101
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Jiménez C, Chan GG, Xu L, Tsakmaklis N, Kofides A, Demos MG, Chen J, Liu X, Munshi M, Yang G, Castillo JJ, Wiestner A, García-Sanz R, Treon SP, Hunter ZR. Genomic evolution of ibrutinib-resistant clones in Waldenström macroglobulinaemia. Br J Haematol 2020; 189:1165-1170. [PMID: 32103491 DOI: 10.1111/bjh.16463] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 12/06/2019] [Indexed: 12/28/2022]
Abstract
Ibrutinib is highly active in Waldenström macroglobulinaemia (WM) patients, but disease progression can occur due to acquired mutations in BTK, the target of ibrutinib, or PLCG2, the protein downstream of BTK. However, not all resistant patients harbour these alterations. We have performed a whole-exome sequencing study to identify alternative molecular mechanisms that can drive ibrutinib resistance. Our findings include deletions on chromosomes 6q, including homozygous deletions, and 8p, which encompass key regulators of BTK, MYD88/NF-κB, and apoptotic signalling. Moreover, we have identified recurring mutations in ubiquitin ligases, innate immune signalling, and TLR/MYD88 pathway regulators in ibrutinib-resistant WM patients.
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Affiliation(s)
- Cristina Jiménez
- Bing Center for Waldenstrom's Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Gloria G Chan
- Bing Center for Waldenstrom's Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Lian Xu
- Bing Center for Waldenstrom's Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Nickolas Tsakmaklis
- Bing Center for Waldenstrom's Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Amanda Kofides
- Bing Center for Waldenstrom's Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Maria G Demos
- Bing Center for Waldenstrom's Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Jiaji Chen
- Bing Center for Waldenstrom's Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Xia Liu
- Bing Center for Waldenstrom's Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Manit Munshi
- Bing Center for Waldenstrom's Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Guang Yang
- Bing Center for Waldenstrom's Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Jorge J Castillo
- Bing Center for Waldenstrom's Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Adrian Wiestner
- Hematology Branch, National Heart, Lung and Blood Institute, Bethesda, MD, USA
| | - Ramón García-Sanz
- Servicio de Hematología, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro de Investigación Biomédica en Red Cáncer, Salamanca, Spain
| | - Steven P Treon
- Bing Center for Waldenstrom's Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Zachary R Hunter
- Bing Center for Waldenstrom's Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
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102
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Treon SP, Xu L, Guerrera ML, Jimenez C, Hunter ZR, Liu X, Demos M, Gustine J, Chan G, Munshi M, Tsakmaklis N, Chen JG, Kofides A, Sklavenitis-Pistofidis R, Bustoros M, Keezer A, Meid K, Patterson CJ, Sacco A, Roccaro A, Branagan AR, Yang G, Ghobrial IM, Castillo JJ. Genomic Landscape of Waldenström Macroglobulinemia and Its Impact on Treatment Strategies. J Clin Oncol 2020; 38:1198-1208. [PMID: 32083995 DOI: 10.1200/jco.19.02314] [Citation(s) in RCA: 91] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Next-generation sequencing has revealed recurring somatic mutations in Waldenström macroglobulinemia (WM), including MYD88 (95%-97%), CXCR4 (30%-40%), ARID1A (17%), and CD79B (8%-15%). Deletions involving chromosome 6q are common in patients with mutated MYD88 and include genes that modulate NFKB, BCL2, Bruton tyrosine kinase (BTK), and apoptosis. Patients with wild-type MYD88 WM show an increased risk of transformation and death and exhibit many mutations found in diffuse large B-cell lymphoma. The discovery of MYD88 and CXCR4 mutations in WM has facilitated rational drug development, including the development of BTK and CXCR4 inhibitors. Responses to many agents commonly used to treat WM, including the BTK inhibitor ibrutinib, are affected by MYD88 and/or CXCR4 mutation status. The mutation status of both MYD88 and CXCR4 can be used for a precision-guided treatment approach to WM.
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Affiliation(s)
- Steven P Treon
- Bing Center for Waldenström's Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA.,Department of Medicine, Harvard Medical School, Boston, MA
| | - Lian Xu
- Bing Center for Waldenström's Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA
| | - Maria Luisa Guerrera
- Bing Center for Waldenström's Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA.,Department of Medicine, Harvard Medical School, Boston, MA
| | - Cristina Jimenez
- Bing Center for Waldenström's Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA.,Department of Medicine, Harvard Medical School, Boston, MA
| | - Zachary R Hunter
- Bing Center for Waldenström's Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA.,Department of Medicine, Harvard Medical School, Boston, MA
| | - Xia Liu
- Bing Center for Waldenström's Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA.,Department of Medicine, Harvard Medical School, Boston, MA
| | - Maria Demos
- Bing Center for Waldenström's Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA
| | - Joshua Gustine
- Bing Center for Waldenström's Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA
| | - Gloria Chan
- Bing Center for Waldenström's Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA
| | - Manit Munshi
- Bing Center for Waldenström's Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA
| | - Nicholas Tsakmaklis
- Bing Center for Waldenström's Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA
| | - Jiaji G Chen
- Bing Center for Waldenström's Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA
| | - Amanda Kofides
- Bing Center for Waldenström's Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA
| | - Romanos Sklavenitis-Pistofidis
- Department of Medicine, Harvard Medical School, Boston, MA.,Center for Prevention of Progression of Blood Cancers, Dana-Farber Cancer Institute, Boston, MA.,Clinical Research Development and Phase I Unit, CREA Laboratory, Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia, Brescia, Italy
| | - Mark Bustoros
- Department of Medicine, Harvard Medical School, Boston, MA.,Center for Prevention of Progression of Blood Cancers, Dana-Farber Cancer Institute, Boston, MA
| | - Andrew Keezer
- Bing Center for Waldenström's Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA
| | - Kirsten Meid
- Bing Center for Waldenström's Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA
| | | | - Antonio Sacco
- Center for Prevention of Progression of Blood Cancers, Dana-Farber Cancer Institute, Boston, MA.,Clinical Research Development and Phase I Unit, CREA Laboratory, Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia, Brescia, Italy
| | - Aldo Roccaro
- Clinical Research Development and Phase I Unit, CREA Laboratory, Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia, Brescia, Italy
| | - Andrew R Branagan
- Division of Hematology and Oncology, Massachusetts General Hospital, Boston, MA
| | - Guang Yang
- Bing Center for Waldenström's Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA.,Department of Medicine, Harvard Medical School, Boston, MA
| | - Irene M Ghobrial
- Department of Medicine, Harvard Medical School, Boston, MA.,Center for Prevention of Progression of Blood Cancers, Dana-Farber Cancer Institute, Boston, MA
| | - Jorge J Castillo
- Bing Center for Waldenström's Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA.,Department of Medicine, Harvard Medical School, Boston, MA
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103
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Munshi M, Liu X, Chen JG, Xu L, Tsakmaklis N, Demos MG, Kofides A, Guerrera ML, Jimenez C, Chan GG, Hunter ZR, Palomba ML, Argyropoulos KV, Meid K, Keezer A, Gustine J, Dubeau T, Castillo JJ, Patterson CJ, Wang J, Buhrlage SJ, Gray NS, Treon SP, Yang G. SYK is activated by mutated MYD88 and drives pro-survival signaling in MYD88 driven B-cell lymphomas. Blood Cancer J 2020; 10:12. [PMID: 32005797 PMCID: PMC6994488 DOI: 10.1038/s41408-020-0277-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 12/30/2019] [Accepted: 01/13/2020] [Indexed: 12/27/2022] Open
Abstract
Activating MYD88 mutations promote pro-survival signaling through BTK and HCK, both targets of ibrutinib. Despite high response rates, complete responses to ibrutinib are lacking, and other MYD88 triggered pro-survival pathways may contribute to primary drug resistance. B-cell receptor (BCR) signaling has been observed in lymphomas driven by mutated MYD88, even without activating the BCR pathway mutations. We identified activated SYK (p-SYK), a component of BCR in complex with MYD88 in MYD88-mutated WM and ABC DLBCL lymphoma cells. Confocal microscopy confirmed co-localization of MYD88 with SYK in MYD88-mutated cells. Knockdown of MYD88 or use of a MYD88 signaling inhibitor abrogated SYK activation, while expression of mutated but not wild-type MYD88 amplified p-SYK in MYD88-mutated and wild-type lymphoma cells. Knockdown of SYK or use of inhibitors targeting SYK blocked p-STAT3 and p-AKT signaling in MYD88-mutated cells. Cell viability analysis showed that combining ibrutinib and SYK inhibitors triggered synthetic killing of MYD88-mutated lymphoma cells. Our findings extend the spectrum of mutated MYD88 pro-survival signaling to include SYK directed BCR cross talk in MYD88-mutated lymphomas. Targeting SYK in combination with ibrutinib produces synthetic lethality, providing a framework for the clinical investigation of ibrutinib with SYK inhibitors in MYD88-mutated lymphomas.
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Affiliation(s)
- Manit Munshi
- Bing Center for Waldenstrom's Macroglobulinemia, Dana Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
| | - Xia Liu
- Bing Center for Waldenstrom's Macroglobulinemia, Dana Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
| | - Jiaji G Chen
- Bing Center for Waldenstrom's Macroglobulinemia, Dana Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
| | - Lian Xu
- Bing Center for Waldenstrom's Macroglobulinemia, Dana Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
| | - Nickolas Tsakmaklis
- Bing Center for Waldenstrom's Macroglobulinemia, Dana Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
| | - Maria G Demos
- Bing Center for Waldenstrom's Macroglobulinemia, Dana Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
| | - Amanda Kofides
- Bing Center for Waldenstrom's Macroglobulinemia, Dana Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
| | - Maria Luisa Guerrera
- Bing Center for Waldenstrom's Macroglobulinemia, Dana Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
| | - Cristina Jimenez
- Bing Center for Waldenstrom's Macroglobulinemia, Dana Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
| | - Gloria G Chan
- Bing Center for Waldenstrom's Macroglobulinemia, Dana Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
| | - Zachary R Hunter
- Bing Center for Waldenstrom's Macroglobulinemia, Dana Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
- Department of Medical Oncology, Dana Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
| | - M Lia Palomba
- Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Kirsten Meid
- Bing Center for Waldenstrom's Macroglobulinemia, Dana Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
| | - Andrew Keezer
- Bing Center for Waldenstrom's Macroglobulinemia, Dana Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
| | - Joshua Gustine
- Bing Center for Waldenstrom's Macroglobulinemia, Dana Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
| | - Toni Dubeau
- Bing Center for Waldenstrom's Macroglobulinemia, Dana Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
- Department of Medical Oncology, Dana Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
| | - Jorge J Castillo
- Bing Center for Waldenstrom's Macroglobulinemia, Dana Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
- Department of Medical Oncology, Dana Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
| | - Christopher J Patterson
- Bing Center for Waldenstrom's Macroglobulinemia, Dana Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
| | - Jinhua Wang
- Department of Biological Chemistry and Molecular Pharmacology, Harvard Medical School, Boston, MA, USA
| | - Sara J Buhrlage
- Department of Biological Chemistry and Molecular Pharmacology, Harvard Medical School, Boston, MA, USA
| | - Nathanael S Gray
- Department of Biological Chemistry and Molecular Pharmacology, Harvard Medical School, Boston, MA, USA
| | - Steven P Treon
- Bing Center for Waldenstrom's Macroglobulinemia, Dana Farber Cancer Institute and Harvard Medical School, Boston, MA, USA.
- Department of Medical Oncology, Dana Farber Cancer Institute and Harvard Medical School, Boston, MA, USA.
| | - Guang Yang
- Bing Center for Waldenstrom's Macroglobulinemia, Dana Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
- Department of Medical Oncology, Dana Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
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104
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Castillo JJ, Itchaki G, Gustine JN, Meid K, Flynn CA, Demos MG, Guerrera ML, Jimenez C, Kofides A, Liu X, Munshi M, Tsakmaklis N, Patterson CJ, Xu L, Yang G, Hunter ZR, Treon SP. A matched case-control study comparing features, treatment and outcomes between patients with non-IgM lymphoplasmacytic lymphoma and Waldenström macroglobulinemia. Leuk Lymphoma 2020; 61:1388-1394. [PMID: 31992103 DOI: 10.1080/10428194.2020.1719100] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Cases of non-IgM lymphoplasmacytic lymphoma (LPL) are rare. We performed a case-control study comparing features and outcomes of 31 non-IgM LPL cases and 93 Waldenström macroglobulinemia (WM) controls matched by age, sex, and year of diagnosis. Odds of MYD88 mutations were lower (odds ratio (OR) 0.22, p = .05), and median time to treatment was shorter in cases than in controls (4 vs. 32 months; p < .001). Odds of extramedullary disease were higher (OR 4.20, p = .01), while odds of neuropathy (OR 0.22, p = .25), and hyperviscosity (OR 0.26, p = .26) were lower in cases than in controls. Odds of using chemoimmunotherapy were higher (OR 2.62, p = .11) while odds of using proteasome inhibitors (OR 0.35, p = .15) and BTK inhibitors (OR 0.17, p = .21) were lower in cases than in controls. There were no differences in response and overall survival (OS) between cases and controls. Despite clinicopathological differences, response, and survival outcomes are similar between non-IgM LPL cases and WM controls.
