The Comparison of Efficacy Between MVEP Chemotherapy and R- MVEP Chemotherapy in Patients of Refractory and Relapsed Non-Hodgkin Lymphoma

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 4963-4963
Author(s):  
Meihua Qian ◽  
Wensong Wang
Keyword(s):  
Complete Remission ◽  
Lymph Nodes ◽  
Hodgkin Lymphoma ◽  
Overall Response Rate ◽  
Response Rate ◽  
Treatment Method ◽  
Old Patients ◽  
Overall Response ◽  
Non Hodgkin Lymphoma ◽  
Better Than

Abstract To observe the efficacy and toxicity of two groups of MVEP Chemotherapy and R-MVEP Chemotherapy in patients of Refractory and relapsed Non-Hodgkin Lymphoma. 19 cases patients of refractory and relapsed Non-Hodgkin Lymphoma, 9 females and 10 male, between 17–75 years of age (mean age 45.5 years), 2 cases IIa,, 11caseIII (9IIIa and 2IIIb), 6 cases IV(4 IVa and 2 IVb).Most of patients showed the enlargement of superficial and/or deep multiple lymph nodes, 4 cases had fever and the enlargement of spleen and/or liver, 2 cases with hydrothorax and ascites, 3 cases with bone marrow infiltration and 1 case with multiple lumps in liver, other 1 case with autoimmune hemolytic anemia (AIHA)and one with pericardial effusion. All patients were treated with chemotherapy included COP (or COPP), CHOP, BCAOP (or BECAOP), etc. and 2 patients of them Had been treated by radiotherapy before they were treated by MVEP Chemotherapy and R- MVEP Chemotherapy. In this experiment, A group of 13 patients were treated by MVEP Chemotherapy and G-CSF ( MVEP, Mitoxantrone 8mg/m2/d1, VP16 O.1/d1 ‘d5 (or,Wumon 0.1/d1 ‘d3),Vinorelbinum 20mg/m2/d1,Prednison 60mg/d1 ‘d7,or DXM 8mg/m2d1 ‘d7), other group of 6 patients were therapied by Rituximab plus MEVP Chemotherapy and G-CSF,( R-MVEP, Rituximab 375 mg/m2/d1,Mitoxantrone 8mg/m2/d3, Wumon 0.1/d3 ‘d5 (or VP16 O.1/d3 ‘d7),Vinorelbinum 20mg/m2/d3,Prednison 60mg/d3 ‘d9 (or DXM 8mg/m2d3 ‘d9 ), G-CSF 100 ‘300/d were injected when the number of WBC was <2.0×109/L after chemotherapy. Each cycle was 28–35 days and assessment was given after 2 cycles. The result is, The overall response rate and complete remission was 61.5 % and 38.4% respectively in treat group of MVEP, The overall response rate and complete remission was 83.3% and 50 % respectively in group of R- MVEP. One of patients of NHL with AIHA after a treating cycle achieved complete remission(all of enlarged lymph nodes disappeared and Hemoglobin return to normal).The main toxicity was mylosuppression, the minimum of WBC after chemotherapy reached 0.5 ‘1.4*109/L, few patients vomited during chemotherapy, All toxicity was no different in two groups of MVEP and R-MVEP BOur study result indicates: MEVP Chemotherapy and G-CSF is an Effective, safety and economy on patients of Refractory and relapsed Non-Hodgkin Lymphoma, but Rituximab in Combination with MEVP Chemotherapy and G-CSF is could improve the efficacy of MEVP Chemotherapy only in patients of Refractory and relapsed Non-Hodgkin Lymphoma. The efficacy of Rituximab in Combination with MEVP Chemotherapy is much better than that of MVEP Chemotherapy only on patients of Refractory and relapsed Non-Hodgkin Lymphoma, the treatment method of R-MVEP are suitable for old patients.

scholarly journals Phase 1/2a study of 177Lu-lilotomab satetraxetan in relapsed/refractory indolent non-Hodgkin lymphoma

2020 ◽  
Vol 4 (17) ◽  
pp. 4091-4101
Author(s):  
Arne Kolstad ◽  
Tim Illidge ◽  
Nils Bolstad ◽  
Signe Spetalen ◽  
Ulf Madsbu ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Overall Response Rate ◽  
Response Rate ◽  
Phase 1 ◽  
B Cell Lymphoma ◽  
Complete Response ◽  
Hematologic Toxicity ◽  
Overall Response ◽  
Non Hodgkin Lymphoma ◽  
Anti Cd20

