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Starr AG, Caimi PF, Fu P, Massoud MR, Meyerson H, Hsi ED, Mansur DB, Cherian S, Cooper BW, De Lima MJ, Lazarus HM, Gerson SL, Jagadeesh D, Smith MR, Dean RM, Pohlman BL, Hill BT, William BM. Splenic marginal zone lymphoma: excellent outcomes in 64 patients treated in the rituximab era. Hematology 2017; 22:405-411. [DOI: 10.1080/10245332.2017.1279842] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Affiliation(s)
- Adam G. Starr
- University Hospitals Case Medical Center/Case Western Reserve University, Cleveland, OH, USA
| | - Paolo F. Caimi
- University Hospitals Case Medical Center/Case Western Reserve University, Cleveland, OH, USA
| | - PingFu Fu
- University Hospitals Case Medical Center/Case Western Reserve University, Cleveland, OH, USA
| | - Mira R. Massoud
- University Hospitals Case Medical Center/Case Western Reserve University, Cleveland, OH, USA
| | - Howard Meyerson
- University Hospitals Case Medical Center/Case Western Reserve University, Cleveland, OH, USA
| | - Eric D. Hsi
- Cleveland Clinic Foundation, Case Comprehensive Cancer Center, Cleveland, OH, USA
| | - David B. Mansur
- University Hospitals Case Medical Center/Case Western Reserve University, Cleveland, OH, USA
| | - Sheen Cherian
- Cleveland Clinic Foundation, Case Comprehensive Cancer Center, Cleveland, OH, USA
| | - Brenda W. Cooper
- University Hospitals Case Medical Center/Case Western Reserve University, Cleveland, OH, USA
| | - Marcos J.G. De Lima
- University Hospitals Case Medical Center/Case Western Reserve University, Cleveland, OH, USA
| | - Hillard M. Lazarus
- University Hospitals Case Medical Center/Case Western Reserve University, Cleveland, OH, USA
| | - Stanton L. Gerson
- University Hospitals Case Medical Center/Case Western Reserve University, Cleveland, OH, USA
| | - Deepa Jagadeesh
- Cleveland Clinic Foundation, Case Comprehensive Cancer Center, Cleveland, OH, USA
| | - Mitchell R. Smith
- Cleveland Clinic Foundation, Case Comprehensive Cancer Center, Cleveland, OH, USA
| | - Robert M. Dean
- Cleveland Clinic Foundation, Case Comprehensive Cancer Center, Cleveland, OH, USA
| | - Brad L. Pohlman
- Cleveland Clinic Foundation, Case Comprehensive Cancer Center, Cleveland, OH, USA
| | - Brian T. Hill
- Cleveland Clinic Foundation, Case Comprehensive Cancer Center, Cleveland, OH, USA
| | - Basem M. William
- University Hospitals Case Medical Center/Case Western Reserve University, Cleveland, OH, USA
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2
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Starr AG, Caimi PF, Fu P, Massoud MR, Meyerson H, Hsi ED, Mansur DB, Cherian S, Cooper BW, De Lima MJG, Lazarus HM, Gerson SL, Jagadeesh D, Smith MR, Dean RM, Pohlman BL, Hill BT, William BM. Dual institution experience of nodal marginal zone lymphoma reveals excellent long-term outcomes in the rituximab era. Br J Haematol 2016; 175:275-280. [DOI: 10.1111/bjh.14228] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Accepted: 05/25/2016] [Indexed: 12/17/2022]
Affiliation(s)
- Adam G. Starr
- University Hospitals Case Medical Center/Case Western Reserve University; Cleveland OH USA
| | - Paolo F. Caimi
- University Hospitals Case Medical Center/Case Western Reserve University; Cleveland OH USA
| | - PingFu Fu
- University Hospitals Case Medical Center/Case Western Reserve University; Cleveland OH USA
| | - Mira R. Massoud
- University Hospitals Case Medical Center/Case Western Reserve University; Cleveland OH USA
| | - Howard Meyerson
- University Hospitals Case Medical Center/Case Western Reserve University; Cleveland OH USA
| | - Eric D. Hsi
- Cleveland Clinic Foundation; Case Comprehensive Cancer Center; Cleveland OH USA
| | - David B. Mansur
- University Hospitals Case Medical Center/Case Western Reserve University; Cleveland OH USA
| | - Sheen Cherian
- Cleveland Clinic Foundation; Case Comprehensive Cancer Center; Cleveland OH USA
| | - Brenda W. Cooper
- University Hospitals Case Medical Center/Case Western Reserve University; Cleveland OH USA
| | - Marcos J. G. De Lima
- University Hospitals Case Medical Center/Case Western Reserve University; Cleveland OH USA
