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Tsirkinidis P, Terpos E, Boutsikas G, Papatheodorou A, Anargyrou K, Lalou E, Dimitrakopoulou A, Kalpadakis C, Konstantopoulos K, Siakantaris M, Panayiotidis P, Pangalis G, Kyrtsonis MC, Vassilakopoulos T, Angelopoulou MK. Bone metabolism markers and angiogenic cytokines as regulators of human hematopoietic stem cell mobilization. J Bone Miner Metab 2018; 36:399-409. [PMID: 28660376 DOI: 10.1007/s00774-017-0853-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 06/06/2017] [Indexed: 10/19/2022]
Abstract
Hematopoietic stem cell (HSC) mobilization involves cleavage of ligands between HSC and niche components. However, there are scarce data regarding the role of bone cells in human HSC mobilization. We studied biochemical markers of bone metabolism and angiogenic cytokines during HSC mobilization in 46 patients' sera with lymphoma and multiple myeloma, by ELISA. Significant changes between pre-mobilization and collection samples were found: (1) Bone alkaline phosphatase (BALP) increased, indicating augmentation of bone formation; (2) Receptor activator of Nf-κB ligand/osteoprotegerin ratio (RANKL/OPG) increased, showing osteoclastic differentiation and survival; however, there was no evidence of increased osteoclastic activity; and (3) Angiopoietin-1/Angiopoietin-2 ratio (ANGP-1/ANGP-2) decreased, consistent with vessel destabilization. Poor mobilizers had significantly higher carboxy-terminal telopeptide of collagen type I (CTX) and lower ANGP-1 at pre-mobilization samples, compared to good ones. CTX, amino-terminal telopeptide of collagen type I (NTX) and ANGP-1 pre-mobilization levels correlated significantly with circulating CD34+ peak cell counts. Our results indicate that bone formation and vessel destabilization are the two major events during human HSC mobilization. Osteoblasts seem to be the orchestrating cells, while osteoclasts are stimulated but not fully active. Moreover, ANGP-1, CTX and NTX may serve as predictors of poor mobilization.
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Affiliation(s)
| | - Evangelos Terpos
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgios Boutsikas
- Department of Hematology, 251 General Air Force Hospital, Athens, Greece
| | | | | | - Eleni Lalou
- Department of Hematology and Bone Marrow Transplantation, School of Medicine, National and Kapodistrian University of Athens, 17, Agiou Thoma Street, 11527, Athens, Greece
| | - Aglaia Dimitrakopoulou
- Department of Immunology Research and Flow Cytometry, 'Laiko' General Hospital of Athens, Athens, Greece
| | - Christina Kalpadakis
- Department of Hematology, School of Medicine, University of Crete, Herakleion, Greece
| | - Konstantinos Konstantopoulos
- Department of Hematology and Bone Marrow Transplantation, School of Medicine, National and Kapodistrian University of Athens, 17, Agiou Thoma Street, 11527, Athens, Greece
| | - Marina Siakantaris
- 1st Department of Internal Medicine, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Panayiotis Panayiotidis
- 1st Propedeutic Department of Internal Medicine, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Gerassimos Pangalis
- Department of Hematology, Psychicon Branch, Athens Medical Center, Athens, Greece
| | - Marie-Christine Kyrtsonis
- 1st Propedeutic Department of Internal Medicine, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Theodoros Vassilakopoulos
- Department of Hematology and Bone Marrow Transplantation, School of Medicine, National and Kapodistrian University of Athens, 17, Agiou Thoma Street, 11527, Athens, Greece
| | - Maria K Angelopoulou
- Department of Hematology and Bone Marrow Transplantation, School of Medicine, National and Kapodistrian University of Athens, 17, Agiou Thoma Street, 11527, Athens, Greece.
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2
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Nicolatou-Galitis O, Galiti D, Moschogianni M, Sachanas S, Edwards BJ, Migliorati CA, Pangalis G. Osteonecrosis of the jaw in a patient with acute myeloid leukemia, who received azacitidine. ACTA ACUST UNITED AC 2016. [DOI: 10.20517/2394-4722.2016.06] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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3
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Lakiotaki E, Levidou G, Angelopoulou MK, Adamopoulos C, Pangalis G, Rassidakis G, Vassilakopoulos T, Gainaru G, Flevari P, Sachanas S, Saetta AA, Sepsa A, Moschogiannis M, Kalpadakis C, Tsesmetzis N, Milionis V, Chatziandreou I, Thymara I, Panayiotidis P, Dimopoulou M, Plata E, Konstantopoulos K, Patsouris E, Piperi C, Korkolopoulou P. Potential role of AKT/mTOR signalling proteins in hairy cell leukaemia: association with BRAF/ERK activation and clinical outcome. Sci Rep 2016; 6:21252. [PMID: 26893254 PMCID: PMC4759548 DOI: 10.1038/srep21252] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2015] [Accepted: 01/20/2016] [Indexed: 01/04/2023] Open
Abstract
The potential role of AKT/mTOR signalling proteins and its association with the Raf-MEK-ERK pathway was investigated in hairy cell leukaemia (HCL). BRAFV600E expression and activated forms of AKT, mTOR, ERK1/2, p70S6k and 4E-BP1 were immunohistochemically assessed in 77 BM biopsies of HCL patients and correlated with clinicopathological and BM microvascular characteristics, as well as with c-Caspase-3 levels in hairy cells. Additionally, we tested rapamycin treatment response of BONNA-12 wild-type cells or transfected with BRAFV600E. Most HCL cases expressed p-p70S6K and p-4E-BP1 but not p-mTOR, being accompanied by p-ERK1/2 and p-AKT. AKT/mTOR activation was evident in BONNA-12 cells irrespective of the presence of BRAFV600E mutation and was implicated in cell proliferation enhancement. In multivariate analysis p-AKT/p-mTOR/p-4E-BP1 overexpression was an adverse prognostic factor for time to next treatment conferring earlier relapse. When p-AKT, p-mTOR and p-4E-BP1 were examined separately only p-4E-BP1 remained significant. Our findings indicate that in HCL, critical proteins up- and downstream of mTOR are activated. Moreover, the strong associations with Raf-MEK-ERK signalling imply a possible biologic interaction between these pathways. Most importantly, expression of p-4E-BP1 alone or combined with p-AKT and p-mTOR is of prognostic value in patients with HCL.