Abstract For patients with indolent non-Hodgkin lymphoma who fail initial anti-CD20–based immunochemotherapy or develop relapsed or refractory disease, there remains a significant unmet clinical need for new therapeutic approaches to improve outcomes and quality of life. 177Lu-lilotomab satetraxetan is a next-generation single-dose CD37-directed radioimmunotherapy (RIT) which was investigated in a phase 1/2a study in 74 patients with relapsed/refractory indolent non-Hodgkin B-cell lymphoma, including 57 patients with follicular lymphoma (FL). To improve targeting of 177Lu-lilotomab satetraxetan to tumor tissue and decrease hematologic toxicity, its administration was preceded by the anti-CD20 monoclonal antibody rituximab and the “cold” anti-CD37 antibody lilotomab. The most common adverse events (AEs) were reversible grade 3/4 neutropenia (31.6%) and thrombocytopenia (26.3%) with neutrophil and platelet count nadirs 5 to 7 weeks after RIT. The most frequent nonhematologic AE was grade 1/2 nausea (15.8%). With a single administration, the overall response rate was 61% (65% in patients with FL), including 30% complete responses. For FL with ≥2 prior therapies (n = 37), the overall response rate was 70%, including 32% complete responses. For patients with rituximab-refractory FL ≥2 prior therapies (n = 21), the overall response rate was 67%, and the complete response rate was 24%. The overall median duration of response was 13.6 months (32.0 months for patients with a complete response). 177Lu-lilotomab satetraxetan may provide a valuable alternative treatment approach in relapsed/refractory non-Hodgkin lymphoma, particularly in patients with comorbidities unsuitable for more intensive approaches. This trial was registered at www.clinicaltrials.gov as #NCT01796171.

scholarly journals Metronomic Chemotherapy Is Effective and Well Tolerated in Relapsed/Refractory Elderly Patients with Aggressive B- and T-Cell Lymphomas

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 5080-5080
Author(s):  
Maria Christina Cox ◽  
Elena Cavalieri ◽  
maria Paola Bianchi ◽  
Raffaele Porrini ◽  
Virginia Naso ◽  
...  
Keyword(s):  
T Cell ◽  
Complete Remission ◽  
Elderly Patients ◽  
Overall Response Rate ◽  
Hospital Admissions ◽  
Response Rate ◽  
Induction Phase ◽  
Overall Response ◽  
T Cell Lymphomas ◽  
Grade 3

Abstract BACKGROUND: Elderly patients with Relapsed/Refractory (R/R) aggressive Large B-cell lymphoma (LBCL) and Peripheral T-cell lymphomas (PTCL), are commonly treated with intravenous conventional chemotherapies, which are often poorly tolerated and of short-lasting efficacy. Therefore only few fit-elderly patients might undergo intensive treatments with curative intent. Metronomic chemoterapy (MTN-CHT) is a new way of administering old drugs at low doses with only short chemotherapy free intervals. MTN-CHT may be combined with new targeted molecules, immunotherapies and radiotherapy. Although very few reports on MTN-CHT in LBCL and PTCL have been published existing data suggest that these lymphomas might respond to this approach. AIM: We aimed at demonstrating the efficacy and safety of MTN-CHT in a retrospective series of elderly patients with LBCL and PTCL, unfit for conventional treatments. PATIENTS AND TREATMENTS: From October 2008 up to May 2015 we treated elderly patients with R/R LBCL, Follicular Lymphoma(FL) and PTCL with MTN-CHT based regimen. Eligible patients should have given written informed consent, have a Performance Status=0-3, a life expection >2 months, be able to take oral therapy and have a care-giver. We used three different MTN schedules: 1] Provecip; 2] Vinblastine+Endoxan+Etoposide+Prednisone (VEED) and in the last two years an all-oral schedule 3] Navelbine+Endoxan+Etoposide+Prednisone (DE-VEC). All three schedules of MTN-CHT consisted of an induction phase of six months followed by a maintenance phase administered until progression or excessive toxicity. Rituximab was added to the induction phase for those patients characterized by CD20 expression. Thrombosis prophylaxis was carried out with aspirin or LMWH. RESULTS Patients features: LBCL=21; PTCL=7, FL=3; Age=77y (median, range 62-90), Previous CHT=2 (median, range 0-5) refractory to last CHT= 43%. MTN-CHT: 8 pts were treated with schedule 1], 8 pts with schedule 2] and 15 pts with schedule 3]. Outcome: in aggressive B and T-cell lymphomas (n=28pts) with all schedules Overall Response Rate = 62%, Complete Remission rate = 36%; Progression Free Survival = 8 months, Median Duration of Response (DOR)= 10 months. Overall Response Rate and Complete Remission in the subset treated with the all-oral DE-VEC schedule were 66% and 50% respectively. Serious adverse events: Extra hematologic toxicity grade 3-4: pulmonary embolism in 1pts; hematological toxicity of grade 3-4 and/or neutropenic infections in 6 patients 5 of whom had >2 previous conventional chemotherapies. The use of DE-VEC all-oral schedule reduced the number and the durations of day-hospital admissions. CONCLUSION Although our series is limited, these results suggest that MTN-CHT in elderly patients with R/R LBCL, PTCL and FL might achieve favorable results in terms of activity, toxicity and costs due to hospital admissions. With MTN-CHT most of the patients did not need G-CSF. Notably, patients who had had >2 lines of chemotherapies may be at very high risk of prolonged cytopenia and infections during MTN-CHT. Since the all-oral DE-VEC schedule was particularly manageable and active we believe that this combination deserve further investigation in aggressive lymphomas. Disclosures No relevant conflicts of interest to declare.

