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Kubicki T, Dytfeld D, Wróbel T, Jamroziak K, Robak P, Czyż J, Tyczyńska A, Druzd-Sitek A, Giannopoulos K, Szczepaniak T, Łojko-Dankowska A, Matuszak M, Gil L, Puła B, Rybka J, Majcherek M, Usnarska-Zubkiewicz L, Szukalski Ł, Zaucha JM, Mikulski D, Czabak O, Lahoud OB, Stefka A, Derman BA, Jakubowiak AJ. Polyclonal immunoglobulin recovery in patients with newly diagnosed myeloma receiving maintenance therapy after autologous haematopoietic stem cell transplantation with either carfilzomib, lenalidomide and dexamethasone or lenalidomide alone: Subanalysis of the randomized phase 3 ATLAS trial. Br J Haematol 2023; 203:792-802. [PMID: 37691005 DOI: 10.1111/bjh.19097] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 08/09/2023] [Accepted: 08/25/2023] [Indexed: 09/12/2023]
Abstract
Previous studies suggest that postautologous stem cell transplant (ASCT) recovery of polyclonal immunoglobulin from immunoparesis in patients with multiple myeloma is a positive prognostic marker. We performed a longitudinal analysis of polyclonal immunoglobulin concentrations and unique B-cell sequences in patients enrolled in the phase 3 ATLAS trial that randomized 180 subjects to either carfilzomib, lenalidomide, dexamethasone (KRd) or lenalidomide (R) maintenance. In the KRd arm, standard-risk patients with minimal residual disease negativity after six cycles de-escalated to R alone after cycle 8. One year from the initiation of maintenance at least partial recovery of polyclonal immunoglobulin was observed in more patients on the R arm (58/66, p < 0.001) and in those who de-escalated from KRd to R (27/38, p < 0.001) compared to the KRd arm (9/36). In patients who switched from KRd to R, the concentrations of uninvolved immunoglobulin and the number of B-cell unique sequences increased over time, approaching values observed in the R arm. There were no differences in progression-free survival between the patients with at least partial immunoglobulin recovery and the remaining population. Our analysis indicates that patients receiving continuous therapy after ASCT experience prolonged immunoparesis, limiting prognostic significance of polyclonal immunoglobulin recovery in this setting.
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Affiliation(s)
- Tadeusz Kubicki
- University of Chicago, Chicago, Illinois, USA
- Poznań University of Medical Sciences, Poznań, Poland
| | | | | | | | | | - Jarosław Czyż
- Nicolaus Copernicus University in Toruń Ludwik Rydygier Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland
| | | | | | | | | | | | | | - Lidia Gil
- Poznań University of Medical Sciences, Poznań, Poland
| | - Bartosz Puła
- Institute of Hematology and Blood Transfusion, Warsaw, Poland
| | | | | | | | - Łukasz Szukalski
- Nicolaus Copernicus University in Toruń Ludwik Rydygier Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland
| | | | | | - Olga Czabak
- Medical University of Lublin, Lublin, Poland
| | - Oscar B Lahoud
- Memorial Sloan-Kettering Cancer Center, New York, New York, USA
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2
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Stuckey R, Ianotto JC, Santoro M, Czyż A, Encinas MMP, Gómez-Casares MT, Pereira MSN, de Nałęcz AK, Gołos A, Lewandowski K, Szukalski Ł, González-Martín JM, Sobas MA. Prediction of major bleeding events in 1381 patients with essential thrombocythemia. Int J Hematol 2023; 118:589-595. [PMID: 37660316 PMCID: PMC10615906 DOI: 10.1007/s12185-023-03650-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 07/27/2023] [Accepted: 08/08/2023] [Indexed: 09/05/2023]
Abstract
The goal of therapy in essential thrombocythemia (ET) is reducing thrombotic risk. No algorithm to predict hemorrhage risk exists. The impact ofanti-platelet, cytoreductive and anticoagulation therapies on risk of major bleeding (MB) was evaluated. MB events were retrospectively analyzed in 1381 ET from 10 European centers. There were 0.286 MB events/person-year. Neither the International Thrombosis Prognostic Score for thrombosis in essential thrombocythemia (IPSET-t) nor the revised IPSET-t (r-IPSET-t) was predictive for hemorrhage-free survival at 10 years (p = 0.092 vs p = 0.1). Ageand leukocyte count were MB risk factors, while low hemoglobin was protective. For ET with extreme thrombocytosis (ExtT) and leukocytosis cytoreduction was not protective. MB were more frequent in ET with ExtT who received anticoagulation. Antiplatelet therapy was not, while anticoagulation was a risk factor for MB (HR 3.05, p = 0.016, CI 1.23-7.56), in particular vitamin K antagonists (22.6% of those treated had a MB event, HR 2.96, p = 0.004, CI 1.41-6.22). Survival at 10 years was associated with hemorrhage (OR 2.54, p < 0.001) but not thrombosis (HR 0.95, p = 0.829). Hemorrhage has a higher risk of mortality than thrombosis. Improved risk stratification for MB is necessary. The choice of anticoagulation, cytoreduction and antiplatelet therapies is an important area of research in ET.
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Affiliation(s)
- Ruth Stuckey
- Hematology Department, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas, Spain
| | - Jean-Christophe Ianotto
- Service d'Hématologie et d'Hémostase Clinique, Institut de Cancéro-Hématologie, Centre Hospitalier Universitaire de Brest, Brest, France
| | - Marco Santoro
- Hematology Unit, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
| | - Anna Czyż
- Department of Hematology and Bone Marrow Transplantation, Wroclaw Medical University, Wrocław, Poland
| | - Manuel M Perez Encinas
- Hematology Department, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | | | | | | | | | - Krzysztof Lewandowski
- Department of Hematology and Bone Marrow Transplantation, Poznan University of Medical Sciences, Poznan, Poland
| | - Łukasz Szukalski
- Department of Haematology CM UMK in Bydgoszcz, Nicolaus Copernicus University in Toruń, Toruń, Poland
| | | | - Marta Anna Sobas
- Department of Hematology and Bone Marrow Transplantation, Wroclaw Medical University, Wrocław, Poland.
