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  • 1
    In: Blood, American Society of Hematology, Vol. 116, No. 21 ( 2010-11-19), p. 1993-1993
    Abstract: Abstract 1993 Granulysin, cytolytic molecules of cytotoxic T lymphocytes and NK cells, is synthesized as 9-kDa and 15-kDa molecule. 9-kDa granulysin is located intracellularly, whereas 15-kDa granulysin is continuously secreted. We investigated the association between pretreatment serum level of 15-kDa granulysin and prognosis in 63 patients with diffuse large B cell lymphoma (DLBL), initially treated by R-CHOP regimen. The mean pretreament serum level of 15-kDa granulysin level of DLBL patients was significantly lower than that of healthy subjects (p 〈 0.0001) (Figure 1A). To analyze the difference in pretreatment serum granulysin levels according to the underlying patients’ characteristics, they were dichotomized in a prognostically meaningful way. There were no significant differeces according to gender, age, performance, histology, stage, existence of B symptom, international prognostic index (IPI) risk group 7, LDH level, β2-microglobulin level, and response to R-CHOP treatment. Among the patients who achieved complete remission, however, the mean pretreatment serum 15-kDa granulysin level of the patients who experienced recurrence within three years was significantly lower than that of the patients without recurence (p=0.035) (Figure 1B). When patients were sorted into two groups with the median pretreatment serum granulysin value (380 pg/ml), the high granulysin group showed significantly longer progression-free survival (PFS) and overall survival (OS) (p=0.044 and p=0.019, respectively) (Figure 1C-D). On univariate analysis for PFS of 1st line therapy, high IPI risk group (high/high-intermediate) (p 〈 0.0001), the presence of B symptom (p 〈 0.0001), high β2-microglobulin level (p=0.002), bulky disease (single lesion diameter 〉 = 10cm) (p=0.017), and low pretreatment serum granulysin level (p=0.044) were shown to sinigicantly influence PFS unfavorably. However, multivariate analysis showed only IPI risk group to be the significant factor for PFS [p=0.001, hazard ratio(HR) 0.156, 95% CI, 0.053–0.456]. With regard to overall survival (OS), the high IPI risk group (p 〈 0.0001), the presence of B symptom (p 〈 0.0001), high β2-microglobulin level (p=0.002), bulky disease (p=0.012), and low pretreatment serum granulysin level (p=0.019) were shown to be significantly influential. Multivariate analysis showed that IPI risk group [p 〈 0.0001, HR 0.082, 95% CI, 0.025 to 0.268], bulky disease (p=0.035, HR 0.337, 95% CI, 0.122 to 0.929), and pretreatment serum granulysin level (p=0.019, HR 0.038, 95% CI, 0.169 to 0.949) were found to be the significant risk factors for OS. Therefore, the impact of pretreatment serum 15-kDa granulysin level on OS was independent. In conclusion, pretreatment serum level of 15-kDa granulysin might be a valuable independent marker to predict prognosis such as recurrence after response and overall survival in DLBL patients who received R-CHOP as frontline treatment. Disclosures: No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2010
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  • 2
    In: Acta Haematologica, S. Karger AG, Vol. 126, No. 2 ( 2011), p. 79-86
    Abstract: 〈 i 〉 Aim: 〈 /i 〉 Granulysin (cytolytic molecules of cytotoxic T lymphocytes and natural killer cells) is synthesized as cytosolic 9-kDa and secretary 15-kDa isoforms. We evaluated the prognostic significance of the pretreatment serum level of 15-kDa granulysin in patients with diffuse large B cell lymphoma (DLBCL). 〈 i 〉 Patients and Methods: 〈 /i 〉 A retrospective analysis was conducted on 88 DLBCL patients treated homogeneously with standard chemotherapy. The granulysin level was quantified in pretreatment samples. 〈 i 〉 Results: 〈 /i 〉 The granulysin level in DLBCL patients was significantly lower than that in healthy controls (522 ± 496 vs. 1,945 ± 1,696 pg/ml; p 〈 0.0001), and the level in patients who experienced recurrence within 3 years was significantly lower than that of patients without recurrence (305 ± 337 vs. 720 ± 607 pg/ml; p = 0.001). Patients with granulysin levels higher than the median level showed significantly longer progression-free and overall survival according to univariate analysis (p = 0.031 and p = 0.014, respectively). In multivariate analysis, the granulysin level was an independently significant prognostic factor of overall survival (p = 0.018; hazard ratio, 0.521; 95% confidence interval, 0.188–0.841). 〈 i 〉 Conclusions: 〈 /i 〉 Pretreatment serum level of 15-kDa granulysin may be a valuable prognostic marker in DLBCL patients treated with standard chemotherapy.
