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Pavlovsky M, Cubero D, Agreda-Vásquez GP, Enrico A, Mela-Osorio MJ, San Sebastián JA, Fogliatto L, Ovilla R, Avendano O, Machnicki G, Barreyro P, Trufelli D, Villanova P. Clinical Outcomes of Patients With B-Cell Non-Hodgkin Lymphoma in Real-World Settings: Findings From the Hemato-Oncology Latin America Observational Registry Study. JCO Glob Oncol 2022; 8:e2100265. [PMID: 35486884 PMCID: PMC9088238 DOI: 10.1200/go.21.00265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Real-world evidence on non-Hodgkin lymphoma (NHL) management in Latin America is currently lacking. The objective of this study was to describe treatment characteristics and outcomes of NHL in Latin America.
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Affiliation(s)
- Miguel Pavlovsky
- Servicio de Hematología e Investigación Clínica, Fundación para Combatir la Leucemia (FUNDALEU), Buenos Aires, Argentina
| | | | | | | | - Maria J Mela-Osorio
- Servicio de Hematología e Investigación Clínica, Fundación para Combatir la Leucemia (FUNDALEU), Buenos Aires, Argentina
| | | | | | | | | | | | - Paula Barreyro
- Janssen-Cilag Farmacêutica Ltda, Buenos Aires, Argentina
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2
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Weisel K, Spencer A, Lentzsch S, Avet-Loiseau H, Mark TM, Spicka I, Masszi T, Lauri B, Levin MD, Bosi A, Hungria V, Cavo M, Lee JJ, Nooka A, Quach H, Munder M, Lee C, Barreto W, Corradini P, Min CK, Chanan-Khan AA, Horvath N, Capra M, Beksac M, Ovilla R, Jo JC, Shin HJ, Sonneveld P, Casneuf T, DeAngelis N, Amin H, Ukropec J, Kobos R, Mateos MV. Daratumumab, bortezomib, and dexamethasone in relapsed or refractory multiple myeloma: subgroup analysis of CASTOR based on cytogenetic risk. J Hematol Oncol 2020; 13:115. [PMID: 32819447 PMCID: PMC7439722 DOI: 10.1186/s13045-020-00948-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 07/30/2020] [Indexed: 12/11/2022] Open
Abstract
Background Multiple myeloma (MM) patients with high cytogenetic risk have poor outcomes. In CASTOR, daratumumab plus bortezomib/dexamethasone (D-Vd) prolonged progression-free survival (PFS) versus bortezomib/dexamethasone (Vd) alone and exhibited tolerability in patients with relapsed or refractory MM (RRMM). Methods This subgroup analysis evaluated D-Vd versus Vd in CASTOR based on cytogenetic risk, determined using fluorescence in situ hybridization and/or karyotype testing performed locally. High-risk patients had t(4;14), t(14;16), and/or del17p abnormalities. Minimal residual disease (MRD; 10−5 sensitivity threshold) was assessed via the clonoSEQ® assay V2.0. Of the 498 patients randomized, 40 (16%) in the D-Vd group and 35 (14%) in the Vd group were categorized as high risk. Results After a median follow-up of 40.0 months, D-Vd prolonged median PFS versus Vd in patients with standard (16.6 vs 6.6 months; HR, 0.26; 95% CI, 0.19-0.37; P < 0.0001) and high (12.6 vs 6.2 months; HR, 0.41; 95% CI, 0.21–0.83; P = 0.0106) cytogenetic risk. D-Vd achieved deep responses, including higher rates of MRD negativity and sustained MRD negativity versus Vd, regardless of cytogenetic risk. The safety profile was consistent with the overall population of CASTOR. Conclusion These updated data reinforce the effectiveness and tolerability of daratumumab-based regimens for RRMM, regardless of cytogenetic risk status. Trial registration ClinicalTrials.gov, NCT02136134. Registered 12 May 2014
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Affiliation(s)
- Katja Weisel
- Department of Oncology, Hematology and Bone Marrow Transplantation with Section of Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Andrew Spencer
- Malignant Haematology and Stem Cell Transplantation Service, Alfred Health-Monash University, Melbourne, Australia
