1
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Eichhorst B, Robak T, Montserrat E, Ghia P, Niemann CU, Kater AP, Gregor M, Cymbalista F, Buske C, Hillmen P, Hallek M, Mey U. Chronic lymphocytic leukaemia: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2021; 32:23-33. [PMID: 33091559 DOI: 10.1016/j.annonc.2020.09.019] [Citation(s) in RCA: 229] [Impact Index Per Article: 76.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 09/24/2020] [Accepted: 09/28/2020] [Indexed: 12/28/2022] Open
Affiliation(s)
- B Eichhorst
- Department I Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf, University of Cologne, Cologne, Germany
| | - T Robak
- Department of Hematology, Medical University of Lodz, Copernicus Memorial Hospital, Lodz, Poland
| | - E Montserrat
- Institute of Hematology and Oncology, Department of Hematology, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - P Ghia
- Strategic Research Program on CLL, Division of Experimental Oncology, Università Vita-Salute San Raffaele and IRCCS Ospedale San Raffaele, Milano, Italy
| | - C U Niemann
- Department of Hematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - A P Kater
- Department of Hematology, Cancer Center Amsterdam, Lymphoma and Myeloma Center Amsterdam, LYMMCARE, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - M Gregor
- Hematology, Luzerner Kantonsspital, Luzern, Switzerland
| | - F Cymbalista
- Hematology Biology, Hôpital Avicenne, Assistance Publique Hopitaux de Paris, UMR U978 INSERM, Bobigny, France
| | - C Buske
- Institute of Experimental Cancer Research, Comprehensive Cancer Center, University Hospital of Ulm, Ulm, Germany
| | - P Hillmen
- Leeds Institute of Medical Research, University of Leeds, St James's University Hospital, Leeds, UK
| | - M Hallek
- Department I Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf, University of Cologne, Cologne, Germany; Center of Excellence on Cellular Stress Responses in Aging-Associated Diseases, University of Cologne, Cologne, Germany
| | - U Mey
- Department of Oncology and Haematology, Kantonsspital Graubuenden, Chur, Switzerland
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Condoluci A, Terzi di Bergamo L, Langerbeins P, Hoechstetter M, Herling C, De Paoli L, Delgado J, Gentile M, Doubek M, Mauro F, Chiodin G, Mattsson M, Bahlo J, Cutrona G, Kotaskova J, Deambrogi C, Moia R, Gerber B, Zucca E, Ghielmini M, Cavalli F, Stüssi G, Neri A, Ferrarini M, Rosenquist R, Forconi F, Foà R, Pospisilova S, Morabito F, Wierda W, Montserrat E, Gaidano G, Hallek M, Rossi D. INTERNATIONAL PROGNOSTIC SCORE FOR EARLY STAGE CHRONIC LYMPHOCYTIC LEUKEMIA (IPS-A). Hematol Oncol 2019. [DOI: 10.1002/hon.51_2629] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- A. Condoluci
- Experimental Hematology; Institute of Oncology Research; Oncology Institute of Southern Switzerland; Bellinzona Switzerland
| | - L. Terzi di Bergamo
- Experimental Hematology; Institute of Oncology Research; Bellinzona Switzerland
| | - P. Langerbeins
- University of Cologne; Center of Integrated Oncology Cologne-Bonn, German CLL Study Group; Köln Germany
| | - M. Hoechstetter
- University of Cologne; Center of Integrated Oncology Cologne-Bonn, German CLL Study Group; Köln Germany
| | - C. Herling
- University of Cologne; Center of Integrated Oncology Cologne-Bonn, German CLL Study Group; Köln Germany
| | - L. De Paoli
- Translational Medicine; University of Eastern Piedmont; Novara Italy
| | - J. Delgado
- Hematology; Hospital Clínic de Barcelona; Barcelona Spain
| | - M. Gentile
- Hematology; Azienda Ospedaliera (AO) of Cosenza; Cosenza Italy
| | - M. Doubek
- Hematology and Oncology; University Hospital of Brno; Brno Czech Republic
| | - F.R. Mauro
- Hematology; Sapienza University; Rome Italy
| | - G. Chiodin
- Hematology; Southampton University; Southampton United Kingdom
| | - M. Mattsson
- Immunology; Genetics and Pathology, Uppsala University; Uppsala Sweden
| | - J. Bahlo
- University of Cologne; Center of Integrated Oncology Cologne-Bonn, German CLL Study Group; Köln Germany
| | - G. Cutrona
- Hematology; IRCCS Ospedale Policlinico San Martino; Genoa Italy
| | - J. Kotaskova
- Hematology and Oncology; University Hospital of Brno; Brno Czech Republic
| | - C. Deambrogi
- Translational Medicine; University of Eastern Piedmont; Novara Italy
| | - R. Moia
- Translational Medicine; University of Eastern Piedmont; Novara Italy
| | - B. Gerber
- Onco-hematology; Oncology Institute of Southern Switzerland; Bellinzona Switzerland
| | - E. Zucca
- Onco-hematology; Oncology Institute of Southern Switzerland; Bellinzona Switzerland
| | - M. Ghielmini
- Onco-hematology; Oncology Institute of Southern Switzerland; Bellinzona Switzerland
| | - F. Cavalli
- Onco-hematology; Oncology Institute of Southern Switzerland; Bellinzona Switzerland
| | - G. Stüssi
- Onco-hematology; Oncology Institute of Southern Switzerland; Bellinzona Switzerland
| | - A. Neri
- Hematology; University of Milan; Milan Italy
| | | | - R. Rosenquist
- Immunology; Genetics and Pathology, Uppsala University; Uppsala Sweden
| | - F. Forconi
- Hematology; Southampton University; Southampton United Kingdom
| | - R. Foà
- Hematology; Sapienza University; Rome Italy
| | - S. Pospisilova
- Hematology and Oncology; University Hospital of Brno; Brno Czech Republic
| | - F. Morabito
- Hematology; Augusta Victoria Hospital; Jerusalem Israel
| | - W.G. Wierda
- MD Anderson Cancer Center; University of Texas; Houston United States
| | - E. Montserrat
- Hematology; Hospital Clínic de Barcelona; Barcelona Spain
| | - G. Gaidano
- Translational Medicine; University of Eastern Piedmont; Novara Italy
| | - M. Hallek
- University of Cologne; Center of Integrated Oncology Cologne-Bonn, German CLL Study Group; Köln Germany
| | - D. Rossi
- Experimental Hematology; Institute of Oncology Research; Oncology Institute of Southern Switzerland; Bellinzona Switzerland
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Monreal M, Lafoz E, Montserrat E, Bechini J, Valls R. Impedance Plethysmography or Real-Time Ultrasonography in the Diagnosis of Venous Thrombosis in Pregnant Women. Thromb Haemost 2018. [DOI: 10.1055/s-0038-1645703] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- M Monreal
- Department of Internal Medicine, Hospital Universitario Germans Trias i Pujol, Barcelona, Spain
| | - E Lafoz
- Department of Internal Medicine, Hospital Universitario Germans Trias i Pujol, Barcelona, Spain
| | - E Montserrat
- Department of Radiodiagnostics, Hospital Universitario Germans Trias i Pujol, Barcelona, Spain
| | - J Bechini
- Department of Radiodiagnostics, Hospital Universitario Germans Trias i Pujol, Barcelona, Spain
| | - R Valls
- Department of Radiodiagnostics, Hospital Universitario Germans Trias i Pujol, Barcelona, Spain
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Marsilio S, Khiabanian H, Fabbri G, Vergani S, Scuoppo C, Montserrat E, Shpall EJ, Hadigol M, Marin P, Rai KR, Rabadan R, Devereux S, Pasqualucci L, Chiorazzi N. Somatic CLL mutations occur at multiple distinct hematopoietic maturation stages: documentation and cautionary note regarding cell fraction purity. Leukemia 2017; 32:1041-1044. [PMID: 29203856 PMCID: PMC5886053 DOI: 10.1038/leu.2017.343] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [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: 12/18/2022]
Affiliation(s)
- S Marsilio
- Karches Center for Oncology Research, The Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY, USA
| | - H Khiabanian
- Center for Systems and Computational Biology, Rutgers Cancer Institute of New Jersey, Rutgers University, New Brunswick, NJ, USA
| | - G Fabbri
- Institute for Cancer Genetics, Herbert Irving Comprehensive Cancer Center, Columbia University, New York, NY, USA
| | - S Vergani
- Karches Center for Oncology Research, The Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY, USA
| | - C Scuoppo
- Institute for Cancer Genetics, Herbert Irving Comprehensive Cancer Center, Columbia University, New York, NY, USA
| | - E Montserrat
- Institute of Hematology and Oncology, Department of Hematology, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - E J Shpall
- Department of Stem Cell Transplantation and Cell Therapy, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - M Hadigol
- Center for Systems and Computational Biology, Rutgers Cancer Institute of New Jersey, Rutgers University, New Brunswick, NJ, USA
| | - P Marin
- Institute of Hematology and Oncology, Department of Hematology, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - K R Rai
- Karches Center for Oncology Research, The Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY, USA
| | - R Rabadan
- Department of Systems Biology, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - S Devereux
- Kings College Hospital, NHS Foundation Trust, London, UK
| | - L Pasqualucci
- Institute for Cancer Genetics, Herbert Irving Comprehensive Cancer Center, Columbia University, New York, NY, USA