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Dytfeld D, Wróbel T, Jamroziak K, Kubicki T, Robak P, Walter-Croneck A, Czyż J, Tyczyńska A, Druzd-Sitek A, Giannopoulos K, Nowicki A, Szczepaniak T, Łojko-Dankowska A, Matuszak M, Gil L, Puła B, Rybka J, Majcherek M, Usnarska-Zubkiewicz L, Szukalski Ł, Końska A, Zaucha JM, Walewski J, Mikulski D, Czabak O, Robak T, Lahoud OB, Zonder JA, Griffith K, Stefka A, Major A, Derman BA, Jakubowiak AJ. Carfilzomib, lenalidomide, and dexamethasone or lenalidomide alone as maintenance therapy after autologous stem-cell transplantation in patients with multiple myeloma (ATLAS): interim analysis of a randomised, open-label, phase 3 trial. Lancet Oncol 2023; 24:139-150. [PMID: 36642080 PMCID: PMC10337122 DOI: 10.1016/s1470-2045(22)00738-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 11/19/2022] [Accepted: 11/23/2022] [Indexed: 01/15/2023]
Abstract
BACKGROUND Lenalidomide is a cornerstone of maintenance therapy in patients with newly diagnosed multiple myeloma after autologous stem-cell transplantation. We aimed to compare the efficacy and safety of maintenance therapy with carfilzomib, lenalidomide, and dexamethasone versus lenalidomide alone in this patient population. METHODS This study is an interim analysis of ATLAS, which is an investigator-initiated, multicentre, open-label, randomised, phase 3 trial in 12 academic and clinical centres in the USA and Poland. Participants were aged 18 years or older with newly diagnosed multiple myeloma, completed any type of induction and had stable disease or better, autologous stem-cell transplantation within 100 days, initiated induction 12 months before enrolment, and an Eastern Cooperative Oncology Group performance status of 0 or 1. Patients were randomly assigned (1:1) using permuted blocks of sizes 4 and 6 and a web-based system to receive up to 36 cycles of carfilzomib, lenalidomide, and dexamethasone (28-day cycles of carfilzomib 20 mg/m2 administered intravenously in cycle one on days 1 and 2 then 36 mg/m2 on days 1, 2, 8, 9, 15, and 16 in cycles one to four and 36 mg/m2 on days 1, 2, 15, and 16 from cycle five up to 36 [per protocol]; lenalidomide 25 mg administered orally on days 1-21; and dexamethasone 20 mg administered orally on days 1, 8, 15, and 22) or lenalidomide alone (10 mg administered orally for the first three cycles and then at the best tolerated dose [≤15 mg for 28 days in 28-day cycles]) until disease progression or unacceptable toxicity as maintenance therapy. After 36 cycles, patients in both treatment groups received lenalidomide maintenance. Randomisation was stratified by response to previous treatment, cytogenetic risk factors, and country. Investigators and patients were not masked to treatment allocation. Patients in the carfilzomib, lenalidomide, and dexamethasone group with no detectable minimal residual disease after cycle six (as per International Myeloma Working Group criteria) and standard-risk cytogenetics were switched to lenalidomide maintenance as of cycle nine. The primary endpoint was progression-free survival in the intention-to-treat population (defined as all randomly assigned patients). Safety was analysed in all randomly assigned patients who received at least one dose of study treatment. This unplanned interim analysis was triggered by the occurrence of 59 (61%) of the expected 96 events for the primary analysis and the results are considered preliminary. This trial is registered with ClinicalTrials.gov, NCT02659293 (active, not recruiting) and EudraCT, 2015-002380-42. FINDINGS Between June 10, 2016, and Oct 21, 2020, 180 patients were randomly assigned to receive either carfilzomib, lenalidomide, and dexamethasone (n=93) or lenalidomide alone (n=87; intention-to-treat population). The median age of patients was 59·0 years (IQR 49·0-63·0); 84 (47%) patients were female and 96 (53%) were male. With a median follow-up of 33·8 months (IQR 20·9-42·9), median progression-free survival was 59·1 months (95% CI 54·8-not estimable) in the carfilzomib, lenalidomide, and dexamethasone group versus 41·4 months (33·2-65·4) in the lenalidomide group (hazard ratio 0·51 [95% CI 0·31-0·86]; p=0·012). The most common grade 3 and 4 adverse events were neutropenia (44 [48%] in the carfilzomib, lenalidomide, and dexamethasone group vs 52 [60%] in the lenalidomide group), thrombocytopenia (12 [13%] vs six [7%]), and lower respiratory tract infections (seven [8%] vs one [1%]). Serious adverse events were reported in 28 (30%) patients in the carfilzomib, lenalidomide, and dexamethasone group and 19 (22%) in the lenalidomide group. One treatment-related adverse event led to death (respiratory failure due to severe pneumonia) in the carfilzomib, lenalidomide, and dexamethasone group. INTERPRETATION This interim analysis provides support for considering carfilzomib, lenalidomide, and dexamethasone therapy in patients with newly diagnosed multiple myeloma who completed any induction regimen followed by autologous stem-cell transplantation, which requires confirmation after longer follow-up of this ongoing phase 3 trial. FUNDING Amgen and Celgene (Bristol Myers Squibb).
