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Ferdinandus J, Müller H, Damaschin C, Jacob AS, Meissner J, Krasniqi F, Mey U, Schöndube D, Thiemer J, Mathas S, Zijlstra J, Greil R, Feuring-Buske M, Markova J, Rüffer JU, Kobe C, Eich HT, Baues C, Fuchs M, Borchmann P, Behringer K. Impact of individualized treatment on recovery from fatigue and return to work in survivors of advanced-stage Hodgkin's lymphoma: results from the randomized international GHSG HD18 trial. Ann Oncol 2024; 35:276-284. [PMID: 38061428 DOI: 10.1016/j.annonc.2023.11.014] [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: 09/18/2023] [Revised: 11/01/2023] [Accepted: 11/29/2023] [Indexed: 01/21/2024] Open
Abstract
BACKGROUND Persisting cancer-related fatigue impairs health-related quality of life (HRQoL) and social reintegration in patients with Hodgkin's lymphoma (HL). The GHSG HD18 trial established treatment de-escalation for advanced-stage HL guided by positron emission tomography after two cycles (PET-2) as new standard. Here, we investigate the impact of treatment de-escalation on long-term HRQoL, time to recovery from fatigue (TTR-F), and time to return to work (TTR-W). PATIENTS AND METHODS Patients received European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30) and life situation questionnaires at baseline, interim, end of treatment, and yearly follow-up. TTR-F was defined as time from the end of chemotherapy until the first fatigue score <30. TTR-W was analyzed in previously working or studying patients and measured from the end of treatment until the first documented work or education. We compared duration of treatment on TTR-F and TTR-W using Cox proportional hazards regression adjusted for confounding variables. RESULTS HRQoL questionnaires at baseline were available in 1632 (83.9%) of all randomized patients. Overall, higher baseline fatigue and age were significantly associated with longer TTR-F and TTR-W and male sex with shorter TTR-W. Treatment reduction from eight to four chemotherapy cycles led to a significantly shorter TTR-F [hazard ratio (HR) 1.41, P = 0.008] and descriptively shorter TTR-W (HR 1.24, P = 0.084) in PET-2-negative patients. Reduction from six to four cycles led to non-significant but plausible intermediate accelerations. The addition of rituximab caused significantly slower TTR-F (HR 0.70, P = 0.0163) and TTR-W (HR 0.64, P = 0.0017) in PET-2-positive patients. HRQoL at baseline and age were the main determinants of 2-year HRQoL. CONCLUSIONS Individualized first-line treatment in patients with advanced-stage HL considerably shortens TTR-F and TTR-W in PET-2-negative patients. Our results support the use of response-adapted shortened treatment duration for patients with HL.
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Affiliation(s)
- J Ferdinandus
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Medical Faculty and University Hospital Cologne, Cologne; German Hodgkin Study Group (GHSG), Cologne.
| | - H Müller
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Medical Faculty and University Hospital Cologne, Cologne; German Hodgkin Study Group (GHSG), Cologne
| | - C Damaschin
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Medical Faculty and University Hospital Cologne, Cologne; German Hodgkin Study Group (GHSG), Cologne
| | - A S Jacob
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Medical Faculty and University Hospital Cologne, Cologne; German Hodgkin Study Group (GHSG), Cologne
| | - J Meissner
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany
| | - F Krasniqi
- Medical Oncology, University Hospital of Basel, Basel; Swiss Group for Clinical Cancer Research, Bern
| | - U Mey
- Swiss Group for Clinical Cancer Research, Bern; Oncology and Hematology, Kantonsspital Graubuenden, Chur, Switzerland
| | - D Schöndube
- Department of Oncology and Hematology, Helios Klinikum Bad Saarow, Bad Saarow
| | - J Thiemer
- Department of Hematology and Oncology, Klinikum der Philipps-Universität Marburg, Marburg
| | - S Mathas
- Charité-Universitätsmedizin Berlin, Hematology, Oncology and Tumor Immunology, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin; Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association (MDC), Group Biology of Malignant Lymphomas, Berlin; Experimental and Clinical Research Center (ECRC), a cooperation between the MDC and the Charité, Berlin, Germany
| | - J Zijlstra
- Department of Hematology, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - R Greil
- Illrd Medical Department, Paracelsus Medical University, Salzburg; Salzburg Cancer Research Institute and AGMT, Salzburg, Austria
| | - M Feuring-Buske
- Department of Internal Medicine III, University Hospital of Ulm, Ulm, Germany
| | - J Markova
- Department of Internal Medicine-Hematology, University Hospital Kralovske Vinohrady, Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | | | - C Kobe
- German Hodgkin Study Group (GHSG), Cologne; Department of Nuclear Medicine, University Hospital of Cologne, Cologne
| | - H-T Eich
- German Hodgkin Study Group (GHSG), Cologne; Department of Radiotherapy, University Hospital of Muenster, Muenster
| | - C Baues
- German Hodgkin Study Group (GHSG), Cologne; Department of Radiooncology, Marienhospital Herne, Ruhr University Bochum, Bochum, Germany
| | - M Fuchs
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Medical Faculty and University Hospital Cologne, Cologne; German Hodgkin Study Group (GHSG), Cologne
| | - P Borchmann
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Medical Faculty and University Hospital Cologne, Cologne; German Hodgkin Study Group (GHSG), Cologne
| | - K Behringer
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Medical Faculty and University Hospital Cologne, Cologne; German Hodgkin Study Group (GHSG), Cologne
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2
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Oertel M, Hering D, Kittel C, Nacke N, Kröger K, Kriz J, Fuchs M, Baues C, Vordermark D, Engenhart-Cabillic R, Herfarth KK, Lukas P, Schmidberger H, Marnitz-Schulze S, Borchmann P, Engert A, Haverkamp U, Eich HTT. Quality Analysis of Radiation Therapy for Hodgkin Lymphoma in the HD 16/17 Trials: A Final Report By the Reference Radiation Oncology Panel of the German Hodgkin Study Group. Int J Radiat Oncol Biol Phys 2023; 117:S62. [PMID: 37784540 DOI: 10.1016/j.ijrobp.2023.06.361] [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) The HD 16 and 17 trials by the German Hodgkin Study Group (GHSG) have evaluated the use of consolidative radiotherapy (RT) in early-favorable and -unfavorable stage Hodgkin lymphoma (HL), respectively (1, 2). Quality of RT planning and execution is pivotal for treatment outcome in HL with protocol violations jeopardizing prognosis (3). Consequently, the present work aims at a decisive analysis of quality and dosimetry in the modern era. MATERIALS/METHODS Random samples of 100 involved-field RT (IFRT) plans in HD16 and 176 plans in HD17 (134 involved-node RT (INRT) and 42 IFRT) were selected for analysis. Evaluation was performed systematically by the reference radiation oncology panel using pre-chemotherapy imaging, recommendation by the reference radiation oncology and RT planning imaging and graded as "correct", "minor" or "major deviation", respectively. RT doses to the target volume and organs at risks (OAR) were analyzed using dose-volume histograms. RESULTS Median RT doses were 20 Gy (19.8 Gy-21.6 Gy) in HD16 and 30 Gy in HD17 (IFRT: 18-30.6 Gy, INRT: 14 Gy-40 Gy). Overall, 84.0%, 69.0%, and 76.1% of RT series in HD16, the IFRT-group of HD17 and the INRT-group of HD17, respectively, were planned correctly. The main reason for major deviation was an insufficient coverage of an involved region (11 %-14.3 %). There was no significant difference in quality between IFRT and INRT in HD17 (p = 0.418 for any deviations; p = 0.466 for major deviations). In comparison to previous GHSG studies in the respective stages, a significant increase in correct RT-series (p<0.001) and decrease in major deviations (p<0.001) occurred. However, doses to OAR varied individually with median values of 4.3 Gy (0.2 Gy-9.2 Gy), 4.7 Gy (0.2 Gy-15.2 Gy) and 3.8 Gy (0.0 Gy-16.0 Gy) for mean doses to the right lung, left lung and heart in HD16, respectively. Correspondingly, values were 9.8 Gy (0.3 Gy-20.0 Gy), 10.5 Gy (0.2 Gy-26.5 Gy) and 13.1 Gy (0.5 Gy-30.4 Gy) for mean doses to the right lung, left lung and heart in HD17, respectively. The size of the planning target volume decreased significantly with INRT compared to IFRT (median values: 1163.1 ml vs. 1464.3 ml; p = 0.043). However, only some OAR-parameters (V25 of the right and left lung, respectively, thyroid and spinal cord) showed significant differences between INRT and IFRT in HD17. The use of intensity-modulated techniques in HD 17 resulted in an increase in V5 and V10 of the lungs with a concomitant decrease in V20-V30. CONCLUSION Quality of RT in the planning and treatment of HL has improved significantly with the latest GHSG study generation. Future analyses will focus on a further individualization of treatment fields. LITERATURE
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Affiliation(s)
- M Oertel
- Department of Radiation Oncology, University Hospital Muenster, Muenster, Germany
| | - D Hering
- Department of Radiation Oncology, University Hospital Muenster, Muenster, Germany
| | - C Kittel
- Department of Radiation Oncology, University Hospital Muenster, Muenster, Germany
| | - N Nacke
- Department of Radiation Oncology, University Hospital Muenster, Muenster, Germany
| | - K Kröger
- Department of Radiation Oncology, University Hospital Muenster, Muenster, Germany
| | - J Kriz
- Department of Radiation Oncology, Alexianer Clemenshospital Muenster, Muenster, Germany
| | - M Fuchs
- German Hodgkin Study Group (GHSG), Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany
| | - C Baues
- Department of Radiation Oncology and CyberKnife Center, University Hospital of Cologne, Cologne, Germany
| | - D Vordermark
- Department of Radiation Oncology, University Hospital Halle (Saale), Halle (Saale), Germany
| | - R Engenhart-Cabillic
- Department of Radiotherapy and Radiation Oncology, University Hospital Giessen-Marburg, Marburg, Germany
| | - K K Herfarth
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany
| | - P Lukas
- Department of Radiooncology, Medical University Innsbruck, Innsbruck, Austria
| | - H Schmidberger
- Department of Radiotherapy and Radiation Oncology, University Hospital Mainz, Mainz, Germany
| | - S Marnitz-Schulze
- Department of Radiation Oncology and CyberKnife Center, University Hospital of Cologne, Cologne, Germany
| | - P Borchmann
- German Hodgkin Study Group (GHSG), Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany
| | - A Engert
- German Hodgkin Study Group (GHSG), Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany
| | - U Haverkamp
- Department of Radiation Oncology, University Hospital Muenster, Muenster, Germany
| | - H T T Eich
- Department of Radiation Oncology, University Hospital Muenster, Muenster, Germany
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Gregory G, Timmerman J, Lavie D, Borchmann P, Herrera AF, Minuk L, Vucinic V, Armand P, Avigdor A, Gasiorowski R, Herishanu Y, Keane C, Kuruvilla J, Palcza J, Pillai P, Marinello P, Johnson NA. P1086: FAVEZELIMAB (ANTI–LAG-3) AND PEMBROLIZUMAB CO-BLOCKADE IN ANTI–PD-1–NAIVE PATIENTS WITH RELAPSED OR REFRACTORY CLASSICAL HODGKIN LYMPHOMA: AN OPEN-LABEL PHASE 1/2 STUDY. Hemasphere 2022. [PMCID: PMC9428990 DOI: 10.1097/01.hs9.0000847212.00073.29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Balke-Want H, Borchmann P. [CAR T-cell therapy for malignant B-cell lymphoma : A new treatment paradigm]. Internist (Berl) 2021; 62:589-596. [PMID: 34152469 DOI: 10.1007/s00108-021-01056-3] [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] [Accepted: 05/03/2021] [Indexed: 10/21/2022]
Abstract
Following the first demonstration of efficacy of anti-CD19-directed chimeric antigen receptor (CAR) T cells in a patient with relapsed chronic lymphocytic leukemia (CLL) in 2011, pivotal studies for this innovative therapy were initially conducted in multiple relapsed or refractory (r/r) childhood and young adult acute B‑cell leukemia and in aggressive adult B‑cell lymphoma. The studies demonstrated efficacy even in chemotherapy-refractory disease, resulting in the first approval of autologous and genetically engineered T cells for the treatment of r/r B‑cell acute lymphoblastic leukemia (B-ALL) in the US for the product tisagenlecleucel (Kymriah®, Novartis) back in 2018. Approval for the treatment of r/r aggressive B‑cell lymphoma followed shortly thereafter for tisagenlecleucel and axicabtagene ciloleucel (Yescarta, Kite/Gilead). This review focuses on the treatment of aggressive B‑cell lymphoma and other CD19 positive B‑cell lymphomas by summarizing the study results of clinically tested CAR T cells, discussing possible resistance mechanisms, and providing an outlook on ongoing studies with new target antigens for the treatment of B‑cell lymphomas.
