Praktijkadvies rond de aanpak van anafylaxie bij (Covid-19-)vaccinatie bij kwetsbare ouderen (incl. e-learning)

2021 ◽  
Author(s):  
E. DUYVER ◽  
T. VAN DE VELDE ◽  
D. RAZOOQI ◽  
K. VERSLUYS ◽  
M. PETROVIC ◽  
...  
Keyword(s):  
Older People ◽  
Older Patients ◽  
Large Scale ◽  
Vaccination Campaign ◽  
Line Treatment ◽  
First Line ◽  
Practical Advice ◽  
E Learning ◽  
Treatment Education ◽  
First Line Treatment

Practical advice on the anaphylaxis policy for (COVID-19) vaccination in frail, older patients In view of the imminent start of the COVID-19 vaccination campaign, a practical advice based on the available literature on anaphylaxis in older people was drawn up for use in frail, older patients. The present practical advice provides guidance with regard to the diagnosis of anaphylaxis, the first-line treatment, education and necessary material with the purpose of making nursing homes and vaccination centres well prepared for the large-scale COVID-19 vaccination.

A Phase 2 Evaluation of Single Agent Clofarabine as First Line Treatment for Older Patients with AML Who Are Not Considered Fit for Intensive Chemotherapy.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 869-869 ◽  
Author(s):  
Alan K. Burnett ◽  
Nigel Russell ◽  
Jonathan W. Kell ◽  
Donald Milligan ◽  
Dominic Culligan
Keyword(s):  
Complete Remission ◽  
Older Patients ◽  
Liver Toxicity ◽  
Single Agent ◽  
Randomised Trial ◽  
Significant Proportion ◽  
Intensive Chemotherapy ◽  
Line Treatment ◽  
First Line ◽  
First Line Treatment

Abstract Patients over 70 years represent a significant proportion of patients with AML. They respond poorly to intensive chemotherapy. Although 50% of patients can achieve CR, only 8% are alive at 2 years (MRC Database). In addition significant numbers of these patients either do not wish to undergo, or are not considered fit for intensive chemotherapy. This represents a significant unmet medical need. Nucleoside analogues (Ara-C) provide an active group of agents in AML, Fludarabine however is ineffective at tolerable doses. Clofarabine has been modified by introducing a Fluorine in the 2′ position which confers reduced susceptibility to cleavage of the glycosidic linkage and also reduced toxicity caused by halogenated nucleobases. As such the drug has potential use as an oral formulation. Previous clinical and in vitro studies have established a dose schedule at 40mg/m2 days 1–5. This is associated with CRs in relapse/refractory AML, but with grade ¾ liver toxicity in 25% of patients. Because of these characteristics we undertook a non-randomised study using a dose of 30mg/m2 days 1-5 IV, which could be repeated for up to 4 courses at a minimum of 28 days apart. The target patient group were patients >70 years, or patients 60–70 with a cardiac history, who were not considered fit for conventional chemotherapy. Twenty-eight patients entered the study: 16 males, 12 females of a median age 71 years (range 60 – 79). The FAB distribution was, M0=1;M1=9; M2=8; M4=2; M5=4; M6=3; Unknown=1. The cytogenetic risk group (MRC criteria) were 26 standard and 2 unfavourable risk. All patients received course 1. Five patients died before response could be assessed from causes which were not thought to be associated with the drug. One patient is too early to assess response. Five did not enter complete remission although there was a reduction in bm blasts from 58 to 18%, 55 to 20% and 30 to 15% in 3 cases. Sixteen patients (59%) achieved complete remission after course 1. Grade 3 toxicity was seen in 3 patients, but this recovered in all cases in a few days. Patients who did not enter CR did not show haematological recovery after course 1 and were considered treatment failures. Of the 16 patients who entered CR, haematological recovery to ANC 1.0 x 109/l took 28 days (range 21–42) Platelets to 50x109/l took 25 days (range 21–38). Conclusions: Clofarabine is an active agent when used alone as first line treatment. It is well tolerated but is associated with cytopenia of an average 28 days. At the dose chosen for this study grade ¾ liver toxicity was uncommon. The drug is a candidate for evaluation in a randomised trial and/or in combination schedules, and lower doses should be explored in older patients. This study was partially supported by an unrestricted grant from Bioenvison Inc.

scholarly journals Efficacy and Safety of Docetaxel Plus Oxaliplatin and Capecitabine in the First Line Treatment of Advanced Gastric Adenocarcinoma

