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Demel I, Skopal D, Šafránková E, Rozsívalová P, Jindra P, Šrámek J, Turková A, Vydra J, Labská K, Vedrová J, Čerňan M, Szotkowski T, Móciková H, Hynková L, Šušol O, Kováčová I, Belada D, Hájek R. Effectiveness of tixagevimab/cilgavimab in patients with hematological malignancies as a pre-exposure prophylaxis to prevent severe COVID-19: a Czech retrospective multicenter study. Ann Hematol 2024; 103:981-992. [PMID: 38092996 PMCID: PMC10866774 DOI: 10.1007/s00277-023-05572-0] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 11/28/2023] [Indexed: 02/15/2024]
Abstract
Despite lower virulence, the omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that causes coronavirus disease 2019 (COVID-19) still poses a relevant threat for immunocompromised patients. A retrospective multicentric study was conducted to evaluate the efficacy of pre-exposure prophylaxis with tixagevimab/cilgavimab (Evusheld) with a 6-month follow-up for preventing severe COVID-19 in adult patients with hematology malignancy. Among the 606 patients in the cohort, 96 (16%) contracted COVID-19 with a median of 98.5 days after Evusheld administration. A total of 75% of patients had asymptomatic or mild severity of COVID-19, while just 25% of patients with SARS-CoV-2 positivity had to be hospitalized. Two patients (2%) died directly, and one patient (1%) in association with COVID-19. Eight patients (1.3%) of every cohort experienced adverse events related to Evusheld, mostly grade 1 and of reversible character. It was found that complete vaccination status or positive seroconversion was not associated with lower risk of COVID-19 infection. Previous treatment with an anti-CD20 monoclonal antibody was associated with higher rates of COVID-19, while previous treatment with anti-CD38 monoclonal antibody was not, as was the case for recipients of hematopoietic stem cell transplantation or CAR-T cell therapy. Presence of other comorbidities was not associated with more severe COVID-19. The results support the growing evidence for Evusheld's efficacy against severe COVID-19 in patients with hematology malignancies.
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Affiliation(s)
- Ivo Demel
- Department of Haematooncology, University Hospital Ostrava, 17. Listopadu 1790/5, 708 52, Ostrava, Czech Republic.
- Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic.
| | - David Skopal
- 4th Department of Internal Medicine - Haematology, Hospital and Faculty of Medicine, Charles University, Hradec Kralove, Czech Republic
| | - Eliška Šafránková
- 4th Department of Internal Medicine - Haematology, Hospital and Faculty of Medicine, Charles University, Hradec Kralove, Czech Republic
| | - Petra Rozsívalová
- Hospital Pharmacy, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
- Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
| | - Pavel Jindra
- Department of Haematology & Oncology, University Hospital Pilsen, Pilsen, Czech Republic
| | - Jiří Šrámek
- Department of Haematology & Oncology, University Hospital Pilsen, Pilsen, Czech Republic
- Department of Histology and Embryology, Faculty of Medicine, Pilsen, Czech Republic
| | - Adéla Turková
- Department of Haematology & Oncology, University Hospital Pilsen, Pilsen, Czech Republic
| | - Jan Vydra
- Institute of Haematology and Blood Transfusion, Prague, Czech Republic
| | - Klára Labská
- Institute of Haematology and Blood Transfusion, Prague, Czech Republic
| | - Jana Vedrová
- Institute of Haematology and Blood Transfusion, Prague, Czech Republic
| | - Martin Čerňan
- Department of Haemato-Oncology, Faculty of Medicine and Dentistry, Palacky University and University Hospital Olomouc, Olomouc, Czech Republic
| | - Tomáš Szotkowski
- Department of Haemato-Oncology, Faculty of Medicine and Dentistry, Palacky University and University Hospital Olomouc, Olomouc, Czech Republic
| | - Heidi Móciková
- Department of Internal Medicine and Haematology, Faculty Hospital Kralovske Vinohrady, Prague, Czech Republic
| | - Lenka Hynková
- Department of Internal Medicine and Haematology, Faculty Hospital Kralovske Vinohrady, Prague, Czech Republic
| | - Ondrej Šušol
- Department of Haematooncology, University Hospital Ostrava, 17. Listopadu 1790/5, 708 52, Ostrava, Czech Republic
- Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Ingrid Kováčová
- Department of Haematooncology, University Hospital Ostrava, 17. Listopadu 1790/5, 708 52, Ostrava, Czech Republic
| | - David Belada
- 4th Department of Internal Medicine - Haematology, Hospital and Faculty of Medicine, Charles University, Hradec Kralove, Czech Republic
| | - Roman Hájek
- Department of Haematooncology, University Hospital Ostrava, 17. Listopadu 1790/5, 708 52, Ostrava, Czech Republic
- Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
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2
