/m(2) for 6 weeks, followed by a 2-week rest period. Treatment was continued for up to four cycles or until disease progression, unacceptable toxicity or patient refusal. RESULTS There were no significant differences between the study arms in the overall response rate (33% with IRI/LV/5-FU versus 32% with OXA/LV/5-FU based on responses demonstrated on a single evaluation; 23% with IRI/LV/5-FU versus 22.3% with OXA/LV/5-FU based on responses confirmed according to WHO criteria) median time to progression (8.9 versus 7.6 months), and median overall survival (17.6 versus 17.4 months). Toxicity profiles (grades 3 and 4) were similar in the IRI and OXA arms (diarrhea 12.3% and 9.8%, neutropenia 8.2% and 4.9%, and febrile neutropenia 1.4% and 1.4%, respectively), with the exception of grade 3 sensory neuropathy, which almost exclusively occurred in the OXA arm (0% versus 5.6%; P=0.003, Fisher's exact test). CONCLUSION The IRI/LV/5-FU and OXA/LV/5-FU regimens demonstrated equally substantial efficacies and manageable toxicity profiles in the first-line treatment of patients with advanced CRC. However, IRI/LV/5-FU may be the preferable regimen to avoid significant neurotoxicity associated with OXA-LV/5-FU.
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Razis E, Skarlos D, Briasoulis E, Dimopoulos M, Fountzilas G, Lambropoulos S, Rigatos S, Kopterides P, Efstathiou H, Tzamakou E, Bakoyannis C, Pectasides D, Makatsoris T, Varthalitis G, Papadopoulos S, Kosmidis P. Treatment of non-small cell lung cancer with gefitinib (???Iressa???, ZD1839): the Greek experience with a compassionate-use program. Anticancer Drugs 2005; 16:191-8. [PMID: 15655417 DOI: 10.1097/00001813-200502000-00011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This is a retrospective analysis of 150 patients with advanced non-small cell lung cancer who had failed prior treatment or were unfit for chemotherapy and were treated with oral gefitinib ('Iressa', ZD1839; AstraZeneca) 250 mg/day. Thirty-two patients who received gefitinib for 3 weeks or less were not included in the analysis. For the remaining 118 evaluable patients, the mean age was 63.1 years; most patients had received prior chemotherapy (97.5%), Eastern Cooperative Oncology Group performance status scores 0-2 (97.4%) and stage IV disease (64.4%). The majority were symptomatic (84.6%). Disease control was observed in 30 patients (25.4%), of whom five had a partial response and 25 had stable disease; 18 (15.3%) were not evaluable. Median duration of treatment was 29.9 weeks in responding patients and 11.5 in patients with progressive disease (p<0.0001). Median overall survival was 7.3 months (15.2 months for disease control) and median progression-free survival was 3.2 months. Gefitinib was well tolerated, with grade 3/4 skin rash and diarrhea seen in 2.5 and 4.2% of patients, respectively. Clinical benefit was evaluated using questionnaires before and following treatment with gefitinib. In 82 patients with completed questionnaires, evaluation revealed symptom improvement in 40.1% and improvement in general feeling in 31.4%. Epidermal growth factor receptor (EGFR) analysis found that efficacy did not correlate with tumor EGFR overexpression. Therefore, in this retrospective analysis, gefitinib treatment provided disease control in 25% of patients who derived significant palliative benefit.
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Affiliation(s)
- E Razis
- HYGEIA Medical Center, Athens, Greece.
