Advances in Hematology最新文献

{"title":"Safety and Efficacy of Subcutaneous Rituximab in Previously Untreated Patients with CD20+ Diffuse Large B-Cell Lymphoma or Follicular Lymphoma: Results from an Italian Phase IIIb Study.","authors":"Mario Petrini,&nbsp;Gianluca Gaidano,&nbsp;Andrea Mengarelli,&nbsp;Ugo Consoli,&nbsp;Armando Santoro,&nbsp;Anna Maria Liberati,&nbsp;Marco Ladetto,&nbsp;Vincenzo Fraticelli,&nbsp;Attilio Guarini,&nbsp;Donato Mannina,&nbsp;Paola Ferrando,&nbsp;Paolo Corradini,&nbsp;Pellegrino Musto,&nbsp;Caterina Stelitano,&nbsp;Dario Marino,&nbsp;Andrea Camera,&nbsp;Marco Murineddu,&nbsp;Roberta Battistini,&nbsp;Giuseppe Caparrotti,&nbsp;Mauro Turrini,&nbsp;Luca Arcaini,&nbsp;Simone Santini,&nbsp;Manuela Cerqueti,&nbsp;Andres J M Ferreri,&nbsp;Nicola Cantore,&nbsp;Alessandro Inzoli,&nbsp;Giovanni Cardinale,&nbsp;Benedetto Ronci,&nbsp;Giorgio La Nasa,&nbsp;Stefano Massimi,&nbsp;Gianfranco Gaglione,&nbsp;Valentina Barbiero,&nbsp;Maurizio Martelli","doi":"10.1155/2022/5581772","DOIUrl":"https://doi.org/10.1155/2022/5581772","url":null,"abstract":"<p><p>Subcutaneous (SC) rituximab may be beneficial in terms of convenience and tolerability, with potentially fewer and less severe administration-related reactions (ARRs) compared to the intravenous (IV) form. This report presents the results of a phase IIIb study conducted in Italy. The study included adult patients with CD20+ DLBCL or FL having received at least one full dose of IV RTX 375 mg/m² during induction or maintenance. Patients on induction received ≥4 cycles of RTX SC 1400 mg plus standard chemotherapy and FL patients on maintenance received ≥6 cycles of RTX SC. Overall, 159 patients (73 DLBCL, 86 FL) were enrolled: 103 (54 DLBCL, 49 FL) completed induction and 42 patients with FL completed 12 maintenance cycles. ARRs were reported in 10 patients (6.3%), 3 (4.2%) with DLBCL and 7 (8.1%) with FL, all of mild severity, and resolved without dose delay/discontinuation. Treatment-emergent adverse events (TEAEs) and serious adverse events occurred in 41 (25.9%) and 14 patients (8.9%), respectively. Two patients with DLBCL had fatal events: <i>Klebsiella</i> infection (related to rituximab) and septic shock (related to chemotherapy). Neutropenia (14 patients, 8.9%) was the most common treatment-related TEAE. Two patients with DLBCL (2.8%) and 6 with FL (7.0%) discontinued rituximab due to TEAEs. 65.2% and 69.7% of patients with DLBCL and 67.9% and 73.6% of patients with FL had complete response (CR) and CR unconfirmed, respectively. The median time to events (EFS, PFS, and OS) was not estimable due to the low rate of events. At a median follow-up of 29.5 and 47.8 months in patients with DLBCL and FL, respectively, EFS, PFS, and OS were 70.8%, 70.8%, and 80.6% in patients with DLBCL and 77.9%, 77.9%, and 95.3% in patients with FL, respectively. The switch from IV to SC rituximab in patients with DLBCL and FL was associated with low risk of ARRs and satisfactory response in both groups. This trial was registered with NCT01987505.</p>","PeriodicalId":7325,"journal":{"name":"Advances in Hematology","volume":" ","pages":"5581772"},"PeriodicalIF":0.0,"publicationDate":"2022-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8813238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39894248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ibrutinib plus Obinutuzumab as Frontline Therapy for Chronic Lymphocytic Leukemia Is Associated with a Lower Rate of Infusion-Related Reactions and with Sustained Remissions after Ibrutinib Discontinuation: A Single-Arm, Open-Label, Phase 1b/2 Clinical Trial NCT0231576.","authors":"Januario E Castro,&nbsp;Paula A Lengerke-Diaz,&nbsp;Juliana Velez Lujan,&nbsp;Michael Y Choi,&nbsp;Eider F Moreno-Cortes,&nbsp;Jose V Forero,&nbsp;Juan Esteban Garcia-Robledo,&nbsp;Chaja Jacobs,&nbsp;Colin McCarthy,&nbsp;Alaina Heinen,&nbsp;Carlos I Amaya-Chanaga,&nbsp;Thomas J Kipps","doi":"10.1155/2022/4450824","DOIUrl":"https://doi.org/10.1155/2022/4450824","url":null,"abstract":"<p><p>Ibrutinib-based therapies are costly and require continuous administration. We hypothesized combining BTK inhibition with anti-CD20 monoclonal antibodies would yield deep remissions allowing discontinuation. We enrolled 32 therapy-naïve CLL patients to receive ibrutinib