| | - Hillard M. Lazarus
- University Hospitals Case Medical Center/Case Western Reserve University; Cleveland OH USA
| | - Stanton L. Gerson
- University Hospitals Case Medical Center/Case Western Reserve University; Cleveland OH USA
| | - Deepa Jagadeesh
- Cleveland Clinic Foundation; Case Comprehensive Cancer Center; Cleveland OH USA
| | - Mitchell R. Smith
- Cleveland Clinic Foundation; Case Comprehensive Cancer Center; Cleveland OH USA
| | - Robert M. Dean
- Cleveland Clinic Foundation; Case Comprehensive Cancer Center; Cleveland OH USA
| | - Brad L. Pohlman
- Cleveland Clinic Foundation; Case Comprehensive Cancer Center; Cleveland OH USA
| | - Brian T. Hill
- Cleveland Clinic Foundation; Case Comprehensive Cancer Center; Cleveland OH USA
| | - Basem M. William
- University Hospitals Case Medical Center/Case Western Reserve University; Cleveland OH USA
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Allen JM, Ruano Mendez AL, Rybicki LA, Jagadeesh D, Dean RM, Pohlman BL, Smith MR, Hsi ED, Hill BT. Outcomes of patients with relapsed/refractory diffuse large B-cell lymphoma treated with R-ICE based on dual expression of MYC and BCL2.. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.e19043] [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: 11/20/2022] Open
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4
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Sawalha Y, Rouphail B, Jia X, Dean RM, Hill BT, Jagadeesh D, Pohlman BL, Smith MR. Is rituximab sub-optimally dosed in indolent B cell lymphoma? Br J Haematol 2016; 174:721-9. [DOI: 10.1111/bjh.14114] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2015] [Accepted: 02/19/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Yazeed Sawalha
- Department of Medical Oncology and Hematology; Taussig Cancer Institute; Cleveland OH USA
| | - Basel Rouphail
- Department of Medical Oncology and Hematology; Taussig Cancer Institute; Cleveland OH USA
| | - Xuefei Jia
- Quantitative Health Sciences; Cleveland Clinic; Cleveland OH USA
| | - Robert M. Dean
- Department of Medical Oncology and Hematology; Taussig Cancer Institute; Cleveland OH USA
| | - Brian T. Hill
- Department of Medical Oncology and Hematology; Taussig Cancer Institute; Cleveland OH USA
| | - Deepa Jagadeesh
- Department of Medical Oncology and Hematology; Taussig Cancer Institute; Cleveland OH USA
| | - Brad L. Pohlman
- Department of Medical Oncology and Hematology; Taussig Cancer Institute; Cleveland OH USA
| | - Mitchell R. Smith
- Department of Medical Oncology and Hematology; Taussig Cancer Institute; Cleveland OH USA
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5
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Starr AG, Caimi PF, Fu P, Massoud MR, Meyerson H, Hsi ED, Mansur DB, Cherian S, Singh AD, Cooper BW, De Lima MJ, Lazarus HM, Gerson SL, Jagadeesh D, Smith MR, Dean RM, Pohlman BL, Hill BT, William BM. Dual institution experience of extranodal marginal zone lymphoma reveals excellent long-term outcomes. Br J Haematol 2016; 173:404-12. [DOI: 10.1111/bjh.13975] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 12/21/2015] [Indexed: 12/14/2022]
Affiliation(s)
- Adam G. Starr
- University Hospitals Case Medical Center; Case Western Reserve University; Cleveland OH USA
| | - Paolo F. Caimi
- University Hospitals Case Medical Center; Case Western Reserve University; Cleveland OH USA
| | - PingFu Fu
- University Hospitals Case Medical Center; Case Western Reserve University; Cleveland OH USA
| | - Mira R. Massoud
- University Hospitals Case Medical Center; Case Western Reserve University; Cleveland OH USA
| | - Howard Meyerson
- University Hospitals Case Medical Center; Case Western Reserve University; Cleveland OH USA
| | - Eric D. Hsi
- Cleveland Clinic Foundation; Case Comprehensive Cancer Center; Cleveland OH USA
| | - David B. Mansur
- University Hospitals Case Medical Center; Case Western Reserve University; Cleveland OH USA
| | - Sheen Cherian
- Cleveland Clinic Foundation; Case Comprehensive Cancer Center; Cleveland OH USA
| | - Arun D. Singh
- Cleveland Clinic Foundation; Case Comprehensive Cancer Center; Cleveland OH USA
| | - Brenda W. Cooper
- University Hospitals Case Medical Center; Case Western Reserve University; Cleveland OH USA
| | - Marcos J.G. De Lima
- University Hospitals Case Medical Center; Case Western Reserve University; Cleveland OH USA
| | - Hillard M. Lazarus
- University Hospitals Case Medical Center; Case Western Reserve University; Cleveland OH USA
| | - Stanton L. Gerson
- University Hospitals Case Medical Center; Case Western Reserve University; Cleveland OH USA
| | - Deepa Jagadeesh
- Cleveland Clinic Foundation; Case Comprehensive Cancer Center; Cleveland OH USA
| | - Mitchell R. Smith
- Cleveland Clinic Foundation; Case Comprehensive Cancer Center; Cleveland OH USA
| | - Robert M. Dean
- Cleveland Clinic Foundation; Case Comprehensive Cancer Center; Cleveland OH USA
| | - Brad L. Pohlman
- Cleveland Clinic Foundation; Case Comprehensive Cancer Center; Cleveland OH USA
| | - Brian T. Hill
- Cleveland Clinic Foundation; Case Comprehensive Cancer Center; Cleveland OH USA
| | - Basem M. William
- University Hospitals Case Medical Center; Case Western Reserve University; Cleveland OH USA
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Starr A, Fu P, Caimi PF, Campagnaro EL, Cooper BW, De Lima MJ, Lazarus HM, Gerson SL, Meyerson H, Jagadeesh D, Smith MR, Dean RM, Pohlman BL, Hill BT, William BM. Outcomes and prognostic factors in marginal zone lymphoma: Case comprehensive cancer center cumulative experience of 358 cases. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.8554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Adam Starr
- Case Western Reserve University, Cleveland, OH
| | - PingFu Fu
- Case Comprehensive Cancer Center, Cleveland, OH
| | - Paolo Fabrizio Caimi
- University Hospitals Seidman Cancer Center, Case Western Reserve University, and Case Comprehensive Cancer Center, Cleveland, OH
| | - Erica Leigh Campagnaro
- University Hospitals Seidman Cancer Center, Case Western Reserve University, and Case Comprehensive Cancer Center, Cleveland, OH
| | - Brenda W. Cooper
- University Hospitals Seidman Cancer Center, Case Western Reserve University, and Case Comprehensive Cancer Center, Cleveland, OH
| | - Marcos J.G. De Lima
- University Hospitals Seidman Cancer Center, Case Western Reserve University, and Case Comprehensive Cancer Center, Cleveland, OH
| | - Hillard M. Lazarus
- University Hospitals Seidman Cancer Center, Case Western Reserve University, and Case Comprehensive Cancer Center, Cleveland, OH
| | - Stanton L. Gerson
- University Hospitals Seidman Cancer Center, Case Western Reserve University, and Case Comprehensive Cancer Center, Cleveland, OH
| | | | - Deepa Jagadeesh
- Cleveland Clinic Taussig Cancer Institute and Case Comprehensive Cancer Center, Cleveland, OH
| | | | - Robert M. Dean
- Cleveland Clinic Taussig Cancer Institute and Case Comprehensive Cancer Center, Cleveland, OH
| | - Brad L. Pohlman
- Cleveland Clinic Taussig Cancer Institute and Case Comprehensive Cancer Center, Cleveland, OH
| | - Brian Thomas Hill
- Cleveland Clinic Taussig Cancer Institute and Case Comprehensive Cancer Center, Cleveland, OH
| | - Basem M. William
- University Hospitals Seidman Cancer Center, Case Western Reserve University, and Case Comprehensive Cancer Center, Cleveland, OH
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Madanat Y, Rybicki LA, Jagadeesh D, Dean RM, Pohlman BL, Kalaycio ME, Smith MR, Hill BT. Long term outcomes of hairy cell leukemia patients treated with first and subsequent line with purine analog: The Cleveland Clinic experience. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.e18034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | | | | | - Matt E. Kalaycio
- Leukemia Program, Department of Hematology and Oncology, Cleveland Clinic, Cleveland, OH
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Sawalha Y, Rouphail B, Jia X, Dean RM, Hill BT, Jagadeesh D, Pohlman BL, Elson P, Smith MR. Is rituximab sub-optimally dosed in indolent B cell lymphoma? J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.8567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Ganjoo KN, de Vos S, Pohlman BL, Flinn IW, Forero-Torres A, Enas NH, Cronier DM, Dang NH, Foon KA, Carpenter SP, Slapak CA, Link BK, Smith MR, Mapara MY, Wooldridge JE. Phase 1/2 study of ocaratuzumab, an Fc-engineered humanized anti-CD20 monoclonal antibody, in low-affinity FcγRIIIa patients with previously treated follicular lymphoma. Leuk Lymphoma 2014; 56:42-8. [PMID: 24717109 DOI: 10.3109/10428194.2014.911859] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This phase 2 study assessed the safety and efficacy of ocaratuzumab, a humanized anti-CD20 monoclonal antibody. Fifty patients with previously treated follicular lymphoma (FL) and a low-affinity genotype of FcγRIIIa received ocaratuzumab 375 mg/m(2) weekly for 4 weeks. Grade 3/4/5 adverse events (AEs) were reported in 11/1/1 patients, respectively. Serious AEs were reported by 11/50 patients, and three discontinued due to AEs. One patient died from aspiration pneumonia due to possibly drug-related nausea and vomiting. Investigator-assessed response rate was 30% (15/50), including four complete responses (CR), three CR unconfirmed (CRu) and eight partial responses (PR). Investigator-assessed median Progression-free survivial (PFS) was 38.3 weeks. Ocaratuzumab's pharmacokinetic profile was similar to that reported for rituximab. Lymphocyte subset analysis showed significant, selective reduction of B-cells during and after ocaratuzumab treatment. Ocaratuzumab at this dose and schedule is active and well tolerated in patients with previously treated FL with low affinity FcγRIIIa genotypes. ClinTrials registry number: NCT00354926.
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Keng MK, Thallner EA, Elson P, Ajon C, Sekeres J, Wenzell CM, Gallagher EM, Weber CM, Earl MA, Mukherjee S, Seastone DJ, Pohlman BL, Cober E, Rodgers B, Foster VB, Yuhas J, Kalaycio ME, Bolwell BJ, Sekeres MA. Defining quality and value in a prospective study of an emergency department (ED) febrile neutropenia pathway (FNP). J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.6632] [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: 11/20/2022] Open
Affiliation(s)
| | | | - Paul Elson
- Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH
| | - Christine Ajon
- Leukemia Program, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH
| | | | | | | | | | - Marc A. Earl
- Department of Pharmacy, Cleveland Clinic, Cleveland, OH
| | - Sudipto Mukherjee
- Leukemia Program, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH
| | | | - Brad L. Pohlman
- Leukemia Program, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH
| | - Eric Cober
- Department of Infectious Diseases, Cleveland Clinic, Cleveland, OH
| | - Beth Rodgers
- Emergency Services Institute, Cleveland Clinic, Cleveland, OH
| | | | - Joy Yuhas
- Enterprise Business Intelligence, Cleveland Clinic, Cleveland, OH
| | - Matt E. Kalaycio
- Leukemia Program, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH
| | | | - Mikkael A. Sekeres
- Leukemia Program, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH
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Wayne JL, Ganjoo KN, Pohlman BL, De Vos S, Flinn IW, Dang NH, Mapara MY, Smith MR, O'Reilly AM, Marulappa SY, Jain VK. Efficacy of ocaratuzumab (AME-133v) in relapsed follicular lymphoma patients refractory to prior rituximab. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.8081] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
8081 Background: Ocaratzumab, previously known as AME-133v, is a humanized next-generation anti-CD20 monoclonal antibody. It has been optimized with a 13 to 20-fold increase in binding affinity to CD20 and improved binding to the low-affinity (F/F and F/V) polymorphisms of FcγRIIIa (CD16), which are thought to predict lower response rates and shorter duration of responses to rituximab. Methods: In a phase I dose escalation study in relapsed follicular lymphoma (FL) patients, ocaratuzumab was well-tolerated at doses up to 375 mg/m2 (Forero-Torres et al. CCR 2012). In a follow-on phase II trial, 44 patients with relapsed FL following prior rituximab and the low-affinity FcγRIIIa polymorphism (F-carriers) received 375 mg/m2 of ocaratuzumab weekly for 4 doses. In this study, overall response rate (ORR) was 36% and median progression free survival (PFS) was 91 weeks (Ganjoo et al. Haematologica 2011). Results: Amongst the 56 patients receiving 100 and 375 mg/m2 of ocaratuzumab, 8 patients had a previous time to progression of ≤ 180 days following their last rituximab treatment. These patients had a median of 2 prior rituximab treatments, (range 1-6 treatments), and median PFS following last treatment of 159 days. Five of the 8 patients showed a longer PFS after ocaratuzumab administration, compared with last rituximab treatment. All 5 patients expressed the homozygous low-affinity genotype of FcγRIIIa (F/F). At the time of study closure, 3 of the patients were still in remission (indicated by * in the table). Conclusions: This retrospective analysis suggests that ocaratuzumab may be non-cross-resistant to rituximab in patients with the low-affinity FcγRIIIa polymorphism. Prolonged PFS in selected patients following ocaratuzumab suggests that the increased binding affinity to CD16 and improved antibody-dependent cell-mediated cytotoxicity (ADCC) of this antibody is clinically relevant. As a single agent, ocaratuzumab may provide prolonged clinical benefit in relapsed FL patients and a clinical trial comparing ocaratuzumab to rituximab is in preparation. [Table: see text]
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Affiliation(s)
| | | | | | - Sven De Vos
- University of California, Los Angeles Medical Center, Los Angeles, CA
| | - Ian W. Flinn
- Sarah Cannon Research Institute/Tennessee Oncology, PLLC, Nashville, TN
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Lazaryan A, Copelan EA, Bejanyan N, Dean RM, Sobecks RM, Hill BT, Pohlman BL, Kalaycio ME, Bolwell BJ, Sweetenham JW. Association of prior rituximab exposure among patients undergoing autologous stem cell transplantation for relapsed/refractory diffuse large B-cell lymphoma with inferior outcomes in males compared with females. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.8055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
8055 Background: The combination of rituximab with CHOP remains the standard upfront therapy of patients (pts) with advanced diffuse large B-cell lymphoma (DLBCL). Gender disparity in survival of pts with DLBCL appears to be significantly modified by the use of rituximab in both upfront (Ngo, 2008; Pfreundschuh, 2009; Riihijarvi, 2010) and post-transplant maintenance (CORAL trial) settings. The presence of interaction between gender and prior rituximab exposure remains unknown in pts with relapsed/refractory DLBCL undergoing autologous stem cell transplantation (ASCT). Methods: We conducted a retrospective cohort study of 320 consecutive pts who underwent ASCT for relapsed/refractory DLBCL at our center from 01/1998 to 12/2010. Relapse-free survival (RFS) and overall survival (OS) were estimated by Kaplan-Meier method and by Cox proportional hazards regression analysis in SAS 9.1 (Cary, NC). Results: Among all pts (median age=54 yrs (IQR, 45-61); 92% Caucasians) 210 (66%) were males and 110 (34%) were females. 85 pts (27%) received more than two prior chemotherapy regimens. 174 pts (55%) had pre-ASCT exposure to rituximab as a part of induction or salvage regimens. Preparative regimen for ASCT uniformly consisted of Bu/Cy/VP-16. In the stratified univariate analysis of pts treated with rituximab prior to the ASCT, male pts had inferior RFS (p=0.02; hazard ratio [HR]=1.86, 95% CI, 1.09-3.18) and OS (p=0.03; HR=1.94, 95% CI, 1.05-3.58). In pts who did not receive rituximab prior to the ASCT, no difference in RFS or OS according to gender was observed (all p>0.4). Gender disparity among rituximab recipients was even more evident for both RFS (p=0.004; HR=2.22, 95% CI, 1.28-3.83) and OS (p=0.005; HR=2.42, 95% CI, 1.3-4.5) in the multivariable analyses controlling for age at transplant, number of prior chemotherapies, and pre-ASCT disease response. Conclusions: Our data support an emerging concern that male patients with DLBCL have inferior outcomes when treated with rituximab. The present study has extended this observation to pts with relapsed/refractory DLBCL treated with ASCT.
