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Tsukada N, Oda Y, Nomura M, Kasuya Y, Takei T, Sato K, Ogura M, Kikuchi T, Abe Y, Suzuki K, Ishida T. [A retrospective analysis of 124 patients with multiple myeloma who received up-front autologous hematopoietic cell transplantation following triplet induction therapy]. Rinsho Ketsueki 2023; 64:1397-1403. [PMID: 38072424 DOI: 10.11406/rinketsu.64.1397] [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] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
The IFM/DFCI group reported that VRD induction followed by up-front autologous peripheral blood stem cell transplantation (ASCT) and maintenance therapy led to median PFS of 50 months, which established up-front ASCT as the standard of care even in the era of novel agents. We conducted a retrospective analysis on outcomes of patients who received triplet induction therapy followed by up-front ASCT at our institution. A total of 124 patients received ASCT between November 2016 and December 2021 at Japanese Red Cross Medical Center. Patient characteristics, treatment response before and after ASCT, and PFS and OS were retrospectively analyzed. VRD-based induction therapy was used for 94%. Among 118 evaluable patients, 116 (98%) received either consolidation and/or maintenance therapy. Best responses were ≥CR 77% and ≥VGPR 94%, respectively. Sixty-eight out of 104 patients achieved MRD-negativity by multiparameter FCM (<10-5). Five-year estimated PFS and OS were 54.7% and 80.2%, respectively. Age ≥65, high-risk cytogenetic abnormalities, and
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Affiliation(s)
| | - Yuki Oda
- Department of Hematology, Japanese Red Cross Medical Center
| | - Moe Nomura
- Department of Hematology, Japanese Red Cross Medical Center
| | - Yuki Kasuya
- Department of Hematology, Japanese Red Cross Medical Center
| | - Tomomi Takei
- Department of Hematology, Japanese Red Cross Medical Center
| | - Kota Sato
- Department of Hematology, Japanese Red Cross Medical Center
| | - Mizuki Ogura
- Department of Hematology, Japanese Red Cross Medical Center
| | - Taku Kikuchi
- Department of Hematology, Japanese Red Cross Medical Center
| | - Yu Abe
- Department of Hematology, Japanese Red Cross Medical Center
| | - Kenshi Suzuki
- Department of Hematology, Japanese Red Cross Medical Center
| | - Tadao Ishida
- Department of Hematology, Japanese Red Cross Medical Center
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Kodama Y, Saburi M, Maruyama R, Sakata M, Takata H, Miyazaki Y, Kawano K, Wada J, Urabe S, Hazuku T, Ohtsuka E. [Busulfan/thiotepa followed by autologous peripheral blood stem cell transplantation for refractory diffuse large B-cell lymphoma accompanied by hypopyon]. Rinsho Ketsueki 2022; 63:1409-1414. [PMID: 36351648 DOI: 10.11406/rinketsu.63.1409] [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] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
A 54-year-old male patient, who presented with multiple lymphadenopathies, bilateral leg edema, and oscheohydrocele, was diagnosed with diffuse large B-cell lymphoma (DLBCL) stage IVB. His lymphadenopathies disappeared after six courses of R-CHOP therapy, which consist of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone); however, right hypopyon and partly remaining testicular soft tissue masses with fluorodeoxyglucose accumulation were observed. Lymphoma cell infiltration was observed in the aqueous humor of the right anterior chamber and testis, which indicates DLBCL progression. Hypopyon disappeared after the first course of intrathecal chemotherapy combined with R-HDMA therapy, which consists of rituximab and high-dose methotrexate/cytarabine, but recurred in the third course. The patient then underwent busulfan and thiotepa (BuTT) therapy followed by autologous peripheral blood stem cell transplantation (auto-PBSCT) after four courses of R-HDMA therapy. Hypopyon promptly disappeared after BuTT therapy and no hypopyon recurrence was observed 9 months after auto-PBSCT. Therefore, BuTT therapy is effective for hypopyon associated with refractory DLBCL.