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Affiliation(s)
- H Balke-Want
- Uniklinik Köln, Medizinische Klinik 1, 50937, Köln, Deutschland
| | - P Borchmann
- Uniklinik Köln, Medizinische Klinik 1, 50937, Köln, Deutschland.
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Heger J, Gödel P, Balke‐Want H, Altmüller J, Mattlener J, Dörr H, Weiss J, Sieg N, Kutsch N, Reinhardt HC, Borchmann P, Tresckow B, Borchmann S. LIQUID‐BIOPSY BASED GENOTYPING OF PRIMARY CENTRAL NERVOUS SYSTEM LYMPHOMA (PCNSL). Hematol Oncol 2021. [DOI: 10.1002/hon.67_2880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- J.‐M. Heger
- Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) University of Cologne Faculty of Medicine and University Hospital of Cologne Department I of Internal Medicine Cologne Germany
| | - P. Gödel
- Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) University of Cologne Faculty of Medicine and University Hospital of Cologne Department I of Internal Medicine Cologne Germany
| | - H. Balke‐Want
- Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) University of Cologne Faculty of Medicine and University Hospital of Cologne Department I of Internal Medicine Cologne Germany
| | - J. Altmüller
- University of Cologne West German Genome Center Cologne Germany
| | - J. Mattlener
- Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) University of Cologne Faculty of Medicine and University Hospital of Cologne Department I of Internal Medicine Cologne Germany
| | - H. Dörr
- Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) University of Cologne Faculty of Medicine and University Hospital of Cologne Department I of Internal Medicine Cologne Germany
| | - J. Weiss
- Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) University of Cologne Faculty of Medicine and University Hospital of Cologne Department I of Internal Medicine Cologne Germany
| | - N. Sieg
- Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) University of Cologne Faculty of Medicine and University Hospital of Cologne Department I of Internal Medicine Cologne Germany
| | - N. Kutsch
- Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) University of Cologne Faculty of Medicine and University Hospital of Cologne Department I of Internal Medicine Cologne Germany
| | - H. C. Reinhardt
- West German Cancer Center University Hospital Essen University of Duisburg‐Essen Department of Hematology and Stem Cell Transplantation Essen Germany
| | - P. Borchmann
- Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) University of Cologne Faculty of Medicine and University Hospital of Cologne Department I of Internal Medicine Cologne Germany
| | - B. Tresckow
- West German Cancer Center University Hospital Essen University of Duisburg‐Essen Department of Hematology and Stem Cell Transplantation Essen Germany
| | - S. Borchmann
- Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) University of Cologne Faculty of Medicine and University Hospital of Cologne Department I of Internal Medicine Cologne Germany
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Bröckelmann PJ, Müller H, Gillessen S, Yang X, Koeppel L, Pilz V, Marinello P, Kaskel P, Raut M, Fuchs M, Borchmann P, Engert A, Tresckow B. CLINICAL OUTCOMES OF RELAPSED HODGKIN LYMPHOMA PATIENTS AFTER CONTEMPORARY FIRST‐LINE TREATMENT: RESULTS FROM THE GERMAN HODGKIN STUDY GROUP. Hematol Oncol 2021. [DOI: 10.1002/hon.107_2880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- P. J. Bröckelmann
- Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) University of Cologne Department I of Internal Medicine and German Hodgkin Study Group (GHSG) Cologne Germany
| | - H. Müller
- Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) University of Cologne Department I of Internal Medicine and German Hodgkin Study Group (GHSG) Cologne Germany
| | - S. Gillessen
- Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) University of Cologne Department I of Internal Medicine and German Hodgkin Study Group (GHSG) Cologne Germany
| | - X. Yang
- Merck & Co., Inc. Kenilworth USA
| | | | - V. Pilz
- MSD Sharp & Dohme GmbH Haar Germany
| | | | | | - M. Raut
- Merck & Co., Inc. Kenilworth USA
| | - M. Fuchs
- Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) University of Cologne Department I of Internal Medicine and German Hodgkin Study Group (GHSG) Cologne Germany
| | - P. Borchmann
- Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) University of Cologne Department I of Internal Medicine and German Hodgkin Study Group (GHSG) Cologne Germany
| | - A. Engert
- Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) University of Cologne Department I of Internal Medicine and German Hodgkin Study Group (GHSG) Cologne Germany
| | - B. Tresckow
- University Hospital Essen University of Duisburg‐Essen Department of Hematology and Stem Cell Transplantation West German Cancer Center Essen Germany
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Jaeger U, Worel N, McGuirk JP, Riedell PA, Fleury I, Borchmann P, Du Y, Abdelhady AM, Han X, Martinez‐Prieto M, Waller EK. SAFETY AND EFFICACY OF TISAGENLECLEUCEL PLUS PEMBROLIZUMAB IN PATIENTS WITH RELAPSED/REFRACTORY DIFFUSE LARGE B‐CELL LYMPHOMA: UPDATED ANALYSIS OF THE PHASE 1B PORTIA STUDY. Hematol Oncol 2021. [DOI: 10.1002/hon.179_2880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- U. Jaeger
- Medical University of Vienna Vienna Austria
| | - N. Worel
- Medical University of Vienna Vienna Austria
| | - J. P. McGuirk
- Division of Hematologic Malignancies and Cellular Therapeutics University of Kansas Medical Center Kansas City USA
| | | | - I. Fleury
- Maisonneuve‐Rosemont Hospital University of Montreal Montreal Canada
| | | | - Y. Du
- Novartis Pharma AG Shanghai China
| | | | - X. Han
- Novartis Pharmaceuticals Corporation East Hanover USA
| | | | - E. K. Waller
- Emory University Winship Cancer Institute Atlanta Georgia USA
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Eichenauer DA, Kreissl S, Bühnen I, Baues C, Kobe C, van Heek L, Goergen H, Fuchs M, Hartmann S, von Tresckow B, Engert A, Borchmann P. PET-2-guided escalated BEACOPP for advanced nodular lymphocyte-predominant Hodgkin lymphoma: a subgroup analysis of the randomized German Hodgkin Study Group HD18 study. Ann Oncol 2021; 32:807-810. [PMID: 33667668 DOI: 10.1016/j.annonc.2021.02.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 02/10/2021] [Accepted: 02/16/2021] [Indexed: 11/25/2022] Open
Affiliation(s)
- D A Eichenauer
- First Department of Internal Medicine, Center for Integrated Oncology Aachen, Bonn, Cologne and Dusseldorf, University of Cologne, Cologne, Germany; German Hodgkin Study Group (GHSG), University Hospital Cologne, Cologne, Germany.
| | - S Kreissl
- First Department of Internal Medicine, Center for Integrated Oncology Aachen, Bonn, Cologne and Dusseldorf, University of Cologne, Cologne, Germany; German Hodgkin Study Group (GHSG), University Hospital Cologne, Cologne, Germany
| | - I Bühnen
- First Department of Internal Medicine, Center for Integrated Oncology Aachen, Bonn, Cologne and Dusseldorf, University of Cologne, Cologne, Germany; German Hodgkin Study Group (GHSG), University Hospital Cologne, Cologne, Germany
| | - C Baues
- German Hodgkin Study Group (GHSG), University Hospital Cologne, Cologne, Germany; Department of Radiation Oncology, University of Cologne, Cologne, Germany
| | - C Kobe
- German Hodgkin Study Group (GHSG), University Hospital Cologne, Cologne, Germany; Department of Nuclear Medicine, University of Cologne, Cologne, Germany
| | - L van Heek
- German Hodgkin Study Group (GHSG), University Hospital Cologne, Cologne, Germany; Department of Nuclear Medicine, University of Cologne, Cologne, Germany
| | - H Goergen
- First Department of Internal Medicine, Center for Integrated Oncology Aachen, Bonn, Cologne and Dusseldorf, University of Cologne, Cologne, Germany; German Hodgkin Study Group (GHSG), University Hospital Cologne, Cologne, Germany
| | - M Fuchs
- First Department of Internal Medicine, Center for Integrated Oncology Aachen, Bonn, Cologne and Dusseldorf, University of Cologne, Cologne, Germany; German Hodgkin Study Group (GHSG), University Hospital Cologne, Cologne, Germany
| | - S Hartmann
- Senckenberg Institute of Pathology, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - B von Tresckow
- First Department of Internal Medicine, Center for Integrated Oncology Aachen, Bonn, Cologne and Dusseldorf, University of Cologne, Cologne, Germany; German Hodgkin Study Group (GHSG), University Hospital Cologne, Cologne, Germany; Clinic for Hematology and Stem Cell Transplantation, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - A Engert
- First Department of Internal Medicine, Center for Integrated Oncology Aachen, Bonn, Cologne and Dusseldorf, University of Cologne, Cologne, Germany; German Hodgkin Study Group (GHSG), University Hospital Cologne, Cologne, Germany
| | - P Borchmann
- First Department of Internal Medicine, Center for Integrated Oncology Aachen, Bonn, Cologne and Dusseldorf, University of Cologne, Cologne, Germany; German Hodgkin Study Group (GHSG), University Hospital Cologne, Cologne, Germany
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9
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Borchmann S, Müller H, Hude I, Fuchs M, Borchmann P, Engert A. Thrombosis as a treatment complication in Hodgkin lymphoma patients: a comprehensive analysis of three prospective randomized German Hodgkin Study Group (GHSG) trials. Ann Oncol 2020; 30:1329-1334. [PMID: 31132094 DOI: 10.1093/annonc/mdz168] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [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: 11/14/2022] Open
Abstract
BACKGROUND The prognosis of Hodgkin lymphoma (HL) is excellent rendering research into treatment complications highly important. An important complication of cancer and its treatment is thrombosis. Thrombotic events are regularly observed in HL patients but precise information on incidence and risk factors is lacking and the value of prophylactic anticoagulation unclear. PATIENTS AND METHODS Thus, we comprehensively studied thrombotic events in 5773 patients from the German Hodgkin Study Group (GHSG) HD13-15 trials in early-favorable, intermediate and advanced HL. We estimated the incidence of and identified risk factors for thrombotic events. Additionally, we provide detailed data on the time course and characteristics of thrombotic events. RESULTS A total of 193 thrombotic events occurred for an incidence of 3.3%. Out of these, 175 (90.7%) were venous thromboses, 3 (1.5%) newly emerging post-thrombotic syndromes and 15 (7.8%) arterial thromboses. There were 11 (0.7%) events in early-favorable, 27 (1.3%) in early-unfavorable and 155 (7.3%) in advanced patients, the latter incidence being significantly higher (P < 0.001). The most common locations were deep vein thrombosis of the arm (46.3%) and leg (24.6%). Most venous thrombotic events occurred during chemotherapy (78.9%). We observed 59 (30.6%) catheter-associated events and a descriptively increased risk of venous thrombotic events in patients with oral contraception use during treatment (6.8% versus 3.9%). In advanced HL, the incidence of venous thrombotic events was increased upon treatment with BEACOPP-14 (9.4%, P = 0.0079) compared with 5.1% with 6×BEACOPPesc and 5.7% with 8×BEACOPPesc. Among commonly applied risk factors, including the Khorana score, only age and smoking were prognostic. CONCLUSIONS The incidence of thrombotic events in advanced stage HL is comparable to other high-risk cancer patients, especially if treated with dose-dense regimens. Additional risk factors are higher age and smoking. Selected HL patients could benefit from prophylactic anticoagulation, however, further interventional studies are needed before general recommendations can be made.