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Affiliation(s)
- Jorge J Castillo
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA.,Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Gilad Itchaki
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA.,Institute of Hematology, Davidoff Cancer Center, Rabin Medical Center, Petah-Tikva, Israel
| | - Joshua N Gustine
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA.,Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Kirsten Meid
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Catherine A Flynn
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Maria G Demos
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Maria L Guerrera
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Cristina Jimenez
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Amanda Kofides
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Xia Liu
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Manit Munshi
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Nicholas Tsakmaklis
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Christopher J Patterson
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Lian Xu
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Guang Yang
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Zachary R Hunter
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Steven P Treon
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA.,Department of Medicine, Harvard Medical School, Boston, MA, USA
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105
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Abstract
With so many recent advances in relapsed/refractory multiple myeloma, keeping abreast with current treatment recommendations can be challenging. Novel immunomodulators, proteasome inhibitors, monoclonal antibodies, histone deacetylase inhibitors, and nuclear export inhibitors have all been added to the armamentarium, and the choice of which of these drugs or drug combinations to use depends on individual disease-related and patient-related factors, previous therapies, and treatment toxicities. At the NCCN 2019 Annual Congress: Hematologic Malignancies, Dr. Jorge J. Castillo provided an overview of the myriad treatments available for patients with relapsed/refractory multiple myeloma, as well as therapies on the horizon.
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106
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Bustoros M, Sklavenitis-Pistofidis R, Castillo JJ, Treon SP, Ghobrial IM. Reply to F.D. Leonard. J Clin Oncol 2019; 37:2701-2702. [DOI: 10.1200/jco.19.01708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Mark Bustoros
- Mark Bustoros, MD; Romanos Sklavenitis-Pistofidis, MD; Jorge J. Castillo, MD; Steven P. Treon, MD, PhD; and Irene M. Ghobrial, MD, Dana-Farber Cancer Institute, Boston, MA
| | - Romanos Sklavenitis-Pistofidis
- Mark Bustoros, MD; Romanos Sklavenitis-Pistofidis, MD; Jorge J. Castillo, MD; Steven P. Treon, MD, PhD; and Irene M. Ghobrial, MD, Dana-Farber Cancer Institute, Boston, MA
| | - Jorge J. Castillo
- Mark Bustoros, MD; Romanos Sklavenitis-Pistofidis, MD; Jorge J. Castillo, MD; Steven P. Treon, MD, PhD; and Irene M. Ghobrial, MD, Dana-Farber Cancer Institute, Boston, MA
| | - Steven P. Treon
- Mark Bustoros, MD; Romanos Sklavenitis-Pistofidis, MD; Jorge J. Castillo, MD; Steven P. Treon, MD, PhD; and Irene M. Ghobrial, MD, Dana-Farber Cancer Institute, Boston, MA
| | - Irene M. Ghobrial
- Mark Bustoros, MD; Romanos Sklavenitis-Pistofidis, MD; Jorge J. Castillo, MD; Steven P. Treon, MD, PhD; and Irene M. Ghobrial, MD, Dana-Farber Cancer Institute, Boston, MA
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107
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Castillo JJ, Treon SP. What is new in the treatment of Waldenstrom macroglobulinemia? Leukemia 2019; 33:2555-2562. [PMID: 31591468 DOI: 10.1038/s41375-019-0592-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 09/14/2019] [Accepted: 09/25/2019] [Indexed: 01/12/2023]
Abstract
Waldenstrom macroglobulinemia (WM) is a rare type of non-Hodgkin lymphoma. The diagnosis of WM is established by the presence of lymphoplasmacytic lymphoma in the bone marrow or other organs, a monoclonal IgM paraproteinemia and the recurrent MYD88 L265P somatic mutation. Some patients with WM can be asymptomatic, in which case treatment is not indicated. However, most patients with WM will become symptomatic during the course of the disease, due to anemia, hyperviscosity, neuropathy, or other processes, necessitating therapy. Current treatment options for symptomatic WM patients include alkylating agents, proteasome inhibitors and anti-CD20 monoclonal antibodies. The approval of the oral Bruton tyrosine kinase (BTK) inhibitor ibrutinib alone and in combination with rituximab has expanded the treatment options for WM patients. The present Perspective would focus on exciting treatment strategies under development for WM patients, such as proteasome inhibitors (e.g., ixazomib), BTK inhibitors (e.g., acalabrutinib, zanubrutinib, vecabrutinib), BCL2 inhibitors (e.g., venetoclax), and anti-CXCR4 antibodies (e.g., ulocuplumab), among others. It is certainly an exciting time for WM therapy development with novel and promising treatment options in the horizon.
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Affiliation(s)
- Jorge J Castillo
- Bing Center for Waldenstrom Macroglobulinemia, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.
| | - Steven P Treon
- Bing Center for Waldenstrom Macroglobulinemia, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
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108
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Avivi I, Cohen YC, Suska A, Shragai T, Mikala G, Garderet L, Seny GM, Glickman S, Jayabalan DS, Niesvizky R, Gozzetti A, Wiśniewska‐Piąty K, Waszczuk‐Gajda A, Usnarska‐Zubkiewicz L, Hus I, Guzicka R, Radocha J, Milunovic V, Davila J, Gentile M, Castillo JJ, Jurczyszyn A. Hematogenous extramedullary relapse in multiple myeloma - a multicenter retrospective study in 127 patients. Am J Hematol 2019; 94:1132-1140. [PMID: 31334859 DOI: 10.1002/ajh.25579] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Revised: 07/10/2019] [Accepted: 07/13/2019] [Indexed: 12/19/2022]
Abstract
The current study assesses the characteristics and outcomes of multiple myeloma (MM) patients, treated with novel agents for hematogenous extramedullary (HEMM) relapse. Consecutive patients diagnosed with HEMM between 2010-2018 were included. Patients' characteristics at diagnosis and at HEMM presentation, response to treatment, survival and factors predicting survival were recorded and analyzed. A group of 127 patients, all diagnosed with HEMM by imaging (87.3%) and/or biopsy (79%), were included. Of those, 44% were initially diagnosed with ISS3, 57% presented with plasmacytomas, and 30% had high-risk cytogenetics. Median time to HEMM was 32 months. In multivariate analysis, ISS3 and bone plasmacytoma predicted shorter time to HEMM (P = .005 and P = .008, respectively). Upfront autograft was associated with longer time to HEMM (P = .002). At HEMM, 32% of patients had no BM plasmacytosis, 20% had non-secretory disease and 43% had light-chain disease. Multiple HEMM sites were reported in 52% of patients, mostly involving soft tissue, skin (29%), and pleura/lung (25%). First treatment for HEMM included proteasome inhibitors (50%), immunomodulatory drugs (IMiDs) (39%), monoclonal antibodies (10%), and chemotherapy (53%). Overall response rate (ORR) was 57%. IMiDs were associated with higher ORR (HR 2.2, 95% CI 1.02-4.7, P = .04). Median survival from HEMM was 6 months (CI 95% 4.8-7.2). Failure to achieve ≥VGPR was the only significant factor for worse OS in multivariate analyses (HR = 9.87, CI 95% 2.35 - 39, P = .001). In conclusion, HEMM occurs within 3 years of initial myeloma diagnosis and is associated with dismal outcome. The IMiDs might provide a higher response rate, and achievement of ≥VGPR predicts longer survival.
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Affiliation(s)
- Irit Avivi
- Tel Aviv Medical Center and Sackler Faculty of Medicine Tel Aviv Israel
| | - Yael C. Cohen
- Tel Aviv Medical Center and Sackler Faculty of Medicine Tel Aviv Israel
| | - Anna Suska
- Department of HematologyJagiellonian University Medical College Cracow Poland
| | - Tamir Shragai
- Department of Hematology and Stem Cell TransplantationSouth‐Pest Central Hospital, Natl. Inst. Hematol. Infectol Budapest Hungary
| | - Gabor Mikala
- Department of Hematology and Stem Cell TransplantationSouth‐Pest Central Hospital, Natl. Inst. Hematol. Infectol Budapest Hungary
| | - Laurent Garderet
- Service d'Hématologie et thérapie cellulaireHôpital Saint Antoine Paris France
- Service d'HématologieHôpital Pitié Salpêtrière Paris France
| | - Gueye M. Seny
- Service d'Hématologie et thérapie cellulaireHôpital Saint Antoine Paris France
| | | | | | | | | | | | - Anna Waszczuk‐Gajda
- Department of Hematology, Oncology and Internal DiseasesWarsaw Medical University Warsaw Poland
| | - Lidia Usnarska‐Zubkiewicz
- Department of Hematology, Blood Neoplasms and Bone Marrow TransplantationWroclaw Medical University Poland
| | - Iwona Hus
- Department of Haematology and Bone Marrow TransplantationMedical University of Lublin Lublin Poland
| | - Renata Guzicka
- Department of HaematologyPomeranian Medical University Szczecin Poland
| | - Jakub Radocha
- 4th Department of Medicine – HaematologyCharles University Hospital Hradec Kralove Hradec Kralove Czech Republic
| | - Vibor Milunovic
- Division of HematologyClinical Hospital Merkur Zagreb Croatia
| | | | - Massimo Gentile
- Hematology Unit, Department of Onco‐HematologyAzienda Ospendaliera of Cosenza Cosenza Italy
| | - Jorge J. Castillo
- Dana‐Farber Cancer InstituteHarvard Medical School Boston Massachusetts
| | - Artur Jurczyszyn
- Department of HematologyJagiellonian University Medical College Cracow Poland
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109
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Abstract
Bing-Neel syndrome (BNS) is an uncommon presentation of Waldenström macroglobulinaemia (WM), seen during the course of the disease in about 1% of patients. BNS occurs when WM cells gain access to the central nervous system (CNS) causing neurological deficits. The diagnosis of BNS is suggested by the presence of radiological abnormalities, such as leptomeningeal enhancement on magnetic resonance imaging and confirmed by the presence of clonal lymphoplasmacytic cells and MYD88 L265P in the cerebrospinal fluid. The treatment of BNS requires agents with good penetration into the CNS, such as fludarabine, methotrexate and cytarabine. The novel Bruton Tyrosine Kinase inhibitor ibrutinib has shown CNS-penetrating properties, and recent data suggest a therapeutic role in BNS. In this review, we will discuss the clinical and pathological features, diagnostic criteria, treatment options and outcomes of patients with BNS.
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Affiliation(s)
- Jorge J Castillo
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Steven P Treon
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
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110
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Affiliation(s)
- Jorge J Castillo
- Division of Hematological Malignancies, Harvard Medical School, Dana-Farber Cancer Institute, Boston, MA, USA
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112
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Castillo JJ, Moreno DF, Arbelaez MI, Hunter ZR, Treon SP. CXCR4 mutations affect presentation and outcomes in patients with Waldenström macroglobulinemia: A systematic review. Expert Rev Hematol 2019; 12:873-881. [PMID: 31343930 DOI: 10.1080/17474086.2019.1649132] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Introduction: The genomic landscape of Waldenström macroglobulinemia (WM) is characterized by recurrent MYD88 (MYD88L265P) and CXCR4 mutations (CXCR4MUT), detected in 90% and 30% of cases, respectively. The role of CXCR4MUT in clinical features and outcomes to therapy in WM patients is evolving. Areas covered: We performed a systematic review aimed at evaluating the prevalence of CXCR4MUT in WM patients, and at assessing differences in clinical features and outcomes to therapy between WM patients with and without CXCR4MUT. Seventeen studies were included in our analysis. The pooled prevalence of CXCR4MUT in WM patients was 31%; 34% in MYD88L265P and 5% in MYD88WT patients. CXCR4MUT were associated with higher serum IgM levels and higher risk of hyperviscosity than CXCR4WT patients. Very good partial response (VGPR) and progression-free survival (PFS) rates to ibrutinib, with and without rituximab, appeared lower in CXCR4MUT than in CXCR4WT patients. Response and PFS rates were not affected by CXCR4MUT status on patients treated with proteasome inhibitors. Expert opinion: Our systematic review shows that WM patients with CXCR4MUT have specific clinical features and have lower response and PFS rates to BTK inhibitors. Our findings support standardization of CXCR4 testing and development of CXCR4-directed therapy.