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Markovic MG, Choudhury NR, Dimopoulos M, Matisons JG, Dutta NK, Bhattacharya AK. Rheological behavior of highly filled ethylene propylene diene rubber compounds. POLYM ENG SCI 2004. [DOI: 10.1002/pen.11234] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Abstract
A study was undertaken to evaluate the frequency and natural history of disease in patients with asymptomatic Waldenstrom's macroglobulinemia (WM). Among 132 consecutive, newly diagnosed patients with monoclonal IgM, 82 (27%) had symptomatic WM indicated by anemia, lymphadenopathy, or splenomegaly. Thirty-one patients had similar clinical features but were asymptomatic and followed without therapy until disease progression. There were 19 patients with monoclonal gammopathy of undetermined significance of IgM type (MGUS). In comparison to overt WM, patients with asymptomatic WM had significantly higher hemoglobin (Hgb) level (median, 12.1 v 9.7 g/dL), lower serum beta(2)-microglobulin (B(2)M) level (median, 2.4 v 3.4 mg/L), and similar IgM peaks (median, 2.2 and 1.8 g/dL). The IgM component was 3.6 g/dL or less in all patients with asymptomatic disease. For asymptomatic WM, median time to disease progression was 6.9 years with rare morbidity. Prognostic factors for early progression were Hgb <11.5 g/dL, B(2)M >or= 3.0 mg/L, and IgM peak >3.0 g/dL. Combinations of these variables defined three risk groups for progression with markedly different median times to progression of >5 years, 2 years, and 0.5 year, respectively. Response rate and survival after institution of treatment were similar to those of patients treated promptly for overt disease. We conclude that, among patients with WM, 27% were asymptomatic with slow disease progression before the need for chemotherapy. Since disease outcomes after treatment were similar to those of patients treated at diagnosis, patients with asymptomatic disease should be identified and followed without treatment for as long as risks of complications remain low.
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Affiliation(s)
- R Alexanian
- University of Texas M.D. Anderson Cancer Center, Houston 77030-4009, USA
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Abstract
Determinations of the cadmium content of a wide variety of foodstuffs from the Greek market were carried out. The values detected ranged from <0.1 ng x g(-1) in alcoholic beverages to 1595.8 ng x g(-1) in large snails. The highest values were observed in molluscs and crustaceans (117.4 ng x g(-1)), followed by leafy vegetables (28.3 ng x g(-1)), potatoes (22.3 ng x g(-1)) and organs and offal (20.7 ng x g(-1)), whereas the other food categories had a lower cadmium content. The results are comparable with those from the rest of Europe. Preliminary analytical data on the cadmium content of food samples of organic cultivation showed significantly lower values compared with those of samples of conventional produce.
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Affiliation(s)
- S Karavoltsos
- University of Athens, Chemistry Department, Division III, Inorganic and Environmental Chemistry and Technology, Panepistimiopolis, Athens, Greece
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37
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Alexanian R, Weber D, Giralt S, Dimopoulos M, Delasalle K, Smith T, Champlin R. Impact of complete remission with intensive therapy in patients with responsive multiple myeloma. Bone Marrow Transplant 2001; 27:1037-43. [PMID: 11438818 DOI: 10.1038/sj.bmt.1703035] [Citation(s) in RCA: 109] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2000] [Accepted: 02/01/2001] [Indexed: 11/08/2022]
Abstract
Clinical outcomes were assessed in 68 consecutive patients with multiple myeloma of high or intermediate tumor mass that had responded to VAD or dexamethasone-based therapy and were consolidated with early intensive therapy and autologous stem cell transplantation. Results were compared with those of 50 comparable patients who refused or were unable to receive intensive treatment for socioeconomic reasons. Following high-dose therapy, the rate of CR increased from 6 to 37%, with median survival prolonged by 10 months. Survival of 21 patients with disease converted from PR to CR (median 8.3 years) was significantly longer than that of similarly-treated patients who remained in PR (median 5.0 years). CR of myeloma represents the major surrogate marker of long survival and the primary goal of myeloablative treatment for patients in PR. Twelve of 18 patients with rapid reduction of myeloma protein (T(1/2) < 0.5 months), and myeloma protein reduction to <1.0 g/dl after primary therapy achieved CR (67%), identifying pretransplant features favorable to intensive therapy. Among 35 patients with slower reduction or higher residual myeloma protein, CR occurred in eight patients (23%) (P < 0.01), for whom other treatments should be considered. The kinetics of response to initial therapy should be considered in selecting patients more likely to achieve CR and consequent long survival after intensive treatment.