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Affiliation(s)
| | | | | | | | | | | | - Jarosław Czyż
- Department of Hematology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Torun, Poland
| | - Agata Tyczyńska
- Department of Hematology and Transplantology, Medical University of Gdansk, Gdansk, Poland
| | | | | | - Adam Nowicki
- Poznan University of Medical Sciences, Poznan, Poland
| | | | | | | | - Lidia Gil
- Poznan University of Medical Sciences, Poznan, Poland
| | - Bartosz Puła
- Poznan University of Medical Sciences, Poznan, Poland
| | | | | | | | - Łukasz Szukalski
- Department of Hematology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Torun, Poland
| | | | - Jan Maciej Zaucha
- Department of Hematology and Transplantology, Medical University of Gdansk, Gdansk, Poland
| | - Jan Walewski
- Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | | | - Olga Czabak
- Medical University of Lublin, Lublin, Poland
| | | | - Oscar B Lahoud
- Memorial Sloan-Kettering Cancer Institute, New York, NY, USA
| | | | | | - Andrew Stefka
- University of Chicago Medical Center, Chicago, IL, USA
| | - Ajay Major
- University of Chicago Medical Center, Chicago, IL, USA; University of Colorado School of Medicine, Aurora, CO, USA
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Stuckey R, Ianotto JC, Santoro M, Czyż A, Perez Encinas MM, Gómez-Casares MT, Noya Pereira MS, de Nałęcz AK, Gołos A, Lewandowski K, Szukalski Ł, González-Martín JM, Wróbel T, Sobas MA. Validation of thrombotic risk factors in 1381 patients with essential thrombocythaemia: A multicentre retrospective real-life study. Br J Haematol 2022; 199:86-94. [PMID: 35906782 DOI: 10.1111/bjh.18387] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 02/22/2022] [Revised: 07/07/2022] [Accepted: 07/17/2022] [Indexed: 11/29/2022]
Abstract
Thrombosis and haemorrhage are frequent in patients with essential thrombocythaemia (ET). The 2016 revised International Prognostic Score for Thrombosis in Essential Thrombocythaemia-thrombosis (r-IPSET-t) score stratifies patients into very-low- (VLR), low- (LR), intermediate- (IR) and high-risk (HR) groups. We validated the r-IPSET-t in the biggest population of patients with ET (n = 1381) to date and found it to be a better fit than the earlier IPSET-t score. With an average follow-up of 87.7 months, there were 0.578 thrombotic events/person-year and 0.286 bleeding events/person-year after diagnosis. The 10-year thrombosis-free survival was 88% and 99% for the r-IPSET-t LR and VLR groups (p < 0.001). Cytoreduction was a thrombotic risk factor in younger patients (aged <60 years, hazard ratio 9.49, p = 0.026; aged ≥60 years, hazard ratio 1.04, p = 0.93). In multivariable Cox regression analysis, anti-aggregation after diagnosis was protective for thrombosis (hazard ratio 0.31, p = 0.005) but a risk factor for major bleeding (hazard ratio 10.56, p = 0.021). Of the IPSET-t HR and LR groups, 132/780 and 249/301 were re-classified as LR and VLR respectively (p < 0.001). The European LeukemiaNET (ELN) does not recommend aspirin for VLR patients but in this real-life analysis 83.1% of VLR patients received it. Our results validate the r-IPSET-t score as more predictive for thrombosis than the ELN-recommended IPSET-t and raise concerns about unnecessary cytoreductive and anti-aggregative therapy.
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Affiliation(s)
- Ruth Stuckey
- Hematology Department, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas, Spain
| | - Jean-Christophe Ianotto
- Service d'Hématologie Clinique, Institut de Cancéro-Hématologie, Centre Hospitalier Régional et Universitaire de Brest, Brest, France
| | - Marco Santoro
- Hematology Unit, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
| | - Anna Czyż
- Department of Hematology and Bone Marrow Transplantation, Wroclaw Medical University, Wroclaw, Poland
| | - Manuel M Perez Encinas
- Hematology Department, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | | | | | | | - Aleksandra Gołos
- Department of Hematology, Institute of Hematology, Warsaw, Poland
| | - Krzysztof Lewandowski
- Department of Hematology and Bone Marrow Transplantation, Poznan University of Medical Sciences, Poznan, Poland
| | - Łukasz Szukalski
- Department of Haematology CM UMK in Bydgoszcz, Nicolaus Copernicus University in Toruń, Toruń, Poland
| | | | - Tomasz Wróbel
- Department of Hematology and Bone Marrow Transplantation, Wroclaw Medical University, Wroclaw, Poland
| | - Marta Anna Sobas
- Department of Hematology and Bone Marrow Transplantation, Wroclaw Medical University, Wroclaw, Poland
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5
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Czyż J, Szukalski Ł, Szukalska A, Budziszewska BK, Lech-Marańda E, Zdziarska J, Sacha T. Eculizumab treatment in pregnant women with paroxysmal nocturnal hemoglobinuria: A Polish experience. ADV CLIN EXP MED 2022; 31:707-710. [PMID: 35699586 DOI: 10.17219/acem/150600] [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: 11/24/2022]
Abstract
BACKGROUND Eculizumab is an antibody targeting the C5 complement protein. Clinical trials suggest that eculizumab significantly reduces transfusion requirements and prevents disease complications in patients with paroxysmal nocturnal hemoglobinuria (PNH). OBJECTIVES To analyze the outcome of pregnancies among Polish women with PNH treated with eculizumab as a part of the Polish National Health Fund program. MATERIAL AND METHODS We report the outcomes of 3 pregnancies among women treated with eculizumab between 2017 and 2020. For 1 of these woman, it was the 1st pregnancy, while the remaining 2 patients had previously had 1 previous successful pregnancy each. RESULTS All 3 mothers survived pregnancy, and all children were born alive. One of the patients had a vaginal delivery. Another required cesarean delivery at the 34th week due to a decreasing platelet count. In 1 case, premature rupture of the fetal membranes occurred at week 36, followed by artificial labor induction. All children were born without any inborn defects. The 2 prematurely born babies required a prolonged hospital stay. CONCLUSION Treatment with eculizumab seems to reduce the risk to a mother and a child associated with PNH. However, more data are necessary to confirm this notion.
