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Hontecillas-Prieto L, García-Domínguez DJ, Palazón-Carrión N, Martín García-Sancho A, Nogales-Fernández E, Jiménez-Cortegana C, Sánchez-León ML, Silva-Romeiro S, Flores-Campos R, Carnicero-González F, Ríos-Herranz E, de la Cruz-Vicente F, Rodríguez-García G, Fernández-Álvarez R, Martínez-Banaclocha N, Gumà-Padrò J, Gómez-Codina J, Salar-Silvestre A, Rodríguez-Abreu D, Gálvez-Carvajal L, Labrador J, Guirado-Risueño M, Provencio-Pulla M, Sánchez-Beato M, Marylene L, Álvaro-Naranjo T, Casanova-Espinosa M, Rueda-Domínguez A, Sánchez-Margalet V, de la Cruz-Merino L. CD8+ NKs as a potential biomarker of complete response and survival with lenalidomide plus R-GDP in the R2-GDP-GOTEL trial in recurrent/refractory diffuse large B cell lymphoma. Front Immunol 2024; 15:1293931. [PMID: 38469299 PMCID: PMC10926187 DOI: 10.3389/fimmu.2024.1293931] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 02/12/2024] [Indexed: 03/13/2024] Open
Abstract
Background Diffuse large B cell lymphoma (DLBCL) is the most common non-Hodgkin lymphoma worldwide. DLBCL is an aggressive disease that can be cured with upfront standard chemoimmunotherapy schedules. However, in approximately 35-40% of the patients DLBCL relapses, and therefore, especially in this setting, the search for new prognostic and predictive biomarkers is an urgent need. Natural killer (NK) are effector cells characterized by playing an important role in antitumor immunity due to their cytotoxic capacity and a subset of circulating NK that express CD8 have a higher cytotoxic function. In this substudy of the R2-GDP-GOTEL trial, we have evaluated blood CD8+ NK cells as a predictor of treatment response and survival in relapsed/refractory (R/R) DLBCL patients. Methods 78 patients received the R2-GDP schedule in the phase II trial. Blood samples were analyzed by flow cytometry. Statistical analyses were carried out in order to identify the prognostic potential of CD8+ NKs at baseline in R/R DLBCL patients. Results Our results showed that the number of circulating CD8+ NKs in R/R DLBCL patients were lower than in healthy donors, and it did not change during and after treatment. Nevertheless, the level of blood CD8+ NKs at baseline was associated with complete responses in patients with R/R DLBCL. In addition, we also demonstrated that CD8+ NKs levels have potential prognostic value in terms of overall survival in R/R DLBCL patients. Conclusion CD8+ NKs represent a new biomarker with prediction and prognosis potential to be considered in the clinical management of patients with R/R DLBCL. Clinical trial registration https://www.clinicaltrialsregister.eu/ctr-search/search?query=2014-001620-29 EudraCT, ID:2014-001620-29.
