1
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Martín García-Sancho A, Baile M, Rodríguez G, Dlouhy I, Sancho JM, Jarque I, González-Barca E, Salar A, Espeso M, Grande C, Bergua J, Montes-Moreno S, Redondo A, Enjuanes A, Campo E, López-Guillermo A, Caballero D. Lenalidomide in combination with R-ESHAP in patients with relapsed or refractory diffuse large B-cell lymphoma: A phase 2 study from GELTAMO. Br J Haematol 2023; 203:202-211. [PMID: 37485564 DOI: 10.1111/bjh.18989] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 06/18/2023] [Accepted: 07/10/2023] [Indexed: 07/25/2023]
Abstract
Diffuse large B-cell lymphoma (DLBCL) patients with relapsed or refractory (RR) disease have poor outcomes with current salvage regimens. We conducted a phase 2 trial to analyse the safety and efficacy of adding lenalidomide to R-ESHAP (LR-ESHAP) in patients with RR DLBCL. Subjects received 3 cycles of lenalidomide 10 mg/day on days 1-14 of every 21-day cycle, in combination with R-ESHAP at standard doses. Responding patients underwent autologous stem-cell transplantation (ASCT). The primary endpoint was the overall response rate (ORR) after 3 cycles. Centralized cell-of-origin (COO) classification was performed. Forty-six patients were included. The ORR after LR-ESHAP was 67% (35% of patients achieved complete remission). Patients with primary refractory disease (n = 26) had significantly worse ORR than patients with non-refractory disease (54% vs. 85%, p = 0.031). No differences in response rates according to the COO were observed. Twenty-eight patients (61%) underwent ASCT. At a median follow-up of 41 months, the estimated 3-year PFS and OS were 42% and 48%, respectively. The most common grade ≥3 adverse events were thrombocytopenia (70% of patients), neutropenia (67%) and anaemia (35%). There were no treatment-related deaths during LR-ESHAP cycles. In conclusion, LR-ESHAP is a feasible salvage regimen with promising efficacy results for patients with RR DLBCL.
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Affiliation(s)
- A Martín García-Sancho
- Hematology Department, Hospital Universitario de Salamanca-IBSAL, CIBERONC, Universidad de Salamanca, Salamanca, Spain
| | - M Baile
- Hematology Department, Hospital Universitario de Salamanca-IBSAL, CIBERONC, Universidad de Salamanca, Salamanca, Spain
| | - G Rodríguez
- Hematology Department, Hospital Universitario Virgen del Rocío/Virgen Macarena, Sevilla, Spain
| | - I Dlouhy
- Hematology Department, Hospital Clinic, Barcelona, Spain
| | - J M Sancho
- Hematology Department, Hospital Germans Trias i Pujol/ICO-IJC, Badalona, Spain
| | - I Jarque
- Hematology Department, Hospital Universitari i Plotècnic La Fe, CIBERONC, Valencia, Spain
| | - E González-Barca
- Institut Català d'Oncologia-Hospitalet, IDIBELL, Universitat de-Barcelona, Barcelona, Spain
| | - A Salar
- Hematology Department, Hospital del Mar, Barcelona, Spain
| | - M Espeso
- Hematology Department, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - C Grande
- Hematology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - J Bergua
- Hematology Department, Hospital San Pedro de Alcántara, Cáceres, Spain
| | - S Montes-Moreno
- Pathology Department, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - A Redondo
- Hematology Department, Hospital Virgen del Puerto, Plasencia, Spain
| | - A Enjuanes
- Unidad de Genómica del IDIBAPS, Barcelona, Spain
| | - E Campo
- Pathology Department, Hospital Clinic, Barcelona, Spain
| | | | - D Caballero
- Hematology Department, Hospital Universitario de Salamanca-IBSAL, CIBERONC, Universidad de Salamanca, Salamanca, Spain
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2
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Ciavarella S, Vegliante MC, Fabbri M, De Summa S, Melle F, Motta G, De Iuliis V, Opinto G, Enjuanes A, Rega S, Gulino A, Agostinelli C, Scattone A, Tommasi S, Mangia A, Mele F, Simone G, Zito AF, Ingravallo G, Vitolo U, Chiappella A, Tarella C, Gianni AM, Rambaldi A, Zinzani PL, Casadei B, Derenzini E, Loseto G, Pileri A, Tabanelli V, Fiori S, Rivas-Delgado A, López-Guillermo A, Venesio T, Sapino A, Campo E, Tripodo C, Guarini A, Pileri SA. Dissection of DLBCL microenvironment provides a gene expression-based predictor of survival applicable to formalin-fixed paraffin-embedded tissue. Ann Oncol 2019; 30:2015. [PMID: 31539020 PMCID: PMC6938597 DOI: 10.1093/annonc/mdz386] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- S Ciavarella
- Hematology and Cell Therapy Unit, IRCCS-Istituto Tumori 'Giovanni Paolo II', Bari
| | - M C Vegliante
- Hematology and Cell Therapy Unit, IRCCS-Istituto Tumori 'Giovanni Paolo II', Bari
| | - M Fabbri
- Division of Diagnostic Haematopathology, European Institute of Oncology, IRCCS, Milan
| | - S De Summa
- Molecular Diagnostics and Pharmacogenetics Unit, IRCCS-Istituto Tumori 'Giovanni Paolo II', Bari
| | - F Melle
- Division of Diagnostic Haematopathology, European Institute of Oncology, IRCCS, Milan
| | - G Motta
- Division of Diagnostic Haematopathology, European Institute of Oncology, IRCCS, Milan
| | - V De Iuliis
- Post-graduated Medical School of Clinical Pathology, "Gabriele D'Annunzio", University of Chieti, Chieti
| | - G Opinto
- Functional Biomorphology Laboratory, IRCCS-Istituto Tumori 'Giovanni Paolo II', Bari, Italy
| | - A Enjuanes
- Unitat de Genòmica, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona; CIBERONC, Barcelona, Spain
| | - S Rega
- Pathology Department, IRCCS-Istituto Tumori 'Giovanni Paolo II', Bari
| | - A Gulino
- Tumor Immunology Unit, Dipartimento per la Promozione della Salute e Materno Infantile "G. D'Alessandro", University of Palermo, Palermo
| | - C Agostinelli
- Department of Experimental, Diagnostic, and Specialty Medicine (DIMES), Bologna University School of Medicine, Bologna
| | - A Scattone
- Pathology Department, IRCCS-Istituto Tumori 'Giovanni Paolo II', Bari
| | - S Tommasi
- Molecular Diagnostics and Pharmacogenetics Unit, IRCCS-Istituto Tumori 'Giovanni Paolo II', Bari
| | - A Mangia
- Functional Biomorphology Laboratory, IRCCS-Istituto Tumori 'Giovanni Paolo II', Bari, Italy
| | - F Mele
- Pathology Department, IRCCS-Istituto Tumori 'Giovanni Paolo II', Bari
| | - G Simone
- Pathology Department, IRCCS-Istituto Tumori 'Giovanni Paolo II', Bari
| | - A F Zito
- Pathology Department, IRCCS-Istituto Tumori 'Giovanni Paolo II', Bari
| | - G Ingravallo
- Pathology Section, Department of Emergency and Organ Transplantation (DETO), University of Bari "Aldo Moro", Bari
| | - U Vitolo
- Department of Hematology, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Torino
| | - A Chiappella
- Department of Hematology, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Torino
| | - C Tarella
- Onco-Hematology Unit, European Institute of Oncology, IRCCS, Milan
| | - A M Gianni
- Onco-Hematology Unit, European Institute of Oncology, IRCCS, Milan
| | - A Rambaldi
- Department of Hematology and Oncology, Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII, Bergamo; School of Medicine, University of Milan, Milan, Italy
| | - P L Zinzani
- Department of Experimental, Diagnostic, and Specialty Medicine (DIMES), Bologna University School of Medicine, Bologna
| | - B Casadei
- Department of Experimental, Diagnostic, and Specialty Medicine (DIMES), Bologna University School of Medicine, Bologna
| | - E Derenzini
- Onco-Hematology Unit, European Institute of Oncology, IRCCS, Milan
| | - G Loseto
- Hematology and Cell Therapy Unit, IRCCS-Istituto Tumori 'Giovanni Paolo II', Bari
| | - A Pileri
- Department of Experimental, Diagnostic, and Specialty Medicine (DIMES), Bologna University School of Medicine, Bologna
| | - V Tabanelli
- Division of Diagnostic Haematopathology, European Institute of Oncology, IRCCS, Milan
| | - S Fiori
- Division of Diagnostic Haematopathology, European Institute of Oncology, IRCCS, Milan
| | - A Rivas-Delgado
- CIBERONC, Barcelona, Spain; Hematology Department, Hospital Clínic, Barcelona; IDIBAPS, Barcelona, Spain
| | - A López-Guillermo
- CIBERONC, Barcelona, Spain; Hematology Department, Hospital Clínic, Barcelona; IDIBAPS, Barcelona, Spain
| | - T Venesio
- Candiolo Cancer Institute-FPO, IRCCS, Candiolo, Italy
| | - A Sapino
- Candiolo Cancer Institute-FPO, IRCCS, Candiolo, Italy; Department of Medical Sciences, University of Torino, Turin, Italy
| | - E Campo
- CIBERONC, Barcelona, Spain; Haematopathology Unit, Pathology Department, Hospital Clínic, Barcelona; University of Barcelona, Barcelona, Spain
| | - C Tripodo
- Pathology Department, IRCCS-Istituto Tumori 'Giovanni Paolo II', Bari
| | - A Guarini
- Hematology and Cell Therapy Unit, IRCCS-Istituto Tumori 'Giovanni Paolo II', Bari
| | - S A Pileri
- Division of Diagnostic Haematopathology, European Institute of Oncology, IRCCS, Milan
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Ciavarella S, Vegliante MC, Fabbri M, De Summa S, Melle F, Motta G, De Iuliis V, Opinto G, Enjuanes A, Rega S, Gulino A, Agostinelli C, Scattone A, Tommasi S, Mangia A, Mele F, Simone G, Zito AF, Ingravallo G, Vitolo U, Chiappella A, Tarella C, Gianni AM, Rambaldi A, Zinzani PL, Casadei B, Derenzini E, Loseto G, Pileri A, Tabanelli V, Fiori S, Rivas-Delgado A, López-Guillermo A, Venesio T, Sapino A, Campo E, Tripodo C, Guarini A, Pileri SA. Dissection of DLBCL microenvironment provides a gene expression-based predictor of survival applicable to formalin-fixed paraffin-embedded tissue. Ann Oncol 2019; 29:2363-2370. [PMID: 30307529 PMCID: PMC6311951 DOI: 10.1093/annonc/mdy450] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background Gene expression profiling (GEP) studies recognized a prognostic role for tumor microenvironment (TME) in diffuse large B-cell lymphoma (DLBCL), but the routinely adoption of prognostic stromal signatures remains limited. Patients and methods Here, we applied the computational method CIBERSORT to generate a 1028-gene matrix incorporating signatures of 17 immune and stromal cytotypes. Then, we carried out a deconvolution on publicly available GEP data of 482 untreated DLBCLs to reveal associations between clinical outcomes and proportions of putative tumor-infiltrating cell types. Forty-five genes related to peculiar prognostic cytotypes were selected and their expression digitally quantified by NanoString technology on a validation set of 175 formalin-fixed, paraffin-embedded DLBCLs from two randomized trials. Data from an unsupervised clustering analysis were used to build a model of clustering assignment, whose prognostic value was also assessed on an independent cohort of 40 cases. All tissue samples consisted of pretreatment biopsies of advanced-stage DLBCLs treated by comparable R-CHOP/R-CHOP-like regimens. Results In silico analysis demonstrated that higher proportion of myofibroblasts (MFs), dendritic cells, and CD4+ T cells correlated with better outcomes and the expression of genes in our panel is associated with a risk of overall and progression-free survival. In a multivariate Cox model, the microenvironment genes retained high prognostic performance independently of the cell-of-origin (COO), and integration of the two prognosticators (COO + TME) improved survival prediction in both validation set and independent cohort. Moreover, the major contribution of MF-related genes to the panel and Gene Set Enrichment Analysis suggested a strong influence of extracellular matrix determinants in DLBCL biology. Conclusions Our study identified new prognostic categories of DLBCL, providing an easy-to-apply gene panel that powerfully predicts patients’ survival. Moreover, owing to its relationship with specific stromal and immune components, the panel may acquire a predictive relevance in clinical trials exploring new drugs with known impact on TME.
