GLORIA

GEOMAR Library Ocean Research Information Access

X

Your email was sent successfully. Check your inbox.

An error occurred while sending the email. Please try again.

Proceed reservation?

Export
Filter
  • Batar, Peter  (4)
  • Medicine  (4)
  • 1
    Online Resource
    Online Resource
    The Effect of Bortezomib Containing Induction On the Long Term Outcome of autologous Haemopoietic Stem Cell Transplantation in Multiple Myeloma Patients Outside Clinical Trials - a Single Center Experience
    American Society of Hematology ; 2012
    In:  Blood Vol. 120, No. 21 ( 2012-11-16), p. 5050-5050
    Details
    In: Blood, American Society of Hematology, Vol. 120, No. 21 ( 2012-11-16), p. 5050-5050
    Abstract: Abstract 5050 Introduction: We aimed to investigate the effect of bortezomib-based induction therapy for the treatment of transplant-eligible multiple myeloma (MM) patients, as compared to non-bortezomib-based treatments, in daily clinical practice. Patients and methods: All 122 transplant eligible MM patients treated at our center between 2003 and 2011 were reviewed retrospectively without selection. Patients had received induction with or without a bortezomib-based regimen, followed by high dose therapy (single Mel200+APSCT). The group consistend of 64 males and 58 females, mean age: 55, 2±8, 7 year. 45, 9% of the patients had IgGκ (56), 18% IgGλ (22), 10, 6% IgAκ (13), 7, 3% IgAλ (9), 0, 8% IgMκ (1), 3, 2% κ (4), 10, 6% λ (13), and 3, 2% had non secretory (4) MM. Bone marrow FISH analysis revealed del-13q in 2 cases, monosomy 13 in 14, t4:14 in 1, monosomy 13 + del 17p in 1. Plasma cell leukemia (primary and secondary) was found in 2 cases. Induction therapy was applied either in our center, or patients were referred to us to perform high dose therapy after induction therapy given in other regional hematology departments. Due to regulatory reasons, patients mainly received non-bortezomib containing induction (VAD, thal-dex 78%, bortezomib-based 22%) until 2008. Later predominantly bortezomib-based therapy was used (69%, mainly VTD or PAD), the remaining (mainly those referred to our center) cases had thal-dex, or CTD induction. Results: Patients without bortezomib in induction: The mean followup of the 22 patients who did not receive bortezomib as part of induction was 53. 2+21. 9 month, 14 of them died (66, 7%) during followup. Median survival reached at 38 month following induction, or if calculated after completion of high dose therapy median survival was 52 month. Patients with bortezomib based induction. The mean follow-up time of this 100 patients time was 44, 5+ 27, 6 months. 25 pts died (25%) and survival probability at 50 month from the initation of induction was 69. 8 % in these patients compared to the 40. 7% estimated survival for the patients without bortezomib (p 〈 0. 01). Survival probabilty at 50 month after completion of high dose therapy (as a new starting point of followup) was 39, 7% without bortezomib-based induction and 74, 6%, in patients receiving bortezomib-based induction (p 〈 0. 05). Median survival times has not reached following induction and high dose therapy. Conclusions: This retrospective survey clearly supports the important role of that bortezomib containing induction regimens achieving prolonged survival both after induction and following high dose therapy in multiple myeloma clinical practice settings, as compared to regimens without bortezomib. Disclosures: Off Label Use: Rituximab is not authorized for Mantle Cell Lymphoma in Hungary.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    URL: Article
    DOI: 10.1182/blood.V120.21.5050.5050
    RVK:
    XA 33000
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2012
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 2
    Online Resource
    Online Resource
    A New Approach to Predict the Chance of Infectious Complications Following Autologous Hematopoietic Stem Cell Transplantation: Mannose-Binding Lectin ELISA
    American Society of Hematology ; 2011
    In:  Blood Vol. 118, No. 21 ( 2011-11-18), p. 4492-4492
    Details
    In: Blood, American Society of Hematology, Vol. 118, No. 21 ( 2011-11-18), p. 4492-4492
    Abstract: Abstract 4492 Introduction: Haematopoietic stem cell transplantation associated immuncompromised state carries high risk of infectious complications. Gram-positive cocci are responsible for the majority of the post-transplant bloodstream infections. Viral and invasive fungal infections can be significant causes of morbidity. Mannose-binding lectin (MBL) is involved in innate immune response. MBL is an acute phase protein, synthesized in the liver. MBL binds microbial surface carbohydrates and mediates opsonophagocytosis directly and by activation of the lectin complement pathway. MBL also functions as co-receptor of Toll-like receptor. Serum MBL level is genetically determined and quite stable. MBL deficiency is a result of impaired assembly or stability of multimers. In patients who received high dose chemotherapy/transplantation, the innate immunodeficiency is an additive risk factor for infectious complications. According to literature, significant association was shown between low concentrations of MBL and serious infections. MBL is a potential modifier of susceptibility to infection in patients who have chemotherapy-induced neutropenia. Furthermore, infections might also compromise the engraftment of stem cells and the development of cell-lines might be prolonged. Patients