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Affiliation(s)
- Jarosław Czyż
- Clinic of Hematology, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Poland
| | - Łukasz Szukalski
- Clinic of Hematology, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Poland
| | - Adriana Szukalska
- Clinic of Hematology, Jan Biziel University Hospital No. 2 in Bydgoszcz, Poland
| | | | - Ewa Lech-Marańda
- Institute of Hematology and Transfusion Medicine, Warszawa, Poland
| | - Joanna Zdziarska
- Department of Hematology, Jagiellonian University Medical College, Kraków, Poland
| | - Tomasz Sacha
- Department of Hematology, Jagiellonian University Medical College, Kraków, Poland
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6
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Skalska-Bugala A, Starczak M, Szukalski Ł, Gawronski M, Siomek-Gorecka A, Szpotan J, Labejszo A, Zarakowska E, Szpila A, Jachalska A, Szukalska A, Kruszewski M, Sadowska A, Wasilow A, Baginska P, Czyz J, Olinski R, Rozalski R, Gackowski D. Diagnostic and Prognostic Power of Active DNA Demethylation Pathway Intermediates in Acute Myelogenous Leukemia and Myelodysplastic Syndromes. Cells 2022; 11:cells11050888. [PMID: 35269510 PMCID: PMC8909098 DOI: 10.3390/cells11050888] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 02/22/2022] [Accepted: 03/02/2022] [Indexed: 02/01/2023] Open
Abstract
Acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS) are characterized by genomic instability, which may arise from the global hypomethylation of the DNA. The active DNA demethylation process may be linked with aberrant methylation and can be involved in leukemogenesis. The levels of 5-methylcytosine oxidation products were analyzed in minimally invasive material: the cellular DNA from peripheral blood cells and urine of patients with AML and MDS along with the control group, using isotope-dilution two-dimensional ultra-performance liquid chromatography with tandem mass spectrometry. The receiver operating characteristic curve analysis was used for the assessment of the ability to discriminate patients’ groups from the control group, and AML from MDS. The most diagnostically useful for discriminating AML patients from the control group was the urinary excretion of 5-hydroxymethylcytosine (AUC = 0.918, sensitivity: 85%, and specificity: 97%), and 5-(hydroxymethyl)-2′-deoxyuridine (0.873, 74%, and 92%), while for MDS patients 5-(hydroxymethyl)-2′-deoxycytidine in DNA (0.905, 82%, and 98%) and urinary 5-hydroxymethylcytosine (0.746, 66%, and 92%). Multi-factor models of classification trees allowed the correct classification of patients with AML and MDS in 95.7% and 94.7% of cases. The highest prognostic value of the analyzed parameters in predicting the transformation of MDS into AML was observed for 5-carboxy-2′-deoxycytidine (0.823, 80%, and 97%) and 5-(hydroxymethyl)-2′-deoxyuridine (0.872, 100%, and 75%) in DNA. The presented research proves that the intermediates of the active DNA demethylation pathway determined in the completely non-invasive (urine) or minimally invasive (blood) material can be useful in supporting the diagnostic process of patients with MDS and AML. The possibility of an early identification of a group of MDS patients with an increased risk of transformation into AML is of particular importance.
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Affiliation(s)
- Aleksandra Skalska-Bugala
- Department of Clinical Biochemistry, Faculty of Pharmacy, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-092 Bydgoszcz, Poland; (A.S.-B.); (M.S.); (M.G.); (A.S.-G.); (J.S.); (A.L.); (E.Z.); (A.S.); (A.W.); (P.B.); (R.O.)
| | - Marta Starczak
- Department of Clinical Biochemistry, Faculty of Pharmacy, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-092 Bydgoszcz, Poland; (A.S.-B.); (M.S.); (M.G.); (A.S.-G.); (J.S.); (A.L.); (E.Z.); (A.S.); (A.W.); (P.B.); (R.O.)
| | - Łukasz Szukalski
- Department of Hematology, Faculty of Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-168 Bydgoszcz, Poland; (Ł.S.); (A.J.); (J.C.)
| | - Maciej Gawronski
- Department of Clinical Biochemistry, Faculty of Pharmacy, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-092 Bydgoszcz, Poland; (A.S.-B.); (M.S.); (M.G.); (A.S.-G.); (J.S.); (A.L.); (E.Z.); (A.S.); (A.W.); (P.B.); (R.O.)
| | - Agnieszka Siomek-Gorecka
- Department of Clinical Biochemistry, Faculty of Pharmacy, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-092 Bydgoszcz, Poland; (A.S.-B.); (M.S.); (M.G.); (A.S.-G.); (J.S.); (A.L.); (E.Z.); (A.S.); (A.W.); (P.B.); (R.O.)
| | - Justyna Szpotan
- Department of Clinical Biochemistry, Faculty of Pharmacy, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-092 Bydgoszcz, Poland; (A.S.-B.); (M.S.); (M.G.); (A.S.-G.); (J.S.); (A.L.); (E.Z.); (A.S.); (A.W.); (P.B.); (R.O.)
- Department of Human Biology, Institute of Biology, Faculty of Biological and Veterinary Sciences, Nicolaus Copernicus University in Toruń, 87-100 Toruń, Poland
| | - Anna Labejszo
- Department of Clinical Biochemistry, Faculty of Pharmacy, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-092 Bydgoszcz, Poland; (A.S.-B.); (M.S.); (M.G.); (A.S.-G.); (J.S.); (A.L.); (E.Z.); (A.S.); (A.W.); (P.B.); (R.O.)
- Department of Geriatrics, Division of Biochemistry and Biogerontology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-094 Bydgoszcz, Poland
| | - Ewelina Zarakowska
- Department of Clinical Biochemistry, Faculty of Pharmacy, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-092 Bydgoszcz, Poland; (A.S.-B.); (M.S.); (M.G.); (A.S.-G.); (J.S.); (A.L.); (E.Z.); (A.S.); (A.W.); (P.B.); (R.O.)
| | - Anna Szpila
- Department of Clinical Biochemistry, Faculty of Pharmacy, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-092 Bydgoszcz, Poland; (A.S.-B.); (M.S.); (M.G.); (A.S.-G.); (J.S.); (A.L.); (E.Z.); (A.S.); (A.W.); (P.B.); (R.O.)
| | - Anna Jachalska
- Department of Hematology, Faculty of Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-168 Bydgoszcz, Poland; (Ł.S.); (A.J.); (J.C.)
| | - Adriana Szukalska
- Clinic of Hematology, University Hospital No. 2—Jan Biziel Memorial Hospital, 85-168 Bydgoszcz, Poland; (A.S.); (M.K.)
| | - Marcin Kruszewski
- Clinic of Hematology, University Hospital No. 2—Jan Biziel Memorial Hospital, 85-168 Bydgoszcz, Poland; (A.S.); (M.K.)
| | - Anna Sadowska
- Department of Hematology, Nicolaus Copernicus Hospital, 87-100 Toruń, Poland;
| | - Aleksandra Wasilow
- Department of Clinical Biochemistry, Faculty of Pharmacy, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-092 Bydgoszcz, Poland; (A.S.-B.); (M.S.); (M.G.); (A.S.-G.); (J.S.); (A.L.); (E.Z.); (A.S.); (A.W.); (P.B.); (R.O.)
| | - Patrycja Baginska
- Department of Clinical Biochemistry, Faculty of Pharmacy, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-092 Bydgoszcz, Poland; (A.S.-B.); (M.S.); (M.G.); (A.S.-G.); (J.S.); (A.L.); (E.Z.); (A.S.); (A.W.); (P.B.); (R.O.)
| | - Jaroslaw Czyz
- Department of Hematology, Faculty of Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-168 Bydgoszcz, Poland; (Ł.S.); (A.J.); (J.C.)
| | - Ryszard Olinski
- Department of Clinical Biochemistry, Faculty of Pharmacy, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-092 Bydgoszcz, Poland; (A.S.-B.); (M.S.); (M.G.); (A.S.-G.); (J.S.); (A.L.); (E.Z.); (A.S.); (A.W.); (P.B.); (R.O.)
| | - Rafal Rozalski
- Department of Clinical Biochemistry, Faculty of Pharmacy, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-092 Bydgoszcz, Poland; (A.S.-B.); (M.S.); (M.G.); (A.S.-G.); (J.S.); (A.L.); (E.Z.); (A.S.); (A.W.); (P.B.); (R.O.)