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Affiliation(s)
- S Borchmann
- Faculty of Medicine, Department I of Internal Medicine, GHSG; Faculty of Medicine, Center for Molecular Medicine, University Hospital of Cologne, University of Cologne, Cologne, Germany; Faculty of Medicine, Else Kröner Forschungskolleg Clonal Evolution in Cancer, University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - H Müller
- Faculty of Medicine, Department I of Internal Medicine, GHSG
| | - I Hude
- Faculty of Medicine, Department I of Internal Medicine, GHSG; Division of Hematology, Department of Internal Medicine, University Hospital Center Zagreb, Zagreb, Croatia
| | - M Fuchs
- Faculty of Medicine, Department I of Internal Medicine, GHSG
| | - P Borchmann
- Faculty of Medicine, Department I of Internal Medicine, GHSG
| | - A Engert
- Faculty of Medicine, Department I of Internal Medicine, GHSG.
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10
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Voltin CA, Goergen H, Baues C, Fuchs M, Mettler J, Kreissl S, Oertl J, Klaeser B, Moccia A, Drzezga A, Engert A, Borchmann P, Dietlein M, Kobe C. Value of bone marrow biopsy in Hodgkin lymphoma patients staged by FDG PET: results from the German Hodgkin Study Group trials HD16, HD17, and HD18. Ann Oncol 2019; 29:1926-1931. [PMID: 30010775 DOI: 10.1093/annonc/mdy250] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background Bone marrow (BM) involvement defines advanced-stage Hodgkin lymphoma and thus has impact on the assignment to treatment. Our aim was to evaluate whether the established BM biopsy may be omitted in patients if 18F-fluorodeoxyglucose positron emission tomography (PET) scanning is carried out during staging. Patients and methods Our analysis set consisted of 832 Hodgkin lymphoma patients from the German Hodgkin Study Group trials HD16, HD17, and HD18 who underwent both PET scanning and BM biopsy before treatment. All PET studies were centrally reviewed and BM was categorized as showing focal involvement or not. Results Taking BM biopsy as reference standard, baseline PET showed a negative predictive value of 99.9% [95% confidence interval (CI) 99.2% to 100%] with true-negative results in 702 of 703 cases. The sensitivity of PET for detecting BM involvement was 95.0% (95% CI 75.1% to 99.9%) as it could identify 19 out of 20 patients with positive BM biopsy. Moreover, PET found 110 additional subjects with focal BM lesions who would have been considered negative by biopsy. Conclusions When compared with BM biopsy, PET was able to detect focal BM lesions in a large number of additional patients. This indicates that conventional BM biopsy may substantially underestimate the actual incidence of BM involvement. Given the high negative predictive value, baseline PET scanning can safely be used to exclude BM involvement in Hodgkin lymphoma. BM biopsy should be considered only in such patients in whom PET-detected lesions lead to a change of treatment protocol. Registered trials The trials included in this analysis were registered at ClinicalTrials.gov: HD16-NCT00736320, HD17-NCT01356680, and HD18-NCT00515554.
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Affiliation(s)
- C-A Voltin
- Department of Nuclear Medicine, University Hospital of Cologne, Cologne, Germany
| | - H Goergen
- German Hodgkin Study Group (GHSG), Department of Internal Medicine I, University Hospital of Cologne, Cologne, Germany
| | - C Baues
- Departments of Radiation Oncology, University Hospital of Cologne, Cologne, Germany
| | - M Fuchs
- German Hodgkin Study Group (GHSG), Department of Internal Medicine I, University Hospital of Cologne, Cologne, Germany
| | - J Mettler
- Department of Nuclear Medicine, University Hospital of Cologne, Cologne, Germany
| | - S Kreissl
- Departments of Internal Medicine I, University Hospital of Cologne, Cologne, Germany
| | - J Oertl
- Department of Nuclear Medicine, University Hospital of Cologne, Cologne, Germany
| | - B Klaeser
- Department of Nuclear Medicine, Inselspital, Bern University Hospital and University of Bern, Bern; Swiss Group for Clinical Cancer Research (SAKK), Bern
| | - A Moccia
- Swiss Group for Clinical Cancer Research (SAKK), Bern; Department of Medical Oncology, Oncology Institute of Southern Switzerland (IOSI), Bellinzona, Switzerland
| | - A Drzezga
- Department of Nuclear Medicine, University Hospital of Cologne, Cologne, Germany
| | - A Engert
- Departments of Internal Medicine I, University Hospital of Cologne, Cologne, Germany
| | - P Borchmann
- Departments of Internal Medicine I, University Hospital of Cologne, Cologne, Germany
| | - M Dietlein
- Department of Nuclear Medicine, University Hospital of Cologne, Cologne, Germany
| | - C Kobe
- Department of Nuclear Medicine, University Hospital of Cologne, Cologne, Germany.
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11
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Eich H, Baues C, Fuchs M, Kobe C, Greil R, Sasse S, Zijlstra J, Lohri A, Rosenwald A, Tresckow B, Diehl V, Kuhnert G, Dietlein M, Borchmann P, Engert A. PET-Guided Treatment of Early-Stage Favorable Hodgkin Lymphoma: Final Results of the International, Randomized Phase 3 Trial HD16 by the GHSG. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.380] [Citation(s) in RCA: 2] [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: 12/01/2022]
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12
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Baues C, Goergen H, Fuchs M, Kobe C, Dietlein M, Rosenbrock J, Celik E, Eich H, Kriz J, Semrau R, Borchmann P, Engert A, Marnitz S. Consolidating Involved Field Radiotherapy Prevents Early and Local Recurrences in Early Stage Hodgkin Lymphoma. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.445] [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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13
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Bachanova V, Westin J, Tam C, Borchmann P, Jaeger U, McGuirk J, Holte H, Waller E, Jaglowski S, Bishop M, Andreadis C, Foley S, Fleury I, Teshima T, Mielke S, Salles G, Ho P, Izutsu K, Maziarz R, Van Besien K, Kersten M, Wagner-Johnston N, Kato K, Corradini P, Han X, Agoulnik S, Chu J, Eldjerou L, Pacaud L, Schuster S. CORRELATIVE ANALYSES OF CYTOKINE RELEASE SYNDROME AND NEUROLOGICAL EVENTS IN TISAGENLECLEUCEL-TREATED RELAPSED/REFRACTORY DIFFUSE LARGE B-CELL LYMPHOMA PATIENTS. Hematol Oncol 2019. [DOI: 10.1002/hon.118_2630] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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)
- V. Bachanova
- Division of Hematology; Oncology and Transplantation, University of Minnesota; Minneapolis United States
| | - J. Westin
- Department of Lymphoma & Meyloma; M.D. Anderson Cancer Center; Houston United States
| | - C. Tam
- Department of Haematology; Peter MacCallum Cancer Centre; Melbourne Australia
| | - P. Borchmann
- Department of Hematology/Oncology; University Hospital of Cologne; Cologne Germany
| | - U. Jaeger
- Department of Hematology/Hemostaseology; Medical University Vienna; Vienna Austria
| | - J. McGuirk
- Division of Hematologic Malignancies and Cellular Therapeutics; Kansas Hospital and Medical Center; Kansas City United States
| | - H. Holte
- Lymphoma Section; University of Oslo; Oslo Norway
| | - E. Waller
- Department of Stem Cell Transplantation and Immunology; Emory University School of Medicine; Atlanta United States
| | - S. Jaglowski
- Department of Internal Medicine; The Ohio State University; Columbus United States
| | - M. Bishop
- Section of Hematology/Oncology; University of Chicago; Chicago United States
| | - C. Andreadis
- Department of Hematology and Blood and Marrow Transplat; University of California San Francisco; San Francisco United States
| | - S.R. Foley
- Division of Clinical Pathology; McMaster University; Hamilton Canada
| | - I. Fleury
- Department of Hematology; Hôpital Maisonneuve-Rosemont; Montreal Canada
| | - T. Teshima
- Department of Hematology; Hokkaido University Hospital; Sapporo Japan
| | - S. Mielke
- Department of Internal Medicine; University Hospital Wuerzburg; Wuerzburg Germany
| | - G. Salles
- Hematology Department; Lyon-Sud Hospital Center; Pierre-Benite France
| | - P.J. Ho
- Department of Haematology; Royal Prince Alfred Hospital; Camperdown Australia
| | - K. Izutsu
- Department of Hematology; National Cancer Center Hospital; Tokyo Japan
| | - R. Maziarz
- Department of Hematology and Oncology; Oregon Health and Science University; Portland United States
| | - K. Van Besien
- Department of Medical Oncology; Weill Cornell Medicine; New York United States
| | - M.J. Kersten
- Department of Hematology; Academic Medical Center; Amsterdam Netherlands
| | - N. Wagner-Johnston
- Department of Oncology and Hematologic Malignancies; Johns Hopkins Sidney Kimmel Comprehensive Cancer Center; Baltimore United States
| | - K. Kato
- Hematology; Oncology & Cardiovascular Medicine, Kyushu University; Fukuoka Prefecture Japan
| | - P. Corradini
- Department of Oncology and Hemato-oncology; University of Milan; Milan Italy
| | - X. Han
- Biomarkers and Diagnostics Biometrics; Novartis Pharmaceuticals Corporation; East Hanover United States
| | - S. Agoulnik
- Precision Medicine; Novartis Pharmaceuticals Corporation; Cambridge United States
| | - J. Chu
- Novartis Oncology; Novartis Pharmaceuticals Corporation; East Hanover United States
| | - L. Eldjerou
- Global Cell & Gene Medical Affairs; Novartis Pharmaceuticals Corporation; East Hanover United States
| | - L. Pacaud
- Novartis Oncology; Novartis Pharmaceuticals Corporation; East Hanover United States
| | - S. Schuster
- Division of Hematology Oncology; University of Pennsylvania; Philadelphia United States
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14
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Jaeger U, Tam C, Borchmann P, McGuirk J, Holte H, Waller E, Jaglowski S, Andreadis C, Foley S, Fleury I, Westin J, Teshima T, Mielke S, Salles G, Ho P, Izutsu K, Schuster S, Bachanova V, Maziarz R, Van Besien K, Kersten M, Wagner-Johnston N, Kato K, Corradini P, Tiwari R, Forcina A, Pacaud L, Bishop M. INTRAVENOUS IMMUNOGLOBULIN THERAPY USE IN PATIENTS WITH RELAPSED/REFRACTORY DIFFUSE LARGE B-CELL LYMPHOMA TREATED WITH TISAGENLECLEUCEL IN THE JULIET TRIAL. Hematol Oncol 2019. [DOI: 10.1002/hon.189_2631] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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)