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Affiliation(s)
- Lourdes Hontecillas-Prieto
- Clinical Biochemistry Service, Virgen Macarena University Hospital, University of Seville, Seville, Spain
- Department of Medical Biochemistry and Molecular Biology and Immunology, Medical School, Virgen Macarena University Hospital, University of Seville, Seville, Spain
- Institute of Biomedicine of Seville, Virgen Macarena University Hospital, CSIC, University of Seville, Seville, Spain
- Clinical Oncology Service, Hospital Universitario Virgen Macarena, University of Seville, Seville, Spain
| | - Daniel J. García-Domínguez
- Department of Medical Biochemistry and Molecular Biology and Immunology, Medical School, Virgen Macarena University Hospital, University of Seville, Seville, Spain
- Institute of Biomedicine of Seville, Virgen Macarena University Hospital, CSIC, University of Seville, Seville, Spain
| | - Natalia Palazón-Carrión
- Clinical Oncology Service, Hospital Universitario Virgen Macarena, University of Seville, Seville, Spain
- Department of Medicine, University of Seville, Seville, Spain
| | - Alejandro Martín García-Sancho
- Department of Hematology, Hospital Universitario de Salamanca, IBSAL, CIBERONC, University of Salamanca, Salamanca, Spain
| | - Esteban Nogales-Fernández
- Clinical Oncology Service, Hospital Universitario Virgen Macarena, University of Seville, Seville, Spain
- Department of Medicine, University of Seville, Seville, Spain
| | - Carlos Jiménez-Cortegana
- Department of Medical Biochemistry and Molecular Biology and Immunology, Medical School, Virgen Macarena University Hospital, University of Seville, Seville, Spain
| | - María L. Sánchez-León
- Clinical Oncology Service, Hospital Universitario Virgen Macarena, University of Seville, Seville, Spain
| | - Silvia Silva-Romeiro
- Clinical Oncology Service, Hospital Universitario Virgen Macarena, University of Seville, Seville, Spain
| | - Rocío Flores-Campos
- Clinical Oncology Service, Hospital Universitario Virgen Macarena, University of Seville, Seville, Spain
| | | | | | | | | | | | - Natividad Martínez-Banaclocha
- Oncology Dept., Dr. Balmis General University Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Josep Gumà-Padrò
- Department of Clinical Oncology, Hospital Universitari Sant Joan de Reus URV, IISPV, Reus, Spain
| | - José Gómez-Codina
- Department of Clinical Oncology, Hospital Universitario La Fé, Valencia, Spain
| | | | - Delvys Rodríguez-Abreu
- Department of Clinical Oncology, Hospital Universitario Insular, Las Palmas de Gran Canaria, Spain
| | - Laura Gálvez-Carvajal
- Department of Medical Oncology Intercenter Unit, Regional and Virgen de la Victoria University Hospitals, IBIMA, Málaga, Spain
| | - Jorge Labrador
- Department of Hematology, Research Unit, Hospital Universitario de Burgos, Burgos, Spain
| | - María Guirado-Risueño
- Department of Clinical Oncology, Hospital General Universitario de Elche, Elche, Spain
| | - Mariano Provencio-Pulla
- Department of Medical Oncology, Hospital Universitario Puerta de Hierro-Majadahonda, Facultad de Medicina, Universidad Autónoma de Madrid, IDIPHISA, Madrid, Spain
| | - Margarita Sánchez-Beato
- Department of Medical Oncology, Lymphoma Research Group, Hospital Universitario Puerta de Hierro-Majadahonda, IDIPHISA, CIBERONC, Madrid, Spain
| | - Lejeune Marylene
- Department of Pathology, Plataforma de Estudios Histológicos, Citológicos y de Digitalización, Hospital de Tortosa Verge de la Cinta, IISPV, URV, Tortosa, Tarragona, Spain
| | - Tomás Álvaro-Naranjo
- Department of Pathology, Hospital de Tortosa Verge de la Cinta, Catalan Institute of Health, Institut d’Investigació Sanitària Pere Virgili (IISPV), Tortosa, Tarragona, Spain
| | | | | | - Víctor Sánchez-Margalet
- Clinical Biochemistry Service, Virgen Macarena University Hospital, University of Seville, Seville, Spain
- Department of Medical Biochemistry and Molecular Biology and Immunology, Medical School, Virgen Macarena University Hospital, University of Seville, Seville, Spain
- Institute of Biomedicine of Seville, Virgen Macarena University Hospital, CSIC, University of Seville, Seville, Spain
| | - Luis de la Cruz-Merino
- Institute of Biomedicine of Seville, Virgen Macarena University Hospital, CSIC, University of Seville, Seville, Spain
- Clinical Oncology Service, Hospital Universitario Virgen Macarena, University of Seville, Seville, Spain
