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Petrakis G, Kostopoulos I, Venizelos I, Lambropoulou M, Vouras K, Vakalopoulou S, Mandala E, Tsatalas C, Papadopoulos N. Expression of the activation markers Blimp1, Foxp1 and pStat3 in extranodal diffuse large B-cell lymphomas. Histol Histopathol 2016; 32:825-834. [PMID: 27924626 DOI: 10.14670/hh-11-852] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Different studies have suggested that the expression of biomarkers related to lymphoid cell activation may provide information on the behavior of DLBCL. Most studies have concentrated on nodal or a mixture of nodal and extranodal lymphomas. The differential expression and potential clinical impact of these markers in a homogeneous group of extranodal DLBCLs are not well defined. In this study, we investigated the expression of three activation markers, Blimp1, Foxp1 and pStat3, in a cohort of 35 extranodal DLBCLs homogeneously treated with R-CHOP. Immunohistochemical stains were evaluated using an immunoreactivity score on representative paraffin sections. Blimp1 was positive in 55% (19/35), Foxp1 in 60% (21/35), and pStat3 in 69% (24/35) of our cases. We did not observe any statistical differences in the expression of these markers in GCB and non-GCB tumors or in gastrointestinal and non-gastrointestinal tumors. Blimp1 expression was negatively correlated with overall survival (OS) (p=0.001) in the whole series and in the non-GCB group (Muris algorithm) (p=0.002). Foxp1 positivity and pStat3 positivity had no impact on the outcome of the patients in the global cohort, but they were associated with a better survival in the non-GCB subgroup (p=0.033, p=0.044 respectively). Multivariate analysis showed that Blimp1 expression but not COO was an independent negative prognostic factor for OS (HR=17.5, 95%, CI=2.2-141.1, p=0.007). Our results suggest that these markers are differentially expressed and have different impacts on outcome in extranodal DLBCLs compared to nodal tumors, emphasizing the need to evaluate separately these and probably other markers in these subsets of tumors.
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Affiliation(s)
- Georgios Petrakis
- Histology - Embryology Department, Medical School, Democritus University of Thrace, Alexandroupolis, Greece. .,Pathology Department, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioannis Kostopoulos
- Pathology Department, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioannis Venizelos
- Pathology Department of Hippokration Hospital of Thessaloniki, Thessaloniki, Greece
| | - Maria Lambropoulou
- Histology - Embryology Department, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Kyriakos Vouras
- School of Mathematics, Faculty of Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Sofia Vakalopoulou
- Hematology Department, Hippokration Hospital of Thessaloniki, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eudokia Mandala
- Fourth Department of Medicine, Hippokration Hospital of Thessaloniki, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Constantinos Tsatalas
- Hematology Department, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Nicolas Papadopoulos
- Histology - Embryology Department, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
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Spanoudakis E, Papoutselis M, Terpos E, Dimopoulos MA, Tsatalas C, Margaritis D, Rahemtulla A, Kotsianidis I, Karadimitris A. Overexpression of RANKL by invariant NKT cells enriched in the bone marrow of patients with multiple myeloma. Blood Cancer J 2016; 6:e500. [PMID: 27834938 PMCID: PMC5148055 DOI: 10.1038/bcj.2016.108] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [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: 01/02/2023] Open
Affiliation(s)
- E Spanoudakis
- Department of Haematology, Democritus University of Thrace, Alexandroupolis, Greece
| | - M Papoutselis
- Department of Haematology, Democritus University of Thrace, Alexandroupolis, Greece
| | - E Terpos
- Department of Clinical Therapeutics, University of Athens School of Medicine, Athens, Greece
| | - M A Dimopoulos
- Department of Clinical Therapeutics, University of Athens School of Medicine, Athens, Greece
| | - C Tsatalas
- Department of Haematology, Democritus University of Thrace, Alexandroupolis, Greece
| | - D Margaritis
- Department of Haematology, Democritus University of Thrace, Alexandroupolis, Greece
| | - A Rahemtulla
- Centre for Haematology, Department of Medicine, Hammersmith Hospital, Imperial College London, London, UK
| | - I Kotsianidis
- Department of Haematology, Democritus University of Thrace, Alexandroupolis, Greece
| | - A Karadimitris
- Centre for Haematology, Department of Medicine, Hammersmith Hospital, Imperial College London, London, UK
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Bouzani M, Apostolidis J, Rondogianni D, Harhalakis N, Tsatalas C, Nikiforakis E. Idiopathic Plasmacytic Lymphadenopathy with Polyclonal Gammopathy in a Patient of Western Origin. Int J Surg Pathol 2016; 13:125-6. [PMID: 15735869 DOI: 10.1177/106689690501300121] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Miltiades P, Lamprianidou E, Vassilakopoulos TP, Papageorgiou SG, Galanopoulos AG, Kontos CK, Adamopoulos PG, Nakou E, Vakalopoulou S, Garypidou V, Papaioannou M, Hatjiharissi E, Papadaki HA, Spanoudakis E, Pappa V, Scorilas A, Tsatalas C, Kotsianidis I. The Stat3/5 Signaling Biosignature in Hematopoietic Stem/Progenitor Cells Predicts Response and Outcome in Myelodysplastic Syndrome Patients Treated with Azacitidine. Clin Cancer Res 2015; 22:1958-68. [PMID: 26700206 DOI: 10.1158/1078-0432.ccr-15-1288] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Accepted: 11/26/2015] [Indexed: 11/16/2022]
Abstract
PURPOSE Azacitidine is the mainstay of high-risk myelodysplastic syndromes (MDS) therapy, but molecular predictors of response and the mechanisms of resistance to azacitidine remain largely unidentified. Deregulation of signaling via Stat3 and Stat5 in acute myeloid leukemia (AML) is associated with aggressive disease. Numerous genes involved in cell signaling are aberrantly methylated in MDS, yet the alterations and the effect of azacitidine treatment on Stat3/5 signaling in high-risk MDS have not been explored. EXPERIMENTAL DESIGN We assessed longitudinally constitutive and ligand-induced phospho-Stat3/5 signaling responses by multiparametric flow cytometry in 74 patients with MDS and low blast count AML undergoing azacitidine therapy. Pretreatment Stat3/5 signaling profiles in CD34(+)cells were grouped by unsupervised clustering. The differentiation stage and the molecular properties of the CD34(+)G-CSF-inducible Stat3/5 double-positive subpopulation were performed by flow cytometry and quantitative real-time PCR in isolated MDS progenitors. RESULTS The pretreatment Stat3/5 signaling profiles in CD34(+)cells correlated strongly with response and cytogenetics and independently predicted event-free survival. We further identified a CD34(+)G-CSF-inducible Stat3/5 double-positive subpopulation (DP subset) whose pretreatment levels were inversely associated with treatment response and cytogenetics. The kinetics of the DP subset followed the response to azacitidine and the disease course, whereas its molecular characteristics and cellular hierarchy were consistent with a leukemia propagating cell phenotype. CONCLUSIONS Our findings provide a novel link among Stat3/5 signaling and MDS pathobiology and suggest that the Stat3/5 signaling biosignature may serve as both a response biomarker and treatment target.
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Affiliation(s)
- Paraskevi Miltiades
- Department of Hematology, Democritus University of Thrace, Alexandroupolis, Greece
| | | | - Theodoros P Vassilakopoulos
- Department of Hematology, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Sotirios G Papageorgiou
- Second Department of Internal Medicine, Hematology Unit, Attikon University General Hospital, Athens, Greece
| | | | - Christos K Kontos
- Department of Biochemistry and Molecular Biology, National and Kapodistrian University of Athens, Athens, Greece
| | - Panagiotis G Adamopoulos
- Department of Biochemistry and Molecular Biology, National and Kapodistrian University of Athens, Athens, Greece
| | - Evangelia Nakou
- Department of Hematology, Democritus University of Thrace, Alexandroupolis, Greece
| | - Sofia Vakalopoulou
- Second Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece
| | - Vassilia Garypidou
- Second Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece
| | - Maria Papaioannou
- Department of Haematology, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Evdoxia Hatjiharissi
- Department of Hematology, Theageneion Hospital of Thessaloniki, Thessaloniki, Greece
| | - Helen A Papadaki
- Department of Hematology, University Hospital of Heraklion, Heraklion, Greece
| | - Emmanuil Spanoudakis
- Department of Hematology, Democritus University of Thrace, Alexandroupolis, Greece
| | - Vassiliki Pappa
- Second Department of Internal Medicine, Hematology Unit, Attikon University General Hospital, Athens, Greece
| | - Andreas Scorilas
- Department of Biochemistry and Molecular Biology, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Ioannis Kotsianidis
- Department of Hematology, Democritus University of Thrace, Alexandroupolis, Greece.
