Clinical Lymphoma and Myeloma最新文献

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Granulomatous Slack Skin: Assessment of Disease Progression and Treatment Response Using Positron Emission Tomography/Computed Tomography 肉芽肿松弛皮肤:使用正电子发射断层扫描/计算机断层扫描评估疾病进展和治疗反应
Clinical Lymphoma and Myeloma Pub Date : 2009-12-01 DOI: 10.3816/CLM.2009.n.089
Youyu Sheng , Lianjun Chen , Zhemin Huang , Zhanglei Mu , Jincheng Kong , Yan Luo , Qinping Yang
{"title":"Granulomatous Slack Skin: Assessment of Disease Progression and Treatment Response Using Positron Emission Tomography/Computed Tomography","authors":"Youyu Sheng ,&nbsp;Lianjun Chen ,&nbsp;Zhemin Huang ,&nbsp;Zhanglei Mu ,&nbsp;Jincheng Kong ,&nbsp;Yan Luo ,&nbsp;Qinping Yang","doi":"10.3816/CLM.2009.n.089","DOIUrl":"10.3816/CLM.2009.n.089","url":null,"abstract":"<div><p>Granulomatous slack skin (GSS) is an extremely rare subtype of cutaneous T-cell lymphoma. A 14-year-old boy had suffered from progressive infiltrative erythema and plaques that gradually evolved into lax masses and pendulous skin on his axilla, anterior wall of the abdomen, bilateral inguinal region, and thighs. Histopathologic examination of the skin lesion and inguinal lymph node demonstrated granulomatous infiltration with multinucleated giant cells. Positron emission tomography (PET)/computed tomography (CT) scan was performed after acute exacerbation and exhibited slightly high fluorodeoxyglucose (FDG) distribution of skin lesions, without any evidence of abnormality in the metabolism of FDG in lymph nodes or other extralymphatic organs. Concurrent use of corticosteroid and recombinant interferon-α successfully controlled the disease, and posttreatment PET/CT scan confirmed the response to the therapy with decreased levels of FDG uptake. PET/CT is suggested to be helpful in the assessment of disease progression and treatment response in the management of patients with GSS.</p></div>","PeriodicalId":100272,"journal":{"name":"Clinical Lymphoma and Myeloma","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3816/CLM.2009.n.089","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28540109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 9
Favorable Consolidative Effect of High-Dose Melphalan and Total-Body Irradiation Followed by Autologous Peripheral Blood Stem Cell Transplantation After Rituximab-Containing Induction Chemotherapy With In Vivo Purging in Relapsed or Refractory Follicular Lymphoma 含利妥昔单抗诱导化疗伴体内清除治疗复发或难治性滤泡性淋巴瘤后,大剂量美法兰和全身照射后自体外周血干细胞移植的良好巩固效果
Clinical Lymphoma and Myeloma Pub Date : 2009-12-01 DOI: 10.3816/CLM.2009.n.087
Harumi Kato , Hirofumi Taji , Michinori Ogura , Yoshitoyo Kagami , Yasuhiro Oki , Akane Tsujimura , Nobukazu Fuwa , Takeshi Kodaira , Masao Seto , Kazuhito Yamamoto , Yasuo Morishima
{"title":"Favorable Consolidative Effect of High-Dose Melphalan and Total-Body Irradiation Followed by Autologous Peripheral Blood Stem Cell Transplantation After Rituximab-Containing Induction Chemotherapy With In Vivo Purging in Relapsed or Refractory Follicular Lymphoma","authors":"Harumi Kato ,&nbsp;Hirofumi Taji ,&nbsp;Michinori Ogura ,&nbsp;Yoshitoyo Kagami ,&nbsp;Yasuhiro Oki ,&nbsp;Akane Tsujimura ,&nbsp;Nobukazu Fuwa ,&nbsp;Takeshi Kodaira ,&nbsp;Masao Seto ,&nbsp;Kazuhito Yamamoto ,&nbsp;Yasuo Morishima","doi":"10.3816/CLM.2009.n.087","DOIUrl":"10.3816/CLM.2009.n.087","url":null,"abstract":"<div><h3>Purpose</h3><p>In this study, we sought to evaluate the efficacy and toxicity of high-dose therapy followed by autologous peripheral blood stem cell transplantation (autoPBSCT) after rituximab-containing induction chemotherapy with in vivo purging for relapsed or refractory chemosensitive advanced-stage follicular lymphoma (FL).</p></div><div><h3>Patients and Methods</h3><p>A rituximab-containing regimen was used as induction chemotherapy and as in vivo purging before PBSC collection. Patients achieving partial or complete response received a regimen consisting of high-dose melphalan and total-body irradiation (TBI).