- U. Jaeger
- Hematology and Hemostaseology; and Comprehensive Cancer Center, Medical University of Vienna; Vienna Austria
| | - C. Tam
- Department of Hematology; Peter MacCallum Cancer Centre; Melbourne Australia
| | - P. Borchmann
- Department of Hematology/Oncology; University Hospital of Cologne; Cologne Germany
| | - J. McGuirk
- Division of Hematologic Malignancies and Cellular Therapeutics; Kansas Hospital and Medical Center; Kansas City United States
| | - H. Holte
- Lymphoma Section; University of Oslo, Oslo
| | - E. Waller
- Hematology and Medical Oncology; Medicine and Pathology, Emory University School of Medicine; Atlanta United States
| | - S. Jaglowski
- Department of Hematology; Ohio State University, Columbus
| | - C. Andreadis
- Department of Hematology and Blood and Marrow Transplant; University of California San Francisco; San Francisco United States
| | - S.R. Foley
- Division of Clinical Pathology; McMaster University; Hamilton Canada
| | - I. Fleury
- Department of Hematology; Hôpital Maisonneuve-Rosemont; Montreal Canada
| | - J. Westin
- Department of Lymphoma & Meyloma; MD Anderson Cancer Center; Houston United States
| | - T. Teshima
- Department of Hematology; Hokkaido University Hospital; Sapporo Japan
| | - S. Mielke
- Department of Internal Medicine; University Hospital Wuerzburg; Wuerzburg Germany
| | - G. Salles
- Department of Hematology/Oncology; Hospital Center Lyon-Sud; Pierre-Benite France
| | - P.J. Ho
- Department of Haematology; Royal Prince Alfred Hospital; Camperdown Australia
| | - K. Izutsu
- Department of Hematology; National Cancer Center Hospital; Tokyo Japan
| | - S. Schuster
- Division of Hematology Oncology; University of Pennsylvania; Philadelphia United States
| | - V. Bachanova
- Division of Hematology; Oncology and Transplantation, University of Minnesota; Minneapolis United States
| | - R. Maziarz
- Department of Hematology; Oregon Health and Science University; Portland United States
| | - K. Van Besien
- Department of Medical Oncology; Weill Cornell Medicine; New York United States
| | - M.J. Kersten
- Department of Hematology; Academic Medical Center; Amsterdam Netherlands
| | - N. Wagner-Johnston
- Department of Hematology/Oncology; Johns Hopkins Sidney Kimmel Comprehensive Cancer Center; Baltimore United States
| | - K. Kato
- Department of Haematology; Kyushu University Hospital; Fukuoka Prefecture Japan
| | - P. Corradini
- Department of Oncology and Hemato-oncology; University of Milan; Milan Italy
| | - R. Tiwari
- Global Medical Affaris; Novartis Pharmaceuticals Corporation; Hyderabad India
| | - A. Forcina
- Novartis Oncology; Novartis Pharma AG; Basel Switzerland
| | - L. Pacaud
- Novartis Oncology; Novartis Pharmaceuticals Corporation; East Hanover United States
| | - M. Bishop
- Section of Hematology/Oncology; University of Chicago; Chicago United States
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15
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Frontzek F, Ziepert M, Nickelsen M, Altmann B, Glaß B, Hänel M, Trümper L, Held G, Bentz M, Borchmann P, Dreyling M, Viardot A, Metzner B, Kroschinsky F, Staiger A, Ott G, Rosenwald A, Löffler M, Lenz G, Schmitz N. INTENSIVE IMMUNOCHEMOTHERAPY (R-CHOEP) VS HIGH-DOSE IMMUNOCHEMOTHERAPY (R-MegaCHOEP) IN YOUNG PATIENTS WITH AGGRESSIVE B-CELL LYMPHOMA: A 10-YEAR LONG-TERM FOLLOW-UP. Hematol Oncol 2019. [DOI: 10.1002/hon.104_2631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- F. Frontzek
- Department of Hematology; Oncology and Pneumology, University Hospital Münster; Münster Germany
| | - M. Ziepert
- Institute for Informatics; Statistics and Epidemiology, University Leipzig; Leipzig Germany
| | - M. Nickelsen
- Oncology; Oncology Lerchenfeld, Hamburg; Germany
| | - B. Altmann
- Institute for Informatics; Statistics and Epidemiology, University Leipzig; Leipzig Germany
| | - B. Glaß
- Hematology and Stem Cell Transplantation; Helios-Klinikum Berlin-Buch; Berlin Germany
| | - M. Hänel
- Department of Internal Medicine III; Municipal Hospital Chemnitz; Chemnitz Germany
| | - L. Trümper
- Hematology and Oncology; University Göttingen; Göttingen Germany
| | - G. Held
- Departement of Internal Medicine I; Westpfalz-Klinikum GmbH; Kaiserlautern Germany
| | - M. Bentz
- Department of Internal Medicine III; Municipal Hospital Karlsruhe; Karlsruhe Germany
| | - P. Borchmann
- Department of Internal Medicine I; University Hospital Cologne; Cologne Germany
| | - M. Dreyling
- Department of Internal Medicine III; Ludwig-Maximilians University of München; München Germany
| | - A. Viardot
- Department of Internal Medicine III; University Hospital Ulm; Ulm Germany
| | - B. Metzner
- Oncology and Hematology; Hospital Oldenburg; Oldenburg Germany
| | - F. Kroschinsky
- Department Internal Medicine I; University Hospital Carl Gustav Carus; Dresden Germany
| | - A.M. Staiger
- Department of Clinical Pathology; Robert-Bosch Hospital; Stuttgart Germany
| | - G. Ott
- Department of Clinical Pathology; Robert-Bosch Hospital; Stuttgart Germany
| | - A. Rosenwald
- Institute of Pathology; University Würzburg; Würzburg Germany
| | - M. Löffler
- Institute for Informatics; Statistics and Epidemiology, University Leipzig; Leipzig Germany
| | - G. Lenz
- Department of Hematology; Oncology and Pneumology, University Hospital Münster; Münster Germany
| | - N. Schmitz
- Department of Hematology; Oncology and Pneumology, University Hospital Münster; Münster Germany
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16
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Jaeger U, McGuirk J, Worel N, Riedell P, Fleury I, Borchmann P, Forcina A, Chu J, Leung M, Pacaud L, Waller E. PORTIA: A PHASE 1B STUDY EVALUATING SAFETY AND EFFICACY OF TISAGENLECLEUCEL AND PEMBROLIZUMAB IN PATIENTS WITH RELAPSED/REFRACTORY DIFFUSE LARGE B-CELL LYMPHOMA. Hematol Oncol 2019. [DOI: 10.1002/hon.7_2632] [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: 11/05/2022]
Affiliation(s)
- U. Jaeger
- Hematology and Hemostaseology, and Comprehensive Cancer Center; Medical University of Vienna; Vienna Austria
| | - J. McGuirk
- Hematologic Malignancies and Cellular Therapeutics; Kansas Hospital and Medical Center; Kansas City United States
| | - N. Worel
- Hematology and Hemostaseology, and Comprehensive Cancer Center; Medical University of Vienna; Vienna Austria
| | - P. Riedell
- Biomedical Sciences; University of Chicago; Chicago United States
| | - I. Fleury
- Hematology; Hospital Maisonneuve-Rosemont; Montreal Canada
| | - P. Borchmann
- Hematology/Oncology; University Hospital of Cologne; Cologne Germany
| | - A. Forcina
- Novartis Oncology; Novartis Pharma AG; Basel Switzerland
| | - J. Chu
- Novartis Oncology; Novartis Pharmaceuticals Corporation; East Hanover United States
| | - M. Leung
- Oncology Clinical Development; Novartis Pharmaceuticals Corporation; East Hanover United States
| | - L. Pacaud
- Novartis Oncology; Novartis Pharmaceuticals Corporation; East Hanover United States
| | - E. Waller
- Stem Cell Transplantation and Immunotherapy; Emory University School of Medicine; Atlanta United States
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17
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Esser P, Borchmann P, Kuba K, Müller H, Görgen H, Kreissl S, Scheuvens R, Mehnert A. Adaptation of a web-based cognitive-behavioral therapy on fatigue for survivors of Hodgkin's lymphoma. Psychother Psych Med 2018. [DOI: 10.1055/s-0038-1667891] [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] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- P Esser
- Universitätsmedizin Leipzig, Abteilung für Medizinische Psychologie und Medizinische Soziologie, Leipzig, Deutschland
| | | | - K Kuba
- Universitätsmedizin Leipzig, Abteilung für Medizinische Psychologie und Medizinische Soziologie, Leipzig, Deutschland
| | | | | | | | | | - A Mehnert
- Universitätsmedizin Leipzig, Abteilung für Medizinische Psychologie und Medizinische Soziologie, Leipzig, Deutschland
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18
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Müller H, Kreissl S, Görgen H, Mayer A, Behringer K, Bürkle C, Scheuvens R, Fuchs M, Diehl V, Engert A, Borchmann P. Verlauf und Einflussfaktoren von Tumor-assoziierter Fatigue bei Hodgkin-Lymphom: eine longitudinale Studie der deutschen Hodgkin-Studiengruppe. Psychother Psychosom Med Psychol 2018. [DOI: 10.1055/s-0038-1667890] [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: 10/28/2022]
Affiliation(s)
- H Müller
- Universitätsklinikum Köln, Klinik I für Innere Medizin, Deutsche Hodgkin Studiengruppe (GHSG), Köln, Deutschland
| | - S Kreissl
- German Hodgkin Study Group, Köln, Deutschland
| | | | - A Mayer
- RWTH Aachen, Institut für Psychologie, Philosophische Fakultät, Köln, Deutschland
| | - K Behringer
- German Hodgkin Study Group, Köln, Deutschland
| | - C Bürkle
- German Hodgkin Study Group, Köln, Deutschland
| | | | - M Fuchs
- German Hodgkin Study Group, Köln, Deutschland
| | - V Diehl
- German Hodgkin Study Group, Köln, Deutschland
| | - A Engert
- German Hodgkin Study Group, Köln, Deutschland
| | - P Borchmann
- Universitätsklinikum Köln, Klinik I für Innere Medizin, Deutsche Hodgkin Studiengruppe (GHSG), Köln, Deutschland
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19
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Dietlein M, Mauz-Körholz C, Engert A, Borchmann P, Sabri O, Schober O, Schicha H, Kluge R, Kobe C. FDG-PET in Hodgkin lymphoma. Nuklearmedizin 2018; 47:235-8; quiz N75-6. [DOI: 10.3413/nukmed-0216] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
SummaryThe high negative predictive value of FDG-PET in therapy control of Hodgkin lymphoma is proven by the data acquired up to now. Thus, the analysis of the HD15 trial has shown that consolidation radiotherapy might be omitted in PET negative patients after effective chemotherapy. Further response adapted therapy guided by PET seems to be a promising approach in reducing the toxicity for patients undergoing chemotherapy. The criteria used for the PET interpretation have been standardized by the German study groups for Hodgkin lymphoma patients and will be reevaluated in the current studies.