plus obinutuzumab, followed by single-agent ibrutinib. Patients could discontinue ibrutinib after 36 months with sustained complete response (CR). We evaluated treatment safety, efficacy, and outcomes after ibrutinib discontinuation. The overall response rate was 100%, 28% achieved a CR, and 12.5% achieved bone marrow undetectable minimal residual disease. At a three-year median follow-up, 91% remain in remission with 100% overall survival. Five patients in sustained CR stopped ibrutinib and have not progressed. Eight non-CR patients discontinued for other reasons, with only two progressing. The treatment was safe, with a lower IRR rate. All patients responded to treatment with longer time-to-progression after discontinuation of ibrutinib. Our data support the evaluation of ibrutinib discontinuation strategies in more extensive clinical trials (https://Clinicaltrials.gov Identifier https://clinicaltrials.gov/ct2/show/NCT02315768).</p>","PeriodicalId":7325,"journal":{"name":"Advances in Hematology","volume":" ","pages":"4450824"},"PeriodicalIF":0.0,"publicationDate":"2022-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8800600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39876946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anaemia Prevalence More Than Doubles in an Academic Year in a Cohort of Tertiary Students: A Repeated-Measure Study in Cape Coast, Ghana.","authors":"Regina Elorm Amoaning,&nbsp;Ernestina Siaw Amoako,&nbsp;Grace Arezie Kyiire,&nbsp;Dennis Dela Owusu,&nbsp;Happy Bruce,&nbsp;David Larbi Simpong,&nbsp;Patrick Adu","doi":"10.1155/2022/4005208","DOIUrl":"https://doi.org/10.1155/2022/4005208","url":null,"abstract":"<p><strong>Background: </strong>The stress of academic life may predispose young adults to poor dietary habits, which could potentially precipitate nutritional deficiencies, such as iron deficiency. This study evaluated factors predictive of optimal iron stores as well as changes in haematological parameters over the course of an academic year in a cohort of tertiary students.</p><p><strong>Materials and methods: </strong>The repeated-measure cohort study recruited 117 undergraduate students from September 2018 to May 2019. Venous blood samples were drawn for full blood count estimation, qualitative glucose-6-phosphate dehydrogenase (G6PD) status, haemoglobin variants, and blood group determination during the first 2 weeks of semester 1. However, anthropometric parameters as well as full blood counts were determined for each participant during the first week and last week of semesters 1 and 2. Additionally, semistructured questionnaires were used to capture sociodemographic data. Also, serum ferritin was estimated for each participant using enzyme-linked immunosorbent assay.</p><p><strong>Results: </strong>Overall, 23.1% and 15.5% of participants inherited G6PD defect (G6PDd) or haemoglobin variants, respectively. However, group O (68/117; 58.1%) was the predominant ABO blood group and an overwhelming 90.6% (106/117) inherited Rh D antigen. The prevalence of anaemia increased from 20% at the beginning of the first semester to 45.1% at the latter part of the second semester. G6PDd participants had significantly higher median serum ferritin than G6PD normal participants (<i>p</i> = 0.003). Also, a significantly higher proportion of females were iron depleted (25% vs. 2.3%) or iron deficient (14.3% vs. 9.3%) compared to males. Moreover, being male, G6PD deficient, or 21-25 years was associated with increased odds of participants having optimal serum ferritin levels.</p><p><strong>Conclusion: </strong>The progression of anaemia prevalence from mild to severe public health problem over the course of one academic year should urgently be addressed.