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Affiliation(s)
- S Ciavarella
- Hematology and Cell Therapy Unit, IRCCS-Istituto Tumori 'Giovanni Paolo II', Bari, Italy
| | - M C Vegliante
- Hematology and Cell Therapy Unit, IRCCS-Istituto Tumori 'Giovanni Paolo II', Bari, Italy
| | - M Fabbri
- Division of Diagnostic Haematopathology, European Institute of Oncology, IRCCS, Milan, Italy
| | - S De Summa
- Molecular Diagnostics and Pharmacogenetics Unit, IRCCS-Istituto Tumori 'Giovanni Paolo II', Bari, Italy
| | - F Melle
- Division of Diagnostic Haematopathology, European Institute of Oncology, IRCCS, Milan, Italy
| | - G Motta
- Division of Diagnostic Haematopathology, European Institute of Oncology, IRCCS, Milan, Italy
| | - V De Iuliis
- Post-graduated Medical School of Clinical Pathology, "Gabriele D'Annunzio", University of Chieti, Chieti, Italy
| | - G Opinto
- Functional Biomorphology Laboratory, IRCCS-Istituto Tumori 'Giovanni Paolo II', Bari, Italy
| | - A Enjuanes
- Unitat de Genòmica, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; CIBERONC, Barcelona, Spain
| | - S Rega
- Pathology Department, IRCCS-Istituto Tumori 'Giovanni Paolo II', Bari, Italy
| | - A Gulino
- Tumor Immunology Unit, Dipartimento per la Promozione della Salute e Materno Infantile "G. D'Alessandro", University of Palermo, Palermo, Italy
| | - C Agostinelli
- Department of Experimental, Diagnostic, and Specialty Medicine (DIMES), Bologna University School of Medicine, Bologna, Italy
| | - A Scattone
- Pathology Department, IRCCS-Istituto Tumori 'Giovanni Paolo II', Bari, Italy
| | - S Tommasi
- Molecular Diagnostics and Pharmacogenetics Unit, IRCCS-Istituto Tumori 'Giovanni Paolo II', Bari, Italy
| | - A Mangia
- Functional Biomorphology Laboratory, IRCCS-Istituto Tumori 'Giovanni Paolo II', Bari, Italy
| | - F Mele
- Pathology Department, IRCCS-Istituto Tumori 'Giovanni Paolo II', Bari, Italy
| | - G Simone
- Pathology Department, IRCCS-Istituto Tumori 'Giovanni Paolo II', Bari, Italy
| | - A F Zito
- Pathology Department, IRCCS-Istituto Tumori 'Giovanni Paolo II', Bari, Italy
| | - G Ingravallo
- Pathology Section, Department of Emergency and Organ Transplantation (DETO), University of Bari "Aldo Moro", Bari, Italy
| | - U Vitolo
- Department of Hematology, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - A Chiappella
- Department of Hematology, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - C Tarella
- Onco-Hematology Unit, European Institute of Oncology, IRCCS, Milan, Italy
| | - A M Gianni
- Onco-Hematology Unit, European Institute of Oncology, IRCCS, Milan, Italy
| | - A Rambaldi
- Department of Hematology and Oncology, Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy; School of Medicine, University of Milan, Milan, Italy
| | - P L Zinzani
- Department of Experimental, Diagnostic, and Specialty Medicine (DIMES), Bologna University School of Medicine, Bologna, Italy
| | - B Casadei
- Department of Experimental, Diagnostic, and Specialty Medicine (DIMES), Bologna University School of Medicine, Bologna, Italy
| | - E Derenzini
- Onco-Hematology Unit, European Institute of Oncology, IRCCS, Milan, Italy
| | - G Loseto
- Hematology and Cell Therapy Unit, IRCCS-Istituto Tumori 'Giovanni Paolo II', Bari, Italy
| | - A Pileri
- Department of Experimental, Diagnostic, and Specialty Medicine (DIMES), Bologna University School of Medicine, Bologna, Italy
| | - V Tabanelli
- Division of Diagnostic Haematopathology, European Institute of Oncology, IRCCS, Milan, Italy
| | - S Fiori
- Division of Diagnostic Haematopathology, European Institute of Oncology, IRCCS, Milan, Italy
| | - A Rivas-Delgado
- CIBERONC, Barcelona, Spain; Hematology Department, Hospital Clínic, Barcelona, Spain; IDIBAPS, Barcelona, Spain
| | - A López-Guillermo
- CIBERONC, Barcelona, Spain; Hematology Department, Hospital Clínic, Barcelona, Spain; IDIBAPS, Barcelona, Spain
| | - T Venesio
- Pathology Department, Candiolo Cancer Institute, Turin, Italy
| | - A Sapino
- Pathology Department, Candiolo Cancer Institute, Turin, Italy
| | - E Campo
- CIBERONC, Barcelona, Spain; Haematopathology Unit, Pathology Department, Hospital Clínic, Barcelona, Spain; University of Barcelona, Barcelona, Spain
| | - C Tripodo
- Pathology Department, IRCCS-Istituto Tumori 'Giovanni Paolo II', Bari, Italy
| | - A Guarini
- Hematology and Cell Therapy Unit, IRCCS-Istituto Tumori 'Giovanni Paolo II', Bari, Italy
| | - S A Pileri
- Division of Diagnostic Haematopathology, European Institute of Oncology, IRCCS, Milan, Italy.
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Rivas-Delgado A, Nadeu F, Enjuanes A, Magnano L, Castrejón de Anta N, Mozas P, Baumann T, Delgado J, Balagué O, Villamor N, Campo E, Giné E, López-Guillermo A. MUTATIONAL LANDSCAPE OF DIFFUSE LARGE B-CELL LYMPHOMA (DLBCL) AT DIAGNOSIS AND AT PROGRESSION ASSESSED BY CIRCULATING TUMOR DNA ANALYSIS. Hematol Oncol 2019. [DOI: 10.1002/hon.1_2630] [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: 11/10/2022]
Affiliation(s)
- A. Rivas-Delgado
- Hematology Department; Hospital Clínic de Barcelona; Barcelona Spain
| | - F. Nadeu
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Hospital Clínic; Barcelona Spain
| | - A. Enjuanes
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Hospital Clínic; Barcelona Spain
| | - L. Magnano
- Hematopathology Unit; Department of Pathology, Hospital Clínic de Barcelona; Barcelona Spain
| | | | - P. Mozas
- Hematology Department; Hospital Clínic de Barcelona; Barcelona Spain
| | - T. Baumann
- Hematology Department; Hospital Clínic de Barcelona; Barcelona Spain
| | - J. Delgado
- Hematology Department; Hospital Clínic de Barcelona; Barcelona Spain
| | - O. Balagué
- Department of Pathology; Hospital Clínic de Barcelona; Barcelona Spain
| | - N. Villamor
- Hematopathology Unit; Department of Pathology, Hospital Clínic de Barcelona; Barcelona Spain
| | - E. Campo
- Department of Pathology; Hospital Clínic de Barcelona; Barcelona Spain
| | - E. Giné
- Hematology Department; Hospital Clínic de Barcelona; Barcelona Spain
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Perez Galan P, Valero J, Matas-Cespedes A, Rodriguez V, Arenas F, Carreras J, Serrat N, Guerrero-Hernandez M, Corbera M, Yahiaoui A, Martin S, Rivas-Delgado A, Tannheimer S, Cid M, Campo E, López-Guillermo A, Colomer D. DECIPHERING THE CONTRIBUTION OF MACROPHAGES TO FOLLICULAR LYMPHOMA PATHOGENESIS: NEW INSIGHTS INTO THERAPY. Hematol Oncol 2019. [DOI: 10.1002/hon.108_2629] [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] [Indexed: 11/09/2022]
Affiliation(s)
| | | | - A. Matas-Cespedes
- Clinical pharmacology and Safety Sciences; Astra Zeneca; Cambridge United Kingdom
| | - V. Rodriguez
- Tumor Progression; Garvan Institute of Medical Research; Sydney Australia
| | - F. Arenas
- Hemato-Oncology; IDIBAPS; Barcelona Spain
| | - J. Carreras
- Pathology; Tokai University, School of Medicine; Kanagawa Japan
| | - N. Serrat
- Hemato-Oncology; IDIBAPS; Barcelona Spain
| | | | - M. Corbera
- Internal Medicine; IDIBAPS; Barcelona Spain
| | - A. Yahiaoui
- Oncology; Gilead Sciences; Seattle United States
| | - S. Martin
- Hemato-Oncology; IDIBAPS; Barcelona Spain
| | | | | | - M. Cid
- Internal Medicine; IDIBAPS; Barcelona Spain
| | - E. Campo
- Hemato-Oncology; IDIBAPS; Barcelona Spain
| | | | - D. Colomer
- Hemato-Oncology; IDIBAPS; Barcelona Spain
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Rivas-Delgado A, Nadeu F, Enjuanes A, Magnano L, Mozas P, Osuna M, Martín S, Baumann T, Castrejón de Anta N, Balagué O, Delgado J, Villamor N, Campo E, Giné E, López-Guillermo A. GENOTYPING PRIMARY MEDIASTINAL B-CELL LYMPHOMA (PMBCL) BY MEANS OF CIRCULATING TUMOR DNA ANALYSIS. Hematol Oncol 2019. [DOI: 10.1002/hon.9_2631] [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: 11/05/2022]
Affiliation(s)
- A. Rivas-Delgado
- Hematology Department; Hospital Clínic de Barcelona; Barcelona Spain
| | - F. Nadeu
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Hospital Clínic; Barcelona Spain
| | - A. Enjuanes
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Hospital Clínic; Barcelona Spain
| | - L. Magnano
- Hematopathology Unit; Department of Pathology, Hospital Clínic de Barcelona; Barcelona Spain
| | - P. Mozas
- Hematology Department; Hospital Clínic de Barcelona; Barcelona Spain
| | - M. Osuna
- Hematopathology Unit; Department of Pathology, Hospital Clínic de Barcelona; Barcelona Spain
| | - S. Martín
- Hematopathology Unit; Department of Pathology, Hospital Clínic de Barcelona; Barcelona Spain
| | - T. Baumann
- Hematology Department; Hospital Clínic de Barcelona; Barcelona Spain
| | | | - O. Balagué
- Department of Pathology; Hospital Clínic de Barcelona; Barcelona Spain
| | - J. Delgado
- Hematology Department; Hospital Clínic de Barcelona; Barcelona Spain
| | - N. Villamor
- Hematopathology Unit; Department of Pathology, Hospital Clínic de Barcelona; Barcelona Spain
| | - E. Campo
- Department of Pathology; Hospital Clínic de Barcelona; Barcelona Spain
| | - E. Giné
- Hematology Department; Hospital Clínic de Barcelona; Barcelona Spain
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7
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Mozas P, Magnano L, Rivas-Delgado A, Rivero A, Nadeu F, Veloza L, González-Farré B, Baumann T, Balagué O, Giné E, Delgado J, Villamor N, Campo E, López-Guillermo A. PATTERNS OF CHANGE IN TREATMENT, SURVIVAL, HISTOLOGICAL TRANSFORMATION, AND SECONDARY MALIGNANCIES OF FOLLICULAR LYMPHOMA OVER THE LAST 4 DECADES: A SINGLE CENTER EXPERIENCE. Hematol Oncol 2019. [DOI: 10.1002/hon.66_2631] [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: 11/08/2022]
Affiliation(s)
- P. Mozas
- Hematology; Hospital Clínic de Barcelona; Barcelona Spain
| | - L. Magnano
- Hematopathology Unit; Pathology Department, Hospital Clínic de Barcelona; Barcelona Spain
| | | | - A. Rivero
- Hematology; Hospital Clínic de Barcelona; Barcelona Spain
| | - F. Nadeu
- Lymphoid Malignancies; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Barcelona Spain
| | - L. Veloza
- Pathology; Hospital Clínic de Barcelona; Barcelona Spain
| | | | - T. Baumann
- Hematology; Hospital Clínic de Barcelona; Barcelona Spain
| | - O. Balagué
- Pathology; Hospital Clínic de Barcelona; Barcelona Spain
| | - E. Giné
- Hematology; Hospital Clínic de Barcelona; Barcelona Spain
| | - J. Delgado
- Hematology; Hospital Clínic de Barcelona; Barcelona Spain
| | - N. Villamor
- Hematopathology Unit; Pathology Department, Hospital Clínic de Barcelona; Barcelona Spain
| | - E. Campo
- Pathology; Hospital Clínic de Barcelona; Barcelona Spain
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8
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Nadeu F, Clot G, Delgado J, Martín-García D, Baumann T, Salaverria I, Beà S, Pinyol M, Jares P, Navarro A, Suárez-Cisneros H, Aymerich M, Rozman M, Villamor N, Colomer D, González M, Alcoceba M, Terol MJ, Navarro B, Colado E, Payer ÁR, Puente XS, López-Otín C, López-Guillermo A, Enjuanes A, Campo E. Clinical impact of the subclonal architecture and mutational complexity in chronic lymphocytic leukemia. Leukemia 2018; 32:645-653. [PMID: 28924241 PMCID: PMC5843898 DOI: 10.1038/leu.2017.291] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [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: 06/21/2017] [Revised: 08/07/2017] [Accepted: 09/05/2017] [Indexed: 12/11/2022]
Abstract
Genome studies of chronic lymphocytic leukemia (CLL) have revealed the remarkable subclonal heterogeneity of the tumors, but the clinical implications of this phenomenon are not well known. We assessed the mutational status of 28 CLL driver genes by deep-targeted next-generation sequencing and copy number alterations (CNA) in 406 previously untreated patients and 48 sequential samples. We detected small subclonal mutations (0.6-25% of cells) in nearly all genes (26/28), and they were the sole alteration in 22% of the mutated cases. CNA tended to be acquired early in the evolution of the disease and remained stable, whereas the mutational heterogeneity increased in a subset of tumors. The prognostic impact of different genes was related to the size of the mutated clone. Combining mutations and CNA, we observed that the accumulation of driver alterations (mutational complexity) gradually shortened the time to first treatment independently of the clonal architecture, IGHV status and Binet stage. Conversely, the overall survival was associated with the increasing subclonal diversity of the tumors but it was related to the age of patients, IGHV and TP53 status of the tumors. In conclusion, our study reveals that both the mutational complexity and subclonal diversity influence the evolution of CLL.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Biomarkers, Tumor
- Clonal Evolution/genetics
- DNA Copy Number Variations
- Disease Progression
- Female
- Follow-Up Studies
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell/diagnosis
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/mortality
- Male
- Middle Aged
- Mutation/genetics
- Neoplasm Staging
- Prognosis
- Proportional Hazards Models
- Signal Transduction
- Young Adult
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Affiliation(s)
- F Nadeu
- Lymphoid Neoplasms Program, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Tumores Hematológicos, Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - G Clot
- Lymphoid Neoplasms Program, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Tumores Hematológicos, Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - J Delgado
- Lymphoid Neoplasms Program, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Tumores Hematológicos, Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
- Hematology Department, Hospital Clínic, Barcelona, Spain
| | - D Martín-García
- Lymphoid Neoplasms Program, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Tumores Hematológicos, Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - T Baumann
- Hematology Department, Hospital Clínic, Barcelona, Spain
| | - I Salaverria
- Lymphoid Neoplasms Program, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Tumores Hematológicos, Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - S Beà
- Lymphoid Neoplasms Program, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Tumores Hematológicos, Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - M Pinyol
- Tumores Hematológicos, Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
- Unitat de Genòmica, IDIBAPS, Barcelona, Spain
| | - P Jares
- Lymphoid Neoplasms Program, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Tumores Hematológicos, Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
- Hematology Department, Hospital Clínic, Barcelona, Spain
| | - A Navarro
- Lymphoid Neoplasms Program, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Tumores Hematológicos, Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | | | - M Aymerich
- Lymphoid Neoplasms Program, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Tumores Hematológicos, Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
- Hematology Department, Hospital Clínic, Barcelona, Spain
| | - M Rozman
- Lymphoid Neoplasms Program, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Tumores Hematológicos, Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
- Hematology Department, Hospital Clínic, Barcelona, Spain
| | - N Villamor
- Lymphoid Neoplasms Program, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Tumores Hematológicos, Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
- Hematology Department, Hospital Clínic, Barcelona, Spain
| | - D Colomer
- Lymphoid Neoplasms Program, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Tumores Hematológicos, Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
- Hematology Department, Hospital Clínic, Barcelona, Spain
| | - M González
- Tumores Hematológicos, Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
- Biología Molecular e Histocompatibilidad, Hospital Universitario, Salamanca, Spain
| | - M Alcoceba
- Tumores Hematológicos, Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
- Biología Molecular e Histocompatibilidad, Hospital Universitario, Salamanca, Spain
| | - M J Terol
- Unidad de Hematología, Hospital Clínico Universitario, Valencia, Spain
| | - B Navarro
- Unidad de Hematología, Hospital Clínico Universitario, Valencia, Spain
| | - E Colado
- Servicio de Hematología y Hemoterapia, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - ÁR Payer
- Servicio de Hematología y Hemoterapia, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - X S Puente
- Tumores Hematológicos, Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
- Departamento de Bioquímica y Biología Molecular, Instituto Universitario de Oncología, Universidad de Oviedo, Oviedo, Spain
| | - C López-Otín
- Tumores Hematológicos, Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
- Departamento de Bioquímica y Biología Molecular, Instituto Universitario de Oncología, Universidad de Oviedo, Oviedo, Spain
| | - A López-Guillermo
- Lymphoid Neoplasms Program, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Tumores Hematológicos, Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
- Hematology Department, Hospital Clínic, Barcelona, Spain
- Medical School, Universitat de Barcelona, Barcelona, Spain
| | - A Enjuanes
- Tumores Hematológicos, Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
- Unitat de Genòmica, IDIBAPS, Barcelona, Spain
| | - E Campo
- Lymphoid Neoplasms Program, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Tumores Hematológicos, Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
- Hematology Department, Hospital Clínic, Barcelona, Spain
- Medical School, Universitat de Barcelona, Barcelona, Spain
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9
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Magnano L, Balagué O, Dlouhy I, Rovira J, Karube K, Pinyol M, Rivas-Delgado A, Costa D, Martínez-Trillos A, González-Farre B, Martínez-Pozo A, Giné E, Colomer D, Delgado J, Villamor N, Campo E, López-Guillermo A. Clinicobiological features and prognostic impact of diffuse large B-cell lymphoma component in the outcome of patients with previously untreated follicular lymphoma. Ann Oncol 2017; 28:2799-2805. [PMID: 29045517 DOI: 10.1093/annonc/mdx407] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [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] [Indexed: 08/08/2023] Open
Abstract
BACKGROUND The co-existence at diagnosis of follicular lymphoma (FL) and diffuse large B-cell lymphoma (DLBCL) components (FL/DLBCL) has been considered a transformed lymphoma and accordingly treated although clinicobiological information on these patients is scarce. The aim of this study was to analyze the initial features and outcome of FL/DLBCL patients in the rituximab era. PATIENTS AND METHODS All patients consecutively diagnosed at a single institution with FL/DLBCL (n = 40), as well as those with pure FL (n = 328) or de novo DLBCL (n = 510) as controls. RESULTS The proportion of the DLBCL component was highly variable (median 50%). In 29 FL/DLBCL cases analyzed, the cell of origin was GCB in 86%, ABC in 10% and unclassifiable in 4%. NOTCH1-2 was mutated in 10% of these cases. The proportion of DLBCL component did not impact on overall survival (OS). Regarding initial characteristics, patients with FL/DLBCL were closer to FL in terms of primary nodal origin, good performance status and advanced stage, whereas the other features were intermediate between FL and DLBCL. FL/DLBCL patients were treated as DLBCL with no further intensification. Complete response and primary refractory rates were 65% and 20%, respectively, with these figures being similar to DLBCL and worse than FL. Progression-free survival and OS were intermediate between FL and DLBCL (5-year OS: 85%, 73% and 63% for FL, FL/DLBCL and DLBCL, respectively). FL/DLBCL histology did not reach independent prognostic value for OS in the multivariate analyses. CONCLUSIONS The outcome of FL/DLBCL patients is not worse than that of de novo DLBCL. These cases should be treated with immunochemotherapy as DLBCL, but intensification with ASCT may not be necessary. The biological insights of FL/DLBCL warrants further genetic and molecular studies.
