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
  • American Society of Hematology  (8)
  • 1
    Online Resource
    Online Resource
    Interim Positron Emission Tomography Scan Predicts Early Outcomes Of Patients With Peripheral T-Cell Lymphoma
    American Society of Hematology ; 2013
    In:  Blood Vol. 122, No. 21 ( 2013-11-15), p. 4364-4364
    Details
    In: Blood, American Society of Hematology, Vol. 122, No. 21 ( 2013-11-15), p. 4364-4364
    Abstract: Interim positron emission tomography (PET) scan has shown to be useful for evaluating response in Hodgkin lymphoma. And, there has been increasing interests in using interim PET for predicting outcomes in diffuse large B-cell lymphoma. However, few data are available regarding prognostic value of interim PET in patients with peripheral T cell lymphoma (PTCL). Recently, in an attempt to standardize reporting criteria for interim PET, Deauville five-point scale (5-PS), which visually assess the uptake of lesions in comparison with background mediastinal and liver uptakes, were proposed, but this was not investigated in PTCL. Therefore, the aim of this study was to determine the prognostic role of interim PET, assessed by Deauville 5-PS, in patients with PTCL treated with systemic chemotherapy. Patients and Methods We consecutively enrolled newly diagnosed PTCL patients, treated with systemic chemotherapy (CHOP/CHOP-like or non-anthracycline-based) and had the baseline PET data with ³1 evaluable hypermetabolic lesion between 2006 and 2012 in two Korean institutions. Patients treated with upfront chemoradiotherapy before interim PET scan were excluded. Interim PET scan was performed after 3 cycles of chemotherapy, before 1 week of the next cycle. Interim PET response was visually assessed by 5-PS and four point or higher was regarded as positive. All PET assessment was performed by 2 nuclear medicine specialists at each institution, and the discrepancy of assessment was resolved by the agreement through discussion. Results A total of 35 patients was included in this analysis. The median age was 60 years (range, 31-79) and 26 (74%) were male. Histologic subtypes included were PTCL, not otherwise specified in 10 (29%), extranodal NK/T cell lymphoma in 8 (23%), angioimmunoblastic T cell lymphoma in 7 (20%), anaplastic large cell lymphoma, ALK negative in 4 (11%), and others in 6 (18%). 22 patients (63%) were presented as advanced stage disease and 9 (26%) had B symptoms. ECOG performance status was ≥ 2 in 7 (20%), serum LDH level was elevated in 16 (46%), and bone marrow was involved in 5 (14%). Thus, 14 patients (40%) were classified as high risk (≥ 2 factors) by the prognostic index for PTCL (PIT). 31 patients (89%) completed planned systemic chemotherapy ± involved-field radiotherapy and 25 (71%) achieved complete response by systemic chemotherapy. 10 patients (29%) underwent consolidative autologous stem cell transplantation (ASCT). Using 5-PS, interim PET scan was visually scored as follows; 1 point in 10 patients (29%), 2 in 6 (17%), 3 in 8 (23%), 4 in 7 (20%), and 5 in 4 (11%). Among these, 11 patients (31%) had 4 point or above were considered positive for interim PET scan. With a median follow-up of 43.4 (range, 4.3-89.8) months, progression-free survival (PFS; median, 5.2 vs 38.0 months, respectively; P=0.001) and overall survival (median, 12.6 months vs not reached, respectively; P=0.004) was significantly worse in patients with positive interim PET than those with negative results. In multivariate analysis for PFS, high risk of PIT (HR, 3.67; 95% CI, 1.13-11.99) and positive interim PET (HR, 4.02; 95% CI, 1.32-12.23) were independently associated with faster disease progression, whereas consolidation with ASCT was independent prognostic factor for better PFS (HR, 0.23; 95% CI, 0.06-0.84). Conclusion Visual assessment of interim PET scan using Deauville 5-PS appears to predict early outcomes of patients with PTCL. Patients with positive interim PET shows highly predictive of extremely poor outcomes. Therefore, our findings suggest further studies regarding early stratification based on interim PET results as a response-adapted treatment strategies in patients with PTCL are needed to improve outcomes. Disclosures: No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    URL: Article
    DOI: 10.1182/blood.V122.21.4364.4364
    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
  • 2
    Online Resource
    Online Resource