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Affiliation(s)
| | | | | | | | | | | | - Katsuya Kawano
- Department of Clinical Laboratory Technology, Oita Prefectural Hospital
| | - Junpei Wada
- Department of Pathology, Oita Prefectural Hospital
| | - Shogo Urabe
- Department of Pathology, Oita Prefectural Hospital
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Giri S, Chen Y, Wu J, Hageman L, Richman J, Francisco L, Landier W, Costa L, McDonald A, Murdaugh D, Wong FL, Weisdorf DJ, Forman SJ, Arora M, Armenian SH, Bhatia S. Reduction in Late Mortality Among Patients With Multiple Myeloma Treated With Autologous Peripheral Blood Stem Cell Transplantation-A Blood or Marrow Transplant Survivor Study Report. Transplant Cell Ther 2021; 27:840.e1-840.e7. [PMID: 34153501 DOI: 10.1016/j.jtct.2021.06.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 06/09/2021] [Accepted: 06/12/2021] [Indexed: 11/25/2022]
Abstract
Therapeutic practices for multiple myeloma (MM) have evolved, such that novel-agent-based therapy and autologous peripheral blood stem cell transplantation (aPBSCT) is the current standard. Whether cause-specific mortality has changed with time remains unclear. We examined late cause-specific mortality among patients with MM receiving aPBSCT from 1989 to 2014. We conducted a prospective cohort study using participants enrolled in the enrolled in the Blood or Marrow Transplant Survivor Study. We created 3 eras to reflect changing MM therapy: <2000 (pre-thalidomide); 2000-2005 (thalidomide); 2006-2014 (lenalidomide). We used Kaplan-Meier techniques and Cox regression for examining all-cause mortality, and subdistribution hazards models for cause-specific mortality. In total, 1906 patients were followed up for a median of 9.2 years. Conditional on surviving 2 years, the 10-year overall survival was 45%. The 10-year cumulative incidence of myeloma- and non-myeloma-related mortality was 33% and 13%, respectively. Multivariable analysis showed declining MM-specific mortality (subdistribution hazard ratio [SHR]2000-2005 = 0.80, 95% confidence interval [CI], 0.60-1.07; SHR2006-2014 = 0.46, 95% CI, 0.34-0.62; referent group: <2000), infection-related mortality (SHR2000-2005 = 0.50, 95% CI, 0.29-0.85; SHR2006-2014 = 0.35, 95%CI 0.21-0.60; referent group: <2000) and cardiovascular disease-related mortality (SHR2000-2005 = 0.45, 95% CI 0.20-0.99; SHR2006-2014 = 0.41, 95% CI 0.18-0.93; referent group: <2000). Although primary disease remains the major cause of late mortality, we observed a significant temporal decline in myeloma-, infection-, and cardiac-related late mortality over the past 25 years.
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Affiliation(s)
- Smith Giri
- Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham, Alabama; Division of Hematology & Oncology, Department of Medicine, University of Alabama at Birmingham, Alabama
| | - Yanjun Chen
- Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham, Alabama
| | - Jessica Wu
- Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham, Alabama
| | - Lindsey Hageman
- Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham, Alabama
| | - Joshua Richman
- Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham, Alabama; Division of Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, Minnesota
| | - Liton Francisco
- Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham, Alabama
| | - Wendy Landier
- Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham, Alabama; Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, California
| | - Luciano Costa
- Division of Hematology & Oncology, Department of Medicine, University of Alabama at Birmingham, Alabama
| | - Andrew McDonald
- Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham, Alabama; Department of Population Sciences, City of Hope, Duarte, California
| | - Donna Murdaugh
- Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham, Alabama; Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, California
| | - F Lennie Wong
- Division of Hematology-Oncology, Department of Pediatrics, University of Alabama at Birmingham, Alabama
| | - Daniel J Weisdorf
- Division of Hematology-Oncology, Department of Pediatrics, University of Alabama at Birmingham, Alabama
| | - Stephen J Forman
- Division of Hematology-Oncology, Department of Pediatrics, University of Alabama at Birmingham, Alabama
| | - Mukta Arora
- Division of Hematology-Oncology, Department of Pediatrics, University of Alabama at Birmingham, Alabama
| | - Saro H Armenian
- Division of Hematology-Oncology, Department of Pediatrics, University of Alabama at Birmingham, Alabama
| | - Smita Bhatia
- Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham, Alabama; Division of Hematology-Oncology, Department of Pediatrics, University of Alabama at Birmingham, Alabama.
