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Jaworek AK, Sacha T, Woźniak-Knop M, Hałubiec P, Giza A, Wojas-Pelc A. Papular-purpuric "gloves and socks" syndrome in systemic mastocytosis treated with imatinib: a diagnostic challenge. Pol Arch Intern Med 2024:16730. [PMID: 38640058 DOI: 10.20452/pamw.16730] [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: 04/21/2024]
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Witkowska M, Drozd-Sokołowska J, Waszczuk-Gajda A, Giza A, Lewicka B, Zdziarska J, Mikulski D, Smolewski P. Autoimmune cytopenias in patients with malignant lymphoma: A multicenter report by the Polish Lymphoma Research Group. ADV CLIN EXP MED 2023; 33:0-0. [PMID: 38014929 DOI: 10.17219/acem/174502] [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] [Received: 07/05/2023] [Revised: 08/20/2023] [Accepted: 10/25/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND Autoimmune cytopenias (ACs), including immune thrombocytopenia (ITP), autoimmune hemolytic anemia (AIHA) and autoimmune granulocytopenia, are rare complications observed in lymphoma patients. They may appear before, during or after lymphoma diagnosis, whether the patients had disease progression or not. OBJECTIVES This study aims to correlate ACs with lymphoma type, disease course and prognosis. We performed a multicenter retrospective analysis of adult patients with malignant lymphoma and ACs coexistence diagnosed and treated in centers aligned with the Polish Lymphoma Research Group (PLRG). MATERIAL AND METHODS The analysis covers the years 2016-2022 and included 51 patients comprised of 23 women and 28 men. Of these, 35 patients were diagnosed with AIHA, 15 patients with ITP and 1 patient with both AIHA and ITP. RESULTS The most common type of lymphoma was Hodgkin lymphoma (HL) (12 patients) and diffuse large B-cell lymphoma (DLBCL) (14 patients). At the time of diagnosis, 31 (61%) of patients had stage 4 of HL or DLBCL, according to Ann Arbor classification. In total, the response to treatment was evaluated in 50 patients, with 25 being in complete remission and 6 in partial remission. We observed that B cell symptoms (p = 0.036), bone marrow involvement (p = 0.073), splenomegaly (p = 0.025), and more than 2 lines of treatment were more common in AIHA compared to ITP patients. Conversely, eucopenia (p = 0.056) and ACs without lymphoma progression (p = 0.002) were more often diagnosed in ITP patients. CONCLUSIONS In the study group, relapsed and refractory disease was observed more often, and shorter overall survival (OS) was noted in patients with DLBCL. We found that AC is associated with a worse prognosis in comparison to the general population of lymphoma patients. There were no differences in response to AC therapy. To have more accurate data, a larger group, as part of a multicenter study, should be evaluated.
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Affiliation(s)
| | - Joanna Drozd-Sokołowska
- Department of Hematology, Transplantation and Internal Medicine, Medical University of Warsaw, Poland
| | - Anna Waszczuk-Gajda
- Department of Hematology, Transplantation and Internal Medicine, Medical University of Warsaw, Poland
| | - Agnieszka Giza
- Department of Hematology, Jagiellonian University Medical College, Cracow, Poland
| | - Barbara Lewicka
- Department of Hematology, Jagiellonian University Medical College, Cracow, Poland
| | - Joanna Zdziarska
- Department of Hematology, Jagiellonian University Medical College, Cracow, Poland
| | - Damian Mikulski
- Department of Biostatistics and Translational Medicine, Medical University of Lodz, Poland
| | - Piotr Smolewski
- Department of Experimental Hematology, Medical University of Lodz, Poland
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Giza A, Miklusiak K, Hałubiec P, Jaworek A, Zimowska-Curyło D, Dyduch G, Sacha T. Immediate Response to Brentuximab Vedotin in a Patient with Localized MF-LCT. Case Rep Dermatol 2023; 15:110-116. [PMID: 37497303 PMCID: PMC10368084 DOI: 10.1159/000529576] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 01/31/2023] [Indexed: 07/28/2023] Open
Abstract
The large cell transformation of mycosis fungoides (MF-LCT) is a phenomenon observed in the advanced stages of mycosis fungoides (MF), which is the most common primary cutaneous lymphoma. The diagnostic criteria of MF-LCT are a minimum of 25% of large cells or a formation of microscopic nodules of them in the histological examination of skin samples. The clinical outcomes for MF-LCT are poor, as less than 20% of patients survive 5 years after diagnosis, but the expression of the CD30 antigen is generally considered to be associated with a better prognosis. We present a case of a patient with the diagnosis of MF with LCT, with an ulcerated tumor lesion approximately 30 × 20 cm in size on the right lateral abdominal wall. Brentuximab vedotin (BV) treatment was started due to the presence of the CD30 antigen, with a quick and impressive regression of the cutaneous lesion and tumor mass and good treatment tolerance. After follow-up of 20 months, patient remains in complete remission. A schedule of treatment for MF-LCT is directed mainly by the clinical stage of the disease and the comorbidities; the more severe clinical course of the disease requires systemic treatment. If at least 5% of the cells found in the skin lesions biopsy sample express the CD30 antigen, a beneficial effect of BV treatment could be expected. It may seem that the use of BV is one of the optimal therapeutic options in patients with advanced MF-LCT showing expression of CD30.
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Affiliation(s)
- Agnieszka Giza
- Department of Hematology, Jagiellonian University Medical College, Kraków, Poland
| | - Karol Miklusiak
- Department of Hematology, Jagiellonian University Medical College, Kraków, Poland
| | - Przemysław Hałubiec
- Student Scientific Group, Department of Dermatology, Jagiellonian University Medical College, Kraków, Poland
| | - Andrzej Jaworek
- Department of Dermatology, Jagiellonian University Medical College, Kraków, Poland
| | | | - Grzegorz Dyduch
- Department of Pathomorphology, Jagiellonian University Medical College, Kraków, Poland
| | - Tomasz Sacha
- Department of Hematology, Jagiellonian University Medical College, Kraków, Poland
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Paszkiewicz-Kozik E, Hus I, Palka M, Dębowska M, Końska A, Kotarska M, Tyczyńska A, Joks M, Twardosz M, Giza A, Wąsik-Szczepanek E, Kalicińska E, Wiśniewska A, Morawska M, Lewicka B, Szymański M, Targoński Ł, Romejko-Jarosińska J, Drozd-Sokołowska J, Subocz E, Swoboda R, Długosz-Danecka M, Lech-Maranda E, Walewski J. Early efficacy and safety of obinutuzumab with chemotherapy in previously untreated patients with follicular lymphoma: A real-world retrospective report of the Polish Lymphoma Research Group. ADV CLIN EXP MED 2023; 32:131-136. [PMID: 36603138 DOI: 10.17219/acem/157290] [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] [Received: 08/03/2022] [Revised: 09/14/2022] [Accepted: 12/09/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND The first-line obinutuzumab-based immunochemotherapy improves the outcome of patients with follicular lymphoma (FL) compared with rituximab-based regimens. However, infusion-related reactions occur in almost half of patients during the 1st obinutuzumab administration. OBJECTIVES The study aimed to evaluate the early effectiveness and safety of obinutuzumab-based induction regimens in a real-world setting. MATERIAL AND METHODS Outcomes of patients diagnosed with FL and treated with obinutuzumab between January 2020 and September 2021 were analyzed. RESULTS The study group included 143 treatment-naïve patients with FL. The median age was 52 years (range: 28-89 years); 45.1% of patients had a high-risk disease as assessed using the Follicular Lymphoma International Prognostic Index (FLIPI). Induction chemotherapy included: O-CVP (obinutuzumab, cyclophosphamide, vincristine, prednisolone) in 49.0% of patients, O-CHOP (O-CVP plus doxorubicin) in 28.7% and O-BENDA (obinutuzumab, bendamustine) in 22.4%. Complete response (CR) and partial response (PR) rates were 69.9% and 26.5%, respectively. There was no difference in response rates between different regimens (p = 0.309). Maintenance was started in 115 patients (85.2%). In the 1st cycle, obinutuzumab was administered as a single 1000-milligram infusion in 47.9% of patients, whereas in 52.1%, initial infusions were split over 2 days (100 mg/900 mg). Infusion-related reactions were reported only during the 1st administration of obinutuzumab in 9.1% of patients, with a similar incidence in those receiving the total dose on a single day or split over 2 days (p = 0.458). The most common adverse events were hematological. Five patients died from coronavirus disease 2019 (COVID-19). CONCLUSION The early responses to induction regimens and adverse events profile were similar for every type of induction treatment. The infusion-related reactions were rare and limited to the 1st dose of obinutuzumab.
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Affiliation(s)
- Ewa Paszkiewicz-Kozik
- Department of Lymphoid Malignancies, Maria Sklodowska-Curie National Research Institute of Oncology, Warszawa, Poland
| | - Iwona Hus
- Department of Hematology, Institute of Hematology and Transfusion Medicine, Warszawa, Poland
| | - Monika Palka
- Department of Lymphoid Malignancies, Maria Sklodowska-Curie National Research Institute of Oncology, Kraków, Poland
| | - Małgorzata Dębowska
- Department of Mathematical Modeling of Physiological Processes, Nalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, Warszawa, Poland.,Department of Computational Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Warszawa, Poland
| | - Agnieszka Końska
- Department of Hematology, Institute of Hematology and Transfusion Medicine, Warszawa, Poland
| | - Martyna Kotarska
- Department of Lymphoid Malignancies, Maria Sklodowska-Curie National Research Institute of Oncology, Warszawa, Poland
| | - Agata Tyczyńska
- Department of Hematology and Transplantology, Medical University of Gdańsk, Poland
| | - Monika Joks
- Department of Hematology and Marrow Transplantation, Poznan University of Medical Sciences, Poland
| | - Maja Twardosz
- Department of Bone Marrow Transplantation and Oncohematology, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice, Poland
| | - Agnieszka Giza
- Department of Hematology, Jagiellonian University Medical College, Kraków, Poland
| | - Ewa Wąsik-Szczepanek
- Department of Hematooncology and Bone Marrow Transplantation, Medical University in Lublin, Poland
| | | | - Anna Wiśniewska
- Department of Oncology and Chemotherapy, Nicolas Copernicus State Hospital, Koszalin, Poland
| | - Marta Morawska
- Department of Hematology, St. John's Cancer Center, Lublin, Poland
| | - Barbara Lewicka
- Department of Hematology, Ludwik Rydygier Hospital, Kraków, Poland
| | - Marcin Szymański
- Department of Lymphoid Malignancies, Maria Sklodowska-Curie National Research Institute of Oncology, Warszawa, Poland
| | - Łukasz Targoński
- Department of Lymphoid Malignancies, Maria Sklodowska-Curie National Research Institute of Oncology, Warszawa, Poland
| | - Joanna Romejko-Jarosińska
- Department of Lymphoid Malignancies, Maria Sklodowska-Curie National Research Institute of Oncology, Warszawa, Poland
| | - Joanna Drozd-Sokołowska
- Department of Hematology, Transplantation and Internal Diseases, Medical University of Warsaw, Poland
| | - Edyta Subocz
- Department of Hematology, Warmian-Masurian Cancer Center of the Ministry of the Interior and Administration Hospital, Olsztyn, Polan
| | - Ryszard Swoboda
- Department of Bone Marrow Transplantation and Oncohematology, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice, Poland
| | - Monika Długosz-Danecka
- Department of Lymphoid Malignancies, Maria Sklodowska-Curie National Research Institute of Oncology, Kraków, Poland
| | - Ewa Lech-Maranda
- Department of Hematology, Institute of Hematology and Transfusion Medicine, Warszawa, Poland
| | - Jan Walewski
- Department of Lymphoid Malignancies, Maria Sklodowska-Curie National Research Institute of Oncology, Warszawa, Poland
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Lebowa W, Miklusiak K, Chukwu O, Giza A, Sacha T. QUALITY OF LIFE IN HEMATOLOGICAL PATIENTS IN THE POST-COVID ERA. Hematol Transfus Cell Ther 2022. [PMCID: PMC9529925 DOI: 10.1016/j.htct.2022.09.1257] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Objective Methodology Results Conclusion
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Kalicińska E, Giza A, Zaucha JM, Giebel S, Zimowska‐Curyło D, Andrasiak I, Spychałowicz W, Wojnar J, Balcerzak A, Romejko‐Jarosińska J, Paszkiewicz‐Kozik E, Knopińska‐Posłuszny W, Rybka J, Jabłonowska P, Wróbel T. A survey across orbital lymphoma in Poland: Multicenter retrospective study of polish lymphoma research group (PLRG). Cancer Med 2022; 12:3036-3045. [PMID: 36161781 PMCID: PMC9939129 DOI: 10.1002/cam4.5223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 08/16/2022] [Accepted: 08/23/2022] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE To investigate the prevalence of histopathological subtypes, the clinical stage at presentation and treatment modalities in Polish patients with orbital lymphoma (OL) and to determine prognostic outcomes. METHODS The retrospective study of 107 patients with OL treated in a 14-year period in Polish hematological centers. The analysis included histopathological subtype, disease clinical advancement, treatment modalities, progression-free survival (PFS), and overall survival (OS). RESULTS The median patient age was 60 years (range 51-71). Mucosa-associated lymphoid tissue (MALT) lymphoma accounted for slightly more than half of all cases of orbital lymphoma (51%). The second most common subtype was diffuse large B-cell lymphoma (DLBCL) (29%). Primary orbital lymphoma was diagnosed in 48% of all patients. According to the Ann Arbor, localized stage IE of orbital lymphoma was diagnosed only in 39% of all patients. Systemic involvement was observed in more than half of all patients (52%). The median follow-up period was 30 months (range 0-160 months). Patients with non-MALT lymphoma had a significantly inferior PFS compared to patients with MALT lymphoma, (p = 0.047). Patients with primary orbital lymphoma had a superior PFS compared to patients with secondary orbital lymphoma [median PFS 104.5 months vs. 33.4 months], (p = 0.069). Younger patients with MALT lymphoma were characterized by superior PFS (median PFS not reached) compared to other studied subgroups of patients (older patients with MALT lymphoma, younger and older non-MALT lymphoma patients) with a median PFS of 30.5, 32.2, 32.6 months respectively (p = 0.039). Patients treated with chemotherapy alone had inferior PFS compared to patients treated with combined therapies (p = 0.034). The median PFS across patients who received chemotherapy alone was 23.7 months, whereas across other patients was 73.9 months. CONCLUSIONS Secondary lymphoma accounts for more than half of the orbital lymphoma in Polish population. The advanced clinical stage of the disease (non-IE according to Ann Arbor) concerns two-thirds of the overall population of patients with orbital lymphomas and one-third of MALT lymphoma patients. The high incidence of advanced stages of orbital lymphoma may indicate the need for combined treatment. Combined orbital lymphoma treatment is associated with superior PFS compared to chemotherapy alone in overall population of patients with orbital lymphoma.