</p></div><div><h3>Results</h3><p>A total of 18 patients with a median age of 45 years were enrolled. The number of previous chemotherapy regimens was 2. The principal nonhematologic toxicities were grade 3 febrile neutropenia and diarrhea. One patient experienced pneumocystis pneumonia, 2 developed interstitial pneumonitis, and 1 experienced agammaglobulinemia, all of whom had complete improvement except for the patient having agammaglobulinemia. Grade 4 toxicities were not observed, and there have been neither treatment-related mortality nor secondary malignancy to date. At a median follow-up of 4.0 years, the 4-year estimated overall and failure-free survival rates were 100% and 88.9%, respectively.</p></div><div><h3>Conclusion</h3><p>Consolidation of high-dose melphalan and TBI followed by autoPBSCT with in vivo purging is feasible and effective for relapsed or refractory chemosensitive FL. Longer follow-up is needed to confirm the role and late toxicities.</p></div>","PeriodicalId":100272,"journal":{"name":"Clinical Lymphoma and Myeloma","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3816/CLM.2009.n.087","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28540765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 5
Molecular Monitoring of Patients With Chronic Myeloid Leukemia: Clinical Examples From a Non-Trial Setting 慢性髓性白血病患者的分子监测:来自非试验环境的临床实例
Clinical Lymphoma and Myeloma Pub Date : 2009-12-01 DOI: 10.3816/CLM.2009.s.039
Jerald P. Radich
{"title":"Molecular Monitoring of Patients With Chronic Myeloid Leukemia: Clinical Examples From a Non-Trial Setting","authors":"Jerald P. Radich","doi":"10.3816/CLM.2009.s.039","DOIUrl":"10.3816/CLM.2009.s.039","url":null,"abstract":"<div><p>The molecular monitoring of chronic myeloid leukemia allows the clinician a minimally invasive method to judge response to tyrosine kinase therapy and to predict outcome and relapse. Because there are several treatment options for patients with suboptimal response, the ability to proactively predict and respond to relapse makes the “personalization” of treatment a realizable goal. There are practical issues with molecular monitoring, however, including availability of assays, standardization of tests, and the learning curve as doctors and patients learn to follow BCR-ABL levels with interest and reason. This review will examine the use of molecular monitoring in the non-trial setting, concentrating on pitfalls that can occur in the real-world delivery of complex medical care.</p></div>","PeriodicalId":100272,"journal":{"name":"Clinical Lymphoma and Myeloma","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3816/CLM.2009.s.039","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28591506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
Brazilian Experience Using High-Dose Sequential Chemotherapy Followed by Autologous Hematopoietic Stem Cell Transplantation for Relapsed or Refractory Hodgkin Lymphoma 巴西高剂量序贯化疗后自体造血干细胞移植治疗复发或难治性霍奇金淋巴瘤的经验
Clinical Lymphoma and Myeloma Pub Date : 2009-12-01 DOI: 10.3816/CLM.2009.n.088
Bruno K.L. Duarte , Isabella Valente , Afonso C. Vigorito , Francisco J.P. Aranha , Gislaine Oliveira-Duarte , Eliana C.M. Miranda , Irene Lorand-Metze , Katia B. Pagnano , Marcia Delamain , José F. Marques Junior , Silvia R. Brandalise , Márcio Nucci , Carmino A. De Souza
{"title":"Brazilian Experience Using High-Dose Sequential Chemotherapy Followed by Autologous Hematopoietic Stem Cell Transplantation for Relapsed or Refractory Hodgkin Lymphoma","authors":"Bruno K.L. Duarte ,&nbsp;Isabella Valente ,&nbsp;Afonso C. Vigorito ,&nbsp;Francisco J.P. Aranha ,&nbsp;Gislaine Oliveira-Duarte ,&nbsp;Eliana C.M. Miranda ,&nbsp;Irene Lorand-Metze ,&nbsp;Katia B. Pagnano ,&nbsp;Marcia Delamain ,&nbsp;José F. Marques Junior ,&nbsp;Silvia R. Brandalise ,&nbsp;Márcio Nucci ,&nbsp;Carmino A. De Souza","doi":"10.3816/CLM.2009.n.088","DOIUrl":"10.3816/CLM.2009.n.088","url":null,"abstract":"<div><h3>Purpose</h3><p>We evaluate the effectiveness and toxicity of high-dose sequential chemotherapy (HDS) as salvage therapy in patients with advanced-stage Hodgkin lymphoma.