| | - N Chiorazzi
- Karches Center for Oncology Research, The Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY, USA
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Eichhorst B, Robak T, Montserrat E, Ghia P, Hillmen P, Hallek M, Buske C. appendix 6: Chronic lymphocytic leukaemia: eUpdate published online September 2016 (http://www.esmo.org/Guidelines/Haematological-Malignancies). Ann Oncol 2016; 27:v143-v144. [PMID: 27664254 DOI: 10.1093/annonc/mdw359] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- B Eichhorst
- Klinik I für Innere Medizin, Universität zu Köln, Köln, Germany
| | - T Robak
- Department of Hematology, Medical University of Lodz, Copernicus Memorial Hospital, Lodz, Poland
| | - E Montserrat
- Institute of Hematology and Oncology, Department of Hematology, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - P Ghia
- Department of Onco-Hematology and Division of Molecular Oncology, Università Vita-Salute San Raffaele, Fondazione Centro San Raffaele, IRCCS Istituto Scientifico San Raffaele, Milan, Italy
| | - P Hillmen
- Institute of Oncology, St James's University Hospital, Leeds, UK
| | - M Hallek
- Department I Internal Medicine, Center for Integrated Oncology Köln-Bonn, Center of Excellence on Cellular Stress Responses in Aging-Associated Diseases, University of Cologne, Köln
| | - C Buske
- Comprehensive Cancer Center Ulm, Institute of Experimental Cancer Research, University Hospital, Ulm, Germany
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6
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Cervantes F, Salgado C, Feliu E, Montserrat E, Rozman C. Interferon alpha-2b for Essential Thrombocythaemia: Results in 13 Previously Untreated Patients. Leuk Lymphoma 2016; 4:351-4. [PMID: 27467667 DOI: 10.3109/10428199109068085] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Interferon alpha-2b (αIF) was administered to 13 previously untreated patients with essential thrombocythaemia (ET). Pretreatment median platelet count was 1.178 (range, 662 to 1,700) x 10(9)/L, with ten patients showing values above 1,000 × 10(9)/L. Six patients had vascular symptoms attributable to ET, whereas in the remaining cases treatment was instituted due to either an increased vascular risk or platelet counts higher than 1,000 × 10(9)/L. With an induction regimen of αIF 3 MU/day, given subcutaneously, a rapid decrease in the platelet counts was observed in all cases. Two patients did not complete the induction therapy because of unacceptable toxic side-effects at the time their platelet counts approached normal values. In the remaining 11 patients a complete haematologic response (platelets below 400 × 10(9)/L) was observed, after a median of 9.5 (range, 2.6 to 36) weeks from the start of therapy. In only 3 patients was dose escalation of interferon to 5 MU/day required. Eleven patients experienced flu-like symptoms, that could be well controlled by oral paracetamol in 7 cases. After discontinuing therapy a rise in the platelet counts was observed in all patients, after a median of 5 (range, 2 to 35) weeks. Two patients subsequently refused to continue on interferon therapy, whereas in the remainder a dose of 3 MU 2 to 4 times weekly maintained normal platelet counts.
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Affiliation(s)
- F Cervantes
- a Postgraduate School of Haematology "Farreras Valenti", Servicio de Hematologia, Hospital Clinico y Provincial, Barcelona, Spain
| | - C Salgado
- a Postgraduate School of Haematology "Farreras Valenti", Servicio de Hematologia, Hospital Clinico y Provincial, Barcelona, Spain
| | - E Feliu
- a Postgraduate School of Haematology "Farreras Valenti", Servicio de Hematologia, Hospital Clinico y Provincial, Barcelona, Spain
| | - E Montserrat
- a Postgraduate School of Haematology "Farreras Valenti", Servicio de Hematologia, Hospital Clinico y Provincial, Barcelona, Spain
| | - C Rozman
- a Postgraduate School of Haematology "Farreras Valenti", Servicio de Hematologia, Hospital Clinico y Provincial, Barcelona, Spain
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Conconi A, Montoto S, Montserrat E, Zucca E. Reply to the letter to the editor ‘Survival in young adults diagnosed with follicular lymphoma’ by Calvo et al. Ann Oncol 2016; 27:1173. [DOI: 10.1093/annonc/mdw058] [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: 11/13/2022] Open
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8
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Dreger P, Montserrat E. Transplantation in CLL: what we can learn from a dinosaur. Bone Marrow Transplant 2016; 51:765-6. [PMID: 26926227 DOI: 10.1038/bmt.2016.27] [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] [Received: 01/04/2016] [Accepted: 01/19/2016] [Indexed: 11/09/2022]
Affiliation(s)
- P Dreger
- Department of Medicine V, University of Heidelberg, Heidelberg, Germany.,European Society for Blood and Marrow Transplantation (EBMT), Paris, France
| | - E Montserrat
- Department of Hematology, Hospital Clínic, University of Barcelona, Barcelona, Spain.,European Research Initiative on CLL (ERIC), Barcelona, Spain
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Conconi A, Lobetti-Bodoni C, Montoto S, Lopez-Guillermo A, Coutinho R, Matthews J, Franceschetti S, Bertoni F, Moccia A, Rancoita P, Gribben J, Cavalli F, Gaidano G, Lister T, Montserrat E, Ghielmini M, Zucca E. Life expectancy of young adults with follicular lymphoma. Ann Oncol 2015; 26:2317-22. [DOI: 10.1093/annonc/mdv376] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2015] [Accepted: 09/07/2015] [Indexed: 11/13/2022] Open
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Eichhorst B, Robak T, Montserrat E, Ghia P, Hillmen P, Hallek M, Buske C. Chronic lymphocytic leukaemia: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2015; 26 Suppl 5:v78-84. [PMID: 26314781 DOI: 10.1093/annonc/mdv303] [Citation(s) in RCA: 259] [Impact Index Per Article: 28.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Affiliation(s)
- B Eichhorst
- Klinik I für Innere Medizin, Universität zu Köln, Köln, Germany
| | - T Robak
- Department of Hematology, Medical University of Lodz, Copernicus Memorial Hospital, Lodz, Poland
| | - E Montserrat
- Institute of Hematology and Oncology, Department of Hematology, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - P Ghia
- Department of Onco-Hematology and Division of Molecular Oncology, Università Vita-Salute San Raffaele, Fondazione Centro San Raffaele, IRCCS Istituto Scientifico San Raffaele, Milan, Italy
| | - P Hillmen
- Institute of Oncology, St James's University Hospital, Leeds, UK
| | - M Hallek
- Department I Internal Medicine, Center for Integrated Oncology Köln-Bonn, Center of Excellence on Cellular Stress Responses in Aging-Associated Diseases, University of Cologne, Köln
| | - C Buske
- Comprehensive Cancer Center Ulm, Institute of Experimental Cancer Research, University Hospital, Ulm, Germany
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Rodríguez Fernández JM, Montserrat E, Rozman C, Rios A, Vallespí MT, González Aza C, Alcalá A, Gutiérrez M, Morey M, Brugués R. Sequential bone marrow biopsy in chronic lymphocytic leukaemia. Bibl Haematol 2015:81-6. [PMID: 6466285 DOI: 10.1159/000409645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Ghielmini M, Vitolo U, Kimby E, Montoto S, Walewski J, Pfreundschuh M, Federico M, Hoskin P, McNamara C, Caligaris-Cappio F, Stilgenbauer S, Marcus R, Trneny M, Dreger P, Montserrat E, Dreyling M. ESMO Guidelines consensus conference on malignant lymphoma 2011 part 1: diffuse large B-cell lymphoma (DLBCL), follicular lymphoma (FL) and chronic lymphocytic leukemia (CLL). Ann Oncol 2013; 24:561-76. [PMID: 23175624 PMCID: PMC6267877 DOI: 10.1093/annonc/mds517] [Citation(s) in RCA: 166] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2012] [Revised: 08/26/2012] [Accepted: 08/29/2012] [Indexed: 12/29/2022] Open
Abstract
To complete the existing treatment guidelines for all tumor types, ESMO organizes consensus conferences to better clarify open issues in each disease. In this setting, a consensus conference on the management of lymphoma was held on 18 June 2011 in Lugano, immediately after the end of the 11th International Conference on Malignant Lymphoma. The consensus conference convened ∼45 experts from all around Europe and selected six lymphoma entities to be addressed; for each of them three to five open questions were to be discussed by the experts. For each question, a recommendation should be given by the panel, supported by the strength of the recommendation based on the level of evidence. This consensus report focuses on the three most common lymphoproliferative malignancies: diffuse large B-cell lymphoma, follicular lymphoma and chronic lymphocytic leukemia. A second report will concentrate on mantle cell lymphoma, marginal zone lymphoma and T-cell lymphomas.