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Affiliation(s)
- Elżbieta Kalicińska
- Department of Hematology, Blood Neoplasms and Bone Marrow TransplantationWrocław Medical UniversityWrocławPoland
| | - Agnieszka Giza
- Department of HematologyJagiellonian University Medical CollegeKrakówPoland
| | - Jan Maciej Zaucha
- Department of Hematology and TransplantologyMedical University of GdańskGdańskPoland
| | - Sebastian Giebel
- Department of Bone Marrow Transplantation and OncohematologyMaria Sklodowska‐Curie National Research Institute of OncologyGliwicePoland
| | | | | | - Wojciech Spychałowicz
- Department of Internal Medicine and OncologySilesian Medical UniversityKatowicePoland
| | - Jerzy Wojnar
- Department of Internal Medicine and OncologySilesian Medical UniversityKatowicePoland
| | - Andrzej Balcerzak
- Department of Hematology and Bone Marrow TransplantationPoznan University of Medical SciencePoznańPoland
| | | | | | | | - Justyna Rybka
- Department of Hematology, Blood Neoplasms and Bone Marrow TransplantationWrocław Medical UniversityWrocławPoland
| | - Paula Jabłonowska
- Department of Hematology, Blood Neoplasms and Bone Marrow TransplantationWrocław Medical UniversityWrocławPoland
| | - Tomasz Wróbel
- Department of Hematology, Blood Neoplasms and Bone Marrow TransplantationWrocław Medical UniversityWrocławPoland
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Cramer P, Fürstenau M, Giza A, Robrecht S, Tausch E, Schneider C, Wendtner CM, Hoechstetter M, Schetelig J, Böttcher S, Dreger P, Fink AM, Langerbeins P, Al-Sawaf O, Fischer K, Stilgenbauer S, Eichhorst B, Hallek M. P641: RETREATMENT WITH VENETOCLAX AFTER VENETOCLAX, OBINUTUZUMAB +/- IBRUTINIB: POOLED ANALYSIS OF 13 PATIENTS WITH CHRONIC LYMPHOCYTIC LEUKEMIA (CLL) TREATED IN GCLLSG TRIALS. Hemasphere 2022. [DOI: 10.1097/01.hs9.0000845448.71709.3a] [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] Open
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Wawrzycka-Adamczyk K, Matyja-Bednarczyk A, Giza A, Chmura Ł, Kosałka-Węgiel J, Bazan-Socha S. Coexistence of ataxia‑telangiectasia syndrome and idiopathic CD4 lymphopenia: diagnostic difficulties in a complex immunodeficiency case report. Pol Arch Intern Med 2022; 132. [PMID: 35089678 DOI: 10.20452/pamw.16202] [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: 11/23/2022]
Affiliation(s)
| | | | - Agnieszka Giza
- Department of Hematology, Jagiellonian University Medical College, Kraków, Poland
| | - Łukasz Chmura
- Department of Pathomorphology, Jagiellonian University Medical College, Kraków, Poland
| | - Joanna Kosałka-Węgiel
- Department of Rheumatology and Immunology, Jagiellonian University Medical College, Kraków, Poland
| | - Stanisława Bazan-Socha
- Second Department of Internal Medicine, Jagiellonian University Medical College, Kraków, Poland
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Cramer P, Fürstenau M, Robrecht S, Giza A, Fink AM, Fischer K, Langerbeins P, Al Sawaf O, Tausch E, Schneider C, Schetelig J, Dreger P, Böttcher S, Kreuzer KA, Schilhabel A, Brüggemann M, Kneba M, Wendtner CM, Stilgenbauer S, Eichhorst B, Hallek M. BENDAMUSTINE, FOLLOWED BY OBINUTUZUMAB, ACALABRUTINIB AND VENETOCLAX IN PATIENTS (PTS) WITH RELAPSED/REFRACTORY CHRONIC LYMPHOCYTIC LEUKEMIA (CLL): CLL2‐BAAG TRIAL OF THE GCLLSG. Hematol Oncol 2021. [DOI: 10.1002/hon.34_2879] [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: 11/07/2022]
Affiliation(s)
- P Cramer
- University of Cologne Faculty of Medicine and University Hospital of Cologne Department I of Internal Medicine and German CLL Study Group Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Cologne Germany
| | - M Fürstenau
- University of Cologne Faculty of Medicine and University Hospital of Cologne Department I of Internal Medicine and German CLL Study Group Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Cologne Germany
| | - S Robrecht
- University of Cologne Faculty of Medicine and University Hospital of Cologne Department I of Internal Medicine and German CLL Study Group Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Cologne Germany
| | - A Giza
- University of Cologne Faculty of Medicine and University Hospital of Cologne Department I of Internal Medicine and German CLL Study Group Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Cologne Germany
| | - A. M Fink
- University of Cologne Faculty of Medicine and University Hospital of Cologne Department I of Internal Medicine and German CLL Study Group Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Cologne Germany
| | - K Fischer
- University of Cologne Faculty of Medicine and University Hospital of Cologne Department I of Internal Medicine and German CLL Study Group Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Cologne Germany
| | - P Langerbeins
- University of Cologne Faculty of Medicine and University Hospital of Cologne Department I of Internal Medicine and German CLL Study Group Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Cologne Germany
| | - O Al Sawaf
- University of Cologne Faculty of Medicine and University Hospital of Cologne Department I of Internal Medicine and German CLL Study Group Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Cologne Germany
| | - E Tausch
- University Hospital Ulm Department III of Internal Medicine Ulm Germany
| | - C Schneider
- University Hospital Ulm Department III of Internal Medicine Ulm Germany
| | - J Schetelig
- University Hospital Carl Gustav Carus Department I of Internal Medicine Dresden Germany
| | - P Dreger
- University Hospital Heidelberg Department V of Internal Medicine Heidelberg Germany
| | - S Böttcher
- University Hospital Rostock Department III of Internal Medicine Rostock Germany
| | - K. A Kreuzer
- Klinikum Schwabing Department of Hematology, Oncology, Immunology, Palliative Care Infectious Diseases and Tropical Medicine Munich Germany
| | - A Schilhabel
- University of Schleswig‐Holstein Campus Kiel, Department II of Internal Medicine, Kiel Germany
| | - M Brüggemann
- University of Schleswig‐Holstein Campus Kiel, Department II of Internal Medicine, Kiel Germany
| | - M Kneba
- University of Schleswig‐Holstein Campus Kiel, Department II of Internal Medicine, Kiel Germany
| | - C. M Wendtner
- Klinikum Schwabing Department of Hematology, Oncology, Immunology, Palliative Care Infectious Diseases and Tropical Medicine Munich Germany
| | - S Stilgenbauer
- University Hospital Ulm Department III of Internal Medicine Ulm Germany
| | - B Eichhorst
- University of Cologne Faculty of Medicine and University Hospital of Cologne Department I of Internal Medicine and German CLL Study Group Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Cologne Germany
| | - M Hallek
- University of Cologne Faculty of Medicine and University Hospital of Cologne Department I of Internal Medicine and German CLL Study Group Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Cologne Germany
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Liphard M, Giza A. Einflub des Schaums auf die Waschleistung unter Berücksichtigung neuer elektronischer Waschmaschinensteuerungen („fuzzy logic“) / The effect of foam on the washing performance with regard to new control systems for washing machines (“fuzzy logic”). TENSIDE SURFACT DET 2021. [DOI: 10.1515/tsd-1997-340608] [Citation(s) in RCA: 2] [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: 11/15/2022]
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Swoboda R, Giebel S, Knopińska-Posłuszny W, Chmielowska E, Drozd-Sokołowska J, Paszkiewicz-Kozik E, Kulikowski W, Taszner M, Mendrek W, Najda J, Czerw T, Olszewska-Szopa M, Czyż A, Giza A, Spychałowicz W, Subocz E, Szwedyk P, Krzywon A, Wilk A, Zaucha JM. Correction to: High efficacy of BGD (bendamustine, gemcitabine, and dexamethasone) in relapsed/refractory Hodgkin lymphoma. Ann Hematol 2021; 100:1919. [PMID: 33760951 PMCID: PMC8496665 DOI: 10.1007/s00277-021-04503-1] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Ryszard Swoboda
- Department of Bone Marrow Transplantation and Oncohematology, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice branch, Gliwice, Poland
| | - Sebastian Giebel
- Department of Bone Marrow Transplantation and Oncohematology, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice branch, Gliwice, Poland
| | | | - Ewa Chmielowska
- Oncologic Hospital, Tomaszów Mazowiecki, Poland
- Department of Oncology, Oncology Centre, Bydgoszcz, Poland
| | - Joanna Drozd-Sokołowska
- Department of Hematology, Oncology and Internal Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Ewa Paszkiewicz-Kozik
- Department of Lymphoid Malignancies, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw branch, Warsaw, Poland
| | - Waldemar Kulikowski
- Department of Hematology, Independent Public Health Care Ministry of the Interior of Warmia and Mazury Oncology Center, Olsztyn, Poland
| | - Michał Taszner
- Department of Hematology and Transplantology, Medical University of Gdańsk, Gdańsk, Poland
| | - Włodzimierz Mendrek
- Department of Bone Marrow Transplantation and Oncohematology, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice branch, Gliwice, Poland
| | - Jacek Najda
- Department of Bone Marrow Transplantation and Oncohematology, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice branch, Gliwice, Poland
| | - Tomasz Czerw
- Department of Bone Marrow Transplantation and Oncohematology, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice branch, Gliwice, Poland
| | - Magdalena Olszewska-Szopa
- Department of Hematology, Blood Neoplasms and Bone Marrow Transplantation, Wrocław Medical University, Wrocław, Poland
| | - Anna Czyż
- Department of Hematology, Blood Neoplasms and Bone Marrow Transplantation, Wrocław Medical University, Wrocław, Poland
| | - Agnieszka Giza
- Department of Hematology, Jagiellonian University, Krakow, Poland
| | | | - Edyta Subocz
- Department of Hematology, Military Institute of Medicine, Warsaw, Poland
| | - Paweł Szwedyk
- Department of Hematology, Ludwik Rydygier Hospital, Krakow, Poland
| | - Aleksandra Krzywon
- Department of Biostatistics and Bioinformatics, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - Agata Wilk
- Department of Biostatistics and Bioinformatics, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - Jan Maciej Zaucha
- Department of Hematology and Transplantology, Medical University of Gdańsk, Gdańsk, Poland.
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Góra M, Czopek A, Rapacz A, Giza A, Koczurkiewicz-Adamczyk P, Pękala E, Obniska J, Kamiński K. Design, Synthesis and Biological Activity of New Amides Derived from 3-Benzhydryl and 3-sec-Butyl-2,5-dioxo-pyrrolidin-1-yl-acetic Acid. ChemMedChem 2021; 16:1619-1630. [PMID: 33539029 DOI: 10.1002/cmdc.202001007] [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: 12/29/2020] [Revised: 01/26/2021] [Indexed: 12/25/2022]
Abstract
The aim of this study was to design and synthesize two new series of pyrrolidine-2,5-dione-acetamides with a benzhydryl or sec-butyl group at position 3 as potential anticonvulsants. Their anticonvulsant activity was evaluated in standard animal models of epilepsy: the maximal electroshock (MES), the 6 Hz, and the subcutaneous pentylenetetrazole (scPTZ) tests. The in vivo studies revealed the most potent anticonvulsant activity for 15 (3-(sec-butyl)-1-(2-(4-(3-trifluoromethylphenyl)piperazin-1-yl)-2-oxoethyl)pyrrolidine-2,5-dione), with ED50 values of 80.38 mg/kg (MES) and 108.80 mg/kg (6 Hz). The plausible mechanism of action was assessed in in vitro binding assays, in which 15 interacted effectively with voltage-gated sodium (site 2) and L-type calcium channels at a concentration of 100 μM. Subsequently, the antinociceptive activity of compounds 7 and 15 was observed in the hot plate test of acute pain. Moreover, compounds 7, 11 and 15 demonstrated an analgesic effect in the formalin test of tonic pain. The hepatotoxic properties of the most effective compounds (7, 11 and 15) in HepG2 cells were also investigated.
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Affiliation(s)
- Małgorzata Góra
- Department of Medicinal Chemistry, Jagiellonian University Medical College, Faculty of Pharmacy, Medyczna 9, 30-688, Kraków, Poland
| | - Anna Czopek
- Department of Medicinal Chemistry, Jagiellonian University Medical College, Faculty of Pharmacy, Medyczna 9, 30-688, Kraków, Poland
| | - Anna Rapacz
- Department of Pharmacodynamics, Jagiellonian University Medical College, Faculty of Pharmacy, Medyczna 9, 30-688, Kraków, Poland
| | - Agnieszka Giza
- Department of Pharmacodynamics, Jagiellonian University Medical College, Faculty of Pharmacy, Medyczna 9, 30-688, Kraków, Poland
| | - Paulina Koczurkiewicz-Adamczyk
- Department of Pharmaceutical Biochemistry, Jagiellonian University Medical College, Faculty of Pharmacy, Medyczna 9, 30-688, Kraków, Poland
| | - Elżbieta Pękala
- Department of Pharmaceutical Biochemistry, Jagiellonian University Medical College, Faculty of Pharmacy, Medyczna 9, 30-688, Kraków, Poland
| | - Jolanta Obniska
- Department of Medicinal Chemistry, Jagiellonian University Medical College, Faculty of Pharmacy, Medyczna 9, 30-688, Kraków, Poland
| | - Krzysztof Kamiński
- Department of Medicinal Chemistry, Jagiellonian University Medical College, Faculty of Pharmacy, Medyczna 9, 30-688, Kraków, Poland
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13
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Swoboda R, Giebel S, Knopińska-Posłuszny W, Chmielowska E, Drozd-Sokołowska J, Paszkiewicz-Kozik E, Kulikowski W, Taszner M, Mendrek W, Najda J, Czerw T, Olszewska-Szopa M, Czyż A, Giza A, Spychałowicz W, Subocz E, Szwedyk P, Krzywon A, Wilk A, Zaucha JM. High efficacy of BGD (bendamustine, gemcitabine, and dexamethasone) in relapsed/refractory Hodgkin Lymphoma. Ann Hematol 2021; 100:1755-1767. [PMID: 33625572 PMCID: PMC8195914 DOI: 10.1007/s00277-021-04448-5] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 02/02/2021] [Indexed: 10/25/2022]
Abstract
The optimal salvage therapy in relapsed/refractory Hodgkin lymphoma (R/R HL) has not been defined so far. The goal of this multicenter retrospective study was to evaluate efficacy and safety of BGD (bendamustine, gemcitabine, dexamethasone) as a second or subsequent line of therapy in classical R/R HL. We have evaluated 92 consecutive R/R HL patients treated with BGD. Median age was 34.5 (19-82) years. Fifty-eight patients (63%) had received 2 or more lines of chemotherapy, 32 patients (34.8%) radiotherapy, and 21 patients (22.8%) an autologous hematopoietic stem cell transplantation (autoHCT). Forty-four patients (47.8%) were resistant to first line of chemotherapy. BGD therapy consisted of bendamustine 90 mg/m2 on days 1 and 2, gemcitabine 800 mg/m2 on days 1 and 4, dexamethasone 40 mg on days 1-4. Median number of BGD cycles was 4 (2-7). The following adverse events ≥ 3 grade were noted: neutropenia (22.8%), thrombocytopenia (20.7%), anemia (15.2%), infections (10.9%), AST/ALT increase (2.2%), and skin rush (1.1%). After BGD therapy, 51 (55.4%) patients achieved complete remission, 23 (25%)-partial response, 7 (7.6%)-stable disease, and 11 (12%) patients experienced progression disease. AutoHCT was conducted in 42 (45.7%) patients after BGD therapy, and allogeneic HCT (alloHCT) in 16 (17.4%) patients. Median progression-free survival was 21 months. BGD is a highly effective, well-tolerated salvage regimen for patients with R/R HL, providing an excellent bridge to auto- or alloHCT.
