Clinical Hematology International最新文献

The Evolving Role of Bridging Therapy during CAR-T Therapy CAR-T疗法中衔接疗法不断演变的作用

Clinical Hematology International Pub Date : 2024-07-16 DOI: 10.46989/001c.116261

Shakthi T Bhaskar, B. Dholaria, B. Savani, Olalekan O. Oluwole

引用次数: 0

How I treat newly diagnosed acute lymphoblastic leukemia 我如何治疗新确诊的急性淋巴细胞白血病

Clinical Hematology International Pub Date : 2024-05-09 DOI: 10.46989/001c.117026

Giebel Sebastian

{"title":"How I treat newly diagnosed acute lymphoblastic leukemia","authors":"Giebel Sebastian","doi":"10.46989/001c.117026","DOIUrl":"https://doi.org/10.46989/001c.117026","url":null,"abstract":"Treatment algorithms differ for adult patients with Philadelphia-negative (Ph-) and Philadelphia-positive (Ph+) acute lymphoblastic leukemia (ALL). For Ph- ALL intensive induction-consolidation chemotherapy using “pediatric-inspired” protocols is a standard of care. Allogeneic hematopoietic cell transplantation (allo-HCT) from either an HLA-matched sibling, unrelated or haploidentical donor should be considered for patients with high estimated risk of relapse. Inadequate response at the level of measurable residual disease (MRD) is the strongest adverse prognostic factor. Patients with B-ALL and detectable MRD should be treated with blinatumomab. In the future, the use of blinatumomab and/or inotuzumab ozogamycin in addition to first-line chemotherapy may become a new standard of care reducing the role of allo-HCT. For patients with Ph+ ALL, tyrosine kinase inhibitors (TKI) are the most important components of treatment protocols, while the intensity of chemotherapy may be reduced. Allo-HCT is recommended for all patients treated with imatinib along with low-intensity chemotherapy. Results of phase-II studies using front-line dasatinib or ponatinib in sequence or in combination with blinatumomab are very promising. Such a strategy may allow the avoidance of systemic chemotherapy. The future role of allo-HCT in this context appears uncertain.","PeriodicalId":10368,"journal":{"name":"Clinical Hematology International","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140995705","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

Elranatamab treatment in a multiple myeloma patient undergoing renal dialysis 接受肾透析的多发性骨髓瘤患者的艾拉他单抗治疗

Clinical Hematology International Pub Date : 2024-05-06 DOI: 10.46989/001c.116800

Zoé Van de Wyngaert, Irene Romera-Martinez, Céline Chedeville, Paolo Musiu, Souhila Ikhlef, Bénédicte Jonca, M. Mohty, F. Malard

引用次数: 0

Outcomes of Autologous stem cell transplantation in patients with primary refractory Diffuse Large B-cell lymphoma who demonstrate chemosensitivity to salvage chemotherapy 对挽救性化疗化疗敏感的原发性难治性弥漫大B细胞淋巴瘤患者进行自体干细胞移植的疗效

Clinical Hematology International Pub Date : 2024-04-10 DOI: 10.46989/001c.115919

M. Rauf, I. Maghfoor, Muhammad Aseafan, Khadijah Al Shankati, Ali M. Alhanash, Faateh Sohail, Tusneem A. M. Elhassan, S. Akhtar