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20
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Schuster S, Bishop M, Tam C, Waller E, Borchmann P, Mcguirk J, Jäger U, Jaglowski S, Andreadis C, Westin J, Fleury I, Bachanova V, Foley S, Ho P, Mielke S, Holte H, Anak O, Pacaud L, Awasthi R, Tai F, Salles G, Maziarz R. GLOBAL PIVOTAL PHASE 2 TRIAL OF THE CD19-TARGETED THERAPY CTL019 IN ADULT PATIENTS WITH RELAPSED OR REFRACTORY (R/R) DIFFUSE LARGE B-CELL LYMPHOMA (DLBCL)-AN INTERIM ANALYSIS. Hematol Oncol 2017. [DOI: 10.1002/hon.2437_6] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- S.J. Schuster
- Lymphoma Program, Abramson Cancer Center; University of Pennsylvania; Philadelphia USA
| | - M.R. Bishop
- Hematopoietic Cellular Therapy Program; The University of Chicago Medicine; Chicago USA
| | - C. Tam
- Division of Hematology and Oncology; Peter MacCallum Cancer Centre; Melbourne Australia
| | - E.K. Waller
- Department of Hematology and Medical Oncology; Emory University School of Medicine; Atlanta USA
| | - P. Borchmann
- Department of Internal Medicine; University Hospital of Cologne; Cologne Germany
| | - J. Mcguirk
- Department of Blood and Bone Marrow Transplant; The University of Kansas Cancer Center; Kansas City USA
| | - U. Jäger
- Department of Medicine I, Division of Hematology and Hemostaseology; Medical University of Vienna; Vienna Austria
| | - S. Jaglowski
- Department of Internal Medicine; The Ohio State University Wexner Medical Center; Columbus USA
| | - C. Andreadis
- Helen Diller Family Comprehensive Cancer Center; University of California San Francisco Medical Center; San Francisco USA
| | - J. Westin
- Department of Lymphoma/Myeloma; The University of Texas MD Anderson Cancer Center; Houston USA
| | - I. Fleury
- Department of Medicine, University of Montreal; Maisonneuve-Rosemont Hospital CIUSSS East; Montreal Canada
| | - V. Bachanova
- Department of Medicine; University of Minnesota; Minneapolis USA
| | - S.R. Foley
- Department of Medicine; McMaster University; Hamilton Canada
| | - P.J. Ho
- Institute of Haematology; Royal Prince Alfred Hospital & Sydney University; Sydney Australia
| | - S. Mielke
- Medizinische Klinik und Poliklinik II; Universitatsklinikum Würzburg; Würzburg Germany
| | - H. Holte
- Department of Oncology; Oslo University Hospital; Oslo Norway
| | - O. Anak
- Global Drug Development; Novartis Pharma AG; Basel Switzerland
| | - L. Pacaud
- Global Drug Development; Novartis Pharma AG; Basel Switzerland
| | - R. Awasthi
- PK Sciences; Novartis Pharmaceuticals Corporation; East Hanover USA
| | - F. Tai
- Biostatistics; Novartis Pharmaceuticals Corporation; East Hanover USA
| | - G. Salles
- Hospices Civils de Lyon; Université de Lyon; Lyon France
| | - R. Maziarz
- Center for Hematologic Malignancies, Knight Cancer Institute; Oregon Health & Science University; Portland USA
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21
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Borchmann P, Goergen H, Kobe C, Eichenauer D, Greil R, Lohri A, Novak U, Markova J, Beck H, Meissner J, Zijlstra J, Ostermann H, Feuring-Buske M, Dierlamm J, Eich H, Baues C, Rosenwald A, Fuchs M, Diehl V, Kuhnert G, Dietlein M, Engert A. EBEACOPP WITH OR WITHOUT RITUXIMAB IN INTERIM-PET-POSITIVE ADVANCED-STAGE HODGKIN LYMPHOMA: UPDATED RESULTS OF THE INTERNATIONAL, RANDOMIZED PHASE 3 GHSG HD18 TRIAL. Hematol Oncol 2017. [DOI: 10.1002/hon.2437_52] [Citation(s) in RCA: 5] [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: 11/10/2022]
Affiliation(s)
- P. Borchmann
- Department I of Internal Medicine, German Hodgkin Study Group (GHSG); University Hospital of Cologne; Cologne Germany
| | - H. Goergen
- Department I of Internal Medicine, German Hodgkin Study Group (GHSG); University Hospital of Cologne; Cologne Germany
| | - C. Kobe
- Department of Nuclear Medicine; University Hospital of Cologne; Cologne Germany
| | - D. Eichenauer
- Department I of Internal Medicine, German Hodgkin Study Group (GHSG); University Hospital of Cologne; Cologne Germany
| | - R. Greil
- IIIrd Medical Department; Paracelsus Medical University and Salzburg Cancer Research Institute and AGMT (Arbeitsgemeinschaft Medikamentöse Tumortherapie); Salzburg Austria
| | - A. Lohri
- Oncology; Cantonal Hospital Baselland; Liestal Switzerland
| | - U. Novak
- Swiss Group for Clinical Cancer Research (SAKK); Inselspital Bern; Bern Switzerland
| | - J. Markova
- Third Faculty of Medicine; Charles University, University Hospital Kralovske Vinohrady; Prague Czech Republic
| | - H. Beck
- IIIrd Medical Department; University Hospital Mainz; Mainz Germany
| | - J. Meissner
- Center for Internal Medicine; University of Heidelberg; Heidelberg Germany
| | - J.M. Zijlstra
- Oncology; VU University Medical Center; Amsterdam The Netherlands
| | - H. Ostermann
- Department of Internal Medicine III; University Hospital of Munich; Munich Germany
| | - M. Feuring-Buske
- Department of Internal Medicine III; University Hospital of Ulm; Ulm Germany
| | - J. Dierlamm
- Department II; University Hospital Hamburg-Eppendorf; Hamburg Germany
| | - H. Eich
- Department of Radiotherapy; University Hospital of Muenster; Muenster Germany
| | - C. Baues
- Department of Radiotherapy, Germany x Berlin Reference Center for Lymphoma and 17 Berlin; University Hospital of Cologne; Cologne Germany
| | - A. Rosenwald
- 1Institute of Pathology; University of Wuerzburg; Wuerzburg Germany
| | - M. Fuchs
- Department I of Internal Medicine, German Hodgkin Study Group (GHSG); University Hospital of Cologne; Cologne Germany
| | - V. Diehl
- Department I of Internal Medicine, German Hodgkin Study Group (GHSG); University Hospital of Cologne; Cologne Germany
| | - G. Kuhnert
- Department of Nuclear Medicine; University Hospital of Cologne; Cologne Germany
| | - M. Dietlein
- Department of Nuclear Medicine; University Hospital of Cologne; Cologne Germany
| | - A. Engert
- Department I of Internal Medicine, German Hodgkin Study Group (GHSG); University Hospital of Cologne; Cologne Germany
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Bröckelmann P, Müller H, Casasnovas O, Hutchings M, von Tresckow B, Jürgens M, McCall S, Morschhauser F, Fuchs M, Borchmann P, Moskowitz C, Engert A. Risk factors and a prognostic score for survival after autologous stem-cell transplantation for relapsed or refractory Hodgkin lymphoma. Ann Oncol 2017; 28:1352-1358. [DOI: 10.1093/annonc/mdx072] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [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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Eichenauer DA, Goergen H, Plütschow A, Wongso D, Behringer K, Kreissl S, Thielen I, Halbsguth T, Bröckelmann PJ, Fuchs M, Böll B, von Tresckow B, Borchmann P, Engert A. Ofatumumab in relapsed nodular lymphocyte-predominant Hodgkin lymphoma: results of a phase II study from the German Hodgkin study group. Leukemia 2015; 30:1425-7. [DOI: 10.1038/leu.2015.321] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [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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Kobe C, Kuhnert G, Haverkamp H, Fuchs M, Kahraman D, Eich HT, Kriz J, Baues C, Nast-Kolb B, Bröckelmann PJ, Borchmann P, Drzezga A, Engert A, Dietlein M. Concordance in the interpretation of PET after chemotherapy in advanced stage Hodgkin lymphoma. Nuklearmedizin 2015; 54:241-6. [PMID: 26388152 DOI: 10.3413/nukmed-0746-15-06] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 09/16/2015] [Indexed: 01/27/2023]
Abstract
UNLABELLED The aim was to analyze the degree of agreement between the central review panel and the local PET interpretation within the HD15 trial and its impact on subsequent treatment and progression free survival. PATIENTS, METHODS The analysis set consisted of 739 patients with residues ≥ 2.5 cm after 6 or 8 cycles of BEACOPPesc from the HD15 trial performed by the German Hodgkin Study Group. The recommendation for or against further radiotherapy was based on the central [(18)F]FDG-PET interpretation. Central PET interpretation was compared to the local PET interpretation and concordance was measured using Cohen's Kappa coefficient. Prognostic impact of the analysis of concordance between local and central PET interpretations was evaluated using progression free survival (PFS); groups were compared with the log rank test. RESULTS The central panel rated 548 of 739 patients (74%) as PET negative. Of these, 513 were also rated as PET negative in the local PET interpretation. PET positivity was seen by central reviewers in the remaining 191 patients (26%), in concordance with local reviewers in 155 cases. Even though substantial agreement was found (Cohen's Kappa 0.81), the interpretation of the central PET review panel led to a different therapeutic recommendation in 71/739 (10%) patients. PFS was equally high in groups in which the therapeutic regime had been changed on the basis of the central panel decision. CONCLUSION High concordance is found between local and central reviewers with regard to PET interpretation in residual tissue after intense chemotherapy. The existence of the central PET review panel allows the identification of additional patients as PET negative so that radiotherapy can be safely omitted (35 of 548 patients = 4.7%).