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Affiliation(s)
- Ryszard Swoboda
- Department of Bone Marrow Transplantation and Oncohematology, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice branch, Gliwice, Poland
| | - Sebastian Giebel
- Department of Bone Marrow Transplantation and Oncohematology, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice branch, Gliwice, Poland
| | | | - Ewa Chmielowska
- Oncologic Hospital, Tomaszów Mazowiecki, Poland.,Department of Oncology, Oncology Centre, Bydgoszcz, Poland
| | - Joanna Drozd-Sokołowska
- Department of Hematology, Oncology and Internal Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Ewa Paszkiewicz-Kozik
- Department of Lymphoid Malignancies, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw branch, Warsaw, Poland
| | - Waldemar Kulikowski
- Department of Hematology, Independent Public Health Care Ministry of the Interior of Warmia and Mazury Oncology Center, Olsztyn, Poland
| | - Michał Taszner
- Department of Hematology and Transplantology, Medical University of Gdańsk, Gdańsk, Poland
| | - Włodzimierz Mendrek
- Department of Bone Marrow Transplantation and Oncohematology, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice branch, Gliwice, Poland
| | - Jacek Najda
- Department of Bone Marrow Transplantation and Oncohematology, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice branch, Gliwice, Poland
| | - Tomasz Czerw
- Department of Bone Marrow Transplantation and Oncohematology, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice branch, Gliwice, Poland
| | - Magdalena Olszewska-Szopa
- Department of Hematology, Blood Neoplasms and Bone Marrow Transplantation, Wrocław Medical University, Wrocław, Poland
| | - Anna Czyż
- Department of Hematology, Blood Neoplasms and Bone Marrow Transplantation, Wrocław Medical University, Wrocław, Poland
| | - Agnieszka Giza
- Department of Hematology, Jagiellonian University, Krakow, Poland
| | - Wojciech Spychałowicz
- Internal Medicine and Oncology Clinic, Silesian Medical University, Katowice, Poland
| | - Edyta Subocz
- Department of Hematology, Military Institute of Medicine, Warsaw, Poland
| | - Paweł Szwedyk
- Department of Hematology, Ludwik Rydygier Hospital, Krakow, Poland
| | - Aleksandra Krzywon
- Department of Biostatistics and Bioinformatics, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - Agata Wilk
- Department of Biostatistics and Bioinformatics, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - Jan Maciej Zaucha
- Department of Hematology and Transplantology, Medical University of Gdańsk, Gdańsk, Poland.
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14
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Pluta P, Giza A, Kolenda M, Fendler W, Braun M, Chudobiński C, Chałubińska-Fendler J, Araszkiewicz M, Loga K, Lembas L, Witkowska M, Pluta A, Kolasiński J, Basta P, Kołacińska-Voytkuv A, Cieśla S, Jesionek-Kupnicka D, Jankau J, Kuczyński M, Kalinka E, Zadrożny M, Murawa D. Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) in Poland: analysis of patient series and practical guidelines for breast surgeons. Arch Med Sci 2020; 19:1243-1251. [PMID: 37732037 PMCID: PMC10507758 DOI: 10.5114/aoms.2020.100637] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Accepted: 09/07/2020] [Indexed: 09/22/2023] Open
Abstract
Introduction Although breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is infrequent, with less than 1000 noted cases worldwide, patients consenting for breast implant surgery should be aware of its risk. We describe the first Polish multicenter case-series data on BIA-ALCL patients and present diagnostic and treatment recommendation for breast surgeons. Material and methods In cooperation with the Polish Society of Surgical Oncology and Polish Lymphoma Research Group, we collected BIA-ALCL cases in Poland. Results We retrospectively reviewed clinical data of seven BIA-ALCL patients, diagnosed between July 2013 and November 2019. The median time from implant placement to the first BIA-ALCL symptoms was 65 months (range: 33-96 months). All the patients were exposed to textured implants at presentation. Capsulectomy with implant removal was performed in all the patients with immediate reimplantation in 2 cases. In a median follow-up of 19 months (range 5-81 months), there was no recurrence and all the patients stayed alive. Between 2013 and 2019, the incidence of BIA-ALCL in Polish female population age 30 and above ranged from 0 to 0.021/100 000/year. Conclusions BIA-ALCL is scarce in the Polish population. In a short-term follow-up, patients' prognosis remains excellent. Due to the withdrawal of roughly textured implants from the market and the exclusion of likely the most potent etiologic factor, it might be expected that the incidence of BIA-ALCL will become even rarer.
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Affiliation(s)
- Piotr Pluta
- Department of Surgical Oncology and Breast Diseases, Polish Mother’s Memorial Hospital – Research Institute, Lodz, Poland
| | - Agnieszka Giza
- Department of Hematology, Jagiellonian University Medical College, Krakow, Poland
| | | | - Wojciech Fendler
- Department of Radiation Oncology, Harvard Medical School, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Department of Biostatistics and Translational Medicine, Medical University of Lodz, Lodz, Poland
| | - Marcin Braun
- Department of Radiotherapy, Military Institute of Medicine, Warsaw, Poland
| | - Cezary Chudobiński
- Department of Radiology, Regional Oncology Centre, Copernicus Memorial Hospital, Lodz, Poland
| | | | - Michał Araszkiewicz
- Legal Advisor’s Office, Polish Mother’s Memorial Hospital – Research Institute, Lodz, Poland
| | - Karolina Loga
- Department of Radiotherapy and General Oncology, Regional Oncology Centre, Copernicus Memorial Hospital in Lodz, Medical University of Lodz, Lodz, Poland
| | | | - Magdalena Witkowska
- Department of Experimental Hematology, Medical University of Lodz, Lodz, Poland
| | - Agnieszka Pluta
- Department of Hematology, Medical University of Lodz, Lodz, Poland
| | | | - Paweł Basta
- Departament of Gynecology and Oncology, Jagiellonian University, Medical College Breast Unit of University Hospital, Krakow, Poland
| | | | - Sławomir Cieśla
- Clinic of General Surgery and Surgical Oncology, Faculty of Medicine and Health Sciences University, Zielona Gora, Poland
| | | | - Jerzy Jankau
- Department of Plastic Surgery, Gdansk Medical University, Gansk, Poland
| | | | - Ewa Kalinka
- Department of Oncology, Polish Mother’s Memorial Hospital – Research Institute, Lodz, Poland
| | - Marek Zadrożny
- Department of Surgical Oncology and Breast Diseases, Polish Mother’s Memorial Hospital – Research Institute, Lodz, Poland
| | - Dawid Murawa
- Clinic of General Surgery and Surgical Oncology, Faculty of Medicine and Health Sciences University, Zielona Gora, Poland
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15
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Giza A, Gałązka K, Jońca M, Raźny M, Zimowska-Curyło D, Wilk M, Goldman-Mazur S, Piątkowska-Jakubas B, Sacha T. Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) with probable mesentery involvement with associated hemophagocytic syndrome (HPS) - how to treat it? J DERMATOL TREAT 2020; 33:2674-2676. [PMID: 32924664 DOI: 10.1080/09546634.2020.1809624] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Subcutaneous panniculitis-like T-cell lymphoma (SPTL) is a rare, cutaneous lymphoma involving subcutaneous adipose tissue. SPTL is associated in less than 20% with hemophagocytic syndrome (HPS). A 5-year overall survival rate is inferior in pts with SPTLand HPS (46%) as compared with 91% in pts without HPS. No standardized therapy for SPTCL has yet been established. A case of 35-year-old Caucasian man with a one-month history of B symptoms with the suspicion of Still's disease. At admission with leucopenia, high LDH, ferritin, sIl-R2, and triglycerides levels, hepatosplenomegaly, small right supraclavicular nodule, and irregular thickening of trunk subcutaneous tissue. The abdomen MRI showed generalized thickening of mesentery and colonic mucosa. In the patient diagnosis of SPTCL was established with secondary HPS. CHOEP chemotherapy and modified HLH 2014 protocol were applied with subsequent high dose chemotherapy (BEAM) supported by autologous stem cells transplantation. Treatment was complicated by pancytopenia and pneumonia. The outcome of the disease treated by intensive protocol seems to be good.
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Affiliation(s)
- Agnieszka Giza
- Department of Hematology, Jagiellonian University Medical College, ul. Kopernika 17, 31-501 Kraków, Poland
| | - Krystyna Gałązka
- Department of Clinical Patomorphology, Jagiellonian University Medical College, ul. Grzegórzecka 16, 31-531 Kraków, Poland
| | - Marcin Jońca
- Department of Hematology, Rydygier's Specialistic Hospital, Os. Złotej jesieni 1, 31-826 Kraków, Poland
| | - Małgorzata Raźny
- Department of Hematology, Rydygier's Specialistic Hospital, Os. Złotej jesieni 1, 31-826 Kraków, Poland
| | - Dagmara Zimowska-Curyło
- Department of Hematology, Jagiellonian University Medical College, ul. Kopernika 17, 31-501 Kraków, Poland
| | - Mateusz Wilk
- Department of Hematology, Jagiellonian University Medical College, ul. Kopernika 17, 31-501 Kraków, Poland
| | - Sarah Goldman-Mazur
- Department of Hematology, Jagiellonian University Medical College, ul. Kopernika 17, 31-501 Kraków, Poland
| | - Beata Piątkowska-Jakubas
- Department of Hematology, Jagiellonian University Medical College, ul. Kopernika 17, 31-501 Kraków, Poland
| | - Tomasz Sacha
- Department of Hematology, Jagiellonian University Medical College, ul. Kopernika 17, 31-501 Kraków, Poland
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16
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Szczepanek E, Kostkiewicz M, Małecka B, Giza A, Gałązka K, Tomkiewicz-Pająk L. Atypical course of infective endocarditis in a patient with complex congenital heart disease, chronic hepatitis B virus infection, and splenic marginal zone lymphoma. Pol Arch Intern Med 2020; 130:697-699. [PMID: 32426956 DOI: 10.20452/pamw.15367] [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: 11/23/2022]
Affiliation(s)
- Elżbieta Szczepanek
- Department of Cardiac and Vascular Diseases, Institute of Cardiology, Jagiellonian University Medical College, John Paul II Hospital, Kraków, Poland; Department of Hematology, Jagiellonian University Medical College, Kraków, Poland.
| | - Magdalena Kostkiewicz
- Department of Cardiac and Vascular Diseases, Institute of Cardiology, Jagiellonian University Medical College, John Paul II Hospital, Kraków, Poland
| | - Barbara Małecka
- Department of Cardiac and Vascular Diseases, Institute of Cardiology, Jagiellonian University Medical College, John Paul II Hospital, Kraków, Poland
| | - Agnieszka Giza
- Department of Hematology, Jagiellonian University Medical College, Kraków, Poland
| | - Krystyna Gałązka
- Department of Hematology, Jagiellonian University Medical College, Kraków, Poland
| | - Lidia Tomkiewicz-Pająk
- Department of Cardiac and Vascular Diseases, Institute of Cardiology, Jagiellonian University Medical College, John Paul II Hospital, Kraków, Poland
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17
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Ignacak E, Sułowicz J, Giza A, Cieniawski D, Kuźniewski M, Sułowicz W. Post-transplant Lymphoproliferative Disorder in a Patient After Kidney Transplant, 5-Year Follow-up: A Case Report. Transplant Proc 2020; 52:2517-2519. [PMID: 32222386 DOI: 10.1016/j.transproceed.2020.02.083] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Revised: 02/17/2020] [Accepted: 02/22/2020] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Post-transplant lymphoproliferative disorder (PTLD) is a serious, life-threatening complication in organ transplant patients receiving immunosuppressive therapy. The risk factors include Epstein-Barr virus infection and a cumulative dose of the immunosuppression. CASE REPORT We present a 5-year follow-up case of a 28-year-old patient with PTLD in the gastrointestinal tract. In the ninth month after kidney transplant, the patient was hospitalized for pain in the abdomen and diarrhea. Physical examination demonstrated tenderness in the area of the cecum, and colonoscopy revealed ulcerations in the large intestine. Polymorphic lymphoma (PTLD) was found in the collected samples. The patient received monotherapy treatment with anti-CD20 antibodies, resulting in complete remission of disease, confirmed by computed tomography scan and colonoscopy. CONCLUSION PTLD may have a different clinical course and should be considered in the differential diagnosis of patients after organ transplant.
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Affiliation(s)
- Ewa Ignacak
- Department of Nephrology, Jagiellonian University Medical College, Krakow, Poland
| | - Joanna Sułowicz
- Department of Dermatology, Jagiellonian University Medical College, Krakow, Poland.
| | - Agnieszka Giza
- Department of Hematology, Jagiellonian University Medical College, Krakow, Poland
| | - Dominik Cieniawski
- Department of Nephrology, Jagiellonian University Medical College, Krakow, Poland
| | - Marek Kuźniewski
- Department of Nephrology, Jagiellonian University Medical College, Krakow, Poland
| | - Władysław Sułowicz
- Department of Nephrology, Jagiellonian University Medical College, Krakow, Poland
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18
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Drozd-Sokolowska J, Zaucha JM, Biecek P, Giza A, Kobylinska K, Joks M, Wrobel T, Kumiega B, Knopinska-Posluszny W, Spychalowicz W, Romejko-Jarosinska J, Fischer J, Wiktor-Jedrzejczak W, Dlugosz-Danecka M, Giebel S, Jurczak W. Type 2 diabetes mellitus compromises the survival of diffuse large B-cell lymphoma patients treated with (R)-CHOP - the PLRG report. Sci Rep 2020; 10:3517. [PMID: 32103128 PMCID: PMC7044262 DOI: 10.1038/s41598-020-60565-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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] [Received: 07/31/2019] [Accepted: 02/10/2020] [Indexed: 12/01/2022] Open
Abstract
Comorbidities impair the prognosis of diffuse large B-cell lymphoma (DLBCL). Type 2 diabetes mellitus (DMT2) increases the risk of other comorbidities, e.g., heart failure (HF). Thus, we hypothesized that pre-existing DMT2 may negatively affect the outcome of DLBCL. To verify this, DLBCL patients treated with (R)-CHOP were enrolled. 469 patients were eligible, with a median age of 57 years; 356 patients had advanced-stage DLBCL. 126 patients had high-intermediate and 83 high-risk international prognostic index (IPI). Seventy-six patients had DMT2, 46 HF; 26 patients suffered from both DMT2 and HF. In the analyzed group DMT2 or HF significantly shortened overall survival (OS) and progression free survival (PFS): the 5-year OS for patients with DMT2 was 64% vs 79% and for those with HF: 49% vs 79%. The 5-year PFS for DMT2 was 50.6% vs 62.5% and for HF 39.4% vs 63.2%. The relapse/progression incidence was comparable between groups; the non-relapse/progression mortality (NRPM) was significantly higher solely in DMT2 patients (5-year NRPM 22.5% vs 8.4%). The risk of death was higher in patients with higher IPI (HR = 1.85) and with DMT2 (HR = 1.87). To conclude, pre-existing DMT2, in addition to a higher IPI and HF, was a negative predictor for OS and PFS.
