1
|
Radivoyevitch T, Sachs RK, Gale RP, Molenaar RJ, Brenner DJ, Hill BT, Kalaycio ME, Carraway HE, Mukherjee S, Sekeres MA, Maciejewski JP. Defining AML and MDS second cancer risk dynamics after diagnoses of first cancers treated or not with radiation. Leukemia 2015; 30:285-94. [PMID: 26460209 DOI: 10.1038/leu.2015.258] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Accepted: 08/14/2015] [Indexed: 01/22/2023]
Abstract
Risks of acute myeloid leukemia (AML) and/or myelodysplastic syndromes (MDS) are known to increase after cancer treatments. Their rise-and-fall dynamics and their associations with radiation have, however, not been fully characterized. To improve risk definition we developed SEERaBomb R software for Surveillance, Epidemiology and End Results second cancer analyses. Resulting high-resolution relative risk (RR) time courses were compared, where possible, to results of A-bomb survivor analyses. We found: (1) persons with prostate cancer receiving radiation therapy have increased RR of AML and MDS that peak in 1.5-2.5 years; (2) persons with non-Hodgkin lymphoma (NHL), lung and breast first cancers have the highest RR for AML and MDS over the next 1-12 years. These increased RR are radiation specific for lung and breast cancer but not for NHL; (3) AML latencies were brief compared to those of A-bomb survivors; and (4) there was a marked excess risk of acute promyelocytic leukemia in persons receiving radiation therapy. Knowing the type of first cancer, if it was treated with radiation, the interval from first cancer diagnosis to developing AML or MDS, and the type of AML, can improve estimates of whether AML or MDS cases developing in this setting are due to background versus other processes.
Collapse
Affiliation(s)
- T Radivoyevitch
- Department of Quantitative Health Sciences, Cleveland Clinic Lerner Research Institute, Cleveland, OH, USA
| | - R K Sachs
- Department of Mathematics, University of California, Berkeley, CA, USA
| | - R P Gale
- Section of Hematology, Department of Medicine, Imperial College London, London, UK
| | - R J Molenaar
- Department of Cell Biology and Histology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.,Department of Translational Hematology and Oncology Research, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA
| | - D J Brenner
- Department of Radiation Oncology, Center for Radiological Research, Columbia University, New York, NY, USA
| | - B T Hill
- Department of Hematology and Medical Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA
| | - M E Kalaycio
- Department of Hematology and Medical Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA
| | - H E Carraway
- Department of Hematology and Medical Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA
| | - S Mukherjee
- Department of Hematology and Medical Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA
| | - M A Sekeres
- Department of Hematology and Medical Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA
| | - J P Maciejewski
- Department of Translational Hematology and Oncology Research, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA.,Department of Hematology and Medical Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA
| |
Collapse
|
2
|
Hamilton BK, Law AD, Rybicki L, Abounader D, Dabney J, Dean R, Duong HK, Gerds AT, Hanna R, Hill BT, Jagadeesh D, Kalaycio ME, Lawrence C, McLellan L, Pohlman B, Sobecks RM, Bolwell BJ, Majhail NS. Prognostic significance of pre-transplant quality of life in allogeneic hematopoietic cell transplantation recipients. Bone Marrow Transplant 2015; 50:1235-40. [PMID: 26030045 DOI: 10.1038/bmt.2015.122] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Revised: 03/25/2015] [Accepted: 04/05/2015] [Indexed: 11/09/2022]
Abstract
Quality of life (QOL) is an important outcome for hematopoietic cell transplantation (HCT) recipients. Whether pre-HCT QOL adds prognostic information to patient and disease related risk factors has not been well described. We investigated the association of pre-HCT QOL with relapse, non-relapse mortality (NRM), and overall mortality after allogeneic HCT. From 2003 to 2012, the Functional Assessment of Cancer Therapy-Bone Marrow Transplant Scale instrument was administered before transplantation to 409 first allogeneic HCT recipients. We examined the association of the three outcomes with (1) individual QOL domains, (2) trial outcome index (TOI) and (3) total score. In multivariable models with individual domains, functional well-being (hazard ratio (HR) 0.95, P=0.025) and additional concerns (HR 1.39, P=0.002) were associated with reduced risk of relapse, no domain was associated with NRM, and better physical well-being was associated with reduced risk of overall mortality (HR 0.97, P=0.04). TOI was not associated with relapse or NRM but was associated with reduced risk of overall mortality (HR 0.93, P=0.05). Total score was not associated with any of the three outcomes. HCT-comorbidity index score was prognostic for greater risk of relapse and mortality but not NRM. QOL assessments, particularly physical functioning and functional well-being, may provide independent prognostic information beyond standard clinical measures in allogeneic HCT recipients.
