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Saifi O, Lester SC, Rule WG, Breen W, Stish BJ, Rosenthal A, Munoz J, Lin Y, Johnston P, Ansell SM, Paludo J, Khurana A, Bisneto JV, Wang Y, Iqbal M, Moustafa MA, Murthy HS, Kharfan-Dabaja M, Peterson JL, Hoppe BS. Consolidative Radiotherapy for Residual PET-Avid Disease on Day +30 Post CAR T-Cell Therapy in Non-Hodgkin Lymphoma. Int J Radiat Oncol Biol Phys 2023; 117:S52. [PMID: 37784518 DOI: 10.1016/j.ijrobp.2023.06.335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Up to30% of non-Hodgkin lymphoma (NHL) patients achieve a partial response (PR) to anti-CD19 Chimeric Antigen Receptor T-cell Therapy (CART) on day +30. Most PR patients relapse and only 30% achieve spontaneous complete response (CR) without additional therapies. This study is the first to report on the role of consolidative radiotherapy (cRT) for PR PET-avid disease on day +30 post-CART in NHL. MATERIALS/METHODS Aretrospective review across 3 institutions from 2018 to 2022 identified 60 patients with B-cell NHL who received CART and achieved PR (Deauville 4-5) with <5 PET-avid disease sites on day +30. Progression-free survival (PFS) was defined from CART infusion to any disease progression. Overall survival (OS) was defined from CART infusion to death. Local relapse-free survival (LRFS), calculated based on the total number of PR sites, was defined from CART infusion to local relapse (LR) in the PR site identified on day +30. cRT was defined as comprehensive (compRT) - treated all PR PET-avid sites - or focal (focRT). RESULTS Followingday +30 PET scan, 45 PR patients were observed and 15 received cRT. Only one patient received consolidative systemic therapy and belonged to the cRT group. Prior to CART, bridging RT was given to 13 patients (9 in observation group and 4 in cRT group). There were no significant differences in the pre-CART and day +30 baseline characteristics, including the median size and SUVmax of the PR sites, between the two groups. However, the median number of PR sites on day +30 was higher in the cRT group (2 [range 1-3] vs 1 [range 1-3], p = 0.003). The median equivalent 2 Gy dose was 39.1 (Interquartile range 36.8-41) Gy, and the most common cRT regimen was 37.5 Gy in 15 fractions. The median follow-up was 21 months. Among the observed patients, 15 (33%) achieved spontaneous CR, and 27 (60%) experienced disease progression with all relapses involving the initial PR sites. Among patients who received cRT, 10 (67%) achieved CR, and 3 (20%) had disease progression with no relapses in the radiated PR sites. None of the 10 cRT patients achieving CR relapsed or required subsequent therapies. The 2-year PFS was 80% and 37% (p = 0.012) and the 2-year OS was 78% and 43% (p = 0.12) in the cRT and observation groups, respectively. Patients consolidated with compRT (n = 12) had superior 2-year PFS (92% vs 37%, p = 0.003) and 2-year OS (86% vs 43%, p = 0.048) compared to observed or focRT patients (n = 48). There were no grade 3+ RT-related toxicities. A total of 90 PR sites were identified; 64 were observed and 26 received cRT. Fourteen (22%) observed PR sites achieved spontaneous sustained CR and 42 (66%) experienced LR. Twenty-four (92%) PR sites consolidated with cRT achieved sustained CR and none experienced LR. The 2-year LRFS was 100% in the cRT sites and 31% in the observed sites (p<0.001). CONCLUSION NHL patients who achieve PR by PET to CART are at high risk of local progression. cRT for residual PET-avid disease on day +30 post-CART appears to alter the pattern of relapse and improve LRFS and PFS.