- Correspondence: (R.R.); (D.G.); Tel.: +48-525-853-749 (D.G & R.R)
| | - Daniel Gackowski
- Department of Clinical Biochemistry, Faculty of Pharmacy, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-092 Bydgoszcz, Poland; (A.S.-B.); (M.S.); (M.G.); (A.S.-G.); (J.S.); (A.L.); (E.Z.); (A.S.); (A.W.); (P.B.); (R.O.)
- Correspondence: (R.R.); (D.G.); Tel.: +48-525-853-749 (D.G & R.R)
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Masternak M, Puła B, Knap J, Waszczuk-Gajda A, Drozd-Sokołowska J, Wdowiak K, Grosicki S, Kozłowska I, Kaźmierczak M, Łabędź A, Szukalski Ł, Wiśniewski K, Subocz E, Hałka J, Szymczyk A, Hus M, Jamroziak K, Giannopoulos K. Mean Platelet Volume Has Prognostic Value in Chronic Lymphocytic Leukemia. Cancer Manag Res 2020; 12:9977-9985. [PMID: 33116854 PMCID: PMC7567945 DOI: 10.2147/cmar.s246385] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 09/08/2020] [Indexed: 01/11/2023] Open
Abstract
Purpose Mean platelet volume (MPV) is a readily accessible and commonly tested hematological indicator. Recent studies revealed a significant impact of MPV on the course and prognosis of many diseases, including some types of cancer, as well as on the incidence of atrial fibrillation and bleeding. The study aimed to perform a retrospective analysis of MPV in terms of time to first treatment (TTFT) and to determine its prognostic value in the group of patients with chronic lymphocytic leukemia (CLL). Moreover, the study includes a retrospective analysis of platelet parameters in patients treated with ibrutinib concerning bleeding and atrial fibrillation. Patients and Methods The study included 523 patients with CLL, for 344 the most important cytogenetic aberrations were reported. The Mann–Whitney, Kruskal–Wallis, Kaplan–Meier, chi-squared, log‑rank tests and multivariate Cox proportional hazard regression model were used to analyze collected data. Results The receiver operating characteristic curve analysis was performed to identify optimal cut-off value for MPV. The analysis of survival curves showed that in the group of patients with higher values of MPV TTFT was significantly longer than in the group with lower MPV (17.9 vs 36 months, p=0.0015, cut-off value for MPV= 10.4 fl). In multivariate Cox proportional hazard regression model low MPV, the presence of del11q and del13q provided independent prognostic value for TTFT (HR=0.69, 95%-CI, 0.5293 to 0.9081; p=0.0078; HR=1.76, 95%-CI, 1.3000 to 2.3882, p=0.0003, HR=0.74, 95%-Cl, 0.5674 to 0.9588, p=0.0229, respectively). In the group treated with ibrutinib, 59 patients had no significant correlation between MPV level and the incidence of therapy complications, although in the group of patients with low MPV there was a tendency for more frequent occurrence of atrial fibrillation (p=0.259). Conclusion Low MPV values are associated with unfavorable prognosis and might represent a novel, independent prognostic factor in CLL.
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Affiliation(s)
- Marta Masternak
- Department of Experimental Hematooncology, Medical University of Lublin, Lublin, Poland
| | - Bartosz Puła
- Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | - Joanna Knap
- Department of Experimental Hematooncology, Medical University of Lublin, Lublin, Poland
| | - Anna Waszczuk-Gajda
- Department of Hematology, Oncology and Internal Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Joanna Drozd-Sokołowska
- Department of Hematology, Oncology and Internal Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Kamil Wdowiak
- Department of Internal Medicine and Oncological Chemotherapy, Silesian Medical University, Katowice, Poland
| | - Sebastian Grosicki
- Department of Hematology and Cancer Prevention in Chorzow, Faculty of Health Sciences in Bytom, Silesian Medical University, Katowice, Poland
| | - Izabela Kozłowska
- Department of Hematology and Cancer Prevention, Municipal Hospital in Chorzów, Chorzów, Poland
| | - Marta Kaźmierczak
- Department of Hematology and Cancer Prevention, Municipal Hospital in Chorzów, Chorzów, Poland
| | - Anna Łabędź
- Department of Hematology, Rydrygier's Hospital in Cracow, Cracow, Poland
| | - Łukasz Szukalski
- Department of Hematology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Toruń, Poland
| | - Kamil Wiśniewski
- Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | - Edyta Subocz
- Department of Hematology, Military Institute of Medicine, Warsaw, Poland; Clinical Department of Hematology, Independent Public Healthcare Centre of the Ministry of Internal Affairs and Administration with Warmia-Mazury Region's Oncology Centre in Olsztyn, Olsztyn, Poland
| | - Janusz Hałka
- Clinical Department of Hematology, Independent Public Healthcare Centre of the Ministry of Internal Affairs and Administration with Warmia-Mazury Region's Oncology Centre in Olsztyn, Olsztyn, Poland
| | - Agnieszka Szymczyk
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland; Hematology Department, St John's Cancer Center, Lublin, Poland
| | - Marek Hus
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | - Krzysztof Jamroziak
- Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | - Krzysztof Giannopoulos
- Department of Experimental Hematooncology, Medical University of Lublin, Lublin, Poland; Hematology Department, St John's Cancer Center, Lublin, Poland
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8
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Puła B, Długosz-Danecka M, Salomon-Perzyński A, Szymczyk A, Subocz E, Budziszewska BK, Rybka J, Gil L, Waszczuk-Gajda A, Iskierka-Jażdżewska E, Zaucha JM, Osowiecki M, Piszczek W, Steckiewicz P, Szukalski Ł, Hus M, Lech-Marańda E, Jurczak W, Jamroziak K. Efficacy of high-dose corticosteroid-based treatment for chronic lymphocytic leukemia patients with p53 abnormalities in the era of B-cell receptor inhibitors. Adv Med Sci 2020; 65:371-377. [PMID: 32659728 DOI: 10.1016/j.advms.2020.06.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 03/04/2020] [Accepted: 06/06/2020] [Indexed: 12/15/2022]
Abstract
PURPOSE High-dose methylprednisolone (HDMP) with or without anti-CD20 antibody treatment in the pre B-cell receptor inhibitor (BCRi) era was used as potential salvage therapy for relapsed/refractory chronic lymphocytic leukemia/small lymphocytic lymphoma (r/r CLL/SLL) patients bearing the 17p deletion. PATIENTS AND METHODS Outcomes were compared in retrospect between r/r patients treated with HDMP (n = 20), ibrutinib (n = 39) and idelalisib with rituximab (n = 14). RESULTS Higher overall response rates were found in those patients undergoing BCRi therapy compared to HDMP (79.2% vs. 0%; p < 0.0001), along with longer median progression-free survival (not reached vs. 24.1 months; p < 0.01). Nevertheless, there were no differences in the overall survival (HDMP 35.87 months vs. not reached; p = 0.58). CONCLUSION HDMP treatment was significantly inferior in terms of response rate and progression-free survival in r/r CLL/SLL patients with the 17p deletion, and may only be used whenever novel compounds are unavailable.