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Affiliation(s)
- Joanna Drozd-Sokolowska
- Department of Hematology, Oncology and Internal Diseases, Medical University of Warsaw, Banacha 1a Str, 02-097, Warszawa, Poland
| | - Jan Maciej Zaucha
- Department of Hematology and Transplantology, Medical University of Gdansk, Smoluchowskiego 17 Str., 80-214, Gdansk, Poland.
| | - Przemyslaw Biecek
- Faculty of Mathematics and Information Science, Warsaw University of Technology, Koszykowa 75 Str., 00-662, Warszawa, Poland
| | - Agnieszka Giza
- Department of Hematology, Jagiellonian University, Mikołaja Kopernika 17 Str., 30-501, Krakow, Poland
| | - Katarzyna Kobylinska
- Faculty of Mathematics and Information Science, Warsaw University of Technology, Koszykowa 75 Str., 00-662, Warszawa, Poland
| | - Monika Joks
- Department of Hematology, University of Medical Sciences of Poznan, Szamarzewskiego 84 Str., 60-569, Poznan, Poland
| | - Tomasz Wrobel
- Department of Hematology, Wroclaw Medical University, Wybrzeże L. Pasteura 4 Str., 50-367, Wroclaw, Poland
| | - Beata Kumiega
- Department of Hematooncology, Markiewicz Memorial Oncology Center Brzozow, Ks. Bielawskiego 18 Str., 36-200, Brzozow, Poland
| | - Wanda Knopinska-Posluszny
- Hematology Department, Independent Public Health Care Ministry of the Interior of Warmia and Mazury Oncology Center, Aleja Wojska Polskiego 37 Str., 10-228, Olsztyn, Poland
| | - Wojciech Spychalowicz
- Internal Medicine and Oncology Clinic, Silesian Medical University, Reymonta 8 Str., 40-027, Katowice, Poland
| | - Joanna Romejko-Jarosinska
- Department of Lymphoid Malignancies, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Roentgena 5 Str., 02-781, Warszawa, Poland
| | - Joanna Fischer
- Department of Hematology, Jagiellonian University, Mikołaja Kopernika 17 Str., 30-501, Krakow, Poland
| | - Wieslaw Wiktor-Jedrzejczak
- Department of Hematology, Oncology and Internal Diseases, Medical University of Warsaw, Banacha 1a Str, 02-097, Warszawa, Poland
| | - Monika Dlugosz-Danecka
- Department of Hematology, Jagiellonian University, Mikołaja Kopernika 17 Str., 30-501, Krakow, Poland
| | - Sebastian Giebel
- Maria Sklodowska-Curie Institute-Cancer Center, Gliwice Branch, Wybrzeże Armii Krajowej 15 Str., 44-101, Gliwice, Poland
| | - Wojciech Jurczak
- Department of Hematology, Jagiellonian University, Mikołaja Kopernika 17 Str., 30-501, Krakow, Poland
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19
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Walewski J, Paszkiewicz-Kozik E, Michalski W, Rymkiewicz G, Szpila T, Butrym A, Giza A, Zaucha JM, Kalinka-Warzocha E, Wieczorkiewicz A, Zimowska-Curyło D, Knopińska-Posłuszny W, Tyczyńska A, Romejko-Jarosińska J, Dąbrowska-Iwanicka A, Gruszecka B, Jamrozek-Jedlińska M, Borawska A, Hołda W, Porowska A, Romanowicz A, Hellmann A, Stella-Hołowiecka B, Deptała A, Jurczak W. First-line R-CVP versus R-CHOP induction immunochemotherapy for indolent lymphoma with rituximab maintenance. A multicentre, phase III randomized study by the Polish Lymphoma Research Group PLRG4. Br J Haematol 2019; 188:898-906. [PMID: 31792945 PMCID: PMC7154735 DOI: 10.1111/bjh.16264] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [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: 08/12/2019] [Accepted: 10/01/2019] [Indexed: 12/12/2022]
Abstract
R‐CVP (cyclophosphamide, vincristine, prednisone) and R‐CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone + rituximab) are immunochemotherapy regimens frequently used for remission induction of indolent non‐Hodgkin lymphomas (iNHLs). Rituximab maintenance (RM) significantly improves progression‐free survival (PFS) in patients with complete/partial remission (CR/PR). Here we report the final results of a randomized study comparing R‐CVP to R‐CHOP both followed by RM. Untreated patients in need of systemic therapy with symptomatic and progressive iNHLs including follicular (FL) and marginal zone lymphoma (MZL), mucosa‐associated lymphoid tissue (MALT), small lymphocytic (SLL), and lymphoplasmacytic (LPL) lymphoma were eligible. Patients were randomized to receive R‐CVP or R‐CHOP for eight cycles or until complete response (CR). All patients with CR/PR (partial response) received RM 375 mg/m2 q 2 months for 12 cycles. Primary endpoint was event‐free survival (EFS). Two‐hundred and fifty patients [FL 42%, MZL/MALT 38%, LPL/ Waldenström Macroglobulinaemia (WM) 11%, SLL 9%] were enrolled and randomized (R‐CHOP: 127, R‐CVP: 123). Median age was 56 years (21–85), 44% were male, 90% were in stage III–IV, 43% of FL patients had a Follicular Lymphoma International Prognostic Index (FLIPI) score ≥3, and 33·4% of all patients had an IPI score ≥3. At the end of induction treatment, the CR/PR rate was 43·6/50·9% and 36·3/60·8% in the R‐CHOP and R‐CVP groups (P = 0·218) respectively. After a median follow‐up of 67, 66, and 70 months, five‐year EFS was 61% vs. 56% (not significant), progression‐free survival (PFS) was 71% vs. 69% (not significant) and overall survival (OS) was 84% vs. 89% in the R‐CHOP vs. the R‐CVP arm respectively. Grade III/IV adverse events (65 vs. 22) occurred in 40 (33·1%) and 18 (15·3%) patients, P = 0·001; neutropenia in 16 (11·6%) and 4 (3·4%) patients, P = 0·017; infection in 14 (10·7%) and 3 (2·5%) patients,; P = 0·011; and a second neoplasm in three versus seven patients., in the R‐CHOP and the R‐CVP groups respectively. This multicentre randomized study with >five‐year follow‐up shows similar outcome in patients with indolent lymphoma in need of systemic therapy treated with R‐CVP or R‐CHOP immunochemotherapy and rituximab maintenance in both arms. The minor toxicity of the R‐CVP regimen makes it a reasonable choice for induction treatment, leaving other active agents like doxorubicin or bendamustin for second‐line therapy.
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Affiliation(s)
- Jan Walewski
- Maria Sklodowska-Curie Institute - Oncology Center in Warsaw, Warsaw, Poland
| | | | - Wojciech Michalski
- Maria Sklodowska-Curie Institute - Oncology Center in Warsaw, Warsaw, Poland
| | - Grzegorz Rymkiewicz
- Maria Sklodowska-Curie Institute - Oncology Center in Warsaw, Warsaw, Poland
| | - Tomasz Szpila
- Institute of Hematology and Transfusiology, Warsaw, Poland
| | | | - Agnieszka Giza
- Jagiellonian University Collegium Medicum, Krakow, Poland
| | | | | | | | | | | | | | | | | | | | | | - Anna Borawska
- Maria Sklodowska-Curie Institute - Oncology Center in Warsaw, Warsaw, Poland
| | | | | | | | | | | | - Andrzej Deptała
- Central Clinical Hospital of the MSWiA, Warsaw, Poland.,Medical University of Warsaw, Warsaw, Poland
| | - Wojciech Jurczak
- Maria Sklodowska-Curie Institute - Oncology Center in Warsaw, Warsaw, Poland
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Malenda A, Kołkowska‐Leśniak A, Puła B, Długosz‐Danecka M, Chełstowska M, Końska A, Giza A, Lech‐Marańda E, Jurczak W, Warzocha K. Outcomes of treatment with dose‐adjusted EPOCH‐R or R‐CHOP in primary mediastinal large B‐cell lymphoma. Eur J Haematol 2019; 104:59-66. [DOI: 10.1111/ejh.13337] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 09/21/2019] [Accepted: 10/01/2019] [Indexed: 12/22/2022]
Affiliation(s)
- Agata Malenda
- Department of Hematology Institute of Hematology and Transfusion Medicine Warsaw Poland
| | | | - Bartosz Puła
- Department of Hematology Institute of Hematology and Transfusion Medicine Warsaw Poland
| | | | - Monika Chełstowska
- Department of Hematology Institute of Hematology and Transfusion Medicine Warsaw Poland
| | - Agnieszka Końska
- Department of Hematology Institute of Hematology and Transfusion Medicine Warsaw Poland
| | - Agnieszka Giza
- Department of Hematology Jagiellonian University Cracow Poland
| | - Ewa Lech‐Marańda
- Department of Hematology Institute of Hematology and Transfusion Medicine Warsaw Poland
- Department of Hematology and Transfusion Medicine Centre of Postgraduate Medicine Warsaw Poland
| | | | - Krzysztof Warzocha
- Department of Hematology Institute of Hematology and Transfusion Medicine Warsaw Poland
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21
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Jurczak W, Gruszka AM, Sowa Staszczak A, Dlugosz-Danecka M, Szostek M, Zimowska-Curylo D, Giza A, Krawczyk K, Jakobczyk M, Hubalewska-Dydejczyk A, Szymczyk M, Wróbel T, Knopińska-Posłuszny W, Kisiel E, Skotnicki A, Zinzani PL. Consolidation with 90Y ibritumomab tiuxetan radioimmunotherapy in mantle cell lymphoma patients ineligible for high dose therapy: results of the phase II multicentre Polish Lymphoma Research Group trial, after 8-year long follow-up. Leuk Lymphoma 2019; 60:2689-2696. [PMID: 30961415 DOI: 10.1080/10428194.2019.1602261] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 12/14/2022]
Abstract
Polish Lymphoma Research Group performed a phase-II trial to test whether 90Y ibritumomab tiuxetan radioimmunotherapy (Y90) may constitute an alternative consolidation for mantle cell lymphoma patients unfit for high-dose therapy. Forty-six patients were consolidated with Y90 following response to the 1st (n = 34) or 2nd line (n = 12) (immuno)chemotherapy. Majority of the patients had advanced disease (stage IV and presence of B-symptoms in 85% and 70%, respectively) and high MIPI (5.8, range 4-7). Consolidation with Y90 increased the complete remission (CR) rate obtained by the 1st line therapy from 41% to 91% and allowed for median PFS of 3.3 and OS of 6.5 years. In the first relapse, CR rate increased from 16% to 75%, while median PFS and OS totaled 2.2 and 6.5 years, respectively. At 8 years, 30% of patients, consolidated in the 1st line CR were alive, without relapse. Toxicity associated with Y90 is manageable, more severe after fludarabine-based regimens.
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Affiliation(s)
- Wojciech Jurczak
- Department of Haematology, Uniwersytet Jagiellonski w Krakowie Collegium Medicum, Krakow, Poland
| | - Alicja M Gruszka
- Department of Experimental Oncology, Istituto Europeo di Oncologia IRCCS, Milano, Italy
| | - Anna Sowa Staszczak
- Department of Endocrinology, Nuclear Medicine Unit, Uniwersytet Jagiellonski w Krakowie Collegium Medicum, Krakow, Poland
| | - Monika Dlugosz-Danecka
- Department of Haematology, Uniwersytet Jagiellonski w Krakowie Collegium Medicum, Krakow, Poland
| | - Marta Szostek
- Department of Haematology, Uniwersytet Jagiellonski w Krakowie Collegium Medicum, Krakow, Poland
| | - Dagmara Zimowska-Curylo
- Department of Haematology, Uniwersytet Jagiellonski w Krakowie Collegium Medicum, Krakow, Poland
| | - Agnieszka Giza
- Department of Haematology, Uniwersytet Jagiellonski w Krakowie Collegium Medicum, Krakow, Poland
| | - Katarzyna Krawczyk
- Department of Haematology, Uniwersytet Jagiellonski w Krakowie Collegium Medicum, Krakow, Poland
| | - Malgorzata Jakobczyk
- Department of Haematology, Uniwersytet Jagiellonski w Krakowie Collegium Medicum, Krakow, Poland
| | - Alicja Hubalewska-Dydejczyk
- Department of Endocrinology, Nuclear Medicine Unit, Uniwersytet Jagiellonski w Krakowie Collegium Medicum, Krakow, Poland
| | - Michal Szymczyk
- Department of Lymphoid Malignancies, Centrum Onkologii-Instytut im Marii Sklodowskiej-Curie w Warszawie, Warszawa, Poland
| | - Tomasz Wróbel
- Department of Haematology, Uniwersytet Medyczny im Piastow Slaskich we Wroclawiu, Wroclaw, Poland
| | - Wanda Knopińska-Posłuszny
- Department of Hematology, Independent Public Health Care of the Ministry of the Internal Affairs with the Oncology Centre, Olsztyn, Poland
| | | | - Aleksander Skotnicki
- Department of Haematology, Uniwersytet Jagiellonski w Krakowie Collegium Medicum, Krakow, Poland
| | - Pier Luigi Zinzani
- Policlinico "Sant'Orsola-Malpighi" - University of Bologna Institute of Hematology "Seràgnoli", Bologna, Italy
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Długosz-Danecka M, Szmit S, Kocurek A, Koźlik P, Giza A, Zimowska-Curyło D, Małkowski B, Sowa-Staszczak A, Kużdżał J, Jurczak W. Early chemotherapy de-escalation strategy in advanced-stage Hodgkin lymphoma patients with negative positron emission tomography scan after two escalated BEACOPP cycles. Pol Arch Intern Med 2019. [DOI: 10.20452/pamw.14786] [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: 08/30/2023]
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23
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Długosz-Danecka M, Krawczyk K, Ochrem B, Szymczyk M, Joks M, Boguradzki P, Giza A, Zimowska-Curyło D, Mazur G, Jurczak W. The necessity of post-induction therapy in mantle cell lymphoma patients: A multicenter retrospective real-world analysis by Polish Lymphoma Research Group (PLRG). POSTEP HIG MED DOSW 2019. [DOI: 10.5604/01.3001.0013.2520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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
Aim: Mantle cell lymphoma (MCL) patients have poor prognosis, due to development of chemoresistance in relapsing patients. Therefore, despite the features of indolent lymphoma at presentation, consolidation and/or maintenance strategies to achieve minimal tumor burden and postpone subsequent relapses remain the standard of care.