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Šimkovič M, Turcsányi P, Špaček M, Mihályová J, Ryznerová P, Maco M, Vodárek P, Écsiová D, Poul H, Móciková H, Zuchnická J, Panovská A, Lekaa M, Oršulová M, Prchlíková A, Stejskal L, Mašlejová S, Brychtová Y, Bezděková L, Papajík T, Lysák D, Trněný M, Smolej L, Doubek M. COVID-19 in patients with chronic lymphocytic leukemia: a multicenter analysis by the Czech CLL study group. Ann Hematol 2023; 102:811-817. [PMID: 36847805 PMCID: PMC9969021 DOI: 10.1007/s00277-023-05147-z] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 12/15/2022] [Indexed: 03/01/2023]
Abstract
Patients with chronic lymphocytic leukemia (CLL) have a high risk of poor outcomes related to coronavirus disease 2019 (COVID-19). This multicenter cohort study evaluated the impact of COVID-19 infection on the population of CLL patients in the Czech Republic. Between March 2020 and May 2021, 341 patients (237 males) with CLL and COVID-19 disease were identified. The median age was 69 years (range 38-91). Out of the 214 (63%) patients with the history of therapy for CLL, 97 (45%) were receiving CLL-directed treatment at diagnosis of COVID-19: 29% Bruton tyrosine kinase inhibitor (BTKi), 16% chemoimmunotherapy (CIT), 11% Bcl-2 inhibitor, and 4% phosphoinositide 3-kinase inhibitor. Regarding the severity of COVID-19, 60% pts required admission to the hospital, 21% pts were admitted to the intensive care unit (ICU), and 12% received invasive mechanical ventilation. The overall case fatality rate was 28%. Major comorbidities, age over 72, male gender, CLL treatment in history, CLL-directed treatment at COVID-19 diagnosis were associated with increased risk of death. Of note, concurrent therapy with BTKi compared to CIT was not associated with better outcome of COVID-19.
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Affiliation(s)
- Martin Šimkovič
- 4th Department of Internal Medicine - Hematology, Faculty of Medicine in Hradec Králové, University Hospital and Charles University in Prague, Prague, Czech Republic.
| | - Peter Turcsányi
- Department of Haematology-Oncology, University Hospital, Olomouc, Czech Republic
| | - Martin Špaček
- First Department of Medicine - Haematology, University General Hospital, Prague, Czech Republic
| | - Jana Mihályová
- Department of Hematooncology, University Hospital, Ostrava, Czech Republic
| | - Pavlína Ryznerová
- Department of Haematology-Oncology, University Hospital, Olomouc, Czech Republic
| | - Mária Maco
- Department of Internal Medicine - Haematology, University Hospital Královské Vinohrady, Prague, Czech Republic
| | - Pavel Vodárek
- 4th Department of Internal Medicine - Hematology, Faculty of Medicine in Hradec Králové, University Hospital and Charles University in Prague, Prague, Czech Republic
| | - Dominika Écsiová
- 4th Department of Internal Medicine - Hematology, Faculty of Medicine in Hradec Králové, University Hospital and Charles University in Prague, Prague, Czech Republic
| | - Hynek Poul
- Department of Hematology and Transfusion Medicine, Hospital Pelhrimov, Pelhrimov, Czech Republic
| | - Heidi Móciková
- Department of Internal Medicine - Haematology, University Hospital Královské Vinohrady, Prague, Czech Republic
| | - Jana Zuchnická
- Department of Hematooncology, University Hospital, Ostrava, Czech Republic
| | - Anna Panovská
- Department of Internal Medicine - Haematology and Oncology, University Hospital, Brno, Czech Republic
| | - Mohammad Lekaa
- Department of Hematology and Oncology, Medical School and Teaching Hospital in Plzen, Charles University in Prague, Plzen, Czech Republic
| | - Martina Oršulová
- Department of Internal Medicine - Haematology and Oncology, University Hospital, Brno, Czech Republic
| | - Adéla Prchlíková
- Department of Internal Medicine - Haematology and Oncology, University Hospital, Brno, Czech Republic
| | - Lukáš Stejskal
- Haematology/Tranfusiology Department, Silesian Hospital Opava, Opava, Czech Republic
| | - Stanislava Mašlejová
- Department of Internal Medicine - Haematology and Oncology, University Hospital, Brno, Czech Republic
| | - Yvona Brychtová
- Department of Internal Medicine - Haematology and Oncology, University Hospital, Brno, Czech Republic
| | - Lucie Bezděková
- Department of Internal Medicine - Haematology and Oncology, University Hospital, Brno, Czech Republic
| | - Tomáš Papajík
- Department of Haematology-Oncology, University Hospital, Olomouc, Czech Republic
| | - Daniel Lysák
- Department of Hematology and Oncology, Medical School and Teaching Hospital in Plzen, Charles University in Prague, Plzen, Czech Republic
| | - Marek Trněný
- First Department of Medicine - Haematology, University General Hospital, Prague, Czech Republic
| | - Lukáš Smolej
- 4th Department of Internal Medicine - Hematology, Faculty of Medicine in Hradec Králové, University Hospital and Charles University in Prague, Prague, Czech Republic
| | - Michael Doubek
- Department of Internal Medicine - Haematology and Oncology, University Hospital, Brno, Czech Republic
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3