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Affiliation(s)
- O Saifi
- Department of Radiation Oncology, Mayo Clinic, Jacksonville, FL
| | - S C Lester
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN
| | - W G Rule
- Department of Radiation Oncology, Mayo Clinic, Phoenix, AZ
| | - W Breen
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN
| | - B J Stish
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN
| | - A Rosenthal
- Division of Hematology, Mayo Clinic, Phoenix, AZ
| | - J Munoz
- Division of Hematology, Mayo Clinic, Phoenix, AZ
| | - Y Lin
- Division of Experimental Pathology, Mayo Clinic, Rochester, MN; Division of Hematology, Mayo Clinic, Rochester, MN
| | - P Johnston
- Division of Hematology, Mayo Clinic, Rochester, MN
| | - S M Ansell
- Division of Hematology, Mayo Clinic, Rochester, MN
| | - J Paludo
- Division of Hematology, Mayo Clinic, Rochester, MN
| | - A Khurana
- Division of Hematology, Mayo Clinic, Rochester, MN
| | | | - Y Wang
- Division of Hematology, Mayo Clinic, Rochester, MN
| | - M Iqbal
- Division of Hematology, Mayo Clinic, Jacksonville, FL
| | | | - H S Murthy
- Division of Hematology, Mayo Clinic, Jacksonville, FL
| | | | - J L Peterson
- Department of Radiation Oncology, Mayo Clinic, Jacksonville, FL
| | - B S Hoppe
- Department of Radiation Oncology, Mayo Clinic, Jacksonville, FL
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Saifi O, Rule WG, Lester SC, Laack NN, Breen W, Rosenthal A, Ansell SM, Habermann TM, Villasboas Bisneto J, Iqbal M, Alhaj Moustafa M, Tun H, Kharfan-Dabaja M, Peterson JL, Hoppe BS. The Role of Radiation Therapy in the Management of Gray Zone Lymphoma. Int J Radiat Oncol Biol Phys 2023; 117:e484-e485. [PMID: 37785532 DOI: 10.1016/j.ijrobp.2023.06.1711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Gray zone lymphoma (GZL) is a relatively rare disease predominantly affecting young adults with purportedly poor outcomes with current treatment approaches. The role of radiation therapy (RT) in the management of GZL is not well established. This is the largest study to report on the outcomes of GZL patients treated with and without RT. MATERIALS/METHODS A retrospective review of 30 patients with GZL treated across 3 institutions from 2009 to 2021 was performed. Event-free survival (EFS) was defined from initiation of frontline chemotherapy (CHT) to disease progression/relapse, initiation of salvage therapy, or death. Local control (LC) was defined from RT start date to in-field recurrence. RESULTS The median age was 32 (range: 18-86) years, and 16 (53%) patients had early stage (I-II) disease. Bulky mediastinal disease was present in 63% of patients, and the median tumor diameter was 10 (range: 1.5-18) cm. Patients received ABVD (20%), RCHOP (33%), or REPOCH (47%) as frontline CHT. Among 25 patients with interim PET/CT scan, there were 6 rapid early responders and 14 slow early responders (SER), with 2-year EFS of 33% and 24%, respectively (p = 0.13). After the completion of CHT, 15 (50%) patients achieved complete response (CR) and 10 (33%) achieved partial response (PR), with 2-year EFS of 46% and 10%, respectively (p = 0.004). RT was given to 9 patients in CR (n = 3) or in PR (n = 6). The median RT dose was 36 (30.6-48.6) Gy, at 1.8-2 Gy/fraction. Those receiving RT had bulkier disease at diagnosis (p = 0.049) and lower rates of CR following CHT (p = 0.03). After RT, 3/6 (50%) PR patients converted to CR. At a median follow-up of 4 years, the 2-year EFS was 26% for all patients, 33% for RT and 23% for noRT (p = 0.44). Among patients who did not receive upfront RT and experienced progression (n = 17), 16 (94%) relapsed in pre-existing sites. The 5-year OS was 80% for all patients, 88% for RT and 78% for no RT (p = 0.63). Patients who achieved PR to CHT and received RT had better 2-year EFS (17% vs 0%, p = 0.007) compared to patients who did not receive RT. Similarly, patients with SER who received RT had superior 2-year EFS (33% vs 13%, p = 0.038). Patients with bulky mediastinal disease had a 2-year EFS of 43% with RT and 11% without RT (p = 0.08). After 1st line treatment, 22 (73%) patients relapsed and 18 were successfully salvaged with a sustained CR. The most common salvage regimen involved high dose CHT followed by hematopoietic cell transplantation (HCT) (n = 15). RT was given for 7 patients in the relapsed/refractory setting (consolidative peri-HCT n = 4; definitive salvage n = 3) and 5 (71%) achieved a sustained CR. Among the 16 patients who received RT in the upfront (n = 9) or salvage (n = 7) setting, 3 patients experienced in-field recurrence translating to 2-year LC of 79%. CONCLUSION GZL patients have high risk of relapse and maximal upfront combined modality therapy should be considered. RT provides good local control and improves EFS particularly for SER, PR, and bulky mediastinal disease.