    Combined Analysis Using Visual and SUV-Based Quantitative Assessments Improves Predictive Value of Interim Positron Emission Tomography Scan in Diffuse Large B-Cell Lymphoma Treated with R-CHOP
    American Society of Hematology ; 2012
    In:  Blood Vol. 120, No. 21 ( 2012-11-16), p. 3690-3690
    Details
    In: Blood, American Society of Hematology, Vol. 120, No. 21 ( 2012-11-16), p. 3690-3690
    Abstract: Abstract 3690 Introduction Positron emission tomography (PET) has been identified as a useful tool for initial staging and end-of-therapy response assessment in patients with diffuse large B-cell lymphoma (DLBCL). However, the role of an interim PET to predict outcome is still controversial. This may be related that reliable criteria to interpret interim PET has not been established. Recently, Deauville five-point scale (5-PS) and standardized uptake value (SUV)-based analysis were proposed for the interpretation of interim PET. However, Deauville 5-PS might still be related to false positive results in some patients and SUV-based analysis not be suitable for patients with low baseline or high interim SUVmax. Therefore, the aim of this study was to investigate the prognostic implication of interim PET interpretation combining visual and SUV-based quantitative assessments in patients with DLBCL treated with R-CHOP chemotherapy. Patients and methods We consecutively enrolled newly diagnosed DLBCL patients, treated with R-CHOP chemotherapy and had the baseline PET data with 31 evaluable hypermetabolic lesion between 2006 and 2011 in two Korean institutions. Interim PET scan was performed after 3 or 4 cycles of R-CHOP, before 1 week of the next cycle. All PET assessment was performed by 2 nuclear medicine specialists at each institution, and the discrepancy of assessment was resolved by the agreement through discussion. Interim PET response was assessed by visual analysis using Deauville 5-PS and quantitative method based on SUVmax reduction rate. After using the receiver operating characteristics analysis, SUVmax reduction 〈 78.6% was selected as optimal cut-off for positive PET. Results One hundred thirty-two patients were included in this study. The median age was 62 years (range, 15–88) and 85 (64%) were male. Sixty-four patients (49%) were presented as advanced stage disease and 30 (23%) had B symptoms. ECOG performance status was 0 or 1 in 100 (76%) and serum LDH level was elevated in 76 (58%). Thus, 44 (33%) were classified as high-intermediate to high risk of International Prognostic Index (IPI). One hundred twenty-three patients (93%) completed planned R-CHOP ± involved-field radiotherapy. Using visual analysis based on Deauville 5-PS and quantitative analysis by SUVmax reduction, 28 (21%) and 26 patients (20%) were positive on interim PET scan, respectively. 18 patients (14%) showed positive PET in agreement between visual and quantitative assessments. However, 10 (8%) of the 28 PET positive patients on visual analysis showed negative PET based on quantitative assessment. Similarly, 8 (6%) among 26 positive patients on quantitative analysis were negative on visual assessment. Thus, 18 patients showed discordant interim PET results between visual and quantitative assessments. With a median follow-up of 25.3 (range, 5.6–75.5) months, 2-year progression-free survival (PFS) was significantly worse in patients with positive interim PET according to visual (27.4% vs. 88.2%, P 〈 0.001) and quantitative (25.4% vs. 86.6%, P 〈 0.001) assessments than those with negative results, respectively. Combining both visual and quantitative assessments, 2-year PFS was significantly different according to the point of positive results in each assessment (0 point, 90.4% vs. 1 point, 57.3% vs. 2 point, 9.3%, respectively, P 〈 0.001). In multivariate analysis for PFS, high-intermediate to high risk of IPI (HR, 4.67; 95% CI, 1.96–11.14) and 2 points in the combined visual and quantitative analysis of interim PET (HR, 7.20; 95% CI, 2.81–18.46) were independent prognostic factors for worse PFS Conclusion Interim PET appears to predict early outcomes of patients with DLBCL treated with R-CHOP. A positive interim PET in both analyses shows highly predictive of extremely poor outcome. Therefore, combined analysis of visual and SUV-based quantitative assessments makes it possible to more clearly differentiate the clinical outcomes in patients with DLBCL. Further studies are needed to validate our results. Disclosures: No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    URL: Article