</p></div><div><h3>Patients and Methods</h3><p>We performed a retrospective analysis on 77 patients receiving HDS between 1998 and 2006. Patients enrolled were in disease progression or relapsed disease, or did not achieve a complete remission after first-line treatment. HDS consisted of the sequential administration of cyclophosphamide and granulocyte colony-stimulating factor with stem cell harvesting, followed by methotrexate plus vincristine and etoposide.</p></div><div><h3>Results</h3><p>The majority of patients had stage III/IV (64%) and B symptoms (71.4%). Disease status improvement after HDS was observed in 24 of 57 patients (42%) previously in disease progression or relapse. HDS-related deaths occurred in 8 of 77 patients (10.4%). Four patients (5.2%) developed acute myeloid leukemia/myelodysplastic syndrome. Overall, disease-free and progression-free survival was 27%, 57%, and 25%, respectively.</p></div><div><h3>Conclusion</h3><p>Despite the treatment-related mortality, HDS is feasible, with satisfactory response rates, even in patients with poor prognosis.</p></div>","PeriodicalId":100272,"journal":{"name":"Clinical Lymphoma and Myeloma","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3816/CLM.2009.n.088","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28540108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
The Early- and Intermediate-Term Toxicity to Primitive Hematopoietic Progenitor Cells of Three Chemotherapy Regimens for Advanced Hodgkin Lymphoma 晚期霍奇金淋巴瘤三种化疗方案对原始造血祖细胞的早期和中期毒性
Clinical Lymphoma and Myeloma Pub Date : 2009-12-01 DOI: 10.3816/CLM.2009.n.084
Paolo G. Gobbi , Vittorio Rosti , Francesco Valentino , Elisa Bonetti , Francesco Merli , Caterina Stelitano , Alessandra Dondi , Giovanni Quarta , Simona Falorio , Massimo Federico
{"title":"The Early- and Intermediate-Term Toxicity to Primitive Hematopoietic Progenitor Cells of Three Chemotherapy Regimens for Advanced Hodgkin Lymphoma","authors":"Paolo G. Gobbi ,&nbsp;Vittorio Rosti ,&nbsp;Francesco Valentino ,&nbsp;Elisa Bonetti ,&nbsp;Francesco Merli ,&nbsp;Caterina Stelitano ,&nbsp;Alessandra Dondi ,&nbsp;Giovanni Quarta ,&nbsp;Simona Falorio ,&nbsp;Massimo Federico","doi":"10.3816/CLM.2009.n.084","DOIUrl":"10.3816/CLM.2009.n.084","url":null,"abstract":"<div><h3>Background</h3><p>The early stem cell reservoir can be impaired by a few cycles of chemotherapy, and this impairment might persist after normalization of peripheral cytopenias. We directly evaluated the damage caused to marrow progenitor cells by 3 currently used chemotherapy regimens for advanced Hodgkin lymphoma.</p></div><div><h3>Patients and Methods</h3><p>Bone marrow samples from 37 patients randomly treated according to either the ABVD (doxorubicin/bleomycin/vinblastine/dacarbazine), COPPEBVCAD (cyclophosphamide/vincristine/procarbazine/prednisone/epirubicin/bleomycin/vinblastine/lomustine/melphalan/vindesine), or BEACOPP (bleomycin/etoposide/doxorubicin/cyclophosphamide/vincristine/procarbazine/prednisone)schedule were taken a few days before the start of chemotherapy and 30 days and 6 months after its completion. Samples were cryopreserved, thawed in a single session, and cultured for 5 weeks to detect long-term culture-initiating cells (LTC-IC).</p></div><div><h3>Results</h3><p>On the basis of the numbers of LTC-IC detected and of their relative variations, the ABVD regimen was associated with the least early reduction and the best late recovery of LTC-IC. COPPEBVCAD produced the greatest early damage, but recovery was nearly complete by 6 months. BEACOPP caused intermediate early toxicity that persisted at 6 months.</p></div><div><h3>Conclusion</h3><p>The different late toxicity exerted on marrow progenitors by these chemotherapy regimens should be carefully weighed in relation to both the expected early response rate and subsequent possibility of rescue in the case of first treatment failure.</p></div>","PeriodicalId":100272,"journal":{"name":"Clinical Lymphoma and Myeloma","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3816/CLM.2009.n.084","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28540762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 6