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Affiliation(s)
- R Alexanian
- University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA
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Shimoni A, Smith TL, Aleman A, Weber D, Dimopoulos M, Anderlini P, Andersson B, Claxton D, Ueno NT, Khouri I, Donato M, Korbling M, Alexanian R, Champlin R, Giralt S. Thiotepa, busulfan, cyclophosphamide (TBC) and autologous hematopoietic transplantation: an intensive regimen for the treatment of multiple myeloma. Bone Marrow Transplant 2001; 27:821-8. [PMID: 11477439 DOI: 10.1038/sj.bmt.1703007] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.4] [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: 10/12/2000] [Accepted: 02/07/2001] [Indexed: 11/09/2022]
Abstract
The study was designed to evaluate the efficacy and safety of an intensive, tri-alkylator conditioning regimen, consisting of thiotepa, busulfan and cyclophosphamide (TBC), prior to autologous hematopoietic cell transplantation in patients with multiple myeloma (MM) and to analyze factors associated with outcome. One hundred and twenty patients with MM received high-dose chemotherapy with TBC followed by autologous bone marrow (n = 24) or peripheral blood stem cell (PBSC) transplantation (n = 96). Fifty-four patients had chemosensitive disease and 66 had refractory disease at the time of transplantation. The overall response rate was 81% and the complete remission (CR) rate was 26%. Patients with chemosensitive disease had a CR rate of 52% vs 5% for patients with refractory disease. Multivariable analysis determined disease status at transplant as the factor most likely associated with long survival. Estimated median survival was 48, 35 and 9 months for patients with chemosensitive, primary refractory or disease in refractory relapse, respectively. Short interval from diagnosis to transplant among patients with primary refractory disease and younger age were also favorable prognostic factors for survival. Patients with refractory disease pre-transplant who achieved remission criteria rapidly after treatment had a worse outcome than the slow responders. Treatment-related mortality with the introduction of PBSC and better supportive care was 4.8%. In conclusion, TBC is an effective and relatively well-tolerated intensive conditioning regimen in patients with MM. A more favorable outcome was observed in patients with chemosensitive disease and with early treatment for primary refractory disease. TBC merits further study in these subgroups and comparison with alternative regimens in prospective studies is warranted.
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Affiliation(s)
- A Shimoni
- Department of Blood and Bone Marrow Transplantation, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA
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Affiliation(s)
- C Constantinides
- Department of Urology, University of Athens Medical School, Athens, Greece.
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Abstract
In order to assess the role of alpha-interferon or dexamethasone as maintenance therapy for multiple myeloma, 172 consecutive, previously untreated patients with disease of low or intermediate tumor mass received primary therapy with oral melphalan and intermittent, high-dose dexamethasone (MD), repeated monthly. Within 5 months, 84 responding patients were assigned at random to maintenance treatment with alpha-interferon (3 mU s.c. 3 x weekly) or dexamethasone (20 mg/m2 p.o. each morning for 4 days) repeated monthly until relapse. Upon relapse, MD was resumed for 2 cycles and second responses were maintained with 4-day courses of melphalan-dexamethasone until second relapse. Initial response was achieved in 88 patients (51%) after a median 0.7 month and no more than 3 courses of MD, a frequency of response similar to that observed previously with dexamethasone alone. There were identical median remissions of 10 months with interferon or dexamethasone, both maintenance regimens being associated with infrequent, mild, and reversible side effects. Significantly more patients responded again to resumption of MD after disease relapse to interferon (82%) than to dexamethasone (44%) (P = 0.001). The median remission from randomization to melphalan-resistant second relapse was 32 months for patients maintained initially on interferon compared to 19 months for those on dexamethasone (P = 0.01). These findings supported an advantage for interferon in remission maintenance by increasing the frequency of tumor recontrol with later treatment that included dexamethasone.
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Affiliation(s)
- R Alexanian
- University of Texas M.D. Anderson Cancer Center, Houston 77030, USA
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Abstract
Hexamita inflata can derive energy from the degradation of arginine via the arginine dihydrolase pathway. Carbamate kinase catalyses the third enzymatic step of the pathway synthesising ATP from the catabolism of carbamyl phosphate. This study reports the identification and characterisation of a carbamate kinase gene from this free-living diplomonad, together with measurements of carbamate kinase enzyme activity in cell-free extracts and a preliminary analysis of the carbamate kinase mRNA by reverse-transcription polymerase chain reaction. Analysis of the carbamate kinase gene revealed the use of non-canonical codons for glutamine. Phylogenetic studies showed a consistent close relationship between carbamate kinase sequences of H. inflata and Giardia intestinalis.
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Affiliation(s)
- M Dimopoulos
- School of Biochemistry and Molecular Genetics, University of New South Wales, Sydney, Australia
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Kosmidis P, Mylonakis N, Skarlos D, Samantas E, Dimopoulos M, Papadimitriou C, Kalophonos C, Pavlidis N, Nikolaidis C, Papaconstantinou C, Fountzilas G. Paclitaxel (175 mg/m2) plus carboplatin (6 AUC) versus paclitaxel (225 mg/m2) plus carboplatin (6 AUC) in advanced non-small-cell lung cancer (NSCLC): a multicenter randomized trial. Hellenic Cooperative Oncology Group (HeCOG). Ann Oncol 2000; 11:799-805. [PMID: 10997806 DOI: 10.1023/a:1008389402580] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE The combination of paclitaxel and carboplatin has become a widely used regimen in NSCLC due to phase II reports of moderate toxicity, reasonable activity and easy outpatient administration. Purpose of our present prospective study was to evaluate the dose response relationship of paclitaxel. PATIENTS AND METHODS Since July 1996, 198 patients with non-operable NSCLC and measurable disease without previous chemotherapy entered the trial. Ninety nine patients (group A) were randomized to receive paclitaxel 175 mg/m2 in three-hour infusion plus carboplatin dosed to an area under the concentration-time curve of 6 every 3 weeks and 99 (group B) to receive the same regimen with paclitaxel increased to 225 mg/m2. Eligibility criteria included WHO performance status 0-2, documented inoperable stage IIIA and IIIB, IV, no brain metastasis, no prior chemotherapy and adequate renal and hepatic function. Patients in both groups were well-matched with baseline disease characteristics. RESULTS In group A with 90 evaluable patients, the response rate was 25.6% (6 CR, 17 PR) whereas in group B with 88 evaluable patients, the response rate was 31.8% (3 CR, 25 PR), P = 0.733. Median time to progression favored the high-dose paclitaxel (4.3 vs. 6.4 months, P = 0.044). The median survival was 9.5 months for group A versus 11.4 months for group B (P = 0.16). The one-year survival was 37% for group A and 44% for group B (P = 0.35). The best prognostic factor for one-year survival was the response rate (P < 0.0001). With a relative dose intensity of paclitaxel 0.94 in both groups, neurotoxicity (P = 0.025) and leucopenia (P = 0.038) were more pronounced in group B patients. No toxic death was observed. CONCLUSIONS Higher dose paclitaxel prolongs the median time to progression but causes more neurotoxicity and leucopenia. The better response rate, the longer overall and better one-year survival seen with the higher dose of paclitaxel are not statistically significant.
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Dimopoulos M, Papadimitriou C, Aravantinos G, Moulopoulos L, Gika D, Athanassiades P, Georgoulias V. Phase II trial of paclitaxel and cisplatin in advanced or recurrent adenocarcinoma of the endometrium. Eur J Cancer 1999. [DOI: 10.1016/s0959-8049(99)81347-1] [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: 11/17/2022]
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Papadimitriou C, Anagnostopoulos A, Voulgaris Z, Vlahos G, Kioses E, Akrivos T, Dimopoulos M. Paclitaxel, cisplatin and epirubicin (PCE) combination chemotherapy for newly diagnosed patients with advanced epithelial ovarian cancer (AEOC). Eur J Cancer 1999. [DOI: 10.1016/s0959-8049(99)81358-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Papadimitriou C, Dimopoulos M, Lazari D, Ampela C, Louvrou-Fertaki A, Athanassiades P, Stamatelopoulos S, Keramopoulos A. Sequential administration of paclitaxel and doxorubicln followed by CMF in women with advanced breast cancer. Eur J Cancer 1998. [DOI: 10.1016/s0959-8049(98)80050-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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46
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Seong C, Delasalle K, Hayes K, Weber D, Dimopoulos M, Swantkowski J, Huh Y, Glassman A, Champlin R, Alexanian R. Prognostic value of cytogenetics in multiple myeloma. Br J Haematol 1998; 101:189-94. [PMID: 9576200 DOI: 10.1046/j.1365-2141.1998.00657.x] [Citation(s) in RCA: 96] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Karyotypic studies of bone marrow were conducted in 79 previously untreated patients with multiple myeloma who received a standard programme of chemotherapy. An abnormal karyotype was observed in 46% of patients, virtually all showing multiple abnormalities consistent with a long period of preclinical clonal evolution. Patients with an abnormal pattern showed various aberrations with hyperdiploidy in 64%, pseudodiploidy in 5% and hypodiploidy in 31%. The number of chromosomes affected ranged from two to 19 (median 10), with at least one trisomy in 83%, one monosomy in 75%, and one translocation in 42% of patients. Lymphoma-like karyotypes were present in 17% of patients with an abnormality but were not associated with atypical clinical features, such as an extramedullary mass, leukaemia, or increased serum lactate dehydrogenase. Monosomy or deletion of chromosome 13 was present in 47% of patients with an abnormal pattern, who lived for a shorter duration (median 10 months) than patients with other abnormalities (median 34 months) or with diploidy (median 35 months). The cause of the short survival of patients with monosomy or deletion of chromosome 13 was not clear, but further studies on the relationship with specific oncogenes are indicated.
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Affiliation(s)
- C Seong
- The University of Texas M.D. Anderson Cancer Center, Houston 77030, USA
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Lekakis J, Dimopoulos M, Nanas J, Prassopoulos V, Agapitos N, Alexopoulos G, Palazis L, Kostamis P, Stamatelopoulos S, Moulopoulos S. Antimyosin scintigraphy for detection of cardiac amyloidosis. Am J Cardiol 1997; 80:963-5. [PMID: 9382020 DOI: 10.1016/s0002-9149(97)00558-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The diagnostic value of antimyosin scanning in 7 patients with biopsy-proven cardiac amyloidosis was examined in this study. Antimyosin imaging was positive in all amyloid patients, with more intense uptake in patients with heart failure.