Dasatinib therapy for patients with Philadelphia-negative (ph-) myeloproliferative disorders (MPDs), including systemic mastocytosis

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 7086-7086
Author(s):  
S. Verstovsek ◽  
E. Atallah ◽  
D. Thomas ◽  
J. Cortes ◽  
F. Ravanid-Kashami ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Complete Remission ◽  
Tyrosine Kinases ◽  
Overall Response Rate ◽  
Response Rate ◽  
Kinase Inhibitor ◽  
Systemic Mastocytosis ◽  
Fusion Transcript ◽  
Kit Mutation ◽  
Overall Response

7086 There are no curative medical therapies for Ph- MPDs. Over last several years several of the MPDs have been associated with the abnormal expression of selected tyrosine kinases (e.g. c-kit in SM) and others are suspected to be involved too. Therefore, we engaged in conducting a Phase II study with dasatinib, an orally available multi targeted kinase inhibitor, for patient with Ph- MPDs. Dasatinib is administered at 70 mg PO BID continuously (one month equals one cycle). Response is assessed every 3 cycles, and the therapy is discontinued in those without response after 6 cycles of therapy. Patients are observed for any toxicity; in such cases the dose of dasatinib is adjusted to 50 mg PO BID, then to 40 mg PO BID, or discontinued. The study is ongoing and has enrolled 55 patients; 44 are evaluable for response and toxicity, including 24 with SM (6 with aggressive SM, 4 with SM and associated hematologic non-mast cell disease and 14 with indolent SM with uncontrolled symptoms despite optimal supportive care measures), 10 CIMF, 6 HES, 3 unclassifiable MPD and one PV. Median age is 65 years (range, 27–75); 25 males and 19 females. The overall response rate in SM was 42% (10 pts). Of those, two patients (8%) achieved complete remission, one with SM-CIMF, and one with SM-HES. Both were c-KIT mutation negative and had low, not significant tryptase levels. Both were anemic (Hb 9.4g/dL) and failed erythropoietin therapy, and had abnormal WBC differential; one had low platelets (90×109/L). Symptoms related to SM improved significantly in additional 8 patients, however, no significant response in percentage of bone marrow mast cells or blood tryptase levels have been observed so far. The 6 patients with HES had previously failed imatinib therapy and had no evidence of the FIP1L1-PDGFRA fusion transcript; one achieved complete remission (normalization of blood and bone marrow eosinophil percentage) while others did not respond. No responses have been recorded in patients with CIMF, PV and unclassifiable MPD. No grade 4 toxicity has been observed. Dasatinib is active in SM (overall response rate 42%) mainly by improving symptoms. Updated clinical results on all enrolled patients will be presented. No significant financial relationships to disclose.