Material/Methods: In the retrospective analysis of Polish Lymphoma Research Group (PLRG), post-induction strategies were assessed in 355 MCL patients. Those in complete or partial remission (CR or PR) after induction regimen (n = 263, 74.08%) were consolidated with autologous stem cell transplantation (ASCT) (n = 71, 20%) or radioimmunotherapy (RIT, n = 37, 10.42%), subjected to rituximab maintenance (MR, n = 17, 4.79%) or had none post-induction treatment (NPI, n = 138, 38.87%). Responses to therapy, progression and overall survival (PFS and OS) were compared.
Results: CR after induction was significantly increased by consolidation strategies, from 68% to 95% in ASCT and from 43% to 90% in RIT cohort. Median PFS in patients subjected to ASCT and RIT was significantly higher compared to NPI group (2.3, 3.8 and 1.8 years respectively, p <0.05). Consolidation strategies also prolonged median OS (not reached in ASCT, 7.3 in RIT and 4 years in NPI cohort, p <0.005 ).
Conclusions: Our data confirms the efficacy of ASCT consolidation in selected patients and demonstrates that RIT may be regarded as an alternative consolidation strategy for patients not eligible for ASCT. At the time the study was performed, there were few possibilities to retreat elderly and comorbid patients; therefore, despite PFS benefit of RIT, younger, transplanted patients experienced a longer median OS.
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Affiliation(s)
| | | | - Bogdan Ochrem
- Department of Hematology, Jagiellonian University, Krakow, Poland
| | - Michał Szymczyk
- Maria Sklodowska-Curie Institute and Oncology Centre, Warsaw, Poland
| | - Monika Joks
- Department of Hematology and Bone Marrow Transplantation, Poznan University of Medical Sciences, Poznan, Poland
| | - Piotr Boguradzki
- Department of Hematology, Oncology and Internal Medicine, Central Clinical Hospital of the Ministry of the Interior in Warsaw, Warsaw, Poland
| | - Agnieszka Giza
- Department of Hematology, Jagiellonian University, Krakow, Poland
| | | | - Grzegorz Mazur
- Department of Hematology, Oncology and Internal Medicine, Central Clinical Hospital of the Ministry of the Interior in Warsaw, Warsaw, Poland
| | - Wojciech Jurczak
- Department of Hematology, Jagiellonian University, Krakow, Poland
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24
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Wróbel T, Biecek P, Rybka J, Szulgo A, Sorbotten N, Giza A, Tyczyńska A, Nowara E, Badora-Rybicka A, Adamowicz K, Kulikowski W, Kroll-Balcerzak R, Balcerzak A, Spychałowicz W, Kalinka-Warzocha E, Kumiega B, Drozd-Sokołowska J, Subocz E, Sałek A, Machaczka M, Hołojda J, Pogrzeba J, Dobrzyńska O, Chmielowska E, Jurczak W, Knopińska-Posłuszny W, Leśniewski-Kmak K, Maciej Zaucha J. Hodgkin lymphoma of the elderly patients: a retrospective multicenter analysis from the Polish Lymphoma Research Group. Leuk Lymphoma 2018; 60:341-348. [DOI: 10.1080/10428194.2018.1482539] [Citation(s) in RCA: 4] [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: 10/28/2022]
Affiliation(s)
- Tomasz Wróbel
- Department of Hematology, Wroclaw Medical University, Wrocław, Poland
| | - Przemysław Biecek
- Faculty of Mathematics and Information Science, Warsaw University of Technology, Warsaw, Poland
| | - Justyna Rybka
- Department of Hematology, Wroclaw Medical University, Wrocław, Poland
| | - Anna Szulgo
- Department of Oncology, Center of Oncology of Professor Franciszek Łukaszczyk, Bydgoszcz, Poland
| | - Natalia Sorbotten
- Department of Oncology, Center of Oncology of Professor Franciszek Łukaszczyk, Bydgoszcz, Poland
| | - Agnieszka Giza
- Department of Hematology, Collegium Medicum of the Jagiellonian University, Kraków, Poland
| | - Agata Tyczyńska
- Department of Oncology and Radiotherapy, Gdynia Oncology Center, Gdynia, Poland
| | - Elżbieta Nowara
- Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice, Poland
| | | | | | | | | | - Andrzej Balcerzak
- Department of Hematology, University of Medical Sciences, Poznan, Poland
| | - Wojciech Spychałowicz
- Internal Medicine and Oncology Clinic, Silesian Medical University, Katowice, Poland
| | | | - Beata Kumiega
- Department of Hematology, Brzozow Oncology Center, Brzozów, Poland
| | - Joanna Drozd-Sokołowska
- Department of Haematology, Oncology and Internal Medicine, The Medical University of Warsaw, Warsaw, Poland
| | - Edyta Subocz
- Department of Haematology, Military Institute of Medicine in Warsaw, Warsaw, Poland
| | - Agata Sałek
- Department of Hematology KSW No.1 and Medical Faculty, University of Rzeszow, Rzeszow, Poland
| | - Maciej Machaczka
- Department of Hematology KSW No.1 and Medical Faculty, University of Rzeszow, Rzeszow, Poland
| | - Jadwiga Hołojda
- Department of Hematology, Provincial Specialist Hospital, Legnica, Poland
| | - Joanna Pogrzeba
- Department of Hematology, Provincial Specialist Hospital, Opole, Poland
| | - Olga Dobrzyńska
- Department of Hematology, Wroclaw Medical University, Wrocław, Poland
| | - Ewa Chmielowska
- Department of Oncology, Center of Oncology of Professor Franciszek Łukaszczyk, Bydgoszcz, Poland
| | - Wojciech Jurczak
- Department of Hematology, Collegium Medicum of the Jagiellonian University, Kraków, Poland
| | | | - Krzysztof Leśniewski-Kmak
- Department of Oncology and Radiotherapy, Gdynia Oncology Center, Gdynia, Poland
- Department of Oncological Propaedeutics, Medical University of Gdańsk, Gdańsk, Poland
| | - Jan Maciej Zaucha
- Department of Oncology and Radiotherapy, Gdynia Oncology Center, Gdynia, Poland
- Department of Hematology and Transplantology, Medical University of Gdańsk, Gdańsk, Poland
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25
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Zaucha JM, Malkowski B, Chauvie S, Subocz E, Tajer J, Kulikowski W, Fijolek-Warszewska A, Biggi A, Fallanca F, Kobylecka M, Dziuk M, Woszczyk D, Rybka J, Kroll-Balcerzak R, Bergesio F, Romanowicz A, Chamier-Cieminska A, Kurczab P, Giza A, Lesniewski-Kmak K, Zaucha R, Swietlik D, Wróbel T, Knopinska-Posluszny W, Walewski J, Gallamini A. The predictive role of interim PET after the first chemotherapy cycle and sequential evaluation of response to ABVD in Hodgkin's lymphoma patients-the Polish Lymphoma Research Group (PLRG) Observational Study. Ann Oncol 2018; 28:3051-3057. [PMID: 28950332 DOI: 10.1093/annonc/mdx524] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [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 Interim PET after two ABVD cycles (iPET2) predicts treatment outcome in classical Hodgkin's lymphoma. To test whether an earlier assessment of chemosensitivity would improve the prediction accuracy, we launched a prospective, multicenter observational study aimed at assessing the predictive value of iPET after one ABVD (iPET1) and the kinetics of response assessed by sequential PET scanning. Patients and methods Consecutive patients with newly diagnosed classical Hodgkin's lymphoma underwent interim PET scan after one ABVD course (iPET1). PETs were interpreted according to the Deauville score (DS) as negative (-) (DS 1-3) and positive (+) (DS 4, 5). Patients with iPET1 DS 3-5 underwent iPET2. Results About 106 early (I-IIA) and 204 advanced (IIB-IV) patients were enrolled between January 2008 and October 2014. iPET1 was (-) in 87/106 (82%) or (+) in 19/106 (18%) of early, and (-) in 133/204 (65%) or (+) in 71/204 (35%) of advanced stage patients, respectively. Twenty-four patients were excluded from response analysis due to treatment escalation. After a median follow-up of 38.2 (3.2-90.2) months, 9/102 (9%) early and 43/184 (23%) advanced patients experienced a progression-free survival event. At 36 months, negative and positive predictive value for iPET1 were 94% and 41% (early) and 84% and 43% (advanced), respectively. The kinetics of PET response was assessed in 198 patients with both iPETs. All 116 patients with iPET1(-) remained iPET2(-) (fast responders), 41/82 with IPET1(+) became iPET2(-) (slow responders), and the remaining 41 stayed iPET2(+) (non-responders); progression-free survival at 36 months for fast, slow and non-responders was 0.88, 0.79 and 0.34, respectively. Conclusion The optimal tool to predict ABVD outcome in HL remains iPET2 because it distinguishes responders, whatever their time to response, from non-responders. However, iPET1 identified fast responders with the best outcome and might guide early treatment de-escalation in both early and advanced-stage HL.
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Affiliation(s)
- J M Zaucha
- Gdynia Oncology Center, Gdynia.,Departments of Oncological Propedeutics.,Hematology and Transplantology, Medical University of Gdańsk, Gdańsk
| | - B Malkowski
- Nuclear Medicine Department, Oncology Center, Bydgoszcz.,Positron Emission Tomography and Molecular Imagining Department, Collegium Medicum N. Copernicus University, Bydgoszcz, Poland
| | - S Chauvie
- Medical Physics Department, Santa Croce e Carle Hospital, Cuneo, Italy
| | - E Subocz
- Department of Hematology, Military Institute of Medicine, Warszawa
| | - J Tajer
- Department of Lymphoproliferative Diseases, Maria Sklodowska-Curie Memorial Institute, Warszawa
| | - W Kulikowski
- Clinical Department of Hematology, Interior Ministry Hospital, Warmia.,Mazury Medical University, Olsztyn
| | | | - A Biggi
- Nuclear Medicine Department, Santa Croce e Carle Hospital, Cuneo
| | - F Fallanca
- Nuclear Medicine Department, San Raffaele Hospital, Milano, Italy
| | - M Kobylecka
- Nuclear Medicine Department, Warsaw Medical University, Warszawa
| | - M Dziuk
- Nuclear Medicine Department, Military Institute of Medicine, Warszawa
| | - D Woszczyk
- Hematology Unit, Regional Hospital, Opole
| | - J Rybka
- Department of Hematology, Blood Neoplasms and Bone Marrow Transplantation, Wroclaw Medical University, Wroclaw
| | | | - F Bergesio
- Medical Physics Department, Santa Croce e Carle Hospital, Cuneo, Italy
| | - A Romanowicz
- Department of Hematology, Central Clinical Hospital MSW, Warszawa
| | | | - P Kurczab
- Poradnia Onkologiczna z Oddzialem Chemioterapii Dziennej NZOZ Mrukmed, Rzeszów
| | - A Giza
- Department of Hematology, Jagiellonian University Medical College, Krakow
| | - K Lesniewski-Kmak
- Gdynia Oncology Center, Gdynia.,Departments of Oncological Propedeutics.,Hematology and Transplantology, Medical University of Gdańsk, Gdańsk
| | - R Zaucha
- Department of Clinical Oncology and Radiotherapy
| | - D Swietlik
- Intrafaculty College of Medical Informatics & Biostatistics, Medical University of Gdansk, Poland
| | - T Wróbel
- Department of Hematology, Blood Neoplasms and Bone Marrow Transplantation, Wroclaw Medical University, Wroclaw
| | - W Knopinska-Posluszny
- Clinical Department of Hematology, Interior Ministry Hospital, Warmia.,Mazury Medical University, Olsztyn
| | - J Walewski
- Department of Lymphoproliferative Diseases, Maria Sklodowska-Curie Memorial Institute, Warszawa
| | - A Gallamini
- Department of Research, Innovation and Statistics, A. Lacassagne Cancer Center, Nice, France
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26
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Jurczak W, Ramanathan S, Giri P, Romano A, Mocikova H, Clancy J, Lechuga M, Casey M, Boni J, Giza A, Hess G. Comparison of two doses of intravenous temsirolimus in patients with relapsed/refractory mantle cell lymphoma. Leuk Lymphoma 2017; 59:670-678. [PMID: 28768446 DOI: 10.1080/10428194.2017.1357175] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Temsirolimus 175 mg once-weekly for 3 weeks, followed by 75 mg once-weekly intravenously dosed (175/75 mg) is approved in the European Union for treatment of relapsed/refractory mantle cell lymphoma (MCL). A phase IV study explored whether similar efficacy, but improved safety could be achieved with 75 mg without 175 mg loading doses (ClinicaTrials.gov: NCT01180049). Patients with relapsed/refractory MCL were randomized to once-weekly temsirolimus 175/75 mg (n = 47) or 75 mg (n = 42). Treatment continued until objective disease progression. Primary endpoint: progression-free survival (PFS). Secondary endpoints included overall survival (OS) and adverse events (AEs). Median PFS was 4.3 versus 4.5 months (hazard ratio [HR] 0.731; 80% confidence interval [CI], 0.520-1.027), and median OS 18.7 versus 11.0 months (HR 0.681; 80% CI, 0.472-0.982) with 175/75 mg versus 75 mg. There were fewer patients with serious AEs, dose reduction, or death with 175/75 mg (57.4%, 48.9%, and 48.9%) versus 75 mg (73.8%, 64.3%, and 65.1%). Temsirolimus 175/75 mg remains the preferred dosing regimen for relapsed/refractory MCL.
