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Ferdinandus J, Müller H, Damaschin C, Jacob AS, Meissner J, Krasniqi F, Mey U, Schöndube D, Thiemer J, Mathas S, Zijlstra J, Greil R, Feuring-Buske M, Markova J, Rüffer JU, Kobe C, Eich HT, Baues C, Fuchs M, Borchmann P, Behringer K. Impact of individualized treatment on recovery from fatigue and return to work in survivors of advanced-stage Hodgkin's lymphoma: results from the randomized international GHSG HD18 trial. Ann Oncol 2024; 35:276-284. [PMID: 38061428 DOI: 10.1016/j.annonc.2023.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 11/01/2023] [Accepted: 11/29/2023] [Indexed: 01/21/2024] Open
Abstract
BACKGROUND Persisting cancer-related fatigue impairs health-related quality of life (HRQoL) and social reintegration in patients with Hodgkin's lymphoma (HL). The GHSG HD18 trial established treatment de-escalation for advanced-stage HL guided by positron emission tomography after two cycles (PET-2) as new standard. Here, we investigate the impact of treatment de-escalation on long-term HRQoL, time to recovery from fatigue (TTR-F), and time to return to work (TTR-W). PATIENTS AND METHODS Patients received European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30) and life situation questionnaires at baseline, interim, end of treatment, and yearly follow-up. TTR-F was defined as time from the end of chemotherapy until the first fatigue score <30. TTR-W was analyzed in previously working or studying patients and measured from the end of treatment until the first documented work or education. We compared duration of treatment on TTR-F and TTR-W using Cox proportional hazards regression adjusted for confounding variables. RESULTS HRQoL questionnaires at baseline were available in 1632 (83.9%) of all randomized patients. Overall, higher baseline fatigue and age were significantly associated with longer TTR-F and TTR-W and male sex with shorter TTR-W. Treatment reduction from eight to four chemotherapy cycles led to a significantly shorter TTR-F [hazard ratio (HR) 1.41, P = 0.008] and descriptively shorter TTR-W (HR 1.24, P = 0.084) in PET-2-negative patients. Reduction from six to four cycles led to non-significant but plausible intermediate accelerations. The addition of rituximab caused significantly slower TTR-F (HR 0.70, P = 0.0163) and TTR-W (HR 0.64, P = 0.0017) in PET-2-positive patients. HRQoL at baseline and age were the main determinants of 2-year HRQoL. CONCLUSIONS Individualized first-line treatment in patients with advanced-stage HL considerably shortens TTR-F and TTR-W in PET-2-negative patients. Our results support the use of response-adapted shortened treatment duration for patients with HL.
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Affiliation(s)
- J Ferdinandus
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Medical Faculty and University Hospital Cologne, Cologne; German Hodgkin Study Group (GHSG), Cologne.
| | - H Müller
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Medical Faculty and University Hospital Cologne, Cologne; German Hodgkin Study Group (GHSG), Cologne
| | - C Damaschin
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Medical Faculty and University Hospital Cologne, Cologne; German Hodgkin Study Group (GHSG), Cologne
| | - A S Jacob
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Medical Faculty and University Hospital Cologne, Cologne; German Hodgkin Study Group (GHSG), Cologne
| | - J Meissner
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany
| | - F Krasniqi
- Medical Oncology, University Hospital of Basel, Basel; Swiss Group for Clinical Cancer Research, Bern
| | - U Mey
- Swiss Group for Clinical Cancer Research, Bern; Oncology and Hematology, Kantonsspital Graubuenden, Chur, Switzerland
| | - D Schöndube
- Department of Oncology and Hematology, Helios Klinikum Bad Saarow, Bad Saarow
| | - J Thiemer
- Department of Hematology and Oncology, Klinikum der Philipps-Universität Marburg, Marburg
| | - S Mathas