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Affiliation(s)
| | - Georgia Levidou
- Department of Pathology, University of Athens, Medical School, Greece
| | - Maria K Angelopoulou
- Department of Haematology and Bone Marrow Transplantation, University of Athens, Medical School, Greece
| | - Christos Adamopoulos
- Department of Biological Chemistry, University of Athens, Medical School, Greece
| | | | - George Rassidakis
- Department of Pathology, University of Athens, Medical School, Greece.,Department of Oncology-Pathology, Cancer Centrum Karolinska, Karolinska Institutet, Stockholm, Sweden
| | - Theodoros Vassilakopoulos
- Department of Haematology and Bone Marrow Transplantation, University of Athens, Medical School, Greece
| | - Gabriella Gainaru
- Department of Haematology and Bone Marrow Transplantation, University of Athens, Medical School, Greece
| | - Pagona Flevari
- Department of Haematology and Bone Marrow Transplantation, University of Athens, Medical School, Greece
| | - Sotirios Sachanas
- Department of Haematology, Athens Medical Centre, Psychikon Branch, Greece
| | - Angelica A Saetta
- Department of Pathology, University of Athens, Medical School, Greece
| | - Athanasia Sepsa
- Department of Pathology, University of Athens, Medical School, Greece
| | | | | | - Nikolaos Tsesmetzis
- Department of Oncology-Pathology, Cancer Centrum Karolinska, Karolinska Institutet, Stockholm, Sweden
| | | | | | - Irene Thymara
- Department of Pathology, University of Athens, Medical School, Greece
| | - Panayiotis Panayiotidis
- 1st Department of Propaedeutic Internal Medicine, University of Athens, Medical School, Greece
| | - Maria Dimopoulou
- Department of Haematology and Bone Marrow Transplantation, University of Athens, Medical School, Greece
| | - Eleni Plata
- Department of Haematology and Bone Marrow Transplantation, University of Athens, Medical School, Greece
| | | | | | - Christina Piperi
- Department of Biological Chemistry, University of Athens, Medical School, Greece
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4
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Parry M, Rose-Zerilli MJ, Ljungström V, Gibson J, Wang J, Walewska R, Parker H, Parker A, Davis Z, Gardiner A, McIver-Brown N, Kalpadakis C, Xochelli A, Anagnostopoulos A, Fazi C, de Castro DG, Dearden C, Pratt G, Rosenquist R, Ashton-Key M, Forconi F, Collins A, Ghia P, Matutes E, Pangalis G, Stamatopoulos K, Oscier D, Strefford JC. Genetics and Prognostication in Splenic Marginal Zone Lymphoma: Revelations from Deep Sequencing. Clin Cancer Res 2015; 21:4174-4183. [PMID: 25779943 DOI: 10.1158/1078-0432.ccr-14-2759] [Citation(s) in RCA: 97] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Accepted: 03/03/2015] [Indexed: 11/16/2022]
Abstract
PURPOSE Mounting evidence supports the clinical significance of gene mutations and immunogenetic features in common mature B-cell malignancies. EXPERIMENTAL DESIGN We undertook a detailed characterization of the genetic background of splenic marginal zone lymphoma (SMZL), using targeted resequencing and explored potential clinical implications in a multinational cohort of 175 patients with SMZL. RESULTS We identified recurrent mutations in TP53 (16%), KLF2 (12%), NOTCH2 (10%), TNFAIP3 (7%), MLL2 (11%), MYD88 (7%), and ARID1A (6%), all genes known to be targeted by somatic mutation in SMZL. KLF2 mutations were early, clonal events, enriched in patients with del(7q) and IGHV1-2*04 B-cell receptor immunoglobulins, and were associated with a short median time to first treatment (0.12 vs. 1.11 years; P = 0.01). In multivariate analysis, mutations in NOTCH2 [HR, 2.12; 95% confidence interval (CI), 1.02-4.4; P = 0.044] and 100% germline IGHV gene identity (HR, 2.19; 95% CI, 1.05-4.55; P = 0.036) were independent markers of short time to first treatment, whereas TP53 mutations were an independent marker of short overall survival (HR, 2.36; 95 % CI, 1.08-5.2; P = 0.03). CONCLUSIONS We identify key associations between gene mutations and clinical outcome, demonstrating for the first time that NOTCH2 and TP53 gene mutations are independent markers of reduced treatment-free and overall survival, respectively.