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Tsatalas C, Chalkia P, Pantelidou D, Margaritis D, Bourikas G, Spanoudakis E. Pregnancy inβ-thalassemia trait carriers: an uneventful journey. Hematology 2013; 14:301-3. [DOI: 10.1179/102453309x439791] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Affiliation(s)
- Constantinos Tsatalas
- Department of HaematologyDemocritus University of Thrace Medical School, Alexandroupolis, Greece
| | - Panagiota Chalkia
- Thalassaemia UnitA.H.E.P.A. University Hospital, Thessaloniki, Greece
| | | | - Dimitrios Margaritis
- Department of HaematologyDemocritus University of Thrace Medical School, Alexandroupolis, Greece
| | - Georgios Bourikas
- Department of HaematologyDemocritus University of Thrace Medical School, Alexandroupolis, Greece
| | - Emmanouil Spanoudakis
- Department of HaematologyDemocritus University of Thrace Medical School, Alexandroupolis, Greece
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Kontomanolis EN, Arvaniti A, Christoforidou AV, Margaritis D, Tsatalas C, Koutlaki N, Samakouri M, Galazios G, Limperis V. Paroxysmal nocturnal haemoglobinuria, lupus and pregnancy. J OBSTET GYNAECOL 2013; 33:523. [PMID: 23815213 DOI: 10.3109/01443615.2013.777696] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- E N Kontomanolis
- Department of Obstetrics and Gynecology, Democritus University, Alexandroupolis, Greece.
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Lamprianidou E, Miltiades P, Vassilakopoulos T, Papageorgiou S, Galanopoulos A, Spanoudakis E, Nakou E, Margaritis D, Tsatalas C, Kotsianidis I. P-244 Distinct epigenetic modulation of signal transducer and activator of transcription (STAT) signaling in FOXP3+ T regulatory cells of CMML-2 patients. Leuk Res 2013. [DOI: 10.1016/s0145-2126(13)70291-1] [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: 10/26/2022]
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Dimopoulos MA, Kastritis E, Delimpasi S, Katodritou E, Hatzimichael E, Kyrtsonis MC, Repousis P, Tsirogianni M, Kartasis Z, Parcharidou A, Michael M, Michalis E, Tsatalas C, Stefanoudaki E, Hatjiharissi E, Gika D, Symeonidis A, Terpos E, Zervas K. Multiple myeloma in octogenarians: clinical features and outcome in the novel agent era. Eur J Haematol 2012; 89:10-5. [PMID: 22469521 DOI: 10.1111/j.1600-0609.2012.01784.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Multiple myeloma (MM) affects mainly elderly persons and because the population of octogenarians increases, it is common to treat patients ≥ 80 years of age. These patients are often not included in clinical trials; thus, there is limited data on their characteristics and treatment outcome. PATIENTS AND METHODS We retrospectively analyzed 682 consecutive, unselected patients with newly diagnosed symptomatic myeloma who started treatment between January 1, 2003 and December 31, 2010. RESULTS We identified 155 (23%) patients ≥ 80 years of age. Compared to patients <80 years, octogenarians had poorer performance status (P < 0.001), anemia (P = 0.006), low serum albumin (P = 0.001), and advanced ISS (P < 0.001). The median survival of patients ≥ 80 years was 22 months, and 14% died within 2 months from therapy initiation. The median survival of patients ≥ 80 years who received upfront novel agents was 26 vs. 17 months for those who did not. ECOG performance status ≤ 1 and frontline use of novel agents were independently associated with better survival. Response to first-line therapy was associated with improved survival (29 vs. 16 months, P = 0.017). CONCLUSIONS Patients ≥ 80 years of age present with features of advanced myeloma and impaired performance status. The addition of novel agents may improve their outcome, but careful assessment and prospective clinical trials targeting the population of elderly patients are needed.
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Affiliation(s)
- Meletios A Dimopoulos
- Department of Clinical Therapeutics, University of Athens School of Medicine, Athens, Greece.
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Dimopoulos MA, Kastritis E, Michalis E, Tsatalas C, Michael M, Pouli A, Kartasis Z, Delimpasi S, Gika D, Zomas A, Roussou M, Konstantopoulos K, Parcharidou A, Zervas K, Terpos E. The International Scoring System (ISS) for multiple myeloma remains a robust prognostic tool independently of patients' renal function. Ann Oncol 2012; 23:722-729. [PMID: 21652580 DOI: 10.1093/annonc/mdr276] [Citation(s) in RCA: 19] [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: 10/06/2023] Open
Abstract
BACKGROUND The International Staging System (ISS) is the most widely used staging system for patients with multiple myeloma (MM). However, serum β2-microglobulin increases in renal impairment (RI) and there have been concerns that ISS-3 stage may include 'up-staged' MM patients in whom elevated β2-microglobulin reflects the degree of renal dysfunction rather than tumor load. PATIENTS AND METHODS In order to assess the impact of RI on the prognostic value of ISS, we analyzed 1516 patients with symptomatic MM and the degree of RI was classified according to the Kidney Disease Outcomes Quality Initiative-Chronic Kidney Disease (CKD) criteria. RESULTS Forty-eight percent patients had stages 3-5 CKD while 29% of patients had ISS-1, 38% had ISS-2 and 33% ISS-3. The frequency and severity of RI were more common in ISS-3 patients. RI was associated with inferior survival in univariate but not in multivariate analysis. When analyzed separately, ISS-1 and ISS-2 patients with RI had inferior survival in univariate but not in multivariate analysis. In ISS-3 MM patients, RI had no prognostic impact either in univariate or multivariate analysis. Results were similar, when we analyzed only patients with Bence-Jones >200 mg/day. CONCLUSIONS ISS remains unaffected by the degree of RI, even in patients with ISS-3, which includes most patients with renal dysfunction.
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Affiliation(s)
- M A Dimopoulos
- Department of Clinical Therapeutics, University of Athens School of Medicine, Athens.
| | - E Kastritis
- Department of Clinical Therapeutics, University of Athens School of Medicine, Athens
| | - E Michalis
- Department of Hematology, 'G. Gennimatas' Hospital, Athens
| | - C Tsatalas
- Department of Haematology, Democritus University of Thrace Medical School, Alexandroupolis, Greece
| | - M Michael
- Department of Haematology, Nicosia General Hospital, Nicosia, Cyprus
| | - A Pouli
- Department of Hematology, 'Saint Savvas' Anticancer Hospital, Athens
| | - Z Kartasis
- Department of Hematology, Chalkis General Hospital, Chalkis
| | - S Delimpasi
- Department of Hematology, 'Evangelismos' Hospital, Athens
| | - D Gika
- Department of Clinical Therapeutics, University of Athens School of Medicine, Athens
| | - A Zomas
- Fourth Department of Internal Medicine, 'Attikon' University Hospital, Athens
| | - M Roussou
- Department of Clinical Therapeutics, University of Athens School of Medicine, Athens
| | - K Konstantopoulos
- First Department of Medicine, University of Athens School of Medicine, Athens
| | - A Parcharidou
- Third Department of Internal Medicine, Red Cross Hospital 'Korgialenio Benakio', Athens
| | - K Zervas
- Department of Hematology, 'Theagenion' Cancer Center, Thessaloniki, Greece
| | - E Terpos
- Department of Clinical Therapeutics, University of Athens School of Medicine, Athens
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Kalleas C, Anagnostopoulos K, Sinopoulou K, Delaki E, Margaritis D, Bourikas G, Tsatalas C, Kortsaris A, Tentes I. Phenotype and Genotype Frequency of β-Thalassemia and Sickle Cell Disease Carriers in Halkidiki, Northern Greece. Hemoglobin 2011; 36:64-72. [DOI: 10.3109/03630269.2011.642489] [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: 11/13/2022]
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Courcoutsakis N, Spanoudaki A, Maris TG, Astrinakis E, Spanoudakis E, Tsatalas C, Prassopoulos P. Perfusion parameters analysis of the vertebral bone marrow in patients with Ph¹⁻ chronic myeloproliferative neoplasms (Ph(neg) MPN): a dynamic contrast-enhanced MRI (DCE-MRI) study. J Magn Reson Imaging 2011; 35:696-702. [PMID: 22069235 DOI: 10.1002/jmri.22870] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2011] [Accepted: 10/04/2011] [Indexed: 01/05/2023] Open
Abstract
PURPOSE To evaluate perfusion parameters of the vertebral bone marrow in patients with Philadelphia negative chronic myeloproliferative neoplasms (Ph(neg) MPN) using dynamic contrast-enhanced MRI (DCE-MRI). MATERIALS AND METHODS The study enrolled 24 patients with Ph(neg) MPN: 12 patients with myelofibrosis (Group A), 6 with essential thrombocythemia (ET), and 6 with polycythemia vera (PV) (Group B) who underwent DCE-MRI of the lumbosacral spine. Twelve normal individuals served as control group (Group C). Wash-in (WIN), wash-out (WOUT), maximum contrast-enhancement (CE max), time-to-peak (TTPK), time-to-maximum slope (TMSP), and the WIN/TMSP ratio (WTSP) were calculated. RESULTS WIN, CE(max) , and WTSP parameters were higher in Group A than in Group C (P < 0.05). These parameters were significant (P < 0.0001) in discriminating patients with myelofibrosis from normal individuals with sensitivities 74.14%, 87.93%, 74.14%, and specificities 91.07%, 83.93%, 91.07%, respectively. WIN, WOUT, CE(max) , and WTSP parameters were higher in Group A than in Group B (P < 0.05). Group B exhibited no differences in perfusion parameters as compared with Group C with the exception of WOUT. CONCLUSION Patients with myelofibrosis exhibited increased perfusion parameters in vertebral bone marrow, which could be consisted with increased vascularity, probably related to neoangiogenesis as opposed to ET or PV patients showing no increased perfusion. DCE-MRI may be of value in discriminating subgroups of Ph(neg) MPN patients and in indicating those progressing to myelofibrosis.