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Sýkorová A, Procházka V, Móciková H, Janíková A, Pytlík R, Belada D, Benešová K, Klener P, Ďuraš J, Smolej L, Campr V, Blahovcová P, Trněný M. Burkitt lymphoma-a retrospective analysis of data from the Registry of the Czech Lymphoma Study Group with external validation of the Burkitt lymphoma International Prognostic Index. Neoplasma 2022; 69:1466-1473. [PMID: 36591807 DOI: 10.4149/neo_2022_221030n1064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 11/24/2022] [Indexed: 12/31/2022]
Abstract
Burkitt lymphoma (BL) is a rare subtype of non-Hodgkin's lymphoma with an aggressive course. To refine the individual patient's prognosis, the International Prognostic Index for BL (BL-IPI) was recently developed and 4 risk factors (RF) were determined as optimal prognostic cut-off by multivariate analysis: age ≥40 years, lactate dehydrogenase >3× upper limit of normal, ECOG performance status ≥2, and central nervous system involvement. The BL-IPI distinguishes 3 prognostic groups, low (without RF), intermediate (1 RF), and high risk (2-4 RF), with significant differences in survival. The aim of the current project was to perform an external validation of the BL-IPI in 101 patients from the Registry of Czech Lymphoma Study Group diagnosed between 1999 and 2016 (median age, 45 years). The median follow-up was 50.4 months. The induction treatment included rituximab plus chemotherapy in 82% and chemotherapy alone in 18%. The overall response rate was 78% and the complete remission rate was 73%. According to BL-IPI, low/intermediate/high risk was present in 21/35/45% of patients, showing high similarity to the training BL-IPI US (United States) dataset (18/36/46%). There were significant differences in progression-free survival (PFS) and overall survival (OS) between patients with high vs. intermediate risk (PFS: hazard ratio 0.16, 95% confidence interval 0.08-0.31, p<0.0001; OS: hazard ratio 0.17, 95% confidence interval 0.09-0.35, p<0.0001) but not between patients with low vs. intermediate risk. The 3-year OS probability according to BL-IPI with low/intermediate/high risk was 96/76/59% in the BL-IPI training dataset vs. 95/85/45% in our external validation cohort; the 3-year PFS probability with low/intermediate/high risk was 92/72/53% in the BL-IPI training dataset vs. 95/85/42% in our cohort. In summary, our external validation of the BL-IPI confirmed a good separation of high-risk patients, who have a poor prognosis and for whom the new therapeutic approaches are needed; patients with low and intermediate risk had favorable clinical outcomes, and differences between these groups were not significant, likely due to a small number of patients.
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Affiliation(s)
- Alice Sýkorová
- 4th Department of Internal Medicine-Hematology, University Hospital and Faculty of Medicine, Hradec Kralove, Czech Republic
| | - Vít Procházka
- Department of Hemato-Oncology, Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic
| | - Heidi Móciková
- Department of Clinical Hematology, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Andrea Janíková
- Department of Hematology and Oncology, University Hospital, Brno, Czech Republic
| | - Robert Pytlík
- 1st Department of Medicine-Department of Hematology, Charles University, General Hospital, Prague, Czech Republic.,Department of Cell Therapy, Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | - David Belada
- 4th Department of Internal Medicine-Hematology, University Hospital and Faculty of Medicine, Hradec Kralove, Czech Republic
| | - Kateřina Benešová
- 1st Department of Medicine-Department of Hematology, Charles University, General Hospital, Prague, Czech Republic
| | - Pavel Klener
- 1st Department of Medicine-Department of Hematology, Charles University, General Hospital, Prague, Czech Republic
| | - Juraj Ďuraš
- Department of Hemato-Oncology, Faculty of Medicine, Ostrava, Czech Republic
| | - Lukáš Smolej
- 4th Department of Internal Medicine-Hematology, University Hospital and Faculty of Medicine, Hradec Kralove, Czech Republic
| | - Vít Campr
- Institute of Pathology, University Hospital Motol, Prague, Czech Republic
| | - Petra Blahovcová
- Data Management Office, 1st Department of Internal Medicine-Department of Hematology, First Faculty of Medicine and General Teaching Hospital, Prague, Czech Republic
| | - Marek Trněný
- 1st Department of Medicine-Department of Hematology, Charles University, General Hospital, Prague, Czech Republic
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4
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Šimkovič M, Vodárek P, Motyčková M, Écsiová D, Rozsívalová P, Móciková H, Štěpánková P, Sýkorová A, Hrochová K, Vrbacký F, Belada D, Žák P, Smolej L. Rituximab, Cyclophosphamide and Dexamethasone (RCD) Chemoimmunotherapy for Relapsed Chronic Lymphocytic Leukaemia. Eur J Clin Invest 2021; 51:e13421. [PMID: 33022756 DOI: 10.1111/eci.13421] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 09/24/2020] [Accepted: 09/29/2020] [Indexed: 11/29/2022]