{"title":"Outcomes of Autologous stem cell transplantation in patients with primary refractory Diffuse Large B-cell lymphoma who demonstrate chemosensitivity to salvage chemotherapy","authors":"M. Rauf, I. Maghfoor, Muhammad Aseafan, Khadijah Al Shankati, Ali M. Alhanash, Faateh Sohail, Tusneem A. M. Elhassan, S. Akhtar","doi":"10.46989/001c.115919","DOIUrl":"https://doi.org/10.46989/001c.115919","url":null,"abstract":"Rituximab with anthracycline-based combination frontline chemoimmunotherapy can cure 50–60% of patients with diffuse large B-cell lymphoma (DLBCL). However, studies on the outcomes of patients with DLBCL who experience partial response (PR), stable or progressive disease in response to frontline rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (RCHOP) therapy are limited, as are data on the outcomes of high-dose chemotherapy (HDC) and autologous stem cell transplantation (ASCT) in patients with primary refractory DLBCL who demonstrate chemosensitivity to salvage chemotherapy (SC). We assessed the latter among 184 patients, 144 of whom started SC, with 84 responding and 72 receiving HDC–ASCT. The 5-year survival rate was 58.9%; the median overall survival (OS) was not reached. The difference in response to SC (partial response versus complete response) was significant, with higher 2- and 5-year OS rates in patients with CR (78.1% and 74.9%, respectively) than in those with PR (55.3% and 47%, respectively). The median OS for the whole group was 15 months and particularly patients who had progressive disease after frontline R-CHOP had dismal outcomes. Our study suggests that in patients with primary refractory DLBCL without initial progressive disease after frontline R-CHOP, the depth of response to SC before HDC–ASCT is predictive of relapse.","PeriodicalId":10368,"journal":{"name":"Clinical Hematology International","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140716485","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

Outpatient CAR T-Cell Therapy as Standard of Care: Current Perspectives and Considerations 作为标准治疗的门诊 CAR T 细胞疗法：当前的观点和考虑因素

Clinical Hematology International Pub Date : 2024-04-09 DOI: 10.46989/001c.115793

Katie S. Gatwood, Zahra Mahmoudjafari, Brittney Baer, Stacy Pak, Hoim Kim, Karin Abernathy, B. Dholaria, Olalekan Oluwole

{"title":"Outpatient CAR T-Cell Therapy as Standard of Care: Current Perspectives and Considerations","authors":"Katie S. Gatwood, Zahra Mahmoudjafari, Brittney Baer, Stacy Pak, Hoim Kim, Karin Abernathy, B. Dholaria, Olalekan Oluwole","doi":"10.46989/001c.115793","DOIUrl":"https://doi.org/10.46989/001c.115793","url":null,"abstract":"Chimeric antigen receptor T-cell therapy (CAR-T) has altered the treatment landscape of several hematologic malignancies. Until recently, most CAR-T infusions have been administered in the inpatient setting, due to their toxicity profile. However, the advent of new product constructs, as well as improved detection and management of adverse effects, have greatly increased the safety in administering these therapies. CAR-T indications continue to expand, and inpatient administration is associated with increased healthcare resource utilization and overall cost. Therefore, transitioning CAR-T administration to the outpatient setting has been of great interest in an effort to improve access, reduce financial burden, and improve patient satisfaction. Establishment of a successful outpatient CAR-T requires several components, including a multidisciplinary cellular therapy team and an outpatient center with appropriate clinical space and personnel. Additionally, clear criteria for outpatient administration eligibility and for inpatient admission with pathways for prompt toxicity evaluation and admission, and toxicity management guidelines should be implemented. Education about CAR-T therapy and its associated toxicities is imperative for all clinical staff, as well as patients and their caregivers. Finally, rigorous financial planning and close collaboration with payers to ensure equitable access, while effectively managing cost, are essential to program success and sustainability. This review provides a summary of currently published experiences, as well as expert opinion regarding implementation of an outpatient CAR-T program.","PeriodicalId":10368,"journal":{"name":"Clinical Hematology International","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140726005","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

Prevention and management of acute toxicities from conditioning regimens during hematopoietic stem cell transplantation 预防和处理造血干细胞移植过程中调理方案产生的急性毒性反应

Clinical Hematology International Pub Date : 2024-04-03 DOI: 10.46989/001c.94952

Jana Sawyer, Taylor Elliott, Lindsay Orton, Hunter Sowell, Katie S. Gatwood, Kendall Shultes