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Affiliation(s)
- Nikos Courcoutsakis
- Department of Radiology and Medical Imaging, Medical School, Democritus University of Thrace, Greece.
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Symeonidis A, Zikos P, Galanopoulos A, Kotsianidis I, Kouraklis A, Protopapa M, Psyllaki M, Lambropoulou V, Aktypi A, Bakarakos P, Tsatalas C, Terpos E, Anagnostopoulos N, Papadaki E. 319 Response to treatment with erythropoietin in patients with MDS highly predicts low risk of evolution to AML and longer survival. Leuk Res 2011. [DOI: 10.1016/s0145-2126(11)70321-6] [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: 10/18/2022]
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13
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Vadikolia CM, Tsatalas C, Anagnostopoulos K, Trypsianis G, Pantelidou D, Bazdiara I, Anastasiadis A, Spanoudakis E, Kotsianidis I, Margaritis D, Kortsaris A, Bourikas G. Proteolytic matrix metallopeptidases and inhibitors in BCR-ABL1-negative myeloproliferative neoplasms: correlation with JAK2 mutation status. Acta Haematol 2011; 126:54-62. [PMID: 21474922 DOI: 10.1159/000324436] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 11/10/2010] [Accepted: 01/17/2011] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS Philadelphia chromosome-negative myeloproliferative neoplasms (MPNs) share the same acquired lesion JAK2(V617F) and may exhibit substantial overlap. Variability in JAK activation and allele burden, complemented by host, genetic and non-genetic modifiers, determine the phenotype. The aim of this study was to investigate the presence of the JAK2 mutation in association with the ratio of metallopeptidases inhibitors (TIMPs) to tissue metallopeptidases (MMPs) in MPNs, where inhibitory rather than proteolytic activity in marrow microenvironment appears to predominate. METHODS 94 patients with polycythemia vera, essential thrombocythemia and primary myelofibrosis, and 102 healthy individuals were evaluated. Allele-specific PCR and RFLP were used to detect JAK2 and genomic status. Serum concentrations of MMP and TIMP were measured by ELISA. The parameters were assessed with covariance analysis, and adjusted for gender, age and co-morbidity. RESULTS Mutation frequency was 81.91%. Abnormal TIMP/MMP ratios were identified in all three diseases. JAK2 mutation was correlated with significant changes in TIMP concentrations. CONCLUSIONS Identification of an abnormal TIMP/MMP ratio in all three diseases, regardless of the JAK2 status, indicates invariable marrow remodeling. In this particular group of patients, presence of a JAK2(V617F) mutation, being associated with even higher ratios, appears to be a concurring participant in bone marrow-reforming processes. Additional research may delineate correlates with the JAK2 allelic burden.
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Affiliation(s)
- C M Vadikolia
- Department of Hematology, Democritus University Medical School, Alexandroupolis, Greece
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Christoforidou A, Pantelidou D, Anastasiadis A, Goutzouvelidis A, Margaritis D, Kotsianidis I, Spanoudakis E, Kaloutsi V, Bourikas G, Tsatalas C. Hydroxyurea and anagrelide combination therapy in patients with chronic myeloproliferative diseases resistant or intolerant to monotherapy. Acta Haematol 2009; 120:195-8. [PMID: 19129692 DOI: 10.1159/000189381] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2008] [Accepted: 11/05/2008] [Indexed: 11/19/2022]
Affiliation(s)
- A Christoforidou
- Department of Haematology, Democritus University of Thrace, Alexandroupolis, Greece.
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Kotsianidis I, Bouchliou I, Nakou E, Spanoudakis E, Margaritis D, Christophoridou AV, Anastasiades A, Tsigalou C, Bourikas G, Karadimitris A, Tsatalas C. Kinetics, function and bone marrow trafficking of CD4+CD25+FOXP3+ regulatory T cells in myelodysplastic syndromes (MDS). Leukemia 2008; 23:510-8. [PMID: 19020538 DOI: 10.1038/leu.2008.333] [Citation(s) in RCA: 108] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
CD4(+)CD25(+)FOXP3(+) T regulatory cells (T(regs)) prevent autoimmunity by restricting overexuberant immune responses, but the same subpopulation can incur detrimental effects on antitumor responses. In both cases, the suppressor potential of T(regs) appears to be strongly influenced by their compartmentalization. In myelodysplastic syndromes (MDS), immune deregulation and autoimmunity in the early stages might lead to ineffective hematopoiesis and bone marrow (BM) failure, whereas late-stage disease is characterized by the immune escape of the malignant clone. We show that these two stages of MDS are associated with differential T(reg) activity. Specifically, we found that in early stage MDS, compared with normal hematopoiesis and late stage MDS, T(regs) are dysfunctional and their BM homing through the CXCL12/CXCR4 axis is seriously impaired as a result of CXCR4 downregulation. Conversely, in late stage MDS, T(regs) are systemically and locally expanded and retain their function and migratory capacity. Moreover, T(reg) levels follow the disease course and are significantly reduced in treatment responding patients. Our findings indicate T(reg) involvement in the pathophysiology of MDS; defective suppressor function and BM trafficking of T(regs) may be important in the autoimmune process of early MDS, but increased T(reg) activity could favor leukemic clone progression in late stage disease.
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Affiliation(s)
- I Kotsianidis
- Department of Hematology, Democritus University of Thrace Medical School, Alexandroupolis, Greece.
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Spanoudakis E, Margaritis D, Kotsianidis I, Georgiou G, Tripsianis G, Anastasiadis A, Karakolios A, Pantelidou D, Panayiotidis P, Bourikas G, Tsatalas C. Long-term bone marrow cultures (LTBMC) from essential thrombocythemia (ET) patients with or without JAK2617V>F mutation. Leuk Res 2008; 32:1593-6. [DOI: 10.1016/j.leukres.2008.01.013] [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] [Received: 11/23/2007] [Revised: 01/15/2008] [Accepted: 01/18/2008] [Indexed: 10/22/2022]
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Economopoulos T, Psyrri A, Fountzilas G, Tsatalas C, Anagnostopoulos A, Papageorgiou S, Xiros N, Dimopoulos MA. Phase II study of low-grade non-Hodgkin lymphomas with fludarabine and mitoxantrone followed by rituximab consolidation: promising results in marginal zone lymphoma. Leuk Lymphoma 2008; 49:68-74. [PMID: 18203014 DOI: 10.1080/10428190701784714] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The majority of patients with indolent lymphomas relapse due to minimal residual disease (MRD). In the present study, we sought to determine whether by using rituximab consolidation, for eradication of MRD, following induction chemotherapy with fludarabine and mitoxantrone (FN) combination could improve the outcome of indolent lymphomas. Patients with indolent lymphoma received fludarabine 25 mg/m2 Day 1-3 and mitoxantrone 10 mg/m2 on Day 1 every 28 days. Patients who attained a response (complete response, CR or partial response, PR) received four weekly doses of Rituximab 375 mg/m2 1 month and 3 months after completion of treatment. Forty-five patients were entered into this Phase II trial. The median follow-up time was 39 months. The median number of delivered cycles was 6. Fifty-three percent of patients attained a CR and 38% a PR for an overall response rate of 91%. One patient had stable disease, one had progression of the disease, whereas 2 were non-evaluable. After a median follow-up of 39 months, 32 of 46 patients (74%) are alive and disease-free. Grade III and IV toxicities included leucopenia (37%), neutropenia (28%), thrombocytopenia (7%), anemia (4%), and diarrhea (2%). Grade V toxicities included septic death in one patient and death due to hepatitis B reactivation 6 months after the last Rituximab dose in another patient. FN followed by R consolidation is a well-tolerated and active regimen in the treatment of patients with indolent lymphomas. Further follow-up is required to determine if these remissions are maintained.
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Papaxoinis G, Fountzilas G, Rontogianni D, Dimopoulos M, Pavlidis N, Tsatalas C, Pectasides D, Xiros N, Economopoulos T. Low-grade mucosa-associated lymphoid tissue lymphoma: a retrospective analysis of 97 patients by the Hellenic Cooperative Oncology Group (HeCOG). Ann Oncol 2008; 19:780-6. [DOI: 10.1093/annonc/mdm529] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [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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Dimopoulos MA, Anagnostopoulos A, Kyrtsonis MC, Zervas K, Tsatalas C, Kokkinis G, Repoussis P, Symeonidis A, Delimpasi S, Katodritou E, Vervessou E, Michali E, Pouli A, Gika D, Vassou A, Terpos E, Anagnostopoulos N, Economopoulos T, Pangalis G. Primary Treatment of Waldenström Macroglobulinemia With Dexamethasone, Rituximab, and Cyclophosphamide. J Clin Oncol 2007; 25:3344-9. [PMID: 17577016 DOI: 10.1200/jco.2007.10.9926] [Citation(s) in RCA: 184] [Impact Index Per Article: 10.8] [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
PurposeAlkylating agents and the anti-CD20 monoclonal antibody rituximab are among appropriate choices for the primary treatment of symptomatic patients with Waldenström macroglobulinemia (WM), and they induce at least a partial response in 30% to 50% of patients. To improve these results, we designed a phase II study that included previously untreated symptomatic patients with WM who received a combination of dexamethasone, rituximab, and cyclophosphamide (DRC).Patients and MethodsSeventy-two patients were treated with dexamethasone 20 mg intravenously followed by rituximab 375 mg/m2intravenously on day 1 and cyclophosphamide 100 mg/m2orally bid on days 1 to 5 (total dose, 1,000 mg/m2). This regimen was repeated every 21 days for 6 months. Patients' median age was 69 years and many had features of advanced disease such as anemia (57%), hypoalbuminemia (40%), and elevated serum beta2-microglobulin (43%).ResultsOn an intent-to-treat basis, 83% of patients (95% CI, 73% to 91%) achieved a response, including 7% complete, 67% partial, and 9% minor responses. The median time to response was 4.1 months. The 2-year progression-free survival rate for all patients was 67%; for patients who responded to DRC, it was 80%. The 2-year disease-specific survival rate was 90%. Treatment with DRC was well tolerated, with 9% of patients experiencing grade 3 or 4 neutropenia and approximately 20% of patients experiencing some form of toxicity related to rituximab.ConclusionOur large, multicenter trial showed that the non–stem-cell toxic DRC regimen is an active, well-tolerated treatment for symptomatic patients with WM.
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Kalleas C, Tentes I, Margaritis D, Anagnostopoulos K, Toli A, Pendilas D, Bourikas G, Tsatalas C, Kortsaris AH. Effect of HbS in the determination of HbA2 with the Biorad Variant II analyzer. Clin Biochem 2007; 40:744-6. [PMID: 17442293 DOI: 10.1016/j.clinbiochem.2007.03.008] [Citation(s) in RCA: 8] [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] [Received: 01/19/2007] [Revised: 03/05/2007] [Accepted: 03/07/2007] [Indexed: 11/20/2022]
Abstract
OBJECTIVES The effect of the presence of HbS in the determination of HbA2 using the Biorad Variant II analyzer. DESIGN AND METHODS The effect of HbS presence in the samples was quantified using the HELENA SAS-MX alkaline gel electrophoresis kit as the reference method. RESULTS The %HbA2 values from the Variant II analyzer and the HELENA SAS-MX alkaline gel electrophoresis kit show a good linear correlation in the absence of HbS. A strong positive bias in the %HbA2 values from the Variant II is apparent in the presence of HbS in the samples, when compared to the alkaline electrophoresis gel. CONCLUSION The Variant II analyzer gives reliable results for %HbA2 determination when no HbS is detectable in the samples. When HbS is present, the gel electrophoresis method gives more accurate results.
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Kalleas C, Tentes I, Margaritis D, Anagnostopoulos K, Toli A, Pendilas D, Bourikas G, Tsatalas C, Kortsaris AH. Effect of HbS in the determination of HbA2 with the TOSOH HLC-723G7 analyzer and the HELENA Beta-Thal Quik column kit. Clin Biochem 2007; 40:242-7. [PMID: 17196577 DOI: 10.1016/j.clinbiochem.2006.10.016] [Citation(s) in RCA: 5] [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] [Received: 05/23/2006] [Revised: 10/09/2006] [Accepted: 10/10/2006] [Indexed: 10/23/2022]
Abstract
OBJECTIVES The analytical performance of the TOSOH HLC-723G7 hemoglobin HPLC analyzer and the effect of the presence of HbS in the determination of HbA(2) using HPLC and manual column methods. DESIGN AND METHODS The performance characteristics of the TOSOH HLC-723G7 analyzer in the determination of HbA(2) were compared to those of the HELENA Beta-Thal Quik column. The effect of HbS presence in the samples was quantified using the HELENA SAS-MX alkaline gel electrophoresis kit as the reference method. RESULTS Within-run and between-run CVs for HbA(2) were better for the TOSOH HPLC analyzer than for the HELENA manual column method. The presence of HbS in the samples produces a strong positive bias in the %HbA(2) values when using both the HPLC and manual column methods, compared to the alkaline electrophoresis gel. CONCLUSION Both the TOSOH HPLC and the manual column are reliable methods for %HbA(2) determination when no HbS is detectable in the samples. When HbS is present, the gel electrophoresis method gives more accurate results.
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Papaxoinis G, Papageorgiou S, Rontogianni D, Kaloutsi V, Fountzilas G, Pavlidis N, Dimopoulos M, Tsatalas C, Xiros N, Economopoulos T. Primary gastrointestinal non-Hodgkin's lymphoma: a clinicopathologic study of 128 cases in Greece. A Hellenic Cooperative Oncology Group study (HeCOG). Leuk Lymphoma 2007; 47:2140-6. [PMID: 17071488 DOI: 10.1080/10428190600709226] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.1] [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: 12/17/2022]
Abstract
The aim of this retrospective study was to illustrate the clinicopathologic data and the treatment results in patients with primary gastrointestinal tract non-Hodgkin's lymphoma (GI NHL). Among 810 patients with NHL, 128 cases (15.8%) were diagnosed as primary GI tract NHL. There were 79 males and 49 females with median age of 62 years. The most common primary site was the stomach (68%). Overall, 67.2% of the patients were in stages I - II, and 32.8% in stages III - IV. Simultaneous involvement of the GI tract and other extranodal sites was observed in 26 patients (20%). Extranodal marginal zone B-cell lymphoma (MZBL) (i.e., low-grade lymphoma of mucosa-associated lymphoid tissue type) accounted for 48.4% of lymphomas. Aggressive lymphomas (diffuse large B-cell lymphoma [DLBL]) accounted for 44.5%. Eighty-three patients (67.5%) achieved complete response (CR), either by surgery (43/43 patients, 17 with DLBL and 25 with MZBL) or by primary chemotherapy (40/64 patients, 22 with DLBL and 17 with MZBL). Sixty-two patients remain in CR; 33/43 after surgical resection (13/17 with DLBL and 20/25 patients with MZBL), and 29/40 after only chemotherapy (18/22 with DLBL and 10/17 with MZBL). The major prognostic factor for outcome in the present study was the stage of the disease. Patients with localized lymphoma (stage I and II) had significantly longer DFS and OS (DFS and OS at 3-year: 83% and 87%, respectively) than patients with extended disease (stage III and IV) (DFS and OS at 3-year: 46% and 60%, respectively) (P < 0.0001). The International Prognostic Index (IPI) for patients with aggressive lymphomas was prognostic only for DFS (79% for low-risk patients [IPI score 0 - 1] vs 49% for higher risk groups [IPI score >1] at 3-year, P = 0.0131).