Abstract
High doses of corticosteroids in combination with rituximab remain an alternative in the treatment in relapsed or refractory chronic lymphocytic leukaemia (CLL) in the current era of targeted therapies. This study retrospectively evaluates the efficacy of an RCD (rituximab, cyclophosphamide and dexamethasone) regimen in the treatment of 51 patients with relapsed CLL (median age, 72 years). Unfavourable prognostic features, such as Rai stage III/IV, unmutated IGHV, del11q, TP53 mutation/deletion, complex karyotype and bulky lymphadenopathy, were frequent. The overall response or complete remission was of 57% and 7%, respectively, and the median progression-free survival (PFS) was of 12.3 months, median time to next treatment 23.1 months and median overall survival 39.2 months. Significant independent predictors of shorter PFS were TP53 deletion/mutation, advanced Rai stage and ≥2 previous lines of treatment. The incidence of neutropenia grade ≥ 3 was of 13%. Serious (CTCAE grade 3-5) infections were found in 20% of patients. Steroid-induced diabetes or diabetes decompensation occurred in 20% patients. Treatment-related adverse events resulted in RCD dose reduction in 35% of patients. In comparison with a historical R-Dex patient group, the treatment response and/or toxicity in our group was largely similar. However, the substantial differences in the baseline clinical characteristics of the groups may affect this comparison. In conclusion, the RCD regimen is an active, time-limited therapeutic strategy for elderly patients with relapsed CLL. Further, the results of our analysis indicate that the addition of cyclophosphamide to the R-Dex regimen maintains a similar efficacy, even after 50% reduction in the dexamethasone dose.
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Affiliation(s)
- Martin Šimkovič
- 4th Department of Internal Medicine - Haematology, Faculty of Medicine in Hradec Králové, University Hospital and Charles University in Prague, Hradec Kralove, Czech Republic
| | - Pavel Vodárek
- 4th Department of Internal Medicine - Haematology, Faculty of Medicine in Hradec Králové, University Hospital and Charles University in Prague, Hradec Kralove, Czech Republic
| | - Monika Motyčková
- 4th Department of Internal Medicine - Haematology, Faculty of Medicine in Hradec Králové, University Hospital and Charles University in Prague, Hradec Kralove, Czech Republic
| | - Dominika Écsiová
- 4th Department of Internal Medicine - Haematology, Faculty of Medicine in Hradec Králové, University Hospital and Charles University in Prague, Hradec Kralove, Czech Republic
| | - Petra Rozsívalová
- Department of Clinical Pharmacy, Hospital Pharmacy, Faculty of Medicine in Hradec Králové, University Hospital and Charles University in Prague, Hradec Kralove, Czech Republic
| | - Heidi Móciková
- Institute of Clinical Biochemistry and Diagnostics, University Hospital Hradec Králové, Hradec Králové, Czech Republic
| | - Pavla Štěpánková
- 4th Department of Internal Medicine - Haematology, Faculty of Medicine in Hradec Králové, University Hospital and Charles University in Prague, Hradec Kralove, Czech Republic
| | - Alice Sýkorová
- 4th Department of Internal Medicine - Haematology, Faculty of Medicine in Hradec Králové, University Hospital and Charles University in Prague, Hradec Kralove, Czech Republic
| | - Kateřina Hrochová
- Department of Internal Medicine and Haematology, University Hospital Královské Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Filip Vrbacký
- 4th Department of Internal Medicine - Haematology, Faculty of Medicine in Hradec Králové, University Hospital and Charles University in Prague, Hradec Kralove, Czech Republic
| | - David Belada
- 4th Department of Internal Medicine - Haematology, Faculty of Medicine in Hradec Králové, University Hospital and Charles University in Prague, Hradec Kralove, Czech Republic
| | - Pavel Žák
- 4th Department of Internal Medicine - Haematology, Faculty of Medicine in Hradec Králové, University Hospital and Charles University in Prague, Hradec Kralove, Czech Republic
| | - Lukáš Smolej
- 4th Department of Internal Medicine - Haematology, Faculty of Medicine in Hradec Králové, University Hospital and Charles University in Prague, Hradec Kralove, Czech Republic
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Smolej L, Brychtová Y, Cmunt E, Doubek M, Špaček M, Belada D, Šimkovič M, Stejskal L, Zygulová I, Urbanová R, Brejcha M, Zuchnická J, Móciková H, Kozák T. Low-dose fludarabine and cyclophosphamide combined with rituximab in the first-line treatment of elderly/comorbid patients with chronic lymphocytic leukaemia/small lymphocytic lymphoma (CLL/SLL): long-term results of project Q-lite by the Czech CLL Study Group. Br J Haematol 2021; 193:769-778. [PMID: 33618437 DOI: 10.1111/bjh.17373] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 12/23/2020] [Accepted: 01/29/2021] [Indexed: 12/29/2022]
Abstract