Long-Term Outcome of Gemcitabine, Vinorelbine, Liposomal-Doxorubicin (GVD) As Salvage Regimen for Patients with Previously Heavily Treated Hodgkin Lymphoma and Aggressive Non-Hodgkin Lymphoma

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 1609-1609
Author(s):  
Hui-qiang Huang ◽  
Bing Bai ◽  
Qingqing Cai ◽  
Xu-Bin Lin ◽  
Xiao-Xiao Wang ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Liposomal Doxorubicin ◽  
Overall Response Rate ◽  
Stem Cell Transplant ◽  
Response Rate ◽  
Autologous Stem Cell Transplant ◽  
Salvage Chemotherapy ◽  
Cell Transplant ◽  
Salvage Regimen ◽  
Non Hodgkin Lymphoma

Abstract Abstract 1609 Introduction: Salvage chemotherapy followed by autologous stem cell transplant (ASCT) remains to be the standard treatment for most patients with relapsed and refractory aggressive non- Hodgkin lymphoma(NHL) and Hodgkin lymphoma(HL). However, there are no standard salvage chemotherapy regimens for these patients especially for refractory patients. The combination of gemcitabine, vinorelbine and liposomal-doxorubicin (GVD regimen) had been reported to be effective in patients with relapsed HL (N.L.Bartlett et al. Ann Oncol. 2007).The overall response rate was 70% and the complete remission rate was 19%. The main toxicities were mucositis (23%) and febrile neutropenia (9%). Despite this encouraging result in relapsed HL, it was still unclear whether GVD regimen was effective in recurrent aggressive NHL. Objective: This study aimed to evaluate the efficacy and toxicity of GVD regimen in patients with refractory aggressive NHL and HL. Patients and methods: Patients with aggressive NHL and HL who were relapsed or refractory to at least one salvage chemotherapy regimen were enrolled. The GVD regimen was given as follows: gemcitabine: 1000 mg/m2 intravenous(i.v.)on day 1,vinorelbine: 15 mg/m2 i.v. on day 1≤⪢liposomal-doxorubicin: 25 mg/m2 i.v. on day 1, repeated for 14 days≤®Patients with complete response (CR)or partial response (PR) proceeded to autologous stem cell transplant (ASCT) as consolidation. Results: From 1 May 2006 to 30 August 2008, 35 patients (25 NHL and 10 HL) were enrolled and received 129 cycles of chemotherapy. Twenty patients (57.1%) had been treated with at least 3 chemotherapy regimens before enrollment, and 15 patients (42.9%) had been treated with 2 chemotherapy regimens before. The overall response rate (ORR)was 48.6%(95% CI: 32.0%∼65.1%), with 31.4% CR rate(95%CI: 16.0%∼46.8%)≤®The ORR was higher in patients with HL than in patients with NHL(80.0% vs. 36.0%,p=0.023). The ORR was higher in relapsed patients than in refractory patients(73.3% vs. 30.0%,p=0.013). Sixteen patients (9 NHL and 7 HL) were treated by high dose chemotherapy supported by ASCT. With median follow-up of 16 months (2∼61 months),the median progression free survival(PFS) was 5 months(1∼61 months) and the median survival time was 38 months (2∼61 months). 4-year PFS and 4-year overall survival was 28.1% and 58.2% respectively. The serum LDH level and the sequential ASCT were independent prognostic factors. The survival time in patients treated with subsequent ASCT was significantly longer than those without ASCT (median survival: not reached vs. 21 months, p=0.005). The major toxicity was myelosuppression. The incidence of grade ¢ó/¢ô neutropenia and thrombocytopenia was 34.3% and 5.7% respectively≤®Mobilization of hematopoietic progenitor cell was successful in all the 16 patients. There were no treatment-related deaths. Conclusion: GVD regimen is an effective and well-tolerated salvage regimen both for patients with HL and patients with aggressive NHL. GVD followed by AHST yields promising long-lime survival even in patients who are previously heavily treated. Disclosures: No relevant conflicts of interest to declare.