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Affiliation(s)
- C Kobe
- Carsten Kobe, Department of Nuclear Medicine, University Hospital of Cologne, Kerpener Str. 62, 50937 Cologne, Germany, Tel. +49/(0)221/478-50 24, Fax -67 77,
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Rancea M, Will A, Borchmann P, Monsef I, Engert A, Skoetz N. Sixteenth Biannual Report of the Cochrane Haematological Malignancies Group: Focus on Non-Hodgkin's Lymphoma. J Natl Cancer Inst 2014; 106:dju170. [DOI: 10.1093/jnci/dju170] [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: 11/12/2022] Open
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26
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Klimm B, Goergen H, Fuchs M, von Tresckow B, Böll B, Meissner J, Glunz A, Diehl V, Eich HT, Engert A, Borchmann P. Impact of risk factors on outcomes in early-stage Hodgkin's lymphoma: an analysis of international staging definitions. Ann Oncol 2013; 24:3070-6. [PMID: 24148816 DOI: 10.1093/annonc/mdt413] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [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 early-stage Hodgkin's lymphoma (HL), treatment according to the early favorable or unfavorable subgroup is guided by staging definitions, which differ between various study groups worldwide. We analyzed risk factors used in different international staging systems and their impact on the outcome of early-stage HL patients. PATIENTS AND METHODS In 1173 early-stage HL patients treated homogenously within the German Hodgkin Study Group (GHSG) trials HD10 and HD11, the impact of three staging systems developed and used by the GHSG, the European Organization for Research and Treatment of Cancer (EORTC), and the National Comprehensive Cancer Network (NCCN) in discriminating risk groups for progression-free survival (PFS) and overall survival (OS) was assessed and the relevance of their single risk factors was investigated. RESULTS All the three staging systems defined an unfavorable risk group out of early-stage patients of comparable size (56%, 55%, and 57%), having a significantly poorer PFS and OS as compared with the corresponding favorable group; 5-year differences between early favorable and early unfavorable in terms of PFS were 9.4% (HR 2.61, 95% CI 1.74-3.91), 6.7% (HR 2.10, 95% CI 1.41-3.13), and 8.6% (HR 2.14, 95% CI 1.45-3.16) with the GHSG, EORTC, and NCCN definition, respectively. Sensitivity was high for all systems (84%, 79%, and 83%); however, there was a low specificity with high rates of false-positive results (1-specificity 54%, 53%, and 55%, respectively). Models of high sensitivity included risk factors associated with large tumor burden and high tumor activity. Most risk factors for tumor-specific end points were also predictive of OS. CONCLUSIONS Differentiating between a favorable and an unfavorable risk group has significant impact on PFS and OS in early-stage HL patients in the modern treatment era. Risk-adapted treatment strategies using new risk factors with higher specificity are needed.
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Affiliation(s)
- B Klimm
- Department I of Internal Medicine, German Hodgkin Study Group (GHSG), University Hospital Cologne
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Hay AE, Klimm B, Chen BE, Goergen H, Shepherd LE, Fuchs M, Gospodarowicz MK, Borchmann P, Connors JM, Markova J, Crump M, Lohri A, Winter JN, Dörken B, Pearcey RG, Diehl V, Horning SJ, Eich HT, Engert A, Meyer RM. An individual patient-data comparison of combined modality therapy and ABVD alone for patients with limited-stage Hodgkin lymphoma. Ann Oncol 2013; 24:3065-9. [PMID: 24121121 DOI: 10.1093/annonc/mdt389] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [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] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Treatment options for patients with nonbulky stage IA-IIA Hodgkin lymphoma include combined modality therapy (CMT) using doxorubicin, bleomycin, vinblastine and dacarbazine (ABVD) plus involved-field radiation therapy (IFRT), and chemotherapy with ABVD alone. There are no mature randomized data comparing ABVD with CMT using modern radiation techniques. PATIENTS AND METHODS Using German Hodgkin Study Group HD10/HD11 and NCIC Clinical Trials Group HD.6 databases, we identified 588 patients who met mutually inclusive eligibility criteria from the preferred arms of HD10 or 11 (n = 406) and HD.6 (n = 182). We evaluated time to progression (TTP), progression-free (PFS) and overall survival, including in three predefined exploratory subset analyses. RESULTS With median follow-up of 91 (HD10/11) and 134 (HD.6) months, respective 8-year outcomes were for TTP, 93% versus 87% [hazard ratio (HR) 0.44, 95% confidence interval (CI) 0.24-0.78]; for PFS, 89% versus 86% (HR 0.71, 95% CI 0.42-1.18) and for overall survival, 95% versus 95% (HR 1.09, 95% CI 0.49-2.40). In the exploratory subset analysis including HD10 eligible patients who achieved complete response (CR) or unconfirmed complete response (CRu) after two cycles of ABVD, 8-year PFS was 87% (HD10) versus 95% (HD.6) (HR 2.8; 95% CI 0.64-12.5) and overall survival 96% versus 100%. In contrast, among those without CR/CRu after two cycles of ABVD, 8-year PFS was 88% versus 74% (HR 0.35; 95% CI 0.16-0.79) and overall survival 95% versus 91%, respectively (HR 0.42; 95% CI 0.12-1.44). CONCLUSIONS In patients with nonbulky stage IA-IIA Hodgkin lymphoma, CMT provides better disease control than ABVD alone, especially among those not achieving complete response after two cycles of ABVD. Within the follow-up duration evaluated, overall survivals were similar. Longer follow-up is required to understand the implications of radiation and chemotherapy-related late effects. CLINICAL TRIALS The trials included in this analysis were registered at ClinicalTrials.gov: HD10 - NCT00265018, HD11 - NCT00264953, HD.6 - NCT00002561.
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Affiliation(s)
- A E Hay
- NCIC Clinical Trials Group and Queen's University, Kingston, Ontario, Canada
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Rancea M, Will A, Borchmann P, Monsef I, Engert A, Skoetz N. Fifteenth Biannual Report of the Cochrane Haematological Malignancies Group--Focus on Non-Hodgkin's Lymphoma. J Natl Cancer Inst 2013; 105:1159-70. [DOI: 10.1093/jnci/djt165] [Citation(s) in RCA: 6] [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: 11/13/2022] Open
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29
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Kreissl S, Borchmann P. [Treatment of advanced Hodgkin lymphoma]. Dtsch Med Wochenschr 2013; 138:1212-4. [PMID: 23720173 DOI: 10.1055/s-0033-1343209] [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: 10/26/2022]
Affiliation(s)
- S Kreissl
- Klinik I für Innere Medizin, Universitätsklinikum Köln
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Behringer K, Müller H, Görgen H, Flechtner HH, Brillant C, Halbsguth TV, Thielen I, Eichenauer DA, Schober T, Nisters-Backes H, Fuchs M, Engert A, Borchmann P. Sexual quality of life in Hodgkin Lymphoma: a longitudinal analysis by the German Hodgkin Study Group. Br J Cancer 2013; 108:49-57. [PMID: 23321510 PMCID: PMC3553532 DOI: 10.1038/bjc.2012.550] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background: Health-related quality of life (HRQoL) comprises different domains of physical, mental, and social well-being. In this analysis, we focus on sexual quality of life in Hodgkin Lymphoma (HL) patients. Methods: Four-thousand one-hundred and sixty patients enroled in the HD10–HD12 trials underwent HRQoL assessment. Instruments included the Quality of Life Questionnaire for survivors (QLQ-S), combining the European Organisation for Research and Treatment of Cancer QLQ-C30, Multidimensional fatigue (FA) inventory (MFI-20) and an additional sexual functioning (SX) scale. We describe SX up to 27 months after therapy and analyse relationship to stage, age, gender, FA, social functioning, and therapy. Statistical methods range from descriptive statistics to a classification of SX courses, and a longitudinal structural equations model with full information maximum likelihood estimation of missing data. In the analysis, a score below 50 was used to describe severe sexual dysfunction. Results: Three-thousand two-hundred and eight patients provided data on SX. Patients in advanced stages reported lower SX than patients in early stages both, before and after the treatment. During follow-up, an improvement of SX compared with baseline was detected, except for those ⩾50 years. Patients in early stages reached normal SX, whereas advanced-stage patients remained below the reference value for healthy controls. Sexual functioning during follow-up was significantly and strongly related to previous SX, other HRQoL measures, age, and stage, and to lesser degree with gender and chemotherapy. Conclusion: Overall, HL patients have a decreased sexual quality of life at baseline, which improves after therapy and normalises in early-stage patients. Importantly, long-term SX is more closely related to patient characteristics and SX at baseline than to the intensity of treatment.
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Affiliation(s)
- K Behringer
- First Department of Internal Medicine, German Hodgkin Study Group (GHSG), University of Cologne, Kerpener Street 62, D-50924 Cologne, Germany
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Eich H, Kriz J, Klimm B, Sasse S, Görgen H, Diehl V, Borchmann P, Mueller R, Engert A. Involved-field (IF) Versus Extended-field (EF) Radiation Therapy (RT) for Patients in Early Unfavorable Stages of Hodgkin Lymphoma: 10-year Update of the HD8 Trial of the German Hodgkin Study Group (GHSG). Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Sasse S, Klimm B, Görgen H, Fuchs M, Heyden-Honerkamp A, Lohri A, Koch O, Wilhelm M, Trenn G, Finke J, Müller RP, Diehl V, Eich HT, Borchmann P, Engert A. Comparing long-term toxicity and efficacy of combined modality treatment including extended- or involved-field radiotherapy in early-stage Hodgkin's lymphoma. Ann Oncol 2012; 23:2953-2959. [PMID: 22767583 DOI: 10.1093/annonc/mds110] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND To evaluate long-term toxicity and efficacy of a combined modality strategy including extended-field radiotherapy (EF-RT) or involved-field radiotherapy (IF-RT), the German Hodgkin Study Group carried out a follow-up analysis in patients with early unfavorable Hodgkin's lymphoma (HL). PATIENTS AND METHODS One thousand two hundred and four patients were randomized to four cycles of chemotherapy followed by either 30 Gy EF- or 30 Gy IF-RT (HD8 trial); 532 patients in each treatment arm were eligible. RESULTS At 10 years, no arm differences were revealed with respect to freedom from treatment failure (FFTF) (79.8% versus 79.7%), progression-free survival (79.8% versus 80.0%), and overall survival (86.4% versus 87.3%). Non-inferiority of IF-RT was demonstrated for the primary end point FFTF (95% confidence interval for hazard ratio 0.72-1.25). Elderly patients had a poorer outcome when treated with EF-RT. So far, 15.0% of patients in arm A and 12.2% in arm B died, mostly due to secondary malignancies (5.3% versus 3.4%) or HL (3.2% versus 3.4%). After EF-RT, there were more secondary malignancies overall (58 versus 45), especially acute myeloid leukemias (11 versus 4). CONCLUSION Radiotherapy intensity reduction to IF-RT does not result in poorer long-term outcome but is associated with less acute toxicity and might be associated with less secondary malignancies.