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Affiliation(s)
- Marina Parry
- Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | | | - Viktor Ljungström
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Sweden
| | - Jane Gibson
- Centre for Biological Sciences, University of Southampton, Southampton, UK
| | - Jun Wang
- Centre for Molecular Oncology, Barts Cancer Institute, Queen Mary University of London, London, UK
| | - Renata Walewska
- Department of Pathology, Royal Bournemouth Hospital, Bournemouth, UK
| | - Helen Parker
- Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Anton Parker
- Department of Pathology, Royal Bournemouth Hospital, Bournemouth, UK
| | - Zadie Davis
- Department of Pathology, Royal Bournemouth Hospital, Bournemouth, UK
| | - Anne Gardiner
- Department of Pathology, Royal Bournemouth Hospital, Bournemouth, UK
| | - Neil McIver-Brown
- Department of Pathology, Royal Bournemouth Hospital, Bournemouth, UK
| | - Christina Kalpadakis
- Department of Hematology, School of Medicine, University of Crete, Heraklion, Greece
| | - Aliki Xochelli
- Institute of Applied Biosciences, Center for Research and Technology, Thessaloniki, Greece
| | | | - Claudia Fazi
- Division of Molecular Oncology, Department of Onco-Haematology, IRCCS Istituto Scientifico San Raffaele, Fondazione Centro San Raffaele, Università Vita-Salute San Raffaele, Milan, Italy
| | - David Gonzalez de Castro
- Heamato-oncology Unit, Division of Molecular Pathology, Institute for Cancer Research, Sutton, UK
| | - Claire Dearden
- Heamato-oncology Unit, Division of Molecular Pathology, Institute for Cancer Research, Sutton, UK
| | - Guy Pratt
- School of Cancer Studies, University of Birmingham, Birmingham, UK; Department of Haematology, Heart of England NHS Foundation Trust, Birmingham, UK
| | - Richard Rosenquist
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Sweden
| | - Margaret Ashton-Key
- Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Francesco Forconi
- Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Andrew Collins
- Genetic Epidemiology and Bioinformatics, Faculty of Medicine, University of Southampton, UK
| | - Paolo Ghia
- Division of Molecular Oncology, Department of Onco-Haematology, IRCCS Istituto Scientifico San Raffaele, Fondazione Centro San Raffaele, Università Vita-Salute San Raffaele, Milan, Italy
| | - Estella Matutes
- Haematopathology Unit, Hospital Clinic, Barcelona University, Villarroel, Barcelona, Spain
| | | | - Kostas Stamatopoulos
- Institute of Applied Biosciences, Center for Research and Technology, Thessaloniki, Greece.,Hematology Department and HCT Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| | - David Oscier
- Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.,Department of Pathology, Royal Bournemouth Hospital, Bournemouth, UK
| | - Jonathan C Strefford
- Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
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5
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Nicolatou‐Galitis O, Sachanas S, Drogari‐Apiranthitou M, Moschogiannis M, Galiti D, Yiakoumis X, Rontogianni D, Yiotakis I, Petrikkos G, Pangalis G. Mucormycosis presenting with dental pain and palatal ulcer in a patient with chronic myelomonocytic leukaemia: case report and literature review. JMM Case Rep 2015. [DOI: 10.1099/jmmcr.0.000014] [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: 01/31/2023] Open
Affiliation(s)
| | - Sotirios Sachanas
- Department of Hematology, Athens Medical Center‐Psychikon Branch, Athens, Greece
| | - Maria Drogari‐Apiranthitou
- Infectious Diseases Research Laboratory, 4th Department of Internal Medicine, University General Hospital ‘ATTIKON’, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria Moschogiannis
- Department of Hematology, Athens Medical Center‐Psychikon Branch, Athens, Greece
| | - Dimitra Galiti
- Clinic of Hospital Dentistry, School of Dentistry, University of Athens, Athens, Greece
| | - Xanthi Yiakoumis
- Department of Hematology, Athens Medical Center‐Psychikon Branch, Athens, Greece
| | | | - Ioannis Yiotakis
- 2nd ENT Department, University General Hospital ‘ATTIKON’, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - George Petrikkos
- Infectious Diseases Research Laboratory, 4th Department of Internal Medicine, University General Hospital ‘ATTIKON’, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Gerassimos Pangalis
- Department of Hematology, Athens Medical Center‐Psychikon Branch, Athens, Greece
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6
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Sachanas S, Pangalis G, Kalpadakis C, Yiakoumis X, Moschogiannis M, Kyrtsonis MC, Vassilakopoulos T, Tsirkinidis P, Kontopidou F, Kokoris S, Siakantaris M, Viniou NA, Korkolopoulou P, Papadaki H, Panayiotidis P, Angelopoulou M. Composite Lymphomas: A Challenging Entity. CCTR 2014. [DOI: 10.2174/157339471002141124121738] [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: 11/22/2022]
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7
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Diamantopoulos PT, Polonyfi K, Sofotasiou M, Mantzourani M, Galanopoulos A, Spanakis N, Papadopoulou V, Kalala F, Iliakis T, Zareifi DS, Kodandreopoulou E, Vassilakopoulos T, Angelopoulou M, Siakantaris M, Terpos E, Variami E, Kollia P, Vaiopoulos G, Pangalis G, Viniou NA. Survivin Messenger RNA Levels in Epstein-Barr Virus–Positive Patients With Leukemic Low-Grade B-Cell Lymphomas Expressing the Latent Membrane Protein 1: Evidence of Apoptotic Function? Clinical Lymphoma Myeloma and Leukemia 2014; 14:56-60. [DOI: 10.1016/j.clml.2013.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Revised: 09/24/2013] [Accepted: 09/24/2013] [Indexed: 11/30/2022]
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8
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Diamantopoulos PT, Polonyfi K, Sofotasiou M, Papadopoulou V, Kalala F, Iliakis T, Zervakis K, Tsilimidos G, Kouzis P, Kyrtsonis MC, Vassilakopoulos T, Angelopoulou M, Siakantaris M, Vayopoulos G, Kollia P, Pangalis G, Viniou NA. Rituximab in the treatment of EBV-positive low grade B-cell lymphoma. Anticancer Res 2013; 33:5693-5698. [PMID: 24324119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Following infection of B lymphocytes by Epstein Barr virus (EBV), the viral genome remains in the nucleus, and a latency phase is established, during which only a small proportion of the viral genes are expressed. Among them, LMP1 is essential for transformation. Rituximab is a potent agent used in the treatment of low grade B-cell lymphomas and is also widely used for the treatment of post-transplant lymphoproliferative disorders caused by EBV. The effect of rituximab treatment on the latent EBV infection in non-transplant patients with lymphoproliferative disorders has never been studied to our knowledge. PATIENTS AND METHODS We studied, the effect of rituximab-based immunochemotherapy on the EBV status of 44 patients with leukemic low grade B-cell lymphoma. RESULTS After three cycles of rituximab-based treatment, only 1/17 patients was still positive for EBV. DISCUSSION Our results suggest that rituximab used in the treatment of EBV-positive low-grade lymphoma is efficient in eradicating the virus from the peripheral blood, a fact with potential implications in the course and prognosis of the disease.
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Affiliation(s)
- Panagiotis T Diamantopoulos
- Hematology Unit, First Department of Internal Medicine Laikon General Hospital, National and Kapodistrian University of Athens, Athens 11527, Greece.