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Cai Y, Wan L, Yang J, Zhu J, Jiang J, Li S, Song X, Wang C. High-dose etoposide could discriminate the benefit from autologous peripheral blood stem cell transplantation in the patients with refractory diffuse large B cell lymphoma. Ann Hematol 2019; 98:823-31. [PMID: 30715566 DOI: 10.1007/s00277-019-03605-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 01/07/2019] [Indexed: 11/23/2022]
Abstract
To evaluate the strategy of using high-dose etoposide mobilization followed by autologous peripheral blood stem cell transplantation (APBSCT) in patients with diffuse large B cell lymphoma (DLBCL) refractory to rituximab-based chemotherapy. Forty patients with refractory DLBCL were treated with high-dose etoposide for stem cell mobilization. All patients were in progressive disease (PD) prior to mobilization and underwent high-dose chemotherapy followed by APBSCT. Successful PBSC mobilization was achieved in all patients. Twenty-three patients (57.5%) showed a clinical response to high-dose etoposide. After APBSCT, 17 patients (42.5%) achieved CR. The 2-year progression-free (PFS) and overall survival (OS) rate were higher in patients responding to high-dose etoposide (64.1% and 77.7%) compared to those without response (11.8% and 11.8%; P < 0.001 for both). The response to high-dose etoposide mobilization therapy was an independent prognostic factor for CR achievement, PFS and OS after APBSCT. High-dose etoposide mobilization chemotherapy followed by APBSCT could rescue a proportion of patients with refractory DLBCL who responded to etoposide mobilization regimen.
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Yoshimura A, Tsuji T, Kawaji Y, Hirakawa Y, Uchiyama H, Hiraoka N. BK virus pneumonia following stem cell transplantation against diffuse large B-cell lymphoma. Respirol Case Rep 2018; 6:e00348. [PMID: 29983984 PMCID: PMC6018942 DOI: 10.1002/rcr2.348] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 04/20/2018] [Revised: 06/05/2018] [Accepted: 06/08/2018] [Indexed: 11/06/2022] Open
Abstract
The patient, a 70-year-old woman with diffuse large B-cell lymphoma (DLBCL), developed haemorrhagic cystitis associated with the BK virus (BKV) and adenovirus type 11. Moreover, chest computed tomography showed ground-glass opacity (GGO) in the bilateral upper lobe, and we performed bronchoalveolar lavage (BAL). The BKV DNA load was elevated not only in blood but also in BAL fluid (BALF), leading to the diagnosis of BKV pneumonia. After administering cidofovir, the respiratory symptoms and GGO abated. Therefore, detection of BKV DNA in BALF is useful for diagnosing BKV pneumonia. The patient with DLBCL developed BKV pneumonia. We performed BAL, and BKV DNA load was elevated on BALF. The detection of BKV DNA in BALF is useful for diagnosing BKV pneumonia.
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Affiliation(s)
- Akihiro Yoshimura
- Department of Respiratory MedicineJapanese Red Cross Kyoto Daiichi HospitalKyotoJapan
| | - Taisuke Tsuji
- Department of Respiratory MedicineJapanese Red Cross Kyoto Daiichi HospitalKyotoJapan
| | - Yuka Kawaji
- Department of HematologyJapanese Red Cross Kyoto Daiichi HospitalKyotoJapan
| | - Yoshiko Hirakawa
- Department of HematologyJapanese Red Cross Kyoto Daiichi HospitalKyotoJapan
| | - Hitoji Uchiyama
- Department of HematologyJapanese Red Cross Kyoto Daiichi HospitalKyotoJapan
| | - Noriya Hiraoka
- Department of Respiratory MedicineJapanese Red Cross Kyoto Daiichi HospitalKyotoJapan
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Walicka M, Milczarczyk A, Snarski E, Jedynasty K, Halaburda K, Torosian T, Urbanowska E, Król M, Jędrzejczak WW, Franek E. Lack of persistent remission following initial recovery in patients with type 1 diabetes treated with autologous peripheral blood stem cell transplantation. Diabetes Res Clin Pract 2018; 143:357-363. [PMID: 30036612 DOI: 10.1016/j.diabres.2018.07.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 07/03/2018] [Accepted: 07/17/2018] [Indexed: 12/29/2022]
Abstract
AIMS To assess metabolic control in patients with newly diagnosed type 1 diabetes mellitus who underwent immunoablation followed by autologous peripheral blood stem cell transplantation (APBSCT) as a treatment of diabetes. METHODS APBSCT was performed in 23 patients. Control group comprised 8 non-APBSCT patients in whom after diagnosis insulin therapy was initiated. Fasting plasma glucose, glycated hemoglobin, fasting and postprandial C-peptide were assessed in all subjects and continuous glucose monitoring was performed at 6th, 12th, 24th, 36th, 48th month after transplantation. The APBSCT group was observed for 72 months. RESULTS Six months after the procedure, 22 of 23 transplant patients remained insulin-free, but after 6 years, there was only one APBSCT insulin-free patient. Good glycemic control was observed in all patients throughout the observation period, although fasting plasma glucose in control group was significantly higher in comparison with the both transplanted groups up to the 36th month. HbA1c values were significantly lower in the insulin-free group only at the 24th and 36th month. Fasting and postprandial C-peptide concentrations were higher in APBSCT group as compared with control group. The most serious adverse event was a fatal case of Pseudomonas aeruginosa sepsis. CONCLUSIONS The effectiveness of APBSCT as a treatment for newly diagnosed DM1 seems to be limited in time. The metabolic control of APBSCT patients is similar to conventionally treated patients. The lower fasting plasma glucose and higher C-peptide achieved with APBSCT seem to not exceed the risks associated with the procedure.