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Affiliation(s)
- Jorge J Castillo
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Harvard Medical School , Boston , MA , USA
| | - David F Moreno
- Amyloidosis and Myeloma Unit, Hospital Clinic, IDIBAPS, University of Barcelona , Barcelona , Spain
| | - Maria I Arbelaez
- Service of Hematology, Clinica de Marly, Fundacion Universitaria de Ciencias de la Salud , Bogota , Colombia
| | - Zachary R Hunter
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Harvard Medical School , Boston , MA , USA
| | - Steven P Treon
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Harvard Medical School , Boston , MA , USA
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113
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Beltran BE, Paredes S, Castro D, Cotrina E, Sotomayor EM, Castillo JJ. High Red Cell Distribution Width is an Adverse Predictive and Prognostic Factor in Patients With Diffuse Large B-Cell Lymphoma Treated With Chemoimmunotherapy. Clin Lymphoma Myeloma Leuk 2019; 19:e551-e557. [PMID: 31320254 DOI: 10.1016/j.clml.2019.06.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Accepted: 06/08/2019] [Indexed: 12/11/2022]
Abstract
INTRODUCTION The red blood cell distribution width (RDW) is an easy-to-obtain laboratory value that has emerged as a potential prognostic factor in solid and hematologic malignancies. PATIENTS AND METHODS We evaluated 121 patients with de novo diffuse large B-cell lymphoma (DLBCL) treated with standard chemoimmunotherapy at our institution between 2010 and 2012. We categorized patients with high RDW (> 14.6%) and normal RDW (11.6%-14.6%). We fitted multivariate regression models for complete response (CR) and overall survival (OS). RESULTS Patients with high RDW were less likely to achieve CR to chemoimmunotherapy than patients with normal RDW (48% vs. 83%; P < .001). The 5-year OS rate for patients with high RDW was lower than in patients with normal RDW (51% vs. 79%; P = .001). In multivariate regression models, high RDW was independently associated with lower odds of achieving CR (odds ratio, 0.32; 95% confidence interval [CI], 0.12-0.83; P = .02) and with higher risk of death from any cause (hazard ratio [HR], 2.04; 95% CI, 1.03-4.02; P = .04) than normal RDW in patients with DLBCL treated with chemoimmunotherapy. High RDW remained an independent adverse factor for OS after adjustment for the International Prognostic Index and the National Comprehensive Cancer Network-International Prognostic Index scores with HR 2.20 (95% CI, 1.12-4.31; P = .02) and HR 2.67 (95% CI 1.28-5.59; P = .009), respectively. CONCLUSION High RDW appears to be an adverse predictive and prognostic factor in patients with de novo DLBCL treated with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone).
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Affiliation(s)
- Brady E Beltran
- Department of Oncology and Radiotherapy, Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru; Centro de Medicina de Precisión, Universidad de San Martin de Porres, Lima, Peru.
| | - Sally Paredes
- Department of Oncology and Radiotherapy, Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru
| | - Denisse Castro
- Department of Oncology and Radiotherapy, Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru
| | - Esther Cotrina
- Department of Nursing, Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru
| | - Eduardo M Sotomayor
- George Washington Cancer Center, George Washington University, Washington, DC
| | - Jorge J Castillo
- Division of Hematologic Malignancies, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
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114
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Castillo JJ, Xu L, Gustine JN, Keezer A, Meid K, Dubeau TE, Liu X, Demos MG, Kofides A, Tsakmaklis N, Chen JG, Munshi M, Guerrera ML, Chan GG, Patterson CJ, Yang G, Hunter ZR, Treon SP. CXCR4 mutation subtypes impact response and survival outcomes in patients with Waldenström macroglobulinaemia treated with ibrutinib. Br J Haematol 2019; 187:356-363. [PMID: 31267520 DOI: 10.1111/bjh.16088] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Accepted: 05/21/2019] [Indexed: 12/30/2022]
Abstract
Ibrutinib is associated with response rate of 90% and median progression-free survival (PFS) in excess of 5 years in Waldenström macroglobulinaemia (WM) patients. CXCR4 mutations are detected in 30-40% of patients with WM and associate with lower rates of response and shorter PFS to ibrutinib therapy. Both frameshift (CXCR4FS ) and nonsense (CXCR4NS ) CXCR4 mutations have been described. The impact of these mutations on outcomes to ibrutinib have not been evaluated in WM patients. We studied consecutive patients with a diagnosis of WM, on ibrutinib therapy, for the presence of CXCR4FS and CXCR4NS mutations and evaluated the differences in response and PFS between groups. Of 180 patients, 68 patients (38%) had CXCR4 mutations; 49 (27%) had CXCR4NS and 19 (11%) had CXCR4FS mutations. In multivariate models, patients with CXCR4NS had lower odds of major response (Odds ratio 0·25, 95% confidence interval [CI] 0·12-0·53; P < 0·001) and worse PFS (Hazard ratio 4·02, 95% CI 1·95-8·26; P < 0·001) than patients without CXCR4 mutations. CXCR4FS was not associated with worse major response or PFS rates than patients without CXCR4 mutations. Our results suggest different response and PFS rates to ibrutinib for WM patients with CXCR4NS and CXCR4FS , and advocate in favour of CXCR4 mutational testing as well as CXCR4-directed therapy.
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Affiliation(s)
- Jorge J Castillo
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA.,Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Lian Xu
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Joshua N Gustine
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA.,Boston University Medical School, Boston, MA, USA
| | - Andrew Keezer
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Kirsten Meid
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Toni E Dubeau
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Xia Liu
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Maria G Demos
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Amanda Kofides
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Nicholas Tsakmaklis
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Jiaji G Chen
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Manit Munshi
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Maria L Guerrera
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Gloria G Chan
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Christopher J Patterson
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Guang Yang
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA.,Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Zachary R Hunter
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Steven P Treon
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA.,Department of Medicine, Harvard Medical School, Boston, MA, USA
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115
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Bustoros M, Sklavenitis-Pistofidis R, Kapoor P, Liu CJ, Kastritis E, Zanwar S, Fell G, Abeykoon JP, Hornburg K, Neuse CJ, Marinac CR, Liu D, Soiffer J, Gavriatopoulou M, Boehner C, Cappuccio JM, Dumke H, Reyes K, Soiffer RJ, Kyle RA, Treon SP, Castillo JJ, Dimopoulos MA, Ansell SM, Trippa L, Ghobrial IM. Progression Risk Stratification of Asymptomatic Waldenström Macroglobulinemia. J Clin Oncol 2019; 37:1403-1411. [PMID: 30990729 DOI: 10.1200/jco.19.00394] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Waldenström macroglobulinemia (WM) is preceded by asymptomatic WM (AWM), for which the risk of progression to overt disease is not well defined. METHODS We studied 439 patients with AWM, who were diagnosed and observed at Dana-Farber Cancer Institute between 1992 and 2014. RESULTS During the 23-year study period, with a median follow-up of 7.8 years, 317 patients progressed to symptomatic WM (72%). Immunoglobulin M 4,500 mg/dL or greater, bone marrow lymphoplasmacytic infiltration 70% or greater, β2-microglobulin 4.0 mg/dL or greater, and albumin 3.5 g/dL or less were all identified as independent predictors of disease progression. To assess progression risk in patients with AWM, we trained and cross-validated a proportional hazards model using bone marrow infiltration, immunoglobulin M, albumin, and beta-2 microglobulin values as continuous measures. The model divided the cohort into three distinct risk groups: a high-risk group with a median time to progression (TTP) of 1.8 years, an intermediate-risk group with a median TTP of 4.8 years, and a low-risk group with a median TTP of 9.3 years. We validated this model in two external cohorts, demonstrating robustness and generalizability. For clinical applicability, we made the model available as a Web page application ( www.awmrisk.com ). By combining two cohorts, we were powered to identify wild type MYD88 as an independent predictor of progression (hazard ratio, 2.7). CONCLUSION This classification system is positioned to inform patient monitoring and care and, for the first time to our knowledge, to identify patients with high-risk AWM who may need closer follow-up or benefit from early intervention.
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Affiliation(s)
- Mark Bustoros
- 1 Dana-Farber Cancer Institute, Boston, MA.,3 Harvard Medical School, Boston, MA
| | | | | | - Chia-Jen Liu
- 1 Dana-Farber Cancer Institute, Boston, MA.,5 Tapei Veterans General Hospital, Taipei, Taiwan.,6 National Yang-Ming University, Taipei, Taiwan
| | | | | | | | | | | | - Carl Jannes Neuse
- 1 Dana-Farber Cancer Institute, Boston, MA.,8 University of Münster Faculty of Medicine, Münster, Germany
| | - Catherine R Marinac
- 1 Dana-Farber Cancer Institute, Boston, MA.,2 Harvard T.H. Chan School of Public Health, Boston, MA
| | - David Liu
- 1 Dana-Farber Cancer Institute, Boston, MA.,3 Harvard Medical School, Boston, MA
| | - Jenny Soiffer
- 1 Dana-Farber Cancer Institute, Boston, MA.,9 University of Miami Miller School of Medicine, Miami, FL
| | | | - Cody Boehner
- 1 Dana-Farber Cancer Institute, Boston, MA.,10 University of Massachusetts, Boston, MA
| | | | | | | | - Robert J Soiffer
- 1 Dana-Farber Cancer Institute, Boston, MA.,3 Harvard Medical School, Boston, MA
| | | | - Steven P Treon
- 1 Dana-Farber Cancer Institute, Boston, MA.,3 Harvard Medical School, Boston, MA
| | - Jorge J Castillo
- 1 Dana-Farber Cancer Institute, Boston, MA.,3 Harvard Medical School, Boston, MA
| | | | | | - Lorenzo Trippa
- 1 Dana-Farber Cancer Institute, Boston, MA.,2 Harvard T.H. Chan School of Public Health, Boston, MA
| | - Irene M Ghobrial
- 1 Dana-Farber Cancer Institute, Boston, MA.,3 Harvard Medical School, Boston, MA
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116
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Sklavenitis-Pistofidis R, Capelletti M, Liu CJ, Reidy M, Zavidij O, Huynh D, Henrick P, Savell A, Reyes K, Rivotto B, Bustoros M, Perilla-Glen A, Trippa L, Castillo JJ, Treon SP, Ghobrial IM. Bortezomib overcomes the negative impact of CXCR4 mutations on survival of Waldenstrom macroglobulinemia patients. Blood 2018; 132:2608-2612. [PMID: 30366921 PMCID: PMC6293872 DOI: 10.1182/blood-2018-07-863241] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Marzia Capelletti
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; and
| | - Chia-Jen Liu
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; and
| | - Mairead Reidy
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; and
| | - Oksana Zavidij
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; and
| | - Daisy Huynh
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; and
| | - Patrick Henrick
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; and
| | - Alexandra Savell
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; and
| | - Kaitlen Reyes
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; and
| | - Bradley Rivotto
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; and
| | - Mark Bustoros
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; and
| | - Adriana Perilla-Glen
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; and
| | - Lorenzo Trippa
- Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, MA
| | - Jorge J Castillo
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; and
| | - Steven P Treon
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; and
| | - Irene M Ghobrial
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; and
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117
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Caballero SJ, Guerrero MA, Vargas LY, Ortiz CC, Castillo JJ, Gutiérrez JA, Blanco S. Electroanalytical determination of catechol by a biosensor based on laccase from Aspergillus oryzae immobilized on gold screen-printed electrodes. ACTA ACUST UNITED AC 2018. [DOI: 10.1088/1742-6596/1119/1/012009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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118
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Kusztos AE, Cheng MP, Gustine JN, Dubeau TE, Woolley AE, Hammond SP, Baden LR, Castillo JJ, Issa NC. 1130. Low Risk of Pneumocystis jiroveci Pneumonia in Patients With Waldenstrom’s Macroglobulinemia on Ibrutinib. Open Forum Infect Dis 2018. [PMCID: PMC6255451 DOI: 10.1093/ofid/ofy210.963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background Ibrutinib is a Bruton’s tyrosine kinase inhibitor that is FDA approved for the treatment of chronic lymphocytic leukemia (CLL), mantle cell lymphoma, marginal zone lymphoma, and Waldenstrom’s macroglobulinemia (WM). Fungal infections including Pneumocystis jiroveci pneumonia (PCP) are increasingly reported in patients with CLL and lymphoma on ibrutinib possibly due to the off-target effect of ibrutinib on the adaptive immune system. Whether this increased risk is due to the effect of ibrutinib alone or in combination with immune dysregulation due to underlying malignancy is unknown. The purpose of this study was to assess the incidence of PCP in patients with WM on ibrutinib therapy. Methods A retrospective cohort study was performed of all patients with WM who initiated ibrutinib monotherapy at Dana-Farber Cancer Institute between July 1, 2015 and January 30, 2018. Baseline characteristics, laboratory parameters, previous and concomitant malignancy treatment regimens, and antimicrobial medications were collected by chart review. Patients were followed until April 1, 2018 for the development of PCP. Results There were a total of 106 patients with WM on ibrutinib during the study period. Sixty-one (58%) were male, and the median age at initiation of ibrutinib was 69 years (range 43 – 89). Forty-six patients (43%) received prior therapy for WM, with a median of two previous treatment courses (range 1–6). Fourteen patients (13%) were on PCP prophylaxis for a combined duration of 8 person-years. No cohort patient developed PCP during the study period, which included 146 person-years of ibrutinib exposure. Three patients (3%) died due to disease progression (n = 2) and E. coli sepsis (n = 1). Conclusion Patients with WM on ibrutinib monotherapy appear to have a different infectious risk profile than patients with CLL or lymphoma and do not have a high risk of developing PCP. These data suggest that PCP prophylaxis is likely not beneficial for patients with WM on ibrutinib. Disclosures M. P. Cheng, Royal College of Physicians and Surgeons of Canada: Member, Salary. S. P. Hammond, Merck: Investigator, Research support. J. J. Castillo, Pharmacyclics: Consultant and Grant Investigator, Consulting fee and Research grant. N. C. Issa, GSK: Investigator, Research grant. Merck: Investigator, Research grant. Akros Pharma: Consultant, Consulting fee.