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9
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Iliakis T, Papadopoulou V, Diamantopoulos PT, Panayiotidis P, Zervakis K, Giannakopoulou N, Tilimidos G, Angelopoulou M, Siakantaris MP, Pangalis G, Mantzourani M, Variami E, Viniou NA. Cessation of tyrosine kinase inhibitors in patients with chronic-phase chronic myelogenous leukemia following durable complete molecular response: a single center facing the dilemma. Anticancer Res 2013; 33:3509-3514. [PMID: 23898127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Tyrosine kinase inhibitors (TKIs), namely imatinib mesylate (IM) and recently approved second-generation TKIs dasatinib and nilotinib, are currently considered the treatment of choice for newly-diagnosed chronic phase chronic myelogenous leukemia (CP-CML). Although treatment with TKIs has not yet been proven curative, it certainly accomplishes a sustained control of the disease in the vast majority of patients. More than a decade after the successful launching of IM in first-line treatment of CP-CML and the subsequent introduction of second-generation TKIs in this setting, the question of the possibility of TKI cessation in a specific subset of patients has emerged. Side-effects of TKIs, along with some patients' wish to abandon the drugs and the rising financial burden upon healthcare systems, have led to the dilemma whether IM can be safely withdrawn after achieving deep molecular remissions and which patients are suitable for this discontinuation. We examined the data of our patients with CML in search of potential canditates for cessation of TKI therapy and identified their characteristics. We also performed a thorough review of the relevant literature. Eight out of fifty patients were discriminated on grounds of sustained complete molecular response (CMR) exceeding 12 months, most of them with a low or intermediate Sokal score at diagnosis. The median interval from IM initiation to CMR was almost 2 years and the median duration of detected CMR reached 6.5 years. Based on the promising results of prospective clinical trials reporting successful cessation of treatment with TKIs on selected subgroups of patients, we decided to proceed to interruption of therapy in the specific subset of our patients and closely monitor their response.
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Affiliation(s)
- Theodoros Iliakis
- Hematology Unit, First Department of Internal Medicine, Laiko Hospital, University of Athens, 17 Agiou Thoma Street, Athens 11527, Greece
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10
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Vassilakopoulos T, Pangalis G, Angelopoulou M, Pappas P, Kokoris S, Pazaiti A, Konstantopoulos K, Karles D, Papalampros E, Kontos M. Breast Cancer in Patients with Hodgkin's Lymphoma Predominantly Treated with Anthracycline – Based Chemotherapy with or without Radiotherapy: A Preliminary Analysis. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-09-6069] [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: Hodgkin's lymphoma (HL) is a highly curable neoplasm with >70-80% of the patients becoming long-term survivors. The success of treatment however, is associated with long term complications, namely breast cancer, especially if treated with extended-field radiotherapy (RT) at a curative dose as monotherapy. The oncogenic effect of limited field and relatively low-dose RT combined with anthracycline-based chemotherapy (CT) – the current standard of treatment for early stage disease - is not well investigated. The aim of the study is to describe the incidence of breast cancer in a series of patients treated predominantly with anthracycline-based CT with or without RT of limited field and dose.PATIENTS AND METHODS: Among 1125 patients in our database, 479 were females and were evaluated for the occurrence of breast cancer. Important baseline features were: Median age 28 years (14-81); clinical stage I, II, III, IV 17%, 55%, 15%, 13%; B-symptoms 37%; Nodular sclerosis 77%, mixed cellularity 15%, lymphocyte predominance 6%; Anthracycline based CT 86%, MOPP-based CT 12%, RT only without CT 2%; Radiotherapy 74%, mostly to the involved field, usually 2800-3000 cGy. The cumulative incidence of breast cancer was estimated by the Kaplan-Meier method.RESULTS: The median follow-up of the 479 female patients was 88 months: 36% were followed-up for >10 years. At the time of the analysis 6 cases of breast cancer were recorded for a 5-, 10- and 20-year cumulative incidence of 0.5%, 1.7% and 4.4%. The median age of the 6 patients was 43 years (26-54) at diagnosis of HL and 46.5 years (33-63) at breast cancer diagnosis. Clinical stages were I (n=1), II (n=3), III (n=1) and IV (n=1) and 4/6 patients had B-symptoms at diagnosis. All patients were in their 1st complete remission when breast cancer was diagnosed at a median time of 67 months from HL diagnosis (8-198). All 6 patients had received anthracycline-based CT and had been irradiated at a median dose of 2870 cGy, but the mediastinum or the axillae were included in the RT field only in 3/6 patients. Among 646 male patients, a single case of breast cancer was recorded in a 49 year old patient, 265 months after high-dose (4300 cGy) mantle field RT followed by MOPP/ABVDx6.DISCUSSION: In a series of female patients with HL, a median age of 28 years at diagnosis and a median follow-up of ∼7.5 years (>10 years in 36% of them), who were predominantly treated with modern CT with or without limited field and dose RT, the 10- and 20-year incidence of breast cancer was 1.7% and 4.4%, with 6 cases recorded. Three of the cases developed clearly outside the irradiation field. We also recorded a single case of male breast cancer, which was very likely treatment related. Whether these cases are in excess of those expected for the population studied, as well as the features and outcome of breast cancer in HL survivors are currently being investigated.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 6069.
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11
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Abstract
AIM Beta-thalassaemia major (TM) affects oxygen flow and utilization and reduces patients' exercise capacity. The aim of this study was to assess phase I and phase II oxygen kinetics during submaximal exercise test in thalassaemics and make possible considerations about the pathophysiology of the energy-producing mechanisms and their expected exercise limitation. METHODS Twelve TM patients with no clinical evidence of cardiac or respiratory disease and 10 healthy subjects performed incremental, symptom-limited cardiopulmonary exercise testing (CPET) and submaximal, constant workload CPET. Oxygen uptake (VO2), carbon dioxide output and ventilation were measured breath-by-breath. RESULTS Peak VO2 was reduced in TM patients (22.3 +/- 7.4 vs. 28.8 +/- 4.8 mL kg(-1) min(-1), P < 0.05) as was anaerobic threshold (13.1 +/- 2.7 vs. 17.4 +/- 2.6 mL kg(-1) min(-1), P = 0.002). There was no difference in oxygen cost of work at peak exercise (11.7 +/- 1.9 vs. 12.6 +/- 1.9 mL min(-1) W(-1) for patients and controls respectively, P = ns). Phase I duration was similar in TM patients and controls (24.6 +/- 7.3 vs. 23.3 +/- 6.6 s respectively, P = ns) whereas phase II time constant in patients was significantly prolonged (42.8 +/- 12.0 vs. 32.0 +/- 9.8 s, P < 0.05). CONCLUSION TM patients present prolonged phase II on-transient oxygen kinetics during submaximal, constant workload exercise, compared with healthy controls, possibly suggesting a slower rate of high energy phosphate production and utilization and reduced oxidative capacity of myocytes; the latter could also account for their significantly limited exercise tolerance.