Therapeutic options used to be very limited for treatment-naïve elderly/comorbid patients with chronic lymphocytic leukaemia/small lymphocytic lymphoma (CLL/SLL) before the introduction of chemo-immunotherapy. Because dose-reduced fludarabine-based regimens yielded promising results, the Czech CLL Study Group initiated a prospective observational study to assess safety and efficacy of low-dose fludarabine and cyclophosphamide combined with rituximab (FCR) in elderly/comorbid patients. Between March 2009 and July 2012, we enrolled 107 patients considered ineligible for full-dose FCR (median age, 70 years; median Cumulative Illness Rating Scale score, 5; median creatinine clearance, 69 ml/min). Notably, 77% patients had unfavourable biological prognosis [unmutated immunoglobulin heavy-chain variable-region gene (IGHV), 74%; deletion 17p, 9%). Fludarabine was reduced to 12 mg/m2 intravenously (iv) or 20 mg/m2 orally on days 1-3 and cyclophosphamide to 150 mg/m2 iv/orally on days 1-3. Grade 3-4 neutropenia occurred in 56% of the patients, but there were serious infections in only 15%. The median progression-free survival was 29 months, but was markedly longer in patients with mutated IGHV (median 53 months), especially in absence of del 11q or 17p (median 74 months). Low-dose FCR is a well-tolerated and effective first-line regimen for selected elderly/comorbid patients with CLL/SLL with favourable biology. The study was registered at clinicaltrials.gov (NCT02156726).
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Affiliation(s)
- Lukáš Smolej
- 4th Department of Internal Medicine - Haematology, Faculty of Medicine, University Hospital, Hradec Králové, Czech Republic
| | - Yvona Brychtová
- Department of Internal Medicine - Haematology and Oncology, University Hospital, Brno, Czech Republic
| | - Eduard Cmunt
- First Department of Medicine - Haematology, General University Hospital, Prague, Czech Republic
| | - Michael Doubek
- Department of Internal Medicine - Haematology and Oncology, University Hospital, Brno, Czech Republic
| | - Martin Špaček
- First Department of Medicine - Haematology, General University Hospital, Prague, Czech Republic
| | - David Belada
- 4th Department of Internal Medicine - Haematology, Faculty of Medicine, University Hospital, Hradec Králové, Czech Republic
| | - Martin Šimkovič
- 4th Department of Internal Medicine - Haematology, Faculty of Medicine, University Hospital, Hradec Králové, Czech Republic
| | - Lukáš Stejskal
- Haematology/Tranfusiology Department, Silesian Hospital Opava, Opava, Czech Republic
| | - Irena Zygulová
- Haematology/Tranfusiology Department, Silesian Hospital Opava, Opava, Czech Republic
| | - Renata Urbanová
- Department of Haematology - Oncology, University Hospital, Olomouc, Czech Republic
| | | | - Jana Zuchnická
- Department of Haematology, University Hospital, Ostrava, Czech Republic
| | - Heidi Móciková
- Department of Haematology, University Hospital Královské Vinohrady, Prague, Czech Republic
| | - Tomáš Kozák
- Department of Haematology, University Hospital Královské Vinohrady, Prague, Czech Republic
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Smolej L, Turcsányi P, Kubová Z, Zuchnická J, Mihályová J, Šimkovič M, Vodárek P, Krčméryová M, Móciková H, Brejcha M, Špaček M. External validation of International Prognostic Score for asymptomatic early stage chronic lymphocytic leukaemia and proposal of an alternative score. Br J Haematol 2020; 193:133-137. [PMID: 33280081 DOI: 10.1111/bjh.17074] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 07/16/2020] [Accepted: 08/04/2020] [Indexed: 12/20/2022]
Abstract
Most patients with chronic lymphocytic leukaemia (CLL) are nowadays diagnosed without any symptoms and do not require therapy. A prognostic score identifying patients within this large group who are at high risk of disease progression would be highly beneficial. The recently published International Prognostic Score for Early asymptomatic patients (IPS-E) uses combination of absolute lymphocyte count (ALC) >15 × 109 /l, palpable lymphadenopathy, and unmutated immunoglobulin heavy-chain variable-region (IGHV) gene to predict the time to first-line therapy (TTFT). Patients at low, intermediate, and high risk had estimated 5-year TTFT of 8%, 28%, and 61%. We performed an external validation of the IPS-E score using an unselected, consecutive group of 130 Binet A patients. The 5-year TTFT was 11%, 36%, and 78% (C-statistic 0·74). Furthermore, we propose an alternative system (AIPS-E) using cytogenetic aberrations instead of palpable lymphadenopathy. This system yielded 5-year TTFT of 14%, 40%, and 72%. These results were externally validated in 388 Binet A patients from five Czech centres; the 5-year TTFT was 16%, 37%, and 80% (C-statistic 0·74). In conclusion, we have successfully validated the IPS-E score for patients with early stage CLL. In addition, we propose a modified scoring system, the AIPS-E, combining IGHV, fluorescence in situ hybridisation, and ALC.
