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Baptista MJ, Tapia G, Muñoz‐Marmol A, Muncunill J, Garcia O, Montoto S, Gribben JG, Calaminici M, Martinez A, Veloza L, Martínez‐Trillos A, Aldamiz T, Menarguez J, Terol M, Ferrandez A, Alcoceba M, Briones J, González‐Barca E, Climent F, Muntañola A, Moraleda J, Provencio M, Abrisqueta P, Abella E, Colomo L, García‐Ballesteros C, Garcia‐Caro M, Sancho J, Ribera J, Mate J, Navarro J. Genetic and phenotypic characterisation of HIV-associated aggressive B-cell non-Hodgkin lymphomas, which do not occur specifically in this population: diagnostic and prognostic implications. Histopathology 2022; 81:826-840. [PMID: 36109172 PMCID: PMC9828544 DOI: 10.1111/his.14798] [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: 02/21/2022] [Revised: 09/01/2022] [Accepted: 09/12/2022] [Indexed: 01/12/2023]
Abstract
The frequency of aggressive subtypes of B-cell non-Hodgkin lymphoma (B-NHL), such as high-grade B-cell lymphomas (HGBL) with MYC and BCL2 and/or BCL6 rearrangement (HGBL-DH/TH) or Burkitt-like lymphoma (BL) with 11q aberration, is not well known in the HIV setting. We aimed to characterise HIV-associated aggressive B-NHL according to the 2017 WHO criteria, and to identify genotypic and phenotypic features with prognostic impact. Seventy-five HIV-associated aggressive B-NHL were studied by immunohistochemistry (CD10, BCL2, BCL6, MUM1, MYC, and CD30), EBV-encoded RNAs (EBERs), and fluorescence in situ hybridisation (FISH) to evaluate the status of the MYC, BCL2, and BCL6 genes and chromosome 11q. The 2017 WHO classification criteria and the Hans algorithm, for the cell-of-origin classification of diffuse large B-cell lymphomas (DLBCL), were applied. In DLBCL cases, the frequencies of MYC and BCL6 rearrangements (14.9 and 27.7%, respectively) were similar to those described in HIV-negative patients, but BCL2 rearrangements were infrequent (4.3%). MYC expression was identified in 23.4% of DLBCL cases, and coexpression of MYC and BCL2 in 13.0%, which was associated with a worse prognosis. As for BL cases, the expression of MUM1 (30.4%) conferred a worse prognosis. Finally, the prevalence of HGBL-DH/TH and BL-like with 11q aberration are reported in the HIV setting. The phenotypic and genotypic characteristics of HIV-associated aggressive B-NHL are similar to those of the general population, except for the low frequency of BCL2 rearrangements in DLBCL. MYC and BCL2 coexpression in DLBCL, and MUM-1 expression in BL, have a negative prognostic impact on HIV-infected individuals.
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Affiliation(s)
- Maria Joao Baptista
- Department of Hematology, ICO‐Germans Trias i Pujol Hospital, Josep Carreras Leukaemia Research Institute (IJC)Universitat Autònoma de BarcelonaBadalonaSpain
| | - Gustavo Tapia
- Department of Pathology, Hospital Germans Trias i Pujol, IGTPUniversitat Autònoma de BarcelonaBadalonaSpain
| | - Ana‐María Muñoz‐Marmol
- Department of Pathology, Hospital Germans Trias i Pujol, IGTPUniversitat Autònoma de BarcelonaBadalonaSpain
| | - Josep Muncunill
- Department of Hematology, ICO‐Germans Trias i Pujol Hospital, Josep Carreras Leukaemia Research Institute (IJC)Universitat Autònoma de BarcelonaBadalonaSpain
| | - Olga Garcia
- Department of Hematology, ICO‐Germans Trias i Pujol Hospital, Josep Carreras Leukaemia Research Institute (IJC)Universitat Autònoma de BarcelonaBadalonaSpain
| | - Silvia Montoto
- Centre for Haemato‐OncologyBarts Cancer Institute, Queen Mary University of LondonLondonUK
| | - John G Gribben
- Centre for Haemato‐OncologyBarts Cancer Institute, Queen Mary University of LondonLondonUK
| | - Maria Calaminici
- Centre for Haemato‐OncologyBarts Cancer Institute, Queen Mary University of LondonLondonUK
| | - Antonio Martinez
- Department of Pathology, Hospital Clinic, IDIBAPSUniversity of BarcelonaBarcelonaSpain
| | - Luis Veloza
- Department of Pathology, Hospital Clinic, IDIBAPSUniversity of BarcelonaBarcelonaSpain
| | | | - Teresa Aldamiz
- Department of Infectious DiseasesHospital Gregorio MarañónMadridSpain
| | | | - María‐José Terol
- Department of Hematology and OncologyHospital Clínic Universitari de ValènciaValenciaSpain
| | - Antonio Ferrandez
- Department of PathologyHospital Clínic Universitari de ValènciaValenciaSpain
| | - Miguel Alcoceba
- Department of HematologyHospital Universitario de Salamanca (HUS/IBSAL), CIBERONC and Centro de Investigación del Cáncer‐IBMCC (USAL‐CSIC)SalamancaSpain
| | - Javier Briones
- Department of Hematology, Hospital de la Santa Creu i Sant PauJosep Carreras Leukaemia Research Institute (IJC)BarcelonaSpain
| | - Eva González‐Barca
- Department of HematologyICO‐Hospital Duran i ReynalsL'Hospitalet de LlobregatSpain
| | - Fina Climent
- Department of PathologyHospital Universitari de Bellvitge‐IDIBELL, L'Hospitalet de LlobregatBadalonaSpain
| | - Ana Muntañola
- Department of Clinical HematologyHospital Universitari Mutua de TerrassaTerrassaSpain
| | - José‐María Moraleda
- Department of HematologyHospital Clinico Universitario Virgen de la ArrixacaMurciaSpain
| | - Mariano Provencio
- Department of Medical OncologyHospital Universitario Puerta De HierroMajadahondaSpain
| | - Pau Abrisqueta
- Department of HematologyHospital Vall d'HebrónBarcelonaSpain
| | | | - Lluis Colomo
- Department of PathologyHospital del MarBarcelonaSpain
| | | | | | - Juan‐Manuel Sancho
- Department of Hematology, ICO‐Germans Trias i Pujol Hospital, Josep Carreras Leukaemia Research Institute (IJC)Universitat Autònoma de BarcelonaBadalonaSpain
| | - Josep‐Maria Ribera
- Department of Hematology, ICO‐Germans Trias i Pujol Hospital, Josep Carreras Leukaemia Research Institute (IJC)Universitat Autònoma de BarcelonaBadalonaSpain
| | - José‐Luis Mate
- Department of Pathology, Hospital Germans Trias i Pujol, IGTPUniversitat Autònoma de BarcelonaBadalonaSpain
| | - José‐Tomas Navarro
- Department of Hematology, ICO‐Germans Trias i Pujol Hospital, Josep Carreras Leukaemia Research Institute (IJC)Universitat Autònoma de BarcelonaBadalonaSpain
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Cardona L, San Martín J, Benito L, Tomás J, Abella E, Eymar J, Aguilera M, Esteban JA, Tarragó A, Marco A. Global warming facilitates the nesting of the loggerhead turtle on the Mediterranean coast of Spain. Anim Conserv 2022. [DOI: 10.1111/acv.12828] [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: 11/30/2022]
Affiliation(s)
- L. Cardona
- IRBio and Department of Evolutionary Biology, Ecology and Environmental Science, Faculty of Biology University of Barcelona Barcelona Spain
| | | | - L. Benito
- IRBio and Department of Evolutionary Biology, Ecology and Environmental Science, Faculty of Biology University of Barcelona Barcelona Spain
| | - J. Tomás
- Cavanilles Institute of Biodiversity and Evolutionary Biology University of Valencia Valencia Spain
| | - E. Abella
- BETA Technological Center, Universitat de Vic‐ Universitat Central de Catalunya Futurlab‐Can Baumann Vic Spain
| | - J. Eymar
- Conselleria de Agricultura, Desarrollo Rural, Emergencia Climática y Transición Ecológica Dirección General del Medio Natural, Servicio de Vida Silvestre Valencia Spain
| | - M. Aguilera
- BETA Technological Center, Universitat de Vic‐ Universitat Central de Catalunya Futurlab‐Can Baumann Vic Spain
| | | | - A. Tarragó
- Departament d'Acció Climàtica, Alimentació Agenda Rural Generalitat de Catalunya Barcelona Spain
| | - A. Marco
- Estación Biológica de Doñana CSIC Sevilla Spain
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Abella E, Trigueros M, Pradenas E, Muñoz-Lopez F, Garcia-Pallarols F, Ben Azaiz Ben Lahsen R, Trinité B, Urrea V, Marfil S, Rovirosa C, Puig T, Grau E, Chamorro A, Toledo R, Font M, Palacín D, Lopez-Segui F, Carrillo J, Prat N, Mateu L, Clotet B, Blanco J, Massanella M. Efficacy of SARS-CoV-2 vaccination in patients with monoclonal gammopathies: A cross sectional study. Life Sci Alliance 2022; 5:e202201479. [PMID: 35961779 PMCID: PMC9375155 DOI: 10.26508/lsa.202201479] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 07/20/2022] [Accepted: 07/20/2022] [Indexed: 11/24/2022] Open
Abstract
SARS-CoV-2 vaccination is the most effective strategy to protect individuals with haematologic malignancies against severe COVID-19, while eliciting limited vaccine responses. We characterized the humoral responses following 3 mo after mRNA-based vaccines in individuals at different plasma-cell disease stages: monoclonal gammopathy of undetermined significance (MGUS), smoldering multiple myeloma (SMM), and multiple myeloma on first-line therapy (MM), compared with a healthy population. Plasma samples from uninfected MM patients showed lower SARS-CoV-2-specific antibody levels and neutralization capacity compared with MGUS, SMM, and healthy individuals. Importantly, COVID-19 recovered MM individuals presented significantly higher plasma neutralization capacity compared with their uninfected counterparts, highlighting that hybrid immunity elicit stronger immunity even in this immunocompromised population. No differences in the vaccine-induced humoral responses were observed between uninfected MGUS, SMM and healthy individuals. In conclusion, MGUS and SMM patients could be SARS-CoV-2 vaccinated following the vaccine recommendations for the general population, whereas a tailored monitoring of the vaccine-induced immune responses should be considered in uninfected MM patients.
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Affiliation(s)
- Eugenia Abella
- Department of Hematology, Hospital del Mar-IMIM, Barcelona, Spain
- Pompeu Fabra University, Barcelona, Spain
| | - Macedonia Trigueros
- IrsiCaixa-AIDS Research Institute, Hospital Universitari Germans Trias i Pujol, Campus Can Ruti, Badalona, Spain
| | - Edwards Pradenas
- IrsiCaixa-AIDS Research Institute, Hospital Universitari Germans Trias i Pujol, Campus Can Ruti, Badalona, Spain
| | - Francisco Muñoz-Lopez
- IrsiCaixa-AIDS Research Institute, Hospital Universitari Germans Trias i Pujol, Campus Can Ruti, Badalona, Spain
| | | | | | - Benjamin Trinité
- IrsiCaixa-AIDS Research Institute, Hospital Universitari Germans Trias i Pujol, Campus Can Ruti, Badalona, Spain
| | - Victor Urrea
- IrsiCaixa-AIDS Research Institute, Hospital Universitari Germans Trias i Pujol, Campus Can Ruti, Badalona, Spain
| | - Silvia Marfil
- IrsiCaixa-AIDS Research Institute, Hospital Universitari Germans Trias i Pujol, Campus Can Ruti, Badalona, Spain
| | - Carla Rovirosa
- IrsiCaixa-AIDS Research Institute, Hospital Universitari Germans Trias i Pujol, Campus Can Ruti, Badalona, Spain
| | - Teresa Puig
- IrsiCaixa-AIDS Research Institute, Hospital Universitari Germans Trias i Pujol, Campus Can Ruti, Badalona, Spain
| | - Eulàlia Grau
- IrsiCaixa-AIDS Research Institute, Hospital Universitari Germans Trias i Pujol, Campus Can Ruti, Badalona, Spain
| | - Anna Chamorro
- Fundació Lluita Contra les Infeccions, Hospital Universitari Germans Trias i Pujol, Campus Can Ruti, Badalona, Spain
| | - Ruth Toledo
- Fundació Lluita Contra les Infeccions, Hospital Universitari Germans Trias i Pujol, Campus Can Ruti, Badalona, Spain
| | - Marta Font
- Fundació Lluita Contra les Infeccions, Hospital Universitari Germans Trias i Pujol, Campus Can Ruti, Badalona, Spain
| | - Dolors Palacín
- Direcció d'Atenció Primària-Metropolitana Nord, Sabadell, Spain
| | - Francesc Lopez-Segui
- Fundació Lluita Contra les Infeccions, Hospital Universitari Germans Trias i Pujol, Campus Can Ruti, Badalona, Spain
| | - Jorge Carrillo
- IrsiCaixa-AIDS Research Institute, Hospital Universitari Germans Trias i Pujol, Campus Can Ruti, Badalona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, CIBERINFEC, Madrid, Spain
| | - Nuria Prat
- Direcció d'Atenció Primària-Metropolitana Nord, Sabadell, Spain
| | - Lourdes Mateu
- Fundació Lluita Contra les Infeccions, Hospital Universitari Germans Trias i Pujol, Campus Can Ruti, Badalona, Spain
- Infectious Diseases Department, Hospital Universitari Germans Trias i Pujol, Campus Can Ruti, Badalona, Spain
- University of Vic-Central University of Catalonia (UVic-UCC), 08500, Vic, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, CIBERES, Madrid, Spain
| | - Bonaventura Clotet
- IrsiCaixa-AIDS Research Institute, Hospital Universitari Germans Trias i Pujol, Campus Can Ruti, Badalona, Spain
- Fundació Lluita Contra les Infeccions, Hospital Universitari Germans Trias i Pujol, Campus Can Ruti, Badalona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, CIBERINFEC, Madrid, Spain
- University of Vic-Central University of Catalonia (UVic-UCC), 08500, Vic, Spain
| | - Julià Blanco
- IrsiCaixa-AIDS Research Institute, Hospital Universitari Germans Trias i Pujol, Campus Can Ruti, Badalona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, CIBERINFEC, Madrid, Spain
- University of Vic-Central University of Catalonia (UVic-UCC), 08500, Vic, Spain
- Germans Trias i Pujol Research Institute (IGTP), Campus Can Ruti, Badalona Barcelona, Spain
| | - Marta Massanella
- IrsiCaixa-AIDS Research Institute, Hospital Universitari Germans Trias i Pujol, Campus Can Ruti, Badalona, Spain
- University of Vic-Central University of Catalonia (UVic-UCC), 08500, Vic, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, CIBERINFEC, Madrid, Spain
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Moreno DF, Clapés V, Soler JA, González-Montes Y, Gironella M, Motlló C, Granell M, Abella E, García-Pintos M, García-Guiñón A, Cabezudo E, Bladé J, Rosiñol L. Real-World Evidence of Daratumumab Monotherapy in Relapsed/Refractory Multiple Myeloma Patients and Efficacy on Soft-Tissue Plasmacytomas. Clin Lymphoma Myeloma Leuk 2022; 22:635-642. [PMID: 35610120 DOI: 10.1016/j.clml.2022.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/29/2022] [Accepted: 04/12/2022] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Daratumumab is an anti-CD38 agent that was first investigated as single agent in GEN501 and SIRIUS trials in patients with advanced multiple myeloma (MM). Overall response rate (ORR) was 30% with positive impact on progression-free survival (PFS). However, there is a lack of information regarding plasmacytoma response. MATERIALS AND METHODS Here, we described a heavily pretreated group of 43 patients who received daratumumab monotherapy after EMA approval and focused on plasmacytoma response. RESULTS After a median follow-up of 26 months, median time to best response was 2.9 months (range 0.8-13.1), median PFS was 5.2 months (95% CI 2.5 - 8.8) and median OS was 11.2 months (95% CI 6.3 - 17.0). Patients who achieved at least partial response had longer median PFS and OS (12.8 and 20.2 months, respectively) than those who achieved minimal response or stable disease (5.3 and 11.2 months, respectively). Ten patients (23%) had plasmacytomas (70% paraskeletal, 30% extramedullary). The clinical benefit for patients with and without plasmacytomas was 20% versus 42%. A dissociation between serological and plasmacytoma response was observed in 40% of the patients. Thus, 50% of the patients with plasmacytomas achieved at least serological minimal response but only 20% had plasmacytoma response. CONCLUSION This is the first real-world study of daratumumab monotherapy that focuses on efficacy data regarding soft-tissue plasmacytomas in patients with relapsed/refractory mieloma, showing a limited benefit in this patient population.