</p>","PeriodicalId":7325,"journal":{"name":"Advances in Hematology","volume":" ","pages":"4005208"},"PeriodicalIF":0.0,"publicationDate":"2022-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8800615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39876945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of Bruton's Tyrosine Kinase Inhibitors in Light Chain Amyloidosis Caused by Lymphoplasmacytic Lymphoma (Waldenström's Macroglobulinemia).","authors":"Maroun Bou Zerdan,&nbsp;Jason Valent,&nbsp;Maria Julia Diacovo,&nbsp;Karl Theil,&nbsp;Chakra P Chaulagain","doi":"10.1155/2022/1182384","DOIUrl":"https://doi.org/10.1155/2022/1182384","url":null,"abstract":"<p><p>Of the variety of immunoglobulin related amyloidosis (AL), immunoglobulin M (IgM) related AL represents only 6 to 10% of affected patients, and the majority of these cases are associated with underlying non-Hodgkin's Lymphoma including Waldenström's macroglobulinemia (WM). Ibrutinib, acalabrutinib, and zanubrutinib are Bruton tyrosine kinase (BTK) inhibitors approved for certain indolent B cell non-Hodgkin's lymphoma (NHL). BTK is a nonreceptor kinase involved in B-cell survival, proliferation, and interaction with the microenvironment. We retrospectively evaluated the tolerability and effectiveness of BTK inhibitors ibrutinib and acalabrutinib therapy in (<i>n</i> = 4) patients with IgM-related AL amyloidosis with underlying WM. Treatment was well tolerated with both hematologic and organ response in patients with AL amyloidosis in the setting of WM. Atrial fibrillation led to the discontinuation of ibrutinib in one patient, and acalabrutinib caused significant thumb hematoma needing dose reduction in another patient. All patients evaluated had the MYD88 mutation. This may explain the good response to BTK inhibitors therapy in our series. BTK inhibitors should be further investigated in larger prospective studies for treatment of AL amyloidosis in patients with lymphoplasmacytic lymphoma/WM.</p>","PeriodicalId":7325,"journal":{"name":"Advances in Hematology","volume":" ","pages":"1182384"},"PeriodicalIF":0.0,"publicationDate":"2022-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8791721/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39572429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes among Patients with Mantle Cell Lymphoma Post-Covalent BTK Inhibitor Therapy in the United States: A Real-World Electronic Medical Records Study.","authors":"Lisa M Hess,&nbsp;Yongmei Chen,&nbsp;Paolo B Abada,&nbsp;Heiko Konig,&nbsp;Richard A Walgren","doi":"10.1155/2022/8262787","DOIUrl":"https://doi.org/10.1155/2022/8262787","url":null,"abstract":"<p><strong>Purpose: </strong>There remains a lack of consensus among experts regarding the optimal therapeutic approach for Mantle cell lymphoma (MCL) after failure of covalent Bruton Tyrosine Kinase inhibitor (cBTKi)-based therapy. This study was designed to examine patient characteristics, current treatment patterns, and clinical outcomes using a real-world database to evaluate how MCL is currently managed post-cBTKi therapy in the U.S.</p><p><strong>Methods: </strong>A large, deidentified U.S. electronic medical record (EMR) oncology database (ConcertAI) with data from January 2011 to July 2021 was utilized for this study. Eligible patients were adults with MCL who had received at least one cBTKi. Descriptive statistics were used to evaluate patient characteristics and treatment patterns. Time-to-event real-world outcomes of duration of therapy, time to next treatment discontinuation, and overall survival was evaluated using the Kaplan-Meier method.</p><p><strong>Results: </strong>A total of 946 patients met eligibility criteria. Of these, 739 (78.1%) discontinued cBTKi treatment before the end of the follow-up period, while the remaining 207 (21.9%) were still receiving cBTKi therapy at the end of the follow-up period. Among those who had discontinued the cBTKi, 352 (47.6%, 352/739) received at least one subsequent (post-cBTKi) treatment. The median duration of the immediate post-cBTKi therapy was 2.6 months (<i>n</i> = 352). Among the 739 patients who discontinued cBTKi treatment, the median time from cBTKi discontinuation to next treatment discontinuation or death was 3.9 months and the median overall survival was 10.3 months.</p><p><strong>Conclusions: </strong>This study demonstrates the poor outcomes experienced by patients after cBTKi therapy. There is an urgent need for safe and effective treatments for patients with recurrent or progressive MCL.