| | - Suzanne Lentzsch
- Division of Hematology/Oncology, Columbia University, New York, NY, USA
| | | | - Tomer M Mark
- Department of Medicine, University of Colorado, Aurora, CO, USA
| | - Ivan Spicka
- Clinical Department of Haematology, 1st Medical Department, Charles University in Prague, Prague, Czech Republic
| | - Tamas Masszi
- László Hospital, 3rd Department of Internal Medicine, Semmelweis University, Budapest, Hungary
| | - Birgitta Lauri
- Department of Hematology, Sunderbyn Hospital, Luleå, Sweden
| | - Mark-David Levin
- Department of Internal Medicine, Albert Schweitzer Hospital, Dordrecht, The Netherlands
| | - Alberto Bosi
- Department of Hematology, Careggi Hospital and University of Florence, Firenze, Italy
| | - Vania Hungria
- Irmandade Da Santa Casa De Misericordia De São Paulo, São Paulo, Brazil
| | - Michele Cavo
- "Seràgnoli" Institute of Hematology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Je-Jung Lee
- Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, Hwasun, Jeollanamdo, South Korea
| | - Ajay Nooka
- Winship Cancer Institute, Emory University, Atlanta, GA, USA
| | - Hang Quach
- University of Melbourne, St Vincent's Hospital, Melbourne, Australia
| | - Markus Munder
- University Medical Center of the Johannes Gutenberg University, Third Department of Medicine, Mainz, Germany
| | - Cindy Lee
- Royal Adelaide Hospital, North Terrace, Adelaide, Australia
| | | | - Paolo Corradini
- Fondazione IRCCS Istituto Nazionale dei Tumori, University of Milan, Milan, Italy
| | | | | | - Noemi Horvath
- Royal Adelaide Hospital, North Terrace, Adelaide, Australia
| | - Marcelo Capra
- Instituto do Cancer-Hospital Mae de Deus, Porto Alegre, Brazil
| | | | - Roberto Ovilla
- Hospital Angeles Lomas, Naucalpan de Juárez y alrededores, Mexico
| | | | - Ho-Jin Shin
- Department of Internal Medicine, Pusan National University Hospital, Busan, South Korea
| | | | | | | | - Himal Amin
- Janssen Research & Development, LLC, Raritan, NJ, USA
| | - Jon Ukropec
- Janssen Global Scientific Affairs, Horsham, PA, USA
| | - Rachel Kobos
- Janssen Research & Development, LLC, Raritan, NJ, USA
| | - Maria-Victoria Mateos
- University Hospital of Salamanca/IBSAL/Cancer Research Center-IBMCC (USAL-CSIC), Salamanca, Spain
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Tietsche de Moraes Hungria V, Chiattone C, Pavlovsky M, Abenoza LM, Agreda GP, Armenta J, Arrais C, Avendaño Flores O, Barroso F, Basquiera AL, Cao C, Cugliari MS, Enrico A, Foggliatto LM, Galvez KM, Gomez D, Gomez A, de Iracema D, Farias D, Lopez L, Mantilla WA, Martínez D, Mela MJ, Miguel CE, Ovilla R, Palmer L, Pavlovsky C, Ramos C, Remaggi G, Santucci R, Schusterschitz S, Sossa CL, Tuna-Aguilar E, Vela J, Santos T, de la Mora O, Machnicki G, Fernandez M, Barreyro P. Epidemiology of Hematologic Malignancies in Real-World Settings: Findings From the Hemato-Oncology Latin America Observational Registry Study. J Glob Oncol 2020; 5:1-19. [PMID: 31774711 PMCID: PMC6882510 DOI: 10.1200/jgo.19.00025] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [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: 12/12/2022] Open
Abstract
PURPOSE Limited information is available on multiple myeloma (MM), chronic lymphocytic leukemia (CLL), and non-Hodgkin lymphoma (NHL) management in Latin America. The primary objective of the Hemato-Oncology Latin America (HOLA) study was to describe patient characteristics and treatment patterns of Latin American patients with MM, CLL, and NHL. METHODS This study was a multicenter, retrospective, medical chart review of patients with MM, CLL, and NHL in Latin America identified between January 1, 2006, and December 31, 2015. Included were adults with at least 1 year of