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Affiliation(s)
- David F Moreno
- Hematology Department, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Victoria Clapés
- Hematology Department, Institut Català d'Oncologia, Hospital Duran i Reynals, Barcelona, Spain
| | - Juan Alfons Soler
- Hematology Department, Hospital Universitari Parc Taulí Sabadell, Barcelona, Spain
| | | | | | - Cristina Motlló
- Hematology Department, Hospital Sant Joan de Déu Manresa, Barcelona, Spain
| | - Miquel Granell
- Hematology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Eugenia Abella
- Hematology Department, Hospital del Mar, Barcelona, Spain
| | - Marta García-Pintos
- Hematology Department, Hospital Consorci Sanitari de Terrassa, Barcelona, Spain
| | | | - Elena Cabezudo
- Hematology Department, Institut Català d'Oncologia, Hospital Duran i Reynals, Barcelona, Spain
| | - Joan Bladé
- Hematology Department, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Laura Rosiñol
- Hematology Department, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain.
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Martins S, Cardona L, Abella E, Silva E, Loureiro N, Roast M, Marco A. Effect of body size on the long-term reproductive output of East Atlantic loggerhead turtles Caretta caretta. ENDANGER SPECIES RES 2022. [DOI: 10.3354/esr01198] [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: 11/23/2022] Open
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Marco A, Martins S, Martín-Rábano A, Lopes S, Clarke LJ, Abella E. Risk assessment of wildlife-watching tourism in an important endangered loggerhead turtle rookery. ENDANGER SPECIES RES 2021. [DOI: 10.3354/esr01130] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Wildlife-watching tourism is a non-exploitative activity that can contribute to sustainable economic development of coastal communities. However, it is important to assess the potential impact and implement best practices to mitigate any negative effects of such tourism. We studied this issue on Boa Vista (Cabo Verde), which supports around 60% of nesting activity of one of the most endangered loggerhead turtle rookeries globally. Between 2013 and 2016, authorized turtle watching involved 4942 tourists, generating a mean annual direct income of >USD 289000 and the direct creation of >250 jobs. On João Barrosa beach, which supports around 20% of nests and 48% of turtle-watching activity on the island, we tested the influence of turtle watching on nesting behavior, reproduction and nest-site fidelity. Nesting females observed by tourists spent significantly less time on nest-camouflaging behavior, although all other phases of nesting were unaffected. There were no statistically significant differences between the re-nesting frequency of females watched (n = 187) and non-watched (n = 972) by tourists. We found no evidence that the current turtle-watching intensity has an effect on turtle reproduction. Turtle poaching remains a severe threat on beaches with no turtle watching, although it has strongly decreased on beaches with tourist visits. We suggest tour guides follow best practice guidelines to minimize disturbance, specifically retreating from the immediate vicinity of a female during nest camouflaging to mitigate the observed impact.
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Affiliation(s)
- A Marco
- Estación Biológica de Doñana, CSIC, C/ Américo Vespucio s/n, Sevilla 41092, Spain
- BIOS.CV, C/ Sta Isabel s/n, Sal Rei, 5211 Boa Vista, Cabo Verde
| | - S Martins
- BIOS.CV, C/ Sta Isabel s/n, Sal Rei, 5211 Boa Vista, Cabo Verde
| | - A Martín-Rábano
- BIOS.CV, C/ Sta Isabel s/n, Sal Rei, 5211 Boa Vista, Cabo Verde
| | - S Lopes
- Direcção Geral do Ambiente, Cha d’ Areia s/n, Praia, 332A Santiago Island, Cabo Verde
| | - LJ Clarke
- School of Ocean Sciences, Bangor University, Menai Bridge LL59 5AB, UK
| | - E Abella
- Estación Biológica de Doñana, CSIC, C/ Américo Vespucio s/n, Sevilla 41092, Spain
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Cejalvo MJ, Bustamante G, González E, Vázquez-Álvarez J, García R, Ramírez-Payer Á, Pérez-Persona E, Abella E, Garzón S, García A, Jarque I, González MS, Sampol A, Motlló C, Martí JM, Alcalá M, Duro R, González Y, Sastre JL, Sarrà J, Lostaunau G, López R, de la Rubia J. Treatment patterns and outcomes in real-world transplant-ineligible patients newly diagnosed with multiple myeloma. Ann Hematol 2021; 100:1769-1778. [PMID: 33885924 DOI: 10.1007/s00277-021-04529-5] [Citation(s) in RCA: 2] [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] [Received: 09/06/2020] [Accepted: 04/12/2021] [Indexed: 10/21/2022]
Abstract
Despite the significant proportion of older patients with newly diagnosed multiple myeloma (MM), most clinical trials driving therapeutic decisions in routine practice include younger and presumably healthier patients than those in the real world. Furthermore, longitudinal studies suggest that elderly, transplant-ineligible patients with MM are not benefitting enough from new anti-MM agents. We retrospectively analyzed the profile of and treatment patterns and outcomes in 675 transplant-ineligible patients with MM who started frontline therapy in routine practice. The mean (SD) age was 75.6 (6.7) years; 152 (47.4%) had Eastern Cooperative Oncology Group performance status (ECOG PS) 2-4, and 73 (25.1%) had high cytogenetic risk. The most frequent frontline therapy was non-VMP bortezomib-based regimens (n=207; 30.7%), which were more frequent among patients with ECOG PS 0/1 and higher risk (e.g., international staging system (ISS) stage III, severely impaired glomerular filtrate rate (GFR), high lactate dehydrogenase (LDH), and high-risk cytogenetics); 185 patients (27.4%) started an attenuated (lite) VMP regimen, and 159 (23.6%) a VMP (VISTA) regimen. Median progression-free survival and overall survival (OS) were 15.3 months (95%CI 14.0-16.9) and 33.5 months (95%CI 29.1-37.2), respectively; 405 patients (78.2%) achieved partial response or better. Age, ECOG PS, ISS stage, serum LDH, GFR, cytogenetic risk, and treatment regimen significantly influenced OS. In this study, a remarkable proportion of transplant-ineligible patients with MM were older, frontline regimens were highly heterogeneous, and patients at higher risk often received less efficacious combinations. These findings suggest that clinicians have limited objective criteria for therapeutic decisions for this patient group.
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Affiliation(s)
- María José Cejalvo
- Department of Hematology, Hospital Universitario Doctor Peset, Av. de Gaspar Aguilar, 90 46017, Valencia, Spain
| | - Gabriela Bustamante
- Department of Hematology, Institut Català d'Oncologia, Hospital Duran i Reynals, Barcelona, Spain
| | - Esther González
- Department of Hematology, Hospital de Cabueñes, Gijón, Spain
| | | | - Ricarda García
- Department of Hematology, Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | - Ángel Ramírez-Payer
- Department of Hematology, Hospital Universitario Central de Asturias, Oviedo, Spain
| | | | - Eugenia Abella
- Department of Hematology, Hospital del Mar, Barcelona, Spain
| | - Sebastián Garzón
- Department of Hematology, Hospital de Jerez, Jerez de la Frontera, Spain
| | - Antoni García
- Department of Hematology, Hospital Arnau de Vilanova, Lleida, Spain
| | - Isidro Jarque
- Department of Hematology, Hospital Universitario y Politécnico La Fe, Valencia & CIBERONC, Instituto de Salud Carlos III, Valencia, Spain
| | | | - Antonia Sampol
- Department of Hematology, Hospital Son Espases, Palma de Mallorca, Spain
| | | | - Josep María Martí
- Department of Hematology, Hospital Mútua de Terrassa, Terrassa, Spain
| | - Magdalena Alcalá
- Department of Hematology, Hospital Universitario Carlos Haya, Málaga, Spain
| | - Rafael Duro
- Department of Hematology, Hospital Universitario Virgen de la Macarena, Sevilla, Spain
| | - Yolanda González
- Department of Hematology, Hospital Universitario de Girona Doctor Josep Trueta, Girona, Spain
| | - José Luis Sastre
- Department of Hematology, Complejo Hospitalario Universitario de Ourense, Ourense, Spain
| | - Josep Sarrà
- Department of Hematology, Hospital Universitario Joan XXIII, Tarragona, Spain
| | | | - Rocío López
- Celgene S.L.U., Bristol-Myers Squibb Company, Madrid, Spain
| | - Javier de la Rubia
- Department of Hematology, Hospital Universitario Doctor Peset, Av. de Gaspar Aguilar, 90 46017, Valencia, Spain. .,Departamento de Medicina Interna y Odontología, Universidad Católica de Valencia, Valencia, Spain.
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8
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Orduna G, Mellibovsky L, Abella E, Nogués X, Granero R, García-Giralt N, Pineda-Moncusí M, Güerri-Fernández R, Prieto-Alhambra D, Díez-Pérez A. Bone tissue quality in patients with monoclonal gammopathy of uncertain significance. J Bone Miner Metab 2020; 38:563-569. [PMID: 31974675 DOI: 10.1007/s00774-020-01084-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Accepted: 01/06/2020] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Monoclonal gammopathy of uncertain significance (MGUS) is highly prevalent in older adults and affects bone structure, with osteoporosis and increased risk of fractures in up to 14% of affected patients. Dual-energy X-ray absorptiometry (DXA), the standard technique for diagnosing osteoporosis, is ineffective to reveal microstructure and bone quality in this disease. MATERIALS AND METHODS We conducted a cross-sectional study of patients with MGUS, recruited consecutively from the Hematology and Internal Medicine Departments of Hospital del Mar, Barcelona, between January 2011 and January 2018. Medical records, clinical results and spinal X-ray images were collected. Bone mineral density (BMD) at hip and spine was measured by DXA and Bone Material Strength index (BMSi) by impact microindentation on the tibial mid-shaft. RESULTS Thirty-nine patients with MGUS and 65 age-matched controls without previous fractures were included. In the MGUS group, 11 (28.2%) patients had prevalent fractures, nearly half of them vertebral (n = 5, 45.45%). Compared to controls, MGUS patients had significantly lower BMSi, a mean (SD) of 70.72 (9.70) vs. 78.29 (8.70), p = 0.001, and lower spinal BMD values (0.900 [0.159] vs. 1.003 [0.168], respectively, p = 0.012), but no significant differences at femoral neck and total hip. No association was observed between BMSi and DXA. Bone remodeling markers (procollagen type-1 N propeptide, bone-alkaline phosphatase and C-terminal telopeptide of type I collagen) did not differ between the two groups. CONCLUSIONS Spinal BMD and mechanical properties of bone tissue, as measured by impact microindentation, were impaired in patients with MGUS. These changes in bone tissue mechanical resistance were independent of DXA levels.