    DOI: 10.1182/blood.V120.21.3690.3690
    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
  • 3
    Online Resource
    Online Resource
    Risk Stratification Integrating Deauville Score on Interim PET-CT Scan and Baseline International Prognostic Index in Diffuse Large B-Cell Lymphoma Patients
    American Society of Hematology ; 2018
    In:  Blood Vol. 132, No. Supplement 1 ( 2018-11-29), p. 1698-1698
    Details
    In: Blood, American Society of Hematology, Vol. 132, No. Supplement 1 ( 2018-11-29), p. 1698-1698
    Abstract: Background Interim 18F-fluorodeoxyglucose positron emission tomography-computed tomography (PET-CT) scan may predict outcomes in patients with diffuse large B-cell lymphoma (DLBCL). However, overall accuracy in predicting treatment outcomes on adopting 5-point Deauville score (DS) was considerably low in DLBCL because of mainly low positive predictive value of interim PET-CT scans. This suggested that additional tool might be needed to more accurately predict treatment outcomes. International prognostic index (IPI) was greatly associated with outcomes for DLBCL and considered to reflect biologic aggressiveness of DLBCL. Thus, we hypothesized that combined assessments using DS on interim PET-CT scan and baseline IPI might improve the prediction of treatment outcomes in DLBCL patients. In this study, we aimed to establish the risk predicting model integrating DS on interim PET-CT as an estimate of early metabolic response and baseline IPI as a predictor of biologic aggressiveness in patients with newly diagnosed DLBCL. Methods In this retrospective cohort study, we consecutively enrolled patients with newly diagnosed DLBCL. Patients were eligible if they were histologically confirmed with DLBCL from Jan 2007 to June 2016, received R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone), and had PET-CT scan data at baseline and at interim after 3 cycles of R-CHOP. Primary CNS or transformed DLBCLs were excluded. Interim PET-CT was assessed using 5-point DS and four point or higher was regarded as positive. All PET-CT scans were assessed by 2 experienced nuclear medicine physicians, who were masked to treatment outcomes of the patients. Discrepant interpretations between 2 nuclear medicine physicians were resolved by consensus through mutual discussion. Results A total of 316 patients were screened for eligibility. Ninety-six patients were excluded from the analysis due to following reasons: unavailable baseline (n=9) or interim PET-CT scans (n=48), early death before interim PET-CT (n=16), Primary CNS or transformed DLBCLs (n=15), and insufficient medical records (n=8). Thus, 220 patients were analyzed. Median age was 64 years (range, 19-87) and 132 (60%) were male. Based on the IPI risk, patients were classified as the low or low-intermediate (LI; N=126, 57%), and high-intermediate (HI) or high (N=94, 43%) groups. Interim DS was determined as 1 (n=67, 30.5%), 2 (n=65, 29.5%), 3 (n=39, 17.7%), 4 (n=36, 16.4%), and 5 (n=13, 5.9%). With a median follow-up of 56.6 months (IQR 36.0-71.8), 5-year progression-free survival (PFS) rate was 65.2% (95% CI, 58.1-72.3) and overall survival (OS) rate was 69.9% (95% CI, 63.2-76.6). Interim DS (1-3 vs 4-5) and the IPI (low-LI vs HI-high) were independently associated with PFS (for interim DS of 4-5, hazard ratio [HR], 2.96 [95% CI, 1.83-4.78] , P 〈 0.001; for HI-high IPI, HR, 4.84 [2.84-8.24], P 〈 0.001) and OS (for interim DS of 4-5, HR, 2.98 [1.79-4.98], P 〈 0.001; for HI-high IPI, HR, 5.75 [3.14-10.51], P 〈 0.001) in the multivariate analysis. We stratified patients into 3 groups based on the risk of progression: Low (low-LI IPI and interim DS 1-3), Intermediate (low-LI IPI with interim DS 4-5, or HI-high IPI with interim DS 1-3), and High (HI-high IPI and interim DS 4-5) risk groups. The risk stratification model showed a significant association with PFS (for low risk vs intermediate risk, HR 3.98 [95% CI, 2.10-7.54], P 〈 0.001; for low risk vs high risk, HR 13.97 [7.02-27.83], P 〈 0.001; Fig 1A) and OS (for low risk vs intermediate risk, HR 4.14 [2.01-8.54], P 〈 0.001; for low risk vs high risk, HR 16.05 [7.59-33.94], P 〈 0.001; Fig 1B). Conclusion Combining interim DS with baseline IPI can improve risk stratification in patients with newly diagnosed DLBCL. Figure 1. Figure 1. Disclosures No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    URL: Article
    DOI: 10.1182/blood-2018-99-114365
    RVK:
    XA 33000
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2018
