1
|
Torrent A, Morgades M, García-Calduch O, de Llano MPQ, Montesinos P, Navarro I, Hernández-Rivas JM, Bárez-García A, González-Campos J, Oiartzabal I, Valero M, Cervera M, Zudaire T, Albors-Ferreiro M, López-Godino O, Gil-Cortés C, Villalón L, Saldaña R, Ribera JM. Results of the compassionate program of inotuzumab ozogamicin for adult patients with relapsed or refractory acute lymphoblastic leukemia in Spain. Eur J Haematol 2023. [PMID: 37381686 DOI: 10.1111/ejh.14031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 06/13/2023] [Accepted: 06/15/2023] [Indexed: 06/30/2023]
Abstract
INTRODUCTION The prognosis of relapsed B cell precursor acute lymphoblastic leukemia (B-ALL) is poor and few patients can be successfully rescued with conventional therapies. Inotuzumab ozogamicin (IO), an antibody against the CD22 antigen linked to calicheamicin, has been approved as a rescue treatment in relapsed/refractory (R/R) B-ALL. PATIENTS AND METHODS This was an observational, retrospective, multicenter study of adult patients included in the Spanish program of compassionate use of IO in centers from the PETHEMA group (Programa Español de Tratamientos en Hematología). RESULTS Thirty-four patients with a median age of 43 years (range, 19-73) were included. Twenty patients (59%) were refractory to the last treatment, IO treatment was given as ≥3rd salvage treatment in 25 patients (73%) and 20 patients (59%) received allogeneic hematopoietic stem cell transplantation before IO treatment. After a median of 2 cycles of IO, 64% of patients achieved complete response (CR)/complete response with incomplete recovery. The median response duration, progression-free survival and overall survival (OS) were 4.7 (95%CI, 2.4-7.0 months), 3.5 (95%CI, 1.0-5.0 months) and 4 months (95%CI, 1.9-6.1 months) respectively, with better OS for patients with relapsed B-ALL versus refractory disease (10.4 vs. 2.5 months, respectively) (p = .01). There was a trend for better OS for patients with first CR duration >12 months (7.2 months [95%CI, 3.2-11.2] vs. 3 months [95% CI, 1.8-4.2] respectively) (p = .054). There was no sinusoidal obstruction syndrome (SOS) event during IO treatment, but three patients (9%) developed grade 3-4 SOS during alloHSCT after IO treatment. CONCLUSIONS Our study showed slightly inferior outcomes of the pivotal trial probably due to poorer risk factors and late onset of IO therapy of recruited patients. Our results support early use of IO in relapsed/refractory ALL patients.
Collapse
Affiliation(s)
- Anna Torrent
- Hematology Department, ICO-Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute (IJC), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Mireia Morgades
- Hematology Department, ICO-Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute (IJC), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Olga García-Calduch
- Hematology Department, ICO-Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute (IJC), Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | - Pau Montesinos
- Hematology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Irene Navarro
- Hematology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Jesús María Hernández-Rivas
- Departamento de Medicina, Universidad de Salamanca & Hematology Department, Hospital Universitario de Salamanca, Salamanca, Spain
| | | | | | - Itziar Oiartzabal
- Servicio de Hematología y Hemoterapia, Hospital Universitario de Álava, Vitoria-Gasteiz, Álava, Spain
| | - Marta Valero
- Hematology Department, Hospital Arnau de Vilanova, Valencia, Spain
| | - Marta Cervera
- Hematology Department, Hospital Joan XXIII de Tarragona, Tarragona, Spain
| | - Teresa Zudaire
- Hematology Department, Hospital de Navarra, Navarra, Spain
| | | | - Oriana López-Godino
- Hematology Department, Hospital General Universitario Morales Meseguer, Murcia, Spain
| | | | - Lucía Villalón
- Hematology Department, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | | | - Josep-María Ribera
- Hematology Department, ICO-Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute (IJC), Universitat Autònoma de Barcelona, Barcelona, Spain
| |
Collapse
|
2
|
Guillem V, Calabuig M, Brunet S, Esteve J, Escoda L, Gallardo D, Ribera JM, Queipo de Llano MP, Arnan M, Pedro C, Amigo ML, Martí-Tutusaus JM, García-Guiñón A, Bargay J, Sampol A, Salamero O, Font L, Talarn C, Hoyos M, Díaz-Beyá M, Garrido A, Navarro B, Nomdédeu J, Sierra J, Tormo M. Bone marrow VEGFC expression is associated with multilineage dysplasia and several prognostic markers in adult acute myeloid leukemia, but not with survival. Leuk Lymphoma 2018; 59:2383-2393. [PMID: 29345176 DOI: 10.1080/10428194.2017.1422858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Vascular endothelial growth factor C (VEGFC) stimulates leukemia cell proliferation and survival, and promotes angiogenesis. We studied VEGFC expression in bone marrow samples from 353 adult acute myeloid leukemia (AML) patients and its relationship with several clinical, cytogenetic, and molecular variables. We also studied the expression of 84 genes involved in VEGF signaling in 24 patients. We found that VEGFC expression was higher in AML patients with myelodysplasia-related changes (AML-MRC) than in patients with non-AML-MRC. We also found an association between VEGFC expression and the patient cytogenetic risk group, with those with a worse prognosis having higher VEGFC expression levels. No correlation was observed between VEGFC expression and survival or complete remission. VEGFC expression strongly correlated with expression of the VEGF receptors FLT1, KDR, and NRP1. Thus, in this series, VEGFC expression was increased in AML-MRC and in subgroups with a poorer prognosis, but has no impact on survival.
