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Desai SH, Spinner MA, Evens AM, Sykorova A, Bachanova V, Goyal G, Kahl B, Dorritie K, Azzi J, Kenkre VP, Chang C, Michalka J, Ansell SM, Fusco B, Sumransub N, Hatic H, Saba R, Ibrahim U, Harris EI, Shah H, Wagner-Johnston N, Arai S, Nowakowski GS, Mocikova H, Jagadeesh D, Blum KA, Diefenbach C, Iyengar S, Rappazzo KC, Baidoun F, Choi Y, Prochazka V, Advani RH, Micallef I. Overall survival of patients with cHL who progress after autologous stem cell transplant: results in the novel agent era. Blood Adv 2023; 7:7295-7303. [PMID: 37729621 PMCID: PMC10711178 DOI: 10.1182/bloodadvances.2023011205] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 08/08/2023] [Accepted: 08/09/2023] [Indexed: 09/22/2023] Open
Abstract
In the pre-novel agent era, the median postprogression overall survival (PPS) of patients with classic Hodgkin lymphoma (cHL) who progress after autologous stem cell transplant (ASCT) was 2 to 3 years. Recently, checkpoint inhibitors (CPI) and brentuximab vedotin (BV) have improved the depth and durability of response in this population. Here, we report the estimate of PPS in patients with relapsed cHL after ASCT in the era of CPI and BV. In this multicenter retrospective study of 15 participating institutions, adult patients with relapsed cHL after ASCT were included. Study objective was postprogression overall survival (PPS), defined as the time from posttransplant progression to death or last follow-up. Of 1158 patients who underwent ASCT, 367 had progressive disease. Median age was 34 years (range, 27-46) and 192 were male. Median PPS was 114.57 months (95% confidence interval [CI], 91-not achieved) or 9.5 years. In multivariate analysis, increasing age, progression within 6 months, and pre-ASCT positive positron emission tomography scan were associated with inferior PPS. When adjusted for these features, patients who received CPI, but not BV, as first treatment for post-ASCT progression had significantly higher PPS than the no CPI/no BV group (hazard ratio, 3.5; 95% CI, 1.6-7.8; P = .001). Receipt of allogeneic SCT (Allo-SCT) did not improve PPS. In the era of novel agents, progressive cHL after ASCT had long survival that compares favorably with previous reports. Patients who receive CPI as first treatment for progression had higher PPS. Receipt to Allo-SCT was not associated with PPS in this population.
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Affiliation(s)
- Sanjal H. Desai
- Division of Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, MN
- Division of Hematology, Mayo Clinic, Rochester, MN
| | - Michael A Spinner
- Division of Hematology and Oncology, Department of Medicine, University of California San Francisco, San Francisco, CA
| | - Andrew M. Evens
- Department of Medicine, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Alice Sykorova
- University Hospital and Faculty of Medicine, Hradec Kralove, Hradec Kralove, Czech Republic
| | - Veronika Bachanova
- Division of Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, MN
| | - Gaurav Goyal
- Division of Hematology & Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - Brad Kahl
- Division of Oncology, Department of Medicine, Washington University School of Medicine, St. Louis, MO
| | - Kathleen Dorritie
- Division of Hematology & Oncology, Department of Medicine, UPMC Hillman Cancer Center, Pittsburgh, PA
| | - Jacues Azzi
- Icahn School of Medicine Mount Sinai, New York, NY
| | - Vaishalee P. Kenkre
- Division of Hematology, Medical Oncology and Palliative Care, Department of Medicine, University of Wisconsin, Madison, WI
| | - Cheryl Chang
- Division of Oncology, Department of Medicine, Stanford University Medical Center, Stanford, CA
| | - Jozef Michalka
- Department of Internal Medicine, Hematology and Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | | | - Brendon Fusco
- Department of Medicine, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Nuttavut Sumransub
- Division of Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, MN
| | - Haris Hatic
- Division of Hematology & Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - Raya Saba
- Division of Oncology, Department of Medicine, Washington University School of Medicine, St. Louis, MO
| | | | - Elyse I. Harris
- Division of Hematology, Medical Oncology and Palliative Care, Department of Medicine, University of Wisconsin, Madison, WI
| | - Harsh Shah
- Division of Hematology, Department of Medicine, Hunstman Cancer Institute, The University of Utah, Salt Lake City, UT
| | | | - Sally Arai
- Division of Oncology, Department of Medicine, Stanford University Medical Center, Stanford, CA
| | | | - Heidi Mocikova
- Department of Clinical Hematology, Charles University in Prague, Prague, Czech Republic
| | | | - Kristie A. Blum
- Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University, Atlanta, GA
| | | | - Siddharth Iyengar
- Division of Hematology, Department of Medicine, Hunstman Cancer Institute, The University of Utah, Salt Lake City, UT
| | - K. C. Rappazzo
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD
| | | | - Yun Choi
- Perlmutter Cancer Center, NYU Grossman Medical School, New York, NY
| | - Vit Prochazka
- Department of Hemato-Oncology, Faculty of Medicine and Dentistry, Palacky University and University Hospital Olomouc, Czech Republic
| | - Ranjana H. Advani
- Division of Oncology, Department of Medicine, Stanford University Medical Center, Stanford, CA
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Obr A, Benesova K, Janikova A, Mocikova H, Belada D, Hruskova A, Vockova P, Salek D, Sykorova A, Furst T, Malarikova D, Papajik T, Trneny M, Klener P. Ibrutinib in mantle cell lymphoma: a real-world retrospective multi-center analysis of 77 patients treated in the Czech Republic. Ann Hematol 2023; 102:107-115. [PMID: 36369497 PMCID: PMC9807478 DOI: 10.1007/s00277-022-05023-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 08/08/2022] [Accepted: 10/19/2022] [Indexed: 11/12/2022]
Abstract
Ibrutinib revolutionized therapy for relapsed/refractory (R/R) mantle cell lymphoma (MCL). Real-world data on the outcome of unselected patients are still limited. We analyzed 77 R/R MCL patients receiving ibrutinib with at least one prior systemic anti-lymphoma therapy. After a median follow-up of 14.0 months, 56 patients relapsed/progressed, and 45 died. The overall response rate was 66%, with 31% of complete metabolic remissions on PET/CT. The median progression-free and overall survival (OS) rates were 10.3 and 23.1 months, respectively. The median OS from ibrutinib failure was 3.7 months. High proliferation rate by Ki67 (≥ 30%) and two or more previous therapy lines both negatively correlated with outcome (HR = 2.2, p = 0.04, and HR = 2.06, p = 0.08, respectively). Female gender borderline correlated with better outcome (HR = 0.53, p = 0.08). In multivariate analysis, Ki67 and response to ibrutinib both correlated with OS (p < 0.05). Importantly, ibrutinib appeared to better control nodal and extranodal lymphoma than bone marrow (BM) involvement. From 20 patients with detectable BM infiltration (before ibrutinib initiation) achieving complete (n = 13) or partial (n = 7) metabolic remission, none achieved remission in BM. We confirmed good efficacy of ibrutinib in unselected heavily pre-treated MCL patients. Our findings support the use of a combination of ibrutinib and rituximab in patients with BM involvement.