    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
    Pleural Effusion in Dasatinib-Treated Chronic Myeloid Leukemia Patients after Imatinib Failure
    American Society of Hematology ; 2008
    In:  Blood Vol. 112, No. 11 ( 2008-11-16), p. 4270-4270
    Details
    In: Blood, American Society of Hematology, Vol. 112, No. 11 ( 2008-11-16), p. 4270-4270
    Abstract: Dasatinib, as a 2nd generation tyrosine kinase inhibitor, is an effective Bcr-Abl kinase inhibitor for chronic myeloid leukemia (CML) with more than 300-fold and 20-fold potency than imatinib and nilotinib, respectively. Through a series of phase I and II clinical trials, dasatinib has demonstrated durable efficacy in CML patients with resistance, suboptimal response, or intolerance to imatinib. However, some adverse effects from dasatinib therapy have been reported in several studies. Among them, pleural effusion is one of the most common adverse effects, and was reported in 15 to 30% of patients. We investigated the development of pleural effusion from 64 Korean patients registered in a single center for a phase II study which was approved by the institutional review committee and carried out in accordance with the Declaration of Helsinki with informed consent provided from patients. All the patients are under dasatinib therapy after failure of imatinib treatment (22 patients with intolerance and 44 patients with resistance). Median age was 44 years old (range, 18 to 65) and median duration of dasatinib therapy was 29 months (range, 0.5 to 41). The patients were in different phases including 30 in chronic phase (CP) and 30 in accelerated phase (AP) when they started dasatinib treatment. We found that 23 patients (36%) experienced pleural effusion of any grade (grade 1/2 in 22, grade 3/4 in 1) at least one time. Among the 23 patients, 14 (61%) patients experienced recurrent pleural effusion, and two of them showed a change in grade from grade 1 to 2. The median time to the first occurrence of pleural effusion was 18 weeks (range, 1 to 132), developing within the first 6 months and 12 months of treatment in 13 patients (57%) and in 15 patient (65%), respectively, while the adverse effect occurred even after 28 months (2.3 years) of treatment in 3 patients (13%). Age, gender, previous interferon a treatment, duration of imatinib treatment, and duration of dasatinib treatment were not significantly different between patients without pleural effusion and patients developed pleural effusion. However, disease phase when dasatinib therapy started showed significant difference (P=0.002) in the development of pleural effusion. Patients in AP showed higher cumulative % of pleural effusion in comparison with those in CP (16/34, 47% vs. 7/30, 23%). Daily dose amount and dose schedule also gave an influence on occurrence of pleural effusion. We used 4 different categories in dose amount and dose schedule; 100 mg QD (n=3), 140 mg QD (n=32), 50 mg BID (n=7) and 70 mg BID (n=22). Frequency of pleural effusion was higher in the patients treated with BID schedule than in QD schedule (56% vs. 22%, P=0.005), and also higher in the patients treated with 140 mg per day than in 100 mg per day, but not significant (39% vs. 20%, P=0.23). Among 4 categories, 70 mg BID showed relatively higher % of pleural effusion (64%, 14/22, P=0.006). To see whether dose amount or dose schedule can influence on efficacy, we investigate cytogenetic responses from patients. Portion of complete cytogenetic response (CCyR) was not significantly different in 100 mg doge group and 140 mg dose group (67% vs. 64%). Time to achieving CCyR showed no significant difference (P=0.21) between 100 mg dose group (median 3 months, range; 2 to 17) and 140 mg dose group (median 6 month, range; 1 to 18). In addition, dose schedule did not make any significant difference in portion of achieving CCyR between QD group and BID group (60% vs. 59%). Based on the observed characteristics of pleural effusion and analysis of cytogenetic response in this study, lower dose (100 mg) administration by QD can be proposed for dasatinib therapy to reduce any possible occurrence of pleural effusion. Figure Figure
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    URL: Article
    DOI: 10.1182/blood.V112.11.4270.4270
    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
  • 5
    Online Resource
    Online Resource
    Clinical Characteristics and Outcome of 20 Imatinib Mesylate Resistant Patients with T315I BCR-ABL Mutation.