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Affiliation(s)
- Amanda E Kusztos
- Division of Infectious Diseases, Brigham and Women’s Hospital, Boston, Massachusetts
- Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Matthew P Cheng
- Division of Infectious Diseases, Brigham and Women’s Hospital, Boston, Massachusetts
- Dana-Farber Cancer Institute, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Joshua N Gustine
- Bing Center for Waldenstrom’s Macroglobulinemia, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Toni E Dubeau
- Bing Center for Waldenstrom’s Macroglobulinemia, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Ann E Woolley
- Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Sarah P Hammond
- Division of Infectious Diseases, Brigham and Women’s Hospital, Boston, Massachusetts
- Dana-Farber Cancer Institute, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Lindsey R Baden
- Division of Infectious Diseases, Brigham and Women’s Hospital, Boston, Massachusetts
- Dana-Farber Cancer Institute, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Jorge J Castillo
- Harvard Medical School, Boston, Massachusetts
- Bing Center for Waldenstrom’s Macroglobulinemia, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Nicolas C Issa
- Division of Infectious Diseases, Brigham and Women’s Hospital, Boston, Massachusetts
- Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
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119
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Treon SP, Castillo JJ. The real world of Waldenström's macroglobulinaemia. Lancet Haematol 2018; 5:e275-e276. [PMID: 29958567 DOI: 10.1016/s2352-3026(18)30091-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 05/28/2018] [Indexed: 12/15/2022]
Affiliation(s)
- Steven P Treon
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02215, USA.
| | - Jorge J Castillo
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02215, USA
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120
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Cheng MP, Kusztos AE, Gustine JN, Dryden-Peterson SL, Dubeau TE, Woolley AE, Hammond SP, Baden LR, Treon SP, Castillo JJ, Issa NC. Low risk of Pneumocystis jirovecii pneumonia and invasive aspergillosis in patients with Waldenström macroglobulinaemia on ibrutinib. Br J Haematol 2018; 185:788-790. [PMID: 30460682 DOI: 10.1111/bjh.15627] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Matthew P Cheng
- Division of Infectious Diseases, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.,Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Amanda E Kusztos
- Division of Infectious Diseases, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.,Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Joshua N Gustine
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Scott L Dryden-Peterson
- Division of Infectious Diseases, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.,Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Toni E Dubeau
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Ann E Woolley
- Division of Infectious Diseases, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.,Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Sarah P Hammond
- Division of Infectious Diseases, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.,Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Lindsey R Baden
- Division of Infectious Diseases, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.,Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Steven P Treon
- Harvard Medical School, Boston, MA, USA.,Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Jorge J Castillo
- Harvard Medical School, Boston, MA, USA.,Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Nicolas C Issa
- Division of Infectious Diseases, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.,Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
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121
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Barth P, Castillo JJ, Olszewski AJ. Outcomes of secondary solid tumor malignancies among patients with myeloma: A population‐based study. Cancer 2018; 125:550-558. [DOI: 10.1002/cncr.31853] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 09/30/2018] [Accepted: 10/18/2018] [Indexed: 12/12/2022]
Affiliation(s)
- Peter Barth
- Department of Medicine, Warren Alpert Medical School Brown University Providence Rhode Island
- Division of Hematology‐Oncology Rhode Island Hospital Providence Rhode Island
| | - Jorge J. Castillo
- Division of Hematologic Malignancies, Dana‐Farber Cancer Institute Boston Massachusetts
- Department of Medicine Harvard Medical School Boston Massachusetts
| | - Adam J. Olszewski
- Department of Medicine, Warren Alpert Medical School Brown University Providence Rhode Island
- Division of Hematology‐Oncology Rhode Island Hospital Providence Rhode Island
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122
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Babwah A, Gustine J, Meid K, Dubeau T, Xu L, Yang G, Hunter ZR, Treon SP, Castillo JJ. Long survival in patients with Waldenström macroglobulinaemia diagnosed at a young age. Br J Haematol 2018; 185:799-802. [PMID: 30407630 DOI: 10.1111/bjh.15634] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Amaara Babwah
- Bing Center for Waldenstrom Macroglobulinemia, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Joshua Gustine
- Bing Center for Waldenstrom Macroglobulinemia, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Kirsten Meid
- Bing Center for Waldenstrom Macroglobulinemia, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Toni Dubeau
- Bing Center for Waldenstrom Macroglobulinemia, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Lian Xu
- Bing Center for Waldenstrom Macroglobulinemia, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Guang Yang
- Bing Center for Waldenstrom Macroglobulinemia, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Zachary R Hunter
- Bing Center for Waldenstrom Macroglobulinemia, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Steven P Treon
- Bing Center for Waldenstrom Macroglobulinemia, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Jorge J Castillo
- Bing Center for Waldenstrom Macroglobulinemia, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
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Bouyssou JM, Liu CJ, Bustoros M, Sklavenitis-Pistofidis R, Aljawai Y, Manier S, Yosef A, Sacco A, Kokubun K, Tsukamoto S, Perilla Glen A, Huynh D, Castillo JJ, Treon SP, Leblond V, Hermine O, Roccaro AM, Ghobrial IM, Capelletti M. Profiling of circulating exosomal miRNAs in patients with Waldenström Macroglobulinemia. PLoS One 2018; 13:e0204589. [PMID: 30286096 PMCID: PMC6171840 DOI: 10.1371/journal.pone.0204589] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Accepted: 09/11/2018] [Indexed: 01/01/2023] Open
Abstract
Waldenström Macroglobulinemia (WM) is a low-grade B-cell lymphoma characterized by disease progression from IgM MGUS to asymptomatic and then symptomatic disease states. We profiled exosomes from the peripheral blood of patients with WM at different stages (30 smoldering/asymptomatic WM, 44 symptomatic WM samples and 10 healthy controls) to define their role as potential biomarkers of disease progression. In this study, we showed that circulating exosomes and their miRNA content represent unique markers of the tumor and its microenvironment. We observed similar levels of miRNAs in exosomes from patients with asymptomatic (smoldering) and symptomatic WM, suggesting that environmental and clonal changes occur in patients at early stages of disease progression before symptoms occur. Moreover, we identified a small group of miRNAs whose expression correlated directly or inversely with the disease status of patients, notably the known tumor suppressor miRNAs let-7d and the oncogene miR-21 as well as miR-192 and miR-320b. The study of these miRNAs’ specific effect in WM cells could help us gain further insights on the mechanisms underlying WM pathogenesis and reveal their potential as novel therapeutic targets for this disease.
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Affiliation(s)
- Juliette M. Bouyssou
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston MA, United States of America
- Université Paris-Saclay / Hôpital Necker-Enfants Malades, Paris, France
| | - Chia-Jen Liu
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston MA, United States of America
- Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Mark Bustoros
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston MA, United States of America
| | - Romanos Sklavenitis-Pistofidis
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston MA, United States of America
| | - Yosra Aljawai
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston MA, United States of America
| | - Salomon Manier
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston MA, United States of America
| | - Amir Yosef
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston MA, United States of America
| | - Antonio Sacco
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston MA, United States of America
| | - Katsutoshi Kokubun
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston MA, United States of America
| | - Shokichi Tsukamoto
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston MA, United States of America
| | - Adriana Perilla Glen
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston MA, United States of America
| | - Daisy Huynh
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston MA, United States of America
| | - Jorge J. Castillo
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston MA, United States of America
| | - Steven P. Treon
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston MA, United States of America
| | - Véronique Leblond
- Department of Hematology at Pitié Salpêtrière Hospital, Paris, France
| | - Olivier Hermine
- INSERM UMR 1163, Laboratory of Cellular and Molecular Mechanisms of Hematological Disorders and Therapeutic Implications, Paris, France
| | - Aldo M. Roccaro
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston MA, United States of America
| | - Irene M. Ghobrial
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston MA, United States of America
- * E-mail: (MC); (IMG)
| | - Marzia Capelletti
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston MA, United States of America
- * E-mail: (MC); (IMG)
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Treon SP, Xu L, Liu X, Hunter ZR, Yang G, Castillo JJ. Genomic Landscape of Waldenström Macroglobulinemia. Hematol Oncol Clin North Am 2018; 32:745-752. [DOI: 10.1016/j.hoc.2018.05.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Treon SP, Gustine J, Meid K, Yang G, Xu L, Liu X, Demos M, Kofides A, Tsakmaklis N, Chen JG, Munshi M, Chan G, Dubeau T, Raje N, Yee A, O’Donnell E, Hunter ZR, Castillo JJ. Ibrutinib Monotherapy in Symptomatic, Treatment-Naïve Patients With Waldenström Macroglobulinemia. J Clin Oncol 2018; 36:2755-2761. [DOI: 10.1200/jco.2018.78.6426] [Citation(s) in RCA: 110] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Purpose Ibrutinib is active in previously treated Waldenström macroglobulinemia (WM). MYD88 mutations ( MYD88MUT) and CXCR4 mutations ( CXCR4MUT) affect ibrutinib response. We report on a prospective study of ibrutinib monotherapy in symptomatic, untreated patients with WM, and the effect of CXCR4MUT status on outcome. Patients and Methods Symptomatic, treatment-naïve patients with WM were eligible. Ibrutinib (420 mg) was administered daily until progression or unacceptable toxicity. All tumors were genotyped for MYD88MUT and CXCR4MUT. Results A total of 30 patients with WM received ibrutinib. All carried MYD88MUT, and 14 (47%) carried a CXCR4MUT. After ibrutinib treatment, median serum IgM levels declined from 4,370 to 1,513 mg/dL, bone marrow involvement declined from 65% to 20%, and hemoglobin level rose from 10.3 to 13.9 g/dL ( P < .001 for all comparisons). Overall (minor or more than minor) and major (partial or greater than partial) responses for all patients were 100% and 83%, respectively. Rates of major (94% v 71%) and very good partial (31 v 7%) responses were higher and time to major responses more rapid (1.8 v 7.3 months; P = 0.01) in patients with wild-type CXCR4 versus those with CXCR4MUT, respectively. With a median follow-up of 14.6 months, disease in two patients (both with CXCR4MUT) progressed. The 18-month, estimated progression-free survival is 92% (95% CI, 73% to 98%). All patients are alive. Grade 2/3 treatment-related toxicities in > 5% of patients included arthralgia (7%), bruising (7%), neutropenia (7%), upper respiratory tract infection (7%), urinary tract infection (7%), atrial fibrillation (10%), and hypertension (13%). There were no grade 4 or unexpected toxicities. Conclusion Ibrutinib is highly active, produces durable responses, and is safe as primary therapy in patients with symptomatic WM. CXCR4MUT status affects responses to ibrutinib.