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Affiliation(s)
- Guillermina Orduna
- Department of Internal Medicine, Musculoskeletal Research Group, Hospital del Mar-IMIM, Department of Medicine, Autonomous University of Barcelona and CIBERFES, Instituto Carlos III, Barcelona, Spain
| | - Leonardo Mellibovsky
- Department of Internal Medicine, Musculoskeletal Research Group, Hospital del Mar-IMIM, Department of Medicine, Autonomous University of Barcelona and CIBERFES, Instituto Carlos III, Barcelona, Spain
| | - Eugenia Abella
- Department of Hematology, Hospital del Mar, Barcelona, Spain
| | - Xavier Nogués
- Department of Internal Medicine, Musculoskeletal Research Group, Hospital del Mar-IMIM, Department of Medicine, Autonomous University of Barcelona and CIBERFES, Instituto Carlos III, Barcelona, Spain.
| | - Roser Granero
- Department of Psychobiology and Methodology, Autonomous University of Barcelona, Barcelona, Spain
| | - Natalia García-Giralt
- Department of Internal Medicine, Musculoskeletal Research Group, Hospital del Mar-IMIM, Department of Medicine, Autonomous University of Barcelona and CIBERFES, Instituto Carlos III, Barcelona, Spain
| | - Marta Pineda-Moncusí
- Department of Internal Medicine, Musculoskeletal Research Group, Hospital del Mar-IMIM, Department of Medicine, Autonomous University of Barcelona and CIBERFES, Instituto Carlos III, Barcelona, Spain
| | - Roberto Güerri-Fernández
- Department of Internal Medicine, Musculoskeletal Research Group, Hospital del Mar-IMIM, Department of Medicine, Autonomous University of Barcelona and CIBERFES, Instituto Carlos III, Barcelona, Spain
| | - Daniel Prieto-Alhambra
- Oxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, United Kingdom, and CIBERFES, Instituto Carlos III, Barcelona, Spain
| | - Adolfo Díez-Pérez
- Department of Internal Medicine, Musculoskeletal Research Group, Hospital del Mar-IMIM, Department of Medicine, Autonomous University of Barcelona and CIBERFES, Instituto Carlos III, Barcelona, Spain
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9
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Cejalvo MJ, Legarda M, Abella E, Cabezudo E, Encinas C, García‐Feria A, Gironella M, Iñigo B, Martín J, Ribas P, Ruíz MÁ, González Y, Vicuña I, Ramírez Á, Fernández P, Rubia J. Single‐agent daratumumab in patients with relapsed and refractory multiple myeloma requiring dialysis: results of a Spanish retrospective, multicentre study. Br J Haematol 2019; 190:e289-e292. [DOI: 10.1111/bjh.16286] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- María J. Cejalvo
- Department of Hematology University Hospital Doctor Peset Valencia Spain
| | - Mario Legarda
- Department of Hematology University Hospital Doctor Peset Valencia Spain
| | - Eugenia Abella
- Department of Hematology Hospital del Mar Barcelona Spain
| | - Elena Cabezudo
- Department of Hematology Hospital Sant Joan de Déu Barcelona Spain
| | | | | | | | - Belén Iñigo
- Department of Hematology Hospital Clínico San Carlos Madrid Spain
| | - Jesús Martín
- Department of Hematology Hospital Virgen del Rocío Sevilla Spain
| | - Paz Ribas
- Department of Hematology University Hospital Doctor Peset Valencia Spain
| | - Mª Ángeles Ruíz
- Department of Hematology Hospital Francesc Borja Gandía Spain
| | - Yolanda González
- Department of Hematology Instituto Catalán de Oncología Girona Spain
| | - Isabel Vicuña
- Department of Hematology Hospital La Princesa Madrid Spain
| | - Ángel Ramírez
- Department of Hematology Hospital Central de Asturias Oviedo Spain
| | | | - Javier Rubia
- Department of Hematology University Hospital Doctor Peset Valencia Spain
- Internal Medicine School of Medicine and Dentistry Catholic University of Valencia Valencia Spain
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10
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Muñoz-Bermúdez R, Abella E, Zuccarino F, Masclans JR, Nolla-Salas J. Successfully non-surgical management of flail chest as first manifestation of multiple myeloma: A case report. World J Crit Care Med 2019. [DOI: 10.5492/wjcc.v8.i5.59] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
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11
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Muñoz-Bermúdez R, Abella E, Zuccarino F, Masclans JR, Nolla-Salas J. Successfully non-surgical management of flail chest as first manifestation of multiple myeloma: A case report. World J Crit Care Med 2019; 8:82-86. [PMID: 31559147 PMCID: PMC6753394 DOI: 10.5492/wjccm.v8.i5.82] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 07/23/2019] [Accepted: 08/16/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Multiple myeloma is a malignant neoplasm of the bone marrow characterized by neoplastic proliferation of monoclonal plasma cells with a high relationship with destructive bone disease. We present a case of a patient diagnosed with multiple myeloma and sternal fracture in association with multiple bilateral rib fractures and thoracic kyphosis, who developed a severe acute respiratory failure, thus complicating the initial presentation of multiple myeloma. We discuss the therapeutic implications of this uncommon presentation.
CASE SUMMARY A 56-year-old man presented to Hematological Department after he had been experiencing worsening back pain over the last five months, with easy fatigability and progressive weight loss. He had no history of previous trauma. The chemical blood tests were compatible with a diagnosis of multiple myeloma. A radiographic bone survey of all major bones revealed, in addition to multiple bilateral rib fractures, a sternal fracture and compression fracture at T9, T10, T11 and L1 vertebrae. Subcutaneous fat biopsy was positive for amyloid. We started treatment with bortezomib and dexamethasone. After 24 h of treatment, he presented dyspnea secondary to flail chest. He required urgent intubation and ventilatory support being transferred to intensive care unit for further management. The patient remained connected to mechanical ventilation (positive pressure) as treatment which stabilized the thorax. A second cycle of bortezomib plus dexamethasone was started and analgesia was optimized. The condition of the patient improved, as evidenced by callus formation on successive computed tomography scans. The patient was taken off the ventilator one month later, and he was extubated successfully, being able to breathe unaided without paradoxical motion.
CONCLUSION This case highlights the importance of combination between bortezomib and dexamethasone to induce remission of multiple myeloma and the initiation of positive airway pressure with mechanical ventilation to stabilize chest wall to solve the respiratory failure. This combined approach allowed to obtain a quick and complete resolution of the clinical situation.
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Affiliation(s)
| | - Eugenia Abella
- Department of Hematology, Hospital del Mar, Barcelona 08003, Spain
| | - Flavio Zuccarino
- Department of Radiology, Hospital del Mar, Barcelona 08003, Spain
| | | | - Juan Nolla-Salas
- Department of Critical Care, Hospital del Mar, Barcelona 08003, Spain
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12
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Ferraro MP, Gimeno-Vazquez E, Subirana I, Gómez M, Díaz J, Sánchez-González B, García-Pallarols F, Martínez L, Ble M, Molina L, Belarte LC, Abella E, Elosua R, Comín-Colet J, Salar A. Anthracycline-induced cardiotoxicity in diffuse large B-cell lymphoma: NT-proBNP and cardiovascular score for risk stratification. Eur J Haematol 2019; 102:509-515. [PMID: 30972815 DOI: 10.1111/ejh.13234] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 04/03/2019] [Accepted: 04/04/2019] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To evaluate the role of N-terminal pro-brain-type natriuretic peptide (NT-proBNP) and a cardiovascular (CV) risk score named FRESCO for predicting anthracycline-induced cardiotoxicity (AIC) in diffuse large B-cell lymphoma (DLBCL). METHODS A total of 130 consecutive DLBCL patients treated in first-line with anthracycline-containing immunochemotherapy. Competitive risk between NT-proBNP, FRESCO, and time to AIC was considered. RESULTS Cumulative incidence of AIC was 12.2% and 17.5% at 1 and 5 years, respectively. Median time to development cardiotoxicity was 6.4 months, with half of the cases showing heart failure and the other half silent AIC. Both NT-proBNP levels and FRESCO score were independently associated with higher risk of AIC (P = 0.001 and P = 0.03, respectively). Patients with NT-proBNP ≥600 pg/mL or those with FRESCO ≥4.5% had 3.97 or 2.54 times higher risk of AIC than those with lower values (P = 0.001 and P = 0.048, respectively). According to the previous cutoffs, three groups of patients with a significantly different risk of AIC could be identified (P < 0.0001). CONCLUSIONS Doxorubicin-containing chemotherapy is associated with increased risk of silent and overt AIC. Baseline NT-proBNP levels and FRESCO CV risk score are accurate predictors of AIC and can identify groups of patients at different risk, in which personalized cardiologic evaluation should be offered.
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Affiliation(s)
- Mariana Paola Ferraro
- Department of Hematology, Hospital del Mar, Barcelona, Spain.,Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,Clinical Hematology Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Eva Gimeno-Vazquez
- Department of Hematology, Hospital del Mar, Barcelona, Spain.,Clinical Hematology Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Isaac Subirana
- CIBER of Epidemiology and Public Health, Barcelona, Spain.,Cardiovascular Epidemiology and Genetics Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Miquel Gómez
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,Department of Cardiology, Hospital del Mar, Barcelona, Spain.,Heart Diseases Biomedical Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Javier Díaz
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Blanca Sánchez-González
- Department of Hematology, Hospital del Mar, Barcelona, Spain.,Clinical Hematology Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Francesc García-Pallarols
- Department of Hematology, Hospital del Mar, Barcelona, Spain.,Clinical Hematology Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Laia Martínez
- Department of Hematology, Hospital del Mar, Barcelona, Spain
| | - Mireia Ble
- Department of Cardiology, Hospital del Mar, Barcelona, Spain
| | - Lluis Molina
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,Department of Cardiology, Hospital del Mar, Barcelona, Spain.,Heart Diseases Biomedical Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain
| | | | - Eugenia Abella
- Department of Hematology, Hospital del Mar, Barcelona, Spain.,Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,Clinical Hematology Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Roberto Elosua
- Cardiovascular Epidemiology and Genetics Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain.,CIBER of Cardiovascular Disorders, Barcelona, Spain
| | - Josep Comín-Colet
- Department of Cardiology, Hospital del Mar, Barcelona, Spain.,Heart Diseases Biomedical Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain.,Cardiovascular Research Group, Bellvitge Biomedical Research Institute, Hospitalet, Barcelona, Spain
| | - Antonio Salar
- Department of Hematology, Hospital del Mar, Barcelona, Spain.,Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,Clinical Hematology Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain
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13
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Ribera J, García O, Moreno M, Barba P, García‐Cadenas I, Mercadal S, Montesinos P, Barrios M, González‐Campos J, Martínez‐Carballeira D, Gil C, Ribera J, Vives S, Novo A, Cervera M, Serrano J, Lavilla E, Abella E, Tormo M, Amigo M, Artola M, Genescà E, Bravo P, García‐Belmonte D, García‐Guiñón A, Hernández‐Rivas J, Feliu E. Incidence and outcome after first molecular versus overt recurrence in patients with Philadelphia chromosome–positive acute lymphoblastic leukemia included in the ALL Ph08 trial from the Spanish PETHEMA Group. Cancer 2019; 125:2810-2817. [DOI: 10.1002/cncr.32156] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 03/08/2019] [Accepted: 03/18/2019] [Indexed: 01/13/2023]
Affiliation(s)
- Josep‐Maria Ribera
- Department of Clinical Hematology ICO Badalona‐Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Autonomous University of Barcelona Badalona Spain
| | - Olga García
- Department of Clinical Hematology ICO Badalona‐Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Autonomous University of Barcelona Badalona Spain
| | - María‐José Moreno
- Department of Hematology Hospital of the Virgen de la Victoria Malaga Spain
| | - Pere Barba
- Department of Hematology Vall d’Hebron University Hospital, Autonomous University of Barcelona Barcelona Spain
| | | | - Santiago Mercadal
- Department of Hematology ICO‐Hospital Duran i Reynals, L’Hospitalet de Llobregat Catalonia Spain
| | - Pau Montesinos
- Department of Hematology Le Fe University and Polytechnic Hospital Valencia Spain
| | - Manuel Barrios
- Department of Hematology Carlos Haya Hospital Malaga Spain
| | | | | | - Cristina Gil
- Department of Hematology General University Hospital of Alicante Alicante Spain
| | - Jordi Ribera
- Department of Clinical Hematology ICO Badalona‐Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Autonomous University of Barcelona Badalona Spain
| | - Susana Vives
- Department of Clinical Hematology ICO Badalona‐Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Autonomous University of Barcelona Badalona Spain
| | - Andrés Novo
- Department of Hematology Son Espases Hospital Palma de Mallorca Spain
| | - Marta Cervera
- Department of Hematology ICO‐Hospital Joan XXIII Tarragona Spain
| | | | | | - Eugenia Abella
- Department of Hematology del Mar Hospital Barcelona Spain
| | - Mar Tormo
- Department of Hematology Clinical Hospital Valencia Spain
| | - María‐Luz Amigo
- Department of Hematology Morales Meseguer University General Hospital Murcia Spain
| | | | - Eulalia Genescà
- Department of Clinical Hematology ICO Badalona‐Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Autonomous University of Barcelona Badalona Spain
| | - Pilar Bravo
- Department of Hematology Fuenlabrada University Hospital Madrid Spain
| | | | | | | | - Evarist Feliu
- Department of Clinical Hematology ICO Badalona‐Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Autonomous University of Barcelona Badalona Spain
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14
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Ribera J, Granada I, Morgades M, Vives S, Genescà E, González C, Nomdedeu J, Escoda L, Montesinos P, Mercadal S, Coll R, González-Campos J, Abella E, Barba P, Bermúdez A, Gil C, Tormo M, Pedreño M, Martínez-Carballeira D, Hernández-Rivas JM, Orfao A, Martínez-López J, Esteve J, Bravo P, Garcia-Guiñon A, Debén G, Moraleda JM, Queizán JA, Ortín X, Moreno MJ, Feliu E, Solé F, Ribera JM. The poor prognosis of low hypodiploidy in adults with B-cell precursor acute lymphoblastic leukaemia is restricted to older adults and elderly patients. Br J Haematol 2019; 186:263-268. [PMID: 30916384 DOI: 10.1111/bjh.15887] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 01/02/2019] [Accepted: 02/06/2019] [Indexed: 11/28/2022]
Abstract
The prognostic significance of low-hypodiploidy has not been extensively evaluated in minimal residual disease (MRD)-oriented protocols for adult acute lymphoblastic leukaemia (ALL). We analysed the outcome of hypodiploid adult ALL patients treated within Programa Español de Tratamientos en Hematología (PETHEMA) protocols. The 5-year cumulative incidence of relapse (CIR) of low-hypodiploid B-cell precursor (BCP)-ALL was significantly higher than that of high-hypodiploids (52% vs. 12%, P = 0.013). Low-hypodiploid BCP-ALL patients aged ≤35 years showed superior survival (71% vs. 21%, P = 0.026) and lower 5-year CIR (17% vs. 66%, P = 0.090) than low-hypodiploids aged >35 years. Older adults and elderly low-hypodiploid BCP-ALL patients show dismal prognosis although achieving an end-induction good MRD response.
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Affiliation(s)
- Jordi Ribera
- Institut de Recerca contra la Leucemia Josep Carreras, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Isabel Granada
- Institut de Recerca contra la Leucemia Josep Carreras, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain.,Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Mireia Morgades
- Institut de Recerca contra la Leucemia Josep Carreras, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain.,Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Susana Vives
- Institut de Recerca contra la Leucemia Josep Carreras, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain.,Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Eulàlia Genescà
- Institut de Recerca contra la Leucemia Josep Carreras, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Celia González
- Institut de Recerca contra la Leucemia Josep Carreras, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Josep Nomdedeu
- Institut de Recerca contra la Leucemia Josep Carreras, Hospital Sant Pau, Barcelona, Spain
| | - Lourdes Escoda
- Institut Català d'Oncologia, Hospital Joan XXIII, Tarragona, Spain
| | | | - Santiago Mercadal
- Institut Català d'Oncologia, Hospital Duran i Reynals, Hospitalet de Llobregat, Llobregat, Spain
| | - Rosa Coll
- Institut Català d'Oncologia, Hospital Josep Trueta, Girona, Spain
| | | | | | - Pere Barba
- Hospital Vall d'Hebron, Barcelona, Spain
| | | | | | | | | | | | - Jesús-María Hernández-Rivas
- Hospital Universitario de Salamanca, Universidad de Salamanca, IBMCC (CSIC/USAL), IBSAL and CIBERONC, Salamanca, Spain
| | - Alberto Orfao
- Hospital Universitario de Salamanca, Universidad de Salamanca, IBMCC (CSIC/USAL), IBSAL and CIBERONC, Salamanca, Spain
| | | | - Jordi Esteve
- Institut de Recerca contra la Leucemia Josep Carreras, Hospital Clínic, Barcelona, Spain
| | - Pilar Bravo
- Hospital Universitario de Fuenlabrada, Fuenlabrada, Spain
| | | | | | - José M Moraleda
- Hospital Clínico Universitario Virgen de la Arrixaca, IMIB, Universidad de Murcia, Murcia, Spain
| | | | | | | | - Evarist Feliu
- Institut de Recerca contra la Leucemia Josep Carreras, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain.,Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Francesc Solé
- Institut de Recerca contra la Leucemia Josep Carreras, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Josep M Ribera
- Institut de Recerca contra la Leucemia Josep Carreras, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain.,Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Badalona, Spain
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15
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Jiménez-Segura R, Granell M, Gironella M, Abella E, García-Guiñón A, Oriol A, Cabezudo E, Clapés V, Soler JA, Escoda L, López-Pardo J, Fernández de Larrea C, Cibeira MT, Tovar N, Isola I, Bladé J, Rosiñol L. Pomalidomide-dexamethasone for treatment of soft-tissue plasmacytomas in patients with relapsed / refractory multiple myeloma. Eur J Haematol 2019; 102:389-394. [PMID: 30719772 DOI: 10.1111/ejh.13217] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 01/23/2019] [Accepted: 01/24/2019] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The presence of plasmacytomas (Ps) in patients with multiple myeloma (MM) is associated with a poor outcome, both in patients treated conventionally and in patients treated with novel agents. Two types of plasmacytomas have being recognized: paraskeletal plasmacytomas (PPs) and extramedullary plasmacytomas (EMPs), being the incidence of EMPs lower but with worse prognosis. Our aim has been to analyze the efficacy of the pomalidomide-dexamethasone combination in this patient profile. METHOD In the present study, the efficacy of pomalidomide and dexamethasone in 21 patients from nine hospitals of Catalonia (Spain), with relapsed or refractory MM and Ps, was analyzed. For this purpose, we describe the evolution of paraprotein in serum and urine and the size of plasmacytomas during treatment with pomalidomide-dexamethasone. RESULTS While 34% of the patients achieved a paraprotein response, only two patients with PPs (9%) responded (RC and PR). There were no responses among patients with EMPs. The median progression-free survival from the start of treatment with pomalidomide/dexamethasone was only 1.7 months and the median overall survival of 4.5 months. CONCLUSION In conclusion, pomalidomide and dexamethasone has limited efficacy in patients with advanced MM and soft-tissue plasmacytomas.
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Affiliation(s)
| | | | | | | | | | - Albert Oriol
- Hospital Universitari Germans Trias i Pujol, Barcelona, Spain
| | | | - Victoria Clapés
- Instituto Catalán de Oncología Hospitalet de Llobregat, Barcelona, Spain
| | | | | | | | | | | | | | | | - Joan Bladé
- Hospital Clinic, IDIBAPS, Barcelona, Spain
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16
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Senín A, García-Pallarols F, Ben Azaiz R, Martínez-Serra L, Montesdeoca S, Román D, Ferraro M, Párraga I, Besses C, Abella E. Study of the frequency and reasons for discontinuation of different lines of treatment in patients with multiple myeloma. Ann Hematol 2019; 98:705-711. [PMID: 30675673 DOI: 10.1007/s00277-019-03601-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 01/03/2019] [Indexed: 11/24/2022]
Abstract
The availability of new agents for the treatment of multiple myeloma has allowed the use of multiple lines of treatment, but a percentage of patients do not reach to receive this combination because of toxicity and early death. In this regard, a cross-sectional European study evaluated the management of different lines and discontinuation of treatment in 7635 patients from seven countries in routine clinical practice, finding that 39% of European patients do not receive a second line and that only 4% of patients reach third line in Spain, a figure that is striking when comparing with the rest of the countries. We analyze the frequency and causes of treatment discontinuation in a series of 108 patients from a Spanish University hospital showing that the main reason for permanent treatment discontinuation after finishing first line was to have a response, while death due to disease progression accounted for the main reason in subsequent lines of therapy, with its frequency increasing according to the number of lines received. Additionally, in our longitudinal study, we estimated, using a competitive risk analysis, that 22% of patients would not receive a second line of therapy at 60 months and 47% would not reach third line, also at 60 months, showing a marked discrepancy with the results reported in the cross-sectional European study. Although based on limited data, our results suggest the convenience of validating the findings of cross-sectional studies conducted in large cohorts.
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Affiliation(s)
- Alicia Senín
- Hematology Department, Hospital del Mar-IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Universidad Autónoma de Barcelona, Barcelona, Spain.
| | - Francesc García-Pallarols
- Hematology Department, Hospital del Mar-IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Universidad Autónoma de Barcelona, Barcelona, Spain
| | - Randa Ben Azaiz
- Hematology Department, Hospital del Mar-IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Universidad Autónoma de Barcelona, Barcelona, Spain
| | - Laia Martínez-Serra
- Hematology Department, Hospital del Mar-IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Universidad Autónoma de Barcelona, Barcelona, Spain
| | - Sara Montesdeoca
- Hematology Department, Hospital del Mar-IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Universidad Autónoma de Barcelona, Barcelona, Spain
| | - David Román
- Hematology Department, Hospital del Mar-IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Universidad Autónoma de Barcelona, Barcelona, Spain
| | - Mariana Ferraro
- Hematology Department, Hospital del Mar-IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Universidad Autónoma de Barcelona, Barcelona, Spain
| | - Ivonne Párraga
- Hematology Department, Hospital del Mar-IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Universidad Autónoma de Barcelona, Barcelona, Spain
| | - Carlos Besses
- Hematology Department, Hospital del Mar-IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Universidad Autónoma de Barcelona, Barcelona, Spain
| | - Eugenia Abella
- Hematology Department, Hospital del Mar-IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Universidad Autónoma de Barcelona, Barcelona, Spain
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17
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Baptista MJ, Tapia G, Morgades M, Muncunill J, Muñoz-Marmol AM, Montoto S, Gribben JG, Calaminici M, Martinez A, Gonzalez-Farre B, Dlouhy I, González-Barca E, Terol MJ, Miralles P, Alcoceba M, Vall-Llovera F, Briones J, Abrisqueta P, Abella E, Provencio M, García-Ballesteros C, Moraleda JM, Sancho JM, Ribera JM, Mate JL, Navarro JT. Using the Lymph2Cx assay for assessing cell-of-origin subtypes of HIV-related diffuse large B-cell lymphoma. Leuk Lymphoma 2018; 60:1087-1091. [DOI: 10.1080/10428194.2018.1512711] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Maria Joao Baptista
- Department of Hematology, ICO-Hospital Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute (IJC), Institut Germans Trias i Pujol (IGTP), Universitat Autònoma de Barcelona, Badalona, Spain
| | - Gustavo Tapia
- Department of Pathology, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Mireia Morgades
- Department of Hematology, ICO-Hospital Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute (IJC), Institut Germans Trias i Pujol (IGTP), Universitat Autònoma de Barcelona, Badalona, Spain
| | - Josep Muncunill
- Department of Hematology, ICO-Hospital Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute (IJC), Institut Germans Trias i Pujol (IGTP), Universitat Autònoma de Barcelona, Badalona, Spain
| | - Ana-María Muñoz-Marmol
- Department of Pathology, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Silvia Montoto
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London, London, United Kingdom
| | - John G. Gribben
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London, London, United Kingdom
| | - Maria Calaminici
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London, London, United Kingdom
| | - Antonio Martinez
- Department of Pathology, Hospital Clinic, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Blanca Gonzalez-Farre
- Department of Pathology, Hospital Clinic, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Ivan Dlouhy
- Department of Hematology, Hospital Clinic, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Eva González-Barca
- Department of Hematology, ICO-Hospital Duran i Reynals, L’Hospitalet de Llobregat, Spain
| | - María-José Terol
- Department of Hematology and Oncology, Hospital Clínic Universitari de València, Valencia, Spain
| | - Pilar Miralles
- Department of Infectious Diseases, Hospital Gregorio Marañón, Madrid, Spain
| | - Miguel Alcoceba
- Department of Hematology, Hospital Universitario de Salamanca, Salamanca, Spain
| | - Ferran Vall-Llovera
- Department of Clinical Hematology, Hospital Universitari Mutúa de Terrassa, Terrassa, Spain
| | - Javier Briones
- Department of Hematology, Hospital de la Santa Creu i Sant Pau, Josep Carreras Leukaemia Research Institute (IJC), Barcelona, Spain
| | - Pau Abrisqueta
- Department of Hematology, Hospital Vall d’Hebrón, Barcelona, Spain
| | - Eugenia Abella
- Department of Hematology, Hospital del Mar, Barcelona, Spain
| | - Mariano Provencio
- Department of Medical Oncology, Hospital Universitario Puerta De Hierro, Majadahonda, Spain
| | | | - José-María Moraleda
- Department of Hematology, Hospital Clinico Universitario Virgen de la Arrixaca, Murcia, Spain
| | - Juan-Manuel Sancho
- Department of Hematology, ICO-Hospital Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute (IJC), Institut Germans Trias i Pujol (IGTP), Universitat Autònoma de Barcelona, Badalona, Spain
| | - Josep-Maria Ribera
- Department of Hematology, ICO-Hospital Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute (IJC), Institut Germans Trias i Pujol (IGTP), Universitat Autònoma de Barcelona, Badalona, Spain
| | - José-Luis Mate
- Department of Pathology, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | - José-Tomas Navarro
- Department of Hematology, ICO-Hospital Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute (IJC), Institut Germans Trias i Pujol (IGTP), Universitat Autònoma de Barcelona, Badalona, Spain
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18
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Blanco G, Vardi A, Puiggros A, Gómez-Llonín A, Muro M, Rodríguez-Rivera M, Stalika E, Abella E, Gimeno E, López-Sánchez M, Senín A, Calvo X, Abrisqueta P, Bosch F, Ferrer A, Stamatopoulos K, Espinet B. Restricted T cell receptor repertoire in CLL-like monoclonal B cell lymphocytosis and early stage CLL. Oncoimmunology 2018; 7:e1432328. [PMID: 29872562 DOI: 10.1080/2162402x.2018.1432328] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [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: 06/28/2017] [Revised: 01/19/2018] [Accepted: 01/20/2018] [Indexed: 01/16/2023] Open
Abstract
Analysis of the T cell receptor (TR) repertoire of chronic lymphocytic leukemia-like monoclonal B cell lymphocytosis (CLL-like MBL) and early stage CLL is relevant for understanding the dynamic interaction of expanded B cell clones with bystander T cells. Here we profiled the T cell receptor β chain (TRB) repertoire of the CD4+ and CD8+ T cell fractions from 16 CLL-like MBL and 13 untreated, Binet stage A/Rai stage 0 CLL patients using subcloning analysis followed by Sanger sequencing. The T cell subpopulations of both MBL and early stage CLL harbored restricted TRB gene repertoire, with CD4+ T cell clonal expansions whose frequency followed the numerical increase of clonal B cells. Longitudinal analysis in MBL cases revealed clonal persistence, alluding to persistent antigen stimulation. In addition, the identification of shared clonotypes among different MBL/early stage CLL cases pointed towards selection of the T cell clones by common antigenic elements. T cell clonotypes previously described in viral infections and immune disorders were also detected. Altogether, our findings evidence that antigen-mediated TR restriction occurs early in clonal evolution leading to CLL and may further increase together with B cell clonal expansion, possibly suggesting that the T cell selecting antigens are tumor-related.
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Affiliation(s)
- Gonzalo Blanco
- Laboratori de Citogenètica Molecular, Laboratori de Citologia Hematològica, Servei de Patologia, Hospital del Mar, Barcelona, Spain.,Grup de Recerca Translacional en Neoplàsies Hematològiques, Cancer Research Programme, IMIM-Hospital del Mar, Barcelona, Spain.,Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Anna Vardi
- Institute of Applied Biosciences, CERTH, Thessaloniki, Greece
| | - Anna Puiggros
- Laboratori de Citogenètica Molecular, Laboratori de Citologia Hematològica, Servei de Patologia, Hospital del Mar, Barcelona, Spain.,Grup de Recerca Translacional en Neoplàsies Hematològiques, Cancer Research Programme, IMIM-Hospital del Mar, Barcelona, Spain
| | - Andrea Gómez-Llonín
- Laboratori de Citogenètica Molecular, Laboratori de Citologia Hematològica, Servei de Patologia, Hospital del Mar, Barcelona, Spain.,Grup de Recerca Translacional en Neoplàsies Hematològiques, Cancer Research Programme, IMIM-Hospital del Mar, Barcelona, Spain
| | - Manuel Muro
- Immunology Service, University Clinical Hospital Virgen de la Arrixaca-Biomedical Research Institute of Murcia (IMIB), Murcia, Spain
| | - María Rodríguez-Rivera
- Laboratori de Citogenètica Molecular, Laboratori de Citologia Hematològica, Servei de Patologia, Hospital del Mar, Barcelona, Spain.,Grup de Recerca Translacional en Neoplàsies Hematològiques, Cancer Research Programme, IMIM-Hospital del Mar, Barcelona, Spain
| | | | - Eugenia Abella
- Servei d'Hematologia, Hospital del Mar-IMIM, Barcelona, Spain
| | - Eva Gimeno
- Servei d'Hematologia, Hospital del Mar-IMIM, Barcelona, Spain
| | - Manuela López-Sánchez
- Immunology Service, University Clinical Hospital Virgen de la Arrixaca-Biomedical Research Institute of Murcia (IMIB), Murcia, Spain
| | - Alicia Senín
- Servei d'Hematologia, Hospital del Mar-IMIM, Barcelona, Spain
| | - Xavier Calvo
- Laboratori de Citogenètica Molecular, Laboratori de Citologia Hematològica, Servei de Patologia, Hospital del Mar, Barcelona, Spain.,Grup de Recerca Translacional en Neoplàsies Hematològiques, Cancer Research Programme, IMIM-Hospital del Mar, Barcelona, Spain
| | - Pau Abrisqueta
- Servei d'Hematologia, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Francesc Bosch
- Servei d'Hematologia, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Ana Ferrer
- Laboratori de Citogenètica Molecular, Laboratori de Citologia Hematològica, Servei de Patologia, Hospital del Mar, Barcelona, Spain.,Grup de Recerca Translacional en Neoplàsies Hematològiques, Cancer Research Programme, IMIM-Hospital del Mar, Barcelona, Spain
| | | | - Blanca Espinet
- Laboratori de Citogenètica Molecular, Laboratori de Citologia Hematològica, Servei de Patologia, Hospital del Mar, Barcelona, Spain.,Grup de Recerca Translacional en Neoplàsies Hematològiques, Cancer Research Programme, IMIM-Hospital del Mar, Barcelona, Spain
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19
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Ribera JM, Morgades M, Montesinos P, Martino R, Barba P, Soria B, Bermúdez A, Moreno MJ, González-Campos J, Vives S, Gil C, Abella E, Guàrdia R, Martínez-Carballeira D, Martínez-Sánchez P, Amigo ML, Mercadal S, Serrano A, López-Martínez A, Vall-Llovera F, Sánchez-Sánchez MJ, Peñarrubia MJ, Calbacho M, Méndez JA, Bergua J, Cladera A, Tormo M, García-Belmonte D, Feliu E, Ciudad J, Orfao A. Efficacy and safety of native versus pegylated Escherichia coli asparaginase for treatment of adults with high-risk, Philadelphia chromosome-negative acute lymphoblastic leukemia. Leuk Lymphoma 2017; 59:1634-1643. [PMID: 29165013 DOI: 10.1080/10428194.2017.1397661] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [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: 12/26/2022]
Abstract
Native or pegylated (PEG) asparaginase (ASP) are commonly used in treatment of acute lymphoblastic leukemia (ALL), but have been scarcely compared in the same trial in adult patients. Native vs. PEG-ASP administered according to availability in each center were prospectively evaluated in adults with high-risk ALL. Ninety-one patients received native ASP and 35 PEG-ASP in induction. No significant differences were observed in complete remission, minimal residual disease levels after induction and after consolidation, disease-free survival, and overall survival. No significant differences in grades 3-4 toxicity were observed in the induction period, although a trend for higher hepatic toxicity was observed in patients receiving PEG-ASP. In this trial the type of ASP did not influence patient response and outcome.
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Affiliation(s)
- Josep-Maria Ribera
- a ICO Badalona-Hospital Germans Trias i Pujol , Josep Carreras Leukemia Research Institute, Universitat Autònoma de Barcelona , Badalona , Spain
| | - Mireia Morgades
- a ICO Badalona-Hospital Germans Trias i Pujol , Josep Carreras Leukemia Research Institute, Universitat Autònoma de Barcelona , Badalona , Spain
| | - Pau Montesinos
- b Hospital Universitari i Politècnic La Fe , Valencia , Spain
| | | | - Pere Barba
- d Hospital Vall d'Hebron Universitat Autònoma de Barcelona , Barcelona , Spain
| | - Beatriz Soria
- e Hospital Universitario de Canarias , Santa Cruz de Tenerife , Spain
| | - Arancha Bermúdez
- f Hospital Universitario Marqués de Valdecilla , Santander , Spain
| | - María-José Moreno
- g Hospital Clínico Universitario Virgen de la Victoria , Málaga , Spain
| | | | - Susana Vives
- a ICO Badalona-Hospital Germans Trias i Pujol , Josep Carreras Leukemia Research Institute, Universitat Autònoma de Barcelona , Badalona , Spain
| | - Cristina Gil
- i Hospital General de Alicante , Alicante , Spain
| | | | | | | | | | | | - Santiago Mercadal
- o ICO L'Hospitalet-Hospital Duran i Reynals, L'Hospitalet de Llobregat , L'Hospitalet de Llobregat, Spain
| | | | | | | | | | | | | | | | - Juan Bergua
- w Hospital San Pedro de Alcántara , Cáceres , Spain
| | | | - Mar Tormo
- y Hospital Clínico Universitario de Valencia , Valencia , Spain
| | | | - Evarist Feliu
- a ICO Badalona-Hospital Germans Trias i Pujol , Josep Carreras Leukemia Research Institute, Universitat Autònoma de Barcelona , Badalona , Spain
| | - Juana Ciudad
- aa Centro de Investigación del Cáncer (CIC, IBMCC USAL-CSIC), Servicio General de Citometría, and Instituto de Investigación Biomédica de Salamanca (IBSAL) , Universidad de Salamanca , Salamanca , Spain
| | - Alberto Orfao
- aa Centro de Investigación del Cáncer (CIC, IBMCC USAL-CSIC), Servicio General de Citometría, and Instituto de Investigación Biomédica de Salamanca (IBSAL) , Universidad de Salamanca , Salamanca , Spain
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20
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Baptista M, Tapia G, Muñoz-Marmol A, Muncunill J, Montoto S, Gribben J, Calaminici M, Martinez A, Gonzalez-Farre B, López-Guillermo A, González-Barca E, Terol M, Miralles P, Alcoceba M, Vall-Llovera F, Briones J, Abrisqueta P, Abella E, Provencio M, García-Ballesteros C, Moraleda J, Sancho J, Ribera J, Mate J, Navarro J. APPLICATION OF CELL-OF-ORIGIN SUBTYPES DETERMINED BY DIGITAL GENE EXPRESSION IN HIV-RELATED DIFFUSE LARGE B-CELL LYMPHOMAS. Hematol Oncol 2017. [DOI: 10.1002/hon.2438_11] [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)
- M. Baptista
- Department of Hematology; ICO-Hospital Universitari Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute, Universitat Autònoma de Barcelona; Badalona Spain
| | - G. Tapia
- Department of Pathology; Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona; Badalona Spain
| | - A. Muñoz-Marmol
- Department of Pathology; Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona; Badalona Spain
| | - J. Muncunill
- Department of Hematology; ICO-Hospital Universitari Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute, Universitat Autònoma de Barcelona; Badalona Spain
| | - S. Montoto
- Department of Haemato-Oncology, Barts Cancer Institute; Queen Mary University of London; London UK
| | - J. Gribben
- Department of Haemato-Oncology, Barts Cancer Institute; Queen Mary University of London; London UK
| | - M. Calaminici
- Department of Haemato-Oncology, Barts Cancer Institute; Queen Mary University of London; London UK
| | - A. Martinez
- Department of Pathology, Hospital Clinic, Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS); University of Barcelona; Barcelona Spain
| | - B. Gonzalez-Farre
- Department of Pathology, Hospital Clinic, Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS); University of Barcelona; Barcelona Spain
| | - A. López-Guillermo
- Department of Hematology, Hospital Clinic, Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS); University of Barcelona; Barcelona Spain
| | - E. González-Barca
- Department of Hematology; ICO-Hospital Duran i Reynals, L'Hospitalet de Llobregat; Spain
| | - M. Terol
- Department of Hematology and Oncology; Hospital Clínic Universitari de València; Valencia Spain
| | - P. Miralles
- Department of Infectious Diseases; Hospital Gregorio Marañón; Madrid Spain
| | - M. Alcoceba
- Department of Hematology; Hospital Universitario de Salamanca; Salamanca Spain
| | - F. Vall-Llovera
- Servicio de Hematología Clínica; Hospital Universitari Mutúa de Terrassa; Terrassa Spain
| | - J. Briones
- Department of Hematology, Hospital de la Santa Creu i Sant Pau; Josep Carreras Leukaemia Research Institute; Barcelona Spain
| | - P. Abrisqueta
- Department of Hematology; Hospital Vall d'Hebrón; Barcelona Spain
| | - E. Abella
- Department of Hematology; Hospital del Mar; Barcelona Spain
| | - M. Provencio
- Department of Medical Oncology; Hospital Universitario Puerta De Hierro; Majadahonda Spain
| | | | - J. Moraleda
- Department of Hematology; Hospital Clinico Universitario Virgen de la Arrixaca; Murcia Spain
| | - J. Sancho
- Department of Hematology; ICO-Hospital Universitari Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute, Universitat Autònoma de Barcelona; Badalona Spain
| | - J. Ribera
- Department of Hematology; ICO-Hospital Universitari Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute, Universitat Autònoma de Barcelona; Badalona Spain
| | - J. Mate
- Department of Pathology; Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona; Badalona Spain
| | - J. Navarro
- Department of Hematology; ICO-Hospital Universitari Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute, Universitat Autònoma de Barcelona; Badalona Spain
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21
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Ferraro M, Gimeno E, Ble M, Subirana I, Gómez M, Díaz J, Sánchez-González B, García-Pallarols F, Martínez L, Belarte L, Abella E, Elosua R, Salar A. USEFULNESS OF N-TERMINAL BRAIN NATRIURETIC PEPTIDE LEVELS AND FRESCO SCALE FOR THE PREDICTION OF ANTHRACYCLINE-INDUCED CARDIOMYOTOXICITY IN PATIENTS WITH HODGKIN LYMPHOMA. Hematol Oncol 2017. [DOI: 10.1002/hon.2438_35] [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: 11/10/2022]
Affiliation(s)
- M. Ferraro
- Clinical Hematology, Research Group Applied in Hematological diseases; Autonomous University of Barcelona, Hospital del Mar, Institute of Medical Research of Hospital del Mar; Barcelona Spain
| | - E. Gimeno
- Clinical Hematology, Research Group Applied in Malalties Hematolgiques, Hospital del Mar; Institute of Medical Research of Hospital del Mar; Barcelona Spain
| | - M. Ble
- Cardiology; Hospital del Mar; Barcelona Spain
| | - I. Subirana
- CIBER of Epidemiology and Public Health, Research Group on Epidemiology and Cardiovascular Genetics, Hospital del Mar; Institute of Medical Research of Hospital del Mar; Barcelona Spain
| | - M. Gómez
- Cardiology; Hospital del Mar; Barcelona Spain
| | - J. Díaz
- Hematology; Autonomous University of Barcelona; Barcelona Spain
| | - B. Sánchez-González
- Clinical Hematology, Research Group Applied in Malalties Hematolgiques, Hospital del Mar; Institute of Medical Research of Hospital del Mar; Barcelona Spain
| | - F. García-Pallarols
- Clinical Hematology, Research Group Applied in Malalties Hematolgiques, Hospital del Mar; Institute of Medical Research of Hospital del Mar; Barcelona Spain
| | - L. Martínez
- Clinical Hematology; Hospital del Mar; Barcelona Spain
| | | | - E. Abella
- Clinical Hematology, Research Group Applied in Hematological diseases; Autonomous University of Barcelona, Hospital del Mar, Institute of Medical Research of Hospital del Mar; Barcelona Spain
| | - R. Elosua
- CIBER of Epidemiology and Public Health and Cardiovascular Diseases, Research Group on Epidemiology and Cardiovascular Genetics, Hospital del Mar; Institute of Medical Research of Hospital del Mar; Barcelona Spain
| | - A. Salar
- Clinical Hematology, Research Group Applied in Hematological diseases; Autonomous University of Barcelona, Hospital del Mar, Institute of Medical Research of Hospital del Mar; Barcelona Spain
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22
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Barata A, Martino R, Gich I, García-Cadenas I, Abella E, Barba P, Briones J, Brunet S, Esquirol A, García-Pallarols F, Garrido A, Granell M, Martinez J, Mensa I, Novelli S, Sánchez-González B, Valcárcel D, Sierra J. Do Patients and Physicians Agree When They Assess Quality of Life? Biol Blood Marrow Transplant 2017; 23:1005-1010. [DOI: 10.1016/j.bbmt.2017.03.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 03/09/2017] [Indexed: 02/02/2023]
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23
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Motlló C, Ribera JM, Morgades M, Granada I, Montesinos P, Mercadal S, González-Campos J, Moreno MJ, Barba P, Cervera M, Barrios M, Novo A, Bernal T, Hernández-Rivas JM, Abella E, Amigo ML, Tormo M, Martino R, Lavilla E, Bergua J, Serrano A, García-Belmonte D, Guàrdia R, Grau J, Feliu E. Frequency and prognostic significance of additional cytogenetic abnormalities to the Philadelphia chromosome in young and older adults with acute lymphoblastic leukemia. Leuk Lymphoma 2017; 59:146-154. [DOI: 10.1080/10428194.2017.1326596] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
- Cristina Motlló
- Department of Hematology, ICO-Hospital Universitari Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Josep-Maria Ribera
- Department of Hematology, ICO-Hospital Universitari Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Mireia Morgades
- Department of Hematology, ICO-Hospital Universitari Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Isabel Granada
- Department of Hematology, ICO-Hospital Universitari Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Pau Montesinos
- Department of Hematology, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Santiago Mercadal
- ICO-Hospital Duran i Reynals, L’Hospitalet de Llobregat, Barcelona, Spain
| | | | | | | | | | | | - Andrés Novo
- Hospital Son Espases, Palma de Mallorca, Palma, Spain
| | | | | | | | | | | | | | | | - Juan Bergua
- Hospital San Pedro de Alcántara, Cáceres, Spain
| | | | | | - Ramon Guàrdia
- Department of Hematology, ICO – Hospital Josep Trueta, Girona, Spain
| | - Javier Grau
- Department of Hematology, ICO-Hospital Universitari Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Evarist Feliu
- Department of Hematology, ICO-Hospital Universitari Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
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24
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Barba P, Martino R, Martinez-Cuadron D, Olga G, Esquirol A, Gil-Cortés C, Gonzalez J, Fernandez-Avilés F, Valcárcel D, Guardia R, Duarte RF, Hernandez-Rivas JM, Abella E, Montesinos P, Ribera JM. Impact of transplant eligibility and availability of a human leukocyte antigen-identical matched related donor on outcome of older patients with acute lymphoblastic leukemia. Leuk Lymphoma 2015; 56:2812-8. [DOI: 10.3109/10428194.2015.1014365] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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25
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Ancochea A, Sánchez-González B, Maiques JM, Abella E. [Breast plasmocytoma in a male patient]. Med Clin (Barc) 2014; 143:515-6. [PMID: 24581842 DOI: 10.1016/j.medcli.2014.01.010] [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] [Received: 01/13/2014] [Accepted: 01/16/2014] [Indexed: 10/25/2022]
Affiliation(s)
- Agueda Ancochea
- Departamento de Hematología, Hospital del Mar, Barcelona, España
| | | | | | - Eugenia Abella
- Departamento de Hematología, Hospital del Mar, Barcelona, España
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26
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Lyman GH, Dale DC, Legg JC, Abella E, Morrow PK, Whittaker S, Crawford JA. Abstract P3-15-08: A multicenter observational study to investigate the relationship between physician-assessed febrile neutropenia (FN) risk and prediction model FN or SN (severe neutropenia) risk in patients with breast cancer. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p3-15-08] [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: 11/16/2022]
Abstract
Abstract
Background: A prediction model was previously developed to estimate the risk of SN or FN during the first cycle of chemotherapy, taking into account both the myelotoxicity of the chemotherapy regimen and the interplay of specific tumor and patient characteristics (Lyman, 2011). This model may potentially be useful for predicting which patients are at greatest risk for developing neutropenic complications, particularly among those patients receiving intermediate FN risk chemotherapy regimens, where the influence of patient characteristics becomes a critical consideration. To assess the clinical utility of this model, physicians assessed FN risk in patients with non-myeloid malignancies, and then physician-assessed FN risk was compared to prediction model risk.
Methods: This was a prospective, multicenter, observational study (124 community-based oncologists, 944 patients). Analysis of a breast cancer subgroup (93 oncologists, 364 patients) is reported here. Patients were eligible if they were: ≥18 years old, newly diagnosed, and candidates for initiating a new course of chemotherapy using an NCCN intermediate (10-20%) FN risk chemotherapy regimen. Oncologists entered clinical data about the patient into the model; they also made a clinical prediction of FN risk. Oncologists were blinded to both the data elements collected by the model and the risk predicted by the model. Data were only collected until the chemotherapy order was written; no outcome data were collected. The primary objective was to investigate the relationship between physician-assessed FN risk and prediction model SN or FN risk. As an exploratory endpoint, physicians were asked to estimate FN risk on the same set of four hypothetical case studies with varying FN risk factors. The correlation between risk probability scores was estimated as well as a 95% confidence interval accounting for intra-physician correlation. A smooth spline curve was fit to show the average relationship between physician-assessed and prediction model risk probability scores.
Results: Most patients were planning to receive TC (54%) and most had stage I-II disease (71%). Median (min, max) age was 58 years (23, 83). Physician-assessed FN risk correlated weakly with prediction model FN or SN risk: correlation 0.166 (95% CI: 0.027, 0.298). There was wide variability among all 124 physicians in their assessment of FN risk for the four case studies (Q1, Q3 case study 1: 20%, 40%; case study 2: 10%, 18%; case study 3: 20%, 40%; case study 4: 25%, 60%).
Conclusions: This study suggests that community oncologists would benefit from the use of an automated system for assessing FN risk among those receiving intermediate risk chemotherapy regimens. Such a system would help oncologists identify the patients who would benefit most from clinical intervention and help improve practice efficiency and quality of care.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P3-15-08.
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Affiliation(s)
- GH Lyman
- Duke University School of Medicine and The Duke Cancer Institute, Durham, NC; University of Washington, Seattle, WA; Amgen Inc., Thousand Oaks, CA
| | - DC Dale
- Duke University School of Medicine and The Duke Cancer Institute, Durham, NC; University of Washington, Seattle, WA; Amgen Inc., Thousand Oaks, CA
| | - JC Legg
- Duke University School of Medicine and The Duke Cancer Institute, Durham, NC; University of Washington, Seattle, WA; Amgen Inc., Thousand Oaks, CA
| | - E Abella
- Duke University School of Medicine and The Duke Cancer Institute, Durham, NC; University of Washington, Seattle, WA; Amgen Inc., Thousand Oaks, CA
| | - PK Morrow
- Duke University School of Medicine and The Duke Cancer Institute, Durham, NC; University of Washington, Seattle, WA; Amgen Inc., Thousand Oaks, CA
| | - S Whittaker
- Duke University School of Medicine and The Duke Cancer Institute, Durham, NC; University of Washington, Seattle, WA; Amgen Inc., Thousand Oaks, CA
| | - JA Crawford
- Duke University School of Medicine and The Duke Cancer Institute, Durham, NC; University of Washington, Seattle, WA; Amgen Inc., Thousand Oaks, CA
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Ribera JM, García O, Montesinos P, Brunet S, Abella E, Barrios M, González-Campos J, Bravo P, Amigo ML, Hernández-Rivas JM. Treatment of young patients with Philadelphia chromosome-positive acute lymphoblastic leukaemia using increased dose of imatinib and deintensified chemotherapy before allogeneic stem cell transplantation. Br J Haematol 2012; 159:78-81. [PMID: 22823211 DOI: 10.1111/j.1365-2141.2012.09240.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2012] [Accepted: 06/06/2012] [Indexed: 11/27/2022]
Abstract
The main outcomes of the Programa Español para Tratamiento de Hemopatías (PETHEMA)-acute lymphoblastic leukaemia (ALL)-Ph-08 trial were described and compared with those of the historical PETHEMA-CSTIBES02 trial. The trials differed in imatinib dose (600 vs. 400 mg/d) and amount of chemotherapy (one vs. two consolidation cycles) before stem cell transplantation (SCT). All patients (n = 29) enrolled in the ALL-Ph-08 trial achieved complete remission (CR) (vs. 90% in CSTIBES02), and SCT was performed in CR in 90% (vs. 78%). The reduction in early death, relapse before SCT and transplant-related mortality observed in the ALL-Ph-08 trial resulted in an improved 2-year event-free survival (63% vs. 37%, P = 0·009).
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Affiliation(s)
- Josep-María Ribera
- Department of Haematology, ICO-Hospital Germans Trias i Pujol, Jose Carreras Leukaemia Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain.
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Marco A, Abella E, Liria-Loza A, Martins S, López O, Jiménez-Bordón S, Medina M, Oujo C, Gaona P, Godley BJ, López-Jurado LF. Abundance and exploitation of loggerhead turtles nesting in Boa Vista island, Cape Verde: the only substantial rookery in the eastern Atlantic. Anim Conserv 2012. [DOI: 10.1111/j.1469-1795.2012.00547.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- A. Marco
- Estación Biológica de Doñana; CSIC; Seville; Spain
| | | | - A. Liria-Loza
- Instituto Canario de Ciencias Marinas; ICCM; Gran Canaria; Spain
| | - S. Martins
- Cabo Verde Natura 2000; Sal Rei; Boa Vista; Cape Verde
| | - O. López
- Instituto Canario de Ciencias Marinas; ICCM; Gran Canaria; Spain
| | | | - M. Medina
- Instituto Canario de Ciencias Marinas; ICCM; Gran Canaria; Spain
| | - C. Oujo
- Instituto Canario de Ciencias Marinas; ICCM; Gran Canaria; Spain
| | - P. Gaona
- Estación Biológica de Doñana; CSIC; Seville; Spain
| | - B. J. Godley
- Centre for Ecology & Conservation; University of Exeter; Penryn; Cornwall; UK
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Ribera JM, Morgades M, González-Barca E, Miralles P, López-Guillermo A, Gardella S, López A, Abella E, García M, Navarro JT, Feliu E. Long-term follow-up of patients with HIV-related diffuse large B-cell lymphomas treated in a phase II study with rituximab and CHOP. Br J Haematol 2012; 157:637-9. [DOI: 10.1111/j.1365-2141.2012.09046.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | | | | | | | | | | | - Andres López
- PETHEMA, GELTAMO, GELCAB and GESIDA groups; Spain
| | | | - Marta García
- PETHEMA, GELTAMO, GELCAB and GESIDA groups; Spain
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Delgado J, Espinet B, Oliveira AC, Abrisqueta P, de la Serna J, Collado R, Loscertales J, Lopez M, Hernandez-Rivas JA, Ferra C, Ramirez A, Roncero JM, Lopez C, Aventin A, Puiggros A, Abella E, Carbonell F, Costa D, Carrio A, Gonzalez M. Chronic lymphocytic leukaemia with 17p deletion: a retrospective analysis of prognostic factors and therapy results. Br J Haematol 2012; 157:67-74. [PMID: 22224845 DOI: 10.1111/j.1365-2141.2011.09000.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Patients with chronic lymphocytic leukaemia (CLL) whose tumour cells harbour a 17p deletion (17p-) are universally considered to have a poor prognosis. The deletion can be detected at diagnosis or during the evolution of the disease, particularly in patients who have received chemotherapy. We sought to evaluate the natural history of patients with 17p- CLL, identify predictive factors within this prognostic subgroup, and evaluate the results of different therapeutic approaches. Data from 294 patients with 17p- CLL followed up at 20 different institutions was retrospectively collected and analysed. Median age was 68 (range 27-98) years at the time of fluorescence in situ hybridization analysis. After 17p- documentation, 52% received treatment, achieving an overall response rate of 50%. Median overall survival was 41 months, and was significantly shorter in patients with elevated beta(2)-microglobulin concentration (P < 0·001), B symptoms (P = 0·016), higher percentage of cells with deletion (P < 0·001), and acquired deletions (P = 0·012). These findings suggest that patients with 17p- CLL have a variable prognosis that can be refined using simple clinical and laboratory features, including 17p- clone size, beta2-microglobulin concentration, presence of B symptoms and type of deletion (de novo versus acquired).
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Affiliation(s)
- Julio Delgado
- Department of Haematology, Institute of Haematology and Oncology, Hospital Clinic, IDIBAPS, University of Barcelona, C/Villaroel 170, Barcelona, Spain.
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Bordoni RE, Haislip ST, Gilmore JW, Sharpe J, Abella E, Choi MR. P5-20-07: Estimation of Febrile Neutropenia in Women Receiving Docetaxel Plus Cyclophosphamide as Adjuvant Therapy for Early Stage Breast Cancer: A Retrospective Analysis. Cancer Res 2011. [DOI: 10.1158/0008-5472.sabcs11-p5-20-07] [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: 11/16/2022]
Abstract
Abstract
Background: US Oncology Trial 9735 (Jones S, et al. JCO. 2006;24:5381–5387) established the docetaxel plus cyclophosphamide (TC) regimen as an effective adjuvant therapy for early stage breast cancer (ESBC). This trial did not specifically evaluate the incidence of febrile neutropenia (FN) as a study endpoint, but rates of 4%-8% were reported. Prophylactic granulocyte colony-stimulating factor (G-CSF) support was not allowed; reactive G-CSF support overall was not reported. Subsequent reports in the community setting have indicated FN rates of 25%-50% without G-CSF support and 0%-6.3% with G-CSF support (Table 1). To better determine the incidence of FN among ESBC patients treated with TC, we performed a retrospective clinical data review from the electronic medical record (EMR) database of Georgia Cancer Specialists, a large community oncology practice.