    American Society of Hematology ; 2007
    In:  Blood Vol. 110, No. 11 ( 2007-11-16), p. 1954-1954
    Details
    In: Blood, American Society of Hematology, Vol. 110, No. 11 ( 2007-11-16), p. 1954-1954
    Abstract: Most CML patients are sensitive to imatinib mesylate (IM), however, a small fraction develop resistance, mostly through the emergence onset of BCR-ABL mutation. Dasatinib and nilotinib, novel tyrosine kinase inhibitors (NTKIs), are active against most of IM resistant BCR-ABL kinase domain mutants except T315I. Although T315I mutation has been highly resistant to IM and both NTKIs, precise clinical characteristics and outcome have not been known yet. A total of 81 patients with various phases of CML who were intolerant or were resistant to IM (M:F-52:29, median age: 43 years, range; 12–74 years) were enrolled in this study between May 2005 and Sep 2006. Eighty one patients had received dasatinib and/or nilotinib in phase II or extended access program. At the time of IM failure and every 3 months during NTKIs treatment, mutations were screened by both ASO-PCR and direct sequencing. Clinical characteristics and outcome probabilities were statistically analyzed. T315I was detected in 20 of 31 patients (65%) harboring kinase domain mutations; 9 patients had mutation before NTKIs treatment and 11 patients were developing mutation after NTKIs treatment. Median age was 33 years (range, 19–74 years). Transcripts were Major BCR for all patients and 8 patients had received prior interferon therapy. 6 patients had additional chromosomal abnormalities (ACA) at diagnosis. At the time of T315I emergence, 8 patients were CP, 6 patients were AP, and 6 in BC (4 in myeloid and 2 in lymphoid). Median accumulate dose per day was 398.8 mg/day (range, 205.3–600.0 mg/day). 13 patients were received dasatinib, 5 received nilotinib and 2 received both dasatinib and nilotinib. The best response to NTKIs was complete cytogenetic response (CCyR) in 6 and complete hematologic response (CHR) in 8. Median overall survival (OS) from NTKIs start was 7.0 months for advanced phase and 12.3 months for chronic phase. The 3 year survival rate was 21.5%, with median value was 8.4 months in all patients. With NTKIs therapies [median follow-up, 9.7 months (range, 0.7–27.3 months)] , 8 patients are alive (40%); 6 patients are alive with active disease and 2 patients are alive with ongoing response. 10 patients died of disease progression and 2 patients died of pneumonia. Low grade disease phase at discovery of T315I mutation (log-rank P=0.0237) demonstrated significantly favorable outcome but after NTKIs treatment, there was no difference in OS between disease phases (log-rank P=0.271). And there was no difference in OS between T315I mutation and other mutations (P=0.147). However the ACA at diagnosis (P=0.029) and achievement of best CCyR during NTKIs treatment (P=0.085) was different in OS. And there was significant difference in survival between patients with and without ACA and achievement of best CCyR during NTKIs treatment (log-rank P=0.0235), suggesting they have prognostic influences on survival as T315I mutation. In summary, our findings confirm that ACA at diagnosis and achievement of best CCyR during NTKIs treatment are statistically significant prognostic information with respect to survival probability at patients with T315I mutation. However T315I mutation was highly resistant to NTKIs as well as IM, and are associated with poor outcome. As diverse outcomes in patients with T315I mutation have been demonstrated, different strategies such as MK-0457 and/or novel T315I mutation inhibitor should be applied.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    URL: Article
    DOI: 10.1182/blood.V110.11.1954.1954
    RVK:
    XA 33000
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2007
    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
  • 6
    Online Resource
    Online Resource
    Orally bioavailable BTK PROTAC active against wild-type and C481 mutant BTKs in human lymphoma CDX mouse models
    American Society of Hematology ; 2023
    In:  Blood Advances Vol. 7, No. 1 ( 2023-01-10), p. 92-105
    Details
    In: Blood Advances, American Society of Hematology, Vol. 7, No. 1 ( 2023-01-10), p. 92-105
    Abstract: Bruton tyrosine kinase (BTK) is an important signaling hub that activates the B-cell receptor (BCR) signaling cascade. BCR activation can contribute to the growth and survival of B-cell lymphoma or leukemia. The inhibition of the BCR signaling pathway is critical for blocking downstream events and treating B-cell lymphomas. Herein, we report potent and orally available proteolysis-targeting chimeras (PROTACs) that target BTK to inactivate BCR signaling. Of the PROTACs tested, UBX-382 showed superior degradation activity for wild-type (WT) and mutant BTK proteins in a single-digit nanomolar range of half-maximal degradation concentration in diffuse large B-cell lymphoma cell line. UBX-382 was effective on 7 out of 8 known BTK mutants in in vitro experiments and was highly effective in inhibiting tumor growth in murine xenograft models harboring WT or C481S mutant BTK–expressing TMD-8 cells over ibrutinib, ARQ-531, and MT-802. Remarkably, oral dosing of UBX-382 for & lt;2 weeks led to complete tumor regression in 3 and 10 mg/kg groups in murine xenograft models. UBX-382 also provoked the cell type–dependent and selective degradation of cereblon neosubstrates in various hematological cancer cells. These results suggest that UBX-382 treatment is a promising therapeutic strategy for B-cell–related blood cancers with improved efficacy and diverse applicability.