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Affiliation(s)
- Magdalena Walicka
- Department of Internal Diseases, Endocrinology and Diabetology, Central Clinical Hospital of the Ministry of the Interior and Administration in Warsaw, Ul. 02-507 Warsaw, 137 Wołoska Street, Poland(1).
| | - Alicja Milczarczyk
- Department of Internal Diseases, Endocrinology and Diabetology, Central Clinical Hospital of the Ministry of the Interior and Administration in Warsaw, Ul. 02-507 Warsaw, 137 Wołoska Street, Poland(1).
| | - Emilian Snarski
- Department of Oncology and Haematology, Medical University of Warsaw, Ul. 02-097 Warsaw, 1a Banacha Street, Poland(2)
| | - Krystyna Jedynasty
- Department of Internal Diseases, Endocrinology and Diabetology, Central Clinical Hospital of the Ministry of the Interior and Administration in Warsaw, Ul. 02-507 Warsaw, 137 Wołoska Street, Poland(1).
| | - Kazimierz Halaburda
- Department of Oncology and Haematology, Medical University of Warsaw, Ul. 02-097 Warsaw, 1a Banacha Street, Poland(2).
| | - Tigran Torosian
- Department of Oncology and Haematology, Medical University of Warsaw, Ul. 02-097 Warsaw, 1a Banacha Street, Poland(2).
| | - Elżbieta Urbanowska
- Department of Oncology and Haematology, Medical University of Warsaw, Ul. 02-097 Warsaw, 1a Banacha Street, Poland(2).
| | - Małgorzata Król
- Department of Oncology and Haematology, Medical University of Warsaw, Ul. 02-097 Warsaw, 1a Banacha Street, Poland(2).
| | - Wiesław Wiktor Jędrzejczak
- Department of Oncology and Haematology, Medical University of Warsaw, Ul. 02-097 Warsaw, 1a Banacha Street, Poland(2).
| | - Edward Franek
- Department of Internal Diseases, Endocrinology and Diabetology, Central Clinical Hospital of the Ministry of the Interior and Administration in Warsaw, Ul. 02-507 Warsaw, 137 Wołoska Street, Poland(1); Department of Human Epigenetics, Mossakowski Medical Research Centre Polish Academy of Sciences, Ul. 02-106 Warsaw, 5 Pawińskiego Street, Poland(3).