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Affiliation(s)
- Lukáš Smolej
- 4th Department of Internal Medicine - Haematology, University Hospital and Faculty of Medicine, Hradec Králové, Czech Republic
| | - Peter Turcsányi
- Department of Haematology-Oncology, University Hospital, Olomouc, Czech Republic
| | - Zuzana Kubová
- Department of Haematology-Oncology, University Hospital, Olomouc, Czech Republic
| | - Jana Zuchnická
- Department of Haematooncology, University Hospital Ostrava and Faculty of Medicine, Ostrava University, Ostrava, Czech Republic
| | - Jana Mihályová
- Department of Haematooncology, University Hospital Ostrava and Faculty of Medicine, Ostrava University, Ostrava, Czech Republic
| | - Martin Šimkovič
- 4th Department of Internal Medicine - Haematology, University Hospital and Faculty of Medicine, Hradec Králové, Czech Republic
| | - Pavel Vodárek
- 4th Department of Internal Medicine - Haematology, University Hospital and Faculty of Medicine, Hradec Králové, Czech Republic
| | - Mária Krčméryová
- Department of Internal Medicine - Haematology, University Hospital Královské Vinohrady, Prague, Czech Republic
| | - Heidi Móciková
- Department of Internal Medicine - Haematology, University Hospital Královské Vinohrady, Prague, Czech Republic
| | - Martin Brejcha
- Department of Haematology, Oncology Center, Nový Jičín, Czech Republic, Prague, Czech Republic
| | - Martin Špaček
- First Department of Medicine - Haematology, University General Hospital, Prague, Czech Republic
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7
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Král Z, Michalka J, Móciková H, Marková J, Sýkorová A, Belada D, Jungová A, Vokurka S, Lukášová M, Procházka V, Ďuraš J, Hájek R, Dušek L, Drgoňa Ľ, Ladická M, Ballová V, Vranovský A. Treatment of Relapsed/Refractory Hodgkin Lymphoma: Real-World Data from the Czech Republic and Slovakia. J Cancer 2019; 10:5041-5048. [PMID: 31602255 PMCID: PMC6775599 DOI: 10.7150/jca.29308] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 08/17/2018] [Accepted: 07/13/2019] [Indexed: 11/05/2022] Open
Abstract
Introduction: Clinical trials have demonstrated the effectiveness of the CD30-targeted antibody-drug conjugate brentuximab vedotin (BV) for the treatment of relapsed/refractory Hodgkin lymphoma (R/R HL). In this study, we report on outcomes with BV in a real-world setting using data collected in clinics in the Czech Republic and Slovakia. Patients and Methods: Clinical and epidemiological data for patients with R/R HL who received treatment with BV at eight centers across the Czech Republic and Slovakia were examined. Data were amalgamated and analyzed retrospectively. Results: Clinical data for 58 patients (median age: 30.5 years) with R/R HL who received BV during the course of their treatment were collected and analyzed. Patients had received a median of 3 prior treatment regimens and most (91%) were treated with BV after relapse following autologous stem cell transplantation. Therapeutic responses after BV included 19 (33%) complete responses (CRs) and 8 (14%) partial responses. CRs occurred more frequently in patients who had received fewer prior treatment regimens. The 1-, 2-, and 3-year overall survival (OS) rates from initiation of BV were 78%, 62%, and 41%, respectively. Conclusion: Response rates and OS in this analysis of BV in real-world settings in the Czech Republic and Slovakia were consistent with those reported for pivotal clinical trials and from previous studies outside the clinical trial setting. The results support the efficacy of BV for treatment of R/R HL in real-life clinical practice.