2013 ◽  
Vol 2013 ◽  
pp. 1-6
Author(s):  
Ying Liu ◽  
Zhengbao Ye ◽  
Wenqi Xi ◽  
Tao Ma ◽  
Min Shi ◽  
...  
Keyword(s):  
Gastric Adenocarcinoma ◽  
Large Scale ◽  
Objective Response ◽  
Line Treatment ◽  
Efficacy And Safety ◽  
First Line ◽  
Common Grade ◽  
Advanced Gastric Adenocarcinoma ◽  
Grade 3 ◽  
First Line Treatment

Objective.To evaluate the efficacy and safety of docetaxel plus oxaliplatin and capecitabine (DOX) in the first line treatment of advanced gastric adenocarcinoma.Methods.A total of 37 patients were enrolled into this study, and they received DOX regimen (docetaxel 75 mg/m2and oxaliplatin 130 mg/m2intravenous infusion on day 1, and capecitabine 1000 mg/m2orally twice daily on d1–14); treatment was repeated every 3 weeks.Results.All 37 patients were assessable for evaluation. The numbers of patients with complete response (CR), partial responses (PR), stable disease (SD), and progressive disease (PD) were 1, 10, 23, and 3, respectively. The objective response rate (ORR) was 29.7%, with the disease control rate (DCR) of 91.9%. Median progression-free survival (mPFS) and overall survival (mOS) were 197 days and 364 days, respectively. The most common grade 3/4 toxicities were hematological toxicities. The most common grade 3/4 nonhematological toxicities were fatigue, nausea, vomiting, anorexia, diarrhea, and hand-foot syndrome.Conclusion.The DOX regimen demonstrated a promising efficacy as the first line regimen in treating advanced gastric cancer patients with good performance status, the toxicities were tolerated and controllable. Large-scale clinical observation is necessary to get further evidence.

scholarly journals A phase 2 study of rituximab, bendamustine, bortezomib and dexamethasone for first-line treatment of older patients with mantle cell lymphoma

Haematologica ◽  
2018 ◽  
Vol 104 (1) ◽  
pp. 138-146 ◽  
Author(s):  
Rémy Gressin ◽  
Nicolas Daguindau ◽  
Adrian Tempescul ◽  
Anne Moreau ◽  
Sylvain Carras ◽  
...  
Keyword(s):  
Mantle Cell Lymphoma ◽  
Older Patients ◽  
Cell Lymphoma ◽  
Line Treatment ◽  
Phase 2 ◽  
First Line ◽  
Phase 2 Study ◽  
Mantle Cell ◽  
First Line Treatment

The advantage of pemetrexed combined with platium chemotherapy treatement for advanced nonsquamous non-small-cell lung cancer (NSCLC) patients without drive oncogene.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e20527-e20527
Author(s):  
Haiyan Xu ◽  
Yan Wang
Keyword(s):  
Large Scale ◽  
Objective Response ◽  
Evaluation Criteria ◽  
Progression Free Survival ◽  
The Other ◽  
Line Treatment ◽  
First Line ◽  
Platinum Based Chemotherapy ◽  
Nsclc Patients ◽  
First Line Treatment

e20527 Background:Platinum-based chemotherapy is the standard first-line treatment for non-squamous NSCLC patients without driver oncogene (EGFR, KRAS, and ALK mutations). However, it remains unknown that from which chemotherapy regimens can those patients get more benefit. Therefore, the study explore whether pemetrexed combined with platinum chemotherapy is superior to the other platinum-based chemotherapy regimens.Methods:We performed a retrospective study on 114 histologically or cytologically advanced IIIB-IV NSCLC patients admitted to Cancer Hospital from 1 Jan 2013 to 30 Dec 2015. The primary endpoint was the median progression free survival (PFS) and the disease control rate (DCR). And objective response was evaluated every two cycles by imaging according to the Response Evaluation Criteria In Solid Tumors (RECIST version 1.0). The multivariate logistic analyses were carried out by SPSS version 16.0. Results:114 patients received platinum-base doublet as first-line treatment. Among them, 59 patients underwent pemetrexed-containing regimens, and 55 patients received non-pemetrexed-containing regimens (38 patients for paclitaxel-containing regimens, 13 patients for gemcitabine-containing regimens, and 4 patients for other regimens.). The baseline characteristics between two groups were comparable ( p>0.05). The median PFS of pemetrexed-containing regimens was significantly longer compared with that of non-pemetrexed-containing regimens (7.2 months [95% CI: 5.3–9.1] vs. 4.9 months [95% CI: 3.2–6.6], p%0.05). DCR of pemetrexed-containing regimens was better than that of non-pemetrexed-containing regimens in the multivariate logistic analysis (89.8% vs.74.5%, p%0.05).Conclusions:Pemetrexed-containing regimens displayed more benefit than the other chemotherapy regimens for non-squamous NSCLC patients without driver oncogene. However, large scale perspective study is warranted in the future.

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