- Department of Medicine, University of Seville, Seville, Spain
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Palazón-Carrión N, Martín García-Sancho A, Nogales-Fernández E, Jiménez-Cortegana C, Carnicero-González F, Ríos-Herranz E, de la Cruz-Vicente F, Rodríguez-García G, Fernández-Álvarez R, Martínez-Banaclocha N, Gumà-Padrò J, Gómez-Codina J, Salar-Silvestre A, Rodríguez-Abreu D, Gálvez-Carvajal L, Labrador J, Guirado-Risueño M, García-Domínguez DJ, Hontecillas-Prieto L, Espejo-García P, Fernández-Román I, Provencio-Pulla M, Sánchez-Beato M, Navarro M, Marylene L, Álvaro-Naranjo T, Casanova-Espinosa M, Sánchez-Margalet V, Rueda-Domínguez A, de la Cruz-Merino L. Lenalidomide plus R-GDP (R2-GDP) in Relapsed/Refractory Diffuse Large B-Cell Lymphoma: Final Results of the R2-GDP-GOTEL Trial and Immune Biomarker Subanalysis. Clin Cancer Res 2022; 28:3658-3668. [PMID: 35727601 PMCID: PMC9433956 DOI: 10.1158/1078-0432.ccr-22-0588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 05/06/2022] [Accepted: 06/17/2022] [Indexed: 01/07/2023]
Abstract
PURPOSE New therapeutic options are needed in relapsed/refractory diffuse large B-cell lymphoma (R/R DLBCL). Lenalidomide-based schedules can reverse rituximab refractoriness in lymphoma. PATIENTS AND METHODS In the phase II R2-GDP trial, 78 patients unsuitable for autologous stem cell transplant received treatment with the following schedule: lenalidomide 10 mg Days (D)1-14, rituximab 375 mg/m2 D1, cisplatin 60 mg/m2 D1, gemcitabine 750 mg/m2 D1 and D8, and dexamethasone 20 mg D1-3, up to 6 cycles (induction phase), followed by lenalidomide 10 mg (or last lenalidomide dose received) D1-21 every 28 days (maintenance phase). Primary endpoint was overall response rate (ORR). Secondary endpoints included progression-free survival (PFS), overall survival (OS), safety, and monitorization of key circulating immune biomarkers (EU Clinical Trials Register number: EudraCT 2014-001620-29). RESULTS After a median follow-up of 37 months, ORR was 60.2% [37.1% complete responses (CR) and 23.1% partial responses (PR)]. Median OS was 12 months (47 vs. 6 months in CR vs. no CR); median PFS was 9 months (34 vs. 5 months in CR vs. no CR). In the primary refractory population, ORR was 45.5% (21.2% CR and 24.3% PR). Most common grade 3-4 adverse events were thrombocytopenia (60.2%), neutropenia (60.2%), anemia (26.9%), infections (15.3%), and febrile neutropenia (14.1%). Complete responses were associated with a sharp decrease in circulating myeloid-derived suppressor cells and regulatory T cells. CONCLUSIONS R2-GDP schedule is feasible and highly active in R/R DLBCL, including the primary refractory population. Immune biomarkers showed differences in responders versus progressors.
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Affiliation(s)
- Natalia Palazón-Carrión
- Department of Clinical Oncology, Hospital Universitario Virgen Macarena, University of Seville, Seville, Spain.,Department of Medicine, University of Seville, Seville, Spain
| | | | - Esteban Nogales-Fernández
- Department of Clinical Oncology, Hospital Universitario Virgen Macarena, University of Seville, Seville, Spain.,Department of Medicine, University of Seville, Seville, Spain
| | - Carlos Jiménez-Cortegana
- Department of Medical Biochemistry and Molecular Biology and Immunology, Medical School, Hospital Universitario Virgen Macarena, Seville, Spain
| | | | | | | | | | | | | | - Josep Gumà-Padrò
- Department of Clinical Oncology, Hospital Universitari Sant Joan de Reus URV, IISPV, Reus, Spain
| | - José Gómez-Codina
- Department of Clinical Oncology, Hospital Universitario La Fé, Valencia, Spain
| | | | - Delvys Rodríguez-Abreu
- Department of Clinical Oncology, Hospital Universitario Insular, Las Palmas de Gran Canaria, Spain
| | - Laura Gálvez-Carvajal
- Department of Medical Oncology Intercenter Unit, Regional and Virgen de la Victoria University Hospitals, IBIMA, Málaga, Spain
| | - Jorge Labrador
- Department of Hematology, Research Unit, Hospital Universitario de Burgos, Burgos, Spain
| | - María Guirado-Risueño
- Department of Clinical Oncology, Hospital General Universitario de Elche, Elche, Spain
| | - Daniel J. García-Domínguez