Kinetics of Molecular Response to Imatinib in Patients With Chronic Myeloid Leukemia May Predict Persistent Polymerase Chain Reaction Negativity After Imatinib Discontinuation 慢性髓性白血病患者对伊马替尼的分子反应动力学可以预测伊马替尼停药后持续的聚合酶链反应阴性
Clinical Lymphoma and Myeloma Pub Date : 2009-12-01 DOI: 10.3816/CLM.2009.n.103
Carmen Fava, Stefano Ulisciani, Emilia Giugliano, Vanessa Brunetto, Enrico Gottardi, Lorena Giaretto, Giuseppe Saglio, Giovanna Rege-Cambrin
{"title":"Kinetics of Molecular Response to Imatinib in Patients With Chronic Myeloid Leukemia May Predict Persistent Polymerase Chain Reaction Negativity After Imatinib Discontinuation","authors":"Carmen Fava,&nbsp;Stefano Ulisciani,&nbsp;Emilia Giugliano,&nbsp;Vanessa Brunetto,&nbsp;Enrico Gottardi,&nbsp;Lorena Giaretto,&nbsp;Giuseppe Saglio,&nbsp;Giovanna Rege-Cambrin","doi":"10.3816/CLM.2009.n.103","DOIUrl":"10.3816/CLM.2009.n.103","url":null,"abstract":"<div><p>Four patients with a rapid clearance of leukemic cells maintained a molecular response after discontinuation of therapy. We adopted a new, more sensitive technique to detect minimal residual disease that can help to detect those patients who might be the most eligible for discontinuation when they achieve a complete molecular response.</p></div><div><h3>Full Abstract</h3><p>Only a restricted group of patients with Philadelphia chromosome—positive (Ph<sup>+</sup>) CML is able to achieve a complete molecular response (CMR) after treatment with imatinib. Clinical studies evaluating patients who discontinued treatment are ongoing, and initial reports have pointed out that approximately 50% of patients relapsed within 6 months. We report 4 cases of patients who stopped imatinib in sustained CMR, defined as BCR-ABL/ABL levels below a detection threshold of 5-log reduction and undetectable BCR-ABL transcript by qualitative polymerase chain reaction (PCR), either on BM and PB samples, in at least 2 samples. Cessation was due to some degree of toxicity. CCyR was reached within 3 months of imatinib therapy, and CMR was achieved after 12, 6 (2 cases), and 9 months. The duration of treatment before discontinuation was 43, 54, 16, and 51 months, respectively, while the median time of PCR negativity on imatinib was 36 months. Three patients did not relapse and are PCR-negative with a follow-up of 62, 47, and 41 months, respectively. The fourth patient stayed off of treatment in confirmed CMR for 28 months, until an RQ-PCR analysis on PB disclosed a BCR-ABL/ABL ratio of 0.0208%. She refused to restart imatinib, and she is currently off therapy after 1 year with an RQ-PCR still in the MMR range. Minimal residual disease was assessed with a new strategy with multiple PCR reactions on a 82-well plate, increasing the sensitivity to a 6-log reduction. Patients who remained persistently negative at standard PCR techniques behaved like the normal controls. The single patient who relapsed proved to be positive also in samples obtained during the PCR negativity at the standard methods. This report confirms that a molecular response can be sustained after discontinuation of imatinib. All patients were characterized by a rapid clearance of leukemic cells, suggesting that the kinetics of molecular response might predict prolonged remission after imatinib discontinuation. Furthermore, though in the literature all relapses occurred early, we observed a late molecular recurrence, not associated with progression. Finally we adopted a new, more sensitive technique to detect minimal residual disease that can help to detect those patients who can be the most eligible for discontinuation when they achieve a CMR.</p></div>","PeriodicalId":100272,"journal":{"name":"Clinical Lymphoma and Myeloma","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3816/CLM.2009.n.103","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75156353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Protein Kinase C Beta II Expression in Diffuse Large B-Cell Lymphoma Predicts for Inferior Outcome of Anthracycline-Based Chemotherapy With And Without Rituximab 蛋白激酶C β II在弥漫性大b细胞淋巴瘤中的表达可预测蒽环类化疗加或不加利妥昔单抗的不良预后
