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Mota ACMF, Alves JA, Canicoba GS, Brito GAD, Vieira GMM, Baptista AL, Andrade LAS, Imanishe MH, Pereira BJ. Acute Kidney Injury after Bone Marrow Transplantation in Patients with Lymphomas and Leukemias. REVISTA BRASILEIRA DE CANCEROLOGIA 2023. [DOI: 10.32635/2176-9745.rbc.2023v69n1.3423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023] Open
Abstract
Introduction: Hematologic malignancies, including lymphomas and leukemias, may be treated with autologous or allogeneic bone marrow transplantation. However, these approaches can increase the risk of infection, sepsis, graft-versus-host disease, and nephrotoxicity, possibly resulting in acute kidney injury (AKI). Objective: To evaluate AKI in patients with lymphomas or leukemia submitted to bone marrow transplantation (BMT). Method: Retrospective, observational cohort study of cases from a database of 256 patients (53.9% males) hospitalized for BMT between 2012 and 2014 at a cancer hospital in Sao Paulo, Brazil. Of these, 79 were selected randomly for analysis. Demographic data, length of hospitalization, and associated morbidities were recorded. AKI was identified according to Kidney Diseases Improving Global Outcomes (KDIGO) criteria. Results: The most frequent diagnoses for the 79 cases were non-Hodgkin’s lymphoma (30.4%), acute myeloid leukemia (26.6%), and Hodgkin’s lymphoma (24.1%). The probability of 100 days-survival after BMT was 81%, and three years after BMT was 61%. In-hospital mortality was significantly higher among patients who presented AKI during hospitalization (p<0.001). However, there was no difference in overall life expectancy (p=0.770). Conclusion: A significant prevalence of AKI was found in patients with leukemia or lymphoma while they were hospitalized for BMT, resulting in significantly increased rates of in-hospital mortality. The presence of AKI during hospitalization was not associated with a subsequent reduction in life expectancy.
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Cakić J, Đunić I. Therapeutic response in patients with CD30+ lymphomas to biological therapy. MEDICINSKI PODMLADAK 2020. [DOI: 10.5937/mp71-25438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Introduction: Improvements in combined chemotherapy and radiotherapy of the newly diagnosed Hodgkin's lymphoma (HL) resulted in sustained remission rates of approximately 60% to 80%. However, about 5% of the early stages of the disease and 30% to 40% of advanced disease experience relapses after initial chemiotherapy. Standard in the treatment of patients with relapse or refractory HL is salvage therapy followed by autologous stem cell transplantation (ASCT). In approximately 50% patients relapse after ASCT and then effective therapeutic options are limited. Brentuximab vedotin (Adcetris®) is a new antibody-drug conjugate that leads to a high response in the CD30 + lymphomas after ASCT. Material and Methods: Retrospective study included 20 patients, on average aged 53.31 years, that were diagnosed with Hodgkin and Non-Hodgkin lymphomas and treated with Brentuximab vedotin in Clinic for Hematology, Clinical Center of Serbia, in period of 2002 to 2018. The informations of the patients were gathered and databases have been formed from the history of the disease. Statistical analisis included descriptive statistical methods that were done in SPSS programe. Results: The objective response rate (CR + PR) was 76.5% with 29.4% complete remissions (CR) and 47.1% partial remissions (PR). Progressive disease was observed in 17.6%. The median duration of the therapeutic response was 9 months. Conclusion: The application of biological therapy has led to significant progression in the treatment of relapse/refractory Hodgkin's lymphoma, but it is more effective to apply it as a consolidative therapy after ASCT in order to achieve better results of treatment of these patients.
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Patel DA. Haploidentical Stem Cell Transplantation With Post-Transplantation Cyclophosphamide for Aggressive Lymphomas: How Far Have We Come and Where Are We Going? World J Oncol 2019; 10:1-9. [PMID: 30834047 PMCID: PMC6396776 DOI: 10.14740/wjon1164] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 12/14/2018] [Indexed: 01/14/2023] Open
Abstract
Haploidentical hematopoietic stem cell transplantation (haplo-HSCT) with post-transplant cyclophosphamide (PTCy) offers universal donor availability and can potentially cure relapsed or primary refractory Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL). However, a conditioning regimen intensity that balances the graft-versus-lymphoma (GvL) effect with regimen-related toxicities (RRTs) has not yet been optimized. Limited data exist on the management of relapse, which is common post-transplant. Few prospective or randomized control trials have been conducted on lymphoma patients undergoing haplo-HSCT. Therefore, the current review aims to summarize published retrospective data in the field to help guide clinical decision making for high-risk patients. Retrospective studies in the field are characterized by variability in patient population and sample sizes, eligibility criteria, number of prior treatments (e.g., chemotherapy, radiation therapy, and autologous transplant), graft source (bone marrow or peripheral blood), as well as choice and intensity of the conditioning regimen (non-myeloablative, reduced intensity, or myeloablative). Nonetheless, common themes that emerge from the literature include: 1) Enhanced donor availability and selection with haplo-HSCT with success in heterogeneous patient populations; 2) Outcomes that are comparable if not superior to matched related (MRD) or unrelated (MUD) donor transplants; 3) The benefit of PTCy for reducing incidence of relapse and chronic graft-versus-host disease (GvHD); 4) Presence of co-morbidities leading to poorer transplant-related outcomes; and 5) The need for novel approaches to address disease relapse, particularly for patients with active disease at the time of transplant. Excellent transplant-related outcomes with haplo-HSCT with PTCy have been seen for HL and NHL based on retrospective data. Further studies are needed to determine integration with advanced cellular therapy techniques, such as chimeric antigen receptor (CAR) T-cell, antibody drug conjugates, and checkpoint inhibitors. Graft manipulation may be another avenue for future research.
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Affiliation(s)
- Dilan A Patel
- Vanderbilt Ingram Cancer Center, Vanderbilt University School of Medicine, 2220 Pierce Avenue, Nashville, TN 37232, USA.
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Fahy AS, Kong I, Weitzman S, Dix D, Baruchel S, Gerstle JT. A role for surgery in the treatment of relapsed Hodgkin lymphoma. Pediatr Blood Cancer 2019; 66:e27402. [PMID: 30294914 DOI: 10.1002/pbc.27402] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 07/15/2018] [Accepted: 07/16/2018] [Indexed: 01/01/2023]
Abstract
Treatment of Hodgkin lymphoma (HL) has advanced over time, rendering a fatal disease now largely curable. Multiagent chemotherapy regimens, hematopoietic stem cell transplantation, and radiotherapy are the mainstays of care. Surgical intervention is rarely indicated other than for biopsy at diagnosis. However, for patients with recurrent relapsed HL isolated to one anatomical location, refractory to all other therapy, there may be a beneficial role for surgical excision. Herein, we report the surgical management of three relapsed patients with stage IVB HL who were refractory to multiple other therapeutic approaches, who all achieved good event-free survival after operative management.
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Affiliation(s)
- A S Fahy
- Division of General and Thoracic Surgery, Hospital for Sick Children/University of Toronto, Toronto, Canada
| | - I Kong
- Department of Oncology, McMaster University, Alberta, Canada
| | - S Weitzman
- Division of Hematology/Oncology, Hospital for Sick Children, Toronto, Canada
| | - D Dix
- Division of Hematology/Oncology, Hospital for Sick Children, Toronto, Canada
| | - S Baruchel
- Division of Hematology/Oncology, Hospital for Sick Children, Toronto, Canada
| | - J T Gerstle
- Division of General and Thoracic Surgery, Hospital for Sick Children/University of Toronto, Toronto, Canada
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Walewski J, Paszkiewicz-Kozik E, Borsaru G, Hellmann A, Janikova A, Warszewska A, Mais A, Ammendola A, Herz T, Krauss B, Henning SW. Resminostat in patients with relapsed or refractory Hodgkin lymphoma: results of the phase II SAPHIRE study. Leuk Lymphoma 2018; 60:675-684. [DOI: 10.1080/10428194.2018.1492122] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- Jan Walewski
- Department of Lymphoid Malignancies, Maria Skłodowska-Curie Institute – Oncology Center, Warszawa, Poland
| | - Ewa Paszkiewicz-Kozik
- Department of Lymphoid Malignancies, Maria Skłodowska-Curie Institute – Oncology Center, Warszawa, Poland
| | | | - Andrzej Hellmann
- Department for Hematology and Transplantology, University Clinical Centre, Medical University of Gdansk, Gdansk, Poland
| | - Andrea Janikova
- Department of Internal Medicine, Hematology and Oncology, University Hospital Brno, Brno, Czech Republic
| | - Agnieszka Warszewska
- Department of Lymphoid Malignancies, Maria Skłodowska-Curie Institute – Oncology Center, Warszawa, Poland
| | - Anna Mais
- 4SC AG, Martinsried, Planegg, Germany
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Guo X, Wang J, Jin J, Chen H, Zhen Z, Jiang W, Lin T, Huang H, Xia Z, Sun X. High Serum Level of Soluble Programmed Death Ligand 1 is Associated With a Poor Prognosis in Hodgkin Lymphoma. Transl Oncol 2018; 11:779-785. [PMID: 29698935 PMCID: PMC6058012 DOI: 10.1016/j.tranon.2018.03.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 03/14/2018] [Accepted: 03/19/2018] [Indexed: 01/06/2023] Open
Abstract
Blockade of the programmed cell death 1-programmed cell death ligand 1 pathway is a new and promising therapeutic approach in Hodgkin lymphoma (HL). To our knowledge, the impact of soluble programmed cell death ligand 1 (sPD-L1) serum levels on HL patient prognosis has not yet been investigated. In this study, the prognostic value of sPD-L1 was assessed in patients with HL. We measured serum sPD-L1 levels and identified their prognostic value in 108 newly diagnosed HL patients using an enzyme-linked immunosorbent assay (ELISA). We found higher serum sPD-L1 concentrations in HL patients than in healthy controls. The best sPD-L1 cutoff value for predicting disease progression risk was 25.1674 ng/ml. The 4-year progression-free survival (PFS) rates for the high-sPD-L1 and low-sPD-L1 groups were 78.8% and 93.3%, respectively. Multivariate survival analysis showed that advanced stage and higher sPD-L1 levels (>25.1674 ng/ml) were independent prognostic factors for shorter PFS. In addition, higher sPD-L1 levels were positively correlated with advanced stage and negatively correlated with peripheral blood monocyte number. The serum sPD-L1 level is an independent prognostic factor for PFS in HL patients and may allow identification of a subgroup of patients who require more intensive therapy and who may benefit from anti-PD-1 agents.
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Affiliation(s)
- Xiaofang Guo
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Department of Pediatric Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China; The Eastern Hospital of the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Juan Wang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Department of Pediatric Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Jietian Jin
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Department of Pathology, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Hao Chen
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Department of Clinical Laboratory, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Zijun Zhen
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Department of Pediatric Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Wenqi Jiang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Department of Medical Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Tongyu Lin
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Department of Medical Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Huiqiang Huang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Department of Medical Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Zhongjun Xia
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Department of Hematology Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Xiaofei Sun
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Department of Pediatric Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China.
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Kallam A, Armitage JO. Current and emerging treatment options for a patient with a second relapse of Hodgkin’s lymphoma. Expert Rev Hematol 2018. [DOI: 10.1080/17474086.2018.1449637] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Avyakta Kallam
- Division of Oncology/Hematology, University of Nebraska Medical Center, Nebraska Medical Center, Omaha, NE, USA
| | - James O. Armitage
- Division of Oncology/Hematology, University of Nebraska Medical Center, Nebraska Medical Center, Omaha, NE, USA
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Jaime-Pérez JC, Gamboa-Alonso CM, Padilla-Medina JR, Jiménez-Castillo RA, Olguín-Ramírez LA, Gutiérrez-Aguirre CH, Cantú-Rodríguez OG, Gómez-Almaguer D. High frequency of primary refractory disease and low progression-free survival rate of Hodgkin's lymphoma: a decade of experience in a Latin American center. Rev Bras Hematol Hemoter 2017; 39:325-330. [PMID: 29150104 PMCID: PMC5693277 DOI: 10.1016/j.bjhh.2017.08.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 08/09/2017] [Accepted: 08/10/2017] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Reports dealing with clinical outcomes of classical Hodgkin's lymphoma in low- to middle-income countries are scarce and response to therapy is poorly documented. This report describes the characteristics and clinical outcomes of patients with classical Hodgkin's lymphoma from a single institution in Latin America. METHOD A retrospective study was conducted over ten years of patients with classical Hodgkin's lymphoma treated at a referral center. Progression-free and overall survival rates were estimated by Kaplan-Meier analysis. The univariate Cox regression model was used to estimate associations between important variables and clinical outcomes. MAIN RESULTS One hundred and twenty-eight patients were analyzed. The mean age was 28.5 years. The five-year progression-free and overall survival were 37.3% and 78.9%, respectively. Of the whole group, 55 (43%) were primary refractory cases. Only 39/83 (47%) patients with advanced disease vs. 34/45 (75.6%) in early stages (p-value=0.002) achieved complete remission. Those with advanced disease had a five-year overall survival of 68.7% vs. 91.8% for early disease (p-value=0.132). Thirty-one patients relapsed (24.2%) and 20 (64.5%) received a transplant. The hazard ratio for progression with bone marrow infiltration was 2.628 (p-value=0.037). For death, an International Prognostic Score ≥4 had a hazard ratio of 3.355 (p-value=0.050) in univariate analysis. Two-thirds of classical Hodgkin's lymphoma patients diagnosed at advanced stages had a low progression-free survival but an overall survival similar to high-income countries. CONCLUSION Patients diagnosed with classical Hodgkin's lymphoma in Northeastern Mexico had a significantly low progression-free survival rate and presented with advanced disease, underscoring the need for earlier diagnosis and improved contemporary therapeutic strategies in these mainly young productive-age Hodgkin's lymphoma patients.
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Biasoli I, Spector N. New agents in relapsed/refractory Hodgkin's lymphoma. Rev Bras Hematol Hemoter 2017; 39:193-196. [PMID: 28830595 PMCID: PMC5568577 DOI: 10.1016/j.bjhh.2017.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 05/08/2017] [Indexed: 11/17/2022] Open
Affiliation(s)
- Irene Biasoli
- Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil.
| | - Nelson Spector
- Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
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Duarte FB, Fernandes MGDB, Kaufmann J, Barroso KSN, Leitão JPDV, Araujo BSGDSP, Costa CMBED, Quixadá-medica AT, Holanda JDS, Landim SV, Pitombeira MH. Hodgkin’s Lymphoma - evaluation of patients submitted to Autologous transplantation of hematopoietic cells in the Hematology Service of the Hospital Walter Cantídio – Fortaleza, Brazil. Rev Assoc Med Bras (1992) 2016; 62 Suppl 1:34-38. [DOI: 10.1590/1806-9282.62.suppl1.34] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
SUMMARY The Autologous HSCT is an important alternative for refractory or recurrent HL patients in terms of survival and improved quality of life. This study analyzes the results of autologous BMT performed in HL patients in the Transplant Unit of the HUWC/ HEMOCE (Fortaleza - CE, Brazil). Fifty-two transplanted patients were studied from January 2009 to October 2015, among them, 30 men and 22 women, mean age of 28.2 years. All of them received GCS-F during the mobilization, in some cases associated with Vinorelbine or Plerixafor, with CD34 collection averaging 4.8 CD34/kg. The conditioning was performed with BEAC, NEAM or BEAM and the grafting with an average of 10 days. The evaluation on D + 100 showed: CR - 42 (82.7%), PR - 08 (13.5%) and 02 (3.8%) deaths, three and six days after cell infusion. After the D+100, 08 patients in CR showed HL recurrence from 06 to 36 months; 03 died and 05 are being treated with brentuximab; among the 08 patients in PR, 01 died due to HL activity, 04 months after BMT and 07 patients are undergoing treatment. The final evaluation of HL transplant patients showed an OS of 88.5% and a DFS of 61.5% in 6 years, with OS of the chemosensitive patients of 81% and of the chemoresistant ones, of 72.6%. It is possible to conclude that the Autologous HSCT has shown to be an excellent rescue therapy regarding tolerance, as well as the overall survival.
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Son CH, Chiu BCH, Koshy M. Patterns of care and survival outcomes examining radiation therapy for advanced Hodgkin lymphoma. Leuk Lymphoma 2016; 58:343-347. [PMID: 27339611 DOI: 10.1080/10428194.2016.1193856] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The use of radiation therapy (RT) and its impact on survival in advanced Hodgkin lymphoma (HL) is controversial. Data were obtained from the surveillance, epidemiology, and end results (SEER) registries from 1988-2011. There were 9467 adults who met inclusion criteria; 19% received RT. Radiation use declined from 25% in 1988 to 16% in 2011. Five-year overall survival (OS) for stage III and IV patients for the no versus RT cohorts were 79% versus 88% (p < 0.0001) and 73% versus 84% (p < 0.0001), respectively. RT was associated with improved OS (HR = 0.76; 0.68-0.85) on multivariable analysis and in patients diagnosed after 2000. Although there was a decline in utilization of RT from 1988 to 2011, RT was associated with a survival benefit in stage III-IV HL.
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Affiliation(s)
- Christina H Son
- a Department of Radiation and Cellular Oncology , University of Chicago Medicine , Chicago , IL , USA
| | - Brian C H Chiu
- b Department of Public Health Sciences , University of Chicago , Chicago , IL , USA
| | - Matthew Koshy
- a Department of Radiation and Cellular Oncology , University of Chicago Medicine , Chicago , IL , USA.,c Department of Radiation Oncology , University of Illinois at Chicago , Chicago , IL , USA
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