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Affiliation(s)
- Ales Obr
- Department of Haemato-Oncology, Faculty of Medicine and Dentistry, Palacky University and University Hospital, Olomouc, Czech Republic
| | - Katerina Benesova
- First Department of Internal Medicine–Department of Haematology, University General Hospital and First Faculty of Medicine, Charles University, U Nemocnice 499/2, Prague, 12808 Czech Republic
| | - Andrea Janikova
- Department of Haematology and Oncology, University Hospital, Brno, Czech Republic
| | - Heidi Mocikova
- Department of Internal Medicine and Haematology, Faculty Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - David Belada
- 4th Department of Internal Medicine–Haematology, University Hospital and Faculty of Medicine, Hradec Kralove, Czech Republic
| | - Andrea Hruskova
- Department of Haemato-Oncology, Faculty of Medicine and Dentistry, Palacky University and University Hospital, Olomouc, Czech Republic
| | - Petra Vockova
- First Department of Internal Medicine–Department of Haematology, University General Hospital and First Faculty of Medicine, Charles University, U Nemocnice 499/2, Prague, 12808 Czech Republic
| | - David Salek
- Department of Haematology and Oncology, University Hospital, Brno, Czech Republic
| | - Alice Sykorova
- 4th Department of Internal Medicine–Haematology, University Hospital and Faculty of Medicine, Hradec Kralove, Czech Republic
| | - Tomas Furst
- Department of Mathematical Analysis and Applications of Mathematics, Faculty of Science, Palacky University, Olomouc, Czech Republic
| | - Diana Malarikova
- First Department of Internal Medicine–Department of Haematology, University General Hospital and First Faculty of Medicine, Charles University, U Nemocnice 499/2, Prague, 12808 Czech Republic
| | - Tomas Papajik
- Department of Haemato-Oncology, Faculty of Medicine and Dentistry, Palacky University and University Hospital, Olomouc, Czech Republic
| | - Marek Trneny
- First Department of Internal Medicine–Department of Haematology, University General Hospital and First Faculty of Medicine, Charles University, U Nemocnice 499/2, Prague, 12808 Czech Republic
| | - Pavel Klener
- First Department of Internal Medicine–Department of Haematology, University General Hospital and First Faculty of Medicine, Charles University, U Nemocnice 499/2, Prague, 12808 Czech Republic ,Institute of Pathological Physiology, First Faculty of Medicine, Charles University, Prague, Czech Republic
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Mocikova H, Pytlík R, Benesova K, Janikova A, Duras J, Sykorova A, Steinerova K, Prochazka V, Campr V, Belada D, Trneny M. Peripheral T-Cell Lymphomas Involving the Central Nervous System: A Report From the Czech Lymphoma Study Group Registry. Front Oncol 2022; 12:874462. [PMID: 35646641 PMCID: PMC9133472 DOI: 10.3389/fonc.2022.874462] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 02/12/2022] [Accepted: 04/08/2022] [Indexed: 11/26/2022] Open
Abstract
Introduction We analyzed the incidence, risk factors of central nervous system (CNS) relapse, and outcome of CNS involvement in patients with peripheral T-cell lymphomas (PTCL) from the Czech Lymphoma Study Group Registry NiHiL (Clinical Trial gov. NCT03199066). Materials and Methods Out of 1,040 patients with PTCL, we identified 29 patients (2.79%) with CNS involvement: 2 patients with primary CNS T cell lymphoma, 11 patients with CNS and systemic disease at diagnosis, and 16 patients (1.54%) at CNS relapse. The most common histology with CNS disease was PTCL, not otherwise specified. Progression-free survival (PFS) was defined as the time interval from diagnosis to progression or death. PFS-2 was defined as the interval from the date of a new relapse until the next relapse. Results Patients with testicular involvement received intrathecal prophylaxis with methotrexate. High-dose methotrexate-based treatment was administered in 44.8% of patients with CNS disease. Median follow-up was 71.3 months. The difference between the median PFS of 1,027 patients without initial CNS disease (32.6 months) and 11 patients with initial CNS and systemic disease (4.8 months) was significant (p = 0.04). The difference between the median PFS2 in CNS relapses (10.1 months) and 493 relapses outside of CNS (9.1 months) was not significant (p = 0.6). Risk factors for CNS relapses included the following: involvement of more than one extranodal site (p = 0.008), soft tissue involvement (p = 0.003), testicular involvement (p = 0.046), and the presence of B symptoms (p = 0.035). The difference between the median OS of 1,027 patients without initial CNS disease (46.0 months) and 11 patients with initial CNS and systemic disease (18.2 months) was significant (p = 0.02). The median OS2 in CNS relapses was 11.8 months and that in relapses outside of CNS was 21.3 months. CNS involvement was not associated with a significantly worse OS compared to relapsed/refractory patients without CNS involvement (p = 0.1). Conclusions The incidence of CNS disease at the time of diagnosis and at relapse in PTCL is low and usually associated with other systemic involvement. The prognosis of PTCL with initial CNS involvement is significantly worse when compared to patients without CNS disease at diagnosis. The outcome of CNS relapse is comparable with relapsed PTCL outside of CNS. The optimal treatment is not defined yet.