Methods: EMR data were captured between January 2006 and March 2010. Eligibility included women ≥ 18 years old with ESBC (stage I-IIIA) who completed ≥ 1 cycle of TC. The study time period was from the first dose of chemotherapy (CTX) to 6 weeks after the last dose of CTX, death, or loss to follow-up. The primary endpoint was the incidence of FN. Other endpoints included the incidence of severe (grade 3/4) neutropenia, neutropenia-related hospitalizations, G-CSF use, relative dose intensity (RDI), and dose delays and reductions. Results: Data from 662 patients were included in the analysis. Median age was 55 (range: 25–81) years. 40% of patients were white. The median number of CTX cycles received was 4 (range: 1–6). Most patients (91%) received G-CSF support; 73% as primary prophylaxis. See Table 2 for additional results.
Conclusions: This is the largest retrospective, community-based study to evaluate the incidence of FN in ESBC patients treated with TC. The observed FN rate of 5% (with 91% of patients receiving G-CSF) is consistent with other published reports using TC (Table 1). Our results suggest that TC is a taxane regimen with clinically significant myelosuppression (similar to other commonly used regimens in ESBC, such as TAC [NCCN Guidelines v2.2011]) and that the use of G-CSF support should always be considered.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P5-20-07.
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Affiliation(s)
- RE Bordoni
- 1Georgia Cancer Specialists, Marietta, GA; Amgen Inc., Thousand Oaks, CA
| | - ST Haislip
- 1Georgia Cancer Specialists, Marietta, GA; Amgen Inc., Thousand Oaks, CA
| | - JW Gilmore
- 1Georgia Cancer Specialists, Marietta, GA; Amgen Inc., Thousand Oaks, CA
| | - J Sharpe
- 1Georgia Cancer Specialists, Marietta, GA; Amgen Inc., Thousand Oaks, CA
| | - E Abella
- 1Georgia Cancer Specialists, Marietta, GA; Amgen Inc., Thousand Oaks, CA
| | - MR Choi
- 1Georgia Cancer Specialists, Marietta, GA; Amgen Inc., Thousand Oaks, CA
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Serrano D, Aguado J, Escola J, Peral A, Morales G, Abella E. Synthesis of hierarchical ZSM-5 by silanization and alkoxylation of protozeolitic units. Catal Today 2011. [DOI: 10.1016/j.cattod.2010.12.040] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [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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Gimeno E, Sorli L, Abella E, Alvarez-Larran A, Horcajada JP, Garrigos L, Taus A, Salar A, Sanchez B, Pedro C, Besses C, Salvado M. Molecular diagnosis of bacteriemia in patients with neutropenic febrile oncohematologic. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.9033] [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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Xicoy B, Ribera JM, Miralles P, Berenguer J, Rubio R, Mahillo B, Valencia ME, Abella E, López-Guillermo A, Sureda A, Morgades M, Navarro JT, Esteban H. Limited prognostic value of the International Prognostic Score in advanced stage human immunodeficiency virus infection-related Hodgkin lymphoma treated with the doxorubicin, bleomycin, vinblastine, and dacarbazine regimen. Leuk Lymphoma 2010; 50:1718-20. [PMID: 19757300 DOI: 10.1080/10428190903174359] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Alvarez-Larrán A, Bellosillo B, Martínez-Avilés L, Saumell S, Salar A, Abella E, Gimeno E, Serrano S, Florensa L, Sánchez B, Pedro C, Besses C. Postpolycythaemic myelofibrosis: frequency and risk factors for this complication in 116 patients. Br J Haematol 2009; 146:504-9. [DOI: 10.1111/j.1365-2141.2009.07804.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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36
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Bosch F, Abrisqueta P, Villamor N, Terol MJ, González-Barca E, Ferra C, González Diaz M, Abella E, Delgado J, Carbonell F, García Marco JA, Escoda L, Ferrer S, Monzó E, González Y, Estany C, Jarque I, Salamero O, Muntañola A, Montserrat E. Rituximab, fludarabine, cyclophosphamide, and mitoxantrone: a new, highly active chemoimmunotherapy regimen for chronic lymphocytic leukemia. J Clin Oncol 2009; 27:4578-84. [PMID: 19704063 DOI: 10.1200/jco.2009.22.0442] [Citation(s) in RCA: 108] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
PURPOSE The addition of monoclonal antibodies to chemotherapy has significantly improved treatment of chronic lymphocytic leukemia (CLL). Based on excellent results with the chemotherapy-only regimen fludarabine, cyclophosphamide, and mitoxantrone (FCM), we built a new chemoimmunotherapy combination--rituximab plus FCM (R-FCM). We report a phase II clinical trial consisting of an initial treatment with R-FCM followed by rituximab maintenance. PATIENTS AND METHODS Seventy-two untreated CLL patients age 70 years or younger received rituximab 500 mg/m(2) on day 1 (375 mg/m(2) the first cycle), fludarabine 25 mg/m(2) IV on days 1 to 3, cyclophosphamide 200 mg/m(2) on days 1 to 3, and mitoxantrone 6 mg/m(2) IV on day 1, given at 4-week intervals with up to six cycles supported with colony-stimulating factor. Patients achieving response received maintenance with rituximab 375 mg/m(2) every 3 months for 2 years. RESULTS The overall response, minimal residual disease (MRD) -negative complete response (CR), MRD-positive CR, and partial response rates were 93%, 46%, 36%, and 11%, respectively. Severe neutropenia developed in 13% of patients. Major and minor infections were reported in 8% and 5% of cycles, respectively. Advanced clinical stage, del(17p), or increased serum beta2-microglobulin levels correlated with a lower CR rate. CONCLUSION R-FCM is highly effective in previously untreated CLL, with an 82% CR rate and a high proportion of MRD-negative CRs (46%). Treatment toxicity is acceptable. Parameters correlating with a lower response rate were advanced clinical stage, high serum beta2-microglobulin levels, and del(17p). Based on these results, R-FCM warrants further investigation in randomized clinical trials.
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Affiliation(s)
- Francesc Bosch
- Department of Hematology, Hospital Clínic, Villarroel 170, 08036 Barcelona, Spain.
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Heras GL, Ribera JM, Roca-ribas F, Abella E, Batlle M, Roig I, Milla F. Primary Hodgkin's Disease of the Tonsil. Report of a Case and Review of the Literature. Leuk Lymphoma 2009. [DOI: 10.3109/10428199209064906] [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: 11/13/2022]
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38
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Gallardo F, García-Muret MP, Servitje O, Estrach T, Bielsa I, Salar A, Abella E, Barranco C, Pujol RM. Cutaneous lymphomas showing prominent granulomatous component: clinicopathological features in a series of 16 cases. J Eur Acad Dermatol Venereol 2009; 23:639-47. [DOI: 10.1111/j.1468-3083.2008.03020.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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39
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Abella E, Gimenez T, Gimeno J, Cervera M, Pedro C, Gimeno E, Alvarez A, Salar A, Bellosillo B, Serrano S, Besses C. Diarrheic syndrome as a clinical sign of intestinal infiltration in progressive B-cell chronic lymphocytic leukemia. Leuk Res 2009; 33:159-61. [DOI: 10.1016/j.leukres.2008.03.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2008] [Revised: 03/14/2008] [Accepted: 03/15/2008] [Indexed: 10/22/2022]
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40
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Sancho JM, Morgades M, Alonso N, Deben G, de Sevilla AF, Vázquez L, Nicolás C, García Vela JA, Arranz R, Abella E, Canales MÁ, Miralles P, Sánchez E, Hermosilla M, Conde E, Rueda A, Ribera JM. Prospective study on the practice of central nervous system prophylaxis and treatment in non-Hodgkin’s lymphoma in Spain. Med Clin (Barc) 2008; 131:441-6. [DOI: 10.1157/13126952] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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41
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Sorli M, Gimeno E, Abella E, Besses C, Knobel H. Smoldering myeloma in HIV patient: A complete remission after antiretroviral therapy. Leuk Res 2008; 32:1482-3. [DOI: 10.1016/j.leukres.2007.11.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2007] [Revised: 11/15/2007] [Accepted: 11/15/2007] [Indexed: 10/22/2022]
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Peres E, Wood GW, Poulik J, Baynes R, Sood S, Abidi MH, Klein J, Bhambhani K, Dansey R, Abella E. High-dose chemotherapy and adoptive immunotherapy in the treatment of recurrent pediatric brain tumors. Neuropediatrics 2008; 39:151-6. [PMID: 18991194 DOI: 10.1055/s-0028-1093333] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Pediatric patients with recurrent brain tumors have a poor prognosis and limited therapeutic options. We investigated the use of high-dose chemotherapy with adoptive immunotherapy for recurrent brain tumors. Three pediatric patients with recurrent brain tumors received high-dose chemotherapy. This was followed by adoptive transfer of ex-vivo expanded T-cells. The T-cells were generated from peripheral blood after immunization with autologous cancer cells. The objectives of this study included (1) establishing the safety and feasibility of this potential treatment, (2) measuring changes in immune response after high-dose chemotherapy and adoptive immunotherapy, and (3) determining whether adoptive immunotherapy would be able to translate into a clinical response. Immune function was tested in all patients at the time of enrollment into the study. Humoral responses to recall antigens delayed-type hypersensitivity (DTH) were intact in all patients. After immunizing patients with autologous cancer cells, peripheral blood lymphocytes were harvested and activated with anti-CD3, expanded in-vitro, and infused post-autologous transplant. Patients received at least three doses of the vaccine, each consisting of an intradermal administration near a draining lymph node at biweekly intervals. Toxicity was limited and well tolerated in all patients. All three patients showed a tumor-specific immune response by serial imaging. Responses were durable at 16, 23, and 48 months, respectively.
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Affiliation(s)
- E Peres
- Dept. of Hematology & Oncology, Karmanos Cancer Institute, Div. of Pediatric Hematology-Oncology, and Dept. of Pediatric Neurosurgery, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, Michigan, USA.
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Ribera JM, Oriol A, Sanz MA, Tormo M, Fernández-Abellán P, del Potro E, Abella E, Bueno J, Parody R, Bastida P, Grande C, Heras I, Bethencourt C, Feliu E, Ortega JJ. Comparison of the results of the treatment of adolescents and young adults with standard-risk acute lymphoblastic leukemia with the Programa Español de Tratamiento en Hematología pediatric-based protocol ALL-96. J Clin Oncol 2008; 26:1843-9. [PMID: 18398150 DOI: 10.1200/jco.2007.13.7265] [Citation(s) in RCA: 209] [Impact Index Per Article: 13.1] [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
PURPOSE Retrospective studies have shown that adolescents and young adults with acute lymphoblastic leukemia (ALL) treated with pediatric protocols have better outcomes than similarly aged patients treated with adult protocols, but prospective studies comparing adolescents and young adults using pediatric schedules are scarce. The ALL-96 protocol was addressed to compare the toxicity and results of a pediatric-based protocol in adolescents (age 15-18 years) and young adults (age 19-30 years) with standard-risk (SR) ALL. PATIENTS AND METHODS Adolescents (n = 35) and young adults (n = 46) received a standard five-drug/5-week induction course followed by two cycles of early consolidation, maintenance with monthly reinforcement cycles up to 1 year in continuous complete remission (CR) and 1 year with standard maintenance chemotherapy up to 2 years in CR. RESULTS Adolescents and young adults were comparable in the main pretreatment ALL characteristics. The CR rate was 98% and. after a median follow-up of 4.2 years, 6-year event-free survival (EFS) and overall survival (OS) were 61% (95% CI, 51% to 72%) and 69% (95% CI, 59% to 79%), respectively, with no differences between adolescents and young adults. The hematologic toxicity in consolidation and reinforcement cycles was higher in young adults than in adolescents. Slow response to induction therapy was the only parameter associated with poor EFS (34% v 67%) and OS (40% v 76%). CONCLUSION The response to the pediatric ALL-96 protocol was identical in adolescents and young adults despite a slight increase in hematologic toxicity observed in adults. This justifies the age-unrestricted use of pediatric regimens to treat patients with SR ALL.
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Affiliation(s)
- Josep-María Ribera
- Servicio de Hematología Clínica, Institut Català d'Oncologia-Hospital Universitari Germans Trias i Pujol, C/ Canyet S/N, 08916 Badalona, Spain.
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Bosch F, Ferrer A, Villamor N, González M, Briones J, González-Barca E, Abella E, Gardella S, Escoda L, Pérez-Ceballos E, Asensi A, Sayas MJ, Font L, Altés A, Muntañola A, Bertazzoni P, Rozman M, Aymerich M, Giné E, Montserrat E. Fludarabine, cyclophosphamide, and mitoxantrone as initial therapy of chronic lymphocytic leukemia: high response rate and disease eradication. Clin Cancer Res 2008; 14:155-61. [PMID: 18172266 DOI: 10.1158/1078-0432.ccr-07-1371] [Citation(s) in RCA: 104] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Fludarabine, cyclophosphamide, and mitoxantrone (FCM) results in a high response rate in previously treated patients with chronic lymphocytic leukemia (CLL). The aim of this study was to investigate FCM as frontline therapy in CLL. EXPERIMENTAL DESIGN Sixty-nine patients under the age of 65 years with active CLL were treated. Patients received six cycles of fludarabine 25 mg/m(2) i.v. x 3 days, cyclophosphamide 200 mg/m(2) i.v. x 3 days, and mitoxantrone 6 mg/m(2) i.v. x 1 day. Treatment outcome was correlated with clinical and biological variables. The clinical significance of eradicating minimal residual disease (MRD) was also analyzed. RESULTS The overall response, MRD-negative complete response (CR), MRD-positive CR, nodular partial response (PR), and PR rates were 90%, 26%, 38%, 14%, and 12%, respectively. Severe (grades 3 or 4) neutropenia developed in 10% of the patients. Major and minor infections were reported in 1% and 8% of cases, respectively. Median response duration was 37 months. Patients with del(17p) failed to attain CR. Patients achieving MRD-negative CR had a longer response duration and overall survival than patients with an inferior response. Low serum lactate dehydrogenase levels, low ZAP-70 expression, and mutated IgV(H) genes predicted longer response duration. Finally, both low ZAP-70 and CD38 expression in leukemic cells correlated with MRD-negativity achievement. CONCLUSION FCM induces a high response rate, including MRD-negative CRs in untreated patients with active CLL. Treatment toxicity is acceptable. Both high ZAP-70 and increased CD38 expression predict failure to obtain MRD-negative response. Patients in whom MRD can be eradicated have longer response duration and overall survival than those with inferior response. These results indicate that FCM can be an ideal companion for chemoimmunotherapy of patients with CLL.