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MESH Headings
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Combined Modality Therapy
- Disease Management
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell/immunology
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Leukemia, Lymphocytic, Chronic, B-Cell/therapy
- Lymphoma, Follicular/drug therapy
- Lymphoma, Follicular/pathology
- Lymphoma, Follicular/radiotherapy
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large B-Cell, Diffuse/pathology
- Neoplasm Staging
- Positron-Emission Tomography
- Practice Guidelines as Topic
- Stem Cell Transplantation
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Affiliation(s)
- M Ghielmini
- Department of Medical Oncology, Oncology Institute of Southern Switzerland, Ospedale San Giovanni, Bellinzona, Switzerland.
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Pospisilova S, Gonzalez D, Malcikova J, Trbusek M, Rossi D, Kater AP, Cymbalista F, Eichhorst B, Hallek M, Döhner H, Hillmen P, van Oers M, Gribben J, Ghia P, Montserrat E, Stilgenbauer S, Zenz T. ERIC recommendations on TP53 mutation analysis in chronic lymphocytic leukemia. Leukemia 2012; 26:1458-61. [PMID: 22297721 DOI: 10.1038/leu.2012.25] [Citation(s) in RCA: 149] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Recent evidence suggests that - in addition to 17p deletion - TP53 mutation is an independent prognostic factor in chronic lymphocytic leukemia (CLL). Data from retrospective analyses and prospective clinical trials show that ∼5% of untreated CLL patients with treatment indication have a TP53 mutation in the absence of 17p deletion. These patients have a poor response and reduced progression-free survival and overall survival with standard treatment approaches. These data suggest that TP53 mutation testing warrants integration into current diagnostic work up of patients with CLL. There are a number of assays to detect TP53 mutations, which have respective advantages and shortcomings. Direct Sanger sequencing of exons 4-9 can be recommended as a suitable test to identify TP53 mutations for centers with limited experience with alternative screening methods. Recommendations are provided on standard operating procedures, quality control, reporting and interpretation. Patients with treatment indications should be investigated for TP53 mutations in addition to the work-up recommended by the International workshop on CLL guidelines. Patients with TP53 mutation may be considered for allogeneic stem cell transplantation in first remission. Alemtuzumab-based regimens can yield a substantial proportion of complete responses, although of short duration. Ideally, patients should be treated within clinical trials exploring new therapeutic agents.
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Affiliation(s)
- S Pospisilova
- Central European Institute of Technology, Masaryk University, Czech Republic
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López-Guerra M, Xargay-Torrent S, Pérez-Galán P, Saborit-Villarroya I, Rosich L, Villamor N, Aymerich M, Roué G, Campo E, Montserrat E, Colomer D. Sorafenib targets BCR kinases and blocks migratory and microenvironmental survival signals in CLL cells. Leukemia 2011; 26:1429-32. [PMID: 22182921 DOI: 10.1038/leu.2011.364] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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Eichhorst B, Dreyling M, Robak T, Montserrat E, Hallek M. Chronic lymphocytic leukemia: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2011; 22 Suppl 6:vi50-4. [DOI: 10.1093/annonc/mdr377] [Citation(s) in RCA: 113] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Fernández de Larrea C, Martínez C, Gaya A, López-Guillermo A, Rovira M, Fernández-Avilés F, Lozano M, Bosch F, Esteve J, Nomdedeu B, Montserrat E, Carreras E. Salvage chemotherapy with alternating MINE–ESHAP regimen in relapsed or refractory Hodgkin’s lymphoma followed by autologous stem-cell transplantation. Ann Oncol 2010; 21:1211-1216. [DOI: 10.1093/annonc/mdp487] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Gine E, Martinez A, Villamor N, Lopez-Guillermo A, Camos M, Martinez D, Esteve J, Calvo X, Muntanola A, Abrisqueta P, Rozman M, Rozman C, Bosch F, Campo E, Montserrat E. Expanded and highly active proliferation centers identify a histological subtype of chronic lymphocytic leukemia ("accelerated" chronic lymphocytic leukemia) with aggressive clinical behavior. Haematologica 2010. [DOI: 10.3324/haematol.2009.022277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Enjuanes A, Benavente Y, Bosch F, Martin-Guerrero I, Colomer D, Perez-Alvarez S, Reina O, Ardanaz MT, Jares P, Garcia-Orad A, Pujana MA, Montserrat E, de Sanjose S, Campo E. Genetic Variants in Apoptosis and Immunoregulation-Related Genes Are Associated with Risk of Chronic Lymphocytic Leukemia. Cancer Res 2008; 68:10178-86. [DOI: 10.1158/0008-5472.can-08-2221] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Lenz G, Wright G, Dave SS, Xiao W, Powell J, Zhao H, Xu W, Tan B, Goldschmidt N, Iqbal J, Vose J, Bast M, Fu K, Weisenburger DD, Greiner TC, Armitage JO, Kyle A, May L, Gascoyne RD, Connors JM, Troen G, Holte H, Kvaloy S, Dierickx D, Verhoef G, Delabie J, Smeland EB, Jares P, Martinez A, Lopez-Guillermo A, Montserrat E, Campo E, Braziel RM, Miller TP, Rimsza LM, Cook JR, Pohlman B, Sweetenham J, Tubbs RR, Fisher RI, Hartmann E, Rosenwald A, Ott G, Muller-Hermelink HK, Wrench D, Lister TA, Jaffe ES, Wilson WH, Chan WC, Staudt LM. Stromal gene signatures in large-B-cell lymphomas. N Engl J Med 2008; 359:2313-23. [PMID: 19038878 PMCID: PMC9103713 DOI: 10.1056/nejmoa0802885] [Citation(s) in RCA: 1316] [Impact Index Per Article: 82.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND The addition of rituximab to combination chemotherapy with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP), or R-CHOP, has significantly improved the survival of patients with diffuse large-B-cell lymphoma. Whether gene-expression signatures correlate with survival after treatment of diffuse large-B-cell lymphoma is unclear. METHODS We profiled gene expression in pretreatment biopsy specimens from 181 patients with diffuse large-B-cell lymphoma who received CHOP and 233 patients with this disease who received R-CHOP. A multivariate gene-expression-based survival-predictor model derived from a training group was tested in a validation group. RESULTS A multivariate model created from three gene-expression signatures--termed "germinal-center B-cell," "stromal-1," and "stromal-2"--predicted survival both in patients who received CHOP and patients who received R-CHOP. The prognostically favorable stromal-1 signature reflected extracellular-matrix deposition and histiocytic infiltration. By contrast, the prognostically unfavorable stromal-2 signature reflected tumor blood-vessel density. CONCLUSIONS Survival after treatment of diffuse large-B-cell lymphoma is influenced by differences in immune cells, fibrosis, and angiogenesis in the tumor microenvironment.
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MESH Headings
- Antibodies, Monoclonal/administration & dosage
- Antibodies, Monoclonal, Murine-Derived
- Antineoplastic Combined Chemotherapy Protocols
- Cyclophosphamide
- Disease Progression
- Doxorubicin
- Extracellular Matrix/genetics
- Gene Expression
- Gene Expression Profiling
- Gene Expression Regulation, Neoplastic
- Genes, MHC Class II
- Germinal Center
- Humans
- Immunologic Factors/administration & dosage
- Kaplan-Meier Estimate
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large B-Cell, Diffuse/genetics
- Lymphoma, Large B-Cell, Diffuse/mortality
- Lymphoma, Large B-Cell, Diffuse/pathology
- Middle Aged
- Multivariate Analysis
- Neovascularization, Pathologic/genetics
- Prednisone
- Prognosis
- Rituximab
- Stromal Cells/metabolism
- Stromal Cells/pathology
- Vincristine
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Affiliation(s)
- G Lenz
- Metabolism Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
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Affiliation(s)
- E Montserrat
- Institute of Hematology and Oncology, Department of Hematology, Hospital Clinic, IDIBAPS, University of Barcelona, Barcelona, Spain
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Pérez-Galán P, Roué G, López-Guerra M, Nguyen M, Villamor N, Montserrat E, Shore GC, Campo E, Colomer D. BCL-2 phosphorylation modulates sensitivity to the BH3 mimetic GX15-070 (Obatoclax) and reduces its synergistic interaction with bortezomib in chronic lymphocytic leukemia cells. Leukemia 2008; 22:1712-20. [PMID: 18596739 DOI: 10.1038/leu.2008.175] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Chronic lymphocytic leukemia (CLL) is a B-cell lymphoid neoplasm with deregulated apoptosis and overexpression of several antiapoptotic BCL-2 proteins. GX15-070/Obatoclax is a small-molecule BH3 mimetic compound that has shown activity against several hematologic malignancies and solid tumors. In the present work, we report that GX15-070 led to the disruption of BCL-2/BIM and MCL-1/BAK complexes in CLL cells, followed by the activation of the mitochondrial apoptotic pathway. CLL cells showed lower sensitivity to GX15-070 than primary mantle cell lymphoma (MCL) ones, in correlation with higher levels of phosphorylated BCL-2 at serine 70 residue (pBCL-2(Ser70)) in CLL cells. Decrease in BCL-2 phosphorylation by extracellular signal-regulated kinase (ERK)1/2 inhibition increased CLL sensitivity to GX15-070, while blocking BCL-2 dephosphorylation using a PP2A antagonist reduced the activity of this BH3 mimetic. GX15-070 activity was increased by cotreatment with the proteasome inhibitor bortezomib. However, as proteasome inhibition led to the accumulation of phosphorylated BCL-2, the degree of interaction between GX15-070 and bortezomib was regulated by basal pBCL-2(Ser70) levels. These results support the role of BCL-2 phosphorylation as a mechanism of resistance to BH3 mimetic compounds, and demonstrate that combination approaches including ERK inhibitors could enhance BH3 mimetics activity both alone or in combination with proteasome inhibitors.
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Affiliation(s)
- P Pérez-Galán
- Department of Pathology, Hematopathology Unit, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain
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22
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23
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Montserrat E, Marques-Pereira JP, Rozman C, Ballesta AM, Aguilar JL, Elena M. Serum beta-2 microglobulin in chronic lymphocytic leukaemia. Clin Lab Haematol 2008; 4:323-5. [PMID: 6184192 DOI: 10.1111/j.1365-2257.1982.tb00083.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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24
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Fouillard L, Labopin M, Gratwohl A, Gluckman E, Frassoni F, Beelen DW, Willemze R, Montserrat E, Blaise D, Atienza AI, Sierra J, Santos M, Gorin NC, Rocha V. Results of syngeneic hematopoietic stem cell transplantation for acute leukemia: risk factors for outcomes of adults transplanted in first complete remission. Haematologica 2008; 93:834-41. [DOI: 10.3324/haematol.11277] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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25
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Brunet S, Esteve J, Nomdedéu J, Ribera JM, Llorente A, Duarte R, Tormo M, Guardia R, Montserrat E, Sierra J. Prognostic significance of mutations of nucleophosmin (NPM1) gene and internal tandem duplication of FLT3 gene (FLT3 ITD) in acute myeloid leukemia (AML) with normal karyotype. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.7024] [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: 11/20/2022] Open
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26
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Mercadal S, Briones J, Xicoy B, Pedro C, Escoda L, Estany C, Camós M, Colomo L, Espinosa I, Martínez S, Ribera JM, Martino R, Gutiérrez-García G, Montserrat E, López-Guillermo A. Intensive chemotherapy (high-dose CHOP/ESHAP regimen) followed by autologous stem-cell transplantation in previously untreated patients with peripheral T-cell lymphoma. Ann Oncol 2008; 19:958-63. [PMID: 18303032 DOI: 10.1093/annonc/mdn022] [Citation(s) in RCA: 158] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- S Mercadal
- Department of Hematology, Hospital Clínic, Villarroel 170, 08036 Barcelona, Spain
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27
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Montoto S, Moreno C, Domingo-Domenech E, Estany C, Oriol A, Altes A, Besalduch J, Pedro C, Gardella S, Escoda L, Asensio A, Vivancos P, Galan P, de Sevilla AF, Ribera JM, Briones J, Colomer D, Campo E, Montserrat E, Lopez-Guillermo A. High clinical and molecular response rates with fludarabine, cyclophosphamide and mitoxantrone in previously untreated patients with advanced stage follicular lymphoma. Haematologica 2008; 93:207-14. [DOI: 10.3324/haematol.11671] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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28
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Fernandez V, Jares P, Salaverria I, Gine E, Bea S, Aymerich M, Colomer D, Villamor N, Bosch F, Montserrat E, Campo E. Gene expression profile and genomic changes in disease progression of early-stage chronic lymphocytic leukemia. Haematologica 2008; 93:132-6. [DOI: 10.3324/haematol.11694] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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29
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Ferrer A, Bosch F, Villamor N, Rozman M, Graus F, Gutiérrez G, Mercadal S, Campo E, Rozman C, López-Guillermo A, Montserrat E. Central nervous system involvement in mantle cell lymphoma. Ann Oncol 2007; 19:135-41. [PMID: 17962207 DOI: 10.1093/annonc/mdm447] [Citation(s) in RCA: 82] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Extranodal involvement, including central nervous system (CNS), is a frequent event in patients with mantle cell lymphoma (MCL). However, the incidence, risk factors, and impact on outcome remain controversial. PATIENTS AND METHODS Main clinical, biological, and evolutive features of 82 patients (60 males/22 females; median age: 61 years) diagnosed with MCL (blastoid, 26%) in a single institution were analyzed for risk of CNS involvement and prognosis. RESULTS Most patients had advanced stage and intermediate or high-risk International Prognostic Index (IPI). Eleven patients eventually developed CNS involvement with an actuarial 5-year risk of 26% (95% confidence interval 10% to 42%). In one asymptomatic patient, cerebrospinal fluid infiltration was detected at staging maneuvers (1/62; 1.6%). The remaining 10 patients developed neurological symptoms during the course of the disease (median time from diagnosis, 25 months). Initial variables predicting CNS involvement were blastoid histology, high proliferative index measured by Ki-67 staining, high lactate dehydrogenase (LDH) and intermediate- or high-risk IPI. Histological subtype and serum LDH maintained significance in multivariate analysis. Treatment of CNS infiltration consisted of intrathecal chemotherapy (two cases), and intrathecal chemotherapy plus systemic treatment (seven cases). Median survival after CNS involvement was 4.8 months, patients with this complication having shorter survival than those with no CNS disease. CONCLUSION This study confirms the high incidence of CNS involvement in MCL patients. Treatments aimed at preventing this complication are warranted.
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Affiliation(s)
- A Ferrer
- Department of Hematology, Hospital Clínic, Postgraduate School of Hematology Farreras Valentí, Institut d'Investigacio Biomedica August Pi i Sunyer, Barcelona, Spain
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30
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Montserrat E. OP65 First line therapy for chronic lymphocytic leukemia. Leuk Res 2007. [DOI: 10.1016/s0145-2126(07)70345-4] [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: 11/27/2022]
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31
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Pavletic SZ, Zhou G, Sobocinski K, Marti G, Doney K, DiPersio J, Feremans W, Foroni L, Goodman S, Prentice G, LeMaistre C, Bandini G, Ferrant A, Jacobsen N, Khouri I, Gale RP, Wiestner A, Giralt S, Montserrat E, Chan WC, Bredeson C. Genetically identical twin transplantation for chronic lymphocytic leukemia. Leukemia 2007; 21:2452-5. [PMID: 17728782 DOI: 10.1038/sj.leu.2404928] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
We identified 19 persons with B-cell chronic lymphocytic leukemia (CLL) who received genetically identical twin blood cell or bone marrow transplants after high-dose conditioning. Ten are alive (eight disease-free) with a median follow-up of 89 months (range, 31-171 months); 5-year relapse rate was 50% (95% confidence interval (CI), 26-73%). Estimated 5-year survival and disease-free survival were 61% (95% CI, 37-82%) and 45% (95% CI, 23-68%). In two of four patients tested at 12 and 21 months by polymerase chain reaction no evidence of residual CLL was detected post-transplant. In one recipient who relapsed at 6 years, molecular studies showed a different CLL clone from that detected pretransplant. This clone was subsequently identified in the donor suggesting transfer of occult leukemia at the time of transplant. Genetically identical twin transplants can result in long-term disease-free survival and molecular remissions, these data suggest the potential for CLL control in the absence of allogeneic graft-versus-leukemia effect. The case of leukemia transfer indicates the need for careful evaluation of donors prior to graft collection.
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MESH Headings
- Adult
- Aged
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Biomarkers, Tumor/analysis
- Biomarkers, Tumor/genetics
- Bone Marrow Transplantation/adverse effects
- Bone Marrow Transplantation/statistics & numerical data
- Combined Modality Therapy
- Disease-Free Survival
- Diseases in Twins/genetics
- Female
- Follow-Up Studies
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/surgery
- Male
- Middle Aged
- Neoplastic Stem Cells/transplantation
- Peripheral Blood Stem Cell Transplantation/adverse effects
- Peripheral Blood Stem Cell Transplantation/statistics & numerical data
- Postoperative Complications/mortality
- Recurrence
- Remission Induction
- Retrospective Studies
- Survival Rate
- Transplantation Conditioning
- Transplantation, Homologous/adverse effects
- Transplantation, Homologous/statistics & numerical data
- Twins, Monozygotic/genetics
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Affiliation(s)
- S Z Pavletic
- National Cancer Institute, Center for Cancer Research, National Institutes of Health, Bethesda, MD 20892-1203, USA.
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32
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Rawstron AC, Villamor N, Ritgen M, Böttcher S, Ghia P, Zehnder JL, Lozanski G, Colomer D, Moreno C, Geuna M, Evans PAS, Natkunam Y, Coutre SE, Avery ED, Rassenti LZ, Kipps TJ, Caligaris-Cappio F, Kneba M, Byrd JC, Hallek MJ, Montserrat E, Hillmen P. International standardized approach for flow cytometric residual disease monitoring in chronic lymphocytic leukaemia. Leukemia 2007; 21:956-64. [PMID: 17361231 DOI: 10.1038/sj.leu.2404584] [Citation(s) in RCA: 300] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The eradication of minimal residual disease (MRD) in chronic lymphocytic leukaemia (CLL) predicts for improved outcome. However, the wide variety of MRD techniques makes it difficult to interpret and compare different clinical trials. Our aim was to develop a standardized flow cytometric CLL-MRD assay and compare it to real-time quantitative allele-specific oligonucleotide (RQ-ASO) Immunoglobulin heavy chain gene (IgH) polymerase chain reaction (PCR). Analysis of 728 paired blood and marrow samples demonstrated high concordance (87%) for patients off-therapy. Blood analysis was equally or more sensitive than marrow in 92% of samples but marrow analysis was necessary to detect MRD within 3 months of alemtuzumab therapy. Assessment of 50 CLL-specific antibody combinations identified three (CD5/CD19 with CD20/CD38, CD81/CD22 and CD79b/CD43) with low inter-laboratory variation and false-detection rates. Experienced operators demonstrated an accuracy of 95.7% (specificity 98.8%, sensitivity 91.1%) in 141 samples with 0.01-0.1% CLL. There was close correlation and 95% concordance with RQ-ASO IgH-PCR for detection of CLL above 0.01%. The proposed flow cytometry approach is applicable to all sample types and therapeutic regimes, and sufficiently rapid and sensitive to guide therapy to an MRD-negativity in real time. These techniques may be used as a tool for assessing response and comparing the efficacy of different therapeutic approaches.
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Dreger P, Corradini P, Kimby E, Michallet M, Milligan D, Schetelig J, Wiktor-Jedrzejczak W, Niederwieser D, Hallek M, Montserrat E. Indications for allogeneic stem cell transplantation in chronic lymphocytic leukemia: the EBMT transplant consensus. Leukemia 2006; 21:12-7. [PMID: 17109028 DOI: 10.1038/sj.leu.2404441] [Citation(s) in RCA: 257] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The aim of this project was to identify situations where allogeneic stem cell transplantation (allo-SCT) might be considered as a preferred treatment option for patients with B-cell chronic lymphocytic leukemia (CLL). Based on a MEDLINE search and additional sources, a consented proposal was drafted, refined and approved upon final discussion by an international expert panel. Key elements of the consensus are (1) allo-SCT is a procedure with evidence-based efficacy in poor-risk CLL; (2) although definition of 'poor-risk CLL' requires further investigation, allo-SCT is a reasonable treatment option for younger patients with (i) non-response or early relapse (within 12 months) after purine analogues, (ii) relapse within 24 months after having achieved a response with purine-analogue-based combination therapy or autologous transplantation, and (iii) patients with p53 abnormalities requiring treatment; and (3) optimum transplant strategies may vary according to distinct clinical situations and should be defined in prospective trials. This is the first attempt to define standard indications for allo-SCT in CLL. Nevertheless, whenever possible, allo-SCT should be performed within disease-specific prospective clinical protocols in order to continuously refine transplant indications according to new developments in risk assessment and treatment of CLL.
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Affiliation(s)
- P Dreger
- Department of Medicine V, University of Heidelberg, Heidelberg, Germany.
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34
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Giné E, Montoto S, Bosch F, Arenillas L, Mercadal S, Villamor N, Martínez A, Colomo L, Campo E, Montserrat E, López-Guillermo A. The Follicular Lymphoma International Prognostic Index (FLIPI) and the histological subtype are the most important factors to predict histological transformation in follicular lymphoma. Ann Oncol 2006; 17:1539-45. [PMID: 16940035 DOI: 10.1093/annonc/mdl162] [Citation(s) in RCA: 94] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Histological transformation (HT) is a well-known event in patients with follicular lymphoma (FL) conferring an unfavorable prognosis. The aim of the study was to analyze incidence and risk factors for HT in a large series of FL patients. PATIENTS AND METHODS 276 patients (median age: 54 years; M139/F137) diagnosed with FL (42% grade 1, 51% 2, 7% 3) in a single institution were studied. Initial treatment consisted of combined chemotherapy in most cases. Median survival was 11.3 years. Main clinic and biological variables were assessed for HT and survival. RESULTS 30 of 276 patients (11%) presented HT after a median follow-up of 6.5 years, with a risk of 15% and 22% at 10 and at 15 years, respectively. All HT corresponded to diffuse large B-cell lymphoma (DLBCL). Grade 3 histology, nodal areas >4, increased LDH and beta(2)-microglobulin, and high-risk IPI and FLIPI were associated with HT. In multivariate analysis, grade 3 histology and FLIPI retained prognostic significance. Only FLIPI predicted HT in grade 1-2 patients. 28 patients received salvage treatment for HT, with a CR rate of 52%. Median survival from transformation was 1.2 years, with 6/13 CR patients being alive >5 years after HT. CONCLUSION FLIPI and histology were the most important variables predicting HT. Upon HT, only patients achieving CR reached prolonged survival, thus emphasizing the need for effective therapies once this event occurs.