    Type of Medium: Online Resource
    ISSN: 0001-5792 , 1421-9662
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2011
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  • 3
    In: Cancer Medicine, Wiley, Vol. 12, No. 5 ( 2023-03), p. 5558-5568
    Abstract: Although various coronavirus disease 2019 (COVID‐19) vaccines have been delivered to the public worldwide, data on cancer populations are limited. Vaccine hesitancy related to safety concerns is observed among cancer patients. We report the perception of COVID‐19 vaccines and their safety profile after vaccination among cancer patients. Materials and Methods Between April and November 2021, a multicenter survey was conducted on 318 patients treated in any hemato‐oncology outpatient clinic among three hospitals under the Korea University Medical Center. The medical records of the patients were reviewed to obtain detailed clinical and hematological toxicity data. Results A perception survey was conducted among 293 patients. Among them, 53.9% were concerned about developing vaccine‐related adverse events (VRAEs) and 23.5%, about negative effects on cancer treatment. During the study period, 255 and 186 patients participated in a safety survey after the first and second doses, respectively. After the first dose, 62% of patients reported VRAEs (2.4%, grade 3), whereas 48.9% reported VRAEs (2.7%, grade 3) after the second dose. For both doses, injection‐site pain and sore arm pain were the most common VRAEs, followed by myalgia, fatigue, and headache. No grade 4/5 VRAEs were observed, and there were no differences in complete blood count after vaccination. Multivariate analysis revealed female sex, active cancer treatment, and mRNA vaccines as independent risk factors for VRAE development in cancer patients. Conclusion Despite high levels of concern, COVID‐19 vaccines were well tolerated by cancer patients, with a safety profile consistent with that of the general population.
    Type of Medium: Online Resource
    ISSN: 2045-7634 , 2045-7634
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2023
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  • 4
    In: Blood, American Society of Hematology, Vol. 112, No. 11 ( 2008-11-16), p. 5285-5285
    Abstract: Extranodal marginal zone B cell lymphoma(MZBL), leukemic subtype is a rare B cell neoplasm characterized by peripheral lymphocytosis and bone marrow infiltration without nodal involvement. We report the case of a man who presented a simultaneous bilateral optic neuropathy as the initial clinical manifestation of extranodal MZBL. A 62-year-old man was referred to the Neuro-Ophthalmology Department because of a decrease in visual acuity, dyschromatopsia, visual field defects. Optic disc swelling was present in both eyes with peripapillary hemorrhages. Bilateral anterior ischemic optic neuropathy was diagnosed. Marked visual improvement occurred after 24 hours of intravenous methylprednisolone therapy, and vision completely recovered within a week. Eight weeks later, vision deteriorated again with bilateral optic disc swelling. A magnetic resonance image of the brain and orbit showed only enhancement of the optic nerve. Complete blood count(CBC) studies revealed hyperleukocytosis (13699/uL) with 72 % lymphocytes. There was no anemia and thrombocytopenia. Bone marrow(BM) study showed hypercellular with diffuse infiltration of small lymphocytic cells comprising 65.5% of all nucleasted cells. On immunophenotyping of BM aspirate, lymphocytic cells were CD2-CD3-CD5-CD10-CD23-CD33-CD34-CD117-CD138-cMPO-CD7+CD13+CD19+CD20+CD22+CD45+CD79+FMC7+kappa+lamda-. Cervicothoracic & abdominal CT scan showed no hepatosplenomegaly and no systemic lymphadenopathy. Depending on findings of BM and CT scan, extranodal marginal zone B cell lymphoma, leukemic subtype was diagnosed. Lumbar puncture revealed a white blood cell count of 790/uL with 90% lymphocyte. Flow cytometry was significant for a predominant population of CD3-CD4-CD8-CD20+CD13+ B-cell lymphocytes, diagnostic of cerebrospinal fluid involvement by lymphoma. So we could diagnosed the patient as optic nerve invasion of MZBL without optic nerve biopsy. The patient took several intrathecal chemotherapy with MHA(methotrexate, hydrocortisone, cytosine arabinoside)and 4th systemic treatment with R-CVP(rituximab, cyclophosphamide, prednosone). After all the visual acuity were improved and the infiltrative lesion of lymphoma on both optic nerve was found improved on the following MRI of orbit. The laboratory finding of CBC and CSF were completely normalized.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
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    RVK:
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2008
    detail.hit.zdb_id: 1468538-3
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  • 5