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Affiliation(s)
- Wojciech Jurczak
- a Department of Haematology , Jagiellonian University , Kraków , Poland
| | - Sundra Ramanathan
- b Haematology Department , Cancer Care Centre, The St George Hospital , Kogarah , Australia
| | - Pratyush Giri
- c Lyell McEwin Hospital (LMH), Royal Adelaide Hospital (RAH) , Adelaide , Australia
| | - Alessandra Romano
- d Division of Hematology , A.O.U. Policlinico-Vittorio Emanuele, University of Catania , Catania , Italy
| | - Heidi Mocikova
- e Department of Clinical Hematology , University Hospital Královské Vinohrady, Third Faculty of Medicine, Charles University in Prague , Prague , Czech Republic
| | - Jill Clancy
- f inVentiv Health Clinical , Princeton , NJ , USA
| | | | | | | | - Agnieszka Giza
- a Department of Haematology , Jagiellonian University , Kraków , Poland
| | - Georg Hess
- i Department of Hematology/Oncology , Johannes Gutenberg University , Mainz , Germany
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Trněný M, Lamy T, Walewski J, Belada D, Mayer J, Radford J, Jurczak W, Morschhauser F, Alexeeva J, Rule S, Afanasyev B, Kaplanov K, Thyss A, Kuzmin A, Voloshin S, Kuliczkowski K, Giza A, Milpied N, Stelitano C, Marks R, Trümper L, Biyukov T, Patturajan M, Bravo MLC, Arcaini L. Lenalidomide versus investigator's choice in relapsed or refractory mantle cell lymphoma (MCL-002; SPRINT): a phase 2, randomised, multicentre trial. Lancet Oncol 2016; 17:319-331. [PMID: 26899778 DOI: 10.1016/s1470-2045(15)00559-8] [Citation(s) in RCA: 112] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 11/26/2015] [Accepted: 11/26/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Lenalidomide, an immunomodulatory drug with antineoplastic and antiproliferative effects, showed activity in many single-group studies in relapsed or refractory mantle cell lymphoma. The aim of this randomised study was to examine the efficacy and safety of lenalidomide versus best investigator's choice of single-agent therapy in relapsed or refractory mantle cell lymphoma. METHODS The MCL-002 (SPRINT) study was a randomised, phase 2 study of patients with mantle cell lymphoma aged 18 years or older at 67 clinics and academic centres in 12 countries who relapsed one to three times, had Eastern Cooperative Oncology Group performance status of 0-2, at least one measurable lesion to be eligible, and who were ineligible for intensive chemotherpy or stem-cell transplantation. Using a centralised interactive voice response system, we randomly assigned (2:1) patients in a permuted block size of six to receive lenalidomide (25 mg orally on days 1-21 every 28 days) until progressive disease or intolerability, or single-agent investigator's choice of either rituximab, gemcitabine, fludarabine, chlorambucil, or cytarabine. Randomisation was stratified by time from diagnosis, time from last anti-lymphoma therapy, and previous stem-cell transplantation. Individual treatment assignment between lenalidomide and investigator's choice was open label, but investigators had to register their choice of comparator drug before randomly assigning a patient. Patients who progressed on investigator's choice could cross over to lenalidomide treatment. We present the prespecified primary analysis results in the intention-to-treat population for the primary endpoint of progression-free survival, defined as the time from randomisation to progressive disease or death, whichever occurred first. Patient enrolment is complete, although treatment and collection of additional time-to-event data are ongoing. This study is registered with ClinicalTrials.gov, number NCT00875667. FINDINGS Between April 30, 2009, and March 7, 2013, we enrolled 254 patients in the intention-to-treat population (170 [67%] were randomly assigned to receive lenalidomide, 84 [33%] to receive investigator's choice monotherapy). Patients had a median age of 68·5 years and received a median of two previous regimens. With a median follow-up of 15·9 months (IQR 7·6-31·7), lenalidomide significantly improved progression-free survival compared with investigator's choice (median 8·7 months [95% CI 5·5-12·1] vs 5·2 months [95% CI 3·7-6·9]) with a hazard ratio of 0·61 (95% CI 0·44-0·84; p=0·004). In the 167 patients in the lenalidomide group and 83 patients in the investigator's choice group who received at least one dose of treatment the most common grade 3-4 adverse events included neutropenia (73 [44%] of 167 vs 28 [34%] of 83) without increased risk of infection, thrombocytopenia (30 [18%] vs 23 [28%]), leucopenia (13 [8%] vs nine [11%]), and anaemia (14 [8%] vs six [7%]). INTERPRETATION Patients with relapsed or refractory mantle cell lymphoma ineligible for intensive chemotherapy or stem-cell transplantation have longer progression-free survival, with a manageable safety profile when treated with lenalidomide compared with monotherapy investigator's choice options. FUNDING Celgene Corporation.
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Affiliation(s)
- Marek Trněný
- Department of Hematology, Charles University Hospital, Prague, Czech Republic.
| | - Thierry Lamy
- Department of Hematology, Rennes University Hospital, Rennes, France
| | - Jan Walewski
- Department of Lymphoid Malignancies, Maria Sklodowska-Curie Memorial Institute and Oncology Centre, Warsaw, Poland
| | - David Belada
- Fourth Department of Internal Medicine-Hematology, Charles University Hospital and Faculty of Medicine, Hradec Králové, Czech Republic
| | - Jiri Mayer
- Department of Internal Medicine, Hematology and Oncology, Masaryk University Hospital, Brno, Czech Republic
| | - John Radford
- The University of Manchester and The Christie NHS Foundation Trust, Manchester, UK
| | - Wojciech Jurczak
- Department of Haematology, Jagiellonian University, Krakow, Poland
| | - Franck Morschhauser
- Centre Hospitalier Universitaire Régional de Lille, Unité GRITA, Lille, France
| | | | - Simon Rule
- Department of Hematology, Derriford Hospital, Plymouth, UK
| | - Boris Afanasyev
- First Pavlov State Medical University of St Petersburg, St Petersburg, Russia
| | - Kamil Kaplanov
- Volgograd Regional Clinical Oncology Dispensary Number 1, Department of Hematology, Volgograd, Russia
| | - Antoine Thyss
- Medical Oncology Department, Centre Antoine Lacassagne, Nice, France
| | - Alexej Kuzmin
- Republican Clinical Oncology Dispensary, Kazan, Russia
| | - Sergey Voloshin
- Russian Research Institute of Hematology and Transfusion, St Petersburg, Russia
| | - Kazimierz Kuliczkowski
- Department of Hematology, Blood Neoplasms and Bone Marrow Transplantation, Wroclaw Medical University, Wroclaw, Poland
| | - Agnieszka Giza
- Department of Haematology, Jagiellonian University, Krakow, Poland
| | - Noel Milpied
- Service d'Hématologie et de Thérapie Cellulaire, CHU Haut-Lévêque, Bordeaux, France; University of Bordeaux, Bordeaux, France
| | | | - Reinhard Marks
- Department of Hematology and Oncology, University Medical Center Freiburg, Freiburg, Germany
| | - Lorenz Trümper
- Department of Hematology and Oncology, Universitätsmedizin Göttingen, Georg-August-Universität, Göttingen, Germany
| | | | | | | | - Luca Arcaini
- Department of Hematology Oncology, Fondazione IRCCS Policlinico San Matteo & Department of Molecular Medicine, University of Pavia, Pavia, Italy
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Wertheim-Tysarowska K, Ołdak M, Giza A, Kutkowska-Kaźmierczak A, Sota J, Przybylska D, Woźniak K, Śniegórska D, Niepokój K, Sobczyńska-Tomaszewska A, Rygiel AM, Płoski R, Bal J, Kowalewski C. Novel sporadic and recurrent mutations in KRT5 and KRT14 genes in Polish epidermolysis bullosa simplex patients: further insights into epidemiology and genotype-phenotype correlation. J Appl Genet 2015; 57:175-81. [PMID: 26432462 PMCID: PMC4830863 DOI: 10.1007/s13353-015-0310-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [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: 04/11/2015] [Revised: 07/26/2015] [Accepted: 08/12/2015] [Indexed: 12/25/2022]
Abstract
Epidermolysis bullosa simplex (EBS) is a hereditary genodermatosis characterised by trauma-induced intraepidermal blistering of the skin. EBS is mostly caused by mutations in the KRT5 and KRT14 genes. Disease severity partially depends on the affected keratin type and may be modulated by mutation type and location. The aim of our study was to identify the molecular defects in KRT5 and KRT14 in a cohort of 46 Polish and one Belarusian probands with clinical suspicion of EBS and to determine the genotype-phenotype correlation. The group of 47 patients with clinical recognition of EBS was enrolled in the study. We analysed all coding exons of KRT5 and KRT14 using Sanger sequencing. The pathogenic status of novel variants was evaluated using bioinformatical tools, control group analysis (DNA from 100 healthy population-matched subjects) and probands' parents testing. We identified mutations in 80 % of patients and found 29 different mutations, 11 of which were novel and six were found in more than one family. All novel mutations were ascertained as pathogenic. In the majority of cases, the most severe genotype was associated with mutations in highly conserved regions. In some cases, different inheritance mode and clinical significance, than previously reported by others, was observed. We report 11 novel variants and show novel genotype-phenotype correlations. Our data give further insight into the natural history of EBS molecular pathology, epidemiology and mutation origin.
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Affiliation(s)
- K Wertheim-Tysarowska
- Department of Medical Genetics, Institute of Mother and Child, Kasprzaka 17a, 01211, Warsaw, Poland.
| | - M Ołdak
- Department of Histology and Embryology, Center of Biostructure Research, Medical University of Warsaw, Chalubinskiego 5, 02004, Warsaw, Poland.,Department of Genetics, World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw, Poland
| | - A Giza
- Department of Medical Genetics, Institute of Mother and Child, Kasprzaka 17a, 01211, Warsaw, Poland
| | - A Kutkowska-Kaźmierczak
- Department of Medical Genetics, Institute of Mother and Child, Kasprzaka 17a, 01211, Warsaw, Poland
| | - J Sota
- Department of Medical Genetics, Institute of Mother and Child, Kasprzaka 17a, 01211, Warsaw, Poland
| | - D Przybylska
- Department of Histology and Embryology, Center of Biostructure Research, Medical University of Warsaw, Chalubinskiego 5, 02004, Warsaw, Poland
| | - K Woźniak
- Department of Dermatology and Immunodermatology, Medical University of Warsaw, Chalubinskiego 5, 02004, Warsaw, Poland
| | - D Śniegórska
- Department of Medical Genetics, Institute of Mother and Child, Kasprzaka 17a, 01211, Warsaw, Poland
| | - K Niepokój
- Department of Medical Genetics, Institute of Mother and Child, Kasprzaka 17a, 01211, Warsaw, Poland
| | - A Sobczyńska-Tomaszewska
- Department of Medical Genetics, Institute of Mother and Child, Kasprzaka 17a, 01211, Warsaw, Poland
| | - A M Rygiel
- Department of Medical Genetics, Institute of Mother and Child, Kasprzaka 17a, 01211, Warsaw, Poland
| | - R Płoski
- Department of Genetics, Medical University of Warsaw, Pawińskiego 5a, 02004, Warsaw, Poland
| | - J Bal
- Department of Medical Genetics, Institute of Mother and Child, Kasprzaka 17a, 01211, Warsaw, Poland
| | - C Kowalewski
- Department of Dermatology and Immunodermatology, Medical University of Warsaw, Chalubinskiego 5, 02004, Warsaw, Poland
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Jurczak W, Ochrem B, Giza A, Zimowska-Curyło D, Górecki T, Boguradzki P, Knopińska-Posłuszny W, Stella-Hołowiecka B, Walewski J, Joks M, Wróbel T, Zaucha JM. Role of rituximab in the first-line therapy of high-risk diffuse large B-cell lymphoma: a retrospective analysis by the Polish Lymphoma Research Group. ACTA ACUST UNITED AC 2015; 125:741-8. [PMID: 26334344 DOI: 10.20452/pamw.3113] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
INTRODUCTION R-CHOP immunochemotherapy (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) is a standard first-line treatment for diffuse large B-cell lymphoma (DLBCL). None of the randomized trials have proved a statistically significant overall survival (OS) benefit in high-risk subgroups according to the International Prognostic Index (IPI). OBJECTIVES We retrospectively investigated the role of adding rituximab to anthracycline-based chemotherapy in patients with high-risk DLBCL according to the IPI. PATIENTS AND METHODS A total of 371 patients with high-risk DLBCL treated at 15 Polish hematology centers were retrospectively analyzed in 2 distinct age groups: older than 60 years and 60 years old or younger. Response rates, OS, and progression-free survival (PFS) were compared and analyzed. RESULTS The overall response rate (ORR) of high-risk DLBCL patients significantly improved in rituximabtreated patients compared with patients treated without rituximab (76.7% vs 95.6%; P <0.05). The R-CHOP immunochemotherapy prolonged survival in both older and younger subgroups. The 5-year projected OS and PFS in younger patients treated with rituximab vs chemotherapy alone were 42% vs 38% and 46% vs 27%, respectively (P <0.05), while the 5-year projected OS and PFS in older patients treated with rituximab vs chemotherapy alone were 82% vs 52% and 67% vs 45%, respectively (P <0.05). CONCLUSIONS With all the limitations of a retrospective analysis, the superiority of adding rituximab to CHOP combination chemotherapy has been clearly demonstrated regarding ORR, OS, and PFS in both age subgroups of patients with high-risk DLBCL.
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Rybka J, Jurczak W, Giza A, Paszkiewicz-Kozik E, Kumiega B, Drozd-Sokołowska J, Butrym A, Kuliczkowski K, Wróbel T. Gemcitabine-Based Treatment in Poor-Prognosis Patients with Relapsed and Refractory Hodgkin Lymphoma and Non-Hodgkin Lymphoma--a Multicenter Polish Experience. ADV CLIN EXP MED 2015; 24:783-9. [PMID: 26768628 DOI: 10.17219/acem/34795] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 11/24/2022]
Abstract
BACKGROUND The treatment of patients with relapsed or refractory Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) remains challenging. Gemcitabine is a cytidine analog with a wide spectrum of antitumor activity. Gemcitabine treatment is widely used to treat patients with certain solid tumors and relapsed/refractory hematological malignancies. There are several reports indicating that this compound is active in lymphoid malignancies. In patients with relapsed or refractory HL and NHL, gemcitabine has demonstrated efficacy as a single agent and in combination with other cytostatics. OBJECTIVES The aim of the study was to analyze the efficacy and toxicity of gemcitabine-based chemotherapy in patients with relapsed or refractory lymphomas. MATERIAL AND METHODS The study evaluated 68 heavily pretreated patients with relapsed/refractory HL and NHL. The median age of the patients was 36 years. All the patients received gemcitabine-based chemotherapy (gemcitabine monotherapy or gemcitabine in combination with other cytostatics). RESULTS The overall response rate was 46%. Complete response was achieved by 21% of the patients and partial response by 25%. Out of those who responded to gemcitabine treatment, 26 patients proceeded to autologous stem cell transplant. Toxicities connected with gemcitabine therapy occurred in 44% of the patients and included grade 3/4 neutropenia, thrombocytopenia and anemia. CONCLUSIONS The results suggest that gemcitabine-based salvage chemotherapy is effective and well tolerated in patients with relapsed/refractory HL and NHL.