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Affiliation(s)
- I Vasileiadis
- Pulmonary & Critical Care Medicine Department, Cardiopulmonary Exercise Testing and Rehabilitation Laboratory, Evgenidio Hospital, National and Kapodistrian University of Athens, Athens, Greece
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12
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Ferreri AJ, Reni M, Martelli M, Pangalis G, Frezzato M, Cabras G, Fabbri A, Corazzelli G, Zucca E, Cavalli F. Randomized phase II trial on primary chemotherapy with high-dose methotrexate (HD-MTX) alone or associated with high-dose cytarabine (HD-araC) for patients with primary CNS lymphoma (I.E.L.S.G. #20 Trial): Tolerability, activity, and survival analyses. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.8545] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
8545 Background: HD-MTX-based chemotherapy (cht) is the conventional approach to primary CNS lymphoma (PCNSL), but superiority of polycht over HD-MTX alone is unproven. A benefit of adding HD-araC to MTX has been suggested. This is a randomized phase II trial comparing HD-MTX monocht versus HD-MTX plus HD-araC as primary cht in immunocompetent patients (pts) with PCNSL. Methods: 79 HIV- pts with newly diagnosed PCNSL, age 18–75 ys, ECOG-PS≤3, and measurable disease were randomly assigned to receive 4 courses (interval 3 weeks) of MTX 3.5 g/mq (control arm; n=40) or MTX (same dose) + araC 2 g/mq × 2/d, d 2–3 (experimental arm; n=39). Cht was followed by whole-brain irradiation. Pts were stratified based on IELSG score and centre irradiation policy for pts >60 ys in complete remission (CR) after cht. CR rate (CRR) after cht was the primary endpoint; planned accrual (α=.05 β=.2) for P0 30% and P1 50% was 39 pts/arm. Results: Median age of the 79 entered pts was 58 ys (range 25–74). No differences in clinical presentation between arms were observed. Two hundred thirty-one (73%) of the 316 planned courses were actually delivered (MTX 71%; MTX+araC 76%). Causes of cht interruption were: progressive disease in 20 MTX and 8 MTX+araC pts, toxicity in 1 MTX and 7 MTX+araC pts and refusal in 2 MTX+araC pts. As expected, neutropenia, thrombocytopenia and infections were more common in MTX+araC arm. All G3–4 non-hematological toxicities were <5%. One MTX pt and 3 MTX+araC pts died of toxicity. CRR was 18% after MTX and 46% after MTX+araC (p=0.006), with an ORR of 40% and 69% (p=0.009), respectively. At a median follow-up of 30 m., 31 MTX and 22 MTX+araC pts experienced failure, with a 3-yr FFS of 21±6% and 38±8% (p=0.01), respectively. No differences in relapse sites or salvage efficacy between treatment arms were observed. Twelve MTX and 20 MTX+araC pts are alive, with a 3-yr OS of 32±8% and 46±9% (p=0.07). Conclusions: This is the first randomized trial on PCNSL with completed accrual. The addition of HD-araC to HD-MTX resulted in significantly better outcome and acceptable toxicity. MTX+araC may be the cht combination used as control arm in future randomized trials. No significant financial relationships to disclose.
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Affiliation(s)
- A. J. Ferreri
- International Extranodal Lymphoma Study Group; San Raffaele Scientific Institute, Milan, Italy; University La Sapienza, Rome, Italy; Laikon General Hospital, Athens, Greece; San Bortolo Hospital, Vicenza, Italy; Hospital Businco, Cagliari, Italy; Policlinico Le Scotte, Siena, Italy; Istituto Pascale, Naples, Italy; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - M. Reni
- International Extranodal Lymphoma Study Group; San Raffaele Scientific Institute, Milan, Italy; University La Sapienza, Rome, Italy; Laikon General Hospital, Athens, Greece; San Bortolo Hospital, Vicenza, Italy; Hospital Businco, Cagliari, Italy; Policlinico Le Scotte, Siena, Italy; Istituto Pascale, Naples, Italy; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - M. Martelli
- International Extranodal Lymphoma Study Group; San Raffaele Scientific Institute, Milan, Italy; University La Sapienza, Rome, Italy; Laikon General Hospital, Athens, Greece; San Bortolo Hospital, Vicenza, Italy; Hospital Businco, Cagliari, Italy; Policlinico Le Scotte, Siena, Italy; Istituto Pascale, Naples, Italy; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - G. Pangalis
- International Extranodal Lymphoma Study Group; San Raffaele Scientific Institute, Milan, Italy; University La Sapienza, Rome, Italy; Laikon General Hospital, Athens, Greece; San Bortolo Hospital, Vicenza, Italy; Hospital Businco, Cagliari, Italy; Policlinico Le Scotte, Siena, Italy; Istituto Pascale, Naples, Italy; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - M. Frezzato
- International Extranodal Lymphoma Study Group; San Raffaele Scientific Institute, Milan, Italy; University La Sapienza, Rome, Italy; Laikon General Hospital, Athens, Greece; San Bortolo Hospital, Vicenza, Italy; Hospital Businco, Cagliari, Italy; Policlinico Le Scotte, Siena, Italy; Istituto Pascale, Naples, Italy; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - G. Cabras
- International Extranodal Lymphoma Study Group; San Raffaele Scientific Institute, Milan, Italy; University La Sapienza, Rome, Italy; Laikon General Hospital, Athens, Greece; San Bortolo Hospital, Vicenza, Italy; Hospital Businco, Cagliari, Italy; Policlinico Le Scotte, Siena, Italy; Istituto Pascale, Naples, Italy; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - A. Fabbri
- International Extranodal Lymphoma Study Group; San Raffaele Scientific Institute, Milan, Italy; University La Sapienza, Rome, Italy; Laikon General Hospital, Athens, Greece; San Bortolo Hospital, Vicenza, Italy; Hospital Businco, Cagliari, Italy; Policlinico Le Scotte, Siena, Italy; Istituto Pascale, Naples, Italy; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - G. Corazzelli
- International Extranodal Lymphoma Study Group; San Raffaele Scientific Institute, Milan, Italy; University La Sapienza, Rome, Italy; Laikon General Hospital, Athens, Greece; San Bortolo Hospital, Vicenza, Italy; Hospital Businco, Cagliari, Italy; Policlinico Le Scotte, Siena, Italy; Istituto Pascale, Naples, Italy; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - E. Zucca
- International Extranodal Lymphoma Study Group; San Raffaele Scientific Institute, Milan, Italy; University La Sapienza, Rome, Italy; Laikon General Hospital, Athens, Greece; San Bortolo Hospital, Vicenza, Italy; Hospital Businco, Cagliari, Italy; Policlinico Le Scotte, Siena, Italy; Istituto Pascale, Naples, Italy; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - F. Cavalli
- International Extranodal Lymphoma Study Group; San Raffaele Scientific Institute, Milan, Italy; University La Sapienza, Rome, Italy; Laikon General Hospital, Athens, Greece; San Bortolo Hospital, Vicenza, Italy; Hospital Businco, Cagliari, Italy; Policlinico Le Scotte, Siena, Italy; Istituto Pascale, Naples, Italy; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
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Nanas S, Vasileiadis I, Dimopoulos S, Sakellariou D, Kapsimalakou S, Papazachou O, Tasoulis A, Ladis V, Pangalis G, Aessopos A. New insights into the exercise intolerance of beta-thalassemia major patients. Scand J Med Sci Sports 2009; 19:96-102. [PMID: 18312483 DOI: 10.1111/j.1600-0838.2008.00778.x] [Citation(s) in RCA: 11] [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: 02/05/2023]
Abstract
The purpose of our study was assessment of the relative contribution of the systems involved in blood gas exchange to the limited exercise capacity in patients with beta-thalassemia major (TM) using integrative cardiopulmonary exercise testing (CPET) with estimation of oxygen kinetics. The study consisted of 15 consecutive TM patients and 15 matched controls who performed spirometric evaluation, measurement of maximum inspiratory pressure (Pimax) and an incremental symptom-limited CPET on a cycle ergometer. Exercise capacity was markedly reduced in TM patients as assessed by peak oxygen uptake (pVO(2), mL/kg/min: 22.1+/-6.6 vs 33.8+/-8.3; P<0.001) and anaerobic threshold (mL/kg/min: 13.0+/-3.0 vs 18.7+/-4.6; P<0.001) compared with controls. No ventilatory limitation to exercise was noted in TM patients (VE/VCO(2) slope: 23.4+/-3.2 vs 27.8+/-2.6; P<0.001 and breathing reserve, %: 42.9+/-17.0 vs 29.5+/-12.0; P<0.005) and no difference in oxygen cost of work (peak VO(2)/WR, mL/min W: 12.2+/-1.7 vs 12.2+/-1.5; P=NS). Delayed recovery oxygen kinetics after exercise was observed in TM patients (VO(2)/t slope, mL/kg/min(2): 0.67+/-0.27 vs 0.93+/-0.23; P<0.05) that was significantly correlated with Pimax at rest (r: 0.81; P<0.001). The latter was also significantly correlated to pVO(2) (r: 0.84; P<0.001) and inversely correlated to ferritin levels (r: -0.6; P<0.02). Exercise capacity is markedly reduced in TM patients and this reduction is highly associated with the limited functional status of peripheral muscles.
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Affiliation(s)
- S Nanas
- Pulmonary & Critical Care Medicine Department, Cardiopulmonary Exercise Testing and Rehabilitation Laboratory, Evgenidio Hospital, National and Kapodestrian University of Athens, Athens, Greece.
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14
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Visco C, Nadali G, Vassilakopoulos TP, Bonfante V, Viviani S, Gianni AM, Federico M, Luminari S, Peethambaram P, Witzig TE, Pangalis G, Cabanillas F, Medeiros LJ, Sarris AH, Pizzolo G. Very high levels of soluble CD30 recognize the patients with classical Hodgkin's lymphoma retaining a very poor prognosis. Eur J Haematol 2006; 77:387-94. [PMID: 16879607 DOI: 10.1111/j.1600-0609.2006.00725.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To evaluate the prognostic role of pretreatment serum levels of soluble CD30 (sCD30) in patients with advanced stage classical Hodgkin's lymphoma (cHL) treated with adriamycin, bleomycin, vinblastine, and dacarbazine or equivalent regimens. METHODS We identified 321 previously untreated patients with cHL who presented to the participating centers between 1985 and 2002, and had serum samples available for the determination of sCD30 levels. RESULTS With a median follow-up of 72 months, the actuarial 5-year overall survival was 82%, and failure-free survival (FFS) was 71%. The median serum level of sCD30 was 65 U/mL (range: 1-2230), and was significantly higher (P < 0.0001) when compared with a group of 113 healthy controls (4 U/mL, range: 0-20). Increasing level of sCD30 was associated with a continuous worsening of FFS and OS, and patients with sCD30 >or=200 U/mL had a 5-year FFS of 39%. With multivariate analysis, sCD30, Ann Arbor stage, and lactic acid dehydrogenase were significant independent factors in terms of FFS. The association of the above-mentioned three independent prognostic variables could discriminate 22% of patients with 5-year FFS of 40%. CONCLUSIONS Our data confirm the independent prognostic role of sCD30 in identifying the patients with high risk of treatment failure, and show that its association with other variables can recognize patients with FFS considerably lower than 50%.
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Affiliation(s)
- Carlo Visco
- Department of Hematology, Ospedale S. Bortolo, Vicenza, Italy
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15
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Papalambros E, Felekouras E, Karavokyros IG, Diamantis T, Androulaki A, Boutsis D, Sigala F, Tsavaris N, Pangalis G. Acute abdomen as initial manifestation of M4 - acute non-lymphocytic leukemia. J BUON 2005; 10:277-80. [PMID: 17343343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Visceral involvement in acute non-lymphocytic leukemia (ANLL) seldom precedes hematological manifestation. We report on a patient with M4 - ANLL presenting with acute abdomen without any evidence of blood disorder. Laparotomy revealed only ileal wall oedema. Postoperative clinical deterioration led to a second-look operation combined with intraoperative endoscopy. Biopsied tissues were diffusely infiltrated by blasts characterised as HLA-DR (+), PGM1 (50% +), MPO (50% +) and CD 34 (-). Bone marrow reconfirmed these findings and showed positivity for CD4 (44%), CD11b (50%), CD11c (42%), CD13 (33%), CD34 (32%), and CD56 (54%). Chemotherapy achieved a complete but short remission. Relapse occurred 7 months later. Immediately after consolidation chemotherapy the profoundly immunosuppressed patient passed away after a lower respiratory tract infection. We discuss the contrast between histology and short disease duration, the unusual presentation and the bad prognosis, and attempt to correlate the clinical course with the coexpression of markers.