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Affiliation(s)
- Heidi Mocikova
- Department of Internal Medicine - Hematology, Third Faculty of Medicine, Charles University, Prague, Czechia
| | - Robert Pytlík
- Institute of Haematology and Blood Transfusion, Prague, Czechia
| | - Katerina Benesova
- 1st Department of Medicine, First Faculty of Medicine, Charles University, Prague, Czechia
| | - Andrea Janikova
- Department of Internal Medicine, Hematology and Oncology, University Hospital Brno, Brno, Czechia
| | - Juraj Duras
- Department of Hemato-Oncology, University Hospital and Faculty of Medicine, Ostrava, Czechia
| | - Alice Sykorova
- 4th Department of Internal Medicine - Hematology, University Hospital and Faculty of Medicine, Hradec Kralove, Czechia
| | | | - Vit Prochazka
- Department of Haemato-Oncology, Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czechia
| | - Vit Campr
- Institute of Pathology and Molecular Medicine, University Hospital Motol, Prague, Czechia
| | - David Belada
- 4th Department of Internal Medicine - Hematology, University Hospital and Faculty of Medicine, Hradec Kralove, Czechia
| | - Marek Trneny
- 1st Department of Medicine, First Faculty of Medicine, Charles University, Prague, Czechia
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Vodicka P, Benesova K, Janikova A, Prochazka V, Belada D, Mocikova H, Steinerova K, Duras J, Karban J, Hanackova V, Sykorova A, Obr A, Trneny M. Polatuzumab vedotin plus bendamustine and rituximab in patients with relapsed/refractory diffuse large B-cell lymphoma in the real world. Eur J Haematol 2022; 109:162-165. [PMID: 35502609 DOI: 10.1111/ejh.13784] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 01/02/2022] [Revised: 04/27/2022] [Accepted: 04/29/2022] [Indexed: 12/31/2022]
Abstract
OBJECTIVES Polatuzumab vedotin with bendamustine and rituximab (Pola-BR) was approved for treatment of transplant-ineligible patients with relapsed/refractory DLBCL (R/R DLBCL). However, the number of patients treated in the GO29365 trial including the extension cohort was limited, and more data evaluating the efficacy of this treatment regimen is needed. METHODS We analyzed 21 patients with R/R DLBCL to determine real-life efficacy and safety of Pola-BR regimen. Data of all patients entered the database of the NiHiL project (NCT03199066). RESULTS Median overall survival was 8.7 months, and progression-free survival 3.8 months. The overall response rate was 33%. Grade 3-4 neutropenia was detected in 29%, thrombocytopenia in 38%, anemia in 19%, infections in 24% cases, and peripheral neuropathy in 5%. Discontinuation of treatment was caused by progression in 50%, adverse events in 31%, and intended bridging to CAR-T therapy in 19%. CONCLUSION Although the outcome of patients is worse than in GO29365 trial, the use of Pola-BR regimen in the real world demonstrates tolerable toxicity profile and efficacy in transplant-ineligible patients with R/R DLBCL. Moreover, this regimen might represent a perspective option as a bridge to CAR-T therapy.
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Affiliation(s)
- Prokop Vodicka
- First Department of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Katerina Benesova
- First Department of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Andrea Janikova
- Department of Hematology and Oncology, Faculty of Medicine, Masaryk University and University Hospital, Brno, Czech Republic
| | - Vit Prochazka
- Department of Haemato-Oncology, Faculty of Medicine and Dentistry, Palacky University and University Hospital, Olomouc, Czech Republic
| | - David Belada
- 4th Department of Internal Medicine - Hematology, Faculty of Medicine, Charles University and University Hospital, Hradec Kralove, Czech Republic
| | - Heidi Mocikova
- Department of Internal Medicine - Hematology, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic
| | - Katerina Steinerova
- Department of Haemato-Oncology, Faculty of Medicine, Charles University and University Hospital Pilsen, Pilsen, Czech Republic
| | - Juraj Duras
- Department of Hematology, Medical Faculty of the Ostrava University and University Hospital, Ostrava, Czech Republic
| | - Josef Karban
- First Department of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Veronika Hanackova
- Department of Haemato-Oncology, Faculty of Medicine and Dentistry, Palacky University and University Hospital, Olomouc, Czech Republic
| | - Alice Sykorova
- 4th Department of Internal Medicine - Hematology, Faculty of Medicine, Charles University and University Hospital, Hradec Kralove, Czech Republic
| | - Ales Obr
- Department of Haemato-Oncology, Faculty of Medicine and Dentistry, Palacky University and University Hospital, Olomouc, Czech Republic
| | - Marek Trneny
- First Department of Medicine, Charles University and General University Hospital, Prague, Czech Republic
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Vodicka P, Benesova K, Janikova A, Prochazka V, Belada D, Mocikova H, Steinerova K, Duras J, Karban J, Hanackova V, Sykorova A, Obr A, Trneny M. POLATUZUMAB VEDOTIN PLUS BENDAMUSTINE AND RITUXIMAB IN PATIENTS WITH RELAPSED/REFRACTORY DIFFUSE LARGE B‐CELL LYMPHOMA IN THE REAL WORLD. Hematol Oncol 2021. [DOI: 10.1002/hon.43_2881] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- P Vodicka
- Charles University and General University Hospital First Department of Medicine Prague Czech Republic
| | - K Benesova
- Charles University and General University Hospital First Department of Medicine Prague Czech Republic
| | - A Janikova
- Faculty of Medicine, Masaryk University and University Hospital Department of Haematology and Oncology Brno Czech Republic
| | - V Prochazka
- Faculty of Medicine and Dentistry, Palacky University and University Hospital Department of Haemato‐Oncology Olomouc Czech Republic
| | - D Belada
- Faculty of Medicine, Charles University and University Hospital 4th Department of Internal Medicine ‐ Haematology Hradec Kralove Czech Republic
| | - H Mocikova
- Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady Department of Internal Medicine – Haematology Prague Czech Republic
| | - K Steinerova
- Faculty of Medicine, Charles University and University Hospital Department of Haemato‐Oncology Pilsen Czech Republic
| | - J Duras
- Medical Faculty of the Ostrava University and University Hospital Department of Haematology Ostrava Czech Republic
| | - J Karban
- Charles University and General University Hospital First Department of Medicine Prague Czech Republic
| | - V Hanackova
- Faculty of Medicine and Dentistry, Palacky University and University Hospital Department of Haemato‐Oncology Olomouc Czech Republic
| | - A Sykorova
- Faculty of Medicine, Charles University and University Hospital 4th Department of Internal Medicine ‐ Haematology Hradec Kralove Czech Republic
| | - A Obr
- Faculty of Medicine and Dentistry, Palacky University and University Hospital Department of Haemato‐Oncology Olomouc Czech Republic
| | - M Trneny
- Charles University and General University Hospital First Department of Medicine Prague Czech Republic
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Mocikova H, Pytlik R, Benesova K, Janikova A, Duras J, Sykorova A, Steinerova K, Prochazka V, Campr V, Belada D, Dlouha J, Trneny M. PERIPHERAL T‐CELL LYMPHOMAS INVOLVING CENTRAL NERVOUS SYSTEM: A REPORT FROM THE CZECH LYMPHOMA STUDY GROUP REGISTRY. Hematol Oncol 2021. [DOI: 10.1002/hon.132_2880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- H. Mocikova
- University Hospital Kralovske Vinohrady and Third Faculty of Medicine Charles University Department of Haematology Prague Czech Republic
| | - R. Pytlik
- Institute of Haematology and Blood Transfusion Cell Therapy Department Prague Czech Republic
| | - K. Benesova
- Charles University General Hospital First Department of Medicine Department of Hematology Prague Czech Republic
| | - A. Janikova
- University Hospital Brno Department of Hematology and Oncology Brno Czech Republic
| | - J. Duras
- University Hospital and Faculty of Medicine Department of Hemato‐Oncology Ostrava Czech Republic
| | - A. Sykorova
- University Hospital and Faculty of Medicine 4th Department of Internal Medicine– Hematology Hradec Kralove Czech Republic
| | - K. Steinerova
- University Hospital Department of Clinical Hematology Pilsen Czech Republic
| | - V. Prochazka
- Faculty of Medicine and Dentistry Palacky University Department of Haemato‐Oncology Olomouc Czech Republic
| | - V. Campr
- University Hospital Motol Institute of Pathology and Molecular Medicine Prague Czech Republic
| | - D. Belada
- University Hospital and Faculty of Medicine 4th Department of Internal Medicine– Hematology Hradec Kralove Czech Republic
| | - J. Dlouha
- Czech Lymphoma Study Group Registry Data Management Office Prague Czech Republic
| | - M. Trneny
- Charles University General Hospital First Department of Medicine Department of Hematology Prague Czech Republic
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Jehlicka P, Rajdl D, Sladkova E, Sykorova A, Sykora J. Dynamic changes of high-sensitivity troponin T concentration during infancy: Clinical implications. Physiol Res 2021; 70:27-32. [PMID: 33453718 DOI: 10.33549/physiolres.934453] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Cardiac troponin T determination plays a dominant role in diagnosis of myocardial pathologies. Despite generally accepted use of high-sensitive cardiac troponin T assays (hscTnT) and clearly defined cut-off limit in adults, the uncertainty persists in infants. The aim of this study was to assess plasmatic concentrations of hscTnT and describe sequential age-related dynamic changes of hscTnT in healthy infants and toddlers. Seventy-eight children (52 males/26 females) from Czech Republic aged 44 to 872 days (median, interquartile range 271; 126 to 486 days) were consecutively enrolled in the single-center, prospective observational study. Plasma concentrations of hscTnT were analyzed by the electrochemiluminescent method, age-related reference intervals were calculated using the polynominal regression model. Amongst the study population (n=78), the upper limit of hscTnT concentration defined as the 99th percentile was calculated. The 99th percentile with 95 % confidence interval at the end of 2nd, 3rd, 4th, 5th, 6th and 7th month of postnatal life were: 81 (40.6 to 63.6), 61 (36.0 to 55.3), 47 (31.9 to 48.3), 37 (28.1 to 42.3), 30 (24.7 to 37.2) and 25 (21.5 to 32.7) ng/l, respectively. Concentration of adults 99th percentile (14 ng/l) was achieved approximately at 1 year of postnatal life. Statistically significant negative correlation of hscTnT concentration with age (r=-0.81, p<0.001) was found. Significant gender differences were not found (p>0.07). The study revealed substantially increased reference intervals of hscTnT levels in infants when compared with adult population. Based on our preliminary results, the age-related interpretation of hscTnT plasmatic concentration is recommended.
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Affiliation(s)
- P Jehlicka
- Charles University in Prague, Faculty of Medicine in Pilsen, Faculty Hospital, Department of Paediatrics, Pilsen, Czech Republic.