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MESH Headings
- Aged
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Case-Control Studies
- Female
- Follow-Up Studies
- Humans
- Lymphoma, Follicular/complications
- Lymphoma, Follicular/drug therapy
- Lymphoma, Follicular/mortality
- Lymphoma, Follicular/pathology
- Lymphoma, Large B-Cell, Diffuse/complications
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large B-Cell, Diffuse/mortality
- Lymphoma, Large B-Cell, Diffuse/pathology
- Male
- Neoplasm Recurrence, Local/complications
- Neoplasm Recurrence, Local/drug therapy
- Neoplasm Recurrence, Local/mortality
- Neoplasm Recurrence, Local/pathology
- Prognosis
- Survival Rate
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Affiliation(s)
- L Magnano
- Department of Hematology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona;; Hematopathology Unit, Department of Pathology, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona;; CIBERONC, Barcelona
| | - O Balagué
- CIBERONC, Barcelona;; Department of Pathology, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - I Dlouhy
- Department of Hematology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona;; CIBERONC, Barcelona
| | - J Rovira
- Department of Hematology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona;; CIBERONC, Barcelona
| | - K Karube
- Department of Pathology and Cell Biology, Graduate School of Medicine, University of the Ryukyus;; Faculty of Medicine, University of the Ryukyus, Japan
| | - M Pinyol
- CIBERONC, Barcelona;; Genomics Unit, IDIBAPS, Barcelona, Spain
| | - A Rivas-Delgado
- Department of Hematology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona;; CIBERONC, Barcelona
| | - D Costa
- Hematopathology Unit, Department of Pathology, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona;; CIBERONC, Barcelona
| | - A Martínez-Trillos
- Department of Hematology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona;; CIBERONC, Barcelona
| | - B González-Farre
- CIBERONC, Barcelona;; Department of Pathology, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - A Martínez-Pozo
- CIBERONC, Barcelona;; Department of Pathology, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - E Giné
- Department of Hematology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona;; CIBERONC, Barcelona
| | - D Colomer
- Hematopathology Unit, Department of Pathology, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona;; CIBERONC, Barcelona
| | - J Delgado
- Department of Hematology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona;; CIBERONC, Barcelona
| | - N Villamor
- Hematopathology Unit, Department of Pathology, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona;; CIBERONC, Barcelona
| | - E Campo
- Hematopathology Unit, Department of Pathology, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona;; CIBERONC, Barcelona
| | - A López-Guillermo
- Department of Hematology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona;; CIBERONC, Barcelona;.
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10
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Karube K, Enjuanes A, Dlouhy I, Jares P, Martin-Garcia D, Nadeu F, Ordóñez GR, Rovira J, Clot G, Royo C, Navarro A, Gonzalez-Farre B, Vaghefi A, Castellano G, Rubio-Perez C, Tamborero D, Briones J, Salar A, Sancho JM, Mercadal S, Gonzalez-Barca E, Escoda L, Miyoshi H, Ohshima K, Miyawaki K, Kato K, Akashi K, Mozos A, Colomo L, Alcoceba M, Valera A, Carrió A, Costa D, Lopez-Bigas N, Schmitz R, Staudt LM, Salaverria I, López-Guillermo A, Campo E. Integrating genomic alterations in diffuse large B-cell lymphoma identifies new relevant pathways and potential therapeutic targets. Leukemia 2017; 32:675-684. [PMID: 28804123 PMCID: PMC5843901 DOI: 10.1038/leu.2017.251] [Citation(s) in RCA: 119] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 07/24/2017] [Accepted: 07/27/2017] [Indexed: 02/08/2023]
Abstract
Genome studies of diffuse large B-cell lymphoma (DLBCL) have revealed a large number of somatic mutations and structural alterations. However, the clinical significance of these alterations is still not well defined. In this study, we have integrated the analysis of targeted next-generation sequencing of 106 genes and genomic copy number alterations (CNA) in 150 DLBCL. The clinically significant findings were validated in an independent cohort of 111 patients. Germinal center B-cell and activated B-cell DLBCL had a differential profile of mutations, altered pathogenic pathways and CNA. Mutations in genes of the NOTCH pathway and tumor suppressor genes (TP53/CDKN2A), but not individual genes, conferred an unfavorable prognosis, confirmed in the independent validation cohort. A gene expression profiling analysis showed that tumors with NOTCH pathway mutations had a significant modulation of downstream target genes, emphasizing the relevance of this pathway in DLBCL. An in silico drug discovery analysis recognized 69 (46%) cases carrying at least one genomic alteration considered a potential target of drug response according to early clinical trials or preclinical assays in DLBCL or other lymphomas. In conclusion, this study identifies relevant pathways and mutated genes in DLBCL and recognizes potential targets for new intervention strategies.
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Affiliation(s)
- K Karube
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.,Department of Pathology and Cell Biology, Graduate School of Medicine and Faculty of Medicine, University of the Ryukyus, Nishihara, Japan
| | - A Enjuanes
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.,CIBERONC, Madrid, Spain
| | - I Dlouhy
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - P Jares
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.,CIBERONC, Madrid, Spain
| | - D Martin-Garcia
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.,CIBERONC, Madrid, Spain
| | - F Nadeu
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.,CIBERONC, Madrid, Spain
| | | | - J Rovira
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - G Clot
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.,CIBERONC, Madrid, Spain
| | - C Royo
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - A Navarro
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.,CIBERONC, Madrid, Spain
| | - B Gonzalez-Farre
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.,CIBERONC, Madrid, Spain
| | - A Vaghefi
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - G Castellano
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - C Rubio-Perez
- Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Research Unit on Biomedical Informatics, Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - D Tamborero
- Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Research Unit on Biomedical Informatics, Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - J Briones
- Servei de Patologia, Hospital de Sant Pau, Barcelona, Spain
| | - A Salar
- Department of Pathology, Hospital del Mar, Universitat Pompeu Fabra, Barcelona, Spain
| | - J M Sancho
- ICO-Hospital Germans Trias i Pujol, Barcelona, Spain
| | - S Mercadal
- ICO-Hospital Duran i Reynals, L'Hospitalet, Barcelona, Spain
| | | | - L Escoda
- Department of Hematology, Hospital Universitari Joan XXIII, Tarragona, Spain
| | - H Miyoshi
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - K Ohshima
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - K Miyawaki
- Department of Medicine and Biosystemic Science, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - K Kato
- Department of Medicine and Biosystemic Science, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - K Akashi
- Department of Medicine and Biosystemic Science, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - A Mozos
- Servei de Patologia, Hospital de Sant Pau, Barcelona, Spain
| | - L Colomo
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.,Department of Pathology, Hospital del Mar, Universitat Pompeu Fabra, Barcelona, Spain
| | - M Alcoceba
- CIBERONC, Madrid, Spain.,Unidad de Biología Molecular/Histocompatibilidad, Servicio de Hematología, Hospital Universitario de Salamanca, Salamanca, Spain
| | - A Valera
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - A Carrió
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.,CIBERONC, Madrid, Spain
| | - D Costa
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.,CIBERONC, Madrid, Spain
| | - N Lopez-Bigas
- Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Research Unit on Biomedical Informatics, Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain.,Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
| | - R Schmitz
- Lymphoid Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - L M Staudt
- Lymphoid Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - I Salaverria
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.,CIBERONC, Madrid, Spain
| | - A López-Guillermo
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.,CIBERONC, Madrid, Spain
| | - E Campo
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.,CIBERONC, Madrid, Spain
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11
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Pérez-Galán P, Vidal-Crespo A, Matas-Céspedes A, Rodriguez V, Rossi C, Roué G, López-Guillermo A, Giné E, Campo E, Colomer D, Wiestner A, Bezombes C, Balasubramanian S, Chiu C, Doshi P. ANTI-TUMOR ACTIVITY OF DARATUMUMAB, A NOVEL HUMAN ANTI CD38 MONOCLONAL ANTIBODY, IN IN VITRO
AND IN VIVO
MODELS OF B-CELL NON-HODGKIN LYMPHOMA. Hematol Oncol 2017. [DOI: 10.1002/hon.2437_29] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
| | | | | | | | - C. Rossi
- Hematology-Oncology; Centre de Recherche en Cancérologie de Toulouse (CRCT); Toulouse France
| | - G. Roué
- Hemato-Oncology; IDIBAPS; Barcelona Spain
| | | | - E. Giné
- Hematology; Hospital Clínic-IDIBAPS; Barcelona Spain
| | - E. Campo
- Hematophathology; Hospital Clínic-IDIBAPS; Barcelona Spain
| | - D. Colomer
- Hematophathology; Hospital Clínic-IDIBAPS; Barcelona Spain
| | - A. Wiestner
- Hematology Branch; National Heart, Lung, and Blood Institute, National Institutes of Health; Bethesda Maryland USA
| | - C. Bezombes
- Hematology-Oncology; Centre de Recherche en Cancérologie de Toulouse (CRCT); Toulouse France
| | | | - C. Chiu
- Oncology; Janssen R&D, Spring House; Pennsylvania USA
| | - P. Doshi
- Oncology; Janssen R&D, Spring House; Pennsylvania USA
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12
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Magnano L, Alonso-Alvarez S, Alcoceba M, Rivas-Delgado A, Muntañola A, Andrade-Campos M, Rodriguez G, Sancho J, Mercadal S, Salar A, Arranz R, Terol M, Jiménez-Ubieto A, González de Villambrosía S, Bello J, López L, Novelli S, De Cabo E, Infante M, Pardal E, Canals M, González M, Martín A, Caballero M, López-Guillermo A. PATIENTS WITH FOLLICULAR LYMPHOMA (FL) IN MAINTAINED COMPLETE RESPONSE (CR) AT 30 MONTHS SHOW A SURVIVAL SIMILAR TO A SEX- AND AGE-MATCHED SPANISH GENERAL POPULATION. Hematol Oncol 2017. [DOI: 10.1002/hon.2438_90] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- L. Magnano
- Hematology; Hospital Clinico de Barcelona; Barcelona Spain
| | | | - M. Alcoceba
- Hematology; Hospital Universitario de Salamanca; Salamanca Spain
| | | | - A. Muntañola
- Hematology; Hospital Universitario Mútua de Terrassa, Terrassa; Barcelona Spain
| | | | - G. Rodriguez
- Hematology; Hospital Universitario Virgen del Rocío; Sevilla Spain
| | - J. Sancho
- Hematology; Hospital H. Germans Trias i Pujol (ICO-IJC); Badalona Spain
| | - S. Mercadal
- Hematology; Hospital Duran i Reynals (ICO), Hospitalet de Llobregat; Barcelona Spain
| | - A. Salar
- Hematology; Hospital del Mar; Barcelona Spain
| | - R. Arranz
- Hematology; Hospital de la Princesa; Madrid Spain
| | - M. Terol
- Hematology; Hospital Clínico de Valencia; Valencia Spain
| | | | | | - J. Bello
- Hematology; Hospital de Nuestra Señora de la Esperanza; Santiago de Compostela Spain
| | - L. López
- Hematology; Hospital MD Anderson; Madrid Spain
| | - S. Novelli
- Hematology; Hospital de la Santa Creu i Sant Pau; Barcelona Spain
| | - E. De Cabo
- Hematology; Hospital del Bierzo, Ponferrada; León Spain
| | - M. Infante
- Hematology; Hospital Infanta Leonor; Madrid Spain
| | - E. Pardal
- Hematology; Hospital Virgen del Puerto, Plasencia; Cáceres Spain
| | - M. Canals
- Hematology; Hospital Universitario La Paz; Madrid Spain
| | - M. González
- Hematology; Hospital Universitario de Salamanca; Salamanca Spain
| | - A. Martín
- Hematology; Hospital Universitario de Salamanca; Salamanca Spain
| | - M. Caballero
- Hematology; Hospital Universitario de Salamanca; Salamanca Spain
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13