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Affiliation(s)
| | - Edward Alan Copelan
- Department of Hematologic Oncology and Blood Disorders, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH
| | - Nelli Bejanyan
- Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH
| | | | - Ronald M. Sobecks
- Department of Hematologic Oncology and Blood Disorders, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH
| | | | | | - Matt E. Kalaycio
- Department of Hematologic Oncology and Blood Disorders, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH
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Forero-Torres A, de Vos S, Pohlman BL, Pashkevich M, Cronier DM, Dang NH, Carpenter SP, Allan BW, Nelson JG, Slapak CA, Smith MR, Link BK, Wooldridge JE, Ganjoo KN. Results of a phase 1 study of AME-133v (LY2469298), an Fc-engineered humanized monoclonal anti-CD20 antibody, in FcγRIIIa-genotyped patients with previously treated follicular lymphoma. Clin Cancer Res 2012; 18:1395-403. [PMID: 22223529 DOI: 10.1158/1078-0432.ccr-11-0850] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE AME-133v is a humanized monoclonal antibody engineered to have increased affinity to CD20 and mediate antibody-dependent cell-mediated cytotoxicity (ADCC) better than rituximab. Safety, pharmacokinetics, and efficacy were assessed in a phase 1/2 trial in patients with previously treated follicular lymphoma (FL). PATIENTS AND METHODS AME-133v was characterized in vitro by ADCC and cell binding assays. A phase 1 study was conducted in which 23 previously treated patients with FL were assigned sequentially to one of five dose-escalation cohorts of AME-133v at 2, 7.5, 30, 100, or 375 mg/m(2) weekly × 4 doses. RESULTS AME-133v showed a 13- to 20-fold greater binding affinity for CD20 and was 5- to 7-fold more potent than rituximab in ADCC assays. Cell binding assays showed AME-133v and rituximab competed for an overlapping epitope on the CD20 antigen, and AME-133v inhibited binding of biotinylated rituximab to CD20 in a concentration-dependent manner. AME-133v was well tolerated by patients and common related adverse events included chills and fatigue. One patient experienced a dose-limiting toxicity of neutropenia. AME-133v showed nonlinear pharmocokinetics with properties similar to rituximab. Selective reduction of B cells during and after AME-133v treatment was shown by flow cytometry of peripheral blood. A partial or complete response was observed in 5 of 23 (22%) patients and the median progression-free survival was 25.4 weeks. CONCLUSIONS AME-133v was safe and well tolerated at the doses tested. AME-133v showed encouraging results as an anti-CD20 therapy in heavily pretreated FL patients with the less favorable FcγRIIIa F-carrier genotype.
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Smith SD, Smith SD, Bolwell BJ, Advani AS, Andresen SW, Chan JL, Dean RM, Hsi ED, Kalaycio ME, Pohlman BL, Rybicki LA, Sweetenham JW. High rate of survival in transformed lymphoma after autologous stem cell transplant: pathologic analysis and comparison withde novodiffuse large B-cell lymphoma. Leuk Lymphoma 2009; 50:1625-31. [DOI: 10.1080/10428190903128652] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Avery RK, Pohlman BL, Mossad SB, Goormastic M, Longworth DL, Kalaycio ME, Sobecks RM, Andresen SW, Kuczkowski E, Bernhard L, Ostendorf H, Wise K, Bolwell BJ. The efficacy of prophylactic outpatient antibiotics for the prevention of neutropenic fever associated with high-dose etoposide (VP-16) for stem cell mobilization. Bone Marrow Transplant 2002; 30:311-4. [PMID: 12209353 DOI: 10.1038/sj.bmt.1703622] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2001] [Accepted: 04/12/2002] [Indexed: 11/08/2022]
Abstract
High-dose etoposide (2 g/m(2)) plus G-CSF is a very effective regimen for peripheral blood progenitor cell (PBPC) mobilization. Unfortunately, neutropenia is common. The infectious complications associated with high-dose etoposide have not been previously described. After noting a high incidence of hospitalizations for neutropenic fever, we began a vigorous prophylactic antibiotic regimen for patients receiving high-dose etoposide plus G-CSF, attempting to reduce infectious complications. Ninety-eight patients underwent etoposide mobilization between December 1997 and June 2000. Three chronological patient groups received: (1) no specific antibiotic prophylaxis (n = 44); (2) vancomycin i.v., cefepime i.v., clarithromycin p.o., and ciprofloxacin p.o. (n = 27); and (3) vancomycin i.v., clarithromycin p.o., and ciprofloxacin p.o. (n = 27). The patients not receiving antibiotic prophylaxis had a 68% incidence of hospitalization for neutropenic fever. In the patients receiving prophylaxis, the incidence was reduced to 26% and 15% respectively, for an overall incidence of 20% (P < 0.001 for comparison between prophylaxed and unprophylaxed groups). We conclude that etoposide mobilization is associated with a significant incidence of neutropenic fever, which can be substantially reduced by a vigorous antimicrobial prophylactic program.