    Type of Medium: Online Resource
    ISSN: 2473-9529 , 2473-9537
    URL: Article
    DOI: 10.1182/bloodadvances.2022008121
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2023
    detail.hit.zdb_id: 2876449-3
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 7
    Online Resource
    Online Resource
    Hematopoietic Progenitor Cell Counts Is a Useful Indicator To Determine Appropriate Time For Peripheral Blood Stem Cell Collection
    American Society of Hematology ; 2013
    In:  Blood Vol. 122, No. 21 ( 2013-11-15), p. 2037-2037
    Details
    In: Blood, American Society of Hematology, Vol. 122, No. 21 ( 2013-11-15), p. 2037-2037
    Abstract: The optimal peripheral blood stem cell (PBSC) collection is a key step for successful outcome in hematopoietic stem cell transplantation (HSCT). Many indicators including preharvest white blood cell (WBC), mononuclear cell (MNC), and CD34 positive cell counts have been used for deciding the adequate time for collection of PBSCs, but each indicator has limitations. Here we investigated hematopoietic progenitor cell (HPC) count as an indicator for PBSC collection. Methods: Data from 851 autologous PBSC collections from 233 patients at the National Cancer Center, Korea, were analyzed. The correlations between harvested CD34 cell counts with preharvest WBC, MNC, CD34 cell counts, and HPC were analyzed, as were correlations by disease and mobilizing agent. Also how the outcome for engraftment can be predicted based on HPC count was studied. Results: The median age of patients was 41 years (range 0.1-72 years). The most frequent diseases were multiple myeloma (n=64) and non-Hodgkin lymphoma (n=56). The correlation coefficient between collected CD34 cells and preharvest CD34 count was (r=0.669, p 〈 0.001), followed by preharvest HPC count (r=0.419, p 〈 0.001), preharvest MNC (r=0.190, p 〈 0.001) and preharvest WBC (r=0.014, p=0.679). The most adequate cut-off value for obtaining 〉 1x106 CD34+ cells/kg at first time of PBSC was 24.0 HPCs/μL with sensitivity and specificity of 67.7% and 74.3% respectively. The cutoff as 28.0 HPCs/μL was adequate for obtaining 2.0 x106 CD34+ cells/kg with sensitivity and specificity of 73.7% and 72.2% respectively. HPC was well correlated with CD34 in PBSC of patients with multiple myeloma (r=0.326, p=0.009), non-Hodgkin lymphoma (r=0.353, p=0.008), especially diffuse large B-cell lymphoma (r=0.810, p 〈 0.001) and acute leukemia (r=0.998, p 〈 0.001). HPC was a better indicator for non-cyclophosphamide (r=0.337, p 〈 0.001) than cyclophosphamide-based chemomobilization (r=0.572, p=0.052). Infused number of HPCs did not affect the times to engraftment of platelets (p=0.896) and neutrophils (p=0.953), though CD34 count of infusion had positive effect on platelet engraftment (p=0.017). Conclusion: HPC count represented good correlation with CD34+ and high area under the curve. Considering advantages of ease for use and cost-effectiveness than those of CD34 count, HPC is a good surrogate marker to determine appropriate timing for PBSC. Disclosures: No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    URL: Article
    DOI: 10.1182/blood.V122.21.2037.2037
    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
  • 8
    Online Resource
    Online Resource
    Long-Term Follow-up Results after Imatinib Discontinuation in Chronic Myeloid Leukemia Patients with Undetectable Minimal Residual Disease
    American Society of Hematology ; 2014
    In:  Blood Vol. 124, No. 21 ( 2014-12-06), p. 4553-4553
    Details
    In: Blood, American Society of Hematology, Vol. 124, No. 21 ( 2014-12-06), p. 4553-4553