and methods: The association between serum MBL level and frequency, severity and occurrence of infections has been studied in 127 patients following autologous stem cell transplantation (ASCT). Subgroups, i.e. multiple myeloma, non-Hodgkin and Hodgkin lymphoma were formed and the infectious complications have been compared. A double-monoclonal antibody sandwich ELISA system (BioPorto, Denmark) was used, which is a sensitive method for determining the MBL antigen levels in the sera. The range of MBL level in healthy population varies between 5 and 5000 ng/ml, 〈 100 ng/ml is defined as MBL deficiency. MBL antigen levels were measured following transplantation, in a period without the presence of active infection. Results: 18 patients (out of 127) proved to be MBL deficient. The median time of the onset of first infection was day +5 in MBL deficient, while day +15 among non-MBL deficient patients following transplantation. More infections were found among MBL deficient patients (2.44 vs 2.28 infectious episodes/patient). When patients with more and less than 500 ng/ml serum MBL level were compared, similar trends were seen, but the difference was not significant. The occurrence of absolute MBL deficiency was not different between patients with malignant hematological diseases and the 294 healthy controls (14.5% vs 14%). Interestingly, MBL serum levels were significantly higher in the examined patients with malignant hematological diseases compared to healthy controls. Conclusions: MBL deficiency may predispose to infections. To our best knowledge, this is one of the first reports regarding MBL deficiency in bone marrow transplant settings. Our MBL deficient patients had a greater number of severe infections and experienced their first severe infection earlier, compared to nondeficient patients following ASCT. The measuring of MBL may be helpful in antibiotic treatment, in case of MBL deficiency earlier and more intensive treatment may be indicated. Disclosures: No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    URL: Article
    DOI: 10.1182/blood.V118.21.4492.4492
    RVK:
    XA 33000
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2011
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 3
    Online Resource
    Online Resource
    Retrospective Comparison Of Autologous Transplantation Results Of Decreased MNC Viability Graft Cases (n=52) To Good Viability Graft Cases (n=306), a Single Centre Experience
    American Society of Hematology ; 2013
    In:  Blood Vol. 122, No. 21 ( 2013-11-15), p. 2164-2164
    Details
    In: Blood, American Society of Hematology, Vol. 122, No. 21 ( 2013-11-15), p. 2164-2164
    Abstract: Importance of the viability of stem cell grafts on transplantation outcome is not fully explored; however, presumably better viability results in better posttransplantation disease course. The results of the past eight years gained in our center with autologous hemopoietic stem cell transplantation were analysed, mainly in multiple myeloma (MM), Non-Hodgkin lymphoma (NHL), Hodgkin disease (HD) and some autoimmune diseases. Right before the beginning of the transplantation procedure a small aliquot of the cell products were transferred to a haematological cell counter (Abacus Junior, Diatron, Austria), CD34+ cell counts were established by immunophenotyping, and to assess the global MNC viability trypan blue dye exclusion was used (European Pharmacopoeia 7.0; 01/2008:20729). A retrospective survey of our regular autologous transplant cases and their follow up was analysed in the so called poor viability cases, as opposed to the so called better viability cohort. Our arbitrary poor viability cut off point was less than 81% global MNC viability. To characterize the transplantation outcome the following parameters were used: duration of aplasia, length of neutrophil and platelet engraftment, post transplantation overall survival data. We could not rely upon standard progression free survival asssessment and median survival analysis, due to the broad range of the timing of the interventions (including quite recent cases, too) and also due to changes in therapy along with the new innovative agents used predominantly more recently. We performed 358 autologous transplants between 2006 and June 2013. Considering our viability cut-off point we divided our patients into good viability graft group (n=306) and into poor viability graft group (n=52). The poor viability grafts contained significantly lower stem cells, but we did not identify how this viability data affected the rather mixed other cell lines of the MNC complex. There were no significant differences observed regarding the duration of aplasia, neutrophil and platelet engraftment times between two groups (Table 2).Table 1Main graft parameters in two patient group (Mean±SD)Low viability graftGood viability graftP valueMNC (×108/bw)4.132±3.6894.969±5.881P=0.3215CD34+ (×106/bw)3.554±2.2245.527±2.339P 〈 0.001Table 2Post transplantation parameters in the poor viability graft groupDg 〈 0.5 G/L WBC(day) 〈 20 G/L PLT(day)Aplasia(day)Engraftment time( 〉 1.0 G/L WBC)HD7.69.84.610.3NHL9.210.25.210.2MM4.83.82.910.6 There was no correlation between low viability CD34+ cell number and survival time if analysed independently of the diagnosis. No more severe neutropenic infections (grade III-IV) were registered in the low viability graft cohort compared to the good viability patients. Interestingly 7 out of 11 patients autotransplanted with autoimmune