    In: Leukemia Research, Elsevier BV, Vol. 34, No. 3 ( 2010-3), p. 294-300
    Type of Medium: Online Resource
    ISSN: 0145-2126
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2010
    detail.hit.zdb_id: 2008028-1
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  • 6
    In: Blood, American Society of Hematology, Vol. 112, No. 11 ( 2008-11-16), p. 4007-4007
    Abstract: Background: The results of salvage chemotherapy for patient with refractory or relapsed acute myeloid leukemia(AML) have been generally disappointing with low response rates and occasional long-term survivors in most studies. Since therapeutic failure seems to be inevitable in the great majority of these patients, development of more effective salvage therapy is warranted. Recent approaches to the treatment of previously treated AML generally involved the use of cytarabine in intermediate or high-dose alone or in association with new intercalating agents, such as amsacrine, mitoxantrone or idarubicin, etoposide, or asparaginase. Methods: A single course of mitoxantrone 6 mg/m2 intravenous (IV) bolus, etoposide 80 mg/m2 IV for 1 hour, and cytarabine (Ara-C) 1g/m2 IV for 6 hours daily for 6 days (MEC), has been proposed as a salvage regimen. Between October 1998 and May 2005, thirty refractory/relapsed AML patients have been treated by MEC salvage chemotherapy. Twenty two patients were in relapse and eight patients were refractory after conventional induction chemotherapy including cytarabine and idarubicin or mitoxantrone. Two patient were in relapse after allogenous hematopoietic stem cell transplantation(SCT). Results: Complete remission(CR) was obtained in 12 of 30 patients(40%) and 3 of 30(10%) died during salvage treatment: 2 due to intracranial hemorrhage and 1 due to fungemia sepsis. After CR achievement, 5 patients received consolidation chemotherapy. Two patients with an HLA-identical sibling donor underwent allogeneic SCT, and one patient received autologous SCT. Severe myelosuppression was observed in all patients resulting in fever or documented infections in 90% of patients. Nonhematologic toxicity was minimal. At the time of analysis, 9 of 11 patients who achieved CR have relapsed. Median disease-free survival was 12 months. Median overall survival was 13.5 months. There were only two longterm remitters. Several clinicolaboratory and treatment-related variables were analyzed to determine their prognostic significance for CR achievement, duration of CR, overall survival. Conclusions: Our results suggest that MEC combination chemotherapy might induce CR in a patient with refractory or relapsed AML, although new agents or new therapeutic strategies should be required for long term remission.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
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    RVK:
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2008
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
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  • 7
    In: Journal of Clinical Apheresis, Wiley, Vol. 34, No. 5 ( 2019-10), p. 579-588
    Abstract: Single‐dose etoposide was used an outpatient‐based protocol for mobilization in patients with multiple myeloma (MM) for autologous stem cell transplantation (ASCT). Thus, we retrospectively analyzed the efficacy and safety of our one‐day protocol in comparison with that of previous methods. Methods We retrospectively analyzed 168 patients with MM who underwent peripheral blood stem cell collection for upfront ASCT between 2008 and 2018. The mobilization protocols included G‐CSF alone (G‐mobilization), one‐day 375 mg/m 2 of etoposide (E375), two‐days of 375 mg/m 2 of etoposide (E750), or one‐day high‐dose (3.5 g/m 2 ) cyclophosphamide (HD CY). For comparison of efficacy of each protocol, collected CD34+ cells over 4 × 10 6 /kg and under 2 × 10 6 /kg were defined as “adequate harvest” and “harvest failure,” respectively. Results The median number of collected CD34+ cells was 5.58 × 10 6 /kg in patients receiving single‐dose etoposide, and the percentage of uncomplicated optimal harvest of E375 (65.6%, 21/32) was significantly higher than that of E750 (41.9%, 13/31) and HD CY (31.3%, 15/48). The E375 showed the highest rate of adequate harvest (96.9%, 31/32) compared to that of E750 (87.1%), HD CY (75.0%), and G‐mobilization (59.6%). Most E375 patients achieved adequate harvest without complication (29/32, 90.6%), the CD34+ cell collection yield on apheresis days one and two of E375 was not significantly different from that of E750, and no harvest failures occurred for E375. Neutrophil and platelet engraftments were significantly faster in E375 than other groups ( P   〈  .001). Conclusions The use of single‐dose etoposide could be an effective and safe method for mobilization in patients with MM.