Collapse
Affiliation(s)
- Vicent Guillem
- a Department of Hematology and Medical Oncology , Hospital Clínico Universitario INCLIVA Biomedical Research Institute , Valencia , Spain
| | - Marisa Calabuig
- a Department of Hematology and Medical Oncology , Hospital Clínico Universitario INCLIVA Biomedical Research Institute , Valencia , Spain
| | - Salut Brunet
- b Department of Hematology , Hospital de Sant Pau, IIB Sant Pau and Jose Carreras Leukemia Research Institutes, Universidad Autónoma de Barcelona , Spain
| | - Jordi Esteve
- c Department of Hematology , Hospital Clínic, IDIBAPS , Barcelona , Spain
| | - Lourdes Escoda
- d Department of Hematology , Hospital Universitari Joan XIII , Tarragona , Spain
| | - David Gallardo
- e Department of Hematology , ICO Girona, Hospital Josep Trueta, IDIBGI Foundation , Girona , Spain
| | - Josep-Maria Ribera
- f Department of Hematology , ICO Badalona - Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Universitat Autonoma de Barcelona , Badalona , Spain
| | | | - Montserrat Arnan
- h Department of Hematology , ICO - Hospital Duran i Reynals , Barcelona , Spain
| | - Carme Pedro
- i Department of Hematology , Hospital del Mar, Parc de Salut Mar , Barcelona , Spain
| | - María Luz Amigo
- j Department of Hematology , Hospital Morales Meseguer , Murcia , Spain
| | | | - Antoni García-Guiñón
- l Department of Hematology , Hospital Universitari Arnau de Villanova , Lleida , Spain
| | - Joan Bargay
- m Department of Hematology , Hospital Son Llatzer , Mallorca , Spain
| | - Antonia Sampol
- n Department of Hematology , University Hospital Son Espases, Instituto IDISPA , Palma de Mallorca , Spain
| | - Olga Salamero
- o Department of Hematology , Hospital Vall d'Hebron , Barcelona , Spain
| | - Llorenç Font
- p Department of Hematology , Hospital Verge de la Cinta , Tortosa , Spain
| | - Carme Talarn
- c Department of Hematology , Hospital Clínic, IDIBAPS , Barcelona , Spain
| | - Montserrat Hoyos
- b Department of Hematology , Hospital de Sant Pau, IIB Sant Pau and Jose Carreras Leukemia Research Institutes, Universidad Autónoma de Barcelona , Spain
| | - Marina Díaz-Beyá
- c Department of Hematology , Hospital Clínic, IDIBAPS , Barcelona , Spain
| | - Ana Garrido
- b Department of Hematology , Hospital de Sant Pau, IIB Sant Pau and Jose Carreras Leukemia Research Institutes, Universidad Autónoma de Barcelona , Spain
| | - Blanca Navarro
- a Department of Hematology and Medical Oncology , Hospital Clínico Universitario INCLIVA Biomedical Research Institute , Valencia , Spain
| | - Josep Nomdédeu
- b Department of Hematology , Hospital de Sant Pau, IIB Sant Pau and Jose Carreras Leukemia Research Institutes, Universidad Autónoma de Barcelona , Spain
| | - Jordi Sierra
- b Department of Hematology , Hospital de Sant Pau, IIB Sant Pau and Jose Carreras Leukemia Research Institutes, Universidad Autónoma de Barcelona , Spain
| | - Mar Tormo
- a Department of Hematology and Medical Oncology , Hospital Clínico Universitario INCLIVA Biomedical Research Institute , Valencia , Spain
| |
Collapse
|