</p>","PeriodicalId":7325,"journal":{"name":"Advances in Hematology","volume":"2022 ","pages":"8262787"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9812614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10510046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Anticoagulation Control among Patients Taking Warfarin in University of Gondar Hospital, Northwest Ethiopia.","authors":"Zelalem Liyew, Abilo Tadesse, Nebiyu Bekele, Tewodros Tsegaye","doi":"10.1155/2021/7530997","DOIUrl":"10.1155/2021/7530997","url":null,"abstract":"<p><strong>Introduction: </strong>Warfarin is a widely used oral anticoagulant in clinical practice. It has variable intraindividual and interindividual dose response and a narrow therapeutic index. Therefore, it requires frequent and regular international normalized ratio (INR) determination to maintain the INR within the therapeutic range. The study evaluated parameters of anticoagulation control among patients on warfarin.</p><p><strong>Methods: </strong>A cross-sectional study was conducted at University of Gondar hospital. A consecutive sampling method was used to recruit study subjects. The anticoagulation control was evaluated by determining the proportion of desired INRs and the proportion of time spent in the therapeutic range (TTR). Logistic regression analysis was used to identify associated factors with adequate TTR. A <i>P</i> value <0.05 was used to declare significant association.</p><p><strong>Result: </strong>A total of 338 study subjects were included in the study. The mean age of patients was 48.8 (SD = 16.4) years. Atrial fibrillation was the commonest indication for warfarin therapy. One-third (33%) of study subjects achieved the desired INRs of 2.0-3.0, while about one-tenth (13%) of patients attained good INR control (TTR ≥ 65%). Multivariate logistic regression analysis revealed no significant association of sociodemographic and clinical characteristics with good TTR outcome.</p><p><strong>Conclusion: </strong>The level of anticoagulation control with warfarin among study subjects was very low. The authors recommend to implement a validated warfarin-dose titration protocol and to establish anticoagulation clinics to mitigate the low anticoagulation level.</p>","PeriodicalId":7325,"journal":{"name":"Advances in Hematology","volume":"2021 ","pages":"7530997"},"PeriodicalIF":0.0,"publicationDate":"2021-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8714382/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39775312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heritable Thrombophilia in Venous Thromboembolism in Northern Pakistan: A Cross-Sectional Study.","authors":"Maria Khan, Chaudhry Altaf, Hamid Saeed Malik, Muhammad Abdul Naeem, Aamna Latif","doi":"10.1155/2021/8317605","DOIUrl":"10.1155/2021/8317605","url":null,"abstract":"<p><strong>Background: </strong>Venous thromboembolism (VTE) is referred to as formation of clots in a deep vein or lodging of thrombus towards the lungs which could be fatal yet preventable. The risk of developing VTE can be increased by various factors. Where there are innumerable acquired causes, the possibility of inherited thrombophilia cannot be ignored. In view of this, we have evaluated all patients with venous thromboembolism for inherited thrombophilia.</p><p><strong>Objective: </strong>To evaluate the frequencies of antithrombin (AT) deficiency, protein C and S deficiencies, Factor V Leiden, and prothrombin gene mutations in patients harboring venous thromboembolism.</p><p><strong>Materials and methods: </strong>A study comprising of 880 patients who were presented with manifestations of venous thromboembolism was conducted from July 2016 to June 2017. A blood sample collected from patients was screened for thrombophilia defects encompassing AT, protein C and S deficiencies, Factor V Leiden, and prothrombin gene mutations. All acquired causes of thrombosis were excluded.</p><p><strong>Results: </strong>Of 880 patients who underwent screening for thrombophilia, 182 patients demonstrated VTE history. Their age ranged from 1 to 58 years. Males constituted a predominant group. About 45 (24.7%) patients had evidence of heritable thrombophilia. Of these, 20 (10.9%) had AT deficiency, 9 (4.9%) had Factor V Leiden mutation, 6 (3.2%) had protein C deficiency, whereas protein S deficiency and prothrombin gene mutation both were found in 5 (2.7%) patients.</p><p><strong>Conclusion: </strong>Our study illustrated the highest frequency of antithrombin deficiency among other investigated thrombophilia defects.