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Jiménez Ubieto A, Grande C, Caballero D, Yañez L, Novelli S, Hernández-Garcia M, Manzanares M, Arranz R, Ferreiro J, Bobillo S, Mercadal S, Galego A, López-Jiménez J, Moraleda J, Vallejo C, Albo C, Pérez-Ceballos E, Marrero C, Magnano L, Palomera L, Jarque I, Martín A, Coria E, López-Guillermo A, Salar A, Lahuerta J. AUTOLOGOUS STEM CELL TRANSPLANTATION MAY POTENTIALLY ABROGATE THE NEGATIVE PROGNOSTIC EFFECT OF EARLY RELAPSE AFTER CHEMO OR INMUNOCHEMOTHERAPY IN FOLLICULAR LYMPHOMA. Hematol Oncol 2017. [DOI: 10.1002/hon.2438_85] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
| | - C. Grande
- Hematology; Hospital 12 de Octubre; Madrid Spain
| | - D. Caballero
- Hematology; Hospital Universitario de Salamanca; Salamanca Spain
| | - L. Yañez
- Hematology; Hospital Universitario Marqués de Valdecilla; Santander Spain
| | - S. Novelli
- Hematology; Hospital Universitario Sant Pau; Barcelona Spain
| | | | - M. Manzanares
- Hematology; Hospital Universitario de Jerez; Jerez Spain
| | - R. Arranz
- Hematology; Hospital Universitario La Princesa; Madrid Spain
| | - J. Ferreiro
- Hematology; Hospital Universitario Donostia-Aránzazu; San Sebastián Spain
| | - S. Bobillo
- Hematology; Hospital Universitario Vall de Hebrón; Barcelona Barcelona Spain
| | - S. Mercadal
- Hematology; Hospital Universitario de Bellvitge, l'Hospitalet de Llobregat; Spain
| | - A. Galego
- Hematology; Hospital Universitario A Coruña, A Coruña; Spain
| | - J. López-Jiménez
- Hematology; Hospital Universitario Ramón y Cajal, Madrid; Madrid Spain
| | - J. Moraleda
- Hematology; Hospital Universitario Virgen de la Arriaxaca, El Palmar; Murcia Spain
| | - C. Vallejo
- Hematology; Hospital Central de Asturias, Asturias; Oviedo Spain
| | - C. Albo
- Hematology; Hospital Universitario de Vigo; Vigo Spain
| | - E. Pérez-Ceballos
- Hematology; Hospital Universitario Morales de Messeguer; Murcia Spain
| | - C. Marrero
- Hematology; Hospital Universitario Nuestra Señora de La Candelaria, Tenerife, Santa Cruz de Tenerife; Spain
| | - L. Magnano
- Hematology; Hospital Clinic de Barcelona; Barcelona Spain
| | - L. Palomera
- Hematology; Hospital Clínico Universitario Lozano Blesa; Zaragoza Spain
| | - I. Jarque
- Hematology; Hospital Universitario La Fe; València Spain
| | - A. Martín
- Hematology; Hospital Universitario de Salamanca; Salamanca Spain
| | - E. Coria
- Hematology; Hospital Clínico San Carlos; Madrid Spain
| | | | - A. Salar
- Hematology; Hospital del Mar; Barcelona Spain
| | - J. Lahuerta
- Hematology; Hospital 12 de Octubre; Madrid Spain
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14
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Baptista M, Tapia G, Muñoz-Marmol A, Muncunill J, Montoto S, Gribben J, Calaminici M, Martinez A, Gonzalez-Farre B, López-Guillermo A, González-Barca E, Terol M, Miralles P, Alcoceba M, Vall-Llovera F, Briones J, Abrisqueta P, Abella E, Provencio M, García-Ballesteros C, Moraleda J, Sancho J, Ribera J, Mate J, Navarro J. APPLICATION OF CELL-OF-ORIGIN SUBTYPES DETERMINED BY DIGITAL GENE EXPRESSION IN HIV-RELATED DIFFUSE LARGE B-CELL LYMPHOMAS. Hematol Oncol 2017. [DOI: 10.1002/hon.2438_11] [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: 11/08/2022]
Affiliation(s)
- M. Baptista
- Department of Hematology; ICO-Hospital Universitari Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute, Universitat Autònoma de Barcelona; Badalona Spain
| | - G. Tapia
- Department of Pathology; Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona; Badalona Spain
| | - A. Muñoz-Marmol
- Department of Pathology; Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona; Badalona Spain
| | - J. Muncunill
- Department of Hematology; ICO-Hospital Universitari Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute, Universitat Autònoma de Barcelona; Badalona Spain
| | - S. Montoto
- Department of Haemato-Oncology, Barts Cancer Institute; Queen Mary University of London; London UK
| | - J. Gribben
- Department of Haemato-Oncology, Barts Cancer Institute; Queen Mary University of London; London UK
| | - M. Calaminici
- Department of Haemato-Oncology, Barts Cancer Institute; Queen Mary University of London; London UK
| | - A. Martinez
- Department of Pathology, Hospital Clinic, Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS); University of Barcelona; Barcelona Spain
| | - B. Gonzalez-Farre
- Department of Pathology, Hospital Clinic, Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS); University of Barcelona; Barcelona Spain
| | - A. López-Guillermo
- Department of Hematology, Hospital Clinic, Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS); University of Barcelona; Barcelona Spain
| | - E. González-Barca
- Department of Hematology; ICO-Hospital Duran i Reynals, L'Hospitalet de Llobregat; Spain
| | - M. Terol
- Department of Hematology and Oncology; Hospital Clínic Universitari de València; Valencia Spain
| | - P. Miralles
- Department of Infectious Diseases; Hospital Gregorio Marañón; Madrid Spain
| | - M. Alcoceba
- Department of Hematology; Hospital Universitario de Salamanca; Salamanca Spain
| | - F. Vall-Llovera
- Servicio de Hematología Clínica; Hospital Universitari Mutúa de Terrassa; Terrassa Spain
| | - J. Briones
- Department of Hematology, Hospital de la Santa Creu i Sant Pau; Josep Carreras Leukaemia Research Institute; Barcelona Spain
| | - P. Abrisqueta
- Department of Hematology; Hospital Vall d'Hebrón; Barcelona Spain
| | - E. Abella
- Department of Hematology; Hospital del Mar; Barcelona Spain
| | - M. Provencio
- Department of Medical Oncology; Hospital Universitario Puerta De Hierro; Majadahonda Spain
| | | | - J. Moraleda
- Department of Hematology; Hospital Clinico Universitario Virgen de la Arrixaca; Murcia Spain
| | - J. Sancho
- Department of Hematology; ICO-Hospital Universitari Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute, Universitat Autònoma de Barcelona; Badalona Spain
| | - J. Ribera
- Department of Hematology; ICO-Hospital Universitari Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute, Universitat Autònoma de Barcelona; Badalona Spain
| | - J. Mate
- Department of Pathology; Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona; Badalona Spain
| | - J. Navarro
- Department of Hematology; ICO-Hospital Universitari Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute, Universitat Autònoma de Barcelona; Badalona Spain
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15
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Martín A, Baile M, Rodríguez G, Dlouhy I, Sancho J, Jarque I, González-Barca E, Salar A, Espeso M, Grande C, Bergua J, Montes-Moreno S, López-Guillermo A, Campo E, Caballero D. Lenalidomide in combination with R-ESHAP in patients with relapsed or refractory diffuse large B-cell lymphoma: A phase 2 study from the Spanish group GELTAMO. Hematol Oncol 2017. [DOI: 10.1002/hon.2439_93] [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: 11/08/2022]
Affiliation(s)
- A. Martín
- Hematology; Hospital Universitario de Salamanca and IBSAL; Salamanca Spain
| | - M. Baile
- Hematology; Hospital Universitario de Salamanca and IBSAL; Salamanca Spain
| | - G. Rodríguez
- Hematology; UGC HH.UU. Virgen del Rocío / Virgen Macarena; Sevilla Spain
| | - I. Dlouhy
- Hematology; Hospital Clinic; Barcelona Spain
| | - J.M. Sancho
- Hematology; Hospital Germans Trias i Pujol / ICO-IJC, Barcelona; Badalona Spain
| | - I. Jarque
- Hematology; Hospital Universitario La Fe; Valencia Spain
| | - E. González-Barca
- Hematology; Hospital Duran i Reynals / ICO-IDIBELL, Hospitalet de Llobregat; Barcelona Spain
| | - A. Salar
- Hematology; Hospital del Mar; Barcelona Spain
| | - M. Espeso
- Hematology; Hospital Regional Universitario de Málaga; Málaga Spain
| | - C. Grande
- Hematology; Hospital Universitario 12 de Octubre; Madrid Spain
| | - J. Bergua
- Hematology; Hospital San Pedro de Alcántara; Cáceres Spain
| | - S. Montes-Moreno
- Pathology; Hospital Universitario Marqués de Valdecilla; Santander Spain
| | | | - E. Campo
- Pathology; Hospital Clinic; Barcelona Spain
| | - D. Caballero
- Hematology; Hospital Universitario de Salamanca and IBSAL; Salamanca Spain
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16
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Alcoceba M, Magnano L, Alonso-Álvarez S, Andrade-Campos M, Espinosa-Lara N, Rodríguez G, Sancho J, Moreno M, Mercadal S, García-Pallarols F, Cannata J, Teruel A, Rodríguez A, González de Villambrosía S, Bello J, López L, Monsalvo S, Novelli S, de Cabo E, Infante M, Pardal E, Muntañola A, González M, Caballero M, Martín A, López-Guillermo A. CLINICAL CHARACTERISTICS AND PROGNOSIS OF ELDERLY (>70 YEARS) FOLLICULAR LYMPHOMA IN THE RITUXIMAB ERA: MULTICENTRE RETROSPECTIVE ANALYSIS OF THE GELTAMO SPANISH GROUP. Hematol Oncol 2017. [DOI: 10.1002/hon.2439_122] [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: 11/07/2022]
Affiliation(s)
- M. Alcoceba
- Hematology; Spanish Group of Lymphomas and Autologous Stem-cell Transplantation (GELTAMO); Spain
| | - L. Magnano
- Hematology; Spanish Group of Lymphomas and Autologous Stem-cell Transplantation (GELTAMO); Spain
| | - S. Alonso-Álvarez
- Hematology; Spanish Group of Lymphomas and Autologous Stem-cell Transplantation (GELTAMO); Spain
| | - M. Andrade-Campos
- Hematology; Spanish Group of Lymphomas and Autologous Stem-cell Transplantation (GELTAMO); Spain
| | - N. Espinosa-Lara
- Hematology; Spanish Group of Lymphomas and Autologous Stem-cell Transplantation (GELTAMO); Spain
| | - G. Rodríguez
- Hematology; Spanish Group of Lymphomas and Autologous Stem-cell Transplantation (GELTAMO); Spain
| | - J.M. Sancho
- Hematology; Spanish Group of Lymphomas and Autologous Stem-cell Transplantation (GELTAMO); Spain
| | - M. Moreno
- Hematology; Spanish Group of Lymphomas and Autologous Stem-cell Transplantation (GELTAMO); Spain
| | - S. Mercadal
- Hematology; Spanish Group of Lymphomas and Autologous Stem-cell Transplantation (GELTAMO); Spain
| | - F. García-Pallarols
- Hematology; Spanish Group of Lymphomas and Autologous Stem-cell Transplantation (GELTAMO); Spain
| | - J. Cannata
- Hematology; Spanish Group of Lymphomas and Autologous Stem-cell Transplantation (GELTAMO); Spain
| | - A.I. Teruel
- Hematology; Spanish Group of Lymphomas and Autologous Stem-cell Transplantation (GELTAMO); Spain
| | - A. Rodríguez
- Hematology; Spanish Group of Lymphomas and Autologous Stem-cell Transplantation (GELTAMO); Spain
| | | | - J. Bello
- Hematology; Spanish Group of Lymphomas and Autologous Stem-cell Transplantation (GELTAMO); Spain
| | - L.I. López
- Hematology; Spanish Group of Lymphomas and Autologous Stem-cell Transplantation (GELTAMO); Spain
| | - S. Monsalvo
- Hematology; Spanish Group of Lymphomas and Autologous Stem-cell Transplantation (GELTAMO); Spain
| | - S. Novelli
- Hematology; Spanish Group of Lymphomas and Autologous Stem-cell Transplantation (GELTAMO); Spain
| | - E. de Cabo
- Hematology; Spanish Group of Lymphomas and Autologous Stem-cell Transplantation (GELTAMO); Spain
| | - M.S. Infante
- Hematology; Spanish Group of Lymphomas and Autologous Stem-cell Transplantation (GELTAMO); Spain
| | - E. Pardal
- Hematology; Spanish Group of Lymphomas and Autologous Stem-cell Transplantation (GELTAMO); Spain
| | - A. Muntañola
- Hematology; Spanish Group of Lymphomas and Autologous Stem-cell Transplantation (GELTAMO); Spain
| | - M. González
- Hematology; Spanish Group of Lymphomas and Autologous Stem-cell Transplantation (GELTAMO); Spain
| | - M.D. Caballero
- Hematology; Spanish Group of Lymphomas and Autologous Stem-cell Transplantation (GELTAMO); Spain
| | - A. Martín
- Hematology; Spanish Group of Lymphomas and Autologous Stem-cell Transplantation (GELTAMO); Spain
| | - A. López-Guillermo
- Hematology; Spanish Group of Lymphomas and Autologous Stem-cell Transplantation (GELTAMO); Spain
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17
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Dlouhy I, Karube K, Enjuanes A, Salaverría I, Pérez-Galán P, Jares P, Martín-García D, Nadeu F, Rivas-Delgado A, Rovira J, Gonzalez B, Mozos A, Clot G, Sancho J, Salar A, Mercadal S, Escola L, Briones J, Colomo L, Alcoceba M, Valera A, Campo E, López-Guillermo A. GENE MUTATIONS AND COPY NUMBER ALTERATIONS (CNA) PREDICT FOR EARLY FAILURE IN PATIENTS WITH DIFFUSE LARGE B-CELL LYMPHOMA (DLBCL) TREATED WITH R-CHOP. Hematol Oncol 2017. [DOI: 10.1002/hon.2437_82] [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: 11/11/2022]
Affiliation(s)
- I. Dlouhy
- Hematology; Hospital Clinic Barcelona; Barcelona Spain
| | - K. Karube
- Department of Pathology and Cell Biology, Graduate School of Medicine and Faculty of Medicine; University of the Ryukyus; Nishihara Japan
| | - A. Enjuanes
- Hematology; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Barcelona Spain
| | - I. Salaverría
- Hematology; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Barcelona Spain