Collapse
Affiliation(s)
- B K Hamilton
- Taussig Cancer Institute, Blood & Marrow Transplant Program, Cleveland Clinic, Cleveland, OH, USA
| | - A D Law
- Taussig Cancer Institute, Blood & Marrow Transplant Program, Cleveland Clinic, Cleveland, OH, USA
| | - L Rybicki
- Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA
| | - D Abounader
- Taussig Cancer Institute, Blood & Marrow Transplant Program, Cleveland Clinic, Cleveland, OH, USA
| | - J Dabney
- Taussig Cancer Institute, Blood & Marrow Transplant Program, Cleveland Clinic, Cleveland, OH, USA
| | - R Dean
- Taussig Cancer Institute, Blood & Marrow Transplant Program, Cleveland Clinic, Cleveland, OH, USA
| | - H K Duong
- Taussig Cancer Institute, Blood & Marrow Transplant Program, Cleveland Clinic, Cleveland, OH, USA
| | - A T Gerds
- Taussig Cancer Institute, Blood & Marrow Transplant Program, Cleveland Clinic, Cleveland, OH, USA
| | - R Hanna
- Taussig Cancer Institute, Blood & Marrow Transplant Program, Cleveland Clinic, Cleveland, OH, USA
| | - B T Hill
- Taussig Cancer Institute, Blood & Marrow Transplant Program, Cleveland Clinic, Cleveland, OH, USA
| | - D Jagadeesh
- Taussig Cancer Institute, Blood & Marrow Transplant Program, Cleveland Clinic, Cleveland, OH, USA
| | - M E Kalaycio
- Taussig Cancer Institute, Blood & Marrow Transplant Program, Cleveland Clinic, Cleveland, OH, USA
| | - C Lawrence
- Taussig Cancer Institute, Blood & Marrow Transplant Program, Cleveland Clinic, Cleveland, OH, USA
| | - L McLellan
- Taussig Cancer Institute, Blood & Marrow Transplant Program, Cleveland Clinic, Cleveland, OH, USA
| | - B Pohlman
- Taussig Cancer Institute, Blood & Marrow Transplant Program, Cleveland Clinic, Cleveland, OH, USA
| | - R M Sobecks
- Taussig Cancer Institute, Blood & Marrow Transplant Program, Cleveland Clinic, Cleveland, OH, USA
| | - B J Bolwell
- Taussig Cancer Institute, Blood & Marrow Transplant Program, Cleveland Clinic, Cleveland, OH, USA
| | - N S Majhail
- Taussig Cancer Institute, Blood & Marrow Transplant Program, Cleveland Clinic, Cleveland, OH, USA
| |
Collapse
|
3
|
Tabarroki A, Lindner DJ, Visconte V, Zhang L, Rogers HJ, Parker Y, Duong HK, Lichtin A, Kalaycio ME, Sekeres MA, Mountantonakis SE, Heresi GA, Tiu RV. Ruxolitinib leads to improvement of pulmonary hypertension in patients with myelofibrosis. Leukemia 2014; 28:1486-93. [DOI: 10.1038/leu.2014.5] [Citation(s) in RCA: 42] [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] [Received: 12/12/2013] [Accepted: 12/16/2013] [Indexed: 01/10/2023]
|
4
|
Saglio G, Kantarjian H, Reiffers J, Jootar S, Kalaycio ME, Shibayama H, Fan X, Gallagher NJ, Shou Y, Larson RA, Hughes TP, Hochhaus A. The incidence of BCR-ABL mutations in patients (pts) with newly diagnosed chronic myeloid leukemia (CML) in chronic phase (CP) treated with nilotinib or imatinib in ENESTnd: 24-month follow-up. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.6502] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
5
|
Mohan SR, Elson P, Kalaycio ME, Tiu RV, Advani AS, Copelan EA, Maciejewski JP, Sekeres MA. Influence of type of antecedent disorder on outcome of therapy-related AML. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.6628] [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
|
6
|
Mansour MG, Fu AZ, Copelan EA, Kalaycio ME, Advani AS, Saunthararajah Y, Sobecks RM, Sekeres MA. The relationship of cigarette smoking to invasive fungal disease (IFD) in acute myeloid leukemia (AML) patients undergoing induction chemotherapy (IC). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.6547] [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
|
7
|