Clinical Lymphoma and Myeloma Pub Date : 2009-12-01 DOI: 10.3816/CLM.2009.n.093
Harshal Nandurkar , Kritika Chaiwatanatorn , Georgia Stamaratis , Kenneth Opeskin , Frank Firkin
{"title":"Protein Kinase C Beta II Expression in Diffuse Large B-Cell Lymphoma Predicts for Inferior Outcome of Anthracycline-Based Chemotherapy With And Without Rituximab","authors":"Harshal Nandurkar ,&nbsp;Kritika Chaiwatanatorn ,&nbsp;Georgia Stamaratis ,&nbsp;Kenneth Opeskin ,&nbsp;Frank Firkin","doi":"10.3816/CLM.2009.n.093","DOIUrl":"10.3816/CLM.2009.n.093","url":null,"abstract":"<div><p>Protein kinase C beta II expression in diffuse large B-cell lymphoma has prognostic significance not only for CHOP therapy in low-risk International Prognostic Index disease but also for all patients receiving CHOP plus rituximab.</p></div><div><h3>Full Abstract</h3><p></p></div><div><h3>Introduction</h3><p>Protein kinase C beta II (PKCbII) expression has been reported to indicate inferior prognosis in diffuse large B-cell lymphoma (DLBCL) treated with anthracycline-based chemotherapy.</p></div><div><h3>Aim</h3><p>To compare the prognostic significance of immunohistochemically determined PKCbII expression in de novo DLBCL treated with CHOP chemotherapy (cyclophosphamide/doxorubicin/vincristine/prednisone) with and without rituximab.</p></div><div><h3>Patients and Methods</h3><p>80 consecutive patients treated at St. Vincent's Hospital with de novo DLBCL, 48 treated with CHOP, and 32 with R-CHOP (rituximab plus CHOP), were studied using immunohistochemistry for PKCbII on diagnostic tissue samples. Staining results were correlated with patient characteristics and clinical outcome. Overall survival (OS) and progression-free survival (PFS) were determined by the Kaplan-Meier method, and comparisons were determined by the log-rank test.</p></div><div><h3>Results</h3><p>PKCbII expression correlated with inferior OS and PFS in CHOP-treated patients with low-risk International Prognostic Index (IPI) disease (0–2 adverse factors) but not in the overall patient group unstratified by IPI. PKCbII expression significantly correlated with inferior OS and PFS in R-CHOP—treated patients unstratified by IPI status.</p></div><div><h3>Conclusion</h3><p>PKCbII expression has prognostic significance not only for CHOP therapy in low-risk IPI disease but also for all patients receiving R-CHOP. Immunohistochemically demonstrated PKCbII expression thus identified patient subgroups in which alternative treatment strategies might confer superior outcome.</p></div>","PeriodicalId":100272,"journal":{"name":"Clinical Lymphoma and Myeloma","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3816/CLM.2009.n.093","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89888590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 7
Dasatinib and Chronic Myeloid Leukemia: Two-Year Follow-up in Eight Clinical Trials 达沙替尼和慢性髓性白血病:8项临床试验的2年随访
Clinical Lymphoma and Myeloma Pub Date : 2009-12-01 DOI: 10.3816/CLM.2009.n.083
Jiří Pavlů, David Marin
{"title":"Dasatinib and Chronic Myeloid Leukemia: Two-Year Follow-up in Eight Clinical Trials","authors":"Jiří Pavlů,&nbsp;David Marin","doi":"10.3816/CLM.2009.n.083","DOIUrl":"10.3816/CLM.2009.n.083","url":null,"abstract":"<div><p>Imatinib is currently regarded as the best initial treatment for patients with chronic myeloid leukemia (CML). However, a significant proportion of patients who relapse, fail to respond, or develop intolerance might benefit from the use of second-generation tyrosine kinase inhibitors. In this review, we report the 2-year results in 8 clinical trials involving more than 2000 patients treated with dasatinib (phases I-III). Patients with CML who had failed to respond or were intolerant to imatinib were enrolled in a phase I trial. The positive results emanating from this study led to a series of 5 phase II trials known as START (SRC/ABL tyrosine kinase inhibition activity: research trials of dasatinib). In addition, 2 phase III dose-optimization trials have now been completed. These trials demonstrate that dasatinib offers clinical benefit to patients resistant or intolerant to imatinib, with a well-described and manageable adverse event profile.</p></div>","PeriodicalId":100272,"journal":{"name":"Clinical Lymphoma and Myeloma","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3816/CLM.2009.n.083","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28540761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 14