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Affiliation(s)
- Steven P. Treon
- Steven P. Treon, Joshua Gustine, Kirsten Meid, Guang Yang, Lian Xu, Xia Liu, Maria Demos, Amanda Kofides, Nicholas Tsakmaklis, Jiaji G. Chen, Manit Munshi, Gloria Chan, Toni Dubeau, Zachary R. Hunter, and Jorge J. Castillo, Dana-Farber Cancer Institute; Steven P. Treon, Guang Yang, Xia Liu, Noopur Raje, Andrew Yee, Elizabeth O’Donnell, Zachary R. Hunter, and Jorge J. Castillo, Harvard Medical School; and Noopur Raje, Andrew Yee, and Elizabeth O’Donnell, Massachusetts General Hospital, Boston, MA
| | - Joshua Gustine
- Steven P. Treon, Joshua Gustine, Kirsten Meid, Guang Yang, Lian Xu, Xia Liu, Maria Demos, Amanda Kofides, Nicholas Tsakmaklis, Jiaji G. Chen, Manit Munshi, Gloria Chan, Toni Dubeau, Zachary R. Hunter, and Jorge J. Castillo, Dana-Farber Cancer Institute; Steven P. Treon, Guang Yang, Xia Liu, Noopur Raje, Andrew Yee, Elizabeth O’Donnell, Zachary R. Hunter, and Jorge J. Castillo, Harvard Medical School; and Noopur Raje, Andrew Yee, and Elizabeth O’Donnell, Massachusetts General Hospital, Boston, MA
| | - Kirsten Meid
- Steven P. Treon, Joshua Gustine, Kirsten Meid, Guang Yang, Lian Xu, Xia Liu, Maria Demos, Amanda Kofides, Nicholas Tsakmaklis, Jiaji G. Chen, Manit Munshi, Gloria Chan, Toni Dubeau, Zachary R. Hunter, and Jorge J. Castillo, Dana-Farber Cancer Institute; Steven P. Treon, Guang Yang, Xia Liu, Noopur Raje, Andrew Yee, Elizabeth O’Donnell, Zachary R. Hunter, and Jorge J. Castillo, Harvard Medical School; and Noopur Raje, Andrew Yee, and Elizabeth O’Donnell, Massachusetts General Hospital, Boston, MA
| | - Guang Yang
- Steven P. Treon, Joshua Gustine, Kirsten Meid, Guang Yang, Lian Xu, Xia Liu, Maria Demos, Amanda Kofides, Nicholas Tsakmaklis, Jiaji G. Chen, Manit Munshi, Gloria Chan, Toni Dubeau, Zachary R. Hunter, and Jorge J. Castillo, Dana-Farber Cancer Institute; Steven P. Treon, Guang Yang, Xia Liu, Noopur Raje, Andrew Yee, Elizabeth O’Donnell, Zachary R. Hunter, and Jorge J. Castillo, Harvard Medical School; and Noopur Raje, Andrew Yee, and Elizabeth O’Donnell, Massachusetts General Hospital, Boston, MA
| | - Lian Xu
- Steven P. Treon, Joshua Gustine, Kirsten Meid, Guang Yang, Lian Xu, Xia Liu, Maria Demos, Amanda Kofides, Nicholas Tsakmaklis, Jiaji G. Chen, Manit Munshi, Gloria Chan, Toni Dubeau, Zachary R. Hunter, and Jorge J. Castillo, Dana-Farber Cancer Institute; Steven P. Treon, Guang Yang, Xia Liu, Noopur Raje, Andrew Yee, Elizabeth O’Donnell, Zachary R. Hunter, and Jorge J. Castillo, Harvard Medical School; and Noopur Raje, Andrew Yee, and Elizabeth O’Donnell, Massachusetts General Hospital, Boston, MA
| | - Xia Liu
- Steven P. Treon, Joshua Gustine, Kirsten Meid, Guang Yang, Lian Xu, Xia Liu, Maria Demos, Amanda Kofides, Nicholas Tsakmaklis, Jiaji G. Chen, Manit Munshi, Gloria Chan, Toni Dubeau, Zachary R. Hunter, and Jorge J. Castillo, Dana-Farber Cancer Institute; Steven P. Treon, Guang Yang, Xia Liu, Noopur Raje, Andrew Yee, Elizabeth O’Donnell, Zachary R. Hunter, and Jorge J. Castillo, Harvard Medical School; and Noopur Raje, Andrew Yee, and Elizabeth O’Donnell, Massachusetts General Hospital, Boston, MA
| | - Maria Demos
- Steven P. Treon, Joshua Gustine, Kirsten Meid, Guang Yang, Lian Xu, Xia Liu, Maria Demos, Amanda Kofides, Nicholas Tsakmaklis, Jiaji G. Chen, Manit Munshi, Gloria Chan, Toni Dubeau, Zachary R. Hunter, and Jorge J. Castillo, Dana-Farber Cancer Institute; Steven P. Treon, Guang Yang, Xia Liu, Noopur Raje, Andrew Yee, Elizabeth O’Donnell, Zachary R. Hunter, and Jorge J. Castillo, Harvard Medical School; and Noopur Raje, Andrew Yee, and Elizabeth O’Donnell, Massachusetts General Hospital, Boston, MA
| | - Amanda Kofides
- Steven P. Treon, Joshua Gustine, Kirsten Meid, Guang Yang, Lian Xu, Xia Liu, Maria Demos, Amanda Kofides, Nicholas Tsakmaklis, Jiaji G. Chen, Manit Munshi, Gloria Chan, Toni Dubeau, Zachary R. Hunter, and Jorge J. Castillo, Dana-Farber Cancer Institute; Steven P. Treon, Guang Yang, Xia Liu, Noopur Raje, Andrew Yee, Elizabeth O’Donnell, Zachary R. Hunter, and Jorge J. Castillo, Harvard Medical School; and Noopur Raje, Andrew Yee, and Elizabeth O’Donnell, Massachusetts General Hospital, Boston, MA
| | - Nicholas Tsakmaklis
- Steven P. Treon, Joshua Gustine, Kirsten Meid, Guang Yang, Lian Xu, Xia Liu, Maria Demos, Amanda Kofides, Nicholas Tsakmaklis, Jiaji G. Chen, Manit Munshi, Gloria Chan, Toni Dubeau, Zachary R. Hunter, and Jorge J. Castillo, Dana-Farber Cancer Institute; Steven P. Treon, Guang Yang, Xia Liu, Noopur Raje, Andrew Yee, Elizabeth O’Donnell, Zachary R. Hunter, and Jorge J. Castillo, Harvard Medical School; and Noopur Raje, Andrew Yee, and Elizabeth O’Donnell, Massachusetts General Hospital, Boston, MA
| | - Jiaji G. Chen
- Steven P. Treon, Joshua Gustine, Kirsten Meid, Guang Yang, Lian Xu, Xia Liu, Maria Demos, Amanda Kofides, Nicholas Tsakmaklis, Jiaji G. Chen, Manit Munshi, Gloria Chan, Toni Dubeau, Zachary R. Hunter, and Jorge J. Castillo, Dana-Farber Cancer Institute; Steven P. Treon, Guang Yang, Xia Liu, Noopur Raje, Andrew Yee, Elizabeth O’Donnell, Zachary R. Hunter, and Jorge J. Castillo, Harvard Medical School; and Noopur Raje, Andrew Yee, and Elizabeth O’Donnell, Massachusetts General Hospital, Boston, MA
| | - Manit Munshi
- Steven P. Treon, Joshua Gustine, Kirsten Meid, Guang Yang, Lian Xu, Xia Liu, Maria Demos, Amanda Kofides, Nicholas Tsakmaklis, Jiaji G. Chen, Manit Munshi, Gloria Chan, Toni Dubeau, Zachary R. Hunter, and Jorge J. Castillo, Dana-Farber Cancer Institute; Steven P. Treon, Guang Yang, Xia Liu, Noopur Raje, Andrew Yee, Elizabeth O’Donnell, Zachary R. Hunter, and Jorge J. Castillo, Harvard Medical School; and Noopur Raje, Andrew Yee, and Elizabeth O’Donnell, Massachusetts General Hospital, Boston, MA
| | - Gloria Chan
- Steven P. Treon, Joshua Gustine, Kirsten Meid, Guang Yang, Lian Xu, Xia Liu, Maria Demos, Amanda Kofides, Nicholas Tsakmaklis, Jiaji G. Chen, Manit Munshi, Gloria Chan, Toni Dubeau, Zachary R. Hunter, and Jorge J. Castillo, Dana-Farber Cancer Institute; Steven P. Treon, Guang Yang, Xia Liu, Noopur Raje, Andrew Yee, Elizabeth O’Donnell, Zachary R. Hunter, and Jorge J. Castillo, Harvard Medical School; and Noopur Raje, Andrew Yee, and Elizabeth O’Donnell, Massachusetts General Hospital, Boston, MA
| | - Toni Dubeau
- Steven P. Treon, Joshua Gustine, Kirsten Meid, Guang Yang, Lian Xu, Xia Liu, Maria Demos, Amanda Kofides, Nicholas Tsakmaklis, Jiaji G. Chen, Manit Munshi, Gloria Chan, Toni Dubeau, Zachary R. Hunter, and Jorge J. Castillo, Dana-Farber Cancer Institute; Steven P. Treon, Guang Yang, Xia Liu, Noopur Raje, Andrew Yee, Elizabeth O’Donnell, Zachary R. Hunter, and Jorge J. Castillo, Harvard Medical School; and Noopur Raje, Andrew Yee, and Elizabeth O’Donnell, Massachusetts General Hospital, Boston, MA
| | - Noopur Raje
- Steven P. Treon, Joshua Gustine, Kirsten Meid, Guang Yang, Lian Xu, Xia Liu, Maria Demos, Amanda Kofides, Nicholas Tsakmaklis, Jiaji G. Chen, Manit Munshi, Gloria Chan, Toni Dubeau, Zachary R. Hunter, and Jorge J. Castillo, Dana-Farber Cancer Institute; Steven P. Treon, Guang Yang, Xia Liu, Noopur Raje, Andrew Yee, Elizabeth O’Donnell, Zachary R. Hunter, and Jorge J. Castillo, Harvard Medical School; and Noopur Raje, Andrew Yee, and Elizabeth O’Donnell, Massachusetts General Hospital, Boston, MA
| | - Andrew Yee
- Steven P. Treon, Joshua Gustine, Kirsten Meid, Guang Yang, Lian Xu, Xia Liu, Maria Demos, Amanda Kofides, Nicholas Tsakmaklis, Jiaji G. Chen, Manit Munshi, Gloria Chan, Toni Dubeau, Zachary R. Hunter, and Jorge J. Castillo, Dana-Farber Cancer Institute; Steven P. Treon, Guang Yang, Xia Liu, Noopur Raje, Andrew Yee, Elizabeth O’Donnell, Zachary R. Hunter, and Jorge J. Castillo, Harvard Medical School; and Noopur Raje, Andrew Yee, and Elizabeth O’Donnell, Massachusetts General Hospital, Boston, MA
| | - Elizabeth O’Donnell
- Steven P. Treon, Joshua Gustine, Kirsten Meid, Guang Yang, Lian Xu, Xia Liu, Maria Demos, Amanda Kofides, Nicholas Tsakmaklis, Jiaji G. Chen, Manit Munshi, Gloria Chan, Toni Dubeau, Zachary R. Hunter, and Jorge J. Castillo, Dana-Farber Cancer Institute; Steven P. Treon, Guang Yang, Xia Liu, Noopur Raje, Andrew Yee, Elizabeth O’Donnell, Zachary R. Hunter, and Jorge J. Castillo, Harvard Medical School; and Noopur Raje, Andrew Yee, and Elizabeth O’Donnell, Massachusetts General Hospital, Boston, MA
| | - Zachary R. Hunter
- Steven P. Treon, Joshua Gustine, Kirsten Meid, Guang Yang, Lian Xu, Xia Liu, Maria Demos, Amanda Kofides, Nicholas Tsakmaklis, Jiaji G. Chen, Manit Munshi, Gloria Chan, Toni Dubeau, Zachary R. Hunter, and Jorge J. Castillo, Dana-Farber Cancer Institute; Steven P. Treon, Guang Yang, Xia Liu, Noopur Raje, Andrew Yee, Elizabeth O’Donnell, Zachary R. Hunter, and Jorge J. Castillo, Harvard Medical School; and Noopur Raje, Andrew Yee, and Elizabeth O’Donnell, Massachusetts General Hospital, Boston, MA
| | - Jorge J. Castillo
- Steven P. Treon, Joshua Gustine, Kirsten Meid, Guang Yang, Lian Xu, Xia Liu, Maria Demos, Amanda Kofides, Nicholas Tsakmaklis, Jiaji G. Chen, Manit Munshi, Gloria Chan, Toni Dubeau, Zachary R. Hunter, and Jorge J. Castillo, Dana-Farber Cancer Institute; Steven P. Treon, Guang Yang, Xia Liu, Noopur Raje, Andrew Yee, Elizabeth O’Donnell, Zachary R. Hunter, and Jorge J. Castillo, Harvard Medical School; and Noopur Raje, Andrew Yee, and Elizabeth O’Donnell, Massachusetts General Hospital, Boston, MA
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Castillo JJ, Kastritis E, Treon SP. Waldenström Macroglobulinemia: Lessons Learned from Basic and Clinical Research. Hematol Oncol Clin North Am 2018; 32:xiii-xiv. [PMID: 30190026 DOI: 10.1016/j.hoc.2018.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Jorge J Castillo
- Bing Center for Waldenström's Macroglobulinemia, Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, M221, Boston, MA 02215, USA.
| | - Efstathios Kastritis
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, 80 Vasilissis Sofias Avenue, Athens, Attica 11528, Greece.
| | - Steven P Treon
- Bing Center for Waldenström's Macroglobulinemia, Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, M548, Boston, MA 02215, USA.
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127
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Dominguez A, Kastritis E, Castillo JJ. Monoclonal Antibodies for Waldenström Macroglobulinemia. Hematol Oncol Clin North Am 2018; 32:841-852. [PMID: 30190022 DOI: 10.1016/j.hoc.2018.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
For the last 2 decades, anti-CD20 monoclonal antibodies have revolutionized the treatment of patients with B-cell lymphomas. These agents have shown efficacy when used as single agents and also have improved response and survival rates when added to chemotherapy. Monoclonal antibodies are safe and effective as well in patients with Waldenström macroglobulinemia (WM). The purpose of this article is to review the mechanism of action of monoclonal antibodies and to discuss current clinical data supporting their use in patients with WM. This review focuses on retrospective and prospective studies and clinical trials on anti-CD20 antibodies, anti-CD38 antibody, and anti-CXCR4 antibody.
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Affiliation(s)
- Andres Dominguez
- Department of Internal Medicine, Fundación Valle del Lili, CES University, Cali, Colombia
| | - Efstathios Kastritis
- Department of Clinical Therapeutics, National and Kapodistrian University, Athens, Greece
| | - Jorge J Castillo
- Bing Center for Waldenstrom Macroglobulinemia, Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, Mayer 221, Boston, MA 02215, USA.
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Gustine JN, Tsakmaklis N, Demos MG, Kofides A, Chen JG, Liu X, Munshi M, Guerrera ML, Chan GG, Patterson CJ, Meid K, Dubeau T, Yang G, Hunter ZR, Treon SP, Castillo JJ, Xu L. TP53 mutations are associated with mutated MYD88 and CXCR4, and confer an adverse outcome in Waldenström macroglobulinaemia. Br J Haematol 2018; 184:242-245. [PMID: 30183082 DOI: 10.1111/bjh.15560] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 07/05/2018] [Indexed: 12/28/2022]
Abstract
Little is known about TP53 mutations in Waldenström Macroglobulinaemia (WM). We evaluated 265 WM patients for TP53 mutations by next-generation sequencing, and validated the findings by Sanger sequencing. TP53 mutations were identified and validated in 6 (2·6%) patients that impacted the DNA-binding domain. All six were MYD88- and CXCR4-mutated. Ibrutinib showed activity in patients carrying all three mutations. With a median follow-up of 18 months, 2 (33%) with biallelic TP53 inactivation died of progressive disease. TP53 mutations are rare in WM, and associate with MYD88 and CXCR4 mutations. WM patients with TP53 mutations show response to ibrutinib.
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Affiliation(s)
- Joshua N Gustine
- Bing Center for Waldenström's Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Nicholas Tsakmaklis
- Bing Center for Waldenström's Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Maria G Demos
- Bing Center for Waldenström's Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Amanda Kofides
- Bing Center for Waldenström's Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Jiaji G Chen
- Bing Center for Waldenström's Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Xia Liu
- Bing Center for Waldenström's Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Manit Munshi
- Bing Center for Waldenström's Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Maria L Guerrera
- Bing Center for Waldenström's Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Gloria G Chan
- Bing Center for Waldenström's Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Christopher J Patterson
- Bing Center for Waldenström's Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Kirsten Meid
- Bing Center for Waldenström's Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Toni Dubeau
- Bing Center for Waldenström's Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Guang Yang
- Bing Center for Waldenström's Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA.,Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Zachary R Hunter
- Bing Center for Waldenström's Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA.,Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Steven P Treon
- Bing Center for Waldenström's Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA.,Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Jorge J Castillo
- Bing Center for Waldenström's Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA.,Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Lian Xu
- Bing Center for Waldenström's Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
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Jurczyszyn A, Castillo JJ, Vesole DH, Liu J, Avivi I, Waszczuk-Gajda A, Lech-Maranda E, Gentile M, Mikala G, Guerrero-Garcia T, Suska A, Gertz MA. Clinical characteristics and treatment outcomes in IgE multiple myeloma: A case-control study. Am J Hematol 2018; 93:E238-E241. [PMID: 29989240 DOI: 10.1002/ajh.25209] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 06/18/2018] [Indexed: 11/05/2022]
Affiliation(s)
- Artur Jurczyszyn
- Department of Hematology; Jagiellonian University Medical College; Cracow Poland
| | - Jorge J. Castillo
- Dana-Farber Cancer Institute; Harvard Medical School; Boston Massachusetts
| | - David H. Vesole
- John Theurer Cancer Center; Hackensack University Medical Center; Jersey
| | - Jieqi Liu
- Rutgers New Jersey Medical School; Newark New Jersey
| | | | - Anna Waszczuk-Gajda
- Department of Hematology, Oncology and Internal Diseases; Warsaw Medical University; Warsaw Poland
| | - Ewa Lech-Maranda
- Institute of Hematology and Transfusion Medicine; Warsaw Poland
- Centre of Postgraduate Medical Education; Warsaw Poland
| | - Massimo Gentile
- Hematology Unit, Department of Onco-Hematology; A.O. of Cosenza; Cosenza Italy
| | - Gabor Mikala
- Department of Hematology and Stem Cell Transplantation; South-Pest Central Hospital, National Instistute of Hematology and Infectology; Budapest Hungary
| | | | - Anna Suska
- Department of Hematology; Jagiellonian University Medical College; Cracow Poland
| | - Morie A. Gertz
- Division of Hematology; Mayo Clinic; Rochester Minnesota
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Gustine JN, Meid K, Dubeau T, Severns P, Hunter ZR, Guang Y, Xu L, Treon SP, Castillo JJ. Ibrutinib discontinuation in Waldenström macroglobulinemia: Etiologies, outcomes, and IgM rebound. Am J Hematol 2018; 93:511-517. [PMID: 29280186 DOI: 10.1002/ajh.25023] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 12/20/2017] [Accepted: 12/21/2017] [Indexed: 12/21/2022]
Abstract
Ibrutinib is the first approved therapy for symptomatic patients with Waldenström macroglobulinemia (WM). The reasons for discontinuing ibrutinib and subsequent outcomes have not been previously evaluated in WM patients. We therefore conducted a retrospective review of 189 WM patients seen at our institution who received treatment with ibrutinib, of whom 51 (27%) have discontinued therapy. Reasons for discontinuation include: disease progression (n = 27; 14%), toxicity (n = 15; 8%), nonresponse (n = 5; 3%), and other unrelated reasons (n = 4; 2%). The cumulative incidence of ibrutinib discontinuation at 12, 24, 36, and 48 months from treatment initiation was 22%, 26%, 35%, and 43%, respectively. A baseline platelet count ≤100 K/µL and presence of tumor CXCR4 mutations were independently associated with 4-fold increased odds of ibrutinib discontinuation. An IgM rebound (≥25% increase in serum IgM) was observed in 37 patients (73%) following ibrutinib discontinuation and occurred within 4 weeks for nearly half of patients. The response rate to salvage therapy was 71%; responses were higher in patients without an IgM rebound and when salvage therapy was initiated within 2 weeks of stopping ibrutinib. Patients who discontinued ibrutinib due to disease progression versus nonprogression events had significantly shorter overall survival (21 versus 32 months; P = .046). Response to salvage therapy was associated with an 82% reduction in the risk of death following ibrutinib discontinuation. WM patients who discontinue ibrutinib require close monitoring, and continuation of ibrutinib until the next therapy should be considered to maintain disease control.
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Affiliation(s)
- Joshua N. Gustine
- Bing Center for Waldenström's Macroglobulinemia; Dana-Farber Cancer Institute; Boston Massachusetts
| | - Kirsten Meid
- Bing Center for Waldenström's Macroglobulinemia; Dana-Farber Cancer Institute; Boston Massachusetts
| | - Toni Dubeau
- Bing Center for Waldenström's Macroglobulinemia; Dana-Farber Cancer Institute; Boston Massachusetts
| | - Patricia Severns
- Bing Center for Waldenström's Macroglobulinemia; Dana-Farber Cancer Institute; Boston Massachusetts
| | - Zachary R. Hunter
- Bing Center for Waldenström's Macroglobulinemia; Dana-Farber Cancer Institute; Boston Massachusetts
- Department of Medicine; Harvard Medical School; Boston Massachusetts
| | - Yang Guang
- Bing Center for Waldenström's Macroglobulinemia; Dana-Farber Cancer Institute; Boston Massachusetts
- Department of Medicine; Harvard Medical School; Boston Massachusetts
| | - Lian Xu
- Bing Center for Waldenström's Macroglobulinemia; Dana-Farber Cancer Institute; Boston Massachusetts
| | - Steven P. Treon
- Bing Center for Waldenström's Macroglobulinemia; Dana-Farber Cancer Institute; Boston Massachusetts
- Department of Medicine; Harvard Medical School; Boston Massachusetts
| | - Jorge J. Castillo
- Bing Center for Waldenström's Macroglobulinemia; Dana-Farber Cancer Institute; Boston Massachusetts
- Department of Medicine; Harvard Medical School; Boston Massachusetts
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Abstract
The initial evaluation of the patient with Waldenström macroglobulinemia can be challenging. Not only is it a rare disease, but the clinical features can vary greatly from patient to patient. In this article, we aim at providing concise and practical recommendations for the initial evaluation of patients with Waldenström macroglobulinemia, specifically regarding history taking, physical examination, laboratory testing, bone marrow aspiration, and biopsy evaluation and imaging studies. We then review the most common special clinical situations seen in patients with Waldenström macroglobulinemia, especially anemia, hyperviscosity, cryoglobulinemia, peripheral neuropathy, extramedullary disease, Bing-Neel syndrome, and amyloidosis.
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Affiliation(s)
- Jorge J Castillo
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, Mayer 221, Boston, MA 02215, USA.
| | - Steven P Treon
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, Mayer 221, Boston, MA 02215, USA
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132
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Jurczyszyn A, Davila J, Kortüm KM, Jayabalan DS, Vij R, Fiala M, Milunovic V, Chim CS, Wiśniewska-Piąty K, Waszczuk-Gajda A, Crusoe E, Hajek R, Robak P, Raźny M, Zawirska D, Bittrich M, Nahi H, Liu J, Castillo JJ, Vesole DH. Multiple myeloma in patients up to 30 years of age: a multicenter retrospective study of 52 cases. Leuk Lymphoma 2018; 60:471-476. [PMID: 30033832 DOI: 10.1080/10428194.2018.1480766] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
A small proportion of patients with multiple myeloma (MM) are diagnosed at a very young age. The clinicopathological characteristics and prognosis of these patients are not well known. This analysis included 52 patients diagnosed with MM at the age of ≤30 years (range: 8-30 years). 68% of patients had International Scoring System (ISS) 1 MM; 22% presented with the light chain-only disease, and 48% with elevated serum lactate dehydrogenase (LDH). 85% of patients were treated with novel agents, and 62% received front-line autologous stem cell transplantation (ASCT). Overall response rate (ORR) to front-line treatment and ASCT were 71% and 90%, respectively. The group was followed-up for the median period of 86 months. The median overall survival (OS) was 166 months (95% CI: 53-222), with 5-year OS rate of 77% (95% CI: 61.0-87.9). This findings suggest that the prognosis in young MM patients may be as good if not better than in the general population of MM patients.
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Affiliation(s)
- Artur Jurczyszyn
- a Department of Hematology , Jagiellonian University Medical College , Cracow , Poland
| | - Julio Davila
- b Department of Hematology , Hospital Universitario de Salamanca , Salamanca , Spain
| | - K Martin Kortüm
- c Department of Internal Medicine II , University Hospital Würzburg , Würzburg , Germany
| | | | - Ravi Vij
- e Washington University School of Medicine , Saint Louis , MO , USA
| | - Mark Fiala
- e Washington University School of Medicine , Saint Louis , MO , USA
| | - Vibor Milunovic
- f Division of Hematology , Clinical Hospital Merkur , Zagreb , Croatia
| | - C S Chim
- g Queen Mary Hospital , University of Hong Kong , Hong Kong
| | - Katarzyna Wiśniewska-Piąty
- h School of Medicine in Katowice Department of Hematology and Bone Marrow Transplantation , Silesian Medical University , Katowice , Poland
| | - Anna Waszczuk-Gajda
- i Department of Hematology Oncology and Internal Medicine , Warsaw Medical University , Warsaw , Poland
| | - Edvan Crusoe
- j Hospital Universitario Professor Edgar Santos , Salvador , Brazil
| | - Roman Hajek
- k Department of Hematooncology University Hospital Ostrava and Faculty of Medicine University of Ostrava , Ostrava , Czech Republic
| | - Paweł Robak
- l Department of Hematology , Medical University of Lodz , Memorial , Hospital Lodz , Poland Copernicus
| | | | - Daria Zawirska
- n Faculty of Medicine , Jagiellonian University Medical College , Cracow , Poland
| | - Max Bittrich
- c Department of Internal Medicine II , University Hospital Würzburg , Würzburg , Germany
| | - Hareth Nahi
- o Haematology Centre Karolinska , Karolinska University Hospital , Stockholm , Sweden
| | - Jieqi Liu
- p Rutgers New Jersey Medical School , Newark , NJ , USA
| | - Jorge J Castillo
- q Dana-Farber Cancer Institute, Harvard Medical School , Boston , MA , USA
| | - David H Vesole
- r John Theurer Cancer Center Hackensack University Medical Center , Hackensack , NJ , USA
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133
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Jurczyszyn A, Castillo JJ, Avivi I, Czepiel J, Davila J, Vij R, Fiala MA, Gozzetti A, Grząśko N, Milunovic V, Hus I, Mądry K, Waszczuk-Gajda A, Usnarska-Zubkiewicz L, Dębski J, Atilla E, Beksac M, Mele G, Sawicki W, Jayabalan D, Charliński G, Gyula Szabo A, Hajek R, Delforge M, Kopacz A, Fantl D, Waage A, Crusoe E, Hungria V, Richardson P, Laubach J, Guerrero-Garcia T, Liu J, Vesole DH. Secondary plasma cell leukemia: a multicenter retrospective study of 101 patients. Leuk Lymphoma 2018; 60:118-123. [DOI: 10.1080/10428194.2018.1473574] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Artur Jurczyszyn
- Hematology Department, Jagiellonian University Medical College, Cracow, Poland
| | - Jorge J. Castillo
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Irit Avivi
- Tel Aviv Medical Center, Tel Aviv, Israel
| | - Jacek Czepiel
- Department of Infectious and Tropical Diseases, Jagiellonian University Medical College, Cracow, Poland
| | - Julio Davila
- Hospital Universitario de Salamanca, Salamanca, Spain
| | - Ravi Vij
- Washington University School of Medicine, Saint Louis, MO, USA
| | - Mark A. Fiala
- Washington University School of Medicine, Saint Louis, MO, USA
| | | | - Norbert Grząśko
- Department of Hematology, St John’s Cancer Center, Lublin, Poland
- Department of Experimental Hematology, Medical University of Lublin, Lublin, Poland
| | - Vibor Milunovic
- Division of Hematology, Clinical Hospital Merkur, Zagreb, Croatia
| | - Iwona Hus
- Department of Haematology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | - Krzysztof Mądry
- Department of Hematology, Oncology and Internal Medicine, Warsaw Medical University, Warsaw, Poland
| | - Anna Waszczuk-Gajda
- Department of Hematology, Oncology and Internal Medicine, Warsaw Medical University, Warsaw, Poland
| | - Lidia Usnarska-Zubkiewicz
- Department of Hematology, Blood Neoplasms and Bone Marrow Transplantation, Wroclaw Medical University, Wroclaw, Poland
| | - Jakub Dębski
- Department of Hematology, Blood Neoplasms and Bone Marrow Transplantation, Wroclaw Medical University, Wroclaw, Poland
| | - Erden Atilla
- Hematology Department and Bone Marrow Transplantation Unit, Ankara University Medical School, Ankara, Turkey
| | - Meral Beksac
- Hematology Department and Bone Marrow Transplantation Unit, Ankara University Medical School, Ankara, Turkey
| | | | - Waldemar Sawicki
- Department of Internal Medicine and Hematology, Military Institute of Medicine, Warsaw, Poland
| | | | | | | | - Roman Hajek
- Faculty of Medicine, University Hospital Ostrava, University of Ostrava, Ostrava, Czech Republic
| | | | | | - Dorotea Fantl
- Seccion Hematologia Adultos, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Anders Waage
- Norwegian University of Science and Technology, St. Olav’s Hospital, Trondheim, Norway
| | - Edvan Crusoe
- Hospital Universitario Professor Edgar Santos, Salvador, Brazil
| | - Vania Hungria
- Hospital Universitario Professor Edgar Santos, Salvador, Brazil
| | - Paul Richardson
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Jacob Laubach
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Thomas Guerrero-Garcia
- Division of Hematology and Oncology, Dana-Farber Cancer Institute at St. Elizabeth’s Medical Center, Brighton, MA, USA
| | - Jieqi Liu
- Rutgers New Jersey Medical School, Newark, NJ, USA
| | - David H. Vesole
- John Theurer Cancer Center, Myeloma Division, Hackensack University Medical Center, Hackensack, NJ, USA
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134
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Castillo JJ, Gustine JN, Meid K, Dubeau T, Severns P, Treon SP. Ibrutinib withdrawal symptoms in patients with Waldenström macroglobulinemia. Haematologica 2018; 103:e307-e310. [PMID: 29472352 PMCID: PMC6029546 DOI: 10.3324/haematol.2017.186908] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Jorge J Castillo
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Joshua N Gustine
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Kirsten Meid
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Toni Dubeau
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Patricia Severns
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Steven P Treon
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
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135
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Castillo JJ, Beltran BE, Miranda RN, Young KH, Chavez JC, Sotomayor EM. EBV-positive diffuse large B-cell lymphoma, not otherwise specified: 2018 update on diagnosis, risk-stratification and management. Am J Hematol 2018; 93:953-962. [PMID: 29984868 DOI: 10.1002/ajh.25112] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 04/10/2018] [Indexed: 12/29/2022]
Abstract
DISEASE OVERVIEW Epstein Barr virus-positive (EBV+) diffuse large B-cell lymphoma (DLBCL), not otherwise specified (NOS) is an entity included in the 2016 WHO classification of lymphoid neoplasms. EBV+ DLBCL, NOS, is an aggressive B-cell lymphoma associated with chronic EBV infection, and a poor prognosis with standard chemotherapeutic approaches. DIAGNOSIS The diagnosis is made through a careful pathological evaluation. Detection of EBV-encoded RNA is considered standard for diagnosis; however, a clear cutoff for positivity has not been defined. The differential diagnosis includes plasmablastic lymphoma, DLBCL associated with chronic inflammation, primary effusion lymphoma, HHV8+ DLBCL, NOS, and EBV+ mucocutaneuos ulcer. RISK-STRATIFICATION The International prognostic index (IPI) and the Oyama score can be used for risk-stratification. The Oyama score includes age >70 years and presence of B symptoms. The expression of CD30 is emerging as a potential adverse, and targetable, prognostic factor. MANAGEMENT Patients with EBV+ DLBCL, NOS, should be staged and managed following similar guidelines than patients with EBV-negative DLBCL. EBV+ DLBCL, NOS, however, has a worse prognosis than EBV-negative DLBCL in the era of chemoimmunotherapy. There is an opportunity to study and develop targeted therapy in the management of patients with EBV+ DLBCL, NOS.
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Affiliation(s)
- Jorge J. Castillo
- Division of Hematologic Malignancies; Dana-Farber Cancer Institute, Harvard Medical School; Boston Massachusetts
| | - Brady E. Beltran
- Department of Oncology and Radiotherapy; Hospital Nacional Edgardo Rebagliati Martins, and Research Center for Precision Medicine, Universidad San Martin de Porres Medical School; Lima Peru
| | - Roberto N. Miranda
- Department of Hematopathology; The University of Texas MD Anderson Cancer Center; Houston Texas
| | - Ken H. Young
- Department of Hematopathology; The University of Texas MD Anderson Cancer Center; Houston Texas
| | - Julio C. Chavez
- Section of Malignant Hematology; Moffitt Cancer Center, University of South Florida; Tampa Florida
| | - Eduardo M. Sotomayor
- Department of Hematology and Oncology; George Washington Cancer Center, George Washington University; Washington DC
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136
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Castillo JJ. Viral lymphomagenesis: beyond the usual suspects. Br J Haematol 2018; 182:617-618. [PMID: 29808932 DOI: 10.1111/bjh.15414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Jorge J Castillo
- Division of Hematologic Malignancies, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
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137
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Paredes S, Beltran BE, Sotomayor EM, Castillo JJ, Salas R. High RDW as a predictive and prognostic factor in patients with diffuse large B-cell lymphoma treated with chemoimmunotherapy. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e19547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Sally Paredes
- Hospital Nacional Edgardo Rebagliati Martins, Lima, PE
| | | | | | | | - Renzo Salas
- Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru
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138
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Castillo JJ, Gustine JN, Meid K, Dubeau TE, Xu L, Yang G, Hunter ZR, Advani R, Palomba L, Treon SP. Impact of ibrutinib dose intensity on patient outcomes in previously treated Waldenström macroglobulinemia. Haematologica 2018; 103:e466-e468. [PMID: 29773590 DOI: 10.3324/haematol.2018.191999] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
- Jorge J Castillo
- Bing Center for Waldenstrom Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA .,Harvard Medical School, Boston, MA, USA
| | - Joshua N Gustine
- Bing Center for Waldenstrom Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Kirsten Meid
- Bing Center for Waldenstrom Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Toni E Dubeau
- Bing Center for Waldenstrom Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Lian Xu
- Bing Center for Waldenstrom Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Guang Yang
- Bing Center for Waldenstrom Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Zachary R Hunter
- Bing Center for Waldenstrom Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | | | - Lia Palomba
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Steven P Treon
- Bing Center for Waldenstrom Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
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139
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Castillo JJ, Dubeau T, Kofides A, Demos MG, Tsakmaklis N, Xu L, Hunter ZR, Treon SP. Spotting the elusive Siberian tiger: Complete response to ibrutinib in a patient with Waldenström Macroglobulinemia. Am J Hematol 2018; 93. [PMID: 29756293 DOI: 10.1002/ajh.25142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 05/10/2018] [Indexed: 11/12/2022]
Affiliation(s)
- Jorge J Castillo
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Toni Dubeau
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Amanda Kofides
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Maria G Demos
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Nicholas Tsakmaklis
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Lian Xu
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Zachary R Hunter
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Steven P Treon
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
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140
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Castillo JJ, Gustine JN, Treon SP. Fitting mSMART Into the Current Clinical Management of Waldenström Macroglobulinemia. JAMA Oncol 2018; 4:744-745. [DOI: 10.1001/jamaoncol.2017.0734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Jorge J. Castillo
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Joshua N. Gustine
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Steven P. Treon
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
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141
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Singh A, Geller HI, Alexander KM, Padera RF, Mitchell RN, Dorbala S, Castillo JJ, Falk RH. True, true unrelated? Coexistence of Waldenström macroglobulinemia and cardiac transthyretin amyloidosis. Haematologica 2018; 103:e374-e376. [PMID: 29674499 DOI: 10.3324/haematol.2018.190405] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Affiliation(s)
- Avinainder Singh
- Cardiac Amyloidosis Program, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Hallie I Geller
- Cardiac Amyloidosis Program, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Kevin M Alexander
- Cardiac Amyloidosis Program, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Robert F Padera
- Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA
| | | | - Sharmila Dorbala
- Cardiac Amyloidosis Program, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Jorge J Castillo
- Bing Center for Waldenstrom's Macroglobulinemia, Dana Faber Cancer Institute, Boston, MA, USA
| | - Rodney H Falk
- Cardiac Amyloidosis Program, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
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142
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Castillo JJ, Meid K, Gustine JN, Dubeau T, Severns P, Hunter ZR, Yang G, Xu L, Treon SP. Prospective Clinical Trial of Ixazomib, Dexamethasone, and Rituximab as Primary Therapy in Waldenström Macroglobulinemia. Clin Cancer Res 2018; 24:3247-3252. [DOI: 10.1158/1078-0432.ccr-18-0152] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Revised: 03/09/2018] [Accepted: 04/10/2018] [Indexed: 11/16/2022]
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143
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Guerrera ML, Tsakmaklis N, Xu L, Yang G, Demos M, Kofides A, Chan GG, Manning RJ, Liu X, Chen JG, Munshi M, Patterson CJ, Castillo JJ, Dubeau T, Gustine J, Carrasco RD, Arcaini L, Varettoni M, Cazzola M, Treon SP, Hunter ZR. MYD88 mutated and wild-type Waldenström's Macroglobulinemia: characterization of chromosome 6q gene losses and their mutual exclusivity with mutations in CXCR4. Haematologica 2018; 103:e408-e411. [PMID: 29599202 DOI: 10.3324/haematol.2018.190181] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Maria Luisa Guerrera