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Wu M, Wang X, Xie Y, Liu W, Zhang C, Ping L, Ying Z, Deng L, Zheng W, Lin N, Tu M, Song Y, Zhu J. Outcome and Prospective Factor Analysis of High-dose Therapy Combined with Autologous Peripheral Blood Stem Cell Transplantation in Patients with Peripheral T-cell Lymphomas. Int J Med Sci 2018; 15:867-874. [PMID: 30008598 PMCID: PMC6036090 DOI: 10.7150/ijms.23067] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 04/12/2018] [Indexed: 01/01/2023] Open
Abstract
Background: For peripheral T-cell lymphomas (PTCLs) patients, high-dose therapy combined with autologous peripheral blood stem cell transplantation (HDT/ASCT) has been an alternative treatment option, due to the lack of efficacy from conventional chemotherapy. While not all PTCLs could have benefit in survival from HDT/ASCT. The aim of this study was to evaluate the value of high-dose therapy combined with autologous peripheral blood stem cell transplantation (HDT/ASCT) in Chinese patients with Peripheral T-cell Lymphomas (PTCLs), in order to determine the cohort most suitable to receive HDT/ASCT. Methods: A total of 79 patients with PTCLs who received HDT/ASCT in Peking University Cancer Hospital & Institute from January 2001 to august 2016 were retrospectively analyzed. Results: At a median follow-up time of 23.6 months, the 2-year progression-free survival (PFS) and 2-year overall survival (OS) of the entire cohort were 75.2% and 83.6% respectively. Patients with first complete remission (CR1) (2-year PFS 85.8%, 2-year OS 94.2%) were superior to others in survival. Patients with second complete remission (CR2) had no advantage in survival compared with those with first partial remission (PR1) (2-year PFS: 43.8% vs. 76.2%, p=0.128; 2-year OS: 72.9% vs. 77.1%, p=0.842). In multivariate analysis, response before HDT/ASCT (p=0.001) and LDH before HDT/ASCT (p=0.047) were highly predictive for PFS, while no factors could independently predict OS. Subgroup analysis revealed that HDT/ASCT could improve the survival of patients with angioimmunoblastic T-cell lymphoma (AITL), especially in patients with chemosensitivity. Patients with natural killer / T-cell lymphoma (NKTCL) who received HDT/ASCT with CR1 also had benefit in survival from HDT/ASCT, while nearly 90% of non-CR1 patients appeared bone marrow involvement after HDT/ASCT. Conclusion: Patients who achieved complete remission after first-line therapy, especially with AITL and NKTCL, should strongly be recommended to receive HDT/ASCT. The future prospective trial is warranted.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Jun Zhu
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Lymphoma, Peking University Cancer Hospital & Institute
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Iino M, Yamamoto T. [Efficacy and safety of biosimilar filgrastim for autologous peripheral blood stem cell harvest and transplantation: a single-institutional retrospective analysis]. Rinsho Ketsueki 2018. [PMID: 29515065 DOI: 10.11406/rinketsu.59.145] [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] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Three biosimilar filgrastim products are currently available in Japan. Among these, the safety and efficacy of two imported drugs for autologous peripheral blood stem cell harvest (autoPBSCH) and autologous peripheral blood stem cell transplantation (autoPBSCT) have been studied widely; however, evidence of the safety and efficacy of domestically manufactured filgrastim is limited. Therefore, we compared the efficacy and safety of domestic biosimilar filgrastim (BF1, n=23) with those of originator filgrastim (OF, n=21) for autoPBSCH and autoPBSCT. Before autoPBSCH, the same median total dose of 3.3 mg filgrastim was administered to patients in the BF1 and OF groups. Median numbers of CD34-positive cells harvested did not significantly differ between BF1 (4.32×106/kg) and OF (4.75×106/kg) groups. After autoPBSCT, the median total doses of BF1 and OF used for neutrophil recovery were 2.7 and 3.3 mg, respectively. There were no significant inter-group differences in the time to bone marrow recovery, total transfusion units, hospitalization duration, overall survival at 1 year, or adverse events. Compared with OF, the cost of BF1 was considerably lower by 229,529 yen per transplantation case. Thus, the efficacy and safety of BF1 were comparable to those of OF, making BF1 an effective and economical alternative to OF.