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Affiliation(s)
- S Sasse
- First Department of Internal Medicine, University Hospital Cologne, Cologne; German Hodgkin Study Group, Cologne, Germany
| | - B Klimm
- First Department of Internal Medicine, University Hospital Cologne, Cologne; German Hodgkin Study Group, Cologne, Germany
| | - H Görgen
- German Hodgkin Study Group, Cologne, Germany
| | - M Fuchs
- German Hodgkin Study Group, Cologne, Germany
| | | | - A Lohri
- Department of Internal Medicine, Kantonsspital Liestal, Liestal, Switzerland
| | - O Koch
- Third Department of Internal Medicine, Klinikum Osnabrück, Osnabrück
| | - M Wilhelm
- Fifth Department of Internal Medicine, Klinikum Nuernberg, Nuernberg
| | - G Trenn
- Department of Internal Medicine, Knappschaftskrankenhaus Bottrop, Bottrop
| | - J Finke
- First Department of Internal Medicine, University Hospital Freiburg, Freiburg
| | - R P Müller
- Department of Radiotherapy, University Hospital Cologne, Cologne
| | - V Diehl
- German Hodgkin Study Group, Cologne, Germany
| | - H T Eich
- Department of Radiotherapy, University Hospital Muenster, Muenster, Germany
| | - P Borchmann
- German Hodgkin Study Group, Cologne, Germany
| | - A Engert
- First Department of Internal Medicine, University Hospital Cologne, Cologne; German Hodgkin Study Group, Cologne, Germany.
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Kobe C, Engert A, Markova J, Haverkamp H, Eich HT, Müller RP, Holstein A, Kahraman D, Dietlein M, Borchmann P, Diehl V. Assessment of residual bulky tumor using FDG-PET in patients with advanced stages after completion of chemotherapy. Final report of the GHSG HD15 trial. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1311119] [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: 10/28/2022]
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Behringer K, Thielen I, Mueller H, Goergen H, Eibl AD, Rosenbrock J, Halbsguth T, Eichenauer DA, Fuchs M, Reiners KS, Renno JH, van der Ven K, Kuehr M, von Wolff M, Diehl V, Engert A, Borchmann P. Fertility and gonadal function in female survivors after treatment of early unfavorable Hodgkin lymphoma (HL) within the German Hodgkin Study Group HD14 trial. Ann Oncol 2012; 23:1818-25. [PMID: 22228451 DOI: 10.1093/annonc/mdr575] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND In the HD14 trial, 2×BEACOPPescalated+2×ABVD (2+2) has improved the primary outcome. Compared with 4×ABVD, this benefit might be compromised by more infertility in women. Therefore, we analyzed gonadal function and fertility. PATIENTS AND METHODS Women≤45 years in ongoing remission at least 1 year after therapy were included. Hormone parameters, menopausal symptoms, measures to preserve fertility, menstrual cycle, pregnancies, and offspring were evaluated. RESULTS Three hundred and thirty one of 579 women addressed participated (57.2%) and 263 per-protocol treated patients qualified (A=ABVD: 137, B=2+2: 126, mean time after therapy 42 and 43 months, respectively). Regular menstrual cycle after treatment (A: 87%, B: 83%) and time to recovery (≤12 months) were not different. Follicle-stimulating hormone and anti-Muellerian hormone were significantly better in arm A. However, pregnancies after therapy favored arm B (A: 15%, B: 26%, P=0.043) and motherhood rates were equivalent to the German normal population. Multivariate analysis revealed prophylactic use of gonadotropin-releasing hormone (GnRH) analogues as highly significant prognostic factor for preservation of fertility (odds ratio=12.87, P=0.001). Severe menopausal symptoms were frequent in women≥30 years (A: 21%, B: 25%). CONCLUSIONS Hormonal levels after 2+2 indicate a reduced ovarian reserve. However, 2+2 in combination with GnRH analogues does not compromise fertility within the evaluated observation time.
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Affiliation(s)
- K Behringer
- First Department of Internal Medicine, University Hospital of Cologne, and Institute for Clinical Chemistry, University of Cologne, Cologne, Germany
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Eich H, Kobe C, Dietlein M, Kriz J, Haverkamp H, Fuchs M, Borchmann P, Engert A, Mueller R. Role of Radiotherapy after Assessment of Residual Bulky Tumor using FDG-PET in Patients with Advanced-stage Hodgkin Lymphoma: Final Report of the GHSG HD15 Trial. Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.006] [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: 10/16/2022]
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Kobe C, Dietlein M, Borchmann P, Engert A, Kuhnert G, Fuchs M, Haverkamp H, Eich H, Kriz J, Diehl V. 57 INVITED PET-Response Adapted Therapy in Hodgkin Lymphoma. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)70272-6] [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: 11/29/2022]
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Schmitz N, Nickelsen M, Ziepert M, Haenel M, Borchmann P, Schmidt C, Viardot A, Bentz M, Peter N, Ehninger G, Doelken G, Truemper LH, Loeffler M, Pfreundschuh M, Glass B. Conventional chemoimmunotherapy (R-CHOEP-14) or high-dose therapy (R-Mega-CHOEP) for young, high-risk patients with aggressive B-cell lymphoma: Final results of the randomized Mega-CHOEP trial of the German High-Grade Non-Hodgkin Lymphona Study Group (DSHNHL). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.8002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Horwitz SM, Coiffier B, Foss FM, Prince HM, Sokol L, Greenwood M, Caballero D, Borchmann P, Morschhauser F, Wilhelm M, Pinter-Brown LC, Padmanabhan S, Shustov AR, Nichols J, Balser J, Carroll S, Pro B. Complete responses (CR/CRu) on a phase II study of romidepsin in relapsed or refractory peripheral T-cell lymphoma (R/R PTCL). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.8033] [Citation(s) in RCA: 3] [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: 11/20/2022] Open
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Behringer K, Wildt L, Mueller H, Mattle V, Ganitis P, van den Hoonaard B, Ott HW, Hofer S, Pluetschow A, Diehl V, Engert A, Borchmann P. No protection of the ovarian follicle pool with the use of GnRH-analogues or oral contraceptives in young women treated with escalated BEACOPP for advanced-stage Hodgkin lymphoma. Final results of a phase II trial from the German Hodgkin Study Group. Ann Oncol 2010; 21:2052-2060. [PMID: 20305034 DOI: 10.1093/annonc/mdq066] [Citation(s) in RCA: 108] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The reduction of treatment-related toxic effects is the main goal in the current trials of the German Hodgkin Study Group (GHSG). In this regard, the protection of the ovarian reserve in young women is very important. Therefore, the GHSG investigated the use of gonadotropin-releasing hormone-analogues (GnRH-a) and oral contraceptives (OC) in young women with advanced-stage Hodgkin lymphoma (HL). PATIENTS AND METHODS Women (18-40 years) were randomly assigned either to receive daily OC or monthly GnRH-a during escalated combination therapy with bleomycin, etoposide, adriamycin, cyclophosphamide, vincristine, procarbazine, and prednisone (BEACOPPesc). Hormonal levels were determined at baseline, during therapy, and at follow-up. RESULTS The study was closed prematurely after an interim analysis of 12 patients in arm A (OC) and 11 in arm B (GnRH-a), 9 and 10 are assessable for the primary end point. Women's median age was 25 years in both arms. The anti-Mullerian hormone level after at least 12 months was reduced in all patients. For the entire study cohort, the respective ovarian follicle preservation rate was 0% (95% confidence interval 0% to 12%). CONCLUSION We observed no protection of the ovarian reserve with hormonal co-treatment during BEACOPPesc. This result supports efforts of ongoing trials to reduce chemotherapy intensity and toxicity. Alternative strategies for the protection of fertility must be offered to young female HL patients before the start of BEACOPPesc therapy.
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Affiliation(s)
- K Behringer
- German Hodgkin Study Group, First Department of Internal Medicine, University Hospital Cologne, Cologne, Germany.
| | - L Wildt
- University Hospital for Gynecology and Reproduction Medicine
| | - H Mueller
- German Hodgkin Study Group, First Department of Internal Medicine, University Hospital Cologne, Cologne, Germany
| | - V Mattle
- University Hospital for Gynecology and Reproduction Medicine
| | - P Ganitis
- German Hodgkin Study Group, First Department of Internal Medicine, University Hospital Cologne, Cologne, Germany
| | - B van den Hoonaard
- German Hodgkin Study Group, First Department of Internal Medicine, University Hospital Cologne, Cologne, Germany
| | - H W Ott
- Institute of Medical and Chemical Laboratory Diagnostics (ZIMCL), University Hospital Innsbruck, Innsbruck, Austria
| | - S Hofer
- Institute of Medical and Chemical Laboratory Diagnostics (ZIMCL), University Hospital Innsbruck, Innsbruck, Austria
| | - A Pluetschow
- German Hodgkin Study Group, First Department of Internal Medicine, University Hospital Cologne, Cologne, Germany
| | - V Diehl
- German Hodgkin Study Group, First Department of Internal Medicine, University Hospital Cologne, Cologne, Germany
| | - A Engert
- German Hodgkin Study Group, First Department of Internal Medicine, University Hospital Cologne, Cologne, Germany
| | - P Borchmann
- German Hodgkin Study Group, First Department of Internal Medicine, University Hospital Cologne, Cologne, Germany
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Borchmann P, Eichhorst B, Hellmann M, Hübel K, Kochanek M, Kreuzer K, Reiser M, Hallek M. Hämatologie 2008. Dtsch Med Wochenschr 2008. [DOI: 10.1055/s-0028-1082776] [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: 10/21/2022]
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Affiliation(s)
- P Borchmann
- Klinik I für Innere Medizin, Universitätsklinikum, Joseph-Stelzmann Str. 9, 50924 Köln.
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Borchmann P, Behringer K, Josting A, Rueffer JU, Schnell R, Diehl V, Engert A, Kvasnicka HM, Thiele J. [Secondary malignancies after successful primary treatment of malignant Hodgkin's lymphoma]. Pathologe 2005; 27:47-52. [PMID: 16369761 DOI: 10.1007/s00292-005-0811-0] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Malignant Hodgkin's lymphoma (HL) has become a curable disease through the increasing intensity of the treatment strategies applied. These regimens are aggressive, including radiotherapy and chemotherapy leading to the possibility of secondary malignancies. The German Hodgkin Lymphoma Study Group considered three cohorts including 5,411 patients with all stages of HL. In 127 patients a secondary solid tumor was diagnosed (cumulative risk 2%, median follow-up 72 months), with bronchial carcinomas (23.6%) and colorectal adenocarcinomas (20.5%) being the most frequent neoplasms. Secondary acute myeloid leukemia was found in 36 patients, another ten developed myeloid dysplasia (cumulative risk 1%, median follow-up 55 months). A total of 52 patients revealed a non-Hodgkin's lymphoma (NHL; cumulative risk 0.9%, median follow-up 46 months). The overall incidence of secondary malignancies was 3.9% in patients who had been treated successfully for their HL with radio- and/or chemotherapy.A secondary NHL can be particularly difficult to be distinguished from the preceding HL. Therefore, in case of a suspected relapse, a complete histopathological work-up must be performed.