- Bing Center for Waldenström's Macroglobulinemia, Dana-Farber Cancer Institute, USA.,Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.,Department of Hematology and Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Nickolas Tsakmaklis
- Bing Center for Waldenström's Macroglobulinemia, Dana-Farber Cancer Institute, USA
| | - Lian Xu
- Bing Center for Waldenström's Macroglobulinemia, Dana-Farber Cancer Institute, USA
| | - Guang Yang
- Bing Center for Waldenström's Macroglobulinemia, Dana-Farber Cancer Institute, USA.,Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Maria Demos
- Bing Center for Waldenström's Macroglobulinemia, Dana-Farber Cancer Institute, USA
| | - Amanda Kofides
- Bing Center for Waldenström's Macroglobulinemia, Dana-Farber Cancer Institute, USA
| | - Gloria G Chan
- Bing Center for Waldenström's Macroglobulinemia, Dana-Farber Cancer Institute, USA
| | - Robert J Manning
- Bing Center for Waldenström's Macroglobulinemia, Dana-Farber Cancer Institute, USA
| | - Xia Liu
- Bing Center for Waldenström's Macroglobulinemia, Dana-Farber Cancer Institute, USA
| | - Jiaji G Chen
- Bing Center for Waldenström's Macroglobulinemia, Dana-Farber Cancer Institute, USA
| | - Manit Munshi
- Bing Center for Waldenström's Macroglobulinemia, Dana-Farber Cancer Institute, USA
| | | | - Jorge J Castillo
- Bing Center for Waldenström's Macroglobulinemia, Dana-Farber Cancer Institute, USA.,Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Toni Dubeau
- Bing Center for Waldenström's Macroglobulinemia, Dana-Farber Cancer Institute, USA
| | - Joshua Gustine
- Bing Center for Waldenström's Macroglobulinemia, Dana-Farber Cancer Institute, USA
| | - Ruben D Carrasco
- Department of Oncologic Pathology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.,Department of Pathology, Brigham & Women's Hospital, Boston, MA, USA
| | - Luca Arcaini
- Department of Hematology and Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.,Department of Molecular Medicine, University of Pavia, Italy
| | - Marzia Varettoni
- Department of Hematology and Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Mario Cazzola
- Department of Hematology and Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.,Department of Molecular Medicine, University of Pavia, Italy
| | - Steven P Treon
- Bing Center for Waldenström's Macroglobulinemia, Dana-Farber Cancer Institute, USA.,Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Zachary R Hunter
- Bing Center for Waldenström's Macroglobulinemia, Dana-Farber Cancer Institute, USA .,Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
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144
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Castillo JJ, Gustine JN, Meid K, Dubeau T, Severns P, Xu L, Yang G, Hunter ZR, Treon SP. Low levels of von Willebrand markers associate with high serum IgM levels and improve with response to therapy, in patients with Waldenström macroglobulinaemia. Br J Haematol 2018. [PMID: 29532913 DOI: 10.1111/bjh.15200] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Jorge J Castillo
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Joshua N Gustine
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Kirsten Meid
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Toni Dubeau
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Patricia Severns
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Lian Xu
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Guang Yang
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Zachary R Hunter
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Steven P Treon
- Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
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145
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Castillo JJ, Guerrero‐Garcia T, Baldini F, Tchernonog E, Cartron G, Ninkovic S, Cwynarski K, Dierickx D, Tousseyn T, Lansigan F, Linnik Y, Mogollon R, Navarro J, Olszewski AJ, Reagan JL, Fedele P, Gilbertson M, Grigoriadis G, Bibas M. Bortezomib plus
EPOCH
is effective as frontline treatment in patients with plasmablastic lymphoma. Br J Haematol 2018. [DOI: 10.1111/bjh.15156] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Jorge J. Castillo
- Division of Hematologic Malignancies Dana‐Farber Cancer Institute Harvard Medical School BostonMAUSA
| | - Thomas Guerrero‐Garcia
- Division of Hematology and Oncology Dana‐Farber Cancer Institute at St. Elizabeth's Medical Center Brighton MA USA
| | - Francesco Baldini
- National Institute for Infectious Diseases Lazzaro Spallanzani Rome Italy
| | | | | | | | | | - Daan Dierickx
- Department of Haematology University Hospitals Leuven Leuven Belgium
| | - Thomas Tousseyn
- Department of Haematology University Hospitals Leuven Leuven Belgium
| | - Frederick Lansigan
- Division of Hematology and Oncology Dartmouth‐Hitchcock Medical Center Dartmouth Medical School Lebanon NH USA
| | - Yevgeny Linnik
- Division of Hematology and Oncology Dartmouth‐Hitchcock Medical Center Dartmouth Medical School Lebanon NH USA
| | - Renzo Mogollon
- Department of Medicine Universidad San Martin de Porres Lima Peru
| | - Jose‐Tomás Navarro
- Catalan Institute of Oncology German Trias I Pujol Hospital Badalona Spain
| | - Adam J. Olszewski
- Division of Hematology and Oncology Rhode Island Hospital The Warren Alpert Medical School of Brown University Providence RI USA
| | - John L. Reagan
- Division of Hematology and Oncology Rhode Island Hospital The Warren Alpert Medical School of Brown University Providence RI USA
| | - Pasquale Fedele
- Monash Haematology, Monash Medical Centre Monash University Clayton Australia
| | - Michael Gilbertson
- Monash Haematology, Monash Medical Centre Monash University Clayton Australia
| | - George Grigoriadis
- Monash Haematology, Monash Medical Centre Monash University Clayton Australia
| | - Michele Bibas
- National Institute for Infectious Diseases Lazzaro Spallanzani Rome Italy
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146
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Castillo JJ, Gustine JN, Meid K, Xu L, Hunter ZR, Treon SP. Comparing apples to oranges: A commentary on the Mayo study of MYD88 significance in Waldenstrom's macroglobulinemia. Am J Hematol 2018; 93:E69-E71. [PMID: 29218718 DOI: 10.1002/ajh.24997] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 12/04/2017] [Indexed: 11/12/2022]
Affiliation(s)
- Jorge J. Castillo
- Department of Medicine; Harvard Medical School; and Bing Center for Waldenstrom's Macroglobulinemia, Dana-Farber Cancer Institute; Boston Massachusetts
| | - Joshua N. Gustine
- Department of Medicine; Harvard Medical School; and Bing Center for Waldenstrom's Macroglobulinemia, Dana-Farber Cancer Institute; Boston Massachusetts
| | - Kirsten Meid
- Department of Medicine; Harvard Medical School; and Bing Center for Waldenstrom's Macroglobulinemia, Dana-Farber Cancer Institute; Boston Massachusetts
| | - Lian Xu
- Department of Medicine; Harvard Medical School; and Bing Center for Waldenstrom's Macroglobulinemia, Dana-Farber Cancer Institute; Boston Massachusetts
| | - Zachary R. Hunter
- Department of Medicine; Harvard Medical School; and Bing Center for Waldenstrom's Macroglobulinemia, Dana-Farber Cancer Institute; Boston Massachusetts
| | - Steven P. Treon
- Department of Medicine; Harvard Medical School; and Bing Center for Waldenstrom's Macroglobulinemia, Dana-Farber Cancer Institute; Boston Massachusetts
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147
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Beltran BE, Castro D, Cruz‐Vargas JA, Cotrina E, Gallo A, Sotomayor EM, Castillo JJ. The neutrophil‐lymphocyte ratio is prognostic in patients with early stage aggressive peripheral T cell lymphoma. Br J Haematol 2018; 184:650-653. [DOI: 10.1111/bjh.15141] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Brady E. Beltran
- Department of Oncology and Radiotherapy Hospital Nacional Edgardo Rebagliati MartinsLimaPeru
- Institute of Research Universidad Ricardo PalmaLimaPeru
| | - Denisse Castro
- Department of Oncology and Radiotherapy Hospital Nacional Edgardo Rebagliati MartinsLimaPeru
| | | | - Esther Cotrina
- Department of Nursing Hospital Nacional Edgardo Rebagliati MartinsLimaPeru
| | - Aly Gallo
- Institute of Research Universidad San Martin de Porres LimaPeru
| | | | - Jorge J. Castillo
- Division of Hematologic Malignancies Dana‐Farber Cancer Institute Harvard Medical School Boston MA USA
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148
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Castillo JJ, Gustine JN, Meid K, Dubeau TE, Severns P, Xu L, Yang G, Hunter ZR, Treon SP. Response and survival for primary therapy combination regimens and maintenance rituximab in Waldenström macroglobulinaemia. Br J Haematol 2018; 181:77-85. [DOI: 10.1111/bjh.15148] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 12/28/2017] [Indexed: 12/20/2022]
Affiliation(s)
- Jorge J. Castillo
- Bing Center for Waldenström Macroglobulinemia Dana‐Farber Cancer Institute Harvard Medical School Boston MA USA
| | - Joshua N. Gustine
- Bing Center for Waldenström Macroglobulinemia Dana‐Farber Cancer Institute Harvard Medical School Boston MA USA
| | - Kirsten Meid
- Bing Center for Waldenström Macroglobulinemia Dana‐Farber Cancer Institute Harvard Medical School Boston MA USA
| | - Toni E. Dubeau
- Bing Center for Waldenström Macroglobulinemia Dana‐Farber Cancer Institute Harvard Medical School Boston MA USA
| | - Patricia Severns
- Bing Center for Waldenström Macroglobulinemia Dana‐Farber Cancer Institute Harvard Medical School Boston MA USA
| | - Lian Xu
- Bing Center for Waldenström Macroglobulinemia Dana‐Farber Cancer Institute Harvard Medical School Boston MA USA
| | - Guang Yang
- Bing Center for Waldenström Macroglobulinemia Dana‐Farber Cancer Institute Harvard Medical School Boston MA USA
| | - Zachary R. Hunter
- Bing Center for Waldenström Macroglobulinemia Dana‐Farber Cancer Institute Harvard Medical School Boston MA USA
| | - Steven P. Treon
- Bing Center for Waldenström Macroglobulinemia Dana‐Farber Cancer Institute Harvard Medical School Boston MA USA
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149
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Jurczyszyn A, Radocha J, Davila J, Fiala MA, Gozzetti A, Grząśko N, Robak P, Hus I, Waszczuk-Gajda A, Guzicka-Kazimierczak R, Atilla E, Mele G, Sawicki W, Jayabalan DS, Charliński G, Szabo AG, Hajek R, Delforge M, Kopacz A, Fantl D, Waage A, Avivi I, Rodzaj M, Leleu X, Richez V, Knopińska-Posłuszny W, Masternak A, Yee AJ, Barchnicka A, Druzd-Sitek A, Guerrero-Garcia T, Liu J, Vesole DH, Castillo JJ. Prognostic indicators in primary plasma cell leukaemia: a multicentre retrospective study of 117 patients. Br J Haematol 2018; 180:831-839. [PMID: 29315478 DOI: 10.1111/bjh.15092] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Accepted: 11/08/2017] [Indexed: 12/13/2022]
Abstract
We report a multicentre retrospective study that analysed clinical characteristics and outcomes in 117 patients with primary plasma cell leukaemia (pPCL) treated at the participating institutions between January 2006 and December 2016. The median age at the time of pPCL diagnosis was 61 years. Ninety-eight patients were treated with novel agents, with an overall response rate of 78%. Fifty-five patients (64%) patients underwent upfront autologous stem cell transplantation (ASCT). The median follow-up time was 50 months (95% confidence interval [CI] 33; 76), with a median overall survival (OS) for the entire group of 23 months (95% CI 15; 34). The median OS time in patients who underwent upfront ASCT was 35 months (95% CI 24·3; 46) as compared to 13 months (95% CI 6·3; 35·8) in patients who did not receive ASCT (P = 0·001). Multivariate analyses identified age ≥60 years, platelet count ≤100 × 109 /l and peripheral blood plasma cell count ≥20 × 109 /l as independent predictors of worse survival. The median OS in patients with 0, 1 or 2-3 of these risk factors was 46, 27 and 12 months, respectively (P < 0·001). Our findings support the use of novel agents and ASCT as frontline treatment in patients with pPCL. The constructed prognostic score should be independently validated.
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Affiliation(s)
| | - Jakub Radocha
- 4th Department of Medicine - Haematology, Charles University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - Julio Davila
- Hospital Universitario de Salamanca, Salamanca, Spain
| | - Mark A Fiala
- Washington University School of Medicine, Saint Louis, MO, USA
| | | | - Norbert Grząśko
- Department of Haematology, St John's Cancer Centre, Lublin, Poland.,Department of Experimental Haematology, Medical University of Lublin, Lublin, Poland
| | - Paweł Robak
- Department of Haematology, Medical University of Lodz, Copernicus Memorial Hospital, Łódź, Poland
| | - Iwona Hus
- Department of Haematology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | - Anna Waszczuk-Gajda
- Department of Haematology, Oncology and Internal Medicine, Warsaw Medical University, Warsaw, Poland
| | | | - Erden Atilla
- Haematology Department and Bone Marrow Transplantation Unit, Ankara University Medical School, Ankara, Turkey
| | | | - Waldemar Sawicki
- Dept. of Internal Medicine and Haematology, Military Institute of Medicine, Warsaw, Poland
| | | | | | - Agoston G Szabo
- Department of Medicine, Section of Haematology, Vejle, Denmark
| | - Roman Hajek
- University Hospital Ostrava and Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | | | - Agnieszka Kopacz
- Department of Haematology, University of Rzeszów, Rzeszów, Poland
| | - Dorotea Fantl
- Seccion Hematologia Adultos, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Anders Waage
- Norwegian University of Science and Technology, Trondheim, Norway
| | - Irit Avivi
- Tel Aviv Medical Centre, Tel Aviv, Israel
| | - Marek Rodzaj
- Department of Haematology, State Hospital, Cracow, Poland
| | - Xavier Leleu
- Service d'Hematologie CHU, Hopital de la Miletrie, Poitiers, France
| | - Valentine Richez
- Ministry of Interior Hospital in Olsztyn with Warmia and Masuria Oncology Centre, Olsztyn, Poland
| | | | - Anna Masternak
- Department of Haematology, State Hospital, Opole, Poland
| | - Andrew J Yee
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Agnieszka Barchnicka
- Department of Doctoral Studies, School of Public Health in Bytom, Medical University of Silesia, Katowice, Poland
| | | | - Thomas Guerrero-Garcia
- Division of Hematology and Oncology, Dana-Farber Cancer Institute at St. Elizabeth's Medical Center, Brighton, MA, USA
| | - Jieqi Liu
- Rutgers New Jersey Medical School, Newark, NJ, USA
| | - David H Vesole
- John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, NJ, USA
| | - Jorge J Castillo
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
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150
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Treon SP, Castillo JJ, Hunter ZR, Merlini G. Waldenström Macroglobulinemia/Lymphoplasmacytic Lymphoma. Hematology 2018. [DOI: 10.1016/b978-0-323-35762-3.00087-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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