{"title":"Prevention and management of acute toxicities from conditioning regimens during hematopoietic stem cell transplantation","authors":"Jana Sawyer, Taylor Elliott, Lindsay Orton, Hunter Sowell, Katie S. Gatwood, Kendall Shultes","doi":"10.46989/001c.94952","DOIUrl":"https://doi.org/10.46989/001c.94952","url":null,"abstract":"Hematopoietic stem cell transplantation (HSCT) remains the only curative option for several hematological malignancies. Its use has continued to grow, with an estimated 23,500 transplants performed annually in the United States alone. The acute toxicities that occur from conditioning chemotherapy can impact the peri-transplant period and have substantial implications on patients’ tolerability and outcomes, irrespective of the treatment of their disease. Chemotherapy-induced nausea vomiting (CINV), mucositis, transplant-associated thrombotic microangiopathy (TA-TMA), and sinusoidal obstruction syndrome, also known as a veno-occlusive disease (SOS/VOD) can all have significant implications for patients. These acute complications begin with the start of conditioning chemotherapy and add to potential toxicity for patients throughout the early post-transplant period, from Day +30 for CINV, mucositis, and SOS, and which can continue through at least Day +100 with the onset of TA-TMA. These toxicities must be prevented and managed appropriately. This review will summarize the literature surrounding them and guide their management.","PeriodicalId":10368,"journal":{"name":"Clinical Hematology International","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140747284","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

A Retrospective Review of Secondary Hemophagocytic Lymphohistiocytosis (HLH) and Dengue-associated HLH from a Teaching Hospital in Singapore. 新加坡一家教学医院对继发性嗜血细胞淋巴组织细胞增多症（HLH）和登革热相关性 HLH 的回顾性研究。

Clinical Hematology International Pub Date : 2024-03-18 DOI: 10.46989/001c.94954

A. Tso, S. Acharyya, S. Z. Fong, L. Lee, S. V. Sreekanth, B. Fan, Seok W. S. Chan, K. Ong

{"title":"A Retrospective Review of Secondary Hemophagocytic Lymphohistiocytosis (HLH) and Dengue-associated HLH from a Teaching Hospital in Singapore.","authors":"A. Tso, S. Acharyya, S. Z. Fong, L. Lee, S. V. Sreekanth, B. Fan, Seok W. S. Chan, K. Ong","doi":"10.46989/001c.94954","DOIUrl":"https://doi.org/10.46989/001c.94954","url":null,"abstract":"Real-world data on the outcome of Asian patients with secondary hemophagocytic lymphohistiocytosis (HLH), especially on dengue-associated HLH, are limited to small case series. This is a retrospective records review of adult patients with secondary HLH between 2015 and 2020. Thirty-two adult patients were followed up for a median of 6.6 months (range 0.1 – 75 months). 15 had underlying lymphomas, and 12 had viral infections. Hemophagocytosis was seen in 28 of 29 patients with a bone marrow biopsy. 100% and 76.5% of patients with and without an underlying malignancy required HLH-directed therapy and blood product transfusion. 12 of 15 patients with lymphomas were treated with additional chemotherapy. Patients with malignancy-associated HLH had poorer survival than non-malignancy-associated HLH (median overall survival (OS) 1.5 months versus not reached, p-value 0.003). The 1-year survival rates of patients with malignancy-associated HLH, HLH with unknown etiologies, and infection-associated HLH were 0.133 (95% CI: 0.036 – 0.484), 0.400 (95% CI: 0.137 – 1.000) and 0.833 (95% CI: 0.647 – 1.000), respectively. Malignancy significantly increased the risk of death compared to infection-associated HLH (HR 9.37, p-value 0.003). Eight patients were diagnosed with dengue-associated HLH with a median HSCORE of 240 (98-99% probability of HLH). Their mean ferritin was 34,740 ng/mL. Three patients required blood product transfusion, 5 required corticosteroids and/or etoposide, with a median duration of treatment of 31 days. Their overall survival rate was 87.5%. Our study highlights the stark contrast in the survival of secondary HLH patients with and without an underlying malignancy. We also present one of the world’s most extensive case series of dengue-associated HLH.","PeriodicalId":10368,"journal":{"name":"Clinical Hematology International","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140232346","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