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Affiliation(s)
- O Saifi
- Department of Radiation Oncology, Mayo Clinic, Jacksonville, FL
| | - W G Rule
- Department of Radiation Oncology, Mayo Clinic, Phoenix, AZ
| | - S C Lester
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN
| | - N N Laack
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN
| | - W Breen
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN
| | - A Rosenthal
- Division of Hematology, Mayo Clinic, Phoenix, AZ
| | - S M Ansell
- Division of Hematology, Mayo Clinic, Rochester, MN
| | | | | | - M Iqbal
- Division of Hematology, Mayo Clinic, Jacksonville, FL
| | | | - H Tun
- Division of Hematology, Mayo Clinic, Jacksonville, FL
| | | | - J L Peterson
- Department of Radiation Oncology, Mayo Clinic, Jacksonville, FL
| | - B S Hoppe
- Department of Radiation Oncology, Mayo Clinic, Jacksonville, FL
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Saifi O, Breen W, Lester S, Rule W, Stish B, Rosenthal A, Munoz J, Murthy H, Lin Y, Kharfan-Dabaja M, Hoppe B, Peterson J. Radiation Therapy as Bridging Treatment to CAR T Cell Therapy in Non-Hodgkin Lymphoma. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.299] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Mishra A, Corrales-Yepez M, Al-Ali N, Kharfan-Dabaja M, Padron E, Zhang L, Epling-Burnette P, Pinilla-Ibarz J, Lancet J, List A, Komrokji R. P-100 Validation of the Revised International Prognostic Scoring System (IPSS-R) and its therapeutic implications. Leuk Res 2013. [DOI: 10.1016/s0145-2126(13)70148-6] [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: 11/24/2022]
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Ayas M, Nassar A, Hamidieh AA, Kharfan-Dabaja M, Othman TB, Elhaddad A, Seraihy A, Hussain F, Alimoghaddam K, Ladeb S, Fahmy O, Bazarbachi A, Mohamed SY, Bakr M, Korthof E, Aljurf M, Ghavamzadeh A. Reduced intensity conditioning is effective for hematopoietic SCT in dyskeratosis congenita-related BM failure. Bone Marrow Transplant 2013; 48:1168-72. [PMID: 23542225 DOI: 10.1038/bmt.2013.35] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2012] [Revised: 12/04/2012] [Accepted: 01/30/2013] [Indexed: 02/08/2023]
Abstract
BM failure (BMF) is a major and frequent complication of dyskeratosis congenita (DKC). Allogeneic hematopoietic SCT (allo-HSCT) represents the only curative treatment for BMF associated with this condition. Transplant-related morbidity/mortality is common especially after myeloablative conditioning regimens. Herein, we report nine cases of patients with DKC who received an allo-SCT at five different member centers within the Eastern Mediterranean Blood and Marrow Transplantation Registry. Between October 1992 and February 2011, nine DKC patients (male, 7 and female, 2), with a median age at transplantation of 19.1 (4.9-31.1) years, underwent an allo-HSCT from HLA-matched, morphologically normal-related donors (100%). Preparative regimens varied according to different centers, but was reduced intensity conditioning (RIC) in eight patients. Graft source was unstimulated BM in five cases (56%) and G-CSF-mobilized PBSCs in four (44%) cases. The median stem cell dose was 6.79 (2.06-12.4) × 10(6) cells/kg body weight. GVHD prophylaxis consisted of CsA in all nine cases; MTX or mycophenolate mofetil were added in five (56%) and two (22%) cases, respectively. Anti-thymocyte globulin was administered at various doses and scheduled in four (44%) cases. Median time-to-neutrophil engraftment was 21 (17-27) days. In one case, late graft failure was noted at 10.4 months post allo-HSCT. Only one patient developed grade II acute GVHD (11%). Extensive chronic GVHD was reported in one case, whereas limited chronic GVHD occurred in another four cases. At a median follow-up of 61 (0.8-212) months, seven (78%) patients were still alive and transfusion independent. One patient died of metastatic gastric adenocarcinoma and graft failure was the cause of death in another patient. This study suggests that RIC preparative regimens are successful in inducing hematopoietic cell engraftment in patients with BMF from DKC. Owing to the limited sample size, the use of registry data and heterogeneity of preparative as well as GVHD prophylaxis regimens reported in this series, we are unable to recommend a particular regimen to be considered as the standard for patients with this disease.
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Affiliation(s)
- M Ayas
- Adult Hematopoietic Stem Cell Transplantation Program, Oncology Centre, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
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Field T, Perkins J, Nishori T, Pidala J, Fernandez H, Tomblyn M, Kharfan-Dabaja M, Perez L, Komrokji R, Lancet J, Kim J, Ayala E, Alsina M, Ochoa-Bayona JL, Locke F, Betts B, List A, Anasetti C. Prospective Trial of Pre-Transplant 5-Azacitidine on Hematopoietic Cell Transplantation Outcomes for Myelodysplastic Syndrome and CMML. Biol Blood Marrow Transplant 2012. [DOI: 10.1016/j.bbmt.2011.12.353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Barker C, Hong S, Klein J, Shaw P, Bredeson C, Angelina A, Rowlings P, Cahn JY, Kharfan-Dabaja M, Aljurf M, Szer J, Wood W, Ahmed I, Gomez Almaguer D, Atsuta Y, Sanz M, Hale G, Litzow M, Pasquini M. Radiotherapeutic Techniques in Allogeneic Hematopoietic Cell Transplant (HCT). Biol Blood Marrow Transplant 2012. [DOI: 10.1016/j.bbmt.2011.12.388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Perkins J, Fields T, Kim J, Fernandez H, Perez L, Ayala E, Kharfan-Dabaja M, Tomblyn M, Sullivan D, Anasetti C. Maximally Tolerated Busulfan Area Under the Concentration-Time Curve (AUC) in Combination With Fludarabine as Conditioning Prior to Allogeneic Hematopoietic Cell Transplantation. Biol Blood Marrow Transplant 2011. [DOI: 10.1016/j.bbmt.2010.12.444] [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: 11/25/2022]
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Gergis U, Markey K, Greene J, Kharfan-Dabaja M, Field T, Wetzstein G, Schell MJ, Huang Y, Anasetti C, Perkins J. Voriconazole provides effective prophylaxis for invasive fungal infection in patients receiving glucocorticoid therapy for GVHD. Bone Marrow Transplant 2010; 45:662-7. [PMID: 19684623 PMCID: PMC2850960 DOI: 10.1038/bmt.2009.210] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2009] [Revised: 05/25/2009] [Accepted: 06/19/2009] [Indexed: 12/05/2022]
Abstract
Patients on systemic glucocorticoids for GVHD after hematopoietic cell transplant are susceptible to invasive fungal infections (IFI), which greatly contribute to morbidity and mortality. We evaluated the efficacy of prophylactic treatment options (voriconazole or fluconazole vs itraconazole) for IFI by performing a retrospective review of patients on glucocorticoids for GVHD who were administered voriconazole (n=97), fluconazole (n=36) or itraconazole (n=36). IFI developed in 7/72 (10%) patients on fluconazole/itraconazole vs 2/97 (2%) on voriconazole (P=0.03) within the first 100 days of glucocorticoids. Five (7%) patients developed Aspergillus IFI on fluconazole/itraconazole, compared with none on voriconazole (0%) (P=0.008); Aspergillus IFI resulted in death in all five patients. We found that IFI occurred in patients who received an initial dose of at least 2 mg/kg/day of prednisone or equivalent; when the analysis was restricted to these patients, the hazard ratio (0.39; 95% confidence interval: 0.08-1.86) was consistent with a protective effect of voriconazole compared with fluconazole/itraconazole, although this subset analysis did not reach significance. OS at 100 days after start of glucocorticoids was 77% in patients administered fluconazole/itraconazole and 85% in those administered voriconazole (P=0.22). Our results suggest that voriconazole is more effective than fluconazole/itraconazole in preventing IFI, especially aspergillosis, in patients receiving glucocorticoids post transplant.
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Affiliation(s)
- U Gergis
- Department of Medicine, Weill Cornell Medical College, New York, NY, USA
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Janssen W, Ayala E, Field T, Kharfan-Dabaja M, Ochoa L, Rahn D, Hackett M, Coyle D, Anasetti C, Fernandez H. Apheresis And Transplant Of Hematopoietic Progenitor Cells (HPC) From Allogeneic Donors ≥60 Years Of Age. Biol Blood Marrow Transplant 2010. [DOI: 10.1016/j.bbmt.2009.12.371] [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: 10/19/2022]
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Anasetti C, Hillgruber R, Nye V, Ayala E, Kharfan-Dabaja M, Fernandez H, Field T, Ochoa J, Perez L, Tomblyn M, Benson K, Davis J, Dodson K, Confer D. Patient Ethnicity Markedly Affects The Probability Of Finding An HLA-A, -B, -C, And DRB1 Allele Matched Unrelated Donor For Hemopoietic Cell Transplantation. Biol Blood Marrow Transplant 2010. [DOI: 10.1016/j.bbmt.2009.12.066] [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: 10/19/2022]
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Pidala J, Kim J, Alsina M, Ayala E, Field T, Fernandez H, Kharfan-Dabaja M, Ochoa L, Perez L, Perkins J, Tomblyn M, Anasetti C. Dysglycemia Following Glucocorticoid Therapy For Acute Graft Vs. Host Disease Adversely Affects Transplantation Outcomes. Biol Blood Marrow Transplant 2010. [DOI: 10.1016/j.bbmt.2009.12.368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Kumar A, Kharfan-Dabaja M, Djulbegovic B. Response: Re: Tandem vs Single Autologous Hematopoietic Cell Transplantation for the Treatment of Multiple Myeloma: A Systematic Review and Meta-analysis. J Natl Cancer Inst 2009. [DOI: 10.1093/jnci/djp321] [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: 11/13/2022] Open
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Pidala J, Kim J, Perkins J, Field T, Fernandez H, Perez L, Ayala E, Kharfan-Dabaja M, Anasetti C. Mycophenolate mofetil for the management of steroid-refractory acute graft vs host disease. Bone Marrow Transplant 2009; 45:919-24. [DOI: 10.1038/bmt.2009.252] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [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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Perkins J, Alsina M, Anasetti C, Ayala E, Fernandez H, Kharfan-Dabaja M, Ochoa-Bayona L, Perez L, Raychaudhuri J, Sullivan D, Kim J, Schell M, Field T. A Randomized, Controlled Trial of Graft-Versus-Host Disease (GVHD) Prophylaxis Comparing Tacrolimus and Mycophenolate Mofetil to Tacrolimus and Methotrexate: Analysis of GVHD, Relapse and Survival. Biol Blood Marrow Transplant 2009. [DOI: 10.1016/j.bbmt.2008.12.271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Raychaudhuri J, Perkins J, Alsina M, Ochoa-Bayona J, Fernandez H, Sullivan D, Dalton W, Kharfan-Dabaja M, Field T, Ayala E, Perez L, Harris J, Janssen W, Tate C, Anasetti C. Long–Term Survival of Allogeneic Transplantation(Allo SCT) In Selected Patients with Multiple Myeloma (MM): Disease Free Survival at Two Years May Indicate Long Term Survival. Biol Blood Marrow Transplant 2009. [DOI: 10.1016/j.bbmt.2008.12.331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Anasetti C, Santarone S, Alsina M, Ayala E, Field T, Kharfan-Dabaja M, Ochoa L, Perez L, Perkins J, Raychaudhuri J, Sullivan D, Fernandez H. Safety and Efficacy of Fludarabine and PK-Targeted Intravenous Busulfan Before Allografting for Adult ALL. Biol Blood Marrow Transplant 2009. [DOI: 10.1016/j.bbmt.2008.12.199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Gergis U, Markey K, Greene J, Kharfan-Dabaja M, Wetzstein G, Anasetti C, Perkins J. 258: Voriconazole is Effective Prophylaxis for Aspergillus Invasive Fungal Infection (IFI) in Patients Receiving Glucocorticosteroid Therapy for GVHD after Allogeneic Transplantation. Biol Blood Marrow Transplant 2008. [DOI: 10.1016/j.bbmt.2007.12.267] [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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Fernandez H, Henao-Uribe A, Poling W, Chavez J, Alsina M, Ayala E, Field T, Kharfan-Dabaja M, Perez L, Raychaudhuri J, Ochoa-Bayona L, Anasetti C. 156: Treatment of Myeloid Malignancies in Elderly Patients with Fludarabine and Targeted Busulfan (t-Bu) and Allogeneic Hematopoietic Cell Transplantation (HCT). Biol Blood Marrow Transplant 2008. [DOI: 10.1016/j.bbmt.2007.12.165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Alsina M, Alekshun T, McIsaac-Simonelli C, Kharfan-Dabaja M, Dalton W, Djulbegovic B, Fernandez H, Sullivan D, Ayala E, Field T, Garrett D, Janssen W, Maddox B, Perez L, Kettner D, Perkins J, Raychaudhuri J, Anasetti C. 184: Phase I Study of Bortezomib, (BTZ) followed by High-Dose Melphalan, (HD Mel) and BTZ as Conditioning Regimen for Tandem Peripheral Blood Stem Cell Transplants (TanPSCT) in Patients with Primary Refractory Multiple Myeloma (MM) and Plasma Cell Leukemia (PCL). Biol Blood Marrow Transplant 2008. [DOI: 10.1016/j.bbmt.2007.12.193] [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]
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Hamadani M, Kharfan-Dabaja M, Kamble R, Kern W, Ozer H. Marginal zone B-cell lymphoma of the uterus: a case report and review of the literature. J Okla State Med Assoc 2006; 99:154-6. [PMID: 16703935] [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: 05/09/2023]
Abstract
We report here a case of a 52-year-old female in whom immunohistological studies of the uterus established a diagnosis of extranodal marginal zone B-cell lymphoma. Malignant lymphoma arising from mucosa-associated lymphoid tissue (MALT) of uterus is extremely rare. Accurate histologic interpretation of uterine lymphoma is essential, as treatment options and prognosis vary based on the histological grade of such lymphomas. Patients with primary uterine lymphoma generally have intermediate or high-grade lymphoma and poorer prognosis.
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Affiliation(s)
- Mehdi Hamadani
- Department of Internal Medicine, OUHSC, Oklahoma City, OK 73104, USA
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Hjortsvang E, Kharfan-Dabaja M, Ozer H, Selby G, Kamble R. Iron overload manifesting as liver graft versus host disease exacerbation: Response to erythropoietin assisted phlebotomy. Biol Blood Marrow Transplant 2006. [DOI: 10.1016/j.bbmt.2005.11.124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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