| | - P. Pérez-Galán
- Hematology; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Barcelona Spain
| | - P. Jares
- Hematology; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Barcelona Spain
| | - D. Martín-García
- Hematology; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Barcelona Spain
| | - F. Nadeu
- Hematology; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Barcelona Spain
| | | | - J. Rovira
- Hematology; Hospital Clinic Barcelona; Barcelona Spain
| | - B. Gonzalez
- Pathology; Hospital Clinic Barcelona; Barcelona Spain
| | - A. Mozos
- Pathology; Hospital Clinic Barcelona; Barcelona Spain
| | - G. Clot
- Hematology; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Barcelona Spain
| | - J.M. Sancho
- Hematology; ICO-Hospital Germans Trias i Pujol; Barcelona Spain
| | - A. Salar
- Hematology; Hospital del Mar; Barcelona Spain
| | - S. Mercadal
- Hematology; ICO-Hospital Duran i Reynals; Barcelona Spain
| | - L. Escola
- Hematology; Hospital Universitari Joan XXIII; Tarragona Spain
| | - J. Briones
- Hematology; Hospital de Sant Pau; Barcelona Spain
| | - L. Colomo
- Pathology; Hospital del Mar; Barcelona Spain
| | - M. Alcoceba
- Hematology; Hospital Universitario de Salamanca; Salamanca Spain
| | - A. Valera
- Hematology; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Barcelona Spain
| | - E. Campo
- Hematology; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Barcelona Spain
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18
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García-Noblejas A, Cannata-Ortiz J, Conde E, González Barca E, Gutiérrez N, Rojas R, Vidal MJ, Ramírez MJ, Jiménez-Ubieto A, García-Ruiz JC, Sancho JM, López A, Ríos Rull P, Novelli S, Albo C, Debén G, López-Guillermo A, Nicolás C, González de Villambrosia S, Mercadal S, Martín García-Sancho A, Arranz R. Autologous stem cell transplantation (ASCT) in patients with mantle cell lymphoma: a retrospective study of the Spanish lymphoma group (GELTAMO). Ann Hematol 2017; 96:1323-1330. [PMID: 28536895 DOI: 10.1007/s00277-017-2998-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 11/29/2016] [Accepted: 04/10/2017] [Indexed: 01/21/2023]
Abstract
Guidelines recommend autologous stem cell transplantation (ASCT) consolidation in first complete or partial response after regimens including rituximab (R) and high-dose AraC (HDAC), but its use beyond that response is questioned. We present a retrospective analysis of 268 patients with MCL who received ASCT. With a median follow-up for survival patients of 54 months, progression-free survival and overall survival for the whole series were 38 and 74 months, respectively, and for patients transplanted in first CR 49 and 97 months, respectively. Patients without CR before transplant were analyzed separately, those who achieved CR after transplantation had better PFS (48 vs 0.03 months, p < 0.001) and OS (92 vs 16 months, p < 0.001) than the remaining. In univariate analysis, first CR at transplant (p = 0.01) and prior rituximab (p = 0.02) were the variables associated with PFS. For OS, the same variables resulted significant (p = 0.03 and p < 0.001, respectively). In multivariate analysis, only the status at transplant (first CR) remained significant. This retrospective study concludes that ASCT consolidation in first CR induces high survival rates. In other stages of disease, the need of ASCT as consolidation may be questioned.
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Affiliation(s)
- A García-Noblejas
- Hospital Universitario La Princesa, Diego de Leon, 62, 28006, Madrid, Spain
| | - J Cannata-Ortiz
- Hospital Universitario La Princesa, Diego de Leon, 62, 28006, Madrid, Spain
| | - E Conde
- HU Marqués de Valdecilla, Santander, Spain
| | | | | | - R Rojas
- HU Reina Sofía, Córdoba, Spain
| | | | | | | | | | - J M Sancho
- H. Germans Trias i Pujol, Barcelona, Spain
| | - A López
- HU Vall d'Hebron, Barcelona, Spain
| | - P Ríos Rull
- HU Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, Spain
| | | | - C Albo
- H Xeral-Cíes, Madrid, Spain
| | | | | | - C Nicolás
- HU Central de Asturias, Oviedo, Spain
| | | | - S Mercadal
- Instituto Catalán de Oncología, Barcelona, Spain
| | | | - R Arranz
- Hospital Universitario La Princesa, Diego de Leon, 62, 28006, Madrid, Spain.
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19
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Velasco R, Mercadal S, Vidal N, Bruna J, González-Barca E, López-Guillermo A, Graus F. OS08.9 Management of Primary Central Nervous System Lymphoma in Spain in the last decade: a case series of the Spanish Group of Neuro-Oncology and GELTAMO. Neuro Oncol 2017. [DOI: 10.1093/neuonc/nox036.059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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20
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Velasco R, Mercadal S, Vidal N, López-Guillermo A, Bruna J, Graus F. P17.02 Diagnostic delay and treatment options of Primary Central Nervous System Lymphoma in the last decade: preliminary results of first 50 patients from two Catalan institutions. Neuro Oncol 2016. [DOI: 10.1093/neuonc/now188.276] [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: 11/14/2022] Open
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21
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Esteban D, Tovar N, Jiménez R, Santacruz R, Baumann T, Pastor MC, de la Riva A, Carrera E, Chaves S, Royo C, Navarro A, Rodríguez S, Ayuso C, Riu G, Creus N, Gómez B, Giné E, López-Guillermo A, Delgado J. Patients with relapsed/refractory chronic lymphocytic leukaemia may benefit from inclusion in clinical trials irrespective of the therapy received: a case-control retrospective analsysis. Blood Cancer J 2015; 5:e356. [PMID: 26430727 PMCID: PMC4635190 DOI: 10.1038/bcj.2015.78] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- D Esteban
- Department of Haematology, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - N Tovar
- Department of Haematology, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - R Jiménez
- Department of Haematology, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - R Santacruz
- Department of Haematology, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - T Baumann
- Department of Haematology, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - M C Pastor
- Department of Haematology, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - A de la Riva
- Department of Haematology, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - E Carrera
- Department of Haematology, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - S Chaves
- Department of Haematology, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - C Royo
- Haematopathology Unit, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - A Navarro
- Haematopathology Unit, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - S Rodríguez
- Department of Radiology, Hospital Clínic, Barcelona, Spain
| | - C Ayuso
- Department of Radiology, Hospital Clínic, Barcelona, Spain
| | - G Riu
- Department of Pharmacy, Hospital Clínic, Barcelona, Spain
| | - N Creus
- Department of Pharmacy, Hospital Clínic, Barcelona, Spain
| | - B Gómez
- Department of Pharmacy, Hospital Clínic, Barcelona, Spain
| | - E Giné
- Department of Haematology, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - A López-Guillermo
- Department of Haematology, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - J Delgado
- Department of Haematology, Hospital Clínic, IDIBAPS, Barcelona, Spain
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22
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Bassaganyas L, Beà S, Escaramís G, Tornador C, Salaverria I, Zapata L, Drechsel O, Ferreira PG, Rodriguez-Santiago B, Tubio JMC, Navarro A, Martín-García D, López C, Martínez-Trillos A, López-Guillermo A, Gut M, Ossowski S, López-Otín C, Campo E, Estivill X. Sporadic and reversible chromothripsis in chronic lymphocytic leukemia revealed by longitudinal genomic analysis. Leukemia 2013; 27:2376-9. [PMID: 23612016 PMCID: PMC3865532 DOI: 10.1038/leu.2013.127] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- L Bassaganyas
- 1] Center for Genomic Regulation (CRG), Barcelona, Spain [2] Pompeu Fabra University (UPF) Barcelona, Spain [3] Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain [4] Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
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Villamor N, Conde L, Martínez-Trillos A, Cazorla M, Navarro A, Beà S, López C, Colomer D, Pinyol M, Aymerich M, Rozman M, Abrisqueta P, Baumann T, Delgado J, Giné E, González-Díaz M, Hernández JM, Colado E, Payer AR, Rayon C, Navarro B, José Terol M, Bosch F, Quesada V, Puente XS, López-Otín C, Jares P, Pereira A, Campo E, López-Guillermo A. NOTCH1 mutations identify a genetic subgroup of chronic lymphocytic leukemia patients with high risk of transformation and poor outcome. Leukemia 2012; 27:1100-6. [DOI: 10.1038/leu.2012.357] [Citation(s) in RCA: 143] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Gutiérrez-García G, García-Herrera A, Cardesa T, Martínez A, Villamor N, Ghita G, Martínez-Trillos A, Colomo L, Setoain X, Rodríguez S, Giné E, Campo E, López-Guillermo A. Comparison of four prognostic scores in peripheral T-cell lymphoma. Ann Oncol 2011; 22:397-404. [PMID: 20631009 DOI: 10.1093/annonc/mdq359] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- G Gutiérrez-García
- Department of Hematology, Institut de Recerca Biome`dica August Pi i Sunyer, Barcelona, Spain
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25
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Fernández de Larrea C, Martínez C, Gaya A, López-Guillermo A, Rovira M, Fernández-Avilés F, Lozano M, Bosch F, Esteve J, Nomdedeu B, Montserrat E, Carreras E. Salvage chemotherapy with alternating MINE–ESHAP regimen in relapsed or refractory Hodgkin’s lymphoma followed by autologous stem-cell transplantation. Ann Oncol 2010; 21:1211-1216. [DOI: 10.1093/annonc/mdp487] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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26
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Mercadal S, Briones J, Xicoy B, Pedro C, Escoda L, Estany C, Camós M, Colomo L, Espinosa I, Martínez S, Ribera JM, Martino R, Gutiérrez-García G, Montserrat E, López-Guillermo A. Intensive chemotherapy (high-dose CHOP/ESHAP regimen) followed by autologous stem-cell transplantation in previously untreated patients with peripheral T-cell lymphoma. Ann Oncol 2008; 19:958-63. [PMID: 18303032 DOI: 10.1093/annonc/mdn022] [Citation(s) in RCA: 158] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- S Mercadal
- Department of Hematology, Hospital Clínic, Villarroel 170, 08036 Barcelona, Spain
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27
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Ferrer A, Bosch F, Villamor N, Rozman M, Graus F, Gutiérrez G, Mercadal S, Campo E, Rozman C, López-Guillermo A, Montserrat E. Central nervous system involvement in mantle cell lymphoma. Ann Oncol 2007; 19:135-41. [PMID: 17962207 DOI: 10.1093/annonc/mdm447] [Citation(s) in RCA: 82] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Extranodal involvement, including central nervous system (CNS), is a frequent event in patients with mantle cell lymphoma (MCL). However, the incidence, risk factors, and impact on outcome remain controversial. PATIENTS AND METHODS Main clinical, biological, and evolutive features of 82 patients (60 males/22 females; median age: 61 years) diagnosed with MCL (blastoid, 26%) in a single institution were analyzed for risk of CNS involvement and prognosis. RESULTS Most patients had advanced stage and intermediate or high-risk International Prognostic Index (IPI). Eleven patients eventually developed CNS involvement with an actuarial 5-year risk of 26% (95% confidence interval 10% to 42%). In one asymptomatic patient, cerebrospinal fluid infiltration was detected at staging maneuvers (1/62; 1.6%). The remaining 10 patients developed neurological symptoms during the course of the disease (median time from diagnosis, 25 months). Initial variables predicting CNS involvement were blastoid histology, high proliferative index measured by Ki-67 staining, high lactate dehydrogenase (LDH) and intermediate- or high-risk IPI. Histological subtype and serum LDH maintained significance in multivariate analysis. Treatment of CNS infiltration consisted of intrathecal chemotherapy (two cases), and intrathecal chemotherapy plus systemic treatment (seven cases). Median survival after CNS involvement was 4.8 months, patients with this complication having shorter survival than those with no CNS disease. CONCLUSION This study confirms the high incidence of CNS involvement in MCL patients. Treatments aimed at preventing this complication are warranted.
