scholarly journals Excellent survival after R‐Hyper‐CVAD in hospitalized patients with high‐risk large B‐cell lymphoma: The Karolinska experience

eJHaem ◽  
2021 ◽  
Author(s):  
Kristina Sonnevi ◽  
Maria Ljungqvist ◽  
Jóel Kristinn Jóelsson ◽  
Sara Harrysson ◽  
Tove Wästerlid ◽  
...  
2020 ◽  
Vol 31 (9) ◽  
pp. 1251-1259 ◽  
Author(s):  
A.K. McMillan ◽  
E.H. Phillips ◽  
A.A. Kirkwood ◽  
S. Barrans ◽  
C. Burton ◽  
...  

2019 ◽  
Vol 25 (3) ◽  
pp. S65 ◽  
Author(s):  
Sattva S. Neelapu ◽  
Armin Ghobadi ◽  
Caron A. Jacobson ◽  
David B. Miklos ◽  
Lazaros J. Lekakis ◽  
...  

2011 ◽  
Vol 90 (10) ◽  
pp. 1145-1151 ◽  
Author(s):  
Yu-Chung Huang ◽  
Chia-Jen Liu ◽  
Chun-Yu Liu ◽  
Jih-Tung Pai ◽  
Ying-Chung Hong ◽  
...  

Haematologica ◽  
2020 ◽  
Vol 105 (11) ◽  
pp. 2667-2670 ◽  
Author(s):  
Marita Ziepert ◽  
Stefano Lazzi ◽  
Raffaella Santi ◽  
Federica Vergoni ◽  
Massimo Granai ◽  
...  

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 3056-3056 ◽  
Author(s):  
Jose Rodriguez ◽  
Eulogio Conde ◽  
Antonio Gutierrez ◽  
Juan Carlos Garcia-Ruiz ◽  
Juan Jose Lahuerta ◽  
...  

Abstract From 1985 to 2006, 71 patients with primary mediastinal large B-cell lymphoma receiving induction doxorubicine-based chemotherapy followed by ASCT as front-line therapy were registered in the GEL-TAMO (Spanish Group for Lymphoma and Autologous Transplantation). Median age was 28 years, 56% of patients were female, 40% presented with an ECOG ≥ 2; B-symptoms at diagnosis were present in 25% of the patients. Most patients presented with high-risk clinical features: bulky tumours defined as ≥10 cms of diameter were observed in most patients (87%), high LDH in 72% and, as previously reported (Rodriguez et al, Ann Oncol, 1994), β2m was elevated only in 7% of the cases. Forty-seven percent of patients presented 2–3 risk factors of the a-IPI. At transplant, thirty-five patients (49%) in first complete remission (CR), 23 (33%) in partial response and 13 patients (18%) failing the first induction therapy were transplanted, respectively. Conditioning regimens were BEAM or BEAC in 90% of the patients. 39 patients received Radiotherapy: 19 prior and 20 after the transplant. Most patients (91%) received peripheral stem cells. Only a patient failed to engraft after the transplant. After the transplant 73% of the patients achieved a CR and 17 patients were refractory. With a median follow-up from transplantation of 46,5 months the OS, PFS and DFS are 68%, 59% and 81% respectively. Progression of the disease was the main cause of death (78%). A patient died of a second neoplasia and 3 patients died of sepsis. There were no deaths related to transplant toxicity. By multivariate survival analysis both status of the disease at transplant (CR vs PR vs failure) and the Tumor score (Rodriguez et al, Ann Oncol,1992 ) were the only independent variables associated with the OS and PFS, respectively. In conclusion our experience, with a prolonged follow-up, shows that patients with primary mediastinal large B-cell lymphoma presenting at diagnosis with high-risk features have an encouraging survival and PFS with front-line ASCT. However, patients who received the transplant having failed the induction regimen have a very poor prognosis and should be tested with another innovative approach.


Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 2478-2478
Author(s):  
Miguel Ángel Gutiérrez-Monreal ◽  
Luis Villela ◽  
Yocanxochitl Perfecto ◽  
Samuel Kettenhofen ◽  
Guy Cardineau ◽  
...  

Abstract Abstract 2478 In Mexico, diffuse large B-cell lymphoma (DLBCL) is the most common histological non-Hodgkin's lymphoma (NHL) subtype and is observed in up to 48% of all diagnoses of lymphoma. It has recently been hypothesized that circadian disruption may have a connection with lymphomagenesis. The circadian clock maintains biological rhythms over a cycle of approximately 24 hours, and many physiological functions in the human body are regulated by this system. The disruption of the circadian cycle may negatively affect cellular function, potentially leading to increased susceptibility to certain malignancies. Evidence in support of this association has been provided by epidemiological studies that demonstrate that night-time work significantly increased the risk of NHL in men, the overall relative risk being 1.10 (95%CI = 1.03–1.19, p = 0.010)(Lahti et al., Int J Cancer 2008). The study was performed to determinate if functional single nucleotide polymorphisms (SNP) in circadian rhythm genes are associated with the presence of DLBCL in Mexican patients. A molecular mechanism to regulate the circadian rhythm has been identified, where nine genes have been involved: clock, npas2, bmal1, per1-3, cry1-2, and csnk1e. Recent studies have shown that approximately 10% of genes exhibit circadian patterns of expression in a given tissue, and 10% of these clock-controlled genes identified regulate either cell proliferation or apoptosis. For this current study, SNPs were evaluated in DNA samples isolated from histopathologically-confirmed DLBCL patients (N=30) and healthy volunteers (N=50) as a control population. Samples were provided by Hospital Regional de Especialidades IMSS No. 25 and Hospital Metropolitano, in Monterrey, Nuevo Leon, Mexico. The selection of functional SNPs was made using a bioinformatic tool called Function Analysis and Selection Tool for Single Nucleotide Polymorphisms (FASTSNP)(Yuan et al., Nucl. Acids Res 2006). Six genes that regulate the circadian rhythm were submitted to FASTSNP, and 13 high-risk SNPs were used for this study. The results provided were npas2 rs11541353, per1 rs3027189, rs3027180, and rs3027177; per2 rs2340885, and rs3739068; per3 rs228697, rs2640905, rs12078704, and rs57875989; tim rs2291739, and rs2638290; and cry2 rs2863712. Primers were designed for the 13 high-risk SNPs. The SNPs were amplified by PCR in a 96-well plate. Alleles were determined by presence of the resultant bands in an agarose gel electrophoresis. SNPs analysis showed that DLBCL patients were mutated in 93.3% (28/30), while the population of controls were only in 74.0% (37/50) who presented with mutations (p = 0.023). The rs2291739 variant of the tim gene was the most frequent homozygous mutant found in at least 50% of both controls and patients. Two SNPs were found to be statistically significant associated with DLBCL, these were per1 rs3027189 (p = 0.006) and cry2 rs2863712 (p = 0.002). The per1 gene plays an important role in regulating growth and DNA damage control and also interacts with proteins in the cell-cycle pathway. CRY2 has been shown to alter genes associated with immune response and hematological system development. These results suggest that these two genes might play an important role in influencing biological pathways relevant for lymphomagenesis. These findings contribute in part to the recent research that links the disruption of circadian rhythm with the processes of lymphomagenesis. Further studies are warranted. This study was supported by Catedra de Hematologia y Cancer from Tecnologico de Monterrey. Disclosures: No relevant conflicts of interest to declare.


Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 1626-1626
Author(s):  
Luigi Rigacci ◽  
Alberto Fabbri ◽  
Benedetta Puccini ◽  
Enrico Orciuolo ◽  
Alice Pietrini ◽  
...  

Abstract Abstract 1626 Diffuse large B cell lymphoma (DLBCL) is one of the most common types of non-Hodgkin's lymphoma. R-CHOP21 (C21) is considered the standard therapy but a large number of studies tested R-CHOP14 (C14). The aim of our study was to evaluate retrospectively a cohort of patients (pts) treated with C21 or C14. All pts with diagnosis of DLBCL or follicular grade IIIb lymphoma, treated with curative intent were accrued. From January 2002 to December 2010, 123 pts were treated with C21 and 142 were treated with C14. The median age was 63 (range 19–89). The two cohorts of pts were balanced for all clinical characteristics a part for age (<65 or >64 years) with more aged pts in C21 arm (p 0.000), PS with more advanced PS (2–3) in C21 arm (0.000) and LDH value which was more frequently elevated in C14 arm (p: 0.002). After induction therapy 190 pts (71%) obtained a complete remission: 82/123 (67%) after C21 and 108/142 (75%) after C14. After a median period of observation of 31 months 81 pts relapsed, 42 (51%) in the C21 arm and 39 (36%) in the C14 arm. Considering the two therapies, C21 vs C14, no differences were reported in OS, PFS and DFS: 61% vs 68%, 59% vs 58% and 74% vs 61% respectively. In univariate analysis OS was lower in older pts (p: 0.02), advanced stage (p: 0.02), symptomatic disease (p: 0.05), elevated LDH (p: 0.001), bone marrow infiltration (p: 0.02) and intermediate or high risk IPI (p: 0.000); PFS was lower in advanced stage (p: 0.002), symptomatic disease (p: 0.009), elevated LDH (p: 0.001), bone marrow infiltration (p: 0.001) and intermediate high risk IPI (p: 0.000). In multivariate analysis OS was significantly better in low-intermediate IPI risk pts (p: 0.000) and in pts treated with C14 (p: 0.02); the PFS was better in low-intermediate IPI risk pts (p: 0.000). Considering only pts with low or low-intermediate IPI we observed that OS was significantly superior in the group treated with C14 (90% vs 64% p: 0.03), moreover in young pts (< 65 years) OS was better in pts treated with C14 (81% vs 58% p: 0.05). As expected hematological grade III/IV toxicity was more frequent in pts treated with C14, all pts but three (2%) completed the therapy without delay or dose reduction. No differences in extra-hematological toxicity were observed. Conclusions: In conclusion our results confirm that C14 do not improve the results of the standard C21 in the whole lymphoma population but in a subset of pts, young and low/intermediate risk pts, the C14 scheme seems to improve the OS. We will enlarge the cohort of studied patients but further prospective randomized studies are needed to verify this preliminary observations. Disclosures: No relevant conflicts of interest to declare.


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