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Affiliation(s)
- E Giné
- Institute of Hematology and Oncology, Department of Hematology and Hematopathology Unit, Hospital Clínic, IDIBAPS, Barcelona, Spain
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35
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Talarn C, Urbano-Ispizua A, Martino R, Batlle M, Fernández-Avilés F, Herrera C, Pérez-Simón JA, Gaya A, Aymerich M, Pétriz J, Marín P, Sierra J, Montserrat E. G-CSF increases the number of peripheral blood dendritic cells CD16+ and modifies the expression of the costimulatory molecule CD86+. Bone Marrow Transplant 2006; 37:873-9. [PMID: 16547488 DOI: 10.1038/sj.bmt.1705345] [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] [Indexed: 11/08/2022]
Abstract
Dendritic cells (DC) play a key role in initiating immune reactions after allogeneic stem cell transplantation. The two main peripheral blood DC populations are myeloid (DC1) and lymphoplasmacytoid (DC2). A new subset of myeloid DC, expressing CD16, has been identified. We analyzed the number and CD86 expression of DC subsets in peripheral blood of 18 healthy donors, before and after granulocyte colony-stimulating factor (G-CSF) and in the inoculum of allogeneic peripheral blood transplants (allo-PBT; n=100) and allogeneic bone marrow transplants (allo-BMT; n=22). Granulocyte colony-stimulating factor administration increased the median number of DC1 (P=0.0007), of DC2 (P<0.0001) and of DC CD16+ (P=0.0001). Granulocyte colony-stimulating factor administration was also associated with a significant decrease of CD86 expression on DC1 (P=0.0003) and with a trend for an increase on DC CD16+ (P=0.07). Recipients of allo-PBT received similar quantities of DC1 and higher doses of DC2 and DC CD16+ than recipients of allo-BMT (P=0.5; P=0.0001; P<0.0001, respectively). Granulocyte colony-stimulating factor modifies the number of DC in peripheral blood and the expression of the costimulatory molecule CD86. This resulted in a different composition of DC2 and especially of DC CD16+ in the harvests, which might explain some of the differences observed in allogeneic reactions after allo-PBT with respect to allo-BMT.
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Affiliation(s)
- C Talarn
- Department of Hematology, Institute of Hematology and Oncology, Hospital Clínic, Barcelona, Spain
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36
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Cervantes F, Alvarez-Larrán A, Arellano-Rodrigo E, Granell M, Domingo A, Montserrat E. Frequency and risk factors for thrombosis in idiopathic myelofibrosis: analysis in a series of 155 patients from a single institution. Leukemia 2005; 20:55-60. [PMID: 16307011 DOI: 10.1038/sj.leu.2404048] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Thrombosis is a frequent complication of polycythemia vera and essential thrombocythemia, but its incidence and predisposing factors in idiopathic myelofibrosis (IM) are unknown. In 18 (11.6%) of 155 patients diagnosed with IM in a single institution, 31 thrombotic events (19 arterial, 12 venous) were registered after a mean follow-up of 4.2 (s.d.: 4.5) years. In six patients, the thrombosis was simultaneous to or appeared a few months before IM diagnosis and 14 had one or more thrombotic episodes. When compared with the general population, a significant increase was observed in the incidence of venous thrombosis (odds ratio 17.5, 95% confidence interval: 10.3-31.4). At multivariate analysis, the initial variables associated with an increased risk of thrombosis were thrombocytosis (platelets >450 x 10(9)/l, P=0.001), presence of one cardiovascular risk factor (arterial hypertension, smoking, hypercholesterolemia, or diabetes, P=0.003), cellular phase of myelofibrosis (P=0.005), and Hb >11 g/dl (P=0.02). Considering post-diagnosis events, the 5-year thrombosis-free survival probability was 90.4% in the series, 80.6% for patients with platelets >450 x 10(9)/l, 82.6% for patients with one cardiovascular risk factor, and 85.1% for those in cellular phase. These results indicate an increased thrombotic risk for IM patients with hyperproliferative features and/or coexistent cardiovascular risk factors.
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Affiliation(s)
- F Cervantes
- Hematology Department, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona, Spain.
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37
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Perea G, Altés A, Montoto S, López-Guillermo A, Domingo-Doménech E, Fernández-Sevilla A, Ribera JM, Grau J, Pedro C, Angel Hernández J, Estany C, Briones J, Martino R, Sureda A, Sierra J, Montserrat E. Prognostic indexes in follicular lymphoma: a comparison of different prognostic systems. Ann Oncol 2005; 16:1508-13. [PMID: 15939718 DOI: 10.1093/annonc/mdi269] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The International Prognostic Index (IPI), initially designed for aggressive lymphomas, is also used in follicular lymphoma (FL) and other indolent lymphomas. Two new prognostic indexes have recently been proposed for FL [the Italian Lymphoma Intergroup (ILI) Index and the Follicular Lymphoma International Prognostic Index (FLIPI)]. PATIENTS AND METHODS Three indexes, IPI [age >60 years, extranodal involvement two or more sites, elevated lactate dehydrogenase (LDH), Eastern Cooperative Oncology Group performance status > or =2, stage > or =3], ILI (age >60 years, extranodal involvement two or more sites, elevated LDH, male sex, B symptoms, erythrocyte sedimentation rate > or =30 mm first hour) and FLIPI (age >60 years, stage > or =3, elevated LDH, nodal involvement five or more, haemoglobin level < or =12 g/dl) were calculated in 411 patients with FL. RESULTS Overall concordance between the three indexes was 54%. A total of 126 (31%) patients were included in the high-risk group according to IPI, 131 (32%) according to ILI and 157 (38%) after FLIPI application. Ten-year overall survival rates after applying the prognostic indexes (IPI, ILI and FLIPI) were, respectively: 72%, 71% and 72%, in the low-risk group; 51%, 60% and 49% in the intermediate-risk group; and 24%, 16% and 31% in the high-risk group. CONCLUSIONS In this series, all three indexes, IPI, ILI and FLIPI, were useful to classify FL patients into differentiated risk groups, although the FLIPI identified a larger proportion of high-risk patients than the IPI and ILI.
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Affiliation(s)
- G Perea
- Clinical Hematology Division, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, Spain.
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Monill J, Pernas J, Montserrat E, Pérez C, Clavero J, Martinez-Noguera A, Guerrero R, Torrubia S. CT features of abdominal plasma cell neoplasms. Eur Radiol 2005; 15:1705-12. [PMID: 16034641 DOI: 10.1007/s00330-005-2642-z] [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: 06/16/2004] [Revised: 12/09/2004] [Accepted: 12/20/2004] [Indexed: 11/29/2022]
Abstract
The aim of this study was to describe the CT features of abdominal plasma cell neoplasms. We reviewed CT imaging findings in 11 patients (seven men, four women; mean age 62 years) with plasma cell neoplasms and abdominal involvement. Helical CT of the entire abdomen and pelvis was performed following intravenous administration of contrast material. Images were analyzed in consensus by two radiologists. Diagnoses were made from biopsy, surgery and/or clinical follow-up findings. Multiple myeloma was found in seven patients and extramedullary plasmacytoma in four patients. All patients with multiple myeloma had multifocal disease with involvement of perirenal space (4/7), retroperitoneal and pelvic lymph nodes (3/7), peritoneum (3/7), liver (2/7), subcutaneous tissues (2/7) and kidney (1/7). In three of the four patients with extramedullary plasmacytoma, a single site was involved, namely stomach, vagina and retroperitoneum. In the fourth patient, a double site of abdominal involvement was observed with rectal and jejunal masses. Plasma cell neoplasm should be considered in the differential diagnosis of single or multiple enhancing masses in the abdomen or pelvis. Abdominal plasma cell neoplasms were most frequently seen as well-defined enhancing masses (10/11).