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Affiliation(s)
- Zdeněk Král
- Department of Internal Medicine, Hematology and Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Jozef Michalka
- Department of Internal Medicine, Hematology and Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Heidi Móciková
- Department of Clinical Hematology, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Jana Marková
- Department of Clinical Hematology, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Alice Sýkorová
- 4th Department of Internal Medicine - Hematology, University Hospital Hradec Kralove, Czech Republic and Charles University in Prague, Faculty of Medicine in Hradec Kralove, Czech Republic
| | - David Belada
- 4th Department of Internal Medicine - Hematology, University Hospital Hradec Kralove, Czech Republic and Charles University in Prague, Faculty of Medicine in Hradec Kralove, Czech Republic
| | - Alexandra Jungová
- Department of Haemato-Oncology, University Hospital in Plzen, Plzen 304 60, Czech Republic
| | - Samuel Vokurka
- Department of Haemato-Oncology, University Hospital in Plzen, Plzen 304 60, Czech Republic
| | - Marie Lukášová
- Department of Hemato-Oncology, Faculty of Medicine and Dentistry, Palacký University, Olomouc, Czech Republic
| | - Vít Procházka
- Department of Hemato-Oncology, Faculty of Medicine and Dentistry, Palacký University, Olomouc, Czech Republic
| | - Juraj Ďuraš
- Department of Hemato-Oncology, Faculty of Medicine, University of Ostrava and University Hospital Ostrava, Ostrava, Czech Republic
| | - Roman Hájek
- Department of Hemato-Oncology, Faculty of Medicine, University of Ostrava and University Hospital Ostrava, Ostrava, Czech Republic
| | - Ladislav Dušek
- Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Czech Republic
| | - Ľuboš Drgoňa
- Department of Oncohematology, Comenius University in Bratislava and National Cancer Institute, Bratislava, Slovakia
| | - Miriam Ladická
- Department of Oncohematology, Comenius University in Bratislava and National Cancer Institute, Bratislava, Slovakia
| | - Veronika Ballová
- Department of Hematology/Oncology, Kantonsspital Baden, Baden, Switzerland
| | - Andrej Vranovský
- Department of Oncohematology, Comenius University in Bratislava and National Cancer Institute, Bratislava, Slovakia
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Ďuraš J, Procházka V, Belada D, Janíková A, Móciková H, Kopečková K, Hájek R, Trněný M. PREDICTIVE VALUE OF PRIMA-PROGNOSTIC INDEX (PRIMA-PI) IN FIRST RELAPSE OF FOLLICULAR LYMPHOMA. Hematol Oncol 2019. [DOI: 10.1002/hon.68_2631] [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)
- J. Ďuraš
- Department of Haematooncology; University Hospital Ostrava and Faculty of Medicine, University of Ostrava; Ostrava Czech Republic
| | - V. Procházka
- Department of Hemato-Oncology; Faculty of Medicine and Dentistry, Palacky University; Olomouc Czech Republic
| | - D. Belada
- Department of Internal Medicine - Hematology; University Hospital Hradec Kralove and Charles University in Prague; Hradec Kralove Czech Republic
| | - A. Janíková
- Department of Hematology and Oncology; University Hospital Brno; Brno Czech Republic
| | - H. Móciková
- Department of Internal Medicine and Haematology; University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University in Prague; Prague Czech Republic
| | - K. Kopečková
- Department on Oncology; University Hospital Motol; Prague Czech Republic
| | - R. Hájek
- Department of Haematooncology; University Hospital Ostrava and Faculty of Medicine, University of Ostrava; Ostrava Czech Republic
| | - M. Trněný
- First Dept. of Medicine - Hematology; Charles University General Hospital and First Faculty of Medicine; Prague Czech Republic
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Šimkovič M, Móciková H, Ďuraš J, Kamarádová K, Štěpánková P, Janíková A, Michalka J, Žák P, Belada D, Trněný M. DA-EPOCH-R VERSUS R-CHOP IN HIGH RISK DLBCL PATIENTS: ANALYSIS OF THE CZECH LYMPHOMA STUDY GROUP (CLSG). Hematol Oncol 2019. [DOI: 10.1002/hon.107_2631] [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: 11/09/2022]
Affiliation(s)
- M. Šimkovič
- Department of Internal Medicine - Haematology; University Hospital and Medical School Hradec Kralove; Hradec Králové Czech Republic
| | - H. Móciková
- Dept. of Internal Medicine and Haematology; Faculty Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University; Prague Czech Republic
| | - J. Ďuraš
- Department of Clinical Hematology; Teaching Hospital Ostrava; Ostrava Czech Republic
| | - K. Kamarádová
- The Fingerland Department of Pathology; University Hospital and Medical School Hradec Kralove; Hradec Kralove Czech Republic
| | - P. Štěpánková
- Department of Internal Medicine - Haematology; University Hospital and Medical School Hradec Kralove; Hradec Králové Czech Republic
| | - A. Janíková
- Department of Internal Medicine - Hematology and Oncology; Masaryk University and University Hospital Brno; Brno Czech Republic
| | - J. Michalka
- Department of Internal Medicine - Hematology and Oncology; Masaryk University and University Hospital Brno; Brno Czech Republic