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Affiliation(s)
- Masaki Iino
- Department of Hematology, Yamanashi Prefectural Central Hospital.,Department of Medical Oncology, Yamanashi Prefectural Central Hospital
| | - Takeo Yamamoto
- Department of Medical Oncology, Yamanashi Prefectural Central Hospital
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Nakamura A, Kojima Y, Miyazawa K, Matsumoto S, Iida H, Nagai H. Clinical Impact of Aprepitant in Patients Receiving High-Dose Chemotherapy prior to Autologous Peripheral Blood Stem Cell Transplantation: A Cost-Effectiveness Analysis. Oncology 2017; 93:302-308. [PMID: 28848220 DOI: 10.1159/000479032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 01/06/2017] [Accepted: 06/26/2017] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To evaluate the clinical and cost benefits of the administration of aprepitant for the prophylaxis of chemotherapy-induced nausea and vomiting (CINV) during high-dose chemotherapy (HDCT). METHODS We retrospectively reviewed the charts of patients who received HDCT at our institution between January 2009 and December 2013. Cost-effectiveness was analyzed using direct medical costs. RESULTS We identified a total of 38 patients (27 with non-Hodgkin lymphoma and 11 with multiple myeloma). Thirteen patients received aprepitant and granisetron (aprepitant group) for CINV prophylaxis, whereas 25 patients received granisetron only (non-aprepitant group). The incidence of severe nausea (≥grade 3) was significantly lower in the aprepitant group than in the non-aprepitant group (p = 0.039). The total mean cost per patient during hospitalization, excluding the cost of HDCT and transplantation, was USD 10,941.8 in the aprepitant group and USD 14,577.2 in the non-aprepitant group (p = 0.041). This cost benefit reflected reductions in the costs of hospitalization, transfusion, and infection treatment. CONCLUSIONS Our data indicated that the addition of aprepitant for CINV prophylaxis during HDCT reduced the incidence of severe nausea and might also provide economic benefit in the overall management of HDCT prior to autologous peripheral blood stem cell transplantation.
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Affiliation(s)
- Ayumi Nakamura
- Department of Pharmacy, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
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Mizutani M, Takami A, Hara M, Mizuno S, Yanada M, Chou T, Uchiyama H, Ohashi K, Miyamoto T, Ozawa Y, Imataki O, Kobayashi N, Uchida N, Kanamori H, Kamimura T, Eto T, Onizuka M, Tanaka J, Atsuta Y, Yano S. Comparison of Autologous and Unrelated Transplants for Cytogenetically Normal Acute Myelogenous Leukemia. Biol Blood Marrow Transplant 2017; 23:1447-1454. [PMID: 28533061 DOI: 10.1016/j.bbmt.2017.05.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [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: 02/20/2017] [Accepted: 05/09/2017] [Indexed: 11/26/2022]
Abstract
Allogeneic stem cell transplantation (SCT) from an HLA-matched sibling donor (MSD) is a postremission treatment that offers a potential cure for adults with cytogenetically normal (CN) acute myelogenous leukemia (AML) in first complete remission (CR1). The best alternative in the absence of an MSD remains unclear, however. The aim of this study was to retrospectively compare the outcomes of autologous peripheral blood stem cell transplantation (auto-PBSCT; n = 177) and allogeneic bone marrow transplantation (BMT) from an HLA-matched unrelated donor (MUD; n = 173) in adult patients with CN-AML/CR1. Both the multivariate analysis (hazard ratio [HR], 1.18; 95% confidence interval [CI], 0.71 to 1.97; P = .53) and propensity score models (HR, 1.40; 95% CI, 0.80 to 2.43; P = .24) indicated that the leukemia-free survival (LFS) rate of auto-PBSCT was not significantly different from that of MUD-BMT. These results suggest that in the absence of an available MSD, auto-PBSCT remains a viable alternative as postremission therapy in patients with CN-AML/CR1.
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Affiliation(s)
- Motonori Mizutani
- Division of Hematology, Department of Internal Medicine, School of Medicine, Aichi Medical University, Nagakute, Japan
| | - Akiyoshi Takami
- Division of Hematology, Department of Internal Medicine, School of Medicine, Aichi Medical University, Nagakute, Japan.