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Kalicińska E, Kuszczak B, Dębski J, Szukalski Ł, Wątek M, Strzała J, Rybka J, Czyż J, Lech-Marańda E, Zaucha J, Wróbel T. Hematological malignancies in Polish population: what are the predictors of outcome in patients admitted to Intensive Care Unit? Support Care Cancer 2020; 29:323-330. [PMID: 32361829 DOI: 10.1007/s00520-020-05480-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 12/20/2019] [Accepted: 04/17/2020] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Patients with hematological malignancies (HM) require intensive chemotherapy with curative intent, especially in case of AML that results in more frequent admissions to Intensive Care Units (ICU). Due to our knowledge, this study is the first multicenter retrospective analysis in Polish population. METHODS A total of 200 patients with HM hospitalized in 4 Polish hematological centers. Data concerning clinical indices and outcomes during admission and ICU stay were collected retrospectively. RESULTS The most common hematological malignancy was acute leukemia (55%). The main cause of ICU admission was respiratory failure (88.5%), often accompanied by sepsis (58.5%) and acute renal failure (51.5%). In patients with hematological malignancies, the following factors were associated with ICU mortality: prolonged ICU stay (odd ratio [OR] = 6.98, 95% confidence interval [CI]: 1.38-35.33, χ2 = 5.61, p = 0.02), the presence of acute respiratory failure (odd ratio [OR] = 5.35, 95% confidence interval [CI]: 1.01-28.46, χ2 = 3.93, p = 0.04), and the need for renal replacement therapy (odd ratio [OR] = 8.75, 95% confidence interval [CI]: 1.23-62.11, χ2 = 4.78, p = 0.03). There were following associations with in-hospital mortality in patients with hematological malignancies: prolonged ICU stay (odd ratio [OR] = 10.12, 95% confidence interval [CI]: 1.85-55.37, χ2 = 7.21, p = 0.008), the presence of acute respiratory failure (odd ratio [OR] =5.24, 95% confidence interval [CI]: 1.36-20.16, χ2 = 5.87, p = 0.02), the need for catecholamine support (odd ratio [OR] =3.43, 95% confidence interval [CI]: 1.06-11.05, χ2 = 4.32, p = 0.04), and renal replacement therapy (odd ratio [OR] =5.55, 95% confidence interval [CI]: 1.14-26.92, χ2 = 4.59, p = 0.03). CONCLUSIONS We have demonstrated that ICU and in-hospital mortalities among patients with hematological malignancies are still poor, but easier access to the intensive care unit and close cooperation between hematologists and intensivists may improve outcomes. We have found that acute failure of key organs (acute respiratory failure, end-stage renal failure requires renal replacement therapy) and length of ICU stay (but probably no comorbidities and illness severity) may have impact on mortality (both ICU and in-hospital).
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Affiliation(s)
- Elżbieta Kalicińska
- Department and Clinic of Hematology, Blood Neoplasms and Bone Marrow Transplantation, Wroclaw Medical University, Wroclaw, Poland.