- Department of Clinical Oncology, Hospital Universitario Virgen Macarena, University of Seville, Seville, Spain.,Department of Medicine, University of Seville, Seville, Spain.,Department of Medical Biochemistry and Molecular Biology and Immunology, Medical School, Hospital Universitario Virgen Macarena, Seville, Spain
| | - Lourdes Hontecillas-Prieto
- Department of Clinical Oncology, Hospital Universitario Virgen Macarena, University of Seville, Seville, Spain.,Department of Medicine, University of Seville, Seville, Spain.,Department of Medical Biochemistry and Molecular Biology and Immunology, Medical School, Hospital Universitario Virgen Macarena, Seville, Spain
| | - Pablo Espejo-García
- Department of Clinical Oncology, Hospital Universitario Virgen Macarena, University of Seville, Seville, Spain.,Department of Medicine, University of Seville, Seville, Spain
| | | | - Mariano Provencio-Pulla
- Department of Medical Oncology, Hospital Universitario Puerta de Hierro-Majadahonda, Facultad de Medicina, Universidad Autónoma de Madrid, IDIPHISA, Madrid, Spain
| | - Margarita Sánchez-Beato
- Department of Medical Oncology, Lymphoma Research Group, Hospital Universitario Puerta de Hierro-Majadahonda, IDIPHISA, CIBERONC, Madrid, Spain
| | - Marta Navarro
- Department of Medical Oncology, Lymphoma Research Group, Hospital Universitario Puerta de Hierro-Majadahonda, IDIPHISA, Madrid, Spain
| | - Lejeune Marylene
- Department of Pathology, Plataforma de Estudios Histológicos, Citológicos y de Digitalización, Hospital de Tortosa Verge de la Cinta, IISPV, URV, Tortosa, Tarragona, Spain
| | - Tomás Álvaro-Naranjo
- Department of Pathology, Hospital de Tortosa Verge de la Cinta, Catalan Institute of Health, Institut d'Investigació Sanitària Pere Virgili (IISPV), Tortosa, Tarragona, Spain
| | | | - Victor Sánchez-Margalet
- Department of Medical Biochemistry and Molecular Biology and Immunology, Medical School, Hospital Universitario Virgen Macarena, Seville, Spain
| | - Antonio Rueda-Domínguez
- Department of Hematology/Clinical Oncology, Hospital Costa del Sol, Marbella, Spain.,Corresponding Authors: Luis de la Cruz-Merino, Hospital Universitario Virgen Macarena and University of Seville, Avenue Doctor Fedriani, 41009 Seville, Spain. Phone: 346-7790-2681; E-mail: ; and Antonio Rueda-Domínguez,
| | - Luis de la Cruz-Merino
- Department of Clinical Oncology, Hospital Universitario Virgen Macarena, University of Seville, Seville, Spain.,Department of Medicine, University of Seville, Seville, Spain.,Corresponding Authors: Luis de la Cruz-Merino, Hospital Universitario Virgen Macarena and University of Seville, Avenue Doctor Fedriani, 41009 Seville, Spain. Phone: 346-7790-2681; E-mail: ; and Antonio Rueda-Domínguez,
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Katz DA, Morris JD, Chu MP, David KA, Thieblemont C, Morley NJ, Khan SS, Viardot A, Martín García-Sancho A, Rodríguez-García G, Bastos-Oreiro M, Lee ST, Kormany W, Chen Y, Wong HL, Anderson AA, Katlinskaya Y, Avilion AA, Dai T, González-Barca E. Open-label, phase 2 study of blinatumomab after frontline R-chemotherapy in adults with newly diagnosed, high-risk DLBCL. Leuk Lymphoma 2022; 63:2063-2073. [PMID: 35503708 DOI: 10.1080/10428194.2022.2064981] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [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: 12/12/2022]
Abstract
This open-label, multicenter, single-arm, phase 2 study assessed the safety and efficacy of blinatumomab consolidation therapy in adult patients with newly diagnosed, high-risk diffuse large B-cell lymphoma (DLBCL; International Prognostic Index 3-5 and/or double-/triple-hit or double MYC/BCL-2 expressors) who achieved complete response (CR), partial response (PR), or stable disease (SD) following run-in with 6 cycles of R-chemotherapy (NCT03023878). Of the 47 patients enrolled, 28 received blinatumomab. Five patients (17.9%) experienced grade 4 treatment-emergent adverse events of interest (neutropenia, n = 4; infection, n = 1). Two deaths reported at the end of the study were unrelated to treatment with blinatumomab (disease progression, n = 1; infection, n = 1). 3/4 patients with PR and 4/4 patients with SD after R-chemotherapy achieved CR following blinatumomab. Consolidation with blinatumomab in patients with newly diagnosed, high-risk DLBCL who did not progress under R-chemotherapy was better tolerated than in previous studies where blinatumomab was used for treatment of patients with lymphoma.