The Implementation of Chimeric Antigen Receptor (CAR) T-cell Therapy in Pediatric Patients: Where Did We Come From, Where Are We Now, and Where are We Going? 嵌合抗原受体（CAR）T 细胞疗法在儿科患者中的应用：我们从哪里来，我们现在在哪里，我们将到哪里去？

Clinical Hematology International Pub Date : 2024-03-13 DOI: 10.46989/001c.94386

Tristan Knight E, Olalekan Oluwole, Carrie Kitko

{"title":"The Implementation of Chimeric Antigen Receptor (CAR) T-cell Therapy in Pediatric Patients: Where Did We Come From, Where Are We Now, and Where are We Going?","authors":"Tristan Knight E, Olalekan Oluwole, Carrie Kitko","doi":"10.46989/001c.94386","DOIUrl":"https://doi.org/10.46989/001c.94386","url":null,"abstract":"CD19-directed Chimeric Antigen Receptor (CAR) T-cell therapy has revolutionized the treatment of patients with B-cell acute lymphoblastic leukemia (B-ALL). Somewhat uniquely among oncologic clinical trials, early clinical development occurred simultaneously in both children and adults. In subsequent years however, the larger number of adult patients with relapsed/refractory (r/r) malignancies has led to accelerated development of multiple CAR T-cell products that target a variety of malignancies, resulting in six currently FDA-approved for adult patients. By comparison, only a single CAR-T cell therapy is approved by the FDA for pediatric patients: tisagenlecleucel, which is approved for patients  25 years with refractory B-cell precursor ALL, or B-cell ALL in second or later relapse. Tisagenlecleucel is also under evaluation in pediatric patients with relapsed/refractory B-cell non-Hodgkin lymphoma, but is not yet been approved for this indication. All the other FDA-approved CD19-directed CAR-T cell therapies available for adult patients (axicabtagene ciloleucel, brexucabtagene autoleucel, and lisocabtagene maraleucel) are currently under investigations among children, with preliminary results available in some cases. As the volume and complexity of data continue to grow, so too does the necessity of rapid assimilation and implementation of those data. This is particularly true when considering “atypical” situations, e.g. those arising when patients do not precisely conform to the profile of those included in pivotal clinical trials, or when alternative treatment options (e.g. hematopoietic stem cell transplantation (HSCT) or bispecific T-cell engagers (BITEs)) are also available. We have therefore developed a relevant summary of the currently available literature pertaining to the use of CD19-directed CAR-T cell therapies in pediatric patients, and sought to provide guidance for clinicians seeking additional data about specific clinical situations.","PeriodicalId":10368,"journal":{"name":"Clinical Hematology International","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140245148","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

A Case of Renal Iron Overload Associated with Cold Agglutinin Disease Successfully Managed by Rituximab 利妥昔单抗成功治愈一例伴有冷凝集素病的肾脏铁过载病例

Clinical Hematology International Pub Date : 2023-12-29 DOI: 10.46989/001c.91478

Kathryn Taberner, Andrew A. House, Aaron Haig, Cyrus C. Hsia

引用次数: 0

Asparaginase-associated Pancreatitis Complicated by Pancreatic Fluid Collection Treated with Endoscopic Cistogastrostomy in Pediatric Acute Lymphoblastic Leukemia: A Case Report and Systematic Review of the Literature. 小儿急性淋巴细胞白血病患者天冬酰胺酶相关性胰腺炎并发胰液收集，采用内镜下胰腺造瘘术治疗：病例报告与文献系统回顾》。

Clinical Hematology International Pub Date : 2023-12-20 DOI: 10.46989/001c.90958

Giulia Fiumana, Alessia Pancaldi, Helga Bertani, Valentina Boarino, Monica Cellini, Lorenzo Iughetti

引用次数: 0