    Type of Medium: Online Resource
    ISSN: 0733-2459 , 1098-1101
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2019
    detail.hit.zdb_id: 2001633-5
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  • 8
    In: Blood, American Society of Hematology, Vol. 126, No. 23 ( 2015-12-03), p. 4890-4890
    Abstract: Standard consolidation therapy of acute myeloid leukemia (AML) contains high-dose cytarabine (HiDC). However, optimal dose of cytarabine and benefit of additional chemotherapeutic agents remain unresolved problems. One hundred and forty-two patients among 173 newly diagnosed AML patients, who achieved complete remission following induction chemotherapy and subsequently received different consolidation therapies in 4 independent institutes, were retrospectively analyzed. Patients were divided into 3 groups by consolidation regimens: HiDC (1.5-3g/m2, bid, Days 1,3,5) alone in 44 patients (Group A), HiDC plus anthracycline in 46 patients (Group B), and intermediate-dose cytarabine (1g/m2, bid, Days 1,3,5) plus anthracycline in 52 patients (Group C). Overall survival (OS), relapse-free survival (RFS), disease-free survival (DFS), and event-free survival (EFS), were not significantly different in Group A vs. Group B. However, Group B showed longer RFS, DFS, and EFS, as compared with Group C. Treatment-related mortality was significantly higher in Group B, as compared with Group A (P=0.040) and Group C (P=0.013). Cytogenetic risk was the only significant prognostic factor in OS, RFS, DFS and EFS. In this study, the addition of anthracycline to HiDC as consolidation chemotherapy in AML patients did not improve treatment outcomes, and had more toxicity. HiDC enhanced RFS, DFS, and EFS, as compared with intermediate-dose cytarabine. Therefore, HiDC single therapy could be considered as standard consolidation therapy for non-promyelocytic AML Disclosures Choi: Alexion Pharmaceuticals: Research Funding.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2015
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  • 9
    In: Blood, American Society of Hematology, Vol. 122, No. 21 ( 2013-11-15), p. 2692-2692
    Abstract: Purpose Based on CALGB trial in 1994, 3-4 cycles of high-dose cytarabine have been one of the standard consolidation therapies. Despite the confirmed efficacy of anthracyclines for remission induction, the role of anthracyclines for postremission consolidation is a subject still under debate. In this retrospective analysis, we compared the efficacy of high-dose cytarabine ( 〉 =1.5 g/m2) and intermediate-dose cytarabine (1 g/m2) combined with anthracyclines as postremission therapy. Methods The patients enrolled in the Korea University AML registry from September 2002 to August 2011 were analyzed. Inclusion criteria were as follows; 1) Complete remission was achieved in first induction by standard 3+7 regimen (idarubicin 12 mg/m2 or daunorubicin 45 or 60 or 90 mg/m2 on D1-3 + cytarabine 100 mg/m2 on D1-7) 2) Postremission therapy was performed for 3-4 cycles by one of the following regimen; Arm A (high-dose cytarabine): cytarabine 3 g/m2 for patients = 〈 60 years old or 1.5 g/m2 for patients 〉 60 years old, q 12 hours on D1, 3, 5. Arm B (intermediate-dose cytarabine combined with anthracyclines): cytarabine 1.0 g/m2 q 12 hours on D1-3 combined with mitoxantrone or idarubicin 12 mg/m2 on D1,2. Univariate and multivariate analysis for survival were performed by Kaplan-Meier and Cox-regression analysis, respectively. Results Among 172 AML patients enrolled in the registry, 95 patients (55%) were satisfactory for inclusion criteria. The number of arm A and B was 51 and 44, respectively. Some patients (N=47) with intermediate or high-risk cytogenetics have undergone autologous or allogeneic stem cell transplantation. Univariate analysis for relapse-free survival (RFS) demonstrated that age (= 〈 60 vs. 