| | - Bartłomiej Kuszczak
- Department and Clinic of Hematology, Blood Neoplasms and Bone Marrow Transplantation, Wroclaw Medical University, Wroclaw, Poland
| | - Jakub Dębski
- Department and Clinic of Hematology, Blood Neoplasms and Bone Marrow Transplantation, Wroclaw Medical University, Wroclaw, Poland
| | - Łukasz Szukalski
- Department of Hematology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland
| | - Marzena Wątek
- Department of Hematology, Institute of Hematology and Transfusion Medicine in Warsaw, Warsaw, Poland
| | - Judyta Strzała
- Department of Hematology, Medical University of Gdańsk, Gdańsk, Poland
| | - Justyna Rybka
- Department and Clinic of Hematology, Blood Neoplasms and Bone Marrow Transplantation, Wroclaw Medical University, Wroclaw, Poland
| | - Jarosław Czyż
- Department of Hematology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland
| | - Ewa Lech-Marańda
- Department of Hematology, Institute of Hematology and Transfusion Medicine in Warsaw, Warsaw, Poland
| | - Jan Zaucha
- Department of Hematology, Medical University of Gdańsk, Gdańsk, Poland
| | - Tomasz Wróbel
- Department and Clinic of Hematology, Blood Neoplasms and Bone Marrow Transplantation, Wroclaw Medical University, Wroclaw, Poland
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Goldman‐Mazur S, Jurczyszyn A, Castillo JJ, Waszczuk‐Gajda A, Grząśko N, Radocha J, Bittrich M, Kortüm KM, Gozzetti A, Usnarska‐Zubkiewicz L, Davila Valls J, Jayabalan DS, Niesvizky R, Kelman J, Coriu D, Rosiñol L, Szukalski Ł, González‐Calle V, Mateos MV, Jamroziak K, Hus I, Avivi I, Cohen Y, Suska A, Chappell A, Madduri D, Chhabra S, Kleman A, Hari P, Delforge M, Robak P, Gentile M, Kozłowska I, Goldberg SL, Czepiel J, Silbermann R, Olszewski AJ, Barth P, Mikala G, Chim CS, Długosz‐Danecka M, Grosicki S, Vesole DH. A multicenter retrospective study of 223 patients with t(14;16) in multiple myeloma. Am J Hematol 2020; 95:503-509. [PMID: 32072687 DOI: 10.1002/ajh.25758] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 02/01/2020] [Accepted: 02/05/2020] [Indexed: 12/20/2022]
Abstract
The t(14;16) translocation, found in 3%-5% of newly diagnosed (ND) multiple myeloma (MM), has been associated with adverse outcomes. However, the studies establishing the characteristics of t(14;16) included solely small cohorts. The goal of the current international, multicenter (n = 25 centers), retrospective study was to describe the characteristics and outcomes of t(14;16) patients in a large, real-world cohort (n = 223). A substantial fraction of patients had renal impairment (24%) and hemoglobin <10 g/dL (56%) on initial presentation. Combined therapy of both immunomodulatory drug and proteasome inhibitor (PI) in the first line was used in 35% of patients. Autologous stem cell transplantation was performed in 42% of patients. With a median follow up of 4.1 years (95% CI 3.7-18.7), the median progression-free survival (PFS) and overall survival (OS) from first line therapy were 2.1 years (95% CI 1.5-2.4) and 4.1 years (95% CI 3.3-5.5), respectively. Worse OS was predicted by age > 60 years (HR = 1.65, 95% CI [1.05-2.58]), as well as revised International Scoring System (R-ISS) 3 (vs R-ISS 2; HR = 2.59, 95% CI [1.59-4.24]). In conclusion, based on the largest reported cohort of t(14;16) patients, quarter of this subset of MM patients initially presents with renal failure, while older age and the R-ISS 3 predict poor survival.
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Affiliation(s)
- Sarah Goldman‐Mazur
- Department of HematologyJagiellonian University Medical College Cracow Poland
| | - Artur Jurczyszyn
- Department of HematologyJagiellonian University Medical College Cracow Poland
| | - Jorge J. Castillo
- Division of Hematological MalignanciesDana‐Farber Cancer Institute, Harvard Medical School Boston Massachusetts
| | - Anna Waszczuk‐Gajda
- Department of Hematology, Oncology and Internal DiseasesWarsaw Medical University Warsaw Poland
| | - Norbert Grząśko
- Department of Experimental HematologyMedical University of Lublin Lublin Poland
- Department of HematologySt. Johnʼs Cancer Center Lublin Poland
| | - Jakub Radocha
- 4th Department of Internal Medicine– HematologyUniversity Hospital and Faculty of Medicine in Hradec Kralove, Charles University Hradec Kralove Czech Republic
| | - Max Bittrich
- Department of Internal Medicine IIUniversity Hospital Würzburg Würzburg Germany
| | - K. Martin Kortüm
- Department of Internal Medicine IIUniversity Hospital Würzburg Würzburg Germany
| | - Alessandro Gozzetti
- Hematology, Department of Medical Science, Surgery and NeuroscienceUniversity of Siena Siena Italy
| | - Lidia Usnarska‐Zubkiewicz
- Department of HematologyBlood Neoplasms and Bone Marrow Transplantation, Wroclaw Medical University Wroclaw Poland
| | | | | | | | | | - Daniel Coriu
- Department of HematologyFundeni Clinical Institute, University of Medicine and Pharmacy “Carol Davila” Bucharest Romania
| | - Laura Rosiñol
- Department of HematologyAmyloidosis and Myeloma Unit, Hospital Clínic, IDIBAPS, University of Barcelona Barcelona Spain
| | - Łukasz Szukalski
- Department of HematologyCollegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń Bydgoszcz Poland
| | - Veronica González‐Calle
- Hospital Universitario de Salamanca/ Instituto Biosanitario de Salamanca (IBSAL) Salamanca Spain
| | - Maria V. Mateos
- Hospital Universitario de Salamanca/ Instituto Biosanitario de Salamanca (IBSAL) Salamanca Spain
| | | | - Iwona Hus
- Department of Experimental HematologyMedical University of Lublin Lublin Poland
- Institute of Hematology and Transfusion Medicine Warsaw Poland
| | - Irit Avivi
- Tel Aviv Sourasky Medical Center Tel Aviv Israel
- The Sackler Faculty of MedicineTel Aviv University Tel Aviv Israel
| | - Yael Cohen
- Tel Aviv Sourasky Medical Center Tel Aviv Israel
- The Sackler Faculty of MedicineTel Aviv University Tel Aviv Israel
| | - Anna Suska
- Department of HematologyJagiellonian University Medical College Cracow Poland
| | - Aimee Chappell
- Department of Hematology/OncologyMedstar Georgetown University Hospital Washington DC
| | - Deepu Madduri
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai New York New York
| | - Saurabh Chhabra
- Division of Hematology/Oncology Department of Medicine Medical College of Wisconsin Milwaukee Wisconsin
| | - Ariel Kleman
- Division of Hematology/Oncology Department of Medicine Medical College of Wisconsin Milwaukee Wisconsin
| | - Parameswaran Hari
- Division of Hematology/Oncology Department of Medicine Medical College of Wisconsin Milwaukee Wisconsin
| | | | | | | | | | - Stuart L. Goldberg
- John Theurer Cancer CenterHackensack University Medical Center Hackensack New Jersey
- Cota Inc. New York New York
| | - Jacek Czepiel
- Department of Infectious and Tropical DiseasesJagiellonian University Medical College Cracow Poland