| | - P. Žák
- Department of Internal Medicine - Haematology; University Hospital and Medical School Hradec Kralove; Hradec Králové Czech Republic
| | - D. Belada
- Department of Internal Medicine - Haematology; University Hospital and Medical School Hradec Kralove; Hradec Králové Czech Republic
| | - M. Trněný
- 1st Department of Medicine; First Medical Faculty, Charles University and General University Hospital; Prague Czech Republic
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Móciková H, Marková J, Gahérová Ľ, Král Z, Sýkorová A, Belada D, Procházka V, Martinková L, Papajík T, Kozák T. [Treatment of Relapsed and Refractory Hodgkin Lymphoma - Recommendations of the Czech Hodgkin Lymphoma Study Group]. Klin Onkol 2017; 29:342-346. [PMID: 27739312 DOI: 10.14735/amko2016342] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
High-dose chemotherapy with autologous stem cell transplantation remains the current standard of treatment for young patients with Hodgkin lymphoma in first relapse or in those who are refractory to first-line treatment. The most important prognostic factors in relapses are clinical stage IV, poor performance status, bulky mass, and less than partial remission after salvage chemotherapy. Standard salvage chemotherapy in relapse before autologous transplantation has not been defined; however, DHAP and ICE are most frequently used in this setting. A standard conditioning regimen before autologous transplantation is BEAM. Tandem autologous transplantation has been investigated in high-risk patients. Brentuximab vedotin is recommended as a consolidation treatment in patients with a high risk of relapse after autologous transplantation. Brentuximab vedotin is the standard of treatment for relapse after autologous transplantation, and subsequent allogeneic stem cell transplantation should be considered in young patients. Bretuximab vedotin in combination with bendamustine, nivolumab, and pembrolizumab, and combinations thereof with other drugs, were investigated in clinical trials in relapsed or refractory patients with Hodgkin lymphoma.Key words: Hodgkin lymphoma - autologous stem cell transplantation - brentuximab vedotin - nivolumabThis work was supported by grant awarded by AZV 16-29857, Ministry of Health in Czech Republic, Research project P 27/2012 awarded by Charles University in Prague, 3rd Faculty of Medicine, Prague.The authors declare they have no potential confl icts of interest concerning drugs, products, or services used in the study.The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.Submitted: 7. 6. 2016Accepted: 24. 8. 2016.
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Sýkorová A, Pytlík R, Móciková H, Janíková A, Procházka V, Belada D, Šálek D, Benešová K, Klener P, Ďuraš J, Smolej L, Šimkovič M, Campr V, Vosáhlová V, Blahovcová P, Trněný M. Burkitt lymphoma-multicenter retrospective data analysis from the Czech Lymphoma Study Group-NiHiL project. Hematol Oncol 2017. [DOI: 10.1002/hon.2439_90] [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)
- A. Sýkorová
- 4th Department of Internal Medicine-Hematology; University Hospital and Faculty of Medicine; Hradec Kralove Czech Republic
| | - R. Pytlík
- 1st Department of Medicine-Department of Hematology; Charles University, General Hospital; Prague Czech Republic
| | - H. Móciková
- Department of Clinical Hematology; University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University; Prague Czech Republic
| | - A. Janíková
- Department of Hematology and Oncology; University Hospital; Brno Czech Republic
| | - V. Procházka
- Department of Hemato-Oncology, Faculty of Medicine and Dentistry; Palacky University; Olomouc Czech Republic
| | - D. Belada
- 4th Department of Internal Medicine-Hematology; University Hospital and Faculty of Medicine; Hradec Kralove Czech Republic
| | - D. Šálek
- Department of Hematology and Oncology; University Hospital; Brno Czech Republic
| | - K. Benešová
- 1st Department of Medicine-Department of Hematology; Charles University, General Hospital; Prague Czech Republic
| | - P. Klener
- 1st Department of Medicine-Department of Hematology; Charles University, General Hospital; Prague Czech Republic
| | - J. Ďuraš
- Department of Hemato-Oncology; Faculty of Medicine; Ostrava Czech Republic
| | - L. Smolej
- 4th Department of Internal Medicine-Hematology; University Hospital and Faculty of Medicine; Hradec Kralove Czech Republic
| | - M. Šimkovič
- 4th Department of Internal Medicine-Hematology; University Hospital and Faculty of Medicine; Hradec Kralove Czech Republic
| | - V. Campr
- Institute of Pathology; University Hospital Motol; Prague Czech Republic
| | - V. Vosáhlová
- 4th Department of Internal Medicine-Hematology; University Hospital and Faculty of Medicine; Hradec Kralove Czech Republic
| | - P. Blahovcová
- Data Management Office, 1st Department of Medicine-Department of Hematology; Charles University, General Hospital; Prague Czech Republic
| | - M. Trněný
- 1st Department of Medicine-Department of Hematology; Charles University, General Hospital; