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Kumar S, Sharma A, Bakhshi S, Pushpam D, Gogia A, Sahoo RK, Pramanik R, Kumar A, Pathak N, Thulkar S, Sharma MC, Gupta R, Mallick S, Raina V. Autologous Stem Cell Transplantation in Adult Hodgkin Lymphoma at a Tertiary Care Center in India: Analysis of Outcomes and Prognostic Factors. Indian J Hematol Blood Transfus 2024; 40:181-189. [PMID: 38708163 PMCID: PMC11065798 DOI: 10.1007/s12288-023-01690-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 08/10/2023] [Indexed: 05/07/2024] Open
Abstract
High-dose chemotherapy and autologous stem cell transplant (ASCT) is the standard of care treatment in relapsed/refractory Hodgkin lymphoma (rrHL). Published long-term follow-up data concerning this modality from the Indian subcontinent is lacking. In this retrospective study, the data on adults (> 16 years) with biopsy-confirmed rrHL who were autografted from 1 January 2000 to 31 December 2021 at our transplant unit were analyzed. Progression-free survival (PFS) was defined as time from transplant to disease progression or death due to any cause. Overall survival (OS) was determined from date of transplant to date of death due to any cause. Overall, 134 patients with Hodgkin lymphoma underwent ASCT. At a median follow-up of 38.2 (range, 0.1-240) months, 5 years PFS was 45.3% (95% CI 35.4-54.4). The probability of OS at 5 years was 60.5% (95% CI 49.6-69.6). Eleven (8.2%) patients suffered transplant-related mortality by 100 days. Post-transplant persistent disease, pre-transplant serum hypoalbuminemia (< 3.5 g/dl) and chemo-resistance (< PR after last salvage regimen) of tumour at transplant were independent prognostic factors associated with worse PFS in multivariable analysis. Likewise, age ≥ 30 years, ECOG performance status ≥ 1 and residual disease after transplantation correlated with inferior OS. Long-term outcomes of rrHL patients undergoing ASCT in India match those from the developed world in the era of peripheral blood stem cell transplantation. Pre-transplant performance status, chemo-sensitivity of disease, serum albumin and post-transplant remission status determined survival in our cohort. Supplementary Information The online version contains supplementary material available at 10.1007/s12288-023-01690-x.
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Affiliation(s)
- Sudhir Kumar
- Department of Medical Oncology, Dr BRA IRCH, All India Institute of Medical Sciences, New Delhi, 110029 India
| | - Atul Sharma
- Department of Medical Oncology, Dr BRA IRCH, All India Institute of Medical Sciences, New Delhi, 110029 India
| | - Sameer Bakhshi
- Department of Medical Oncology, Dr BRA IRCH, All India Institute of Medical Sciences, New Delhi, 110029 India
| | - Deepam Pushpam
- Department of Medical Oncology, Dr BRA IRCH, All India Institute of Medical Sciences, New Delhi, 110029 India
| | - Ajay Gogia
- Department of Medical Oncology, Dr BRA IRCH, All India Institute of Medical Sciences, New Delhi, 110029 India
| | - Ranjit Kumar Sahoo
- Department of Medical Oncology, Dr BRA IRCH, All India Institute of Medical Sciences, New Delhi, 110029 India
| | - Raja Pramanik
- Department of Medical Oncology, Dr BRA IRCH, All India Institute of Medical Sciences, New Delhi, 110029 India
| | - Akash Kumar
- Department of Medical Oncology, Dr BRA IRCH, All India Institute of Medical Sciences, New Delhi, 110029 India
| | - Neha Pathak
- Department of Medical Oncology, Institute of Liver and Biliary Sciences, New Delhi, 110070 India
| | - Sanjay Thulkar
- Department of Radio Diagnosis, Dr BRA IRCH All India Institute of Medical Sciences, New Delhi, 110029 India
| | - Meher Chand Sharma
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, 110029 India
| | - Ritu Gupta
- Department of Medical Oncology, Lab Oncology Unit, Dr BRA IRCH All India Institute of Medical Sciences, New Delhi, 110029 India
| | - Soumya Mallick
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, 110029 India
| | - Vinod Raina
- Fortis Memorial Research Institute, Gurgaon, 122006 India
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Sasi A, Ganguly S, Biswas B, Pushpam D, Kumar A, Agarwala S, Khan SA, Kumar VS, Deo S, Sharma DN, Bakhshi S. Determinants and impact of diagnostic interval in bone sarcomas: A retrospective cohort study. Pediatr Blood Cancer 2023; 70:e30135. [PMID: 36524611 DOI: 10.1002/pbc.30135] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 10/30/2022] [Accepted: 11/14/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Diagnostic delays in cancers are frequent in developing countries due to poor health infrastructure. Existing literature from developed countries suggests that diagnostic interval in bone sarcomas is primarily dictated by tumour biology with no impact on survival. This study evaluates the social and biological determinants of the diagnostic interval in bone sarcomas in a resource-challenged setting and assesses its impact on treatment outcomes. METHODS A retrospective single-institutional study was conducted on patients with high-grade bone sarcomas recorded in the sarcoma clinic database between 2003 and 2018. Baseline clinical characteristics and treatment outcomes were recorded. Logistic regression was performed to assess the impact of baseline clinical and social characteristics (distance from treating centre and rural vs. urban residence) on the diagnostic interval. Further, the impact of diagnostic interval on histologic response to neoadjuvant chemotherapy, amputation requirement in extremity sarcomas and survival was evaluated. RESULTS A total of 1227 patients were included for analysis. The median diagnostic interval was 4 months (3-7 months). Age above 18 years, Ewing sarcoma (ES) diagnosis, absence of fever at presentation and tumour size above 7.5 cm were predictors of a longer diagnostic interval (>4 months). The length of the diagnostic interval did not impact amputation requirement or survival outcomes. However, the proportion of patients with good necrosis post-neoadjuvant chemotherapy was lower among patients with longer diagnostic intervals (25% vs. 34·16%; p-value = .04). CONCLUSION Tumour characteristics rather than social factors determined the diagnostic interval. Diagnostic interval did not impact survival outcomes even in a resource-constrained setting.
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Affiliation(s)
- Archana Sasi
- Department of Medical Oncology, Dr. B.R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Shuvadeep Ganguly
- Department of Medical Oncology, Dr. B.R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Bivas Biswas
- Department of Medical Oncology, Tata Medical Centre, Kolkata, West Bengal, India
| | - Deepam Pushpam
- Department of Medical Oncology, Dr. B.R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Akash Kumar
- Department of Medical Oncology, National Cancer Institute, All India Institute of Medical Sciences, New Delhi, India
| | - Sandeep Agarwala
- Department of Paediatric Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Shah Alam Khan
- Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India
| | | | - Suryanarayana Deo
- Department of Surgical Oncology, Dr. B.R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Daya Nand Sharma
- Department of Radiation Oncology, Dr. B.R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Sameer Bakhshi
- Department of Medical Oncology, Dr. B.R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
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Chavananon S, Sripornsawan P, McNeil EB, Chotsampancharoen T. Predictive factors for adverse outcome of advanced-stage childhood lymphoblastic lymphoma: a single tertiary center retrospective study in Thailand. Pediatr Hematol Oncol 2022; 39:233-242. [PMID: 34378480 DOI: 10.1080/08880018.2021.1963360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Childhood lymphoblastic lymphoma (LL) is a highly aggressive neoplasm which has achieved favorable survival outcomes in many developed countries. However, few studies have reported treatment outcomes of childhood LL in resource-limited counties, nor has a prognostic scoring system been developed. The objectives of this study were to evaluate survival outcomes and identify prognostic factors associated with inferior outcomes of childhood LL in a referral center in March 1985 and April 2017 were retrospectively reviewed. Seventy-five advanced-stage LL patients were included, 47 (62.7%) of whom had stage IV at initial diagnosis. The 5-year DFS and OS rates were 44.6% and 44.7%, respectively. There were 3 significant prognostic factors associated with worse outcomes: presence of B symptoms, low albumin level < 3.5 g/dL and serum LDH level > 500 IU/L. From these three factors, we assigned a score of 1 for each and total scores of 0, 1, 2, and 3 could predict 5-year OS rates of 92.3%, 50.9%, 24.7% and 0%, respectively (p < 0.05). The survival of children in this study was lower than in other studies of advanced-stage childhood LL. We identified 3 adverse prognostic factors and developed a prognostic model for clinical use in advanced-stage childhood LL.
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Affiliation(s)
- Shevachut Chavananon
- Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Thailand
| | - Pornpun Sripornsawan
- Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Thailand
| | - Edward B McNeil
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Thailand
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Yang J, Yan J, Li J, Yang Z, Zhang H, Zhao Q, Xu W. El papel de los parámetros metabólicos de la 18F-FDG PET/TC en el linfoma linfoblástico pediátrico. Rev Esp Med Nucl Imagen Mol 2022. [DOI: 10.1016/j.remn.2020.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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The role of 18F-FDG PET/CT metabolic parameters in pediatric lymphoblastic lymphoma. Rev Esp Med Nucl Imagen Mol 2021; 41:91-99. [DOI: 10.1016/j.remnie.2020.12.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 10/04/2020] [Indexed: 01/02/2023]
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Saeedi A, Baghestani A, Khadem Maboudi A, Farhangi H. Determining the Significant Prognostic Factors for the Recurrence of Pediatric Acute Lymphoblastic Leukemia Using a Competing Risks Approach. IRANIAN JOURNAL OF MEDICAL SCIENCES 2020; 45:304-310. [PMID: 32801420 PMCID: PMC7395949 DOI: 10.30476/ijms.2020.83123.1188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Acute lymphoblastic leukemia (ALL) is the most common cause of cancer-related fatality among children. This study aimed to identify the significant prognostic factors for the incidence of pediatric ALL. This retrospective study, conducted from 2007 to 2016 in the Iranian city of Mashhad, enrolled 417 patients with ALL. The diagnosis was confirmed by Giemsa staining of bone marrow smears. The first recurrence was regarded as the event of interest and non-relapse mortality as the competing event through a three-parameter Gompertz model. The level of statistical significance for univariate and multivariate analyses was set at 0.2 and 0.05, respectively. The first recurrence occurred in 44 (10.6%) survivors. Disease-free survival and 5-year overall survival rates were 85.9% and 74%, correspondingly. The five-year incidence rate for the first recurrence was 11.5% in the presence of non-relapse mortality. Briefly, the characteristics of the Gompertz model conferred more effective prognostic factors. Age above 10 years (P=0.010), involvement of the central nervous system (P=0.050), a high white blood cell count (P=0.020), and tumor lysis syndrome (P=0.010) were the significant prognostic factors for the recurrence and mortality of ALL. Accordingly, careful monitoring in the administration of treatment protocols is suggested to reduce the risk of recurrence and death in these patients.
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Affiliation(s)
- Anahita Saeedi
- Department of Biostatistics, School of Paramedical Sciences, Shahid Beheshti University, Tehran, Iran
| | - Ahmadreza Baghestani
- Physiotherapy Research Center, Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Aliakbar Khadem Maboudi
- Department of Biostatistics, School of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamid Farhangi
- Department of Pediatrics Hematology and Oncology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Chitikela S, Pushpam D. Commentary on Clinical Predictors and Prognostic Model for Pediatric Lymphoblastic Lymphoma Treated with Uniform BFM90 Protocol: A Single-Center Experience of 65 Patients from Asia. Indian J Med Paediatr Oncol 2020. [DOI: 10.4103/ijmpo.ijmpo_12_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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