follow-up (except in cases of death within 1 year of diagnosis) treated at 30 oncology hospitals (Argentina, 5; Brazil, 9; Chile, 1; Colombia, 5; Mexico, 6; Panama/Guatemala, 4). RESULTS Of 5,140 patients, 2,967 (57.7%) had NHL, 1,518 (29.5%) MM, and 655 (12.7%) CLL. Median follow-up was 2.2 years for MM, 3.0 years for CLL, and 2.2 years for NHL, and approximately 26% died during the study observation period. Most patients had at least one comorbidity at diagnosis. The most frequent induction regimen was thalidomide-based chemotherapy for MM and chlorambucil with or without prednisone for CLL. Most patients with NHL had diffuse large B-cell lymphoma (DLBCL; 49.1%) or follicular lymphoma (FL; 19.5%). The majority of patients with DLBCL or FL received rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone. CONCLUSION The HOLA study generated an unprecedented level of high-quality, real-world evidence on characteristics and treatment patterns of patients with hematologic malignancies. Regional disparities in patient characteristics may reflect differences in ethnoracial identity and level of access to care. These data provide needed real-world evidence to understand the disease landscape in Latin America and may be used to inform clinical and health policy decision making.
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Affiliation(s)
| | - Carlos Chiattone
- Faculdade de Ciencias Médicas-Santa Casa de São Paulo, São Paulo, Brazil
| | | | | | - Gladys P Agreda
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | | | | | | | | | - Ana L Basquiera
- Hospital Privado Centro Médico de Córdoba, Córdoba, Argentina
| | - Carmen Cao
- Instituto Nacional del Cancer, Santiago, Chile
| | | | | | | | | | - David Gomez
- Hospital Universitario "Dr José E. González," Mexico City, Mexico
| | | | | | - Danielle Farias
- Hospital das Clinicas da Universidade Federal de Goiás, Goiânia, Brazil
| | - Lineth Lopez
- Complejo Hospitalario Metropolitano Dr Annulfo Arias Madrid, Panama City, Panama
| | | | - Deborah Martínez
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | | | - Carlos E Miguel
- Fundacao Faculdade Regional de Medicina São José do Rio Preto, São José do Rio Preto, Brazil
| | | | - Luis Palmer
- Complejo Médico de la PFA Churruca-Visca, Buenos Aires, Argentina
| | | | | | | | | | | | | | - Elena Tuna-Aguilar
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Jorge Vela
- Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Mexico City, Mexico
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Spencer A, Lentzsch S, Weisel K, Avet-Loiseau H, Mark TM, Spicka I, Masszi T, Lauri B, Levin MD, Bosi A, Hungria V, Cavo M, Lee JJ, Nooka AK, Quach H, Lee C, Barreto W, Corradini P, Min CK, Scott EC, Chanan-Khan AA, Horvath N, Capra M, Beksac M, Ovilla R, Jo JC, Shin HJ, Sonneveld P, Soong D, Casneuf T, Chiu C, Amin H, Qi M, Thiyagarajah P, Sasser AK, Schecter JM, Mateos MV. Daratumumab plus bortezomib and dexamethasone versus bortezomib and dexamethasone in relapsed or refractory multiple myeloma: updated analysis of CASTOR. Haematologica 2018; 103:2079-2087. [PMID: 30237264 PMCID: PMC6269293 DOI: 10.3324/haematol.2018.194118] [Citation(s) in RCA: 201] [Impact Index Per Article: 33.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 08/17/2018] [Indexed: 11/11/2022] Open
Abstract