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Sykorova A, Mocikova H, Lukasova M, Koren J, Stepankova P, Prochazka V, Belada D, Klaskova K, Gaherova L, Chroust K, Buresova L, Markova J. Outcome of elderly patients with classical Hodgkin’s lymphoma. Leuk Res 2020; 90:106311. [DOI: 10.1016/j.leukres.2020.106311] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 01/18/2020] [Accepted: 01/22/2020] [Indexed: 11/27/2022]
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Steinerova K, Jindra P, Lysak D, Karas M, Trneny M, Klener P, Sykorova A, Belada D, Janikova A, Pytlik R, Prochazka V, Benesova K, Blahovcova P. EXTRANODAL NATURAL KILLER (NK)/T-CELL LYMPHOMA, NASAL TYPE - CASE REPORT AND REVIEW OF CZECH LYMPHOMA STUDY GROUP (CLSG) DATABASE. Hematol Oncol 2019. [DOI: 10.1002/hon.157_2631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- K. Steinerova
- Department of Hematology and Oncology; Charles University Hospital; Pilsen Czech Republic
| | - P. Jindra
- Department of Hematology and Oncology; Charles University Hospital; Pilsen Czech Republic
| | - D. Lysak
- Department of Hematology and Oncology; Charles University Hospital; Pilsen Czech Republic
| | - M. Karas
- Department of Hematology and Oncology; Charles University Hospital; Pilsen Czech Republic
| | - M. Trneny
- 1st Department of Internal Medicine-Department of Hematology; First Faculty of Medicine and General Teaching Hospital; Prague Czech Republic
| | - P. Klener
- 1st Department of Internal Medicine-Department of Hematology; First Faculty of Medicine and General Teaching Hospital; Prague Czech Republic
| | - A. Sykorova
- 4th Department of Internal Medicine-Hematology; University Hospital and Faculty of Medicine; Hradec Kralove Czech Republic
| | - D. Belada
- 4th Department of Internal Medicine-Hematology; University Hospital and Faculty of Medicine; Hradec Kralove Czech Republic
| | - A. Janikova
- Department of Hematology and Oncology; University Hospital; Brno Czech Republic
| | - R. Pytlik
- Department of Clinical Hematology; University Hospital Kralovske Vinohrady and 3rd Faculty of Medicine; Praha Czech Republic
| | - V. Prochazka
- Department of Hemato-Oncology; Faculty of Medicine; Olomouc Czech Republic
| | - K. Benesova
- 1st Department of Internal Medicine-Department of Hematology; First Faculty of Medicine and General Teaching Hospital; Prague Czech Republic
| | - P. Blahovcova
- 1st Department of Internal Medicine-Department of Hematology; First Faculty of Medicine and General Teaching Hospital; Prague Czech Republic
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Janikova A, Chloupkova R, Campr V, Kopalova N, Klener P, Benesova K, Hamouzova J, Belada D, Sykorova A, Prochazka V, Pirnos J, Duras J, Mocikova H, Michalka J, Trneny M. PROGNOSTIC VALUE OF THE INTERVAL BETWEEN RELAPSE AND THERAPY INITIATION IN DIFFUSE LARGE B-CELL LYMPHOMA PATIENTS. ANALYSIS FROM THE CZECH LYMPHOMA STUDY GROUP DATABASE. Hematol Oncol 2019. [DOI: 10.1002/hon.83_2631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- A. Janikova
- Department of Internal Medicine - Hematology nad Oncology; Masaryk University and Univesity Hospital Brno; Brno Czech Republic
| | - R. Chloupkova
- Institute of Biostatistics and Analyses; Faculty of Medicine Masaryk University Brno; Brno Czech Republic
| | - V. Campr
- Department of Pathology and Molecular Medicine; 2nd Faculty of Medicine, Charles University Prague and Motol University Hospital; Prague Czech Republic
| | - N. Kopalova
- Department of Internal Medicine - Hematology nad Oncology; Masaryk University and Univesity Hospital Brno; Brno Czech Republic
| | - P. Klener
- First Internal Clinic - Clinic of Hematology; General University Hospital and First Faculty of Medicine, Charles University; Prague Czech Republic
| | - K. Benesova
- First Internal Clinic - Clinic of Hematology; General University Hospital and First Faculty of Medicine, Charles University; Prague Czech Republic
| | - J. Hamouzova
- First Internal Clinic - Clinic of Hematology; General University Hospital and First Faculty of Medicine, Charles University; Prague Czech Republic
| | - D. Belada
- The 4th Department of Internal Medicine - Hematology; University Hospital and Faculty of Medicine in Hradec Králové Charles University; Hradec Kralove Czech Republic
| | - A. Sykorova
- The 4th Department of Internal Medicine - Hematology; University Hospital and Faculty of Medicine in Hradec Králové Charles University; Hradec Kralove Czech Republic
| | - V. Prochazka
- Department of Hemato-Oncology; Faculty of Medicine and Dentistry, Palacky University and University Hospital Olomouc; Olomouc Czech Republic
| | - J. Pirnos
- Department of Oncology; Hospital Ceske Budejovice; Ceske Budejovice Czech Republic
| | - J. Duras
- Department of Haematooncology; University Hospital Ostrava and Medical Faculty of the Ostrava University; Ostrava Czech Republic
| | - H. Mocikova
- Internal Clinic of Haematology; University Hospital Kralovske Vinohrady Prague and Third Faculty of Medicine, Charles University Prague; Prague Czech Republic
| | - J. Michalka
- Department of Internal Medicine - Hematology nad Oncology; Masaryk University and Univesity Hospital Brno; Brno Czech Republic
| | - M. Trneny
- First Internal Clinic - Clinic of Hematology; General University Hospital and First Faculty of Medicine, Charles University; Prague Czech Republic
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Janikova A, Chloupkova R, Klener P, Benesova K, Campr V, Belada D, Sykorova A, Prochazka V, Kopalova N, Hamouzova J, Pirnos J, Duras J, Mocikova H, Trneny M. T-CELL LYMPHOMA IN THE ELDERLY PATIENTS. WHO IS YOUNG, OLD, AND ELDERLY? Hematol Oncol 2019. [DOI: 10.1002/hon.145_2631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- A. Janikova
- Department of Internal Medicine - Hematology nad Oncology; Univesity Hospital Brno; Brno Czech Republic
| | - R. Chloupkova
- Institute of Biostatistics and Analyses; Faculty of Medicine Masaryk University Brno; Brno Czech Republic
| | - P. Klener
- 1st Internal Clinic- Clinic of Hematology; First Medical Faculty, Charles University, and General University Hospital; Prague Czech Republic
| | - K. Benesova
- 1st Internal Clinic- Clinic of Hematology; First Medical Faculty, Charles University, and General University Hospital; Prague Czech Republic
| | - V. Campr
- Department of Pathology and Molecular Medicine; 2nd Faculty of Medicine, Charles University and Faculty Hospital in Motol; Prague Czech Republic
| | - D. Belada
- 4th Department of Internal Medicine - Hematology; Charles University, Hospital and Faculty of Medicine; Hradec Králové Hradec Kralove Czech Republic
| | - A. Sykorova
- 4th Department of Internal Medicine - Hematology; Charles University, Hospital and Faculty of Medicine; Hradec Králové Hradec Kralove Czech Republic
| | - V. Prochazka
- Department of Hemato-Oncology; University Hospital Olomouc; Olomouc Czech Republic
| | - N. Kopalova
- Department of Internal Medicine - Hematology nad Oncology; Univesity Hospital Brno; Brno Czech Republic
| | - J. Hamouzova
- 1st Internal Clinic- Clinic of Hematology; First Medical Faculty, Charles University, and General University Hospital; Prague Czech Republic
| | - J. Pirnos
- Department of Oncology; Hospital Ceske Budejovice; Ceske Budejovice Czech Republic
| | - J. Duras
- Department of Haematooncology; University Hospital Ostrava and Medical Faculty of the Ostrava University; Ostrava Czech Republic
| | - H. Mocikova
- Internal Clinic of Haematology; University Hospital Kralovske Vinohrady Prague and Third Faculty of Medicine, Charles University Prague; Prague Czech Republic
| | - M. Trneny
- 1st Internal Clinic- Clinic of Hematology; First Medical Faculty, Charles University, and General University Hospital; Prague Czech Republic
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Pospiskova J, Smolej L, Belada D, Simkovic M, Motyckova M, Sykorova A, Stepankova P, Zak P. Experiences in the treatment of refractory chylothorax associated with lymphoproliferative disorders. Orphanet J Rare Dis 2019; 14:9. [PMID: 30626415 PMCID: PMC6327395 DOI: 10.1186/s13023-018-0991-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 08/28/2018] [Accepted: 12/28/2018] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Chylothorax is a rare condition which can be associated with malignant lymphoproliferative disorders (LPDs). We retrospectively analyzed the results of the conservative treatment of 10 patients with persistent non-traumatic malignant chylothorax. RESULTS Conservative treatment lead to a decline of chylothorax after mean of 66 days and consisted of the treatment of the underlying disease and of simultaneous long-term supportive care (drainage of the thoracic cavity, dietary measures and nutrition management). In most cases (80%), chylothorax disappeared only after a successful therapeutic response of the underlying disease. Low-dose radiotherapy had very good effects in two patients. CONCLUSION Conservative treatment of malignant chylothorax can be considered a suitable method. Based on our results, successful treatment of the lymphoproliferative disorder seems to be a very important factor for the disappearance of chylothorax.
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Affiliation(s)
- Jana Pospiskova
- 4th Department of Internal Medicine - Hematology, University Hospital, Sokolska Street 581, 5005, Hradec Kralove, Czech Republic
| | - Lukas Smolej
- 4th Department of Internal Medicine - Hematology, University Hospital, Sokolska Street 581, 5005, Hradec Kralove, Czech Republic.,Faculty of Medicine in Hradec Králové, Charles University Prague, Hradec Kralove, Czech Republic
| | - David Belada
- 4th Department of Internal Medicine - Hematology, University Hospital, Sokolska Street 581, 5005, Hradec Kralove, Czech Republic.,Faculty of Medicine in Hradec Králové, Charles University Prague, Hradec Kralove, Czech Republic
| | - Martin Simkovic
- 4th Department of Internal Medicine - Hematology, University Hospital, Sokolska Street 581, 5005, Hradec Kralove, Czech Republic.,Faculty of Medicine in Hradec Králové, Charles University Prague, Hradec Kralove, Czech Republic
| | - Monika Motyckova
- 4th Department of Internal Medicine - Hematology, University Hospital, Sokolska Street 581, 5005, Hradec Kralove, Czech Republic.,Faculty of Medicine in Hradec Králové, Charles University Prague, Hradec Kralove, Czech Republic
| | - Alice Sykorova
- 4th Department of Internal Medicine - Hematology, University Hospital, Sokolska Street 581, 5005, Hradec Kralove, Czech Republic
| | - Pavla Stepankova
- 4th Department of Internal Medicine - Hematology, University Hospital, Sokolska Street 581, 5005, Hradec Kralove, Czech Republic
| | - Pavel Zak
- 4th Department of Internal Medicine - Hematology, University Hospital, Sokolska Street 581, 5005, Hradec Kralove, Czech Republic. .,Faculty of Medicine in Hradec Králové, Charles University Prague, Hradec Kralove, Czech Republic.
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Obr A, Prochazka V, Papajik T, Klener P, Janikova A, Salek D, Belada D, Pytlík R, Sykorova A, Mocikova H, Simkovic M, Campr V, Dlouha J, Furst T, Trněný M. Maintenance rituximab in newly diagnosed mantle cell lymphoma patients: a real world analysis from the Czech lymphoma study group registry †. Leuk Lymphoma 2018; 60:748-755. [PMID: 30188225 DOI: 10.1080/10428194.2018.1508672] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
We analyzed 495 MCL patients from the Czech Lymphoma Study Group data registry. With the median follow-up of 4.4 years, 51.7% patients progressed or relapsed and 34.1% died. Five-year overall survival reached 65.3% and five-year progression free survival 44.1% of the patients. Maintenance rituximab (MR) after first line therapy improved overall and progression free survival compared to the patients under observation only (both p < .001). Elevated beta-2-microglobulin (p = .003), presence of systemic symptoms (p = .002), ECOG >0 (p = .003), age (p = .014), and MIPI (p < .001) were associated with MR failure. Patients who did not achieve complete remission have had two-fold higher risk of MR failure (p < .001). Autologous stem cell transplant reduced the risk of MR failure by 69% (p < .001). The MIPI and the beta-2-microglobulin were identified as independent predictors of MR failure (p = .02 and p = .03, respectively). Patients who relapsed/progressed on MR reached shorter OS calculated from the MR start compared to patients without failure (HR = 15.0; p < .001).
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Affiliation(s)
- Aleš Obr
- a Department of Hemato-Oncology, Faculty of Medicine and Dentistry , Palacky University and University Hospital , Olomouc , Czech Republic
| | - Vit Prochazka
- a Department of Hemato-Oncology, Faculty of Medicine and Dentistry , Palacky University and University Hospital , Olomouc , Czech Republic
| | - Tomas Papajik
- a Department of Hemato-Oncology, Faculty of Medicine and Dentistry , Palacky University and University Hospital , Olomouc , Czech Republic
| | - Pavel Klener
- b 1st Department of Internal Medicine - Department of Hematology , First Faculty of Medicine and General Teaching Hospital , Prague , Czech Republic
| | - Andrea Janikova
- c Department of Hematology and Oncology , University Hospital , Brno , Czech Republic
| | - David Salek
- c Department of Hematology and Oncology , University Hospital , Brno , Czech Republic
| | - David Belada
- d 4th Department of Internal Medicine - Hematology , University Hospital and Faculty of Medicine , Hradec Kralove , Czech Republic
| | - Robert Pytlík
- e Institute of Hematology and Blood Transfusion , Prague , Czech Republic
| | - Alice Sykorova
- d 4th Department of Internal Medicine - Hematology , University Hospital and Faculty of Medicine , Hradec Kralove , Czech Republic
| | - Heidi Mocikova
- f Department of Internal Medicine and Haematology, Faculty Hospital Kralovske Vinohrady and Third Faculty of Medicine , Charles University , Prague , Czech Republic
| | - Martin Simkovic
- d 4th Department of Internal Medicine - Hematology , University Hospital and Faculty of Medicine , Hradec Kralove , Czech Republic
| | - Vit Campr
- g Department of Pathology and Molecular Medicine , University Hospital in Motol , Prague , Czech Republic
| | - Jitka Dlouha
- h Second Faculty of Medicine , Prague , Czech Republic.,i Data Management Office, 1st Department of Internal Medicine - Department of Hematology , First Faculty of Medicine and General Teaching Hospital , Prague , Czech Republic
| | - Tomas Furst
- j Department of Mathematical Analysis and Applications of Mathematics, Faculty of Science , Palacky University , Olomouc , Czech Republic
| | - Marek Trněný
- b 1st Department of Internal Medicine - Department of Hematology , First Faculty of Medicine and General Teaching Hospital , Prague , Czech Republic
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14
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Janikova A, Campr V, Kopalova N, Benesova K, Belada D, Prochazka V, Duras J, Dlouha J, Mocikova H, Sykorova A, Brejcha M, Mayer J, Trneny M. Beyond rituximab maintenance. relapsing follicular lymphoma during or after end of rituximab maintenance: analysis of Czech Lymphoma Study Group (CLSG) database. Hematol Oncol 2017. [DOI: 10.1002/hon.2439_117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- A. Janikova
- Department of Hematology and Oncology, Faculty of Medicine; Masaryk University and University Hospital Brno; Brno Czech Republic
| | - V. Campr
- Department of Pathology and Molecular Medicine, 2nd Faculty of Medicine; Charles University and Faculty Hospital in Motol, Prague; Prague Czech Republic
| | - N. Kopalova
- Department of Hematology and Oncology, Faculty of Medicine; Masaryk University and University Hospital Brno; Brno Czech Republic
| | - K. Benesova
- 1st Department of Medicine, First Medical Faculty; Charles University, and General University Hospital, Prague; Prague Czech Republic
| | - D. Belada
- 4th Department of Internal medicine-Hematology; Charles University Hospital and Faculty of Medicine, Hradec Králové; Hradec Kralove Czech Republic
| | - V. Prochazka
- Department of Hematology; University Hospital Olomouc; Olomouc Czech Republic
| | - J. Duras
- Department of Clinical Hematology; Teaching Hospital Ostrava; Ostrava Czech Republic
| | - J. Dlouha
- 1st Department of Medicine, First Medical Faculty; Charles University, and General University Hospital, Prague; Prague Czech Republic
| | - H. Mocikova
- Internal Clinic of Haematology; University Hospital Kralovske Vinohrady and Charles University, 3rd Faculty of Medicine, Prague; Prague Czech Republic
| | - A. Sykorova
- 4th Department of Internal medicine-Hematology; Charles University Hospital and Faculty of Medicine, Hradec Králové; Hradec Kralove Czech Republic
| | - M. Brejcha
- Department of Hematology; Hospital Novy Jicin; Novy Jicin Czech Republic
| | - J. Mayer
- Department of Hematology and Oncology, Faculty of Medicine; Masaryk University and University Hospital Brno; Brno Czech Republic
| | - M. Trneny
- 1st Department of Medicine, First Medical Faculty; Charles University, and General University Hospital, Prague; Prague Czech Republic
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15
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Janikova A, Campr V, Kopalova N, Benesova K, Belada D, Dlouha J, Duras J, Prochazka V, Mocikova H, Kubackova K, Sykorova A, Brejcha M, Mayer J, Trneny M. INCIDENCE AND OUTCOME OF PRIMARY EXTRANODAL FOLLICULAR LYMPHOMAS. ANALYSIS FROM THE CZECH LYMPHOMA STUDY GROUP (CLSG) REGISTRY. Hematol Oncol 2017. [DOI: 10.1002/hon.2439_143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- A. Janikova
- Hematology and Oncology; University Hospital Brno; Brno Czech Republic
| | - V. Campr
- Department of Pathology and Molecular Medicine, 2nd Faculty of Medicine; Charles University and Faculty Hospital in Motol; Prague Czech Republic
| | - N. Kopalova
- Hematology and Oncology; University Hospital Brno; Brno Czech Republic
| | - K. Benesova
- 1st Department of Medicine, First Medical Faculty; Charles University, and General University Hospital, Prague; Prague Czech Republic
| | - D. Belada
- 4th Department of Internal medicine - Hematology; Charles University Hospital and Faculty of Medicine, Hradec Králové; Hradec Kralove Czech Republic
| | - J. Dlouha
- 1st Department of Medicine, First Medical Faculty; Charles University, and General University Hospital, Prague; Prague Czech Republic
| | - J. Duras
- Department of Clinical Hematology; Teaching Hospital Ostrava; Ostrava Czech Republic
| | - V. Prochazka
- Department of Hematology; University Hospital Olomouc; Olomouc Czech Republic
| | - H. Mocikova
- Internal Clinic of Haematology; University Hospital Kralovske Vinohrady and Charles University, 3rd Faculty of Medicine Prague; Prague Czech Republic
| | - K. Kubackova
- Department of Oncology, 2nd Faculty of Medicine; Charles University and Faculty Hospital in Motol, Prague; Prague Czech Republic
| | - A. Sykorova
- 4th Department of Internal medicine - Hematology; Charles University Hospital and Faculty of Medicine, Hradec Králové; Hradec Kralove Czech Republic
| | - M. Brejcha
- Department of Hematology; Hospital Novy Jicin; Novy Jicin Czech Republic
| | - J. Mayer
- Hematology and Oncology; University Hospital Brno; Brno Czech Republic
| | - M. Trneny
- 1st Department of Medicine, First Medical Faculty; Charles University, and General University Hospital, Prague; Prague Czech Republic
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Benesova K, Janikova A, Belada D, Prochazka V, Pytlik R, Mocikova H, Sykorova A, Campr V, Blahovcova P, Trneny M. SIMULTANEOUS DIFFUSE LARGE B-CELL LYMPHOMA (DLBCL) AND FOLLICULAR LYMPHOMA (FL) AT THE DIAGNOSIS HAS SIMILAR OUTCOME AS DLBCL. Hematol Oncol 2017. [DOI: 10.1002/hon.2438_41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- K. Benesova
- 1st Department of Internal Medicine-Department of Hematology; First Faculty of Medicine and General Teaching Hospital; Prague Czech Republic
| | - A. Janikova
- Department of Hematology and Oncology; University Hospital Brno; Brno Czech Republic
| | - D. Belada
- 4th Department of Internal Medicine-Hematology; University Hospital and Faculty of Medicine; Hradec Kralove Czech Republic
| | - V. Prochazka
- Department of Hemato-Oncology; Faculty of Medicine and Dentistry; Olomouc Czech Republic
| | - R. Pytlik
- 1st Department of Internal Medicine-Department of Hematology; First Faculty of Medicine and General Teaching Hospital; Prague Czech Republic
| | - H. Mocikova
- Department of Clinical Hematology; University Hospital Kralovske Vinohrady and 3rd Faculty of Medicine; Prague 10 Czech Republic
| | - A. Sykorova
- 4th Department of Internal Medicine-Hematology; University Hospital and Faculty of Medicine; Hradec Kralove Czech Republic
| | - V. Campr
- Institute of Pathology; University Hospital Motol; Prague 5 Czech Republic
| | - P. Blahovcova
- 1st Department of Internal Medicine-Department of Hematology; First Faculty of Medicine and General Teaching Hospital; Prague Czech Republic
| | - M. Trneny
- 1st Department of Internal Medicine-Department of Hematology; First Faculty of Medicine and General Teaching Hospital; Prague Czech Republic
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Mocikova H, Pytlik R, Sykorova A, Janikova A, Prochazka V, Vokurka S, Berkova A, Belada D, Campr V, Buresova L, Trneny M. Role of rituximab in treatment of patients with primary central nervous system lymphoma: a retrospective analysis of the Czech lymphoma study group registry. Leuk Lymphoma 2016; 57:2777-2783. [PMID: 27087066 DOI: 10.3109/10428194.2016.1167203] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
We have investigated whether the addition of rituximab to methotrexate, procarbazine, vincristine, radiotherapy and cytarabine was associated with improved outcome of primary central nervous system lymphomas (PCNSL). Of 164 patients, 49 received rituximab. Median age was 63 years, median Karnofsky performance score (KPS) was 60 and median follow-up of living patients was 59.5 months. 1- and 2-year PFS were 49.7 and 37.9%, 1- and 2-year OS were 57.0 and 45.3%. Median progression-free survival (PFS), but not overall survival (OS) was significantly better for patients treated with rituximab (22.9 vs. 10.9 months, p = 0.037). In multivariate analysis, age ≤70 years and KPS ≥90 were predictive for PFS and OS, rituximab was an independent prognostic factor for PFS only. In landmark analyses, rituximab was not found beneficial for long-term survivors and no group particularly benefited from rituximab. In conclusion, addition of rituximab was associated with improved PFS, but not OS in this unselected cohort of PCNSL patients.
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Affiliation(s)
- Heidi Mocikova
- a Department for Internal Medicine and Haematology, Faculty Hospital Kralovske Vinohrady and Third Faculty of Medicine , Charles University in Prague , Czech Republic
| | - Robert Pytlik
- b First Medical Department - Clinical Department of Haemato-oncology , First Faculty of Medicine and General Teaching Hospital, Charles University in Prague , Czech Republic
| | - Alice Sykorova
- c Fourth Department of Internal Medicine - Hematology , Charles University Hospital and Faculty of Medicine , Hradec Kralove , Czech Republic
| | - Andrea Janikova
- d Department of Internal Medicine and Hemato-oncology , University Hospital , Brno , Czech Republic
| | - Vit Prochazka
- e Department of Hemato-oncology, Faculty of Medicine and Dentistry , Palacky University and University Hospital Olomouc , Czech Republic
| | - Samuel Vokurka
- f Department of Hemato-oncology , University Hospital , Pilsen , Czech Republic
| | - Adela Berkova
- b First Medical Department - Clinical Department of Haemato-oncology , First Faculty of Medicine and General Teaching Hospital, Charles University in Prague , Czech Republic
| | - David Belada
- c Fourth Department of Internal Medicine - Hematology , Charles University Hospital and Faculty of Medicine , Hradec Kralove , Czech Republic
| | - Vit Campr
- g Institute of Pathology and Molecular Medicine, Second Faculty of Medicine , Charles University in Prague , Czech Republic
| | | | - Marek Trneny
- b First Medical Department - Clinical Department of Haemato-oncology , First Faculty of Medicine and General Teaching Hospital, Charles University in Prague , Czech Republic
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Sykorova A, Horacek J, Zak P, Kmonicek M, Bukac J, Maly J. A randomized, double blind comparative study of prophylactic parenteral nutritional support with or without glutamine in autologous stem cell transplantation for hematological malignancies -- three years' follow-up. Neoplasma 2005; 52:476-82. [PMID: 16284692] [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: 05/05/2023]
Abstract
Forty-four adult autologous transplant patients with hematological malignancies were randomized to receive either prophylactic parenteral nutrition PN (P group), or PN given ad hoc (C group). In each group, they were further randomized to receive standard PN (B group), or PN with 0.5 g glutamine/kg as L-Ala-L-Gln (A group). The overall survival (OS), disease-free survival (DFS) and event-free survival (EFS) in groups C vs. P and A vs. B were compared during follow-up with median 38 months. The final outcome rates in C/P/A/B groups, respectively (OS 65/81/63/85%, EFS 45/53/33/65% and DFS 56/50/35/77%), were not significantly different, apart from A < B in DFS rate (p=0.03, Fisher's exact test). Also in survival analysis (logrank test), no significant difference between groups C and P was found but generally worse parameters were observed for A vs. B group: for DFS (p=0.04) and EFS (p=0.01) the difference was significant, and for OS (p=0.09) it was borderline. In the three years' follow-up, no clinically useful benefit of prophylactic PN in autologous transplant patients was proven. Also, glutamine supplementation was not helpful, and was even connected with apparently worse long-term outcome.
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Affiliation(s)
- A Sykorova
- 2nd Department of Internal Medicine, Charles University, Faculty of Medicine and University Hospital, 500 05 Hradec Kralove, Czech Republic
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