Brentuximab Vedotin Followed By ABVD in Patients with Previously Untreated Hodgkin Lymphoma. a Pilot Phase II Study

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 3088-3088 ◽  
Author(s):  
Pier Luigi Zinzani ◽  
Stefano Luminari ◽  
Francesco Merli ◽  
Emanuela Anna Pesce ◽  
Stephane Chauvie ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Phase Ii ◽  
Overall Response Rate ◽  
Response Rate ◽  
Phase Ii Study ◽  
Complete Response ◽  
Pilot Phase ◽  
First Line ◽  
Overall Response

Abstract active and well tolerated single agent in the treatment of heavily pretreated Hodgkin lymphoma patients. In this pilot phase II study patients with previously untreated HL underwent sequential regimen consisting in 2 cycles of BV before doxorubicin, bleomycin, vinblastine and dacarbazine (ABVD) +/- radiotherapy (RT). The primary endpoint of the study was the response to BV assessed by positron emission tomography (PET) after the 2 cycles (PET2), defined as reduction of Deauville score or, in case of no change in Deauville score, as any reduction in standard uptake value (SUV) intensity compared to basal SUV. Between April and October 2013, 12 patients with a median age at diagnosis of 36 years (range, 19-70), 11 stage I-IIA and 1 stage IIIA, were enrolled. BV was administered as scheduled and at the full dose of 1.8 mg/kg in all patients. After the 2 cycles of BV, the overall response rate was 91%, comprising of ten (83%) complete responses and one (8%) partial metabolic response. The non responding patient had stage III and showed a new lesion at PET2. After ABVD +/- RT, the overall response rate was 100% with 11 complete responses and 1 partial response (converting from progression disease). At a median follow up of 8 months, all 11 patients are still in complete response, while the remaining one relapsed. During BV therapy, the only grade 3 adverse events were transient and asymptomatic increase in liver transaminases (n=3, 25%) and gamma glutamyl transpeptidase (n=2, 17%). During ABVD +/- RT grade III-IV neutropenia occurred in 9 (75%) patients. All toxicities were transient and resolved with growth factor support. Two cycles of BV as first line-treatment in limited stage HL induced an outstanding complete response rate with limited toxicity and reducing the need of chemotherapy. Waiting for a longer follow up to assess the duration of response, our data (sequential administration of immunotherapy and chemotherapy) should be considered the starting point for further studies in first line therapy for limited stage HL patients. Disclosures No relevant conflicts of interest to declare.

scholarly journals Melphalan 200 mg/m2 versus melphalan 100 mg/m2 in newly diagnosed myeloma patients: a prospective, multicenter phase 3 study

Blood ◽  
2010 ◽  
Vol 115 (10) ◽  
pp. 1873-1879 ◽  
Author(s):  
Antonio Palumbo ◽  
Sara Bringhen ◽  
Benedetto Bruno ◽  
Antonietta Pia Falcone ◽  
Anna Marina Liberati ◽  
...  
Keyword(s):  
Complete Remission ◽  
Partial Remission ◽  
Overall Response Rate ◽  
Response Rate ◽  
Severe Neutropenia ◽  
Severe Thrombocytopenia ◽  
Significant Activity ◽  
Phase 3 ◽  
Overall Response ◽  
Best Response

Abstract High-dose (200 mg/m2, MEL200) and intermediate-dose melphalan (100 mg/m2, MEL100) showed significant activity in myeloma. In a phase 3 study, 298 patients were randomly assigned to receive 2 autologous transplantations after conditioning with MEL200 or MEL100. Ninety-six of 149 (64%) completed MEL200 and 103 of 149 (69%) MEL100. Best response to MEL200 was: complete remission 22 of 149 (15%); partial remission 95 of 149 (64%), for an overall response rate of 79%. Best response to MEL100 was: complete remission 12 of 149 (8%); partial remission 95 of 149 (64%), for an overall response rate of 72%. Overall survival did not differ (P = .13); median progression-free survival (31.4 vs 26.2 months, P = .01), median time to progression (34.4 vs 27.0 months, P = .014) were longer in the MEL200. Treatment-related mortality was 3.1% in the MEL200 and 2.9% in the MEL100 group. Severe neutropenia and infections were marginally superior, whereas severe thrombocytopenia, mucositis, gastrointestinal adverse events, and the overall occurrence of at least 1 nonhematologic grade 3 or 4 adverse event were significantly higher in the MEL200 cohort. We conclude that MEL200 leads to longer remission duration and should be considered the standard conditioning regimen for autologous transplantation. This study was registered at www.clinicaltrials.gov as #NCT00950768.

The Clinical Study of Combination of Bortezomib and Dexamethasone in Treatment of Newly Diagnosed Multiple Myeloma

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 5217-5217
Author(s):  
Juan Li ◽  
Lijin Zeng
Keyword(s):  
Multiple Myeloma ◽  
Complete Remission ◽  
Adverse Effects ◽  
Overall Response Rate ◽  
Response Rate ◽  
Common Adverse Event ◽  
Control Group ◽  
Newly Diagnosed ◽  
Overall Response ◽  
Significant Difference

Abstract OBJECTIVE: To study retrospectively the response and side effects in two groups of patients with newly diagnosed multiple myeloma (MM) receiving bortezomib and dexamethasone regimen (VD) and vincristine combined with pirarubicin and dexamethasone and melphalan regimen (VADM). METHODS: Nineteen patients were enrolled in a group of VD, receiving bortezomib 1.3mg/m2 on days 1,4,8,11 and dexamethasone 20mg on days 1–4 in a 21-day cycle. Blade Standard was used to evaluate the therapeutic effect and NCI-CTC was used to assess the adverse effect. Thirty-one matched patients with newly diagnosed MM who received VADM were used as a historical control group, receiving vincristine 0.4mg/d and pirarubicin 9mg•m−2•d−1 and dexamethasone 20mg/d and melphalan 12mg/d on days 1–4, with 28 days as a cycle. RESULTS: During the median 9 months’ follow-up of patients who received VD, there were 73.7% patients(14/19)responding to the treatment, including 9 cases (47.4%) of complete remission or near complete remission. Light-chain type patients who received VD had a higher overall response rate and CR +nCR rate than that of the VADM (P<0.05). The patients receiving VD who had renal inadequacy had an effective rate of 69.6% (5/6), which was similar to that of the others (69.2%, 9/13), and renal function relieve could be shown in the chemotherapy. The main adverse effects were fatigue, diarrhea, peripheral neuropathy, thrombocytopenia, and infection, with incidences of 73.8%, 68.4%, 63.2%, 31.5% and 26.3% respectively. Most of the adverse effects were mild and could be relieved by symptomatic treatments. The most common adverse event in the control group was neutropenia (83.8%), followed by infection(35.5%), vomiting (35.5%) and loss of hair(32.5%). CONCLUSION: Although there was no significant difference of overall response rate between VD and VADM, VD has higher CR +nCR rate compared with VADM. VD can be tolerant in most patients, and is also safe in patients with renal inadequacy.

Survival Impact of Rituximab Combined to ACVBP (R-ACVBP) in 209 Poor Risk Diffuse Large B-Cell Lymphoma (DLBCL) Patients Treated with Upfront High-Dose Consolidative Autotransplantation (HDC) : A GELA Phase II Study

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 771-771 ◽  
Author(s):  
Christian Gisselbrecht ◽  
Olivier Fitoussi ◽  
Karim Belhadj ◽  
Nicolas Mounier ◽  
Pierre Feugier ◽  
...  
Keyword(s):  
Complete Remission ◽  
Overall Response Rate ◽  
Response Rate ◽  
Remission Rate ◽  
B Cell Lymphoma ◽  
Complete Remission Rate ◽  
Induction Treatment ◽  
High Dose ◽  
Overall Response ◽  
Significant Difference