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Affiliation(s)
- E Papalambros
- First Department of Surgery, "Laikon" General University Hospital, University of Athens, Medical School, Athens, Greece
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16
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Anargyrou K, Petrikkos GL, Suller MTE, Skiada A, Siakantaris MP, Osuntoyinbo RT, Pangalis G, Vaiopoulos G. Pulmonary Balantidium coli infection in a leukemic patient. Am J Hematol 2003; 73:180-3. [PMID: 12827655 DOI: 10.1002/ajh.10336] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
A 59-year-old woman suffering from chronic lymphocytic leukemia developed pulmonary lesions; bronchoalveolar lavage was performed for possible systemic fungal infection. However, direct microscopic analysis revealed ciliated protozoa identified as Balantidium coli. B. coli is the only known pathogenic ciliate, and is usually associated with intestinal infection in areas associated with pig rearing. On very rare occasions the organisms may invade extra-intestinal organs, in this case the lungs of an immunocompromised patient. This case is unusual as balantidiasis is rare in Europe, the patient had no obvious contact with pigs, and there was no history of diarrhea prior to pulmonary colonization. Metronidazole was rapidly administered, and the condition improved after 24-48 hr.
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Affiliation(s)
- K Anargyrou
- Hematology Section, 1st Department of Internal Medicine, Athens University School of Medicine, Laikon General Hospital, Goudi, Athens, Greece
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17
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Zinzani PL, Martelli M, Bertini M, Gianni AM, Devizzi L, Federico M, Pangalis G, Michels J, Zucca E, Cantonetti M, Cortelazzo S, Wotherspoon A, Ferreri AJM, Zaja F, Lauria F, De Renzo A, Liberati MA, Falini B, Balzarotti M, Calderoni A, Zaccaria A, Gentilini P, Fattori PP, Pavone E, Angelopoulou MK, Alinari L, Brugiatelli M, Di Renzo N, Bonifazi F, Pileri SA, Cavalli F. Induction chemotherapy strategies for primary mediastinal large B-cell lymphoma with sclerosis: a retrospective multinational study on 426 previously untreated patients. Haematologica 2002; 87:1258-64. [PMID: 12495899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023] Open
Abstract
BACKGROUND AND OBJECTIVES This multinational retrospective study compares the outcomes of patients with primary mediastinal large B-cell lymphoma (PMLBCL) with sclerosis after first-generation (dose-intensive regimens), third-generation (alternating regimens) and high-dose chemotherapy strategies, frequently with adjuvant radiation therapy. DESIGN AND METHODS Between August 1981 and December 1999, a total of 426 previously untreated patients with confirmed diagnosis were enrolled in 20 institutions to receive combination chemotherapy with either first generation (CHOP or CHOP-like) regimens, third generation (MACOP-B, VACOP-B, ProMACE CytaBOM) regimens or high-dose chemotherapy (HDS/ABMT). RESULTS With chemotherapy, complete response (CR) rates were 49% (50/105), 51% (142/277) and 53% (23/44) with first generation, third generation and high-dose chemotherapy strategies, respectively; partial response (PR) rates were 32%, 36% and 35%, respectively. All patients who achieved CR and 124/142 (84%) with PR had radiation therapy on the mediastinum. The final CR rates became 61% for CHOP/CHOP-like regimens, 79% for MACOP-B and other regimens, and 75% for HDS/ABMT. After median follow-ups from attaining CR of 48.5 months for CHOP/CHOP-like regimens, 51.7 months for MACOP-B type regimens and 32.4 months for HDS/ABMT, relapses occurred in 15/64 (23%), 27/218 (12%) and 0/33 (0%) patients, respectively. Projected 10-year progression-free survival rates were 35%, 67% and 78%, respectively (p=0.0000). Projected 10-year overall survival rates were 44%, 71% and 77%, respectively (p=0.0000), after median follow-ups from diagnosis of 52.3 months, 54.9 months and 35.8 months, respectively. INTERPRETATION AND CONCLUSIONS In patients with PMLBCL with sclerosis, MACOP-B plus radiation therapy may be a better strategy than other treatments; these retrospective data need to be confirmed by prospective studies. The encouraging survival results after high dose chemotherapy require confirmation in selected high-risk patients.
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MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Antineoplastic Combined Chemotherapy Protocols/administration & dosage
- Female
- Humans
- Lymphoma, B-Cell/mortality
- Lymphoma, B-Cell/pathology
- Lymphoma, B-Cell/therapy
- Lymphoma, Large B-Cell, Diffuse/mortality
- Lymphoma, Large B-Cell, Diffuse/pathology
- Lymphoma, Large B-Cell, Diffuse/therapy
- Male
- Mediastinal Neoplasms/mortality
- Mediastinal Neoplasms/pathology
- Mediastinal Neoplasms/therapy
- Middle Aged
- Remission Induction/methods
- Retrospective Studies
- Sclerosis
- Survival Analysis
- Treatment Outcome
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Affiliation(s)
- Pier Luigi Zinzani
- Institute of Hematology and Medical Oncology Seràgnoli, University of Bologna, Italy.
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Tsavaris N, Zorzos C, Kosmas C, Lazaris A, Katsorida M, Pangalis G, Davaris P. Breast cancer (BC) after curative chemotherapy (CT) in non-hodgkin's lymphoma (NHL): drug resistance as the major cause of treatment failure. Eur J Cancer 1999. [DOI: 10.1016/s0959-8049(99)81184-8] [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: 10/27/2022]
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Viniou NA, Matzourani M, Yataganas X, Meletis J, Pangalis G, Loukopoulos D. Correlation of the site of M-bcr breakpoint with chronic phase duration, blastic crisis lineage and thrombocytosis in Ph1-positive chronic myelogenous leukemia. Leuk Lymphoma 1995; 18:335-9. [PMID: 8535202 DOI: 10.3109/10428199509059627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [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: 01/31/2023]
Abstract
The breakpoints on chromosome 22 in CML occur within a 5.8 kb region called the Major breakpoint cluster region (M-bcr). DNA mapping within the M-bcr region was performed in 41 long term followed Ph1-positive CML patients using the Southern blot technique. The purpose of this study was to determine whether localization of M-bcr breakpoint correlates with the length of chronic phase of the disease, blastic crisis lineage and thrombocytosis at the time of initial diagnosis. Our results fail to indicate any correlation between breakpoint localization and duration of chronic phase, blastic crisis lineage and platelet count at diagnosis.