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Affiliation(s)
- George Papaxoinis
- Second Department of Internal Medicine, Athens University, University General Hospital Attikon, Haidari, Greece.
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Pantelidou D, Tsatalas C, Margaritis D, Anastasiadis AG, Kaloutsi V, Argyropoulou P, Prassopoulos P, Bourikas G. Successful treatment of lymph node extramedullary plasmacytoma with bortezomib. Ann Hematol 2006; 85:188-90. [PMID: 16397787 DOI: 10.1007/s00277-005-0052-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2005] [Accepted: 11/12/2005] [Indexed: 12/28/2022]
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24
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Vassilakopoulos TP, Angelopoulou MK, Siakantaris MP, Konstantinou N, Symeonidis A, Karmiris T, Repoussis P, Roussou P, Dimopoulos AM, Kokoris SI, Dimitriadou EM, Kyrtsonis MC, Dimopoulou MN, Tsatalas C, Kokkinis G, Vrakidou E, Grigoraki V, Poziopoulos C, Stamatellou M, Liapis D, Georgiou G, Panayiotidis P, Pangalis GA. Pure infradiaphragmatic Hodgkin's lymphoma. Clinical features, prognostic factor and comparison with supradiaphragmatic disease. Haematologica 2006; 91:32-9. [PMID: 16434368] [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: 05/06/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Pure infradiaphragmatic Hodgkin's lymphoma (HL) is a rare disease. The prognostic impact of a purely infradiaphragmatic localization of this lymphoma is controversial. We aimed to evaluate the baseline clinicopathologic features, prognostic factors and outcome of a large series of consecutive patients with pure infradiaphragmatic HL. DESIGN AND METHODS We analyzed 131 patients with clinical stage I/II infradiaphragmatic HL treated with ABVD or equivalent regimens with or without radiotherapy, and compared 54 of them with 444 patients with pure supradiaphragmatic disease, who were treated at the same center. RESULTS Older age, clinical stage II (borderline), involvement of > or =3 sites, lymphocyte predominant histology, elevated serum beta2-microglobulin and higher International Prognostic Score were more frequent in patients with infradiaphragmatic disease than in those with supradiaphragmatic disease, while nodular sclerosis was less frequent. The complete remission rate was 100%, 97% and 82% for stages I, IIA and IIB, respectively. Only B-symptoms independently predicted for inferior failure-free survival, while inferior overall survival was independently associated with the involvement of > or =3 sites. At 10 years failure-free survival was 82+/-6% (vs. 85+/-2% for patients with supradiaphragmatic disease, p=0.45), overall survival was 74+/-8% (vs. 91+/-2%, p=0.0006), and disease-specific survival 87+/-5% (vs. 94+/-1%, p=0.04). In multivariate analysis the differences between infradiaphragmatic and supradiaphragmatic disease were obscured by older age and B-symptoms. INTERPRETATION AND CONCLUSIONS Pure infradiaphragmatic HL presents with distinct clinicopathologic characteristics. The previously reported poorer outcome may be explained by the unfavorable profile of the patients rather than the infradiaphragmatic presentation per se. Patients with stage IIB disease should probably be classified as having advanced HL because of the unacceptable rate of primary refractory disease.
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Affiliation(s)
- Theodoros P Vassilakopoulos
- First Dept. of Internal Medicine, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
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Economopoulos T, Papageorgiou S, Rontogianni D, Kaloutsi V, Fountzilas G, Tsatalas C, Pavlidis N, Pectasides D, Papageorgiou E, Dimopoulos M. Multifocal Extranodal Non‐Hodgkin Lymphoma: A Clinicopathologic Study of 37 Cases in Greece, a Hellenic Cooperative Oncology Group Study. Oncologist 2005; 10:734-8. [PMID: 16249354 DOI: 10.1634/theoncologist.10-9-734] [Citation(s) in RCA: 19] [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] [Indexed: 11/17/2022] Open
Abstract
The purpose of this retrospective study was to illustrate the clinicopathological features of patients presenting with multifocal extranodal non-Hodgkin lymphoma (NHL). Among 810 patients with NHL, 37 cases (4.2%) were found to have multiple extranodal involvement (two or more sites). There were 24 men and 13 women, with a median age of 63 years. The majority of these cases (n = 26) had gastric or intestinal (GI) involvement with or without other extranodal sites. Lung along with another extranodal site was relatively common in the present series. Stratification of the 37 cases according to the International Prognostic Index (IPI) showed that 89% of the patients belonged to the high-risk groups. Diffuse large-B-cell lymphoma (DLBCL) accounted for 62%, and mucosa-associated lymphoma tissue (MALT) lymphoma accounted for 27% of all cases. After induction treatment with anthracycline-based regimens, complete remission was achieved in 21 patients (57%), partial remission was achieved in six patients (16%), and seven patients (19%) had no response, while three patients (8%) were nonevaluable. In conclusion, multifocal extranodal NHL is a heterogeneous group of diseases. The majority of them arise at various sites in the GI tract. DLBCL was the most frequent histological subtype followed by MALT lymphoma. Risk group, as defined by the IPI, was predictive of survival.
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Affiliation(s)
- Theofanis Economopoulos
- Second Department of Internal Medicine, Athens University, University General Hospital Attikon, Haidari, Greece
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Economopoulos T, Papageorgiou S, Dimopoulos MA, Pavlidis N, Tsatalas C, Symeonidis A, Foudoulakis A, Pectasides D, Rontogianni D, Rizos E, Chalkia P, Anagnostopoulos A, Melachrinou M, Papageorgiou E, Fountzilas G. Non-Hodgkin's lymphomas in Greece according to the WHO classification of lymphoid neoplasms. A retrospective analysis of 810 cases. Acta Haematol 2005; 113:97-103. [PMID: 15802887 DOI: 10.1159/000083446] [Citation(s) in RCA: 25] [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: 11/10/2003] [Accepted: 04/19/2004] [Indexed: 11/19/2022]
Abstract
The purpose of this retrospective study, the largest unselected series in our country, was to illustrate the clinicopathological features of non-Hodgkin's lymphoma (NHL) classified according to the World Health Organization (WHO) classification of lymphoid neoplasms. A retrospective analysis was conducted and clinical features of histological subtypes were established in 810 patients (age > or = 15 years) with NHL who were treated at 8 major centers representative of Greece. There were 435 males and 375 females 95% of them aged >30 years. B symptoms were present in 34% of the patients, while 45.3% had stages I-II and 54.6% had stages III-IV. LDH was increased in 37% of the patients. B cell lymphomas formed 88% of the cases whereas T cell lymphomas formed 12% of the total. Indolent lymphomas accounted for 31.1%, aggressive ones for 66.7% and very aggressive ones for 2.4% of all NHLs. Among indolent lymphomas extranodal ones (MALT B cell lymphoma) were the most common subset while follicular lymphoma grade I and II and small lymphocytic ones presented with equal frequency. Among the aggressive lymphomas diffuse large cell lymphoma (DLCL) was the most common subtype; this entity along with large-cell immunoblastic lymphomas accounted for 45.2% of all B cell lymphomas. Among the T cell lymphomas, peripheral T cell lymphomas and anaplastic large cell lymphomas of the T/null-cell type were the most common subtypes. The most common extranodal presentation was the gastrointestinal tract (GI). Next in frequency were primary extranodal NHL of the head and neck region. MALT B cell lymphomas were found in almost half of the patients with GI tract NHL, whereas in all other extranodal places DLCL was the predominant histological subtype. The median survival for indolent and aggressive NHL was 123.5 and 55.5 months, respectively. This is the first report of a large series of malignant lymphomas in Greece using the WHO classification. It appears that there are no significant differences between NHL in Greece and other large series as far as clinical and extranodal presentation is concerned. The frequency of follicular lymphoma in the current study is comparable to that reported from Asian countries and mainland Europe, but lower than that of US and Northern European series. There were no important differences in the incidence of the remaining histological subtypes between Greece and other European countries.