    Abstract: Introduction Imatinib (IM) is an effective treatment in patients with chronic phase chronic myeloid leukemia (CML-CP). In the previous report (Leukemia research, 2012;36:689-693), we demonstrated that IM could be discontinued in CML patients achieved undetectable minimal residual disease (UMRD) after the treatment of front-line IM therapy. These observations were confirmed by prospective STIM1 and TWISTER studies. However, in both studies, approximately half of patients were treated with front-line interferon therapy, which might be a confounding factor when considering the impact of prior interferon on treatment free remission (TFR) in the previous IM discontinuation studies. Thus, the aim of this study was to investigate the long-term outcomes of IM discontinuation in patients with CML-CP, who have treated with front-line IM therapy and achieved UMRD. Patients and methods We consecutively enrolled patients with CML-CP, discontinued IM therapy after achieving UMRD for at least 12 months in 2 Korean institutions from June 2009 to Jan 2013. Patients with a prior history of any other treatment ( 〉 1 months) for CML before IM administration were excluded. UMRD was defined by undetectable levels of BCR-ABL transcript by RQ-PCR with sensitivity of at least 0.0046%IS. After discontinuation, BCR-ABL/ABL ratio was monitored by RQ-PCR monthly during the first 6 months and every 3 months thereafter, and molecular relapse was defined by detectable levels of BCR-ABL transcript in two successive assays. Results Nineteen patients (8 male, 11 female) with a median age of 52 years (range, 29-78) were included. The reasons for discontinuing IM were shared decision between physicians and patients with long undetectable BCR-ABL transcript (n=9), chronic adverse events of IM (n=6), patient’s request (n=3), and wish for pregnancy (n=1). At initial diagnosis, the Sokal score was low to intermediate in 11 patients and high in 8 patients. All patients started IM at a dose of 400mg/day and median interval between IM initiation and UMRD was 21.5 months (range, 7.0-61.9). IM therapy was then maintained during a median of 34.8 months (range, 12.1-72.4). With a median follow-up of 52.1 months (range, 17.5-60.5), the overall probability of UMRD persistence at 4-year was 22.1% (95% CI, 11.6-32.6). Fourteen patients (73%) lost UMRD after a median of 4.0 months (range, 1.1-22.8). 12 patients relapsed within first 9 months and 2 late relapse were identified at 20.5 and 22.8 months, respectively. No patients included in this analysis were progressed to advanced stage CML or died. IM therapy was resumed in all patients with molecular relapse, but 2 patients were switched to dasatinib owing to chronic adverse events of IM. At the time of this analysis, all patients were still sensitive to IM and dasatinib therapy. 12 patients re-achieved UMRD and 2 patients maintained stable major molecular response. In univariate analysis for molecular relapse, high risk of Sokal score (P 〈 0.001), ≥24 months of interval between IM initiation and UMRD (P=0.016), and 〈 34.8 months of duration of IM therapy after UMRD achievement (P=0.029) were significantly associated with frequent molecular relapse. Conclusion This study represents that IM discontinuation in patients who have received front-line IM therapy and achieved UMRD would be feasible, as approximately one-fourth of these patients could enjoy long-term TFR. Moreover, no molecular relapse was observed after 2 year of IM discontinuation. Although the Sokal score, time to deep molecular response, and duration of IM therapy were suggested as clinical factors for predicting molecular relapse in this analysis, further studies would be necessary to confirm the results in this population. Disclosures No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    URL: Article
    DOI: 10.1182/blood.V124.21.4553.4553
    RVK:
    XA 33000
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2014
    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...