〉 60, p=0.007), stem cell transplantation (p=0.001), and consolidation regimen (Arm A vs. Arm B, p=0.007) were statistically significant. The median RFS of arm A was not reached and significantly superior to that of arm B (14.0 months, 95% CI 8.5 months to 19.5 months) (Figure 1). Multivariate analysis showed that stem cell transplantation (HR 0.384, 95% CI 0.195 to 0.758, p=0.06) and consolidation regimen (HR 0.454, 95% CI 0.237 to 0.872, p=0.018) were independently significant factors for RFS. With regard to overall survival (OS), age (p 〈 0.001), performance status (ECOG 0,1 vs. 2,3, p 〈 0.001), WBC count at diagnosis ( 〈 20000/μL vs. 〉 =20000/μL, p=0.033), WHO classification (de novo vs. secondary, p=0.05), stem cell transplantation (p=0.001), and consolidation regimen (p=0.007) were statistically significant by univariate analysis. The median OS of arm A was also not reached and significantly superior to that of arm B (18.1 months, 95% CI 7.7 months to 28.5j months) (Figure 2). Multivariate analysis for OS showed that age (HR 0.482, 95% CI 0.248 to 0.939, p=0.032), stem cell transplantation (HR 0.469, 95% CI 0.244 to 0.899, p=0.023), and consolidation regimen (HR 0.474, 95% CI 0.252 to 0.894, p=0.021) were independently significant factors. There was no statistical significance in treatment-related mortality between arm A and arm B (7% and 4%, respectively, p=0.541). Conclusions This analysis showed that as compared with intermediate-dose cytarabine (1.0 g/m2) combined with anthracyclines, high-dose cytarabine consolidation ( 〉 =1.5 g/m2) was independently favorable factor for both RFS and OS in AML patients who had achieved complete remissions in first induction by standard 3+7 regimen. Based on this study, we hypothesize that the addition of anthracycline during consolidation might have a limited value as compared with cytarabine intensification. The confirmatory prospective trial should be required. Disclosures: No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2013
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
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  • 10
    In: Acta Haematologica, S. Karger AG, Vol. 133, No. 3 ( 2015), p. 300-309
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Despite the advances in acute myeloid leukemia (AML) treatment, the prognosis of elderly patients remains poor and no definitive treatment guideline has been established. In the present study, we aimed to evaluate the effectiveness of intensive chemotherapy in elderly AML patients and to determine which subgroup of patients would be most responsive to the therapy. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 We retrospectively analyzed 84 elderly patients: 35, 19, and 30 patients were administered intensive chemotherapy, low-dose chemotherapy, and supportive care, respectively. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Among those who received intensive chemotherapy, there were 17 cases of remission after induction chemotherapy; treatment-related mortality was 22.9%. The median overall survival was 7.9 months. Multivariate analysis indicated that the significant prognostic factors for overall survival were performance status, fever before treatment, platelet count, blast count, cytogenetic risk category, and intensive chemotherapy. Subgroup analysis showed that intensive chemotherapy was markedly effective in the relatively younger patients (65-70 years) and those with de novo AML, better-to-intermediate cytogenetic risk, no fever before treatment, high albumin levels, and high lactate dehydrogenase levels. 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 Elderly AML patients had better outcomes with intensive chemotherapy than with low-intensity chemotherapy. Thus, appropriate subgroup selection for intensive chemotherapy is likely to improve therapeutic outcome. © 2014 S. Karger AG, Basel
    Type of Medium: Online Resource
    ISSN: 0001-5792 , 1421-9662
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2015
    detail.hit.zdb_id: 1481888-7
    detail.hit.zdb_id: 80008-9
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