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Affiliation(s)
- Justyna Rybka
- Department of Hematology, Wroclaw Medical University, Poland
| | - Wojciech Jurczak
- Department of Hematology, Collegium Medicum, Jagiellonian University, Kraków, Poland
| | - Agnieszka Giza
- Department of Hematology, Collegium Medicum, Jagiellonian University, Kraków, Poland
| | - Ewa Paszkiewicz-Kozik
- Department of Lymphoid Diseases, the Maria Sklodowska-Curie Memorial Institute and Center of Oncology, Warszawa, Poland
| | - Beata Kumiega
- Department of Hematology, Brzozow Oncology Center, Brzozów, Poland
| | - Joanna Drozd-Sokołowska
- Department of Hematology, Oncology and Internal Medicine, Medical University of Warsaw, Poland
| | | | | | - Tomasz Wróbel
- Department of Hematology, Wroclaw Medical University, Poland
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Jurczak W, Kroll-Balcerzak R, Giebel S, Machaczka M, Giza A, Ogórka T, Fornagiel S, Rybka J, Wróbel T, Kumiega B, Skotnicki AB, Komarnicki M. Liposomal cytarabine in the prophylaxis and treatment of CNS lymphoma: toxicity analysis in a retrospective case series study conducted at Polish Lymphoma Research Group Centers. Med Oncol 2015; 32:90. [PMID: 25716885 PMCID: PMC4341025 DOI: 10.1007/s12032-015-0520-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [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] [Received: 09/11/2014] [Accepted: 02/13/2015] [Indexed: 12/15/2022]
Abstract
Lymphomas with primary or secondary involvement of central nervous system (CNS) have poor prognosis despite specific treatment protocols which include whole brain radiotherapy and high-dose systemic and/or intrathecal chemotherapy. Toxicity of intrathecal liposomal cytarabine-based regimens collected between November 2006 and January 2012 was assessed retrospectively. Data from 120 adult lymphoma patients with, or at high risk of CNS involvement who received intrathecal liposomal cytarabine-based regimens at six Polish Lymphoma Research Group centres between November 2006 and January 2012 were assessed retrospectively. Patients were divided into three cohorts: A (high risk of CNS disease, n = 88), B (cerebrospinal fluid pleocytosis without neurological symptoms or pathological imaging findings, n = 7), and C (CNS disease/neurological involvement; n = 25). In all examined groups, toxicity of treatment was found to be acceptable (including the prophylactic setting). None of the patients in cohorts A or B who took intrathecal liposomal cytarabine 50 mg, repeated every 2–4 weeks (mean 3.8 doses) had experienced a CNS relapse at a median follow-up time of 3 years. Patients in cohort C had a 76 % overall neurological response rate (including a 40 % complete response rate) and median overall survival of 4.8 years. Regimens incorporating liposomal cytarabine seem to be safe and effective treatments for lymphomas with CNS involvement.
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Affiliation(s)
- Wojciech Jurczak
- Department of Haematology, Jagiellonian University, 36 Kopernika str., 30-501, Kraków, Poland
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Jurczyszyn A, Vesole DH, Gdula-Argasińska J, Giza A, Zawirska D, Baster J, Walter Z, Węglarska D, Dadej A, Castillos JJ, Skotnicki AB. Efficacy and safety of stem cell mobilization with cyclophosphamide plus etoposide versus cyclophosphamide alone. Przegl Lek 2015; 72:606-610. [PMID: 27012116] [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: 06/05/2023]
Abstract
The use of the combination of two cytostatics cyclophosphamide (CTX) and etoposide (VEP) and G-CSF is a reasonable alternative, especially for stem mobilization in multiple myeloma (MM) patients from countries in which newer treatments are limited due to financial constraints. The aim of this study was to compare the efficacy and safety of CTX-VEP versus CTX alone for mobilization of hematopoietic stem cells in MM patients. The analysis included 48 consecutive MM patients mobilized with CTX-VEP compared to 43 consecutive historical controls mobilized with CTX alone. The two groups of MM patients did not differ in terms of the median number of apheresis procedures, median yield the first day, median numbers of harvested CD34+ cells, proportion of patients with at least 5 x 10⁶/kg yield and incidence of non-hematological complications. The median cumulative dose of G-CSF given to individuals in the CTX-VEP group was significantly lower than in the CTX group (p < 0.001). The incidence of post-mobilization thrombocytopenia was higher in the CTX group (p<0.001). The median time to platelet count > 20 x 10⁹/l (10 vs. 11 days, p = 0.004) and the median time to neutrophil count > 50 x 10⁹/l (11 vs. 13 days, p < 0.001) were significantly shorter among the patients mobilized with CTX-VEP than in those treated with CTX alone. These findings suggest that CTX-VEP is as efficacious and possibly safer than CTX alone.
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Jurczak W, Szostek M, Jakóbczyk M, Staszczak AS, Zimowska-Curyło D, Giza A, Sobociński M, Hubalewska-Dydejczyk A, Skotnicki AB. [Hematological toxicity of radioimmunotherpy with 90Y Ibritumomab]. Przegl Lek 2012; 69:107-114. [PMID: 22764652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Radioimmunotherapy with 90Y Ibritumomabu (Zevalin, BSP) is a new method of systemic radiotherapy applicable to B-cell lymphoma patients. It may be delivered as a short outpatient procedure, with few adverse effects other than hematological toxicity. In the paper, we present length and depth of cytopenias, together with the results of additional tests performed to reveal the possible pathomechanisms, based on 102 patients treated at the University Hospital in Krakow.
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Jurczak W, Krochmalczyk D, Giza A, Sobociński M, Skotnicki AB. [Escalated BEACOPP as an alternative in high risk Hodgkin lymphoma]. Przegl Lek 2012; 69:171-175. [PMID: 23050411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Hodgkin Disease is one of the common lymphoma subtypes: every year over 750 new cases are diagnosed in Poland. It is most frequent in young adults between 25 - 30 years of age. In a low risk cases prognosis is excellent, and the treatment may be limited to short chemotherapy consolidated by involved field radiotherapy. In high risk cases with a large tumor burden prognosis depends from the choice of the initial therapy. Results of 8 years experience with escalated BEACOPP in UJ CM Department of Hematology are summarized in the paper. Monitoring the early response in imaging studies, particularly in positron emission tomography, allows in the majority of cases to decrease the duration of intensive therapy, without loosing it's efficacy.
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Sobocinski M, Jurczak W, Dzietczenia J, Ogorka T, Fornagiel S, Giza A, Piatkowska-Jakubas B, Kumiega B, Blajer-Olszewska B, Cedrych IIC, Mazur G, Skotnicki AB. Prophylaxis of central nervous system (CNS) relapse in high-risk lymphoma patients with liposomal cytarabine. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e18520] [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: 11/20/2022] Open
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Jurczak W, Giza A, Skotnicki AB, Deptala A, Windemuth-Kiesselbach C, Lorsbach M, Suh C, Zinzani PL, Linkesch WM, Trumper LH. Use of radioimmunotherapy for consolidation for chemosensitive mantle cell lymphoma (MCL): Summary of International Radioimmunotherapy Registry data. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e18519] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Jurczak W, Giza A, Krochmalczyk D, Sobocinski M, Zimowska-Curylo D, Stella-Holowiecka B, Boguradzki P, Kisiel E, Wróbel T, Knopinska-Posluszny W, Skotnicki AB. Survival benefit of post induction consolidation therapy in MCL (mantle cell lymphoma): A Polish Lymphoma Research Group (PLRG) retrospective multicenter analysis. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e19510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e19510 Background: In MCL, early intensification and consolidation of the first line therapy by ASCT is the treatment of choice. Elderly age and co-existing co-morbidities makes it however feasible for less than a third of patients. Methods: All MCL cases consulted in 8 PLRG centers within the last 5 years (n=140) were included in a retrospective analysis. Only 23% (n=32) were consolidated with ASCT, further 28% (n=40) by radioimmunotherapy (Ibritumomab), while in 49% (n=68) neither consolidation was performed. Rituximab was used in 36/72 patients subjected to consolidation and 25/68 treated without consolidation. There were no statistically significant differences in IPI, CS (clinical stage), frequency of extranodal manifestations and B symptoms between analyzed subgroups ( Table ) although patients subjected to ASCT were younger (median age 54 vs 62) and tend to have higher LDH (556 IU vs 473), while those who were not consolidated more frequently had a large tumor burden (defined as a mass > 7 cm, 24 vs 15%). Results: There was a clear impact of consolidation on overall and progression-free survival (OS,PFS): at 5 years OS 65 vs 20 % (p= 0.0003 in Gehan Wilcoxon test); and PFS 40 vs 0 % (p= 0.0003 in Gehan Wilcoxon test). Rituximab used in the first line therapy further increased it's efficiency in terms of PFS, prolonging median time to progression from 15 to 26 months, however the OS benefit was seen only in consolidated patients (at 5 years 75% OS in those with Rituximab including induction followed by consolidation). Conclusions: With all limitations of retrospective analysis, it strongly supports the necessity of post induction therapy in MCL patients. The role of ASCT is established in younger patients, radioimmunotherapy may prove to be a feasible approach for the elderly and unfit ones. [Table: see text] No significant financial relationships to disclose.
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Affiliation(s)
- W. Jurczak
- CMUJ, Krakow, Poland; SLAM, Katowice, Poland; AM, Warsaw, Poland; IH, Warsaw, Poland; AM, Wroclaw, Poland; AM, Gdansk, Poland
| | - A. Giza
- CMUJ, Krakow, Poland; SLAM, Katowice, Poland; AM, Warsaw, Poland; IH, Warsaw, Poland; AM, Wroclaw, Poland; AM, Gdansk, Poland
| | - D. Krochmalczyk
- CMUJ, Krakow, Poland; SLAM, Katowice, Poland; AM, Warsaw, Poland; IH, Warsaw, Poland; AM, Wroclaw, Poland; AM, Gdansk, Poland
| | - M. Sobocinski
- CMUJ, Krakow, Poland; SLAM, Katowice, Poland; AM, Warsaw, Poland; IH, Warsaw, Poland; AM, Wroclaw, Poland; AM, Gdansk, Poland
| | - D. Zimowska-Curylo
- CMUJ, Krakow, Poland; SLAM, Katowice, Poland; AM, Warsaw, Poland; IH, Warsaw, Poland; AM, Wroclaw, Poland; AM, Gdansk, Poland
| | - B. Stella-Holowiecka
- CMUJ, Krakow, Poland; SLAM, Katowice, Poland; AM, Warsaw, Poland; IH, Warsaw, Poland; AM, Wroclaw, Poland; AM, Gdansk, Poland
| | - P. Boguradzki
- CMUJ, Krakow, Poland; SLAM, Katowice, Poland; AM, Warsaw, Poland; IH, Warsaw, Poland; AM, Wroclaw, Poland; AM, Gdansk, Poland
| | - E. Kisiel
- CMUJ, Krakow, Poland; SLAM, Katowice, Poland; AM, Warsaw, Poland; IH, Warsaw, Poland; AM, Wroclaw, Poland; AM, Gdansk, Poland
| | - T. Wróbel
- CMUJ, Krakow, Poland; SLAM, Katowice, Poland; AM, Warsaw, Poland; IH, Warsaw, Poland; AM, Wroclaw, Poland; AM, Gdansk, Poland
| | - W. Knopinska-Posluszny
- CMUJ, Krakow, Poland; SLAM, Katowice, Poland; AM, Warsaw, Poland; IH, Warsaw, Poland; AM, Wroclaw, Poland; AM, Gdansk, Poland
| | - A. B. Skotnicki
- CMUJ, Krakow, Poland; SLAM, Katowice, Poland; AM, Warsaw, Poland; IH, Warsaw, Poland; AM, Wroclaw, Poland; AM, Gdansk, Poland
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Krochmalczyk D, Jurczak W, Giza A, Zimowska-Curylo D, Sobocinski M, Malkowski B, Pietrzak T, Szefer J, Senkus-Konefka E, Kumiega B, Skotnicki AB. Early PET assessment and therapy de-escalation in patients with advanced Hodgkin’s lymphoma treated with escalated BEACOPP regimen. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.8541] [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: 11/20/2022] Open
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Hubalewska-Dydejczyk A, Jurczak W, Sowa-Staszczak A, Kunikowska J, Królicki L, Gilis-Januszewska A, Giza A, Szurkowska M, Pach D, Głowa B, Mikołajczak R, Pawlak D, Stefańska A, Huszno B, Skotnicki AB. New forms of radionuclide therapy with (90)Y in oncology. Nucl Med Rev Cent East Eur 2008; 11:5-11. [PMID: 19173181] [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: 05/27/2023] Open
Abstract
BACKGROUND Currently, there is growing interest in the use of the beta emitter (90)Y in systemic therapy in oncology. For successful therapy, an appropriate ligand is chosen to carry the isotope to the place of its action. As well as performing this function, the type of the ligand influences both the course and the side effects of the treatment. For RIT of lymphomas, bone marrow becomes the critical organ; in NET patients treated with labelled somatostatin analogues, increased kidney irradiation can occur. The aim of this study was to evaluate the side effects of therapy using 90Y associated with different ligands, depending on the charge to critical organs after treatment in two groups of patients: those with neuroendocrine tumours and those with non-Hodgkin's lymphomas. MATERIAL AND METHODS 32 patients with histopathologically confirmed NET treated with (90)Y-DOTATATE (7.4 GBq/m(2) cumulative dose) and 30 NHL patients treated with (90)Y-ibritumomab tiuxetan (1200 MBq max dose) were enrolled in the study. The kidney function and changes of blood indices were assessed during the course of the therapy. RESULTS 59% of NET patients treated with (90)Y-DOTATATE displayed transient reduction of blood indices, the largest after cycles III and IV of therapy. After 5 months an increase in creatinine level was noticed, but no statistically important changes in creatinine level and GFR were observed. In the group of patients with NHL, the change of haematological indices after RIT concerned mainly PLT, ANC and WBC. The reduction of the average PLT and WBC values started in the first weeks after the treatment application, reaching nadir in the 6(th) week and 8(th) week, respectively. No life threatening infections were observed in either group of patients. CONCLUSIONS After treatment with the use of the (90)Y radionuclide, no significant treatment toxicity, including disorders involving the critical organs for both types of therapies, was found in the groups of neuroendocrine tumour and non-Hodgkin's lymphoma patients.
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Affiliation(s)
- Alicja Hubalewska-Dydejczyk
- Department of Endocrinology, Nuclear Medicine Unit, Jagiellonian University, Collegium Medicum, Krakow, Poland.
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Jurczak W, Krochmalczyk D, Giza A, Węgrzyn J, Sobocinski M, Gawelko J, Malkowski B, Czyz J, Pawlega J, Skotnicki AB. The choice of first-line therapy in advanced Hodgkin lymphoma: Retrospective comparison of ABVD and escalated BEACOPP regimen. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.8063] [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: 11/20/2022] Open
Abstract
8063 Background: HD patients with high risk have a relatively poor prognosis with less than 50% 5-year overall survival (OS) if treated with ABVD regimen. Methods: Therapy results of all 105 patients with advanced HL (CS IIBX -IV) treated from diagnosis at our Department in the last decade, are presented. The choice of initial 3 cycles between ABVD and escalated BEACOPP was done at the patients preferal and physician's adivice. Further 3 chemotherapy cycles depended on initial response assessment: poorly responding ABVD treated patients were offered therapy escalation. Patients with a good response (over 80% regression) after the first 3 cycles were later treated with ABVD. EFS and OS were primary endpoints of the study. Results: We divided patients into 2 treatment groups, depending on the first 3 cycles (escalated BEACOPP n = 57 or ABVD n = 48). Poor response resulting in therapy intensification was not considered as an event defined only as a relapse or progression during therapy. There was a statistically insignificant imbalance between the risk factor distribution with less favorable prognosis in patients treated with esc BEACOPP: 38 % of pts in IV th clinical stage (as compared to 31% in ABVD group), 3,08 EORTC risk factors (as compared to 2,64 in ABVD group) and 2,19 according to German Hodgkin Study Group (1.93 respectively). Increased toxicity of esc BEACOPP regimen was due to grade 3/4 cytopaenia (present in all patients) resulting in more infection episodes (according to WHO scale stage 3 - 16 pts , stage 4 - 8 pts; in ABVD group, 2 and 1 pt respectively). There were no treatment related mortalities. In esc BEACOPP projected 5 y OS was 96% and EFS 89% , which is comparable to GHSG results. 5 y OS and EFS in ABVD group are 87% and 66% respectively. The difference in EFS is statistically significant (p< 0.05). Conclusions: In our study we checked the feasibility of esc BEACOPP regimen in high risk HD pts. The results show the importance of the intensity of the first line approach. In the poor responders after the initial 3 cycles, even early treatment intensification, didn’t improve the outcome. De-escalation of therapy after the first 3 cycles, in good responders, didn’t make OS and EFS inferior to GHSG results in which they recommend 6 cycles of esc BEACOPP therapy. No significant financial relationships to disclose.