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Affiliation(s)
- A Ferrer
- Department of Hematology, Hospital Clínic, Postgraduate School of Hematology Farreras Valentí, Institut d'Investigacio Biomedica August Pi i Sunyer, Barcelona, Spain
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29
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Giné E, Montoto S, Bosch F, Arenillas L, Mercadal S, Villamor N, Martínez A, Colomo L, Campo E, Montserrat E, López-Guillermo A. The Follicular Lymphoma International Prognostic Index (FLIPI) and the histological subtype are the most important factors to predict histological transformation in follicular lymphoma. Ann Oncol 2006; 17:1539-45. [PMID: 16940035 DOI: 10.1093/annonc/mdl162] [Citation(s) in RCA: 94] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Histological transformation (HT) is a well-known event in patients with follicular lymphoma (FL) conferring an unfavorable prognosis. The aim of the study was to analyze incidence and risk factors for HT in a large series of FL patients. PATIENTS AND METHODS 276 patients (median age: 54 years; M139/F137) diagnosed with FL (42% grade 1, 51% 2, 7% 3) in a single institution were studied. Initial treatment consisted of combined chemotherapy in most cases. Median survival was 11.3 years. Main clinic and biological variables were assessed for HT and survival. RESULTS 30 of 276 patients (11%) presented HT after a median follow-up of 6.5 years, with a risk of 15% and 22% at 10 and at 15 years, respectively. All HT corresponded to diffuse large B-cell lymphoma (DLBCL). Grade 3 histology, nodal areas >4, increased LDH and beta(2)-microglobulin, and high-risk IPI and FLIPI were associated with HT. In multivariate analysis, grade 3 histology and FLIPI retained prognostic significance. Only FLIPI predicted HT in grade 1-2 patients. 28 patients received salvage treatment for HT, with a CR rate of 52%. Median survival from transformation was 1.2 years, with 6/13 CR patients being alive >5 years after HT. CONCLUSION FLIPI and histology were the most important variables predicting HT. Upon HT, only patients achieving CR reached prolonged survival, thus emphasizing the need for effective therapies once this event occurs.
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Affiliation(s)
- E Giné
- Institute of Hematology and Oncology, Department of Hematology and Hematopathology Unit, Hospital Clínic, IDIBAPS, Barcelona, Spain
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30
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MESH Headings
- Adolescent
- Antibodies, Monoclonal/administration & dosage
- Antibodies, Monoclonal/adverse effects
- Antibodies, Monoclonal/pharmacokinetics
- Antibodies, Monoclonal/therapeutic use
- Antibodies, Monoclonal, Murine-Derived
- Antibody Specificity
- Antigens, CD20/immunology
- Antigens, Neoplasm/immunology
- Child
- Child, Preschool
- Contraindications
- Female
- Humans
- Immunoconjugates/administration & dosage
- Immunoconjugates/adverse effects
- Immunoconjugates/pharmacokinetics
- Immunoconjugates/therapeutic use
- Infant
- Lymphoma, B-Cell/immunology
- Lymphoma, B-Cell/radiotherapy
- Lymphoma, Non-Hodgkin/immunology
- Lymphoma, Non-Hodgkin/radiotherapy
- Male
- Pregnancy
- Pregnancy Complications, Neoplastic/therapy
- Radiation Protection
- Radioimmunotherapy
- Randomized Controlled Trials as Topic
- Rituximab
- Tissue Distribution
- Yttrium Radioisotopes/administration & dosage
- Yttrium Radioisotopes/adverse effects
- Yttrium Radioisotopes/pharmacokinetics
- Yttrium Radioisotopes/therapeutic use
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Affiliation(s)
- X Setoain
- Medicina Nuclear, Hospital Clínic i Provincial de Barcelona, Barcelona.
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31
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Perea G, Altés A, Montoto S, López-Guillermo A, Domingo-Doménech E, Fernández-Sevilla A, Ribera JM, Grau J, Pedro C, Angel Hernández J, Estany C, Briones J, Martino R, Sureda A, Sierra J, Montserrat E. Prognostic indexes in follicular lymphoma: a comparison of different prognostic systems. Ann Oncol 2005; 16:1508-13. [PMID: 15939718 DOI: 10.1093/annonc/mdi269] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The International Prognostic Index (IPI), initially designed for aggressive lymphomas, is also used in follicular lymphoma (FL) and other indolent lymphomas. Two new prognostic indexes have recently been proposed for FL [the Italian Lymphoma Intergroup (ILI) Index and the Follicular Lymphoma International Prognostic Index (FLIPI)]. PATIENTS AND METHODS Three indexes, IPI [age >60 years, extranodal involvement two or more sites, elevated lactate dehydrogenase (LDH), Eastern Cooperative Oncology Group performance status > or =2, stage > or =3], ILI (age >60 years, extranodal involvement two or more sites, elevated LDH, male sex, B symptoms, erythrocyte sedimentation rate > or =30 mm first hour) and FLIPI (age >60 years, stage > or =3, elevated LDH, nodal involvement five or more, haemoglobin level < or =12 g/dl) were calculated in 411 patients with FL. RESULTS Overall concordance between the three indexes was 54%. A total of 126 (31%) patients were included in the high-risk group according to IPI, 131 (32%) according to ILI and 157 (38%) after FLIPI application. Ten-year overall survival rates after applying the prognostic indexes (IPI, ILI and FLIPI) were, respectively: 72%, 71% and 72%, in the low-risk group; 51%, 60% and 49% in the intermediate-risk group; and 24%, 16% and 31% in the high-risk group. CONCLUSIONS In this series, all three indexes, IPI, ILI and FLIPI, were useful to classify FL patients into differentiated risk groups, although the FLIPI identified a larger proportion of high-risk patients than the IPI and ILI.
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Affiliation(s)
- G Perea
- Clinical Hematology Division, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, Spain.
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Montoto S, López-Guillermo A, Altés A, Perea G, Ferrer A, Camós M, Villela L, Bosch F, Esteve J, Cervantes F, Bladé J, Nomdedeu B, Campo E, Sierra J, Montserrat E. Predictive value of Follicular Lymphoma International Prognostic Index (FLIPI) in patients with follicular lymphoma at first progression. Ann Oncol 2005; 15:1484-9. [PMID: 15367408 DOI: 10.1093/annonc/mdh406] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Different prognostic scores have been proposed to predict the outcome of follicular lymphoma (FL) patients at diagnosis. A new prognostic index specifically addressing FL patients, the Follicular Lymphoma International Prognostic Index (FLIPI), has recently been developed, which might also be useful in patients with progression. PATIENTS AND METHODS One hundred and three patients (55 male, 48 female; median age 59 years) with FL in first relapse/progression after an initial response to therapy (50 complete responders/ 53 partial responders) were included in the study. RESULTS Five-year survival from progression (SFP) was 55% (95% confidence interval 44%-66%). The distribution according to the FLIPI at relapse was 39% good prognosis, 24% intermediate prognosis and 37% poor prognosis. Five-year SFP for these groups were 85%, 79% and 28%, respectively (P < 0.0001). Other variables at relapse with prognostic significance for SFP were age, presence of B symptoms, performance status, bulky disease, number of involved nodal sites, lactate dehydrogenase level, hemoglobin level, histological transformation, the Italian Lymphoma Intergroup prognostic index for FL and the International Prognostic Index for aggressive lymphomas. In the multivariate analysis bulky disease (P=0.01), presence of B symptoms (P=0.03) and FLIPI at relapse (P=0.0003) were the most important variables for predicting SFP. CONCLUSIONS In patients with FL at first relapse/progression, the FLIPI, along with the presence of bulky disease and B symptoms, are features that predict SFP and thus could be useful to select candidates for experimental treatments.
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Affiliation(s)
- S Montoto
- Department of Hematology and Hematopathology Unit, Hospital Clínic, IDIBAPS, Barcelona
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Ferreri AJM, Campo E, Ambrosetti A, Ilariucci F, Seymour JF, Willemze R, Arrigoni G, Rossi G, López-Guillermo A, Berti E, Eriksson M, Federico M, Cortelazzo S, Govi S, Frungillo N, Dell'Oro S, Lestani M, Asioli S, Pedrinis E, Ungari M, Motta T, Rossi R, Artusi T, Iuzzolino P, Zucca E, Cavalli F, Ponzoni M. Anthracycline-based chemotherapy as primary treatment for intravascular lymphoma. Ann Oncol 2004; 15:1215-21. [PMID: 15277261 DOI: 10.1093/annonc/mdh274] [Citation(s) in RCA: 87] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Optimal therapeutic management of intravascular lymphoma (IVL) lacks precise guidelines. PATIENTS AND METHODS The clinico-pathological features of 38 HIV-negative patients with IVL were reviewed to define efficacy of chemotherapy in these malignancies. Clinical characteristics of 22 patients treated with chemotherapy and of 16 untreated patients were compared in order to understand better the impact and causes of potential patient selection. RESULTS Median age was 70 years (range 34-90), with a male/female ratio of 0.9; 23 (61%) patients had Eastern Cooperative Oncology Group performance status (ECOG-PS) > 1; 21 (55%) had systemic symptoms. Cutaneous lesions and anemia were significantly more common among patients treated with chemotherapy; central nervous system (CNS) and renal involvement were significantly more common among untreated patients. Chemotherapy was associated with a response rate of 59% and a 3-year overall survival of 33 +/- 11%. Five of six patients with CNS involvement received chemotherapy: four of them died early; only one patient, treated with adriamycin, cyclophosphamide, vincristine, methotrexate, bleomycin and prednisolone (MACOP-B) followed by high-dose chemotherapy and autologous stem cell transplantation (ASCT), was alive at 19 months. High-dose chemotherapy supported by ASCT was indicated at diagnosis in another patient (43 years of age, stage I), who was alive at 71 months, and at relapse after cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP) in two patients who died early after transplantation. PS < or = 1, disease limited to the skin, stage I, and use of chemotherapy were independently associated with better outcome. CONCLUSIONS Anthracycline-based chemotherapy is the standard treatment for IVL. However, survival is disappointing, with a relevant impact of diagnostic delay and lethal complications. More intensive combinations, containing drugs with higher CNS bioavailability, are needed in cases with brain involvement, and the role of high-dose chemotherapy supported by ASCT should be further investigated in younger patients with unfavorable features.
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Affiliation(s)
- A J M Ferreri
- Department of Radiochemotherapy, San Raffaele H Scientific Institute, Milan, Italy.
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Montoto S, Rozman M, Rosiñol L, Nadal E, Giné E, Aymerich M, Ferrer A, Esteve J, Bosch F, López-Guillermo A, Bladé J, Montserrat E. Malignant transformation in IgM monoclonal gammopathy of undetermined significance. Semin Oncol 2003; 30:178-81. [PMID: 12720132 DOI: 10.1053/sonc.2003.50067] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Monoclonal gammopathy of undetermined significance (MGUS) is a frequent disorder characterized by the presence of a small serum M-protein in individuals with no evidence of multiple myeloma (MM), Waldenstrom's macroglobulinemia (WM), or primary amyloidosis (AL). Although one fourth of these individuals will develop a malignant disease, there are no well-established predictors of outcome, particularly in the IgM type MGUS. Among 434 patients diagnosed with MGUS from 1970 to 2001 with a minimum follow-up of 1 year, 52 (27 men and 25 women; median age, 67 years) of IgM type were identified. After a median follow-up of 5 years, five patients (9.6%) have developed WM. The risk of transformation was 13.3% (95% confidence interval [CI], 0 to 27) and 27.7% (95% CI, 0.3 to 55.1) at 10 and 20 years, respectively. The variables significantly associated with transformation were the proportion of bone marrow plasma cells (BMPC) and the percentage of bone marrow lymphocytes (BML). No significant differences in the risk of transformation were found between IgM MGUS and the remaining MGUS types. Thus, in IgM MGUS the rate of transformation was similar to the risk observed in other MGUS types, the percentage of BMPC and BML being the features significantly associated with evolution into WM.
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Affiliation(s)
- S Montoto
- Institute of Hematology and Oncology, Postgraduate School of Hematology Farreras-Valentí, Department of Hematology and Hematopathology Unit, IDIBAPS, Hospital Clínic, Barcelona, Spain
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35
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Vandenberghe E, Ruiz de Elvira C, Loberiza FR, Conde E, López-Guillermo A, Gisselbrecht C, Guilhot F, Vose JM, van Biesen K, Rizzo JD, Weisenburger DD, Isaacson P, Horowitz MM, Goldstone AH, Lazarus HM, Schmitz N. Outcome of autologous transplantation for mantle cell lymphoma: a study by the European Blood and Bone Marrow Transplant and Autologous Blood and Marrow Transplant Registries. Br J Haematol 2003; 120:793-800. [PMID: 12614212 DOI: 10.1046/j.1365-2141.2003.04140.x] [Citation(s) in RCA: 139] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Mantle cell lymphoma (MCL) has an aggressive clinical course with a median survival < 3 years and is incurable with conventional chemotherapy. A large multicentre study with adequate follow-up may clarify the role of significant factors affecting outcome in autologous stem cell transplantation for MCL. Patients receiving an autologous transplant for MCL between 1988 and 1998, and reported to the European Blood and bone Marrow Transplant (EBMT) registry or Autologous Blood and Marrow Transplant Registry (ABMTR), were included. Expert haematopathology review was required on all identified patients. Disease and transplant details were requested from the transplant centres, and the final cohort of patients with verified pathology, adequate clinical information and follow-up was analysed. One hundred and ninety-five patients were included in the analyses (149 EBMT, 46 ABMTR) with a median follow-up of 3.9 years. The 2 year and 5 year overall survival were 76% and 50%, and progression free survival was 55% and 33% respectively. Disease status at transplant was the most significant factor affecting survival: patients with chemosensitive disease but not in first complete remission (CR1) were 2.99 times (95% CI: 1.66-5.38, P < 0.001) more likely to die than patients transplanted in CR1. Autologous transplantation probably improves survival in patients with MCL especially if performed in first CR.