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MESH Headings
- Adolescent
- Adult
- Aged
- Child
- Child, Preschool
- Female
- Gastrointestinal Neoplasms/classification
- Gastrointestinal Neoplasms/epidemiology
- Gastrointestinal Neoplasms/mortality
- Gastrointestinal Neoplasms/pathology
- Greece/epidemiology
- Head and Neck Neoplasms/classification
- Head and Neck Neoplasms/epidemiology
- Head and Neck Neoplasms/mortality
- Head and Neck Neoplasms/pathology
- Humans
- Lymphoma, Large B-Cell, Diffuse/classification
- Lymphoma, Large B-Cell, Diffuse/epidemiology
- Lymphoma, Large B-Cell, Diffuse/mortality
- Lymphoma, Large B-Cell, Diffuse/pathology
- Lymphoma, T-Cell, Peripheral/classification
- Lymphoma, T-Cell, Peripheral/epidemiology
- Lymphoma, T-Cell, Peripheral/mortality
- Lymphoma, T-Cell, Peripheral/pathology
- Male
- Middle Aged
- Neoplasm Staging
- Retrospective Studies
- World Health Organization
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Symeonidis A, Marinakis T, Papadakis H, Kouraklis A, Galanopoulos A, Roussou P, Terpos E, Viniou N, Polyclronopoulou S, Tsatalas C, Zoumbos N. P-36 Trisomy 8 alone in myelodysplasticsyndromes: Recognition of the common clinico-hematologic features from 109 patients. Leuk Res 2005. [DOI: 10.1016/s0145-2126(05)80100-6] [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: 11/30/2022]
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Pantelidou D, Tsatalas C, Margaritis D, Karayiannakis AJ, Kaloutsi V, Spanoudakis E, Katsilieris I, Chatzipaschalis E, Sivridis E, Bourikas G. Extramedullary plasmacytoma: report of two cases with uncommon presentation. Ann Hematol 2004; 84:188-91. [PMID: 15042315 DOI: 10.1007/s00277-004-0854-y] [Citation(s) in RCA: 9] [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] [Received: 11/18/2003] [Accepted: 01/20/2004] [Indexed: 11/24/2022]
Abstract
Lymph node infiltration by monoclonal plasma cells can occur either in aggressive forms of myeloma or may represent regional extension of extramedullary plasmacytomas, whereas lymph node plasmacytoma presenting as a solitary extramedullary plasmacytoma is very unusual. We report two cases of lymph node plasmacytomas without systemic disease diagnosed after surgical excision. Clinical remission was achieved after local radiotherapy although one patient relapsed with multifocal extramedullary plasmacytomas 20 months after radiotherapy.
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Affiliation(s)
- D Pantelidou
- Hematology Department, School of Medicine, Democritus University of Thrace, Alexandroupolis, Greece.
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Dimopoulos MA, Tsatalas C, Zomas A, Hamilos G, Panayiotidis P, Margaritis D, Matsouka C, Economopoulos T, Anagnostopoulos N. Treatment of Waldenstrom's macroglobulinemia with single-agent thalidomide or with the combination of clarithromycin, thalidomide and dexamethasone. Semin Oncol 2003; 30:265-9. [PMID: 12720150 DOI: 10.1053/sonc.2003.50079] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.4] [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
To evaluate the activity of thalidomide in Waldenstrom's macroglobulinemia (WM), 20 patients were treated on a dose schedule that escalated from 200 mg/d to 600 mg/d. On an intention-to-treat basis, five (25%) patients achieved a partial response, which was noted within 3 months of treatment. Adverse effects were common and prevented dose escalation of thalidomide in 75% of patients and led to premature discontinuation of treatment in 35%. We subsequently evaluated the oral combination of clarithromycin (500 mg twice per day), low-dose thalidomide (200 mg once daily), and dexamethasone (40 mg once per week). Our preliminary analysis on 12 previously treated patients indicate activity of this regimen in WM: three patients achieved a partial response and two patients demonstrated monoclonal protein reduction of greater than 25%. This combination was associated with a variety of side effects due not only to thalidomide, but also to corticosteroids and to clarithromycin. Our preliminary data indicate that this combination may be a useful salvage regimen for some patients with heavily pretreated macroglobulinemia.
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Affiliation(s)
- M A Dimopoulos
- Department of Clinical Therapeutics, University of Athens School of Medicine, Athens, Greece
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Tsatalas C, Martinis G, Margaritis D, Spanoudakis E, Kotsianidis I, Karpouzis A, Bourikas G. Long-term remission of recalcitrant tumour-stage mycosis fungoides following chemotherapy with pegylated liposomal doxorubicin. J Eur Acad Dermatol Venereol 2003; 17:80-2. [PMID: 12602979 DOI: 10.1046/j.1468-3083.2003.00642.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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: 11/20/2022]
Abstract
Advanced stage mycosis fungoides (MF) generally has a poor prognosis, and currently there is no standard treatment available. Here we report the case of a young woman with recalcitrant tumour-stage MF (T3, stage IIb) whose disease was unresponsive to several therapeutic modalities, but who has showed sustained clinical response to pegylated liposomal doxorubucin. No severe infectious complications have been observed. The use of this drug in tumour-stage MF should be investigated further.
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Affiliation(s)
- C Tsatalas
- Department of Haematology, School of Medicine, Democritus University of Thrace, Alexandroupolis, Greece.
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31
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Economopoulos T, Dimopoulos MA, Mellou S, Pavlidis N, Samantas E, Nicolaides C, Tsatalas C, Papadopoulos A, Papageogriou E, Papasavvas P, Fountzilas G. Treatment of intermediate- and high-grade non-Hodgkin's lymphoma using CEOP versus CNOP. Eur J Haematol 2002; 68:135-43. [PMID: 12068793 DOI: 10.1034/j.1600-0609.2002.01620.x] [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: 11/23/2022]
Abstract
INTRODUCTION During the last few years epirubicin (E) and mitoxantrone (M) (Novantrone) have been used in the treatment of non-Hodgkin's lymphoma (NHL), because of their favorable principal profile. In particular, M has less severe non-hematological toxicity. PATIENTS AND METHODS A randomized multicenter phase III study was conducted in order to compare the efficacy and toxicity of CEOP and CNOP in intermediate- and high-grade NHL. CEOP (arm A) consisted of cyclophosphamide 1000mg m(-2), vincristine 2mg, E 70mg m(-2) on day 1 and prednisone 60mg on days 1-7. The CNOP regimen (arm B) was identical to CEOP except for replacement of E by M at a dose of 12mg m(-2). Randomization was stratified according to stages I-IV. From September 1993 to March 1999, 249 patients registered for the trial. Patient characteristics were equally distributed in the two arms, except for age and International Prognostic Index (IPI) groups. RESULTS There were no significant differences between the two groups in the rates of complete (CR) and partial response (PR). The overall response rate was 78% in arm A (57% CR, 21% PR) and 82% in arm B (60% CR, 22% PR). With a median follow-up time of 47.3 months, the median survival was not reached in arm A, while it was 39.5 months in arm B (P=0.09). Three-year survival rates were 62.5% for CEOP and 51.5% for CNOP. There was no significant difference regarding the time to progression between the two groups (29.7 vs. 18.5 months); furthermore the median duration of CRs was 71.6 and 49 months for CEOP and CNOP, respectively (P=0.07). The therapeutic efficacies of both regimens were equivalent among the four IPI groups. More alopecia was observed in arm A. WHO grade >2 neutropenia was more frequent in arm B. Supportive treatment with G-CSF was given to 22 and 24 patients, respectively. CONCLUSION There were no significant differences in terms of overall response rates, overall survival and time to progression between CEOP and CNOP in the treatment of intermediate- and high-grade NHL. Patients with low or low intermediate IPI risk treated with either CEOP or CNOP showed significantly better survival, response rates and time to progression than those with high intermediate or high IPI risk. Therefore, new improved therapeutic approaches should be developed for the treatment of high IPI risk patients.
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Affiliation(s)
- T Economopoulos
- Second Department of Internal Medicine - Propaedeutic, Athens University, Evangelismos Hospital, Greece
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Tsatalas C, Margaritis D, Kaloutsi V, Martinis G, Kotsianidis I, Bourikas G. Successful treatment of angioimmunoblastic lymphadenopathy with dysproteinemia-type T-cell lymphoma with fludarabine. Acta Haematol 2001; 105:106-8. [PMID: 11408715 DOI: 10.1159/000046545] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- C Tsatalas
- Department of Hematology, School of Medicine, Democritus University of Thrace, Alexandroupolis, Greece.