- Charité-Universitätsmedizin Berlin, Hematology, Oncology and Tumor Immunology, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin; Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association (MDC), Group Biology of Malignant Lymphomas, Berlin; Experimental and Clinical Research Center (ECRC), a cooperation between the MDC and the Charité, Berlin, Germany
| | - J Zijlstra
- Department of Hematology, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - R Greil
- Illrd Medical Department, Paracelsus Medical University, Salzburg; Salzburg Cancer Research Institute and AGMT, Salzburg, Austria
| | - M Feuring-Buske
- Department of Internal Medicine III, University Hospital of Ulm, Ulm, Germany
| | - J Markova
- Department of Internal Medicine-Hematology, University Hospital Kralovske Vinohrady, Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | | | - C Kobe
- German Hodgkin Study Group (GHSG), Cologne; Department of Nuclear Medicine, University Hospital of Cologne, Cologne
| | - H-T Eich
- German Hodgkin Study Group (GHSG), Cologne; Department of Radiotherapy, University Hospital of Muenster, Muenster
| | - C Baues
- German Hodgkin Study Group (GHSG), Cologne; Department of Radiooncology, Marienhospital Herne, Ruhr University Bochum, Bochum, Germany
| | - M Fuchs
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Medical Faculty and University Hospital Cologne, Cologne; German Hodgkin Study Group (GHSG), Cologne
| | - P Borchmann
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Medical Faculty and University Hospital Cologne, Cologne; German Hodgkin Study Group (GHSG), Cologne
| | - K Behringer
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Medical Faculty and University Hospital Cologne, Cologne; German Hodgkin Study Group (GHSG), Cologne
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Digklia A, Kollár A, Dietrich D, Kronig MN, Britschgi C, Rordorf T, Joerger M, Krasniqi F, Metaxas Y, Colombo I, Ribi K, Rothermundt C. SAKK57/16 Nab-paclitaxel and Gemcitabine in Soft Tissue Sarcoma (NAPAGE): a phase I/II trial. Eur J Cancer 2024; 197:113470. [PMID: 38096656 DOI: 10.1016/j.ejca.2023.113470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 11/27/2023] [Accepted: 11/29/2023] [Indexed: 01/02/2024]
Abstract
BACKGROUND To determine whether the combination of nab-paclitaxel with gemcitabine has activity in patients with pretreated soft tissue sarcoma (STS). PATIENTS AND METHODS NAPAGE is a phase Ib/II clinical trial investigating the combination of nab-paclitaxel (nab-pc) with gemcitabine employing two cohorts. One of a dose-de-escalation phase and one of expansion. In phase I, nab-pc was given at 150 mg/m2 in combination with gemcitabine 1000 mg/m2 every two weeks, until disease progression or unacceptable toxicity. This dose was recommended for phase II (RP2D), as there was no dose limiting toxicity (DLT) or discontinuations due to adverse events (AEs). The primary endpoint of the phase II was progression-free rate (PFR) at 3 months (H0: 20%, H1:40%). The secondary endpoints included progression free survival (PFS), overall survival (OS), AEs, objective response and patient-reported outcomes (PRO). Efficacy analysis was by intention to treat. RESULTS The 3-month PFR was 56.4% (95% confidence interval CI: 39.6-72.2%). The 3-month and 6-month PFS were 58.4% (95% CI: 41.3-72.1%) and 44.6% (95% CI: 28.4-59.5%), respectively. Median PFS was 5.3 months (95% CI: 1.4-8.2) and median OS was 12.8 months (95% CI: 10.5-39.2). The most common treatment-related grade ≥ 3 AE were neutropenia (18%), followed by anemia (2.6%), hypertension (2.6%) and alanine aminotransferase increase (2.6%). Grade 1 and grade 2 peripheral sensory neuropathy (PNP) occurred in 15.4% and 20.5%, respectively. No grade 3-4 PNP was reported. CONCLUSIONS Combining nab-pc and gemcitabine is safe. Promising activity is observed in pretreated STS patients with manageable toxicity. This regimen should be considered for further exploration.
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Affiliation(s)
- A Digklia
- Department of Oncology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland.
| | - A Kollár
- Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - D Dietrich
- Swiss Group for Clinical Cancer Research (SAKK) Competence Center, Bern, Switzerland
| | - M N Kronig
- Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - C Britschgi
- Department of Medical Oncology and Hematology, University Hospital Zurich, Zurich, Switzerland
| | - T Rordorf
- Department of Medical Oncology and Hematology, University Hospital Zurich, Zurich, Switzerland
| | - M Joerger
- Department of Medical Oncology and Hematology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - F Krasniqi
- Department of Medical Oncology, University Hospital of Basel, Basel, Switzerland
| | - Y Metaxas
- Department of Medical Oncology, Cantonal Hospital, Grison Chur, Switzerland, now at Cantonal Hospital Muensterlingen, Muensterlingen, Switzerland
| | - I Colombo
- Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
| | - K Ribi
- International Breast Cancer Study Group IBCSG (IBCSG), Bern, Switzerland
| | - C Rothermundt
- Department of Medical Oncology and Hematology, Kantonsspital St. Gallen, St. Gallen, Switzerland
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3
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Digklia A, Kollar A, Kronig MN, Britschgi C, Rordorf T, Joerger M, Krasniqi F, Metaxas Y, Colombo I, Dietrich D, Chiquet S, Ribi K, Rothermundt C. 1495P SAKK 57/16 nab-paclitaxel and gemcitabine in soft tissue sarcoma (NAPAGE): Final results from the phase Ib/II trial with >2y median follow up. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1598] [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: 11/17/2022] Open
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4
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Fehr M, Lang N, Rubio L, Güsewell S, Templeton A, Aeppli S, Tsang R, Hodgson D, Moccia A, Bargetzi M, Caspar C, Brülisauer DMA, Ebnöther M, Fischer N, Prica A, Kukreti V, Ghilardi G, Krasniqi F, Mey UJ, Mingrone W, Novak U, Richter P, Kridel R, Rodin D, Rütti M, Schmidt A, Stenner F, Voegeli M, Zander T, Crump M, Hitz F, Kuruvilla J. PROGNOSTIC FACTORS IN ELDERLY PATIENTS WITH CLASSICAL HODGKIN LYMPHOMA ‐ A JOINT ANALYSIS OF TWO CLINICAL DATABASES. Hematol Oncol 2021. [DOI: 10.1002/hon.113_2880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- M Fehr
- Cantonal Hospital St. Gallen, Medical Oncology and Haematology St. Gallen Switzerland
| | - N Lang
- Hôpitaux Universitaires Genève, Department of Oncology Genève Switzerland
| | - L Rubio
- Manchester Royal Infirmary, Haematology Manchester UK
| | - S Güsewell
- Cantonal Hospital St. Gallen, Clinical Trials Unit St. Gallen Switzerland
| | - A.J. Templeton
- Claraspital Basel, Oncology and Haematology Basel Switzerland
| | - S Aeppli
- Cantonal Hospital St. Gallen, Medical Oncology and Haematology St. Gallen Switzerland
| | - R Tsang
- Princess Margaret Cancer Centre, Medical Oncology and Haematology Toronto Canada
| | - D Hodgson
- Princess Margaret Cancer Centre, Medical Oncology and Haematology Toronto Canada
| | - A Moccia
- Oncology Institute of Southern Switzerland, Department of Medical Oncology Bellinzona Switzerland
| | - M Bargetzi
- Cantonal Hospital Aarau, Haematology Aarau Switzerland
| | - C Caspar
- Cantonal Hospital Baden, Oncology und Haematology Baden Switzerland
| | | | - M Ebnöther
- Claraspital Basel, Oncology and Haematology Basel Switzerland
| | - N Fischer
- Cantonal Hospital Winterthur, Medical Oncology and Haematology Winterthur Switzerland
| | - A Prica
- Princess Margaret Cancer Centre, Medical Oncology and Haematology Toronto Canada
| | - V Kukreti
- Princess Margaret Cancer Centre, Medical Oncology and Haematology Toronto Canada
| | - G Ghilardi
- Oncology Institute of Southern Switzerland, Haematology Bellinzona Switzerland
| | - F Krasniqi
- University Hospital Basel, Oncology Basel Switzerland
| | - U. J Mey
- Cantonal Hospital Grisons, Oncology and Haematology Chur Switzerland
| | - W Mingrone
- Cantonal Hospital Olten, Centre for Oncology Olten Switzerland
| | - U Novak
- University Hospital Bern, Medical Oncology Bern Switzerland
| | - P Richter
- Cantonal Hospital Grisons, Oncology and Haematology Chur Switzerland
| | - R Kridel
- Princess Margaret Cancer Centre, Medical Oncology and Haematology Toronto Canada
| | - D Rodin
- Princess Margaret Cancer Centre, Radiation Oncology Toronto Switzerland
| | - M Rütti
- Hospital Wil, Medicine Wil Switzerland
| | - A Schmidt
- Stadtspital Triemli, Medical Oncology und Haematology Zürich Switzerland
| | | | - M Voegeli
- Cantonal Hospital Baselland, Oncology and Haematology Liestal Switzerland
| | - T Zander
- Cantonal Hospital Luzern, Medical Oncology Luzern Switzerland
| | - M Crump
- Princess Margaret Cancer Centre, Medical Oncology and Haematology Toronto Canada
| | - F Hitz
- Cantonal Hospital St. Gallen, Medical Oncology and Haematology St. Gallen Switzerland
| | - J Kuruvilla
- Princess Margaret Cancer Centre, Medical Oncology and Haematology Toronto Canada
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5
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Moccia AA, Aeppli S, Güsewell S, Bargetzi M, Caspar C, Brülisauer D, Ebnöther M, Fehr M, Fischer N, Ghilardi G, Krasniqi F, Lang N, Mey U, Mingrone W, Novak U, Pfleger C, Richter P, Rütti M, Schmidt A, Stenner F, Voegeli M, Zander T, Zucca E, Hitz F. Clinical characteristics and outcome of patients over 60 years with Hodgkin lymphoma treated in Switzerland. Hematol Oncol 2020; 39:196-204. [PMID: 33300135 DOI: 10.1002/hon.2830] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 12/06/2020] [Indexed: 11/09/2022]
Abstract
Hodgkin lymphoma (HL) in older patients appears to be a different disease compared with younger patients with historically lower survival rates. This is related to a variety of factors, including increased treatment-related toxicity, the presence of comorbidities, and biologic differences. In order to better assess the clinical characteristics, treatment strategies, and outcome of this particular population, we conducted a population-based, retrospective analysis including 269 patients with HL older than 60 years (median age 71 years, range 60-94), treated between 2000 and 2017 in 15 referral centers across Switzerland. Primary endpoints were overall survival (OS), progression-free survival (PFS), and cause-specific survival (CSS). The vast majority of patients were treated with curative intent, either with a combined modality approach (chemotherapy followed by radiation therapy) or with systemic therapy. At a median follow-up of 6.6 years (95% confidence interval [CI], 6.0-7.6), 5-year PFS was 52.2% (95% CI, 46.0-59.2), 5-year OS was 62.5% (95% CI, 56.4-69.2), and 5-year CSS was 85.1.8% (95% CI, 80.3-90.1) for the entire cohort. A significant difference in terms of CSS was observed for patients older than 71 years in comparison to patients aged 60-70 years (hazard ratio 2.6, 1.3-5.0, p = 0.005). Bleomycin-induced lung toxicity (BLT) was documented in 26 patients (17.7%) out of the 147 patients exposed to this compound and was more frequent in patients older than 71 years (15/60, 25%). Outcome of HL pts older than 71 years appeared to decrease substantially in comparison to the younger counterpart. Treatment-related toxicities appeared to be relevant, in particular, BLT. New, potentially less toxic strategies need to be investigated in prospective clinical trials in this particular frail population.