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Affiliation(s)
- Deborah A Katz
- Division of Hematology/Oncology/Cell Therapy, Rush University Medical Center, Chicago, IL, USA
| | | | - Michael P Chu
- Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Canada
| | - Kevin A David
- Rutgers Cancer Institute of New Jersey, Rutgers Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Catherine Thieblemont
- APHP, Hôpital Saint-Louis, Hemato-Oncology Unit Paris, France.,Diderot University, Paris, France
| | - Nicholas J Morley
- Department of Haematology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Sharif S Khan
- Hematology & Oncology, Bon Secours St. Francis, Greenville, SC, USA
| | - Andreas Viardot
- Department of Internal Medicine III, University Hospital Ulm, Ulm, Germany
| | | | | | - Mariana Bastos-Oreiro
- Haematology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Seung Tae Lee
- Division of Hematology/Oncology, University of Maryland Greenebaum Comprehensive Cancer Center, Baltimore, MD, USA
| | | | | | | | | | | | | | - Tian Dai
- Amgen Inc, Thousand Oaks, CA, USA
| | - Eva González-Barca
- Hematology, IDIBELL, Institut Català d'Oncologia, Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
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Jiménez-Cortegana C, Palazón-Carrión N, Martin Garcia-Sancho A, Nogales-Fernandez E, Carnicero-González F, Ríos-Herranz E, de la Cruz-Vicente F, Rodríguez-García G, Fernández-Álvarez R, Rueda Dominguez A, Casanova-Espinosa M, Martínez-Banaclocha N, Gumà-Padrò J, Gómez-Codina J, Labrador J, Salar-Silvestre A, Rodriguez-Abreu D, Galvez-Carvajal L, Provencio M, Sánchez-Beato M, Guirado-Risueño M, Espejo-García P, Lejeune M, Álvaro T, Sánchez-Margalet V, de la Cruz-Merino L. Circulating myeloid-derived suppressor cells and regulatory T cells as immunological biomarkers in refractory/relapsed diffuse large B-cell lymphoma: translational results from the R2-GDP-GOTEL trial. J Immunother Cancer 2021; 9:jitc-2020-002323. [PMID: 34158317 PMCID: PMC8728348 DOI: 10.1136/jitc-2020-002323] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2021] [Indexed: 12/18/2022] Open
Abstract
Background The search for immunological markers with ability of predicting clinical outcome is a priority in lymphomas, and in cancer in general. It is well known that some immunomodulatory cells, such as myeloid derived suppressor cells (MDSCs) or regulatory T cells (Tregs), are recruited by tumors, jeopardizing antitumor immunosurveillance. In this work, we have studied blood levels of these immunosuppressive cells in patients with relapsed/refractory diffuse large B-cell lymphoma (R/R DLBCL), prior to and along the course of the experimental rituximab, gemcitabine, dexamethasone, and cisplatin (R2-GDP) schedule, as a translational substudy of the R2-GDP-GOTEL trial (EudraCT Number: 2014-001620-29), which included lenalidomide as an immunomodulator. Methods Blood samples were taken before treatment, at cycle 3 and end of induction. Samples were analyzed by flow cytometry. Non-parametric tests were used. Mann-Whitney U test was used to compare basal cells distributions, and Wilcoxon test was considered to compare cells distribution at different times. Spearman test was performed to measure the degree of association between cell populations. Results In this study, MDSC and Treg circulating concentration was found increased in all patients compared with a healthy control group and decreased after treatment only in patients with longest overall survival (>24 months), reaching the levels of the healthy group. Likewise, the number of inhibited T lymphocytes expressing Programmed Death-1 (PD-1) were increased in peripheral blood from patients and decreased on the treatment, whereas activated T lymphocytes increased after therapy in those with better overall survival. Conclusions In conclusion, blood concentration of MDSCs and Treg cells may be good prognostic markers for overall survival after 2 years in R/R DLBCL. These results point to a possible role of these elements in the immunosuppression of these patients, as assessed by the circulating activated and inhibited T lymphocytes, and therefore, they may be considered as therapeutic targets in DLBCL.
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Affiliation(s)
- Carlos Jiménez-Cortegana
- Medical Biochemistry and Molecular Biology and Immunology, Virgen Macarena University Hospital, Sevilla, Seville, Spain
| | | | | | - Esteban Nogales-Fernandez
- Clinical Oncology Dept. Medicine Department, University of Seville, Virgen Macarena University Hospital, Seville, Spain
| | | | | | | | | | | | | | | | | | - Josep Gumà-Padrò
- Clinical Oncology Dept, Sant Joan de Reus University Hospital URV, IISPV, Reus, Spain
| | | | - Jorge Labrador
- Hematology Dept, Hospital Universitario de Burgos, Burgos, Spain
| | | | | | - Laura Galvez-Carvajal
- Unidad de Gestión Clínica Intercentros de Oncología Médica de Málaga, Hospitales Universitarios Regional y Virgen de la Victoria, Málaga, Spain
| | - Mariano Provencio
- Clinical Oncology Dept, Puerta de Hierro University Hospital, Majadahonda, Madrid, Spain
| | - Margarita Sánchez-Beato
- Lymphoma Research Group, Clinical Oncology Dept, Instituto de Investigación Sanitaria Puerta de Hierro-Segovia de Arana, Majadahonda, Madrid, Spain
| | - María Guirado-Risueño
- Clinical Oncology Dept, Elche General University Hospital General, Elche, Alicante, Spain
| | - Pablo Espejo-García
- Clinical Oncology Dept. Medicine Department, University of Seville, Virgen Macarena University Hospital, Seville, Spain
| | - Marylene Lejeune
- Pathology Department, Plataforma de Estudios Histológicos, Citológicos y de Digitalización, Hospital de Tortosa Verge de la Cinta, IISPV, URV, Tortosa, Tarragona, Spain
| | - Tomás Álvaro
- Pathology Dept, Hospital de Tortosa Verge de la Cinta, Catalan Institute of Health, Institut d'Investigació Sanitària Pere Virgili (IISPV), Tortosa, Tarragona, Spain
| | - Victor Sánchez-Margalet
- Medical Biochemistry and Molecular Biology and Immunology, Virgen Macarena University Hospital, Sevilla, Seville, Spain
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5
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Chen-Liang TH, Martín-Santos T, Jerez A, Rodríguez-García G, Senent L, Martínez-Millán C, Muiña B, Orero M, Teruel A, Martín A, Gómez-Espuch J, Kennedy K, Benet C, Raya JM, Fernández-González M, de la Cruz F, Guinot M, Villegas C, Ballester I, Baile M, Moya M, López-Jiménez J, Frutos L, Navarro JL, Uña J, Fernández-López R, Igua C, Contreras J, Sánchez-Vañó R, Cozar MDP, Tamayo P, Mucientes J, Sánchez-Blanco JJ, Pérez-Ceballos E, Ortuño FJ. Bone marrow biopsy superiority over PET/CT in predicting progression-free survival in a homogeneously-treated cohort of diffuse large B-cell lymphoma. Cancer Med 2017; 6:2507-2514. [PMID: 28960797 PMCID: PMC5673915 DOI: 10.1002/cam4.1205] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 08/12/2017] [Accepted: 08/28/2017] [Indexed: 12/11/2022] Open
Abstract
Several studies have reported uneven results when evaluating the prognostic value of bone marrow biopsy (BMB) and PET/CT as part of the staging of diffuse large B‐cell lymphoma (DLBCL). The heterogeneity of the inclusion criteria and not taking into account selection and collinearity biases in the analysis models might explain part of these discrepancies. To address this issue we have carried a retrospective multicenter study including 268 DLBCL patients with a BMB and a PET/CT available at diagnosis where we estimated both the prognosis impact and the diagnostic accuracy of each technique. Only patients treated with R‐CHOP/21 as first line (n = 203) were included in the survival analysis. With a median follow‐up of 25 months the estimated 3‐year progression‐free survival (PFS) and overall survival (OS) were 76.3% and 82.7% respectively. In a multivariate analysis designed to avoid a collinearity bias with IPI categories, BMB‐BMI [bone marrow involvement](+) (HR: 3.6) and ECOG PS > 1 (HR: 2.9) were independently associated with a shorter PFS and three factors, age >60 years old (HR: 2.4), ECOG PS >1 (HR: 2.4), and abnormally elevated B2‐microglobulin levels (HR: 2.2) were independently associated with a shorter OS. In our DLBCL cohort, treated with a uniform first‐line chemotherapy regimen, BMI by BMB complemented performance status in predicting those patients with a higher risk for relapse or progression. In this cohort BMI by PET/CT could not independently predict a shorter PFS and/or OS.
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Affiliation(s)
- Tzu-Hua Chen-Liang
- Servicio de Hematología y Oncología Médica. H.J.M. Morales Meseguer, IMIB-Arrixaca, Murcia, Spain
| | - Taida Martín-Santos
- Servicio de Hematología. H. Universitario de Canarias, La Laguna, Tenerife, Spain
| | - Andrés Jerez
- Servicio de Hematología y Oncología Médica. H.J.M. Morales Meseguer, IMIB-Arrixaca, Murcia, Spain
| | | | | | | | - Begoña Muiña
- Servicio de Hematología. H. R. Méndez, Lorca, Murcia, Spain
| | - Mayte Orero
- Servicio de Hematología. H. General, Valencia, Spain
| | - Anabel Teruel
- Servicio de Hematología y Oncología Médica. H. Clínico, Valencia, Spain
| | - Alejandro Martín
- Servicio de Hematología. H. Clínico Universitario de Salamanca/IBSAL, Salamanca, Spain
| | | | - Kyra Kennedy
- Servicio de Hematología. H. Ramon y Cajal, Madrid, Spain
| | - Carmen Benet
- Servicio de Hematología. H. Arnau de Vilanova, Valencia, Spain
| | - José María Raya
- Servicio de Hematología. H. Universitario de Canarias, La Laguna, Tenerife, Spain
| | | | | | - Marta Guinot
- Servicio de Hematología. H. La Fe, Valencia, Spain
| | | | - Isabel Ballester
- Servicio de Hematología y Oncología Médica. H. Clínico, Valencia, Spain
| | - Mónica Baile
- Servicio de Hematología. H. Clínico Universitario de Salamanca/IBSAL, Salamanca, Spain
| | - María Moya
- Servicio de Hematología. H. Virgen de la Arrixaca, Murcia, Spain
| | | | - Laura Frutos
- Servicio de Medicina Nuclear. H. Virgen de la Arrixaca, Murcia, Spain
| | - José Luis Navarro
- Servicio de Medicina Nuclear. H. Virgen de la Arrixaca, Murcia, Spain
| | - Jon Uña
- Servicio de Medicina Nuclear. H. Universitario N.S. de la Candelaria, Tenerife, Spain
| | | | - Carolina Igua
- Servicio de Medicina Nuclear. H. La Fe, Valencia, Spain
| | - José Contreras
- Servicio de Medicina Nuclear. H. Sta Lucia, Cartagena, Murcia, Spain
| | | | | | - Pilar Tamayo
- Servicio de Medicina Nuclear. H. Clínico Universitario de Salamanca/IBSAL, Salamanca, Spain
| | - Jorge Mucientes
- Servicio de Medicina Nuclear. H. Puerta de Hierro, Madrid, Spain
| | | | - Elena Pérez-Ceballos
- Servicio de Hematología y Oncología Médica. H.J.M. Morales Meseguer, IMIB-Arrixaca, Murcia, Spain
| | - Francisco José Ortuño
- Servicio de Hematología y Oncología Médica. H.J.M. Morales Meseguer, IMIB-Arrixaca, Murcia, Spain
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6
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Marí-Jimenez P, Martínez-Losada C, Centeno-Haro M, Rodríguez-García G, Perez-Seoane C, Sánchez-García J. A rare composite lymphoma: follicular and in situ mantle cell. Ann Hematol 2016; 95:1351-2. [DOI: 10.1007/s00277-016-2680-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 04/17/2016] [Indexed: 11/24/2022]
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7
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Rodríguez-García G, Jiménez-Macías F, Fernández-Jurado A, Domínguez-Macías A. Tratamiento con interferón pegilado y desarrollo de trombocitopenia grave. Med Clin (Barc) 2006. [DOI: 10.1157/13091962] [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: 11/21/2022]
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8
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Rodríguez-García G, Jiménez-Macías F, Fernández-Jurado A, Domínguez-Macías A. Tratamiento con interferón pegilado y desarrollo de trombocitopenia grave. Med Clin (Barc) 2006; 127:316-7. [PMID: 16949021 DOI: 10.1016/s0025-7753(06)72244-8] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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9
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Maragoto-Rizo C, Rodríguez-García G, Gómez-Fernández L, Suárez-Monteagudo C, Alessandrini-Gónzalez R, Ortega-Pérez M. [Prolonged syndrome of diarrhoea due to the administration of carbamazepine]. Rev Neurol 2003; 36:699-700. [PMID: 12666056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Affiliation(s)
- C Maragoto-Rizo
- Centro Internacional de Restauración Neurológica (CIREN), Cubanacán, Playa. La Habana, Cuba.
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Báez-Martín MM, Gómez-Fernández L, Cabrera-Abreu I, Rodríguez-García G. [Can hypervoltage waves exist in brain stem auditory evoked potentials?]. Rev Neurol 2002; 35:196. [PMID: 12221633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Affiliation(s)
- M M Báez-Martín
- Centro Internacional de Restauración Neurológica, La Habana, Cuba.
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Ixta-Rodríguez O, Lugo de la Fuente G, Rodríguez-García G, Barrios-Pompa M. [Frequency of intestinal and bacterial parasites producing diarrhea in children in a regional hospital]. Rev Latinoam Microbiol 1993; 35:137-142. [PMID: 8209105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
The diarrhoea diseases are priority health problems in all countries of the Third World. The number of the cases of diarrhoea and other intestinal infections have very high morbi-mortality rate in mexican childhood. There are many factors that affect these pathologies, those related to social, economic and cultural aspects seem to be the most important. Although the intestinal viruses are frequent, the enteritis produced by bacteria are more severe and acute. There area also parasites that yield the chronic type disease. In this paper, the most frequent parasites and enteropathogenic bacteria infecting children below 15 years old, either hospitalized or being outpatients from the Hospital de Zona No. 29 del IMSS in México City, were studied. The data obtained were related to the socioeconomic level. A total of 415 stool samples were collected from newborn to 14 years old children over a period of nine months. The samples were classified according to the ages, schooling and number of persons who slept with the child in the same bedroom. The samples were examined by a centrifugal concentration technique and by cultivation. The group of children up to five years old were found to be the most infected by bacteria, while children from 10 to 14 years old were by parasites. Those children whose parents either have not finished the elementary school or can not read and write were the most parasitized (40%), these children were also found to be most infected, as the number of persons who slept in the same bedroom increased, the number of infections per children either by bacteria or parasites, also increased.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- O Ixta-Rodríguez
- Departamento de Parasitología, Escuela Nacional de Ciencias Biológicas, México, D.F., Mexico
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