Daratumumab, a CD38 human monoclonal antibody, demonstrated significant clinical activity in combination with bortezomib and dexamethasone versus bortezomib and dexamethasone alone in the primary analysis of CASTOR, a phase 3 study in relapsed and/or refractory multiple myeloma. A post hoc analysis based on treatment history and longer follow up is presented. After 19.4 (range: 0–27.7) months of median follow up, daratumumab plus bortezomib and dexamethasone prolonged progression-free survival (median: 16.7 versus 7.1 months; hazard ratio, 0.31; 95% confidence interval, 0.24-0.39; P<0.0001) and improved the overall response rate (83.8% versus 63.2%; P<0.0001) compared with bortezomib and dexamethasone alone. The progression-free survival benefit of daratumumab plus bortezomib and dexamethasone was most apparent in patients with 1 prior line of therapy (median: not reached versus 7.9 months; hazard ratio, 0.19; 95% confidence interval, 0.12-0.29; P<0.0001). Daratumumab plus bortezomib and dexamethasone was also superior to bortezomib and dexamethasone alone in subgroups based on prior treatment exposure (bortezomib, thalidomide, or lenalidomide), lenalidomide-refractory status, time since last therapy (≤12, >12, ≤6, or >6 months), or cytogenetic risk. Minimal residual disease–negative rates were >2.5-fold higher with daratumumab across subgroups. The safety profile of daratumumab plus bortezomib and dexamethasone remained consistent with longer follow up. Daratumumab plus bortezomib and dexamethasone demonstrated significant clinical activity across clinically relevant subgroups and provided the greatest benefit to patients treated at first relapse. Trial registration: clinicaltrials.gov identifier: 02136134.
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Affiliation(s)
- Andrew Spencer
- Malignant Haematology and Stem Cell Transplantation Service, Alfred Health-Monash University, Melbourne, Australia
| | - Suzanne Lentzsch
- Division of Hematology/Oncology, Columbia University, New York, NY, USA
| | - Katja Weisel
- Universitaetsklinikum Tuebingen der Eberhard-Karls-Universitaet, Abteilung fuer Innere Medizin II, Tübingen, Germany
| | | | - Tomer M Mark
- Department of Medicine, University of Colorado, Aurora, CO, USA
| | - Ivan Spicka
- Clinical Department of Haematology, 1 Medical Department, Charles University in Prague, Czech Republic
| | - Tamas Masszi
- Department of Haematology and Stem Cell Transplantation, St László Hospital, 3 Department of Internal Medicine, Semmelweis University, Budapest, Hungary
| | - Birgitta Lauri
- Department of Hematology, Sunderbyn Hospital, Luleå, Sweden
| | - Mark-David Levin
- Albert Schweitzer Hospital Department of Internal Medicine, Dordrecht, the Netherlands
| | - Alberto Bosi
- Department of Hematology, Careggi Hospital and University of Florence, Italy
| | - Vania Hungria
- Irmandade Da Santa Casa De Misericordia De São Paulo, Brazil
| | - Michele Cavo
- "Seràgnoli" Institute of Hematology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Italy
| | - Je-Jung Lee
- Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, Jeollanamdo, South Korea
| | - Ajay K Nooka
- Winship Cancer Institute, Emory University, Atlanta, GA, USA
| | - Hang Quach
- St. Vincent's Hospital, University of Melbourne, Australia
| | - Cindy Lee
- Royal Adelaide Hospital, North Terrace, Australia
| | | | - Paolo Corradini
- Fondazione IRCCS Instituto Nazionale dei Tumori, University of Milan, Italy
| | | | - Emma C Scott
- Oregon Health & Science University, Portland, OR, USA
| | | | | | - Marcelo Capra
- Instituto do Cancer-Hospital Mae de Deus, Porto Alegre, Brazil
| | | | - Roberto Ovilla
- Hospital Angeles Lomas, Naucalpan de Juárez y alrededores, México
| | | | - Ho-Jin Shin
- Division of Hematology-Oncology, Department of Internal Medicine, School of Medicine, Medical Research Institute, Pusan National University Hospital, Busan, South Korea
| | | | - David Soong
- Janssen Research & Development, LLC, Spring House, PA, USA
| | | | | | - Himal Amin
- Janssen Research & Development, LLC, Raritan, NJ, USA
| | - Ming Qi
- Janssen Research & Development, LLC, Spring House, PA, USA