Sekeres MA, Jin T, Maciejewski J, Kalaycio ME, Brown S, Advani A, Golshayan AR, Sobecks R, Kattan MW. Characterization, resource use, and the economic impact of low-risk myelodysplastic syndrome (MDS) at an MDS specialty center. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.6098] [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: 11/20/2022] Open
Affiliation(s)
| | - T. Jin
- Cleveland Clinic Fdn, Cleveland, OH
| | | | | | - S. Brown
- Cleveland Clinic Fdn, Cleveland, OH
| | | | | | | | | |
Collapse
|
8
|
Avery RK, Pohlman BL, Mossad SB, Goormastic M, Longworth DL, Kalaycio ME, Sobecks RM, Andresen SW, Kuczkowski E, Bernhard L, Ostendorf H, Wise K, Bolwell BJ. The efficacy of prophylactic outpatient antibiotics for the prevention of neutropenic fever associated with high-dose etoposide (VP-16) for stem cell mobilization. Bone Marrow Transplant 2002; 30:311-4. [PMID: 12209353 DOI: 10.1038/sj.bmt.1703622] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2001] [Accepted: 04/12/2002] [Indexed: 11/08/2022]
Abstract
High-dose etoposide (2 g/m(2)) plus G-CSF is a very effective regimen for peripheral blood progenitor cell (PBPC) mobilization. Unfortunately, neutropenia is common. The infectious complications associated with high-dose etoposide have not been previously described. After noting a high incidence of hospitalizations for neutropenic fever, we began a vigorous prophylactic antibiotic regimen for patients receiving high-dose etoposide plus G-CSF, attempting to reduce infectious complications. Ninety-eight patients underwent etoposide mobilization between December 1997 and June 2000. Three chronological patient groups received: (1) no specific antibiotic prophylaxis (n = 44); (2) vancomycin i.v., cefepime i.v., clarithromycin p.o., and ciprofloxacin p.o. (n = 27); and (3) vancomycin i.v., clarithromycin p.o., and ciprofloxacin p.o. (n = 27). The patients not receiving antibiotic prophylaxis had a 68% incidence of hospitalization for neutropenic fever. In the patients receiving prophylaxis, the incidence was reduced to 26% and 15% respectively, for an overall incidence of 20% (P < 0.001 for comparison between prophylaxed and unprophylaxed groups). We conclude that etoposide mobilization is associated with a significant incidence of neutropenic fever, which can be substantially reduced by a vigorous antimicrobial prophylactic program.
Collapse
Affiliation(s)
- R K Avery
- Department of Infectious Diseases, Cleveland Clinic Foundation, Cleveland, OH 44195, USA
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
9
|
Abstract
Chronic myelogenous leukemia (CML) can usually be cured by bone marrow transplantation from matched donors. Donor T-cell activity from the graft is critical to maintaining remission. Myeloablation may not be necessary for cure. Non-myeloablative but immunosuppressive preparative regimens allow donor engraftment with less toxicity. Early combination therapy with interferon-alfa and cytarabine was the preferred option for patients who could not undergo bone marrow transplantation. Now, the advent of imatinib mesylate, a specific inhibitor of BCR/ABL tyrosine kinase, promises to change existing treatment paradigms
Collapse
MESH Headings
- Antineoplastic Agents/therapeutic use
- Benzamides
- Bone Marrow Transplantation
- Clinical Trials as Topic
- Diagnosis, Differential
- Enzyme Inhibitors/therapeutic use
- Graft vs Leukemia Effect
- Humans
- Imatinib Mesylate
- Interferon-alpha/therapeutic use
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/diagnosis
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/therapy
- Piperazines/therapeutic use
- Practice Guidelines as Topic
- Precursor Cell Lymphoblastic Leukemia-Lymphoma/diagnosis
- Protein-Tyrosine Kinases/antagonists & inhibitors
- Pyrimidines/therapeutic use
- Remission Induction
Collapse
Affiliation(s)
- M E Kalaycio
- Department of Hematology and Medical Oncology, The Cleveland Clinic Foundation, OH 44195, USA.