The Impact of Selected Apoptotic Markers and Adhesion Molecules on the Treatment Outcome of Chronic Lymphocytic Leukemia 选择性凋亡标志物和粘附分子对慢性淋巴细胞白血病治疗效果的影响
Clinical Lymphoma and Myeloma Pub Date : 2009-12-01 DOI: 10.3816/CLM.2009.n.097
Thoraya Abdelhamid, Amira Khorshed, Nahed Abdelwahab, Hesham Shahin, Dhalia Khadry, Gehan Abdel Wahab, Nahla Elsharkawy, Nevein Alazhary
{"title":"The Impact of Selected Apoptotic Markers and Adhesion Molecules on the Treatment Outcome of Chronic Lymphocytic Leukemia","authors":"Thoraya Abdelhamid,&nbsp;Amira Khorshed,&nbsp;Nahed Abdelwahab,&nbsp;Hesham Shahin,&nbsp;Dhalia Khadry,&nbsp;Gehan Abdel Wahab,&nbsp;Nahla Elsharkawy,&nbsp;Nevein Alazhary","doi":"10.3816/CLM.2009.n.097","DOIUrl":"10.3816/CLM.2009.n.097","url":null,"abstract":"<div><p>We assessed the impact of selected apoptotic markers and adhesion molecules on the treatment outcome. Thirty newly diagnosed patients and 10 healthy subjects were studied. Proapoptotic markers (BCL2, p53, and CD95) and adhesion molecules (CD18, CD54) were assessed by flow cytometry before and after treatment. p21 mRNA was assessed by RT-PCR. Induction was done with the CVP regimen.</p></div><div><h3>Full Abstract</h3><p>The study included 23 men and 7 women. Median age was 66 years (range, 53-79 years). There were increases of p53 and BCL2 and reductions of CD18 and CD54 in cases compared to control. CD95 did not show significant increase compared to control. There were reductions in BCL2 after (versus before) treatment and increases in CD18 and CD54 after (versus before) treatment. Evaluable patients showed 11 complete remission (CRs; 39.3%), 7 (25%) partial remissions, 6 progressive diseases (21.4%), and 4 stable diseases (14.3%). The observation after treatment was 2 to 13 months. Median time to disease progression (TTP) of the responding patients was 9 months. Death was reported in 1 case. There was an increase in p53 and BCL2 expression in patients who did not achieve CR compared to those with CR and an increase in CD18 level in CR more than no-CR cases. No significant differences were found regarding the expression of CD95 and CD54 between both groups. Comparing the level of expression of the studied markers at initial presentation, there were increases in p53 and decreases in CD18 level in patients with no CR compared to those with CR. There was positive correlation between the expression of p53 and BCL2 and negative correlation between the p53 and CD18 and between BCL2 and CD18. There was significant negative correlation between TTP and BCL2 levels after treatment. Selected cases for p21 mRNA assessment showed negative correlation between p21 mRNA and p53 levels before treatment and decrease in p21 level was associated with poor prognosis and bad response to treatment. In conclusion, measurement of p53 and CD18 level can define a group of patients with aggressive disease who may require more aggressive therapy. BCL2 level after treatment is correlated with TTP.</p></div><div><h3>Acknowledgment</h3><p>The study was conducted at NCI-Cairo between 2004 and 2007.</p></div>","PeriodicalId":100272,"journal":{"name":"Clinical Lymphoma and Myeloma","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3816/CLM.2009.n.097","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86340761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Abstracts From: Hematologic Malignancies 2009 Brussels, Belgium September 30 – October 3, 2009 摘要来自:2009年比利时布鲁塞尔血液恶性肿瘤大会2009年9月30日- 10月3日
Clinical Lymphoma and Myeloma Pub Date : 2009-12-01 DOI: 10.1016/S1557-9190(11)70042-7
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引用次数: 0
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