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Affiliation(s)
- Francesc Bosch
- Department of Haematology, Hospital Clínic de Barcelona, Barcelona, Spain.
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Ribera JM, Oriol A, Morgades M, González-Barca E, Miralles P, López-Guillermo A, Gardella S, López A, Abella E, García M. Safety and efficacy of cyclophosphamide, adriamycin, vincristine, prednisone and rituximab in patients with human immunodeficiency virus-associated diffuse large B-cell lymphoma: results of a phase II trial. Br J Haematol 2008; 140:411-9. [PMID: 18162120 DOI: 10.1111/j.1365-2141.2007.06943.x] [Citation(s) in RCA: 86] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
MESH Headings
- Adult
- Aged
- Antibodies, Monoclonal/administration & dosage
- Antibodies, Monoclonal/adverse effects
- Antibodies, Monoclonal, Murine-Derived
- Antineoplastic Combined Chemotherapy Protocols/administration & dosage
- Antineoplastic Combined Chemotherapy Protocols/adverse effects
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Antiretroviral Therapy, Highly Active
- CD4 Lymphocyte Count
- Cyclophosphamide/administration & dosage
- Cyclophosphamide/adverse effects
- Doxorubicin/administration & dosage
- Doxorubicin/adverse effects
- Female
- Humans
- Lymphoma, AIDS-Related/drug therapy
- Lymphoma, AIDS-Related/immunology
- Lymphoma, AIDS-Related/pathology
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large B-Cell, Diffuse/immunology
- Lymphoma, Large B-Cell, Diffuse/pathology
- Male
- Middle Aged
- Neoplasm Staging
- Prednisone/administration & dosage
- Prednisone/adverse effects
- Prognosis
- Rituximab
- Survival Analysis
- Treatment Outcome
- Vincristine/administration & dosage
- Vincristine/adverse effects
- Viral Load
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Affiliation(s)
- Josep-Maria Ribera
- Haematology Department, Institut Català d'Oncologia-Hospital Universitari Germans Trias i Pujol, Badalona, Spain.
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Xicoy B, Ribera JM, Miralles P, Berenguer J, Rubio R, Mahillo B, Valencia ME, Abella E, López-Guillermo A, Sureda A, Morgades M, Navarro JT, Esteban H. Results of treatment with doxorubicin, bleomycin, vinblastine and dacarbazine and highly active antiretroviral therapy in advanced stage, human immunodeficiency virus-related Hodgkin's lymphoma. Haematologica 2007; 92:191-8. [PMID: 17296568 DOI: 10.3324/haematol.10479] [Citation(s) in RCA: 102] [Impact Index Per Article: 6.0] [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: 11/09/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Although doxorubicin, bleomycin, vinblastine and dacarbazine (ABVD) is considered the standard chemotherapy regimen for Hodgkin's lymphoma (HL), information on the results of this therapy in human immunodeficiency (HIV)-related HL is scarce. We analyzed the results of the ABVD regimen and highly active antiretroviral therapy (HAART) in patients with advanced stage, HIV-related HL. DESIGN AND METHODS From January 1996 to December 2005, 62 HIV-infected patients with newly diagnosed HL were treated in 15 Spanish hospitals. Six to eight cycles of ABVD and HAART were planned. Response to chemotherapy, overall survival (OS) and event-free survival (EFS) were recorded. RESULTS The median age of the patients was 37 years (range, 24-61) and 29 (47%) had a previously known diagnosis of acquired immunodeficiency syndrome. The median CD4 lymphocyte count at diagnosis was 129/muL (range 5-1,209). The histologic subtype of HL was nodular sclerosis in 17 patients (27%), mixed cellularity in 25 (41%), lymphocyte depletion in 10 (16%) and non-specified in the remaining 10 (16%). Twenty-one (34%) patients were in stage III and 41 (66%) in stage IV. The scheduled six to eight ABVD cycles were completed in 82% of cases. Six patients died during induction, 54 (87%) achieved a complete response (CR) and two were resistant. After a median follow-up of 39 and 47 months, 5-year EFS and OS probabilities were 71% (47-95) and 76% (65-87), respectively. An immunological response was observed in 24 out of 43 patients (56%) and a virological response in 27 out of 40 (68%). The immunological response to HAART had a positive impact on OS and EFS (p=0.002 and p=0.001, respectively). INTERPRETATION AND CONCLUSIONS In patients with advanced stage, HIV-related HL, treatment with ABVD together with HAART is feasible and effective. This supports the concept that patients with HIV-related HL should be treated in the same way as immunocompetent patients if HAART, adequate supportive therapy and anti-infectious prophylaxis are given concomitantly. An immunological response to HAART has a positive impact on OS and EFS.
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Affiliation(s)
- Blanca Xicoy
- Institut Català d' Oncologia-Hospital Universitari Germans Trias i Pujol, Badalona, Spain
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Sancho JM, Ribera JM, Xicoy B, Morgades M, Oriol A, Tormo M, del Potro E, Debén G, Abella E, Bethencourt C, Ortín X, Brunet S, Ortega-Rivas F, Novo A, López R, Hernández-Rivas JM, Sanz MA, Feliu E. Results of the PETHEMA ALL-96 trial in elderly patients with Philadelphia chromosome-negative acute lymphoblastic leukemia. Eur J Haematol 2006; 78:102-10. [PMID: 17087744 DOI: 10.1111/j.1600-0609.2006.00778.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIM Only 20-30% of elderly patients with acute lymphoblastic leukemia (ALL) are enrolled in clinical trials because of co-morbid disorders or poor performance status. We present the results of treatment of Philadelphia chromosome-negative (Ph-) ALL patients over 55 yr treated in the PETHEMA ALL-96 trial. PATIENTS AND METHODS From 1996 to 2006, 33 patients > or = 55 yr with Ph- ALL were included. Induction therapy was vincristine, daunorubicin, prednisone, asparaginase, and cyclophosphamide over 5 weeks. Central nervous system (CNS) prophylaxis involved triple intrathecal (IT) therapy, 14 doses over the first year. Consolidation-1 included mercaptopurine, methotrexate, teniposide and cytarabine, followed by one consolidation-2 cycle similar to the induction cycle. Maintenance consisted of mercaptopurine and methotrexate up to 2 yr in complete remission (CR) with monthly reinduction cycles (vincristine, prednisone and asparaginase) during the first year. RESULTS Median (range) age was 65 yr (56-77). Phenotype (30 patients): early-pre-B 7, common/pre-B 18, T 5. Cytogenetics (28 patients): normal 12, complex 10, t(4;11) 2 and other 4. CR was achieved in 19/33 (57.6%) patients, early death occurred in 12 (36.4%) and 2 (6%) were resistant. Overall survival and disease-free survival probabilities (2 yr, 95% CI) were 39% (21%-57%) and 46% (22%-70%), respectively (median follow up of 24 months). Removal of asparaginase and cyclophosphamide from the induction decreased induction death (OR 0.119, CI 95% 0.022-0.637, P = 0.013) and increased survival (20% vs. 52%, P = 0.05). CONCLUSIONS The prognosis of elderly Ph- ALL patients is poor. In this study, less intensive induction decreased toxic death, allowing delivery of planned consolidation therapy and increased survival probability.
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Affiliation(s)
- Juan-Manuel Sancho
- Clinical Hematology Department, Institut Catalá d'Oncologia-Hospital Universitari Germans Trias i Pujol, Badalona, Spain
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Salar A, Juanpere N, Bellosillo B, Domingo-Domenech E, Espinet B, Seoane A, Romagosa V, Gonzalez-Barca E, Panades A, Pedro C, Nieto M, Abella E, Solé F, Ariza A, Fernández-Sevilla A, Besses C, Serrano S. Gastrointestinal involvement in mantle cell lymphoma: a prospective clinic, endoscopic, and pathologic study. Am J Surg Pathol 2006; 30:1274-80. [PMID: 17001159 DOI: 10.1097/01.pas.0000208899.15859.cb] [Citation(s) in RCA: 89] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The frequency of gastrointestinal (GI) tract involvement in mantle cell lymphoma (MCL) at diagnosis is reported to be below 30%. To investigate the actual frequency of GI involvement by MCL, upper and lower endoscopy was prospectively performed on 13 untreated MCL patients at diagnosis. Multiple biopsies from endoscopically normal and abnormal gastric and colonic mucosa were studied with immunohistochemistry (IHC) for CD20, CD5, and cyclin D1, as well as fluorescence in situ hybridization (FISH) for t(11;14) and polymerase chain reaction (PCR) for immunoglobulin heavy chain gene. Abnormal mucosa was identified in 38% of cases by upper endoscopy (mainly mild nonspecific gastritis) and in 54% of cases by lower endoscopy (mostly micropolyps). Histologically, infiltration by MCL was demonstrated in the stomach in 77% of cases and in the colon in 77% of cases. As a whole, 92% of patients showed upper or lower GI tract infiltration by MCL. Histologic evidence of MCL involvement was present in all cases with endoscopically abnormal mucosa, but it was also observed in two-thirds of cases with endoscopically unremarkable mucosa. Positive cyclin D1 IHC was seen in all instances displaying CD20 and CD5-positive lymphoid infiltrates, whereas t(11;14) was demonstrated by FISH in 63.5% and PCR was clonal in 64% of those instances. In conclusion, the great majority of MCL patients showed GI tract involvement at the time of diagnosis, not uncommonly in the form of minute lymphoid infiltrates. IHC for cyclin D1 was significantly more sensitive than FISH t(11;14) or PCR for immunoglobulin heavy chain gene to confirm MCL in this setting.
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Affiliation(s)
- Antonio Salar
- Department of Clinical Hematology, Hospital del Mar, Barcelona, Spain.
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Salar A, Casao D, Cervera M, Pedro C, Calafell M, Abella E, Alvarez-Larrán A, Besses C. Rapid infusion of rituximab with or without steroid-containing chemotherapy: 1-yr experience in a single institution. Eur J Haematol 2006; 77:338-40. [PMID: 16856919 DOI: 10.1111/j.1600-0609.2006.00713.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
UNLABELLED We assessed the feasibility of a rapid infusion of rituximab with or without steroid-containing chemotherapy. INCLUSION CRITERIA previous infusion of rituximab without grade 3 or 4 toxicity, lymphoid cells <5 x 10(9)/L and rituximab dose of 375 mg/m(2). Seventy patients were treated with a total of 319 rapid rituximab infusions [126 (40%) with and 193 (60%) without steroids]. Overall, rapid infusion of rituximab was well tolerated - there were no grade 3 or 4 adverse events. Only, three patients developed symptoms, all grade 1. In conclusion, rituximab administration in a 90-min infusion schedule is well tolerated and safe, both in patients who are administered steroids and in patients who are not.
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Affiliation(s)
- Antonio Salar
- Department of Clinical Hematology, Hospital del Mar, Barcelona, Spain.
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Xicoy B, Ribera JM, Oriol A, Sanz MA, Abella E, Tormo M, del Potro E, Bueno J, Grande C, Fernández-Calvo J, Orts M, Novo A, Rivas C, Hernández-Rivas JM, Feliu E, Ortega JJ. [Prognostic influence of immunological subtypes of T-cell acute lymphoblastic leukemia. Study of 81 patients]. Med Clin (Barc) 2006; 126:41-6. [PMID: 16426542 DOI: 10.1157/13083566] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
BACKGROUND AND OBJECTIVE T-cell acute lymphoblastic leukemia (ALL) includes 4 immunological subtypes: pro-T, pre-T, thymic or cortical and mature. In some studies, pro-T and mature subtypes have a poor prognosis. The objective of this study was to describe the clinical characteristics, the result of treatment and the prognosis of the immunological subtypes of T-cell ALL in 81 adult patients included in 2 protocols of the Spanish PETHEMA group (ALL-96 and ALL-93). PATIENTS AND METHOD Between 1993 and 2003, 81 adult patients from 22 Spanish hospitals were included in two PETHEMA protocols: ALL-96 for standard-risk patients, and ALL-93 for high- risk patients. The main clinical and biological parameters as well as the rate of response to treatment, the frequency of complete remission , disease free survival and overall survival were compared in each T-cell ALL subtype. RESULTS Of the 64 evaluable patients the distribution of the immunological subtypes was: 3 pro-T, 17 pre-T, 22 thymic or cortical and 22 mature. Patients with mature T-ALL had higher frequency of central nervous system involvement and myeloid antigen expression than those of the remaining subgroups. Patients with mature T-cell ALL had a slow rate of response to treatment in comparison with patients wit pre-T and mature T-cell ALL but this did not translate to significant differences in frequency of complete remission (77% vs 94%), disease free survival (42% vs 46%) and overall survival (29% vs 47%). CONCLUSIONS Although patients with mature T-cell ALL had a slow rate of response to treatment and their survival tended to be shorter, in the present study there were no statistically significant differences in the prognosis of the different subtypes of T-cell ALL.
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Affiliation(s)
- Blanca Xicoy
- Servicio de Hematología Clínica, Institut Català d'Oncologia, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
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