| |
Collapse
|
10
|
Mossad SB, Avery RK, Longworth DL, Kuczkowski EM, McBee M, Pohlman BL, Sobecks RM, Kalaycio ME, Andresen SW, Macklis RM, Bolwell BJ. Infectious complications within the first year after nonmyeloablative allogeneic peripheral blood stem cell transplantation. Bone Marrow Transplant 2001; 28:491-5. [PMID: 11593323 DOI: 10.1038/sj.bmt.1703180] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2001] [Accepted: 06/16/2001] [Indexed: 11/08/2022]
Abstract
Nonmyeloablative peripheral blood stem cell transplantation (PBSCT) is a novel therapeutic strategy for patients with malignant and non-malignant hematologic diseases. Infectious complications of this procedure have not been previously well described. Data on 12 patients transplanted at a tertiary care center were collected prospectively and verified retrospectively. Neutropenia developed in a third of patients, lasting for a median of 5 days. All patients developed some degree of graft-versus-host disease, as intended. Most patients achieved full chimerism by week 5. Bacterial infections occurred in two patients (17%). Cytomegalovirus (CMV) viremia occurred in five patients (42%) at a median of 80 days; none had received CMV prophylaxis. Viremia was associated with fever and fatigue in three patients, possible gastrointestinal involvement in one patient and was asymptomatic in one patient. All viremic patients responded to intravenous ganciclovir therapy. No fungal infections were documented. No patients died as a result of infection. The incidence of CMV viremia in our patients was high, but the incidence of invasive disease due to CMV was low. The best strategy to prevent CMV in patients undergoing nonmyeloablative PBSCT remains to be determined, but strategies employed in traditional allogeneic bone marrow transplantation should be considered in these patients.
Collapse
Affiliation(s)
- S B Mossad
- Department of Infectious Diseases, Cleveland Clinic Foundation, 9500 Euclid Avenue S-32, Cleveland, OH 44195, USA
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
11
|
Chauncey TR, Rankin C, Anderson JE, Chen I, Kopecky KJ, Godwin JE, Kalaycio ME, Moore DF, Shurafa MS, Petersdorf SH, Kraut EH, Leith CP, Head DR, Luthardt FW, Willman CL, Appelbaum FR. A phase I study of induction chemotherapy for older patients with newly diagnosed acute myeloid leukemia (AML) using mitoxantrone, etoposide, and the MDR modulator PSC 833: a southwest oncology group study 9617. Leuk Res 2000; 24:567-74. [PMID: 10867130 DOI: 10.1016/s0145-2126(00)00024-2] [Citation(s) in RCA: 45] [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: 10/17/2022]
Abstract
Older patients with acute myelogenous leukemia (AML) have overexpression of P-glycoprotein (Pgp+), and this has been shown to correlate quantitatively with therapeutic outcome. Since Pgp-mediated efflux of cytotoxic drugs can be inhibited by the cyclosporine analogue, PSC 833, we investigated the use of this agent with a 5-day mitoxantrone/etoposide regimen in patients over age 55 with newly diagnosed AML. Previous studies suggested a 33% incidence of grade IV/V non-hematologic toxicity with the use of mitoxantrone 10 mg/M(2) and etoposide 100 mg/M(2), each for 5 days, in this patient population. Since PSC 833 alters the pharmacokinetic excretion of MDR-related cytotoxins, this phase I dose-finding study was performed to identify doses of mitoxantrone/etoposide associated with a similar 33% incidence of grade IV/V non-hematologic toxicity, when given with PSC 833. Mitoxantrone/etoposide (M/E) doses were escalated in fixed ratio from a starting dose of M: 4 mg/M(2) and E: 40 mg/M(2), to M: 7 mg/M(2) and E: 70 mg/M(2), in successive cohorts of eight patients each. PSC 833 was well tolerated and the MTD of this M/E regimen with PSC 833 in this population was M: 6 mg/M(2) and E: 60 mg/M(2). The complete response (CR) rate for all patients was 50% (15/30) and was considerably higher for de novo than for secondary AML. These data suggest that the addition of PSC 833 to an M/E regimen for older patients with untreated AML is well tolerated but requires a reduction in M/E dosing to avoid increased toxicity.