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MESH Headings
- Blast Crisis
- Cell Lineage/genetics
- Chromosomes, Human, Pair 22
- Follow-Up Studies
- Humans
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/blood
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/pathology
- Multigene Family
- Platelet Count
- Thrombocytosis/blood
- Thrombocytosis/genetics
- Thrombocytosis/pathology
- Translocation, Genetic
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Affiliation(s)
- N A Viniou
- First Department of Internal Medicine, National and Kapodistrian University, Laikon General Hospital, Athens, Greece
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Korkolopoulou P, Patsouris E, Pangalis G, Tsenga A, Elemenoglou J, Thomas-Tsangli E, Spandidos D, Kittas C. A comparative assessment of proliferating cell nuclear antigen, c-myc p62, and nucleolar organizer region staining in non-Hodgkin's lymphomas: a histochemical and immunohistochemical study of 200 cases. Hum Pathol 1993; 24:371-7. [PMID: 7684020 DOI: 10.1016/0046-8177(93)90084-t] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Proliferating cell nuclear antigen (PCNA) and c-myc p62 oncoprotein are two nuclear proteins expressed in proliferating and transformed cells. They can be recognized immunohistochemically in paraffin sections by the monoclonal antibodies PC-10 and c-myc 1-9E10, respectively. On the other hand, nucleolar organizer regions (NORs) are loops of DNA that carry the r-RNA genes and can be visualized in paraffin sections as black dots (AgNORs) using a silver impregnation method. It has been suggested that the mean number of AgNORs may reflect the cellular kinetics of a tumor. We independently examined 200 cases of non-Hodgkin's lymphomas using the monoclonal antibodies PC-10 and c-myc 1-9E10, as well as the AgNOR method. Our study shows a very significant correlation between PCNA, c-myc expression, and AgNOR count on the one hand and histologic grade on the other (P < .001), although a significant overlap among the three grades exists. PC-10, c-myc 1-9E10, and AgNOR scores are all shown to be linearly related, even though significant discrepancies were observed, and the correlation is stronger between PCNA and AgNORs (PCNA v c-myc p62, r = .551; PCNA v AgNORs, r = .746; c-myc p62 v AgNORs, r = .529; P < .001). A remarkable finding is that the intermediate group of lymphomas is heterogeneous as far as the proliferative rate is concerned: diffuse large cell cleaved/non-cleaved lymphomas (category G of the Working Formulation) are characterized by a significantly higher proliferative index, as evidenced by the elevated PCNA, c-myc p62, and AgNOR scores, in comparison with the other types of intermediate-grade lymphomas (P < .001). However, the proliferative rate is lower than that of the high-grade lymphomas (PCNA, P < .05; c-myc p62, P < .001; AgNORs, P < .005). No significant difference exists between B-cell and T-cell lymphomas except for the higher expression of c-myc p62 in intermediate-grade B-cell lymphomas, obviously due to the higher proliferative rate of diffuse large cell lymphomas. Based on our findings, it appears that the combination of PCNA, c-myc p62, and AgNORs provides an accurate estimate of the proliferative rate of non-Hodgkin's lymphomas in paraffin sections. Clinical studies may show whether this information has prognostic value independent of histologic classification. In addition, our results suggest that category G (diffuse large cell) lymphomas may belong to a malignancy grade higher than the intermediate grade, a suggestion consistent with their more aggressive biologic behavior.
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Affiliation(s)
- P Korkolopoulou
- Pathology Department, Asklepeion Hospital, Voula, Athens, Greece
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Pangalis G, Tegos C, Beutler E. The effect of external ADP on red cell nucleotide levels. Proc Soc Exp Biol Med 1979; 160:74-5. [PMID: 419131 DOI: 10.3181/00379727-160-40392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Abstract
The clinical course of a 33-year-old man with generalized lymphadenopathy bearing all physical, laboratory and histologic characteristics of "angio-immunoblastic lymphadenopathy with dysproteinemia" (AILD) is described. Therapy was without significant benefit and the patient died 22 months after initial diagnosis. At autopsy in addition to the characteristic cellular polymorphism of AILD, numerous Hodgkin's cells and Sternberg-Reed cells were identified in the lymph nodes and spleen. Pleomorphic cellular infiltrates containing an increased number of immunoblasts and some giant cells were found also in the portal spaces of the liver. The evolution of Hodgkin's disease (H.D.) from AILD suggests that the latter may have represented a reaction to the agent which causes H.D..
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Beutler E, Kuhl W, Matsumoto F, Pangalis G. Acid hydrolases in leukocytes and platelets of normal subjects and in patients with Gaucher's and Fabry's disease. J Exp Med 1976; 143:975-80. [PMID: 3620 PMCID: PMC2190173 DOI: 10.1084/jem.143.4.975] [Citation(s) in RCA: 68] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Lymphocytes, monocytes, neutrophilic granulocytes and platelets were each separated to greater than 95% purity from six normal subjects, three patients with Gaucher's disease, two heterozygotes for Gaucher's disease, and one patient with Fabry's disease. Activities of the following acid hydrolases were determined: "acid" (pH 4.0) beta-glucosidase, pH 5.0 beta-glucosidase, alpha-galactosidase, alpha-arabinosidase, alpha-mannosidase, alpha-glucosidase, beta-glucuronidase, beta-galactosidase, beta-hexosaminidase, and acid phosphatase. Enzymatic activity varied greatly with cell type and the enzyme being measured; the importance of assaying pure preparations especially for heterozygote detection is emphasized. Gaucher's disease patients' cells were found to be deficient in the pH 4.0 acid beta-glucosidase, variable in the pH 5.0 beta-glucosidase, and normal in all other acid hydrolases tested, including acid phosphatase, the activity of which is known to be elevated in plasma. Blood cells of a patient with Fabry's disease were deficient in alpha-galactosidase and normal in all other acid hydrolases tested.
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