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Affiliation(s)
- J Lekakis
- Department of Clinical Therapeutics, Alexandra University Hospital, Athens, Greece
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Dimopoulos M, Louras G, Pantazopoulos D, Deliveliotis C, Constantinidis C, Papadimitriou C, Papadimitris C, Kyriakakis Z, Mitropoulos D, Georgoulias V. Docetaxel and cisplatin (DC) combination chemotherapy for metastatic urothelial cancer. Eur J Cancer 1997. [DOI: 10.1016/s0959-8049(97)84533-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Giralt S, Weber D, Colome M, Dimopoulos M, Mehra R, Van Besien K, Gajewski J, Andersson B, Khouri I, Przepiorka D, von Wolff B, Delasalle K, Korbling M, Seong D, Alexanian R, Champlin R. Phase I trial of cyclosporine-induced autologous graft-versus-host disease in patients with multiple myeloma undergoing high-dose chemotherapy with autologous stem-cell rescue. J Clin Oncol 1997; 15:667-73. [PMID: 9053492 DOI: 10.1200/jco.1997.15.2.667] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
PURPOSE To determine the feasibility and toxicity of inducing autologous graft-versus-host disease (GVHD) with cyclosporine in patients with multiple myeloma undergoing autologous stem-cell transplantation. PATIENTS AND METHODS Fourteen multiple myeloma patients with a median age of 50 years (range, 41 to 63) were enrolled. The median time from diagnosis to transplant was 651 days (range, 229 to 3,353). Ten patients had primary refractory disease, two were in first remission, and two were responsive to salvage therapy. The preparative regimen consisted of thiotepa, busulfan, and cyclophosphamide. Cyclosporine was administered daily for 28 days after the stem-cell infusion, and the dose was adjusted to maintain whole-blood cyclosporine levels between 50 and 150 ng/dL in the first seven patients (low-level group) and between 150 and 300 ng/dL in the other seven patients (high-level group). RESULTS All patients achieved neutrophil engraftment a median of 11 days after transplant. Four patients developed > or = grade 2 hepatic toxicity, six developed > or = grade 2 nephrotoxicity, and four developed reversible cardiac toxicity. Only one treatment-related death occurred. Cyclosporine was withheld in seven patients for a median of 6 days because of renal and/or liver dysfunction. One patient developed clinical skin GVHD, which responded to corticosteroid therapy. Six patients developed histologic evidence of GVHD without clinical signs of GVHD (subclinical GVHD). The incidence of clinical and subclinical GVHD was similar in both cyclosporine groups. Three of 11 patients assessable for response achieved remissions. Three patients experienced disease progression 80, 160, and 354 days after transplant. Ten patients are alive without progression between 56 and 444 days after transplant. CONCLUSION Induction of autologous GVHD by posttransplant cyclosporine is feasible and well tolerated in patients with multiple myeloma.
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Affiliation(s)
- S Giralt
- Department of Hematology, The University of Texas M.D. Anderson Cancer Center, Houston 77030, USA
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Keating MJ, O'Brien S, McLaughlin P, Dimopoulos M, Gandhi V, Plunkett W, Lerner S, Kantarjian H, Estey E. Clinical experience with fludarabine in hemato-oncology. Hematol Cell Ther 1996; 38 Suppl 2:S83-91. [PMID: 9137961] [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: 02/04/2023]
Abstract
Fludarabine monophosphate (Fludara) is a purine analogue which entered clinical trials in 1982. Although inactive in solid tumors, Fludara has marked activity in indolent lymphoproliferative disorders. The exact mechanism of action of Fludara is uncertain. Fludara has been established as the most active single agent in chronic lymphocytic leukemia (CLL) in single arm and comparative clinical trials. The activity has been demonstrated in both previously treated and initially treated patients. Marked activity has been noted in patients with low grade lymphoma, in particular, those with a follicular morphology and in Waldenstrom's macroglobulinemia. Combinations of fludarabine with alkylating agents, anthracyclines, and anthraquinones have led to clinically useful combination approaches. The ability of fludarabine to modulate the levels of the triphosphate form of cytosine arabinoside (ara-C) in acute leukemia cells has led to the development of combinations of fludarabine and ara-C. These combinations have demonstrated marked activity in treatment of relapsed and previously untreated patients with acute myelogenous leukemia (AML) and myelodysplastic syndrome (MDS). The ability to modulate the activity of pyrimidines and to inhibit repair of DNA damage caused by alkylating agents, anthracyclines, and other DNA active drugs suggest that the future of fludarabine will be in combination approaches to modulate the activity of other agents. These activities may extend its role to use in solid tumors.
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Affiliation(s)
- M J Keating
- University of Texas, M.D. Anderson Cancer Center, Houston, USA
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