Collapse
Affiliation(s)
- T R Chauncey
- University of Washington School of Medicine, Seattle, WA, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
12
|
Maran A, Waller CF, Paranjape JM, Li G, Xiao W, Zhang K, Kalaycio ME, Maitra RK, Lichtin AE, Brugger W, Torrence PF, Silverman RH. 2',5'-Oligoadenylate-antisense chimeras cause RNase L to selectively degrade bcr/abl mRNA in chronic myelogenous leukemia cells. Blood 1998; 92:4336-43. [PMID: 9834240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Abstract
We report an RNA targeting strategy, which selectively degrades bcr/abl mRNA in chronic myelogenous leukemia (CML) cells. A 2', 5'-tetraadenylate activator (2-5A) of RNase L was chemically linked to oligonucleotide antisense directed against either the fusion site or against the translation start sequence in bcr/abl mRNA. Selective degradation of the targeted RNA sequences was demonstrated in assays with purified RNase L and decreases of p210(bcr/abl) kinase activity levels were obtained in the CML cell line, K562. Furthermore, the 2-5A-antisense chimeras suppressed growth of K562, while having substantially reduced effects on the promyelocytic leukemia cell line, HL60. Findings were extended to primary CML cells isolated from bone marrow of patients. The 2-5A-antisense treatments both suppressed proliferation of the leukemia cells and selectively depleted levels of bcr/abl mRNA without affecting levels of beta-actin mRNA, determined by reverse transcriptase-polymerase chain reaction (RT-PCR). The specificity of this approach was further shown with control oligonucleotides, such as chimeras containing an inactive dimeric form of 2-5A, antisense lacking 2-5A, or chimeras with altered sequences including several mismatched nucleotides. The control oligonucleotides had either reduced or no effect on CML cell growth and bcr/abl mRNA levels. These findings show that CML cell growth can be selectively suppressed by targeting bcr/abl mRNA with 2-5A-antisense for decay by RNase L and suggest that these compounds should be further explored for their potential as ex vivo purging agents of autologous hematopoietic stem cell transplants from CML patients.
Collapse
MESH Headings
- Adenine Nucleotides/genetics
- Adenine Nucleotides/pharmacology
- Adenine Nucleotides/therapeutic use
- Endoribonucleases/genetics
- Endoribonucleases/pharmacology
- Enzyme Activation/genetics
- Fusion Proteins, bcr-abl/antagonists & inhibitors
- Fusion Proteins, bcr-abl/genetics
- Gene Expression Regulation, Neoplastic
- Humans
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Oligonucleotides, Antisense/genetics
- Oligonucleotides, Antisense/pharmacology
- Oligonucleotides, Antisense/therapeutic use
- Oligoribonucleotides/genetics
- Oligoribonucleotides/pharmacology
- Oligoribonucleotides/therapeutic use
- RNA, Messenger/antagonists & inhibitors
- RNA, Messenger/genetics
- Recombinant Fusion Proteins/genetics
- Recombinant Fusion Proteins/pharmacology
- Recombinant Fusion Proteins/therapeutic use
- Tumor Cells, Cultured
Collapse
Affiliation(s)
- A Maran
- Department of Cancer Biology, The Lerner Research Institute, and Department of Hematology and Oncology, Cleveland Clinic Foundation, Cleveland, OH,USA
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|