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Affiliation(s)
- P Borchmann
- Klinik I für Innere Medizin, Universität zu Köln, Joseph-Stelzmannstrasse 9, 50924 Köln
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Abstract
Many new treatment approaches have given promising results in experimental Hodgkin's lymphoma (HL) models. Early clinical trials evaluating antibody based compounds as immunotoxins (ITs), radioimmunotherapy (RIT), bispecific molecules (BSMs), and recently monoclonal antibodies (MAbs), have demonstrated some clinical efficacy in patients with advanced refractory or relapsed HL. In addition, cellular immunotherapy is evolving. Although it seems unlikely to cure chemotherapy resistant patients with larger tumor masses by either of these approaches alone, the combination with conventional chemotherapy might help to overcome resistance of Hodgkin-/ReedSternberg (H-RS) cells. Another rationale for the development of these immunotherapies is to eliminate residual disease and thereby to prevent relapses from the disease. Currently, several clinical studies are running. A murine MAb (Ki-4) based 131 Iodine conjugate has shown efficacy in refractory HL patients in a phase II study, but less toxic constructs using alternate MAbs or isotopes should be developed. A humanized as well as a fully human anti-CD30 MAb are being tested in clinical phase I/II studies. These MAbs could engage the human immune system against the H-RS cells. In addition, these MAbs could be then combined with conventional chemotherapy in order to improve the treatment of HL.
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Affiliation(s)
- P Borchmann
- Klinik I für Innere Medizin, Universität zu Köln, Germany
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Engert A, Elter T, Borchmann P, Schulz H, Reiser M, Trelle S, Staib P, Schinkoethe T, Hallek M. Concomitant treatment of patients with relapsed/refractory CLL using a combination of fludarabine and alemtuzumab is highly effective: Final results of a phase-II study. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.6558] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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)
- A. Engert
- Univ Hosp of Cologne, Cologne, Germany
| | - T. Elter
- Univ Hosp of Cologne, Cologne, Germany
| | | | - H. Schulz
- Univ Hosp of Cologne, Cologne, Germany
| | - M. Reiser
- Univ Hosp of Cologne, Cologne, Germany
| | - S. Trelle
- Univ Hosp of Cologne, Cologne, Germany
| | - P. Staib
- Univ Hosp of Cologne, Cologne, Germany
| | | | - M. Hallek
- Univ Hosp of Cologne, Cologne, Germany
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Elter T, Borchmann P, Schulz H, Reiser M, Trelle S, Staib P, Schinköthe T, Engert A. Results of a phase II trial of a fludarabine with concomitant application of alemtuzumab in a four-weekly schedule (FluCam) in patients with relapsed CLL. 2nd Interim analysis. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.6693] [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)
- T. Elter
- University of Cologne, Cologne, Germany
| | | | - H. Schulz
- University of Cologne, Cologne, Germany
| | - M. Reiser
- University of Cologne, Cologne, Germany
| | - S. Trelle
- University of Cologne, Cologne, Germany
| | - P. Staib
- University of Cologne, Cologne, Germany
| | | | - A. Engert
- University of Cologne, Cologne, Germany
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Schnell R, Borchmann P, Staak JO, Schindler J, Ghetie V, Vitetta ES, Engert A. Clinical evaluation of ricin A-chain immunotoxins in patients with Hodgkin's lymphoma. Ann Oncol 2003; 14:729-36. [PMID: 12702527 DOI: 10.1093/annonc/mdg209] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.1] [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: 11/15/2022] Open
Abstract
BACKGROUND Immunotoxins (ITs) consist of cell binding ligands coupled to toxins or their subunits. Hodgkin's lymphoma (HL) is an excellent target for ITs since lymphocyte activation markers such as CD25 and CD30 are expressed in large numbers. The ITs RFT5.dgA (anti CD25) and Ki-4.dgA (anti CD30) were constructed by linking the monoclonal antibodies RFT5 and Ki-4 to deglycosylated ricin A-chain (dgA). Both ITs showed potent specific activity against HL cells in vitro and in vivo in animal models, and were subsequently evaluated in phase I/II clinical trials in humans. PATIENTS AND METHODS In two separate trials, the ITs were administered i.v. four times every other day over 4 h. The objectives of the phase I trials included the determination of the maximum tolerated dose (MTD), dose-limiting toxicities (DLTs), pharmacokinetics, antitumor activity and immune response against the IT. RESULTS Twenty-seven patients with refractory HL were included in the phase I/II study of RFT5.dgA and 17 patients were included in the phase I study of Ki-4.dgA. The MTD of RFT5.dgA was 15 mg/m(2), whereas that of Ki-4.dgA was 5 mg/m(2). DLTs were related to vascular leak syndrome, consisting of edema, tachycardia, dyspnea, weakness and myalgia. Measurement of serum levels of RFT5.dgA demonstrated a C(max) of 0.2-9.7 micro g/ml with a half-life (t()) varying from 4 to 10.5 h. Peak serum concentration of Ki-4.dgA ranged from 0.23 to 1.7 micro g/ml. In both trials approximately 60% of patients developed human anti-mouse and/or anti-dgA antibodies. Seventeen of 18 patients treated at the MTD of RFT5.dgA were evaluable for clinical response. Responses included two partial remissions (PR), one minor response (MR) and five stable diseases (SD). Fifteen of 17 patients treated with Ki-4.dgA were evaluable for clinical response. Responses included one PR, one MR and two SD. CONCLUSIONS RFT5.dgA and Ki-4.dgA showed moderate efficacy in heavily pretreated refractory patients with HL. Ki-4.dgA was less well tolerated than RFT5.dgA. This might be due, at least in part, to the formation of Ki-4.dgA/sCD30 complexes.
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Affiliation(s)
- R Schnell
- Klinik I fuer Innere Medizin, Universitaet zu Koeln, 50924 Koeln, Germany.
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Staak JO, Dietlein M, Engert A, Weihrauch MR, Schomäcker K, Fischer T, Eschner W, Borchmann P, Diehl V, Schicha H, Schnell R. [Hodgkin's lymphoma in nuclear medicine: diagnostic and therapeutic aspects]. Nuklearmedizin 2003; 42:19-24. [PMID: 12601450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
Today, diagnostic and therapeutic strategies of Hodgkin lymphoma (HL) with positron emission tomography and radioimmunotherapy include state-of-the-art nuclear medicine which require the cooperation between oncology and nuclear medicine. The benefit of FDG-PET in HL patients with residual tumor masses consists of its high negative predictive value in the therapy control of the disease. The concept of waitful watching in patients with PET-negative residual masses after BEACOPP-chemotherapy will be evaluated in a large multicenter trial of the GHSG (German Hodgkin Study Group). Radioimmunotherapy has been performed in patients with CD20-positive Non-Hodgkin lymphoma for 10 years with promising results. HL is also an excellent target for immunotherapy due to the expression of antigens such as CD25 and CD30. Thus, a new radioimmunoconstruct consisting of the murine anti-CD30 antibody Ki-4 labeled with iodine-131 was developed for patients with relapsed or refractory HL.
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Affiliation(s)
- J O Staak
- Klinik I für Innere Medizin, Labor für Immuntherapie, Universität zu Köln, 50924 Köln.
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Dietlein M, Engert A, Weihrauch MR, Schomäcker K, Fischer T, Eschner W, Borchmann P, Diehl V, Schicha H, Schnell R, Staak JO. Hodgkin’s lymphoma in nuclear medicine: diagnostic and therapeutic aspects. Nuklearmedizin 2003. [DOI: 10.1055/s-0038-1623901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
SummaryToday, diagnostic and therapeutic strategies of Hodgkin lymphoma (HL) with positrone emission tomography and radioiummunotherapy include state-of-the-art nuclear medicine which require the cooperation between oncology and nuclear medicine. The benefit of FDG-PET in HL patients with residual tumor masses consists of its high negative predictive value in the therapy control of the disease. The concept of waitful watching in patients with PET-negative residual masses after BEACOPPchemotherapy will be evaluated in a large multicenter trial of the GHSG (German Hodgkin Study Group). Radioimmunotherapy has been performed in patients with CD20-positive Non-Hodgkin lymphoma for 10 years with promising results. HL is also an excellent target for immunotherapy due to the expression of antigens such as CD25 and CD30. Thus, a new radio-immunoconstruct consisting of the murine anti-CD30 antibody Ki-4 labeled with iodine-131 was developed for patients with relapsed or refractory HL.
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Abstract
Many new approaches involving antibody-based agents have given promising results in experimental Hodgkin's disease (HD) models. Clinical trials with monoclonal antibodies, immunotoxins, bispecific constructs and radioimmunoconjugates have demonstrated some clinical efficacy in patients with advanced refractory HD. Although it seems unlikely that resistant patients with larger tumor masses will be cured by either of these approaches, it might be feasible to treat bulky disease by conventional therapy and then administer biological agents to kill residual Hodgkin and Reed-Sternberg cells. Future phase III trials will have to prove a possible superior effect of this combined immunochemotherapy. Currently, the evaluation of the most promising approaches continues.
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Affiliation(s)
- R Schnell
- Klinik I für Innere Medizin, Universität zu Köln, Germany
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Pfitzner T, Reiser M, Barth S, Borchmann P, Schulz H, Schinköthe T, Oberhäuser F, Wessels J, Tur M, Diehl V, Engert A. Quantitative molecular monitoring of residual tumor cells in chronic lymphocytic leukemia. Ann Hematol 2002; 81:258-66. [PMID: 12029535 DOI: 10.1007/s00277-002-0449-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2001] [Accepted: 02/28/2002] [Indexed: 10/27/2022]
Abstract
New therapeutic approaches for the treatment of B-cell chronic lymphocytic leukemia (B-CLL) can induce remarkable responses. Molecular remissions have been observed occasionally after high-dose chemotherapy. Thus, new improved techniques to monitor residual tumor cells on a molecular basis in CLL are warranted. For this purpose, a real-time quantitative allele-specific oligonucleotide polymerase chain reaction (ASO-PCR) for patients with B-CLL was designed. In the present study, the PCR assay was standardized with identical cycling parameters as well as primer, probe, and MgCl(2) concentration for each patient. Ten patients were monitored with DNA samples obtained at 52 time points (median: 5.2 per patient). The median follow-up per patient was 11.4 months. Nine of ten patients had PCR-detectable residual tumor cells in the peripheral blood after therapy. One patient became PCR negative with a combination of fludarabine and rituximab after the end of treatment. The MRD levels in patients with detectable disease ranged from 0.002% to 10.1% after therapy. We conclude that real-time quantitative ASO-PCR can be utilized for quantitative molecular monitoring of minimal residual disease (MRD) in B-CLL patients in complete remission (CR), that new effective treatment approaches such as combined chemo/immunotherapy can render CLL patients PCR negative, and that different MRD levels in PCR-positive patients were observed warranting further investigation into possible correlation with clinical outcome.
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MESH Headings
- Aged
- Alleles
- Antibodies, Monoclonal/therapeutic use
- Antibodies, Monoclonal, Murine-Derived
- Antineoplastic Agents/therapeutic use
- Computer Systems
- DNA, Neoplasm/analysis
- Female
- Humans
- Immunoglobulin Heavy Chains/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/metabolism
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Male
- Middle Aged
- Neoplasm, Residual/pathology
- Neoplastic Cells, Circulating/pathology
- Polymerase Chain Reaction/methods
- Rituximab
- Vidarabine/analogs & derivatives
- Vidarabine/therapeutic use
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Affiliation(s)
- T Pfitzner
- Department of Internal Medicine, University of Cologne, Joseph-Stelzmannstrasse, Köln, Germany
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