| | - Rebecca Silbermann
- Division of Hematology and Medical OncologyKnight Cancer Institute, Oregon Health and Science University Portland Oregon
| | - Adam J. Olszewski
- Department of MedicineWarren Alpert Medical School, Brown University Providence Rhode Island
| | - Peter Barth
- Department of MedicineWarren Alpert Medical School, Brown University Providence Rhode Island
| | - Gabor Mikala
- Department of Hematology and Stem Cell TransplantationSouth‐Pest Central Hospital, National Institute of Hematology and Infectology Budapest Hungary
| | - Chor S. Chim
- Department of MedicineQueen Mary Hospital, University of Hong Kong Pokfulam, Hong Kong
| | - Monika Długosz‐Danecka
- Department of Clinical OncologyMaria Sklodowska‐Curie National Institute of Oncology Cracow Poland
| | - Sebastian Grosicki
- Department of Cancer PreventionMedical University of Silesia Katowice Poland
| | - David H. Vesole
- John Theurer Cancer CenterHackensack University Medical Center Hackensack New Jersey
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11
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Goldman-Mazur S, Jurczyszyn A, Castillo JJ, Waszczuk-Gajda A, Grząśko N, Radocha J, Bittrich M, Kortüm KM, Gozzetti A, Usnarska-Zubkiewicz L, Valls JD, Jayabalan DS, Niesvizky R, Kelman J, Coriu D, Rosiñol L, Szukalski Ł, González-Calle V, Mateos MV, Jamroziak K, Hus I, Avivi I, Cohen Y, Mazur P, Suska A, Chappell A, Madduri D, Chhabra S, Kleman A, Hari P, Delforge M, Robak P, Gentile M, Kozłowska I, Goldberg SL, Czepiel J, Długosz-Danecka M, Silbermann R, Olszewski AJ, Barth P, Mikala G, Chim CS, Vesole DH. Different MAF translocations confer similar prognosis in newly diagnosed multiple myeloma patients. Leuk Lymphoma 2020; 61:1885-1893. [PMID: 32306794 DOI: 10.1080/10428194.2020.1749605] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 01/17/2023]
Abstract
The MAF translocations, t(14;16) and t(14;20), are considered as adverse prognostic factors based on few studies with small sample sizes. We report on their prognostic impact in a large group of 254 patients - 223 (87.8%) with t(14;16) and 31 (12.2%) with t(14;20). There were no intergroup differences in survival estimates. Median progression-free survival was 16.6 months for t(14;16) and 24.9 months for t(14;20) (p = 0.28). Median overall survival (OS) was 54.0 months and 49.0 months, respectively (p = 0.62). Median OS in patients who underwent double autologous stem cell transplantation (ASCT) was 107.0 months versus 60.0 months in patients who received single ASCT (p < 0.001). ISS 3 was associated with shorter OS (HR = 1.89; 95% CI 1.24-3.19; p = 0.005) in Cox analysis. Our study suggests that t(14;20) should be considered as an adverse factor of equal prognostic implication to t(14;16).
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Affiliation(s)
- Sarah Goldman-Mazur
- Department of Hematology, Jagiellonian University Medical College, Cracow, Poland
| | - Artur Jurczyszyn
- Department of Hematology, Jagiellonian University Medical College, Cracow, Poland
| | - Jorge J Castillo
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Anna Waszczuk-Gajda
- Department of Hematology, Oncology and Internal Diseases, Warsaw Medical University, Warsaw, Poland
| | - Norbert Grząśko
- Department of Experimental Hematology, Medical University of Lublin, Lublin, Poland.,Department of Hematology, St. John's Cancer Center, Lublin, Poland
| | - Jakub Radocha
- 4th Department of Internal Medicine - Hematology, University Hospital, Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
| | - Max Bittrich
- Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany
| | - Klaus Martin Kortüm
- Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany
| | - Alessandro Gozzetti
- Division of Hematology, Department of Medical Science, Surgery and Neuroscience, University of Siena, Siena, Italy
| | | | | | | | | | - Julia Kelman
- Weill Cornell Medical College, New York, NY, USA
| | - Daniel Coriu
- Department of Hematology, Fundeni Clinical Institute, University of Medicine and Pharmacy "Carol Davila", Bucharest, Romania
| | - Laura Rosiñol
- Departments of Hematology, Amyloidosis and Myeloma Unit, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Łukasz Szukalski
- Department of Hematology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Toruń, Poland
| | - Veronica González-Calle
- Hospital Universitario de Salamanca/Instituto Biosanitario de Salamanca (IBSAL), Salamanca, Spain
| | - María-Victoria Mateos
- Hospital Universitario de Salamanca/Instituto Biosanitario de Salamanca (IBSAL), Salamanca, Spain
| | | | - Iwona Hus
- Department of Experimental Hematology, Medical University of Lublin, Lublin, Poland.,Department of Hematology, St. John's Cancer Center, Lublin, Poland.,Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | - Irit Avivi
- Tel Aviv Sourasky Medical Center, Tel Aviv, Israel and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yael Cohen
- Tel Aviv Sourasky Medical Center, Tel Aviv, Israel and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Piotr Mazur
- Institute of Cardiology, Jagiellonian University Medical College, Cracow, Poland
| | - Anna Suska
- Department of Hematology, Jagiellonian University Medical College, Cracow, Poland
| | - Aimee Chappell
- Department of Hematology/Oncology, Medstar Georgetown University Hospital, Washington, NW, USA
| | - Deepu Madduri
- Icahn School of Medicine at Mount Sinai, Tisch Cancer Institute, New York, NY, USA
| | - Saurabh Chhabra
- Division of Hematology/Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Ariel Kleman
- Division of Hematology/Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Parameswaran Hari
- Division of Hematology/Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | | | - Paweł Robak
- Department of Experimental Hematology, Medical University of Lodz, Lodz, Poland
| | | | | | - Stuart L Goldberg
- John Theurer Cancer Center, Hackensack UMC, Hackensack, NJ, USA.,Cota Inc, Boston, MA, USA
| | - Jacek Czepiel
- Department of Infectious and Tropical Diseases, Jagiellonian University Medical College, Cracow, Poland
| | | | - Rebecca Silbermann
- Division of Hematology and Medical Oncology, Knight Cancer Institute, Oregon Health and Science University, Portland, OR, USA
| | - Adam J Olszewski
- Department of Medicine, Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Peter Barth
- Department of Medicine, Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Gabor Mikala
- Department of Hematology and Stem Cell Transplantation, South-Pest Central Hospital, National Institute of Hematology and Infectology, Budapest, Hungary
| | - Chor S Chim
- Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, Hong Kong
| | - David H Vesole
- John Theurer Cancer Center, Hackensack UMC, Hackensack, NJ, USA
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