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Economopoulos T, Dimopoulos MA, Foudoulakis A, Nikolaidis C, Tsatalas C, Pectacides D, Rontogianni D, Papageorgiou E, Fountzilas G. Burkitt's lymphoma in Greek adults. A study of the Hellenic co-operative oncology group. Leuk Res 2000; 24:993-8. [PMID: 11077112 DOI: 10.1016/s0145-2126(00)00077-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [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: 10/17/2022]
Abstract
Non-African Burkitt's lymphoma is a rare disease among adults without AIDS. Among 1352 Greek adult patients with non-Hodgkin's lymphoma, 24 cases (1.8%) were classified as Burkitt's (BL) or Burkitt-like (BLL) lymphoma. Eleven cases fulfilled the criteria of BL and 13 of BLL. No statistical differences were found in the general characteristics of the two groups at the time of diagnosis. Extranodal involvement was a common finding in both groups and bulky disease (>10 cm) was observed in almost one half of the patients. The majority of the patients were treated with intensive, although different, protocols. After induction treatment, complete remission (CR) was achieved in 14 patients (60.8%). CR was reached in all cases with stage I-II, while in stage IV the CR rate was 30.4%. The median overall survival was 27 months. The median survival for BL was 13 months compared to 27 months in the BLL group (P=0.34). The data of the present retrospective analysis, indicated that there were not significant clinical differences between BL and BLL variants. Since BLL is still a non-reproducible category in the REAL classification, all BL variants must be treated uniformly with intensive protocols.
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Affiliation(s)
- T Economopoulos
- Second Department of Internal Medicine, Athens University, Evangelismos Hospital, 10676, Athens, Greece
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Lalayanni C, Theodoridou S, Athanasiadou A, Saloum R, Tsatalas C. Simultaneous occurrence of multiple myeloma and Hodgkin's disease. A case report. Haematologica 2000; 85:772-3. [PMID: 10897138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
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Pectasides D, Economopoulos T, Kouvatseas G, Antoniou A, Zoumbos Z, Aravantinos G, Tsatalas C, Halikia A, Nikolaides C, Kiamouris C, Pappa E, Pavlidis N, Skarlos D, Fountzilas G, Dimopoulos MA. Anthracycline-based chemotherapy of primary non-Hodgkin's lymphoma of the testis: the hellenic cooperative oncology group experience. Oncology 2000; 58:286-92. [PMID: 10838493 DOI: 10.1159/000012114] [Citation(s) in RCA: 23] [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] [Indexed: 11/19/2022]
Abstract
Testicular non-Hodgkin's lymphoma is an uncommon disease and its outcome following chemotherapy and/or radiotherapy has been variable. A retrospective analysis was performed on 26 patients with primary testicular lymphoma treated predominantly with anthracycline-based chemotherapy between 1984 and 1999. The patients' median age was 60 years (range 19-82 years) with 17 (65.4%) patients being older than 60 years. Four (15.4%) patients had constitutional B symptoms. There were 11 (42.3%) patients with high grade lymphoma, 12 (46.2%) with intermediate grade, 1 (3.8%) with low grade and 2 (7.7%) were not classified. According to the Ann-Anbor staging system, 18 patients (69.2%) had early (stage I/II) and 8 (30.8%) advanced (stage III/IV) disease. Chemotherapy was administered to 24 patients including 22 patients who received anthracycline-based chemotherapy. Two stage IEA patients were treated with orchidectomy and adjuvant radiotherapy to the regional lymph nodes without systemic chemotherapy. Chemotherapy alone resulted in a complete remission (CR) in 14 (58.3%) of 24 patients and partial remission in 1 (4.2%), amounting to an overall response rate (RR) of 62.5%. Of the 5 stage I patients who had chemotherapy on an adjuvant basis, 4 (80%) had CR/no evidence of disease. Of the 11 stage II patients, 8 (72.7%) achieved CR and 1 (9.1%) PR (overall RR of 81.8%). CR was obtained in 2 (25%) of 8 stage III/IV patients. Both patients remain disease free for 26 and 65 months. Excluding the 5 stage I patients, chemotherapy resulted in a CR in 10/19 (52.6%) patients and a PR in 1/19 (5.2%), inducing an overall RR of 57.8%. The mean duration of response was 75 months (range 8-145.5+ months). After a median follow-up of 87 months (range 0.13-145.5+ months) the median survival time was 31 months (range 0.13-145.5+ months) and the median time to progression (TTP) 17 months (range 0.13-145.5+ months). The median TTP was significantly higher in early disease compared to that of advanced disease (52 vs. 3 months, p = 0.02). Of the 3 patients who relapsed following disease-free status, CNS involvement occurred in 2 stage II patients and contralateral testis involvement in 1 stage IEA, respectively. The latter remained disease free for 2 years following orchidectomy alone. The other 2 patients who relapsed did not respond to salvage chemotherapy and died. There was no significant relationship between the values of LDH and beta(2)-microglobulin with the outcome except for ESR which was significantly related with the CR (p = 0.005) or RR (p = 0.005). In conclusion, patients with primary testicular lymphoma have a poor outcome, despite the treatment with anthracycline-containing regimens. Treatment with anthracycline-based chemotherapy is recommended in patients at early stages. In advanced disease, more intensive or investigational regimens should be considered. Because the relapse rate in the CNS and contralateral testis is quite high in most studies, prophylactic CNS treatment and radiotherapy to the other testis should be included in the management of testicular lymphoma.
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Affiliation(s)
- D Pectasides
- Hellenic Cooperative Oncology Group (HeCOG), Athens, Greece.
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Tamoakoudis P, Tantanasis T, Vlachaki E, Tzevelekis P, Tsatalas C, Lioupis K, Christakis J, Mantalenakis S. Lymphoma and pregnancy-report on five cases. Int J Gynaecol Obstet 2000. [DOI: 10.1016/s0020-7292(00)83379-2] [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: 10/26/2022]
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MESH Headings
- Female
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell/complications
- Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Middle Aged
- Red-Cell Aplasia, Pure/complications
- Red-Cell Aplasia, Pure/drug therapy
- Red-Cell Aplasia, Pure/pathology
- Vidarabine/analogs & derivatives
- Vidarabine/therapeutic use
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Tampakoudis P, Tsatalas C, Mamopoulos M, Tantanassis T, Christakis JI, Sinakos Z, Mantalenakis S. Transfusion-dependent homozygous beta-thalassaemia major: successful pregnancy in five cases. Eur J Obstet Gynecol Reprod Biol 1997; 74:127-31. [PMID: 9306104 DOI: 10.1016/s0301-2115(97)00089-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [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: 02/05/2023]
Abstract
beta-Thalassaemia major is a severe, transfusion-dependent anaemia that also causes infertility due to iron deposition to endocrine organs. Very few pregnancies have been reported among such patients. In this report we describe the evolution and successful outcome of pregnancy in 5 Greek women with beta-thalassaemia major. There were four full-term and one preterm deliveries of two normal and three small for the date neonates. Cardiovascular changes related to gestation may aggravate the underlying multiorgan damage of the pregnant mother and predispose to poor fetal growth and development. All five patients followed a strict transfusion regimen in order to maintain the haemoglobin level above 10 g/dl. The inadvertent administration of desferrioxamine in one patient until the 8th gestational week did not seem to have any serious effects on the development and well-being of the fetus. Although pregnancy is not contraindicated in beta-thalassaemia major, intensive individualized care is required if it is to be safe for the mother, and have a reasonably good chance of producing a healthy child.
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Affiliation(s)
- P Tampakoudis
- First Department of Obstetrics and Gynaecology, Aristotelian University of Thessaloniki, Ippokration General Hospital, Greece
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Tsatalas C, Chalkia P, Tsantali C, Kakoulidis I, Garyfallos A, Klonizakis I, Panayiotopoulos S. Responsiveness to recombinant human erythropoietin (rh-Epo) of marrow erythroid progenitors (CFU-E and BFU-E) from B-chronic lymphocytic leukemia (B-CLL). J Exp Clin Cancer Res 1997; 16:163-70. [PMID: 9261742] [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: 02/05/2023]
Abstract
The responsiveness of bone marrow erythroid progenitors (CFU-E and BFU-E) to various concentrations of recombinant human erythropoietin (rh-Epo) (2,5,20,40,100,200 and 500 U/ml) was investigated in vitro in 18 patients with B-chronic lymphocytic leukemia to assess the clinical usefulness of rh-Epo in this disease. Bone marrow mononuclear cells were cultured by methylcellulose methods for CFU-E and BFU-E assays. The B-chronic lymphocytic leukemia patients were divided into two groups according to the percentage of lymphocytes in the bone marrow (under 70% and over 70%). Among the patients with few lymphocytes, more than one third demonstrated some degree of response to rh-Epo. Among the patients with a high percentage of lymphocytes in the bone marrow, some revealed no response to rh-Epo, but there were patients who showed a good response to rh-Epo. Because erythroid progenitors from B-chronic lymphocytic leukemia appeared sensitive to rh-Epo in vitro, we propose that high doses of this drug may be clinically effective in some patients with this disease, regardless of the degree of lymphocytic inflitration of the bone marrow.