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Affiliation(s)
- A A Moccia
- Medical Oncology Clinic, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - S Aeppli
- Medical Oncology and Hematology Clinic, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - S Güsewell
- Clinical Trials Unit, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - M Bargetzi
- Hematology, Kantonsspital Aarau, Aarau, Switzerland
| | - C Caspar
- Medical Oncology and Hematology, Kantonsspital Baden, Baden, Switzerland
| | - D Brülisauer
- Medical Oncology Clinic, Inselspital, University Hospital of Bern, Bern, Switzerland
| | - M Ebnöther
- Medical Oncology and Hematology, Claraspital, Basel, Switzerland
| | - M Fehr
- Medical Oncology and Hematology Clinic, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - N Fischer
- Medical Oncology and Hematology Clinic, Kantonsspital Winterthur, Winterthur, Switzerland
| | - G Ghilardi
- Hematology Clinic, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - F Krasniqi
- Medical Oncology Clinic, University Hospital of Basel, Basel, Switzerland
| | - N Lang
- Medical Oncology Clinic, University Hospital of Geneva, Genève, Switzerland
| | - U Mey
- Medical Oncology and Hematology, Kantonsspital Graubünden, Chur, Switzerland
| | - W Mingrone
- Medical Oncology Clinic, Kantonsspital Olten, Olten, Switzerland
| | - U Novak
- Medical Oncology Clinic, Inselspital, University Hospital of Bern, Bern, Switzerland
| | - C Pfleger
- Medical Oncology and Hematology, Claraspital, Basel, Switzerland
| | - P Richter
- Medical Oncology and Hematology, Kantonsspital Graubünden, Chur, Switzerland
| | - M Rütti
- Internal Medicine Clinic, Spital Wil, Wil, Switzerland
| | - A Schmidt
- Medical Oncology and Hematology Clinic, Stadtspital Triemli, Zürich, Switzerland
| | - F Stenner
- Medical Oncology Clinic, University Hospital of Basel, Basel, Switzerland
| | - M Voegeli
- Medical Oncology and Hematology Clinic, Kantonsspital Baselland, Liestal, Switzerland
| | - T Zander
- Medical Oncology, Luzerner Kantonsspital, Luzern, Switzerland
| | - E Zucca
- Medical Oncology Clinic, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - F Hitz
- Medical Oncology and Hematology Clinic, Kantonsspital St. Gallen, St. Gallen, Switzerland
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Digklia A, Britschgi C, Metaxas Y, Kollar A, Krasniqi F, Stathis A, Rordorf T, Colombo I, Mach N, Hofer S, Montemurro M, Stojcheva N, Dietrich D, Rothermundt C. SAKK 57/16 nab-paclitaxel and gemcitabine in soft tissue sarcoma (NAPAGE): Results from the phase I part of a phase I/II trial. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz283.021] [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: 11/12/2022] Open
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7
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Stathis A, Mey U, Schär S, Hitz F, Pott C, Mach N, Krasniqi F, Novak U, Schmidt C, Hohloch K, Kienle D, Hess D, Moccia A, Unterhalt M, Eckhardt K, Hayoz S, Rossi D, Dirnhofer S, Ceriani L, Bertoni F, Buske C, Zucca E, Hiddemann W. SAKK 35/15: A PHASE I TRIAL OF OBINUTUZUMAB IN COMBINATION WITH VENETOCLAX IN PREVIOUSLY UNTREATED FOLLICULAR LYMPHOMA PATIENTS. Hematol Oncol 2019. [DOI: 10.1002/hon.78_2629] [Citation(s) in RCA: 2] [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: 11/08/2022]
Affiliation(s)
- A. Stathis
- Medical Oncology; Oncology Institute of Southern Switzerland; Bellinzona Switzerland
| | - U. Mey
- Oncology and Hematology; Kantonsspital Graubuenden; Chur Switzerland
| | - S. Schär
- Coordinating Center; SAKK; Bern Switzerland
| | - F. Hitz
- Oncology/Hematology; Kantonsspital St.Gallen; St.Gallen Switzerland
| | - C. Pott
- Medizinischen Klinik II Hämatologie und Internistische Onkologie; Universitätsklinikum Schleswig-Holstein; Campus Kiel Kiel Germany
| | - N. Mach
- Service d'Oncologie; Département d'Oncologie, Hôpitaux Universitaires de Genève; Genève Switzerland
| | - F. Krasniqi
- Medical Oncology; University Hospital of Basel; Basel Switzerland
| | - U. Novak
- Department of Medical Oncology; Inselspital / Bern University Hospital; Bern Switzerland
| | - C. Schmidt
- Department of Medicine III; University of Munich; Munich Germany
| | - K. Hohloch
- Oncology and Hematology; Kantonsspital Graubuenden; Chur Switzerland
| | - D. Kienle
- Oncology and Hematology; Kantonsspital Graubuenden; Chur Switzerland
| | - D. Hess
- Oncology/Hematology; Kantonsspital St.Gallen; St.Gallen Switzerland
| | - A. Moccia
- Medical Oncology; Oncology Institute of Southern Switzerland; Bellinzona Switzerland
| | - M. Unterhalt
- Department of Medicine III; University of Munich; Munich Germany
| | | | - S. Hayoz
- Coordinating Center; SAKK; Bern Switzerland