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Affiliation(s)
- W. Jurczak
- Jagiellonian University, Krakow, Poland; Leszczynski Hospital, Katowice, Poland; Oncology Center, Bydgoszcz, Poland; Huddersfield Royal Infirmary, Lindley, United Kingdom
| | - D. Krochmalczyk
- Jagiellonian University, Krakow, Poland; Leszczynski Hospital, Katowice, Poland; Oncology Center, Bydgoszcz, Poland; Huddersfield Royal Infirmary, Lindley, United Kingdom
| | - A. Giza
- Jagiellonian University, Krakow, Poland; Leszczynski Hospital, Katowice, Poland; Oncology Center, Bydgoszcz, Poland; Huddersfield Royal Infirmary, Lindley, United Kingdom
| | - J. Węgrzyn
- Jagiellonian University, Krakow, Poland; Leszczynski Hospital, Katowice, Poland; Oncology Center, Bydgoszcz, Poland; Huddersfield Royal Infirmary, Lindley, United Kingdom
| | - M. Sobocinski
- Jagiellonian University, Krakow, Poland; Leszczynski Hospital, Katowice, Poland; Oncology Center, Bydgoszcz, Poland; Huddersfield Royal Infirmary, Lindley, United Kingdom
| | - J. Gawelko
- Jagiellonian University, Krakow, Poland; Leszczynski Hospital, Katowice, Poland; Oncology Center, Bydgoszcz, Poland; Huddersfield Royal Infirmary, Lindley, United Kingdom
| | - B. Malkowski
- Jagiellonian University, Krakow, Poland; Leszczynski Hospital, Katowice, Poland; Oncology Center, Bydgoszcz, Poland; Huddersfield Royal Infirmary, Lindley, United Kingdom
| | - J. Czyz
- Jagiellonian University, Krakow, Poland; Leszczynski Hospital, Katowice, Poland; Oncology Center, Bydgoszcz, Poland; Huddersfield Royal Infirmary, Lindley, United Kingdom
| | - J. Pawlega
- Jagiellonian University, Krakow, Poland; Leszczynski Hospital, Katowice, Poland; Oncology Center, Bydgoszcz, Poland; Huddersfield Royal Infirmary, Lindley, United Kingdom
| | - A. B. Skotnicki
- Jagiellonian University, Krakow, Poland; Leszczynski Hospital, Katowice, Poland; Oncology Center, Bydgoszcz, Poland; Huddersfield Royal Infirmary, Lindley, United Kingdom
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Jurczak W, Hubalewska-Dydejczyk A, Giza A, Sowa-Staszczak A, Huszno B, Skotnicki AB. Radioimmunotherapy for lymphoma - analysis of clinical trials and treatment algorithms. Nucl Med Rev Cent East Eur 2007; 10:110-115. [PMID: 18228216] [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: 05/25/2023] Open
Abstract
Ibritumomab, an (90)Yttrium ((90)Y) labelled radioimmunoconjugate, is registered in Europe to treat follicular lymphomas. Its mode of action combines the selectivity of monoclonal antibodies with the efficiency of radiotherapy, making it a unique and useful therapeutic agent. This paper is for haemato-oncologists with a decent practice in lymphoma therapy, who have not yet used ibritumomab themselves. It summarizes clinical trials with radioimmunotherapy, indicating clinical situations where it may be specifically useful.
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Affiliation(s)
- Wojciech Jurczak
- Department of Haematology, Collegium Medicum, Jagiellonian University, Kraków, Poland.
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Jurczak W, Hubalewska-Dydejczyk A, Giza A, Sowa-Staszczak A, Wróbel T, Mazur G, Boguradzki P, Knopińska-Posłuszny W, Huszno B, Skotnicki AB. Radioimmunotherapy in follicular lymphomas, a retrospective analysis of the Polish Lymphoma Research Group's (PLRG) experience. Nucl Med Rev Cent East Eur 2007; 10:91-97. [PMID: 18228213] [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: 05/25/2023] Open
Abstract
BACKGROUND Ibritumomab is an (90)Yttrium ((90)Y) labelled radioimmunoconjugate registered to treat follicular lymphoma relapsing or refractory after Rituximab therapy. Combining the specificity of anti CD20 monoclonal antibodies with the efficacy of radiotherapy, it is particularly effective in patients with advanced stages of disease with generalized lymphadenopathy. MATERIAL AND METHODS Twenty-one patients with follicular lymphoma, after failing 2-5 lines of previous treatment, were subjected to radioimmunotherapy in three Polish Lymphoma Research Group (PLRG) centres. Ibritumomab infusion was followed by 2 doses of Rituximab (250 mg/m(2) at day -7 and 0) to enhance its biodistribution. Radioimmunoconjugate was prepared in the Nuclear Medicine Departments of participating centres based on patient weight and full blood count results (14.8 MBq/kg, max 1200 MBq, reduced to 11.1 MBq/kg in cases with blood platelet 100,000-150,000 or leukocytes 1500-2000). 14.8 MBq/kg (0.4 mCi/kg) 100 thousand to 149 thousand/mm(3) platelets 11.1 MBq/kg (0.3 mCi/kg) RESULTS The primary endpoint of the study was the assessment of response rate and haematological toxicity. Objective responses were observed in all patients, with 10 partial and 12 complete regressions. Cytopenia, starting 3-4 weeks after radioimmunotherapy, reflected haematological toxicity - the only important side effect. Thrombocytopenia was more pronounced, with platelet counts of < 50,000/ul in every second patient. One patient developed myelodysplastic syndrome 21 months after the procedure. After the medium time of follow up over 2 years, 2 patients died. Median progression free survival (secondary study endpoint) was 15 months. CONCLUSIONS Ibritumomab radioimmunotherapy is an efficient method of palliation treatment of heavily pre-treated follicular lymphoma patients, failing numerous previous treatment lines. Earlier application increases the number of complete responses and prolongs progression free survival.
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Weigert O, Jurczak W, Von Schilling C, Giza A, Rummel M, Hubalewska A, Pezzutto A, Unterhalt M, Hiddemann W, Skotnicki A, Dreyling M. Efficacy of radioimmunotherapy with (90Y) ibritumomab tiuxetan is superior as consolidation in relapsed or refractory mantle cell lymphoma: Results of two phase II trials of the European MCL Network and the PLRG. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.7533] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
7533 Background: Radioimmunotherapy (RIT) has demonstrated high clinical efficacy in follicular lymphoma but varying results in mantle cell lymphoma (MCL). Methods: We performed a comparative analysis of two phase II studies with similar inclusion criteria to identify potential predictors of response. 32 patients with relapsed or refractory MCL, WHO performance status ≤2, appropriate hematopoesis (ANC > 1,500/mm3, platelets > 100,000/mm3) and adequate function of liver and kidneys were treated with RIT upfront (Arm A, n = 16) or as consolidation after initial cytoreduction (Arm B, n = 16). 28 patients (88%) had been previously treated with rituximab. Patients with >25% bone marrow involvement, known CNS lymphoma, HIV infection or other severe concurrent disease were excluded. Ibritumomab tiuxetan (Zevalin) was applied at a dose of 15 MBq 90Y/kg, whereas patients with reduced platelet counts (<150,000/mm3) received 11 MBq 90Y/kg. Results: The median age was 66.9 years (range 58–72) in Arm A and 63.1 years (range 45–79) in Arm B. The median number of prior regimens was 4 (range 2–6) in Arm A and 1 (1–5) in Arm B. RIT treatment was generally well tolerated with the most common toxicities being hematologic. Thrombocytopenia grade 3 and 4 was observed in 69% of patients, one patient died of hemorrhagic stroke. Granulocytopenia grade 4 occurred in 34% of patients, one patient developed a grade 4 infectious complication. Currently 22 patients are evaluable for response rate and duration of remission (DR). In Arm A a partial response (PR) was observed in 2 of 6 evaluable patients (33.3%) with a median DR of 3.9 months only. In Arm B chemoinduction achieved 2 complete responses (CR) and 14 PR. Following RIT seven of 14 PR patients (50%) converted to CR. Currently, 13 of 16 patients (81%) are still in remission. As expected the most important adverse risk factor was bulky disease before RIT with no responses seen in this patient population. Patients with less prior therapeutic lines (< 2) had significantly higher response rates. Conclusions: In future trials, RIT should be applied earlier in the treatment algorithm of MCL after a debulking strategy with combined immuno-chemotherapy. [Table: see text]
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Affiliation(s)
- O. Weigert
- University Hospital Grosshadern, Munich, Germany; Department of Hematology, Crakow, Poland; University Hospital, Munich, Germany; University Hospital, Frankfurt, Germany; Department of Nuclear Medicine CMUJ, Cracow, Poland; Charité Campus Buch, Berlin, Germany
| | - W. Jurczak
- University Hospital Grosshadern, Munich, Germany; Department of Hematology, Crakow, Poland; University Hospital, Munich, Germany; University Hospital, Frankfurt, Germany; Department of Nuclear Medicine CMUJ, Cracow, Poland; Charité Campus Buch, Berlin, Germany
| | - C. Von Schilling
- University Hospital Grosshadern, Munich, Germany; Department of Hematology, Crakow, Poland; University Hospital, Munich, Germany; University Hospital, Frankfurt, Germany; Department of Nuclear Medicine CMUJ, Cracow, Poland; Charité Campus Buch, Berlin, Germany
| | - A. Giza
- University Hospital Grosshadern, Munich, Germany; Department of Hematology, Crakow, Poland; University Hospital, Munich, Germany; University Hospital, Frankfurt, Germany; Department of Nuclear Medicine CMUJ, Cracow, Poland; Charité Campus Buch, Berlin, Germany
| | - M. Rummel
- University Hospital Grosshadern, Munich, Germany; Department of Hematology, Crakow, Poland; University Hospital, Munich, Germany; University Hospital, Frankfurt, Germany; Department of Nuclear Medicine CMUJ, Cracow, Poland; Charité Campus Buch, Berlin, Germany
| | - A. Hubalewska
- University Hospital Grosshadern, Munich, Germany; Department of Hematology, Crakow, Poland; University Hospital, Munich, Germany; University Hospital, Frankfurt, Germany; Department of Nuclear Medicine CMUJ, Cracow, Poland; Charité Campus Buch, Berlin, Germany
| | - A. Pezzutto
- University Hospital Grosshadern, Munich, Germany; Department of Hematology, Crakow, Poland; University Hospital, Munich, Germany; University Hospital, Frankfurt, Germany; Department of Nuclear Medicine CMUJ, Cracow, Poland; Charité Campus Buch, Berlin, Germany
| | - M. Unterhalt
- University Hospital Grosshadern, Munich, Germany; Department of Hematology, Crakow, Poland; University Hospital, Munich, Germany; University Hospital, Frankfurt, Germany; Department of Nuclear Medicine CMUJ, Cracow, Poland; Charité Campus Buch, Berlin, Germany
| | - W. Hiddemann
- University Hospital Grosshadern, Munich, Germany; Department of Hematology, Crakow, Poland; University Hospital, Munich, Germany; University Hospital, Frankfurt, Germany; Department of Nuclear Medicine CMUJ, Cracow, Poland; Charité Campus Buch, Berlin, Germany
| | - A. Skotnicki
- University Hospital Grosshadern, Munich, Germany; Department of Hematology, Crakow, Poland; University Hospital, Munich, Germany; University Hospital, Frankfurt, Germany; Department of Nuclear Medicine CMUJ, Cracow, Poland; Charité Campus Buch, Berlin, Germany
| | - M. Dreyling
- University Hospital Grosshadern, Munich, Germany; Department of Hematology, Crakow, Poland; University Hospital, Munich, Germany; University Hospital, Frankfurt, Germany; Department of Nuclear Medicine CMUJ, Cracow, Poland; Charité Campus Buch, Berlin, Germany
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Przybylik-Mazurek E, Darczuk A, Huszno B, Budzyński A, Rembiasz K, Gałazka K, Wierzchowski W, Giza A, Jurczak W, Skotnicki AB, Sztuk S, Urbanik A. [Primary adrenal lymphoma in incidentally discovered adrenal tumour]. Przegl Lek 2006; 63:701-5. [PMID: 17441388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
The new imaging techniques used during the last several years: ultrasound, computed tomography and magnetic resonance imaging have improved detection of non-functional adrenal tumours s.c. "incidentaloma". Incidence of adrenal incidentaloma is not very low. They are detected in about 0.35-4.36% CT examination. In most of cases incidentaloma are benign and gave no clinical signs; however primary adrenal cortex cancer and metastases of different cancers are not uncommon. The primary adrenal lymphoma is an extremely rare disease. The predominant group of patients are men over 50 years with other manifestations of non Hodgkin lymphoma. Most frequently both adrenal glands are affected and signs of adrenal insufficiency (despite weakness, fever and loss of weight) are present. In our paper we present a case of primary, unilateral lymphoma in a 19 year old women. It was discovered as incidentaloma in ultrasound examination. Hormonal examinations were normal, but the tumour size was indication for surgery treatment. The diagnosis was made by histological examination and adjuvant chemotherapy was administrated.
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Gomuła A, Giza A, Stawarz B. [Percutaneous descending pyelography under ultrasonographic control]. Pol Przegl Radiol 1988; 52:87-91. [PMID: 3073367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Badowski A, Paczyński A, Forgalski W, Walecki J, Giza A. [Conservatively treated splenic rupture]. Wiad Lek 1984; 37:866-73. [PMID: 6506707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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47
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Dzurak W, Dziuk E, Woynarowski M, Giza A. [Pulmonary circulation disorders based on routine radiographic studies and scintiscanning]. Wiad Lek 1976; 29:1137-43. [PMID: 951995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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48
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Giza A, Grabowski T, Zaborowski P. [Changes in subcardial gastric area in radiological and endoscopic investigations (author's transl)]. Pol Przegl Radiol Med Nukl 1976; 40:257-60. [PMID: 980935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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49
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Zaborowski P, Grabowski T, Giza A. [Duodenal cap ulcer in radiographic and endoscopic observation]. Pol Tyg Lek 1976; 31:931-3. [PMID: 951255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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50
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Grabowski T, Zaborowski P, Giza A, Frankowski I. [Simple preparation of the colon for radiographic studies endoscopy]. Wiad Lek 1976; 29:277-9. [PMID: 1251647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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