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MESH Headings
- Aged
- Bone Marrow/drug effects
- Bone Marrow Cells
- Dose-Response Relationship, Drug
- Erythroid Precursor Cells/drug effects
- Erythropoietin/blood
- Erythropoietin/pharmacology
- Female
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell/blood
- Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Male
- Middle Aged
- Recombinant Proteins/pharmacology
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Affiliation(s)
- C Tsatalas
- Fourth Dept. of Internal Medicine, Aristotelian University of Thessaloniki, Ippokration General Hospital, Greece
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Tsatalas C, Chalkia P, Athanasiadis G, Venizelos I, Karakolios A, Papageorgiou A, Kakoulidis I, Bouricas G. Increased peripheral blood normal myeloid progenitor cells (CFU-GM) in chronic lymphocytic leukemia: a perspective for autologous peripheral blood stem cell transplantation. Eur J Haematol 1995; 54:235-40. [PMID: 7789468 DOI: 10.1111/j.1600-0609.1995.tb00677.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [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: 01/27/2023]
Abstract
We assayed granulocyte-macrophage committed progenitor cells (CFU-GM) in the peripheral blood of 34 patients with chronic lymphocytic leukemia (CLL) and 12 normal individuals. The patients were divided into separate groups on the basis of previous therapy (i.e. analysis performed at diagnosis, during and after chemotherapy) and clinical features of the disease (i.e. disease stage, pattern of bone marrow infiltration, peripheral blood lymphocytosis). The mean CFU-GM colony count of the patients was 30 times higher than that of the controls (206.4 +/- 197.8 (SD) CFU-GM per 5 x 10(5) cells plated versus 6.5 +/- 3.6). There was no statistical difference in the numbers of circulating CFU-GM between the patients studied at diagnosis (257 +/- 215.4 CFU-GM/5 x 10(5) cells) and those studied during (117.6 +/- 169.2 CFU-GM/5 x 10(5) cells) or after chemotherapy (207.5 +/- 105.9 CFU-GM/5 x 10(5) cells), although a trend towards a higher recovery of myeloid progenitors was observed as a function of time elapsing from the last treatment. In addition, we found no significant difference in the in vitro CFU-GM growth of patients grouped according to their disease stage, pattern of bone marrow infiltration and degree of peripheral blood lymphocytosis. In conclusion, our data indicate that intensification with peripheral blood stem cell support may be feasible in CLL, since progenitor cells of myeloid-monocytic series are markedly increased in the peripheral blood of these patients. Moreover, it is possible to extend this kind of therapy to patients who have undergone previous extensive chemotherapy and who might have persisting bone marrow infiltration.
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Affiliation(s)
- C Tsatalas
- Second Propedeutic Clinic of Internal Medicine, Aristotelian University of Thessaloniki, Greece
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Garipidou V, Tsatalas C, Sinacos Z. Severe neutropenia in a patient with large granular lymphocytosis: prolonged successful control with cyclosporin A. Haematologica 1991; 76:424-5. [PMID: 1806448] [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: 12/28/2022] Open
Abstract
A case of severe neutropenia associated with large granular lymphocytosis in a 40-year-old female is described. The patient, with no findings of an underlying systemic disorder, had suffered from recurrent life threatening, mainly pseudomonal, infections for about two years, despite the various regimes tried. During the last twelve months cyclosporin A treatment resulted in a significant increase in absolute neutrophil counts, concomitant with a remarkable decrease in bone marrow infiltration by GLs and almost normal counts of GLs in the peripheral blood. During this time she has remained completely free from infectious episodes. The mechanisms involved remain to be determined.
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Affiliation(s)
- V Garipidou
- B' Propedeutic clinic of Internal Medicine, Aristotelion University of Thessaloniki, Ippokration General Hospital, Greece
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Tsatalas C, Curtoglou G, Fotopoulos D, Halkia P, Vyzantiadis AT, Sinakos Z. 1 alpha(OH)D3 treatment and procollagen III (PC III) studies in idiopathic myelofibrosis. Haematologica 1989; 74:559-62. [PMID: 2628238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Eight patients with idiopathic myelofibrosis (IMF) were treated with escalating doses (0.5 microgram/day to 4.0 micrograms/day) of 1 alpha(OH)D3 for periods up to 6 months. The treatment did not improve the disease parameters in any of the patients under study. No patient demonstrated a decrease in bone marrow fibrosis as determined by serial procollagen (PC III) serum level analysis. Although 1 alpha(OH)D3 was well tolerated at the administered doses, the therapeutic value of this treatment for IMF requires further evaluation.
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Abstract
Patients with aplastic anaemia have a relatively specific immune defect--leucopenia with neutropenia. We have carried out a retrospective analysis of infective episodes in 11 patients with aplastic anaemia. 5723 follow-up days accrued and 29 infective episodes were documented. Overall the number of infective episodes was significantly associated with the mean white cell and monocyte counts (r = 0.59, 0.02 less than P less than 0.05) but not with length of follow-up, presentation values of white cell, neutrophil and monocyte counts, or mean neutrophil count. The patients appeared to divide clinically into two groups, those at low risk (seven patients) and those high risk (four patients) of infection. Patients in the high risk group had significantly more infections (P = 0.01) and significantly lower monocyte counts (0.02 less than P less than 0.05) than patients in the low risk group. These results are in contrast to similar studies in patients with chemotherapy-induced neutropenia; in our patients the overall rate and severity of infection was low, Gram negative infections were uncommon and monocytopenia appeared to be of greater importance than neutropenia in determining susceptibility to infection.
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Apperley JF, Jones L, Hale G, Waldmann H, Hows J, Rombos Y, Tsatalas C, Marcus RE, Goolden AW, Gordon-Smith EC. Bone marrow transplantation for patients with chronic myeloid leukaemia: T-cell depletion with Campath-1 reduces the incidence of graft-versus-host disease but may increase the risk of leukaemic relapse. Bone Marrow Transplant 1986; 1:53-66. [PMID: 3332120] [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: 01/05/2023]
Abstract
Between December 1983 and November 1985 we treated 39 patients with chronic myeloid leukaemia by chemoradiotherapy and transplantation from HLA-identical sibling donors using bone marrow that had been depleted of T cells ex vivo with the rat monoclonal antibody Campath-1. Twenty-eight of the patients were in the chronic phase (good-risk group) and 11 patients were in more advanced phases of the disease (accelerated phase or blastic transformation; poor-risk group). Of the patients of good risk 23 (82%) survive; the median duration of follow-up is 461 (range 111-776) days; of the 11 patients of poor risk four survive; the median duration of follow-up is 280 (range 189-658) days. Acute graft-versus-host disease (GVHD) of grade II or greater occurred in three (11%) of the patients of good risk and in six (55%) of the patients of poor risk. In the patients of good risk haematological evidence of relapse was seen in four and cytogenetic evidence of persisting or relapsed leukaemia (based on the finding of Philadelphia-chromosome-positive marrow metaphases more than 6 months after transplant) was seen in three other patients. In comparison with the patients of good risk transplanted with untreated marrow between February 1981 and December 1983, the incidence of acute GVHD was reduced significantly (P less than 0.001) but the risk of leukaemic relapse (including patients with only cytogenetic evidence of relapse) was increased (P less than 0.005). We conclude that T-cell depletion used in this manner may be associated with an increased risk of leukaemic relapse.
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MESH Headings
- Actuarial Analysis
- Adolescent
- Adult
- Antibodies, Monoclonal/therapeutic use
- Bone Marrow Transplantation
- Child
- Dose-Response Relationship, Immunologic
- Female
- Graft vs Host Disease/etiology
- Graft vs Host Disease/prevention & control
- Humans
- Infections/etiology
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/complications
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/mortality
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/therapy
- Lymphocyte Depletion
- Male
- Middle Aged
- Recurrence
- Risk Factors
- T-Lymphocytes/immunology
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Affiliation(s)
- J F Apperley
- Medical Research Council Leukaemia Unit, Hammersmith Hospital, London, UK
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