Abstract Rituximab (R) combined with CHOP improves complete remission rate and PFS, OS in DLBCL pts. More intensive regimen followed by HDC have been used in patients < 60y with with 2–3 adverse age-adjusted International-Prognostic-Index (aa-IPI) factors, providing a 5y OS of 65% (CI 60–68%), (Haioun LNH 98-3B ASCO 2007). The objective of the study was to see if combining R (375 mg/m2) to the dose intense ACVBP (Doxorubicin 75 mg/m2 d1, Cyclophosphamide 1,200 mg/m2 d1, Vindesine 2 mg/m2 and Bleomycin 10 mg d1 and d5, prednisone 60 mg/m2 d1–d5) translates into an improvement of response rate and also PFS, OS, EFS in pts under 60y with DLBCL and aaIPI 2 or 3. Four cycles of R-ACVBP were delivered every 15 days supported by G CSF. Responding pts received a consolidative BEAM and peripheral blood stem cell rescue. From 01/2004 to 12/2005, 209 DLCBL pts were enrolled. Median age was 49 years (range: 18–60), 22 % with aa-IPI 3, 19 % with bone marrow involvement, 93% with LDH> 1N and 54 % with extranodal sites > 1. Based on International Workshop Criteria, CR+CRu rate after induction treatment was 61%, PR rate 24%, stable disease 2% and progressive disease 1% heading an overall response rate of 84% (176pts). Deaths occurred in 4% of the pts. Hematological toxicity was similar to that observed in previous GELA trials using ACVBP. Collection failure after the 3rd and/or 4th R-ACVBP cycle was observed in 18 pts (10%), Consequently 157 pts were responders and had successful mobilization. Among responding pts, 155 pts received HDC, representing 75% of the whole population. Four patients died without progression during the HDC procedure. At the end of treatment, the overall response rate was 81% with 150 pts (72%) considered in complete remission, 9% in PR and 4% progressed. With a median follow-up of 27 months, using the updated IWC 2007, three-year PFS was 76% (CI 69–81%), and 85% for pts submitted to HDC; OS was 81% (CI 75–86%) and 90% for pts submitted to HDC, finally EFS was 60% (CI 53–66%), and 83% for pts submitted to HDC. For pts with IPI 2 or 3, 3 y PFS were 84%–92% and OS 89%–95% respectively without significant difference. There was no significant difference between pts in CR or PR before transplant. No other prognostic factors could be isolated in multivariate analysis. We conclude that with R-ACVBP induction regimen, 75% of the patients could received HDC. There is an increase of complete remission rate after HDC according the criteria used. An impressive PFS of 76% and OS 81% were observed even in patients with 3 adverse factors. Comparison with previous study without rituximab in induction suggests a major improvement which needs confirmatory prospective randomized study.

Cisplatin in the treatment of recurrent childhood primary brain tumors.

1988 ◽  
Vol 6 (1) ◽  
pp. 62-66 ◽  
Author(s):  
R W Walker ◽  
J C Allen
Keyword(s):  
Brain Tumors ◽  
Germ Cell ◽  
Germ Cell Tumor ◽  
Overall Response Rate ◽  
Response Rate ◽  
Cell Tumor ◽  
Primitive Neuroectodermal Tumors ◽  
Primary Brain Tumors ◽  
Overall Response ◽  
Neuroectodermal Tumors

Thirty-three patients were treated with intravenous (IV) cisplatin (CPDD) of whom 32 were considered evaluable. There were 14 medulloblastomas, five primitive neuroectodermal tumors (PNET), nine gliomas, three ependymomas, and one germ cell tumor. The overall response rate was 13 of 32 (41%). Eleven responses (five complete [CR], five partial [PR], one mixed [MR]) were noted in the patients with medulloblastoma. The response rate within this group was 79%. Toxicity was tolerable, although it precluded further therapy in five patients.

scholarly journals Efficacy of Repetitive Transcranial Magnetic Stimulation (rTMS) for Tinnitus: A Retrospective Study

2021 ◽  
pp. 014556132110168
Author(s):  
Haidi Yang ◽  
Gui Cheng ◽  
Zhengrong Liang ◽  
Wenting Deng ◽  
Xiayin Huang ◽  
...  
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Overall Response Rate ◽  
Response Rate ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Subjective Assessment ◽  
Overall Response ◽  
Duration Of Disease ◽  
Vas Scores ◽  
Assessment Result

Objective: Current studies still find insufficient evidence to support the routine use of repetitive transcranial magnetic stimulation (rTMS) in tinnitus. This study aimed to assess response of tinnitus to treatment with rTMS and identify factors influencing the overall response. Methods: Between January 2016 and May 2017, 199 tinnitus patients were identified from a retrospective review of the electronic patient record at the Sun Yat-sen Memorial Hospital. All patients received rTMS treatment. Their clinicodemographic profile and outcomes, including the tinnitus handicap inventory (THI) and visual analog scale (VAS) scores, were extracted for analysis. Results: Regarding the THI results, 62.3% of all patients responded to rTMS. The analysis of the VAS score revealed an overall response rate of 66.3%. Both percentages were close to the patient’s subjective assessment result, of 63.8%. Patients with tinnitus of less than 1-week duration had the highest response rate to rTMS in terms of either THI/VAS scores or the patient’s subjective assessment of symptoms. Tinnitus duration was recognized as a factor influencing the overall response to the treatment. Conclusions: Repetitive transcranial magnetic stimulation treatment is effective for patients with tinnitus, but its efficacy is affected by tinnitus duration. Tinnitus patients are advised to attend for rTMS as soon as possible since therapy was more effective in those with a shorter duration of disease of less than 1 week.

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