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Giné E, Bosch F, Villamor N, Rozman M, Colomer D, López-Guillermo A, Campo E, Montserrat E. Simultaneous diagnosis of hairy cell leukemia and chronic lymphocytic leukemia/small lymphocytic lymphoma: a frequent association? Leukemia 2002; 16:1454-9. [PMID: 12145685 DOI: 10.1038/sj.leu.2402553] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2001] [Accepted: 02/27/2002] [Indexed: 11/09/2022]
Abstract
The association of hairy cell leukemia (HCL) with other neoplasms, mainly non-Hodgkin's lymphomas, is well known. However, the simultaneous diagnosis of HCL and chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) is rare, with only few cases of such an association having been reported. We describe three patients with a well-characterized HCL in whom a CLL/SLL population was detected. Of note, these cases represent a significant proportion (11.5%; 95% CI: 0% to 24%) of the total number of HCL cases diagnosed in our institution during the same period of time. All three patients were treated with deoxycoformycin. They achieved a complete response of the HCL, whereas the CLL/SLL population persisted in all cases. The immunoglobulin gene rearrangement analysis, in two informative cases, suggested that the HCL and CLL/SLL populations arose from different B cell clones. This study indicates that the association of HCL and CLL/SLL might be much more frequent than previously recognized. Therefore, a large panel of monoclonal antibodies, including those necessary to detect CLL/SLL, should be employed when studying patients with HCL.
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MESH Headings
- Antimetabolites, Antineoplastic/therapeutic use
- B-Lymphocytes/pathology
- Cell Lineage
- Cladribine/therapeutic use
- Combined Modality Therapy
- Comorbidity
- Gene Rearrangement, B-Lymphocyte
- Genes, Immunoglobulin
- Hematopoietic Stem Cell Transplantation
- Humans
- Immunophenotyping
- Leukemia, Hairy Cell/diagnosis
- Leukemia, Hairy Cell/drug therapy
- Leukemia, Hairy Cell/epidemiology
- Leukemia, Hairy Cell/therapy
- Leukemia, Lymphocytic, Chronic, B-Cell/diagnosis
- Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy
- Leukemia, Lymphocytic, Chronic, B-Cell/epidemiology
- Leukemia, Lymphocytic, Chronic, B-Cell/therapy
- Male
- Mass Screening
- Middle Aged
- Neoplasms, Multiple Primary/diagnosis
- Neoplasms, Multiple Primary/drug therapy
- Neoplasms, Multiple Primary/epidemiology
- Neoplasms, Multiple Primary/therapy
- Neoplastic Stem Cells/pathology
- Pentostatin/therapeutic use
- Prospective Studies
- Remission Induction
- Salvage Therapy
- Transplantation, Autologous
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Affiliation(s)
- E Giné
- Institute of Hematology and Oncology, Department of Hematology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
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37
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Cobo F, Martínez A, Pinyol M, Hernández L, Gómez M, Beá S, Esteve J, Rozman M, Bosch F, López-Guillermo A, Montserrat E, Campo E. Multiple cell cycle regulator alterations in Richter's transformation of chronic lymphocytic leukemia. Leukemia 2002; 16:1028-34. [PMID: 12040434 DOI: 10.1038/sj.leu.2402529] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2001] [Accepted: 12/13/2001] [Indexed: 11/09/2022]
Abstract
To investigate the role of the cell cycle regulators p21(Waf1), p27(Kip1), retinoblastoma (Rb), and cyclin D1 in Richter's transformation of chronic lymphocytic leukemia (CLL), we analyzed 19 CLL and eight Richter's syndrome (RS) tumors, previously characterized for p53 and ARF/INK4a abnormalities. p21(Waf1)immunohistochemical expression was negative in 12 of 15 CLL (80%), whereas it was moderate or strong in three of seven RS (43%). p21(Waf1) gene was in germline configuration in all the tumors analyzed. Four immunohistochemical patterns of p53 and p21(Waf1) expression were observed: (1) p53-/p21- in 10 of 15 CLL (67%), but only in two of six RS (33%); (2) p53+/p21+ in three CLL (20%) and two RS (33%); (3) p53-/p21+ in one RS; and (4) p53++/p21- in two CLL and one RS. Two p53+/p21+ CLL evolved into RS. p53 mutations clustered around the p53++/p21- (two CLL and one RS) and p53-/p21- (one CLL and one RS) tumors. While the majority of CLL displayed strong p27 immunoreactivity, RS tumors were constantly p27-negative. p27(Kip1) gene was in germline configuration in all the tumors analyzed. Most CLL cases were negative for Rb expression. In contrast, all RS exhibited strong Rb expression. Cyclin D1 overexpression was only detected in one CLL evolving into RS and one RS. In conclusion, a p53+/p21- immunohistochemical pattern is shown exclusively by p53-mutated CLL/RS. Additionally, our results suggest a possible implication of moderate/strong p21(Waf1) expression, loss of p27 expression, and cyclin D1 overexpression in the Richter's transformation of CLL.
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MESH Headings
- Adult
- Aged
- Cell Cycle
- Cell Cycle Proteins/metabolism
- Cyclin D1/metabolism
- Cyclin-Dependent Kinase Inhibitor p21
- Cyclin-Dependent Kinase Inhibitor p27
- Cyclins/metabolism
- Female
- Genes, p53
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell/diagnosis
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/metabolism
- Lymphoma, Large B-Cell, Diffuse/diagnosis
- Lymphoma, Large B-Cell, Diffuse/genetics
- Lymphoma, Large B-Cell, Diffuse/metabolism
- Male
- Middle Aged
- Mutation
- Retinoblastoma Protein/metabolism
- Tumor Suppressor Proteins/metabolism
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Affiliation(s)
- F Cobo
- Institute of Hematology and Oncology, Department of Hematology, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, University of Barcelona, Barcelona, Spain
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38
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Nadal E, Martinez A, Jiménez M, Ginés A, Campo E, Piqué J, López-Guillermo A. Primary follicular lymphoma arising in the ampulla of Vater. Ann Hematol 2002; 81:228-31. [PMID: 11976827 DOI: 10.1007/s00277-002-0436-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2001] [Accepted: 01/07/2002] [Indexed: 11/26/2022]
Abstract
Primary gastrointestinal lymphomas constitute more than one-third of all extranodal lymphomas, but among them follicular lymphomas (FL) are infrequent, accounting for only 1-4%. We report the case of a 55-year-old man diagnosed with a FL of the ampulla of Vater. He complained of dyspepsia. An upper gastroendoscopic study 1 year before showed a slight enlargement of the papilla with the biopsy initially interpreted as atypical follicular hyperplasia. The study performed because of persistence of the symptoms again showed an enlarged papilla, and the histological examination was diagnostic of FL (CD10+, bcl-2+). The full staging study did not show other FL involvement. The patient was treated with six courses of cyclophosphamide, hydroxydaunomycin, vincristine, and prednisone (CHOP), and the endoscopy as well as the biopsies revealed no abnormalities since the third course of chemotherapy. After 2 years of follow-up he remains asymptomatic and the gastroendoscopic study is normal.
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Affiliation(s)
- E Nadal
- Institute of Hematology and Oncology, Hematology Department, IDIBAPS, Hospital Clínic, Villarroel 170, 08036 Barcelona, Spain.
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Montoto S, López-Guillermo A, Ferrer A, Camós M, Alvarez-Larrán A, Bosch F, Bladé J, Cervantes F, Esteve J, Cobo F, Colomer D, Campo E, Montserrat E. Survival after progression in patients with follicular lymphoma: analysis of prognostic factors. Ann Oncol 2002; 13:523-30. [PMID: 12056701 DOI: 10.1093/annonc/mdf119] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The purpose of this study was to identify prognostic parameters for patients with follicular lymphoma (FL) in first progression/relapse. These would be useful for selection of high-risk patients for inclusion in trials aimed at determining the effect of new treatment approaches in such patients. PATIENTS AND METHODS Ninety patients (48 male, 42 female, median age 56 years) diagnosed with FL, in a single institution during a 20 year period and relapsing/progressing after an initial response to therapy, were recruited. The main end-point of the study was survival from progression (SFP). Univariate and multivariate analyses were performed, including among the predictive variables the response duration (RD) after the initial treatment and the main features of the patients at the first progression or relapse. RESULTS Five-year SFP was 47% (95% confidence interval 35% to 58%). Patients with RD following initial therapy >2 years had a longer SFP (5-year SFP 63 versus 33%, P = 0.012). Other variables with prognostic interest for SFP were stage at diagnosis and the following variables at relapse: age, bulky disease, performance status, serum lactate dehydrogenase level, serum beta2-microglobulin level, bone marrow involvement, stage and International Prognostic Index rating. In the multivariate analysis, poor performance status at progression and a RD <2 years were the most important unfavorable variables to predict SFP. CONCLUSION In patients with FL, RD along with performance status at progression are features that predict SFP. These variables could thus be useful to select candidates for experimental treatments.
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Affiliation(s)
- S Montoto
- Department of Hematology, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Barcelona, Spain
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40
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Jiménez-Hernández M, López-Guillermo A, Cobo F, Bladé J, Aguilar JL, Villamor N, Montserrat E. Bladder involvement of diffuse large B-cell lymphoma diagnosed by a cytological study of the urine. Leuk Lymphoma 2002; 43:187-9. [PMID: 11908726 DOI: 10.1080/10428190210201] [Citation(s) in RCA: 10] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The diagnosis of lymphoma involvement from the urine sediment has been rarely reported in the literature. We present a 78-year-old woman with diffuse large B-cell lymphoma in whom a relapse of the disease was diagnosed due to the presence of lymphoma cells in the urine. The analysis of urine by flow cytometry demonstrated a clonal B-cell origin, with an identical immunophenotype to that of the initial lymphoma. This case emphasizes the interest of cytological studies of the urine in cases with suspected bladder involvement by lymphoma.
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Affiliation(s)
- M Jiménez-Hernández
- Department of Hematology, Instituto de Investigaciones Biomédicas August Pi i Sunyer, Hospital Clinic, Villarroel, Barcelona, Spain
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41
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Bessell EM, López-Guillermo A, Villá S, Verger E, Nomdedeu B, Petit J, Byrne P, Montserrat E, Graus F. Importance of radiotherapy in the outcome of patients with primary CNS lymphoma: an analysis of the CHOD/BVAM regimen followed by two different radiotherapy treatments. J Clin Oncol 2002; 20:231-6. [PMID: 11773174 DOI: 10.1200/jco.2002.20.1.231] [Citation(s) in RCA: 85] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To assess the effect of a reduced dose of radiotherapy (RT) in patients with primary CNS lymphoma (PCNSL) responding to the cyclophosphamide, doxorubicin, vincristine, and dexamethasone (CHOD)/carmustine, vincristine, methotrexate, and cytarabine (BVAM) regimen. PATIENTS AND METHODS Patients received one cycle of CHOD and two of BVAM. In the first trial, all 31 patients received 45-Gy whole-brain RT (CHOD/BVAM I). In the second, with 26 patients, RT dose was reduced to 30.6 Gy if there was a complete response (CR) after chemotherapy (CHOD/BVAM II). RESULTS Age, performance status, and chemotherapy received were similar in both protocols. CR rate at the end of all treatment was 68% for CHOD/BVAM I and 77% and for CHOD/BVAM II. Treatment modality was the only predictor of relapse, with 3-year relapse risks of 29% and 70% for CHOD/BVAM I and II, respectively. This was specifically important in the 25 patients less than 60 years old (3-year relapse risk, 25% v 83%; P =.01). The 5-year overall survival (OS) was 36%. Age (< 60 v > or = 60 years) was the only predictor for OS in the multivariate analysis (relative risk, 2.1; 95% confidence interval, 1.4 to 2.8). RT dose was the only predictor of OS in patients younger than 60 years old who achieved CR at the end of all treatment (3-year OS, 92% v 60% for patients receiving 45 or 30.6 Gy, respectively; P =.04). CONCLUSION Reduction of the RT dose from 45 Gy to 30.6 Gy in patients younger than 60 years old with PCNSL who achieved CR resulted in an increased risk of relapse and lower OS.
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Affiliation(s)
- E M Bessell
- Department of Clinical Oncology, Nottingham City Hospital, Nottingham, United Kingdom
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42
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Alvarez-Larrán A, Villamor N, Hernández-Boluda JC, Ferrer A, Camós M, Campo E, López-Guillermo A. Blastic natural killer cell leukemia/lymphoma presenting as overt leukemia. Clin Lymphoma 2001; 2:178-82; discussion 183-4. [PMID: 11779295 DOI: 10.3816/clm.2001.n.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Blastic natural killer (NK)-cell leukemia/lymphoma is a neoplasm of NK origin with aggressive behavior. The disease affects mainly elderly people and often presents with skin lesions and overt leukemia. Blastic morphology, an NK-cell immunophenotype, and lack of association with Epstein-Barr virus are the clues for the diagnosis. We report herein, the case of a patient with a blastic NK-cell leukemia/lymphoma with overt leukemia at diagnosis, who achieved a complete response after CHOP (cyclophosphamide/doxorubicin/vincristine/prednisone) chemotherapy. However, the patient relapsed a few months later and died due to disease progression. Cases of blastic NK-cell leukemia/ lymphoma previously reported are briefly reviewed.
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Affiliation(s)
- A Alvarez-Larrán
- Institute of Hematology and Oncology, Department of Hematology, Instituto de Investigaciones Biomédicas August Pi i Sunyer Hospital Clínic, Barcelona, Spain
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43
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Bellosillo B, Villamor N, López-Guillermo A, Marcé S, Esteve J, Campo E, Colomer D, Montserrat E. Complement-mediated cell death induced by rituximab in B-cell lymphoproliferative disorders is mediated in vitro by a caspase-independent mechanism involving the generation of reactive oxygen species. Blood 2001; 98:2771-7. [PMID: 11675350 DOI: 10.1182/blood.v98.9.2771] [Citation(s) in RCA: 159] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Mechanisms involving the in vitro effect of rituximab in cells from 55 patients with B-cell lymphoproliferative disorders were investigated. No cytotoxic effect was observed when cells were incubated with rituximab alone, but in the presence of human AB serum rituximab induced complement-dependent cell death (R-CDC). A cytotoxic effect was observed in cells from 9 of 33 patients with B-cell chronic lymphocytic leukemia, 16 of 16 patients with mantle-cell lymphoma, 4 of 4 patients with follicular lymphoma, and 2 of 2 patients with hairy-cell leukemia. R-CDC was observed in cells from patients expressing more than 50 x 10(3) CD20 molecules per cell, and directly correlated with the number of CD20 molecules per cell. Preincubation with anti-CD59 increased the cytotoxic effect of rituximab and sensitized cells from nonsensitive cases. Neither cleavage of poly-ADP ribose polymerase (PARP) nor activation of caspase-3 was observed in R-CDC. In addition, no cells with a hypodiploid DNA content were detected and R-CDC was not prevented by a broad-spectrum caspase inhibitor, suggesting a caspase-independent mechanism. Incubation with rituximab in the presence of AB serum induced a rapid and intense production of reactive oxygen species (ROS). R-CDC was blocked by the incubation of cells with N-acetyl-L-cysteine (NAC) or Tiron, 2 ROS scavengers, indicating that the cytotoxic effect was due to the generation of superoxide (O) radicals. In conclusion, the results of the present study suggest that CD20, CD59, and complement have a role in the in vitro cytotoxic effect of rituximab, which is mediated by a caspase-independent process that involves ROS generation.