| | - D. Rossi
- Laboratory of Experimental Hematology; Institute of Oncology Research; Bellinzona Switzerland
| | - S. Dirnhofer
- Pathologie; Universitätsspital Basel; Basel Switzerland
| | - L. Ceriani
- Nuclear Medicine and PET-CT centre; Imaging Institute of Southern Switzerland; Bellinzona Switzerland
| | - F. Bertoni
- Lymphoma Genomics; Institute of Oncology Research; Bellinzona Switzerland
| | - C. Buske
- CCC Ulm; University Hospital Ulm; Ulm Germany
| | - E. Zucca
- Medical Oncology; Oncology Institute of Southern Switzerland; Bellinzona Switzerland
| | - W. Hiddemann
- Department of Medicine III; University of Munich; Munich Germany
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8
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Gorkhover T, Adolph M, Rupp D, Schorb S, Epp SW, Erk B, Foucar L, Hartmann R, Kimmel N, Kühnel KU, Rolles D, Rudek B, Rudenko A, Andritschke R, Aquila A, Bozek JD, Coppola N, Erke T, Filsinger F, Gorke H, Graafsma H, Gumprecht L, Hauser G, Herrmann S, Hirsemann H, Hömke A, Holl P, Kaiser C, Krasniqi F, Meyer JH, Matysek M, Messerschmidt M, Miessner D, Nilsson B, Pietschner D, Potdevin G, Reich C, Schaller G, Schmidt C, Schopper F, Schröter CD, Schulz J, Soltau H, Weidenspointner G, Schlichting I, Strüder L, Ullrich J, Möller T, Bostedt C. Nanoplasma dynamics of single large xenon clusters irradiated with superintense x-ray pulses from the linac coherent light source free-electron laser. Phys Rev Lett 2012; 108:245005. [PMID: 23004284 DOI: 10.1103/physrevlett.108.245005] [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] [Subscribe] [Scholar Register] [Received: 02/13/2012] [Indexed: 05/09/2023]
Abstract
The plasma dynamics of single mesoscopic Xe particles irradiated with intense femtosecond x-ray pulses exceeding 10(16) W/cm2 from the Linac Coherent Light Source free-electron laser are investigated. Simultaneous recording of diffraction patterns and ion spectra allows eliminating the influence of the laser focal volume intensity and particle size distribution. The data show that for clusters illuminated with intense x-ray pulses, highly charged ionization fragments in a narrow distribution are created and that the nanoplasma recombination is efficiently suppressed.
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Affiliation(s)
- T Gorkhover
- Institut für Optik und Atomare Physik, Technische Universität Berlin, Hardenbergstr. 36, 10623 Berlin, Germany
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9
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Rajkovic I, Busse G, Hallmann J, Moré R, Petri M, Quevedo W, Krasniqi F, Rudenko A, Tschentscher T, Stojanovic N, Düsterer S, Treusch R, Tolkiehn M, Techert S. Diffraction properties of periodic lattices under free electron laser radiation. Phys Rev Lett 2010; 104:125503. [PMID: 20366545 DOI: 10.1103/physrevlett.104.125503] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2009] [Indexed: 05/29/2023]
Abstract
In this Letter, we report the pioneering use of free electron laser radiation for the investigation of periodic crystalline structures. The diffraction properties of silver behenate single nanocrystals (5.8 nm periodicity) with the dimensions of 20 nm x 20 nm x 20 microm and as powder with grain sizes smaller than 200 nm were investigated with 8 nm free electron laser radiation in single-shot modus with 30 fs long free electron laser pulses. This work emphasizes the possibility of using soft x-ray free electron laser radiation for these crystallographic studies on a nanometer scale.
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Affiliation(s)
- I Rajkovic
- Max Planck Institute for Biophysical Chemistry, 37070 Goettingen, Germany
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Beaud P, Johnson SL, Streun A, Abela R, Abramsohn D, Grolimund D, Krasniqi F, Schmidt T, Schlott V, Ingold G. Spatiotemporal stability of a femtosecond hard-x-ray undulator source studied by control of coherent optical phonons. Phys Rev Lett 2007; 99:174801. [PMID: 17995338 DOI: 10.1103/physrevlett.99.174801] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2007] [Indexed: 05/09/2023]
Abstract
We report on the temporal and spatial stability of the first tunable femtosecond undulator hard-x-ray source for ultrafast diffraction and absorption experiments. The 2.5-1 Angstrom output radiation is driven by an initial 50 fs laser pulse employing the laser-electron slicing technique. By using x-ray diffraction to probe laser-induced coherent optical phonons in bulk bismuth, we estimate an x-ray pulse duration of 140+/-30 fs FWHM with timing drifts below 30 fs rms measured over 5 days. Optical control of coherent lattice motion is demonstrated.
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Affiliation(s)
- P Beaud
- Paul Scherrer Institut, CH-5232 Villigen PSI, Switzerland.
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Krasniqi F, Ho A, Egerer G. P728 Initial experience with ertapenem in clinical practice: treatment of twenty patients with chemotherapy-induced low-risk febrile neutropenia in an outpatient setting. Int J Antimicrob Agents 2007. [DOI: 10.1016/s0924-8579(07)70569-1] [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: 11/17/2022]
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Hensel M, Krasniqi F, Villalobos M, Kornacker M, Ho AD. Pentostatin, cyclophosphamide and rituximab is an active regimen with low toxicity for previously treated patients with B-cell chronic lymphocytic leukemia and Waldenström's macroglobulinemia. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.6557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- M. Hensel
- University of Heidelberg, Heidelberg, Germany
| | - F. Krasniqi
- University of Heidelberg, Heidelberg, Germany
| | | | | | - A. D. Ho
- University of Heidelberg, Heidelberg, Germany
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Leo E, Krämer A, Hochhaus A, Krasniqi F, Hehlmann R, Ho AD. Gangrene of the toes in a patient with chronic myelogenous leukemia after long-term hydroxyurea therapy. Ann Hematol 2002; 81:467-9. [PMID: 12224005 DOI: 10.1007/s00277-002-0505-0] [Citation(s) in RCA: 5] [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: 09/24/2001] [Accepted: 06/26/2002] [Indexed: 11/30/2022]
Abstract
Gangrene of the toes and digits appears to be a rare but very severe complication of long-term hydroxyurea therapy. Nothing is known regarding the pathophysiology and the type of vascular damage leading to this syndrome. Here we report a case of a 49-year-old male presenting with gangrene of the toes of both feet 4.5 years after initiation of hydroxyurea therapy for chronic myelogenous leukemia. Blisters on the toes occurred for the first time 9 months prior to hospitalization. Successively, all ten toes showed signs of beginning gangrene with one toe removed surgically 8 months before admission. Presence of diabetes mellitus or peripheral angiopathy was ruled out and platelet counts were within the physiologic range during the last years, excluding thrombocythemia as another rare cause for gangrene in patients with myeloproliferative diseases. Whereas perimalleolar ulcerations of the legs are a more common complication of hydroxyurea, gangrene of the toes as a consequence of hydroxyurea treatment has been described previously only once in the literature. At this point in time cessation of hydroxyurea treatment appears to be the only therapeutic option, thereby avoiding further progress of gangrene in patients with chronic myelogenous leukemia treated with hydroxyurea.
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Affiliation(s)
- E Leo
- Universitätsklinikum Heidelberg, Abteilung für Hämatologie, Onkologie und Rheumatologie, Hospitalstr. 3, 69115 Heidelberg, Germany.
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Abstract
The feasibility and efficacy of a combination of thalidomide, cyclophosphamide, etoposide, and dexamethasone were studied in 56 patients with poor-prognosis multiple myeloma. Of 50 patients evaluable for response, 4% achieved complete response (CR), 64% partial response (PR), 18% minimal response (MR), 6% stable disease (SD), and 8% progressive disease (PD), resulting in an objective response rate (> or = MR) of 86.0% (76.7% overall objective response rate in intent-to-treat analysis; n = 56). Subsequent to successful remission induction, 18 patients received autologous or allogeneic stem cell transplantation. The median progression-free survival in all patients was 16 months. The median overall survival time could not be calculated, since the last observed death occurred after 16 months of follow-up (median follow-up of 14 months) with a corresponding estimated survival probability of 55%. Severe adverse effects (World Health Organization III/IV) included infectious complications (35.7%) and cardiovascular events (7.1%). The data suggest that Thal improves antitumor activity of salvage chemotherapy regimens in poor-prognosis multiple myeloma.
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Affiliation(s)
- T M Moehler
- University of Heidelberg, Department of Hematology/Oncology/ Rheumatology, Germany.
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