| | - Masahiko Hara
- Department of Medical Innovation, Osaka University Hospital, Suita, Japan
| | - Shohei Mizuno
- Division of Hematology, Department of Internal Medicine, School of Medicine, Aichi Medical University, Nagakute, Japan
| | - Masamitsu Yanada
- Department of Hematology, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Takaaki Chou
- Department of Internal Medicine, Niigata Cancer Center Hospital, Niigata, Japan
| | - Hitoji Uchiyama
- Department of Hematology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Kazuteru Ohashi
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Toshihiro Miyamoto
- Department of Hematology and Oncology, Kyushu University Hospital, Fukuoka, Japan
| | - Yukiyasu Ozawa
- Department of Hematology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan
| | - Osamu Imataki
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Kagawa University Hospital, Kagawa, Japan
| | - Naoki Kobayashi
- Department of Hematology, Sapporo Hokuyu Hospital, Hokkaido, Japan
| | - Naoyuki Uchida
- Department of Hematology, Federation of National Public Service Personnel Mutual Aid Associations Toranomon Hospital, Tokyo, Japan
| | - Heiwa Kanamori
- Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan
| | | | - Tetsuya Eto
- Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan
| | - Makoto Onizuka
- Department of Hematology and Oncology, Tokai University School of Medicine, Kanagawa, Japan
| | - Junji Tanaka
- Department of Hematology, Tokyo Women's Medical University, Tokyo, Japan
| | - Yoshiko Atsuta
- Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan; Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shingo Yano
- Division of Clinical Oncology and Hematology, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan
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Alonso S, Cabrero M, Caballero JC, Dávila J, de la Calle VG, López-Godino O, López-Corral L, Pérez E, Vázquez L, Corral R, Caballero D, Del Cañizo C, Mateos MV. Acute graft-versus-host disease and bronchiolitis obliterans after autologous stem cell transplantation in a patient with multiple myeloma. Clin Case Rep 2015; 3:370-5. [PMID: 26185631 PMCID: PMC4498845 DOI: 10.1002/ccr3.231] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 10/19/2014] [Revised: 12/30/2014] [Accepted: 01/20/2015] [Indexed: 12/22/2022] Open
Abstract
Sixty-seven-year-old patient, diagnosed with multiple myeloma who had received autologous stem cell transplantation, following bortezomib, dexamethasone and thalidomide conventional regimen, achieving complete response, developed rash, diarrhea, and severe respiratory failure, 80 days after the transplantation procedure. He was diagnosed with graft-versus-host disease and bronchiolitis obliterans syndrome.
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Affiliation(s)
- Sara Alonso
- Hematology Department, University Hospital of Salamanca Salamanca, Spain
| | - Mónica Cabrero
- Hematology Department, University Hospital of Salamanca Salamanca, Spain
| | - Juan C Caballero
- Hematology Department, University Hospital of Salamanca Salamanca, Spain
| | - Julio Dávila
- Hematology Department, University Hospital of Salamanca Salamanca, Spain
| | | | | | - Lucia López-Corral
- Hematology Department, University Hospital of Salamanca Salamanca, Spain
| | - Estefanía Pérez
- Hematology Department, University Hospital of Salamanca Salamanca, Spain
| | - Lourdes Vázquez
- Hematology Department, University Hospital of Salamanca Salamanca, Spain
| | - Rocío Corral
- Hematology Department, University Hospital of Salamanca Salamanca, Spain
| | - Dolores Caballero
- Hematology Department, University Hospital of Salamanca Salamanca, Spain
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Suh C, Kim SH, Kim HJ, Jang G, Kim EK, Ko OB, Kim S, Sohn HJ, Lee JS, Kim MW, Huh J. Prognostic factors in non-Hodgkin's lymphoma patients treated by autologous stem cell transplantation: a single center experience. Cancer Res Treat 2005; 37:294-301. [PMID: 19956530 DOI: 10.4143/crt.2005.37.5.294] [Citation(s) in RCA: 3] [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: 04/18/2005] [Accepted: 08/11/2005] [Indexed: 11/21/2022] Open
Abstract
PURPOSE Autologous stem cell transplantation (ASCT) is increasingly used in patients with non-Hodgkin's lymphoma (NHL). Various clinical parameters-were evaluated to obtain significant predictors of the outcome following ASCT in patients with NHL. MATERIALS AND METHODS Between April 1994 and December 2003, ASCT was performed on 80 patients with NHL at the Asan Medical Center. RESULTS Patients had various histological subtypes and disease status. The two year progression free survival (PFS) and overall survival for all patients were 34 and 31%, respectively. A univariate analysis showed the performance status, stage, modified extranodal involvement category, International Prognostic Index (IPI) at mobilization, disease status at mobilization, and history of radiation prior to mobilization as significant predictors of the outcome following ASCT. Four risk groups, with different 2 year PFS, were identified by the age adjusted IPI at mobilization (mAAIPI): low risk 44%; low intermediate risk 40%; high intermediate risk 19%; and high risk 0% (p=.0003). A multivariate analysis revealed 3 significant factors for the PFS: disease status, prior RT and mAAIPI. CONCLUSION The mAAIPI was found to be an independent predictor of the outcome of NHL patients undergoing ASCT. This powerful prognostic tool should be used to evaluate potential candidates for ASCT.
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Affiliation(s)
- Cheolwon Suh
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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