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Affiliation(s)
- J Monill
- Hospital de Sant Pau, Universitat Autonoma de Barcelona, Avda. Sant Antoni M. Claret 167, 08025, Barcelona, Spain.
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Montoto S, López-Guillermo A, Altés A, Perea G, Ferrer A, Camós M, Villela L, Bosch F, Esteve J, Cervantes F, Bladé J, Nomdedeu B, Campo E, Sierra J, Montserrat E. Predictive value of Follicular Lymphoma International Prognostic Index (FLIPI) in patients with follicular lymphoma at first progression. Ann Oncol 2005; 15:1484-9. [PMID: 15367408 DOI: 10.1093/annonc/mdh406] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Different prognostic scores have been proposed to predict the outcome of follicular lymphoma (FL) patients at diagnosis. A new prognostic index specifically addressing FL patients, the Follicular Lymphoma International Prognostic Index (FLIPI), has recently been developed, which might also be useful in patients with progression. PATIENTS AND METHODS One hundred and three patients (55 male, 48 female; median age 59 years) with FL in first relapse/progression after an initial response to therapy (50 complete responders/ 53 partial responders) were included in the study. RESULTS Five-year survival from progression (SFP) was 55% (95% confidence interval 44%-66%). The distribution according to the FLIPI at relapse was 39% good prognosis, 24% intermediate prognosis and 37% poor prognosis. Five-year SFP for these groups were 85%, 79% and 28%, respectively (P < 0.0001). Other variables at relapse with prognostic significance for SFP were age, presence of B symptoms, performance status, bulky disease, number of involved nodal sites, lactate dehydrogenase level, hemoglobin level, histological transformation, the Italian Lymphoma Intergroup prognostic index for FL and the International Prognostic Index for aggressive lymphomas. In the multivariate analysis bulky disease (P=0.01), presence of B symptoms (P=0.03) and FLIPI at relapse (P=0.0003) were the most important variables for predicting SFP. CONCLUSIONS In patients with FL at first relapse/progression, the FLIPI, along with the presence of bulky disease and B symptoms, are features that predict SFP and thus could be useful to select candidates for experimental treatments.
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Affiliation(s)
- S Montoto
- Department of Hematology and Hematopathology Unit, Hospital Clínic, IDIBAPS, Barcelona
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40
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Cobol F, Sierra E, Rozman M, Arellano E, Carrio A, Costa D, Valera S, Quinto L, Campo E, Montserrat E, Nomdedeu B. P-32 Reclassification of FAB chronic myelomonocytic leukemia (CMML) according to the World Health Organization (WHO) criteria: An analysis of 41 patients from a single institution. Leuk Res 2005. [DOI: 10.1016/s0145-2126(05)80096-7] [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: 10/25/2022]
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41
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Cobol F, Madrigal I, Rozman M, Costa D, Carrio A, Arellano E, Valera S, Aguilar J, Montserrat E, Campo E, Nomdedeu B. P-31 3q Cytogenetic aberrations in a series of 223 myelodysplastic syndrome (MDS)/chronic myelomonocytic leukemia (CMML) patients from a single institution. Leuk Res 2005. [DOI: 10.1016/s0145-2126(05)80095-5] [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: 10/25/2022]
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42
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Molina-Arcas M, Marcé S, Villamor N, Huber-Ruano I, Casado FJ, Bellosillo B, Montserrat E, Gil J, Colomer D, Pastor-Anglada M. Equilibrative nucleoside transporter-2 (hENT2) protein expression correlates with ex vivo sensitivity to fludarabine in chronic lymphocytic leukemia (CLL) cells. Leukemia 2004; 19:64-8. [PMID: 15510196 DOI: 10.1038/sj.leu.2403582] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Fludarabine is considered the treatment of choice for most patients with chronic lymphocytic leukemia (CLL). We have analyzed the role of plasma membrane transporters in nucleoside-derived drug bioavailability and action in CLL cells. Among the known plasma membrane transporters, we have previously observed a significant correlation between fludarabine uptake via ENT carriers and ex vivo sensitivity of CLL cells to fludarabine, although mRNA amounts of the equilibrative nucleoside transporters hENT1 and hENT2 do not show any predictive response to treatment. In this study, using polyclonal monospecific antibodies we have observed a significant correlation between the expression of hENT2 by Western blot and fludarabine uptake via hENT carriers and also with ex vivo sensitivity of CLL cells to fludarabine. These results suggest that the equilibrative nucleoside transporter hENT2 plays a role in fludarabine responsiveness in CLL patients.
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Affiliation(s)
- M Molina-Arcas
- Departament de Bioquímica i Biologia Molecular, Universitat de Barcelona, E-08028 Barcelona, Spain
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Montserrat E. Assessing prognosis in patients with chronic lymphocytic leukemia a quarter of a century after Rai and Binet staging systems. Ann Oncol 2004; 15:1450-1. [PMID: 15367402 DOI: 10.1093/annonc/mdh408] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
MESH Headings
- Biomarkers, Tumor/analysis
- DNA, Neoplasm/analysis
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell/classification
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Leukemia, Lymphocytic, Chronic, B-Cell/physiopathology
- Neoplasm Staging/methods
- Patient Care Planning
- Polymerase Chain Reaction
- Prognosis
- Survival Analysis
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Nadal E, Giné E, Bladé J, Esteve J, Rosiñol L, Fernández-Avilés F, Marin P, Martinez C, Rovira M, Urbano-Ispizua A, Carreras E, Montserrat E. High-dose therapy/autologous stem cell transplantation in patients with chemosensitive multiple myeloma: predictors of complete remission. Bone Marrow Transplant 2004; 33:61-4. [PMID: 14704657 DOI: 10.1038/sj.bmt.1704313] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.1] [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: 11/09/2022]
Abstract
High-dose therapy (HDT) followed by autologous stem cell support is widely used as intensification treatment in patients with multiple myeloma (MM) responsive to the initial chemotherapy. However, there is growing evidence that only the subset of patients who achieve complete remission (CR) actually benefit from this approach. The aim of this study was to identify pretransplant predictors of CR in responding myeloma patients intensified with HDT. A total of 59 patients with chemosensitive disease received myeloablative therapy. The intensification regimen consisted of MEL-200 (23), MEL-140/TBI 12 Gy (21) or busulfan-based regimens (15). Serum and urine negative immunofixation were required for CR. After HDT, the CR rate increased from 8 to 37%. For the overall series, the median event-free survival (EFS) and overall survival (OS) from the initiation of therapy were 41 and 68 months, respectively. Patients who achieved CR had an EFS (median 47 vs 36 months; P=0.023) as well as an OS (median not reached vs 60 months; P=0.006) significantly longer than those attaining a lower degree of response. Finally, the pretransplant features significantly associated to CR were a low M-protein size (serum </=10 g/l and urine <0.5 g/24 h) (P=0.0003) and a proportion of bone marrow plasma cells of </=5% (P=0.02).
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Affiliation(s)
- E Nadal
- Hematology Department, BMT Section, Institute of Hemato-Oncology, Hospital Clínic, IDIBAPS, Barcelona, Spain
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45
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Rosiñol L, Bladé J, Esteve J, Aymerich M, Rozman M, Montoto S, Giné E, Nadal E, Filella X, Queralt R, Carrió A, Montserrat E. Smoldering multiple myeloma: natural history and recognition of an evolving type. Br J Haematol 2003; 123:631-6. [PMID: 14616966 DOI: 10.1046/j.1365-2141.2003.04654.x] [Citation(s) in RCA: 101] [Impact Index Per Article: 4.8] [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]
Abstract
Patients with smoldering multiple myeloma (SMM) meet the diagnostic criteria of multiple myeloma (MM) but are asymptomatic. Between January 1978 and July 2001, 53 patients (median age 63 years) were diagnosed with SMM. The median serum M-protein and proportion of bone marrow plasma cells were 36 g/l and 27% respectively. Two subsets of SMM were identified: (i) evolving SMM (n = 22), characterized by a progressive increase in serum M-protein, a previously recognized monoclonal gammopathy of undetermined significance (MGUS) and a significant higher proportion of IgA type and (ii) non-evolving SMM (n = 26) with stable M-protein that abruptly increases when symptomatic MM develops. Thirty-four patients developed symptomatic MM. The median time to progression in the overall series was 3.2 years and the only feature associated with a shorter time to progression was the evolving versus non-evolving type (1.3 vs. 3.9 years respectively, P = 0.007). The pattern of progression consisted of anaemia, lytic bone lesions or both, without renal failure, hypercalcaemia or extramedullary plasmacytomas. Fifty-seven per cent of patients that required chemotherapy showed no or minimal response. The median survival from diagnosis and from progression was 8.2 and 3.5 years respectively.