</p>","PeriodicalId":7325,"journal":{"name":"Advances in Hematology","volume":"2021 ","pages":"8317605"},"PeriodicalIF":0.0,"publicationDate":"2021-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8560302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39588782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Haptoglobin Gene Polymorphism among Sickle Cell Patients in West Cameroon: Hematological and Clinical Implications.","authors":"Christian Bernard Kengne Fotsing,&nbsp;Constant Anatole Pieme,&nbsp;Prosper Cabral Biapa Nya,&nbsp;Jean Paul Chedjou,&nbsp;Samuel Ashusong,&nbsp;Gisele Njindam,&nbsp;Jocelyn Tony Nengom,&nbsp;Georges Teto,&nbsp;Carine Nguemeni,&nbsp;Wilfred Fon Mbacham,&nbsp;Donatien Gatsing","doi":"10.1155/2021/6939413","DOIUrl":"https://doi.org/10.1155/2021/6939413","url":null,"abstract":"<p><p>Haptoglobin is a protein involved in protecting the body from the harmful effects of free hemoglobin. The haptoglobin gene exhibits a polymorphism, and the different genotypes do not have the same capacity to combat the free hemoglobin effects. The present study aimed at determining the polymorphic distribution of haptoglobin in sickle cell patients (SCPs) from West Cameroon and their impact on the hematological parameters, as well as clinical manifestations of the disease severity. Haptoglobin genotype of 102 SCPs (SS) and 115 healthy individuals (60 AA and 55 AS) was determined by allele-specific polymerase chain reaction, and the complete blood count was determined using the AutoAnalyser. Results showed that the genotype Hp2-2 was significantly (<i>p</i> < 0.05) represented in SS patients (54%) than in controls AA and AS (27% and 29%, respectively), while Hp2-1 was mostly found (<i>p</i> < 0.05) in AS (42%) and AA (38%), against 15% in SS. The allelic distribution in SS patients was Hp²: 0.613, Hp^1S: 0.304, and Hp^1F: 0.084. In AA and AS controls, the proportions of the Hp¹ and Hp² alleles were similar (around 0.5 each), with 0.282 for Hp^1S and 0.218 for Hp^1F in AS and 0.283 for Hp^1S and 0.258 for Hp^1F in AA. The distribution of the haptoglobin genotypes did not reveal any significant difference across hematological parameters and clinical manifestations of disease severity in SCP and controls. SCP with Hp1S-1F genotype presented the highest level of hemoglobin. Although Hp2-2 was more frequent in SS patients, it appeared not to be related to the hematological parameters and to the disease's severity. Further investigations are necessary to explore the impact of Hp polymorphism such as antioxidant, lipid profile, and functionality of some tissues in SCP in Cameroon.</p>","PeriodicalId":7325,"journal":{"name":"Advances in Hematology","volume":"2021 ","pages":"6939413"},"PeriodicalIF":0.0,"publicationDate":"2021-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8550853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39667609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IL-31 and IL-8 in Cutaneous T-Cell Lymphoma: Looking for Their Role in Itch.","authors":"Maria Abreu,&nbsp;Marta Miranda,&nbsp;Mafalda Castro,&nbsp;Iolanda Fernandes,&nbsp;Renata Cabral,&nbsp;Ana Helena Santos,&nbsp;Sónia Fonseca,&nbsp;João Rodrigues,&nbsp;Magdalena Leander,&nbsp;Catarina Lau,&nbsp;Inês Freitas,&nbsp;Susana Coimbra,&nbsp;Alice Santos-Silva,&nbsp;Margarida Lima","doi":"10.1155/2021/5582581","DOIUrl":"https://doi.org/10.1155/2021/5582581","url":null,"abstract":"<p><p>The itch associated with cutaneous T-cell lymphoma (CTCL), including Mycosis Fungoides (MF) and Sézary syndrome (SS), is often severe and poorly responsive to treatment with antihistamines. Recent studies have highlighted the possible role of interleukins in nonhistaminergic itch. We investigated the role of IL-31 and IL-8 in CTCL, concerning disease severity and associated itch. Serum samples of 27 patients with CTCL (17 MF and 10 SS) and 29 controls (blood donors) were analyzed for interleukin- (IL-) 31 and IL-8; correlations with disease and itch severity were evaluated. IL-31 serum levels were higher in CTCL patients than in controls and higher in SS than in MF. Also, serum IL-31 levels were higher in patients with advanced disease compared to those with early disease, and they correlated positively with lactate dehydrogenase and beta 2-microglobulin levels, as well