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Affiliation(s)
- B Bellosillo
- Hematopathology Unit, Department of Hematology, Institute of Hematology and Oncology, Postgraduate School of Hematology Farreras-Valentí, Barcelona, Spain
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Ferrer A, López-Guillermo A, Montoto S, Estrach T, Colomo L, Montserrat E. Successful treatment of isolated cutaneous relapse of follicular lymphoma with rituximab. Ann Hematol 2001; 80:479-81. [PMID: 11563595 DOI: 10.1007/s002770100314] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Patients with follicular lymphoma (FL) usually present with advanced disease, with lymph nodes and bone marrow involvement. Extranodal infiltration is infrequent. In FL isolated cutaneous relapse is a very rare event that, to the best of our knowledge, has not been previously reported. We report on a 55-year-old woman with FL who presented with an isolated skin relapse 5 years after the diagnosis. The patient, who had relapsed after three lines of chemotherapy, was treated with the chimeric anti-CD20 antibody, rituximab, achieving a complete response, which has now persisted for more than 24 months.
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Affiliation(s)
- A Ferrer
- Department of Hematology, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Barcelona, Spain.
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45
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Bessell EM, Graus F, López-Guillermo A, Villá S, Verger E, Petit J, Holland I, Byrne P. CHOD/BVAM regimen plus radiotherapy in patients with primary CNS non-Hodgkin's lymphoma. Int J Radiat Oncol Biol Phys 2001; 50:457-64. [PMID: 11380234 DOI: 10.1016/s0360-3016(01)01451-1] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To assess the efficacy and toxicity, including long-term neurotoxicity, of combined therapy with the CHOD/BVAM regimen given before cranial radiotherapy in the treatment of primary CNS lymphoma (PCNSL). METHODS AND MATERIALS Thirty-one consecutive patients with PCNSL were treated with one cycle of cyclophosphamide, doxorubicin, vincristine, and dexamethasone (CHOD) and two of carmustine (BCNU), vincristine, cytosine arabinoside, and methotrexate (BVAM), followed by cranial radiotherapy (45 Gy whole brain plus a 10-Gy boost for single lesions). The median age was 59 years (range 21-70) and 39% had poor performance status. The median follow-up of patients was 4.1 years (range 2.7-9.0). RESULTS Twenty-one patients had no PCNSL at the end of treatment. The 5-year actuarial probability of survival was 31% (95% confidence interval [CI]: 11%-57%), with a median survival of 38 months. Patients < 60 years had a survival significantly longer than those > or = 60 years (4-year survival: 58% (95% CI: 34-82%) vs. 29% (95% CI: 5-53%), respectively; p = 0.04). Two patients died during chemotherapy from pulmonary embolism and bronchopneumonia, respectively, with no evidence of PCNSL at the autopsy. Dementia probably related to treatment occurred in 5 (62%) of the 8 patients 60 years and older, and 4 of them died without evidence of relapse of PCNSL. Dementia correlated with developing brain atrophy and leuco-encephalopathy on serial CT or MR scans. CONCLUSION This regimen can be given with the planned dose intensity to patients aged less than 70 years, and produces better survival than that reported with radiotherapy alone; however, dementia occurs in the majority of patients aged 60 years of age or more.
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Affiliation(s)
- E M Bessell
- Department of Clinical Oncology, Nottingham City Hospital, UK
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46
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Villela L, López-Guillermo A, Montoto S, Rives S, Bosch F, Perales M, Ferrer A, Esteve J, Colomo L, Campo E, Montserrat E. Prognostic features and outcome in patients with diffuse large B-cell lymphoma who do not achieve a complete response to first-line regimens. Cancer 2001; 91:1557-62. [PMID: 11301405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
BACKGROUND The current study was conducted to analyze the outcome and prognostic factors of patients with diffuse large B-cell lymphoma (DLCL) who did not achieve a complete response (CR) to first-line treatment. METHODS The current study was comprised of 83 patients (43 males and 40 females with a median age of 62 years) who did not achieve a CR (58 of whom had primary refractory disease and 25 of whom achieved a partial response) with initial treatment (doxorubicin-containing regimens in 87% of cases) from a series of 239 patients consecutively diagnosed with DLCL at a single institution. Initial variables, response to therapy, and salvage treatment were analyzed to predict survival. RESULTS Compared with patients who achieved a CR, nonresponders or partial responders more frequently were of advanced age and had a poor performance status (PS), B-symptoms, advanced stage of disease, bone marrow infiltration, increased serum lactate dehydrogenase, and a high-risk International Prognostic Index. Among the 58 patients with primary refractory disease, 18 died during initial treatment due to toxicity (14 patients) or disease progression (4 patients). The main variables predicting early death were a poor PS, age > 60 years, and an immunoblastic DLCL subtype. Twenty-five of these 58 patients were able to receive salvage regimens, with only 1 of them achieving a CR. The median survival for this group of patients was 10 months. With regard to those patients achieving a partial response, 18 of the 25 patients received further therapy with 28% of them achieving a CR. The median survival was 23 months. The degree of the response was found to be the only significant variable with which to predict survival, with 2-year survival rates of 4% and 40%, respectively, for patients with primary refractory disease and patients who achieved a partial response. CONCLUSIONS The prognosis of patients with primarily refractory DLCL is extremely unfavorable, whereas that of patients who achieve a partial response is slightly better. The inclusion of these patients in experimental trials is limited due to their tendency to be of an older age and to have a poor general status.
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Affiliation(s)
- L Villela
- Department of Hematology, Postgraduate School of Hematology "Farreras Valentí," Instituto de Investigaciones Biomédicas, Hospital Clínic, Barcelona, Spain
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48
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Sureda A, Arranz R, Iriondo A, Carreras E, Lahuerta JJ, García-Conde J, Jarque I, Caballero MD, Ferrà C, López A, García-Laraña J, Cabrera R, Carrera D, Ruiz-Romero MD, León A, Rifón J, Díaz-Mediavilla J, Mataix R, Morey M, Moraleda JM, Altés A, López-Guillermo A, de la Serna J, Fernández-Rañada JM, Sierra J, Conde E. Autologous stem-cell transplantation for Hodgkin's disease: results and prognostic factors in 494 patients from the Grupo Español de Linfomas/Transplante Autólogo de Médula Osea Spanish Cooperative Group. J Clin Oncol 2001; 19:1395-404. [PMID: 11230484 DOI: 10.1200/jco.2001.19.5.1395] [Citation(s) in RCA: 173] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To analyze clinical outcome and significant prognostic factors for overall (OS) and time to treatment failure (TTF) in a group of 494 patients with Hodgkin's disease (HD) undergoing autologous stem-cell transplantation (ASCT). PATIENTS AND METHODS Detailed records from the Grupo Español de Linfomas/Transplante Autólogo de Médula Osea Spanish Cooperative Group Database on 494 HD patients who received an ASCT between January 1984 and May 1998 were reviewed. Two hundred ninety-eight males and 196 females with a median age of 27 years (range, 1 to 63 years) received autografts while in complete remission (n = 203) or when they had sensitive disease (n = 206) or resistant disease (n = 75) at a median time of 26 months (range, 4 to 259 months) after diagnosis. Most patients received high-dose chemotherapy without radiation for conditioning (n = 443). The graft consisted of bone marrow (n = 244) or peripheral blood (n = 250). RESULTS The 100-day mortality rate was 9%. The 5-year actuarial TTF and OS rates were 45.0% (95% confidence interval [CI], 39.5% to 50.5%) and 54.5% (95% CI, 48.4% to 60.6%), respectively. In multivariate analysis, the presence of active disease at transplantation, transplantation before 1992, and two or more lines of therapy before transplantation were adverse prognostic factors for outcome. Sixteen patients developed a secondary malignancy (5-year cumulative incidence of 4.3%) after transplantation. Adjuvant radiotherapy before transplantation, the use of total-body irradiation (TBI) in the conditioning regimen, and age > or = 40 years were found to be predictive factors for the development of second cancers after ASCT. CONCLUSION ASCT achieves long-term disease-free survival in HD patients. Disease status before ASCT is the most important prognostic factor for final outcome; thus, transplantation should be considered in early stages of the disease. TBI must be avoided in the conditioning regimen because of a significantly higher rate of late complications, including secondary malignancies.
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Affiliation(s)
- A Sureda
- Clinical Hematolgy Division, Hospital de la Santa Creu i Sant Pau, St Antoni Maria Claret, Barcelona, Spain.
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49
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Sanz-Vaqué L, Colomer D, Bosch F, López-Guillermo A, Dreyling MH, Bosch F, Montserrat E, Campo E. Microsatellite instability analysis in typical and progressed mantle cell lymphoma and B-cell chronic lymphocytic leukemia. Haematologica 2001; 86:181-6. [PMID: 11224488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Microsatellite instability (MSI) is characterized by tumor-associated alterations in the germline size of microsatellite repeats caused by a reduced efficacy of the DNA mismatch repair machinery. The aim of this study was to investigate the presence of MSI in a number of cases of indolent and aggressive mantle cell lymphoma (MCL) and B-cell chronic lymphocytic leukemia (B-CLL) to determine its possible role in the initial development and progression of these disorders. DESIGN AND METHODS We examined the presence of MSI in 28 B-CLL, 24 typical and 4 transformed B-CLL (Richter's syndrome) and 29 MCL, 19 typical and 10 blastoid variants by using a panel of 10 microsatellite markers and analyzed them using an AbiPrism 310 DNA sequencer. Fisher's exact test was used to compare categorical variables and Mann-Whitney's U-test for continuous variables. RESULTS MSI alterations were not observed in any case of MCL or Richter's syndrome and in only three (13%) patients with typical B-CLL. Two of these patients also had loss of heterozygosity in one of the 10 sites examined. These patients presented with a more advanced stage, diffuse bone marrow involvement, and poorer performance status than patients without these alterations. INTERPRETATION AND CONCLUSIONS These findings indicate that MSI is not involved in the pathogenesis or progression of B-CLL and MCL but may appear in a small subset of patients with advanced B-CLL.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Case-Control Studies
- DNA, Neoplasm/genetics
- Disease Progression
- Female
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell/etiology
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Lymphoma, Mantle-Cell/etiology
- Lymphoma, Mantle-Cell/genetics
- Male
- Microsatellite Repeats
- Middle Aged
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Affiliation(s)
- L Sanz-Vaqué
- Department of Hematology, Hospital Clinic, Universitat de Barcelona, Villarroel 170, 08036 Barcelona, Spain
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50
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Salar A, Sierra J, Gandarillas M, Caballero MD, Marín J, Lahuerta JJ, García-Conde J, Arranz R, León A, Zuazu J, García-Laraña J, López-Guillermo A, Sanz MA, Grañena A, García JC, Conde E. Autologous stem cell transplantation for clinically aggressive non-Hodgkin's lymphoma: the role of preparative regimens. Bone Marrow Transplant 2001; 27:405-12. [PMID: 11313670 DOI: 10.1038/sj.bmt.1702795] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2000] [Accepted: 10/28/2000] [Indexed: 11/09/2022]
Abstract
We investigated the impact of the most commonly used preparative regimens on the outcome of 395 patients with diffuse large cell lymphoma (DLCL), consecutively reported to the registry of the Spanish GEL/TAMO. Among them, 139 (35%) were autografted in 1st CR, 86 (22%) in 2nd/3rd CR, 124 (31%) had chemosensitive disease and 46 (12%) had chemoresistant disease. Conditioning consisted of chemotherapy-only in 348 patients (BEAM, 164; BEAC, 145; and CBV, 39) and radiochemotherapy with CY and TBI in 47. Median times to granulocyte, platelet recovery and to discharge were significantly shorter in the chemotherapy-only group. Early transplant-related mortality was significantly higher when using CY-TBI. After a median follow-up of 28 months, overall survival (OS) at 8 years of patients conditioned with BEAM or BEAC (58% (95% CI 50-66%)) was more favorable than with CBV (40% (95% CI 24-56%)), and significantly better than with CY-TBI (31% (95% CI 18-44%)). Multivariate analysis revealed that patients conditioned with chemotherapy-only regimens had improved OS, disease-free (DFS) and relapse-free survival (RFS) when compared to those conditioned with CY-TBI. Status at transplant was also a powerful prognostic indicator. We conclude that preparative regimens consisting of chemotherapy-only seem more efficacious than CY-TBI as conditioning for DLCL, because of faster engraftment and greater anti-lymphoma effect, as indicated by improved OS, DFS and RFS.
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MESH Headings
- Adolescent
- Adult
- Aged
- Antineoplastic Combined Chemotherapy Protocols/standards
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Antineoplastic Combined Chemotherapy Protocols/toxicity
- Cause of Death
- Child
- Child, Preschool
- Female
- Graft Survival/drug effects
- Graft Survival/radiation effects
- Hematopoiesis/drug effects
- Hematopoiesis/radiation effects
- Hematopoietic Stem Cell Transplantation/methods
- Hematopoietic Stem Cell Transplantation/mortality
- Hematopoietic Stem Cell Transplantation/standards
- Humans
- Lymphoma, Large B-Cell, Diffuse/complications
- Lymphoma, Large B-Cell, Diffuse/mortality
- Lymphoma, Large B-Cell, Diffuse/therapy
- Lymphoma, Non-Hodgkin/complications
- Lymphoma, Non-Hodgkin/mortality
- Lymphoma, Non-Hodgkin/therapy
- Male
- Middle Aged
- Prospective Studies
- Radiotherapy, Adjuvant/standards
- Registries
- Spain/epidemiology
- Transplantation Conditioning/methods
- Transplantation Conditioning/standards
- Transplantation, Autologous/methods
- Transplantation, Autologous/mortality
- Transplantation, Autologous/standards
- Treatment Outcome
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Affiliation(s)
- A Salar
- Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
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