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Affiliation(s)
- L Rosiñol
- Hematology Department, Institut Clínic de Malalties Hemato-Oncològiques, Hospital Clínic, University of Barcelona, Barcelona, Spain
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46
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Giné E, Rovira M, Real I, Burrel M, Montaña J, Carreras E, Montserrat E. Successful treatment of severe hemorrhagic cystitis after hemopoietic cell transplantation by selective embolization of the vesical arteries. Bone Marrow Transplant 2003; 31:923-5. [PMID: 12748670 DOI: 10.1038/sj.bmt.1703954] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Hemorrhagic cystitis (HC) is a common and sometimes life-threatening complication of hemopoietic cell transplantation (HCT) occurring in 7-52% of transplant recipients. In this setting it is usually either related to the use of cyclophosphamide or to a viral infection (BK, JC viruses and adenovirus type 11). Treatment is based on hyperhydration, platelet and blood-cell transfusions, bladder irrigation and pain management. Where these measures have failed to control HC, numerous therapeutic approaches including surgery have been tried with poor success. We report two HCT patients with severe HC successfully treated with selective embolization of the vesical arteries.
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Affiliation(s)
- E Giné
- BMT Unit, Hematology Department, Institute of Hematology and Oncology, Postgraduate School of Hematology, Spain
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47
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Montoto S, Rozman M, Rosiñol L, Nadal E, Giné E, Aymerich M, Ferrer A, Esteve J, Bosch F, López-Guillermo A, Bladé J, Montserrat E. Malignant transformation in IgM monoclonal gammopathy of undetermined significance. Semin Oncol 2003; 30:178-81. [PMID: 12720132 DOI: 10.1053/sonc.2003.50067] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Monoclonal gammopathy of undetermined significance (MGUS) is a frequent disorder characterized by the presence of a small serum M-protein in individuals with no evidence of multiple myeloma (MM), Waldenstrom's macroglobulinemia (WM), or primary amyloidosis (AL). Although one fourth of these individuals will develop a malignant disease, there are no well-established predictors of outcome, particularly in the IgM type MGUS. Among 434 patients diagnosed with MGUS from 1970 to 2001 with a minimum follow-up of 1 year, 52 (27 men and 25 women; median age, 67 years) of IgM type were identified. After a median follow-up of 5 years, five patients (9.6%) have developed WM. The risk of transformation was 13.3% (95% confidence interval [CI], 0 to 27) and 27.7% (95% CI, 0.3 to 55.1) at 10 and 20 years, respectively. The variables significantly associated with transformation were the proportion of bone marrow plasma cells (BMPC) and the percentage of bone marrow lymphocytes (BML). No significant differences in the risk of transformation were found between IgM MGUS and the remaining MGUS types. Thus, in IgM MGUS the rate of transformation was similar to the risk observed in other MGUS types, the percentage of BMPC and BML being the features significantly associated with evolution into WM.
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Affiliation(s)
- S Montoto
- Institute of Hematology and Oncology, Postgraduate School of Hematology Farreras-Valentí, Department of Hematology and Hematopathology Unit, IDIBAPS, Hospital Clínic, Barcelona, Spain
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48
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Fernández-Avilés F, Urbano-Ispizua A, Aymerich M, Colomer D, Rovira M, Martínez C, Nadal E, Talarn C, Carreras E, Montserrat E. Serial quantification of lymphoid and myeloid mixed chimerism using multiplex PCR amplification of short tandem repeat-markers predicts graft rejection and relapse, respectively, after allogeneic transplantation of CD34+ selected cells from peripheral blood. Leukemia 2003; 17:613-20. [PMID: 12646952 DOI: 10.1038/sj.leu.2402854] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We used multiplex amplification of nine microsatellite sequences (PCR-STR) to analyse chimerism in pure populations of T cells and neutrophils from peripheral blood from 40 patients submitted to an allogeneic transplant, 22 having received a T-cell depleted (TCD) peripheral blood graft by means of CD34(+) selection (allo-PBT/CD34(+)), and 18, an unmodified graft (allo-SCT; 13 allogeneic bone marrow transplants and five allo-PBT). T-cell mixed chimerism (TcMC) was observed in 16 of the 22 (72.3%) patients receiving an allo-PBT/CD34(+), but in only one of the 18 (5.5%) patients receiving an allo-SCT (P=0.0001). TcMC was transient (n=6), stable (n=7), and associated with poor haematopoietic engraftment (n=4). All patients with TcMC who developed graft failure had more than 30% of host T cells. Myeloid MC (MyMC) was observed in four (19%) allo-PBT/CD34(+) patients and in three (17%) allo-SCT patients (P=NS). Five out of seven (71%) patients with MyMC relapsed, all of them diagnosed with myeloid malignancies, as compared with two of the 20 (10%) patients with complete donor chimerism (P&<0.0001). In conclusion, TcMC appears in a significant number of allo-PBT/CD34(+) patients and may be associated with poor engraftment when the percentage of host T cells is >30%; likewise, MyMC appears in a small percentage of recipients of both allo-PBT/CD34(+) and allo-SCT patients, and is associated with leukaemia relapse in myeloid malignancies.
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Affiliation(s)
- F Fernández-Avilés
- Institute of Haematology and Oncology, Hospital Clínic of Barcelona, University of Bacelona, Spain
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Carreras E, Saiz A, Marin P, Martinez C, Rovira M, Villamor N, Aymerich M, Lozano M, Fernandez-Aviles F, Urbano-Ispizua A, Montserrat E, Graus F. 147CD34+ selected autologous peripheral blood stem cell transplantation for multiple sclerosis (MS): Report of toxicity and treatment results at one year of follow-up in 15 patients. Biol Blood Marrow Transplant 2003. [DOI: 10.1016/s1083-8791(03)80148-9] [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: 10/24/2022]
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50
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Cibeira MT, Lopez-Guillermo A, Colomer D, Ricart MJ, Alcaraz A, Martinez A, Campo E, Montserrat E. Diffuse large B-cell lymphoma arising from donor lymphoid cells after renal and pancreatic transplantation. Ann Hematol 2003; 82:131-135. [PMID: 12601496 DOI: 10.1007/s00277-002-0591-z] [Citation(s) in RCA: 3] [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] [Received: 04/14/2002] [Accepted: 11/06/2002] [Indexed: 11/28/2022]
Abstract
A patient with both a renal and pancreatic transplantation developed a diffuse large B-cell lymphoma, Epstein-Barr virus-related, 14 months after the surgical procedure. Tumor was confined to the transplanted organs: head of the pancreas and hilar lymph node of the transplanted kidney. Chimerism analysis demonstrated the tumor origin from donor lymphoid cells. Immunosuppression was discontinued and chemotherapy with cyclophosphamide, hydroxydaunomycin, vincristine, and prednisone (CHOP) was started. However, no response was observed after three courses of this regimen. Finally, a transplantectomy was carried out, followed by rituximab (anti-CD20 antibody), with the patient achieving a complete response (CR). Two years later the patient remains in CR.
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Affiliation(s)
- M T Cibeira
- Department of Hematology, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Villarroel 170, 08036, Barcelona, Spain
| | - A Lopez-Guillermo
- Department of Hematology, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Villarroel 170, 08036, Barcelona, Spain.
| | - D Colomer
- Hematopathology Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Barcelona, Spain
| | - M J Ricart
- Department of Urology, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Villarroel 170, 08036, Barcelona, Spain
| | - A Alcaraz
- Department of Urology, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Villarroel 170, 08036, Barcelona, Spain
| | - A Martinez
- Hematopathology Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Barcelona, Spain
| | - E Campo
- Hematopathology Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Barcelona, Spain
| | - E Montserrat
- Department of Hematology, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Villarroel 170, 08036, Barcelona, Spain
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