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Affiliation(s)
- R K Avery
- Department of Infectious Diseases, Cleveland Clinic Foundation, Cleveland, OH 44195, USA
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Witzig TE, Gordon LI, Cabanillas F, Czuczman MS, Emmanouilides C, Joyce R, Pohlman BL, Bartlett NL, Wiseman GA, Padre N, Grillo-López AJ, Multani P, White CA. Randomized controlled trial of yttrium-90-labeled ibritumomab tiuxetan radioimmunotherapy versus rituximab immunotherapy for patients with relapsed or refractory low-grade, follicular, or transformed B-cell non-Hodgkin's lymphoma. J Clin Oncol 2002; 20:2453-63. [PMID: 12011122 DOI: 10.1200/jco.2002.11.076] [Citation(s) in RCA: 772] [Impact Index Per Article: 35.1] [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: 01/13/2023] Open
Abstract
PURPOSE Radioimmunotherapy combines biologic and radiolytic mechanisms to target and destroy tumor cells, thus offering a needed therapeutic alternative for refractory non-Hodgkin's lymphoma (NHL) patients. This phase III randomized study compares the novel radioimmunotherapy yttrium-90 ((90)Y) ibritumomab tiuxetan with a control immunotherapy, rituximab, in 143 patients with relapsed or refractory low-grade, follicular, or transformed CD20(+) transformed NHL. PATIENTS AND METHODS Patients received either a single intravenous (IV) dose of (90)Y ibritumomab tiuxetan 0.4 mCi/kg (n = 73) or rituximab 375 mg/m(2) IV weekly for four doses (n = 70). The radioimmunotherapy group was pretreated with two rituximab doses (250 mg/m(2)) to improve biodistribution and one dose of indium-111 ibritumomab tiuxetan for imaging and dosimetry. The primary end point, overall response rate (ORR), was assessed by an independent, blinded, lymphoma expert panel. RESULTS ORR was 80% for the (90)Y ibritumomab tiuxetan group versus 56% for the rituximab group (P =.002). Complete response (CR) rates were 30% and 16% in the (90)Y ibritumomab tiuxetan and rituximab groups, respectively (P =.04). An additional 4% achieved an unconfirmed CR in each group. Kaplan-Meier estimated median duration of response was 14.2 months in the (90)Y ibritumomab tiuxetan group versus 12.1 months in the control group (P =.6), and time to progression was 11.2 versus 10.1 months (P =.173) in all patients. Durable responses of > or = 6 months were 64% versus 47% (P =.030). Reversible myelosuppression was the primary toxicity noted with (90)Y ibritumomab tiuxetan. CONCLUSION Radioimmunotherapy with (90)Y ibritumomab tiuxetan is well tolerated and produces statistically and clinically significant higher ORR and CR compared with rituximab alone.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Antibodies, Monoclonal/adverse effects
- Antibodies, Monoclonal/therapeutic use
- Antibodies, Monoclonal, Murine-Derived
- Antigens, CD19/metabolism
- Antineoplastic Agents/adverse effects
- Antineoplastic Agents/therapeutic use
- Cell Transformation, Neoplastic
- Disease Progression
- Disease-Free Survival
- Female
- Humans
- Liver/diagnostic imaging
- Liver/pathology
- Lymphoma, B-Cell/immunology
- Lymphoma, B-Cell/pathology
- Lymphoma, B-Cell/therapy
- Lymphoma, Follicular/immunology
- Lymphoma, Follicular/pathology
- Lymphoma, Follicular/therapy
- Lymphoma, Non-Hodgkin/immunology
- Lymphoma, Non-Hodgkin/pathology
- Lymphoma, Non-Hodgkin/therapy
- Male
- Middle Aged
- Radioimmunotherapy/methods
- Radionuclide Imaging
- Rituximab
- Survival Rate
- Treatment Outcome
- Yttrium Radioisotopes/adverse effects
- Yttrium Radioisotopes/therapeutic use
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Affiliation(s)
- Thomas E Witzig
- Division of Internal Medicine and Hematology, Nuclear Medicine, Mayo Clinic and Mayo Foundation, 60 Stabile Building, Rochester, MN 55905, USA.
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Picozzi VJ, Pohlman BL, Morrison VA, Lawless GD, Lee MW, Kerr RO, Ford JM, Delgado DJ, Fridman M, Carter WB. Patterns of chemotherapy administration in patients with intermediate-grade non-Hodgkin's lymphoma. Oncology (Williston Park) 2001; 15:1296-306; discussion 1310-1, 1314. [PMID: 11702959] [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] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
Records from 653 patients treated between 1991 and 1998 in the Oncology Practice Patterns Study (OPPS) were analyzed to determine contemporary chemotherapy delivery patterns in patients with intermediate-grade non-Hodgkin's lymphoma (NHL). Of the 653 patient records reviewed, 90 (14%) omitted an anthracycline or mitoxantrone (Novantrone) from primary therapy. Among patients receiving CHOP (cyclophosphamide [Cytoxan, Neosar], doxorubicin HCl, vincristine [Oncovin], prednisone) or CNOP (cyclophosphamide, mitoxantrone, vincristine, prednisone), 134 (27%) of 492 received an average relative dose intensity of less than 80% of the literature-referenced dose, due either to an inadequate planned or delivered dose. Of 181 advanced-stage patients with responsive disease, 28 (15%) failed to receive at least six treatment cycles. Overall, 283 (43%) of 653 patients potentially received suboptimal chemotherapy due either to choice of regimen or chemotherapy delivered. Patient age > or = 65 years and cardiac comorbidity appeared to have the greatest influence on a physician's decision regarding chemotherapy administration. Among the 492 patients who received CHOP or CNOP, 235 (48%) experienced a delay or reduction in chemotherapy dose (usually neutropenia-related), 100 (20%) developed mucositis, and 116 (24%) were hospitalized for febrile neutropenia. Growth factor was administered to 261 patients (53%), and its primary prophylactic use was associated with a significant reduction in the incidence of hospitalizations for febrile neutropenia in all patient subgroups receiving appropriate chemotherapeutic dose intensity (P = .02). This assessment of chemotherapy delivery to patients with intermediate-grade NHL showed significant variation from current standards. Further analysis of factors influencing chemotherapy delivery might improve therapeutic outcomes.
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Affiliation(s)
- V J Picozzi
- Section of Hematology/Oncology, Virginia Mason Medical Center, Seattle, Washington 98111, USA.
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Mossad SB, Avery RK, Longworth DL, Kuczkowski EM, McBee M, Pohlman BL, Sobecks RM, Kalaycio ME, Andresen SW, Macklis RM, Bolwell BJ. Infectious complications within the first year after nonmyeloablative allogeneic peripheral blood stem cell transplantation. Bone Marrow Transplant 2001; 28:491-5. [PMID: 11593323 DOI: 10.1038/sj.bmt.1703180] [Citation(s) in RCA: 29] [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: 02/12/2001] [Accepted: 06/16/2001] [Indexed: 11/08/2022]
Abstract
Nonmyeloablative peripheral blood stem cell transplantation (PBSCT) is a novel therapeutic strategy for patients with malignant and non-malignant hematologic diseases. Infectious complications of this procedure have not been previously well described. Data on 12 patients transplanted at a tertiary care center were collected prospectively and verified retrospectively. Neutropenia developed in a third of patients, lasting for a median of 5 days. All patients developed some degree of graft-versus-host disease, as intended. Most patients achieved full chimerism by week 5. Bacterial infections occurred in two patients (17%). Cytomegalovirus (CMV) viremia occurred in five patients (42%) at a median of 80 days; none had received CMV prophylaxis. Viremia was associated with fever and fatigue in three patients, possible gastrointestinal involvement in one patient and was asymptomatic in one patient. All viremic patients responded to intravenous ganciclovir therapy. No fungal infections were documented. No patients died as a result of infection. The incidence of CMV viremia in our patients was high, but the incidence of invasive disease due to CMV was low. The best strategy to prevent CMV in patients undergoing nonmyeloablative PBSCT remains to be determined, but strategies employed in traditional allogeneic bone marrow transplantation should be considered in these patients.
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Affiliation(s)
- S B Mossad
- Department of Infectious Diseases, Cleveland Clinic Foundation, 9500 Euclid Avenue S-32, Cleveland, OH 44195, USA
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Abstract
This case report describes the natural history of chronic cadmium intoxication in a woman who was exposed to excessive cadmium in her occupation. We document the clinical, laboratory, and tissue response to the toxicant.
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