diseases had low viability cell product and this subgroup mortality was better, i.e. 29% compared the good viability cases (less T cells contributing to autoimmunity?). However, the cumulative mortality of the hematological patients was associated with excess mortality in our low viability group (Table 3).Table 3Comparison of graft and mortality of transplantation according to diagnostic subgroups with poor or good graft viability (MNC (×108/bw) and CD34+ (×106/bw); Mean±SD)DgParameterLow viability graftGood viability graftPHDn1238MNC3.625±2.2324.989±4.4700.3161CD34+4.008±2.2205.818±3.3890.09mortality33%24%NHLn15104MNC6.700±5.1355.274±4.4960.2616CD34+3.013±1.5815.145±2.1790.0004mortality47%20%MMn17156MNC2.859±2.3194.797±6.9570.2563CD34+2.971±1.4995.626±2.073 〈 0.0001mortality53%23% Poor viability, defined arbitrarily as 80% or less graft MNC trypan blue stain assay resulted in worse outcome in our retrospective analysis of autografted multiple myeloma, Hodgkin and non-Hodgkin lymphoma cases. The corrected CD34+ count seemed to be less important, as the length of aplasia, engraftment period, severe neutropenic infections, etc. seems to be identical with the good viability cohort results. Our results are suggesting that the diminished viability of non CD34+ components of the graft MNC (most likely T cells) might influence the long-term outcome of autologous transplant patients. This hypothesis needs further support, i.e. well planned, prospective, comprehensive analysis, focusing on the autografted T lymphocytes. Disclosures: No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    URL: Article
    DOI: 10.1182/blood.V122.21.2164.2164
    RVK:
    XA 33000
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2013
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 4
    Online Resource
    Online Resource
    Bortezomib+Chemotherapy Based Salvage Combinations in Refractory AML, Preliminary Results
    American Society of Hematology ; 2008
    In:  Blood Vol. 112, No. 11 ( 2008-11-16), p. 4000-4000
    Details
    In: Blood, American Society of Hematology, Vol. 112, No. 11 ( 2008-11-16), p. 4000-4000
    Abstract: Bortezomib (Velcade) proved to be the standard element of refractory myeloma 2nd and 3rd line treatment, while many studies are suggesting excellent results in 1st line. Proteasome inhibition, the block of angiogenesis, modification of the NF-kappa-B system seems to be a challenging target in other malignant diseases, including refractory acute myeloid leukemia (AML), as well. In vitro data clearly support, that bortezomib exerts antiproliferative and pro-apoptotic effects in different AML cell-lines, along with human AML cell cultures, and moreover bortezomib was able to restore, or at least improve anthracyclin and possibly ARA-C sensitivity in different cell-lines (including AML). More recently, a Phase I trial showed bortezomib monotherapy efficient (only in few percents) in childhood refractory acute leukemia. Some case reports were shown at ASH 2007. We have tried bortezomib containing first or second line combinations in 27 (14 female, 13 male, mean age 57.6 years) patients with refractory or poor risk AML, in a small retrospective survey. The combinations were as follows: HAM or Flag-Ida, combined with bortezomib 1,3 mg pro sqm, day O and seven). The following groups were considered as refractory or poor risk AML: De novo AML, 2nd line: No response/remission to first line standard treatment (“3+7”), n=2 (Velcade- Flag-Ida treatment) De novo AML 1st line: bilineal or biphenotypic (flow-cytometry) n=2 (Velcade-Flag- Ida treatment) De novo AML with complex (numerical or more than 3 abnormalities) karyotype or normal karyotype with flt-3 TKD mutation, n=9, 1st line (Velcade-Flag-Ida n=6, Velcade- HAM protocol, n=3) Secondary AML or AML with evidence of previous more than 6 mo duration high grade MDS, n=14, 1st line: (Velcade-Flag-Ida n=9, Velcade-HAM n=5) RESULTS: Complete remission (CR) 12/27, partial remission (PR) 9/27, no remission 5/27, progression during treatment: 1/27.Best responses were seen in de novo cases. CR had been achieved in all patients of group 1 (two standard risk patients not responding to 3+7 protocol), and group 2 (biphenotypic, bilineal). The CR rate was quite appreciable in group 3, i.e. 6/9 (complex karyotype or normal karyotype with FLt-3 mutation – the response rate was excellent with flt-3 mutated cases). In group 4. (MDS, secondary AML) the results were less impressive. There were no major differences according to protocol (Flag-Ida or HAM) Allogeneous stem cell transplantation could have been performed in 1st CR in two patients (one from group 1. and another from group 2.). One of them died due to relapse, the other one is in CR since then. The combinations seem to be relatively safe. Induction related death rate was low (1 elderly patient acute thrombocytopenic bleeding with refractory MDS-AML). 5 other patients had severe neutropenic sepsis (2 with fatal outcome). Pulmonary syndrome, which may follow Velcade+ARA-C had not been documented. Other adverse events did not differ from the pattern observed with standard induction therapies.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    URL: Article
    DOI: 10.1182/blood.V112.11.4000.4000
    RVK:
    XA 33000
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2008
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
Close ⊗
This website uses cookies and the analysis tool Matomo. More information can be found here...