as with the Sézary cell count. Itch affected 67% of CTCL patients (MF: 47%; SS: 100%). Serum IL-31 levels were higher in itching patients than in controls and in patients without itching. There was no association between serum IL-8 and disease severity, nor with itching. Serum IL-8 levels correlated positively with peripheral blood leukocyte and neutrophil counts in CTCL patients. Our study suggests a role for IL-31 in CTCL-associated itch, especially in advanced disease and SS, offering a rational target for new therapeutic approaches. Increased serum IL-8 observed in some patients may be related to concomitant infections, and its role in exacerbating itch by recruiting neutrophils and promoting the release of neutrophil proteases deserves further investigation.</p>","PeriodicalId":7325,"journal":{"name":"Advances in Hematology","volume":"2021 ","pages":"5582581"},"PeriodicalIF":0.0,"publicationDate":"2021-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8318769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39265309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Phase II Trial of Melphalan Based Reduced-Intensity Conditioning for Transplantation of T-Replete HLA-Haploidentical Peripheral Blood Stem Cells with Posttransplant Cyclophosphamide in Patients with Hematologic Malignancies.","authors":"Melhem M Solh,&nbsp;Gabriel Hinojosa,&nbsp;Justin Laporte,&nbsp;Scott R Solomon,&nbsp;Lawrence E Morris,&nbsp;Xu Zhang,&nbsp;H Kent Holland,&nbsp;Asad Bashey","doi":"10.1155/2021/8868142","DOIUrl":"https://doi.org/10.1155/2021/8868142","url":null,"abstract":"<p><p>T-replete haploidentical donor transplants using posttransplant cyclophosphamide (haplo) have greatly expanded donor availability and are increasingly utilized. Haplo were originally performed using truly nonmyeloablative conditioning and a bone marrow graft. We have also developed myeloablative conditioning and peripheral blood stem cell (PBSC) grafts for use with haplo. However, some patients may not tolerate myeloablative conditioning but may still benefit from a more dose-intensified preparative regimen to control malignancy and diminish graft rejection. To this end, we enrolled 25 patients on a prospective phase II trial utilizing a regimen of fludarabine 30 mg/m²/day × 5 days and Melphalan 140 mg/m² on day -1 (flu/Mel) followed by infusion of unmanipulated PBSC graft from a haploidentical donor. GVHD prophylaxis included cyclophosphamide 50 mg/kg/day on days 3 and 4, mycophenolate mofetil on day 35, and tacrolimus on day 180. Median age was 57 years (range from 35 to 68). Transplantation diagnosis included AML (<i>n</i> = 11), ALL (<i>n</i> = 4), MDS/MPD (<i>n</i> = 6), NHL/CLL (<i>n</i> = 3), and MM (<i>n</i> = 1). Using the refined Disease Risk Index (DRI), patients were low (<i>n</i> = 1), intermediate (<i>n</i> = 13), and high/very high (<i>n</i> = 11). 22 out of 25 patients engrafted with a median time to neutrophil and platelet engraftment of 18 days and 36 days, respectively. All engrafting patients achieved full peripheral blood T-lymphocyte and myeloid donor chimerism at day 30. The 180-day cumulative incidence for acute GVHD grades II-IV and III-IV was seen in 20% (95% CI 8%-37%) and 8% (95% CI 2%-22%), respectively. The 2-year cumulative incidence of chronic GVHD was 16% (95% CI 5%-33%) (moderate-severe 12% (95% CI 3%-27%)). After a median follow-up of 28.3 months, the estimated 2-year OS, DFS, NRM, and relapse were 56% (95%CI 33-74%), 44% (95%CI 23%-64%), 20% (95% CI 8%-37%), and 36% (95% CI 17%-55%), respectively. Among patients with high/very high risk DRI, 2-year OS was 53% compared to 69% for low/intermediate DRI. When compared with a contemporaneous cohort of patients at our center receiving haploidentical transplant with nonablative fludarabine, Cytoxan, and total body irradiation flu/Cy/TBI regimen, the outcomes were statistically similar to the 2-year OS at 56% vs. 63% <i>p</i>=0.75 and DFS at 44% vs. 46% <i>p</i>=0.65.</p>","PeriodicalId":7325,"journal":{"name":"Advances in Hematology","volume":"2021 ","pages":"8868142"},"PeriodicalIF":0.0,"publicationDate":"2021-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8009703/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38798545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}