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Alaez C, Loyola M, Murguía A, Flores H, Rodríguez A, Ovilla R, Ignacio G, Amador R, Salinas V, Perez F, Rodríguez D, Morales Z, Llinguin G, Vazquez A, Altamirano A, Gorodezky C. Hematopoietic stem cell transplantation (HSCT): An approach to autoimmunity. Autoimmun Rev 2006; 5:167-79. [PMID: 16483916 DOI: 10.1016/j.autrev.2005.06.003] [Citation(s) in RCA: 13] [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: 03/30/2005] [Accepted: 06/06/2005] [Indexed: 11/17/2022]
Abstract
HSCT provides the opportunity to replace a damaged tissue. It is the most important treatment for high risk hematologic malignant and non malignant disorders. An important challenge in the identification of matched donors/patients is the HLA diversity. The Mexican Bone Marrow Registry (DONORMO) has nowadays > 5000 donors. The prevalent alleles are Amerindian, Mediterranean (Semitic and Spanish genes) and African. In theory, it is possible to find 11% of 6/6 A-B-DR low resolution matches for 70% of patients with Mexican ancestry. We contributed with 39 unrelated, cord blood and autologous HSCT for patients with malignant, genetic and autoimmune disorders. Overall disease survival was 50% (2-7 years) depending on the initial diagnosis, conditioning, disease evolution or other factors. Clinical studies using autologous and unrelated HSC are performed on patients with refractory autoimmune diseases producing mixed results: mainly, T1D, RA, MS, SLE. Improvement has been observed in skin damage and quality of life in SLE and systemic sclerosis. Disease stabilization in 2/3 of MS patients. However, in RA and T1D, initial benefits have been followed by eventual relapse. With growing clinical experience and protocol improvement, treatment-related mortality is decreasing. Proof efficacy will be achieved by comparing HSCT with standard therapy in autoimmunity.
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Affiliation(s)
- Carmen Alaez
- Department of Immunology and Immunogenetics, Instituto de Diagnóstico y Referencia Epidemiológicos-InDRE, Secretary of Health (SSA), Mexico City, Mexico
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Mejía-Arreguí M, Ovilla R, Girolami A, Ambriz-Fernández R. [Transfusion medicine]. Rev Invest Clin 1997; 49 Suppl 1:64-74. [PMID: 9380992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- M Mejía-Arreguí
- Educación e Investigación Médica Banco Central de Sangre del Centro Médico Nacional Siglo XXI IMSS, México, D.F
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Avilés A, Ovilla R, García LD, Rubio ME, González-Llaven J. Prognostic factors in myelodysplasic syndromes: a multivariante analysis in 138 patients. Arch Invest Med (Mex) 1989; 20:45-52. [PMID: 2764668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
A multivariate analysis of clinical, biochemical and hematologic data was performed in 138 patients with myelodysplastic syndromes (MDS) in order to evaluate their prognostic significance. The most important individual variables, isolated in a previous univariate analysis, were placed in a multiple regression modeling procedure to identify major prognostic factors. Multivariate analysis tends to identify prognostic variables containing significant predictive information. Characteristics were examined on both continuous and binary bases. The FAB classification was the first parameter entered in regression equations of both models, followed by platelet count, systemic symptoms, bone marrow blast and infection. Our analysis confirms FAB classification as the best prognostic factor in MDS. It supports the previously predictive value of platelet count, hemoglobin level and bone marrow blast and recognizes the importance of systemic symptoms and infection as prognostic characteristics in MDS.
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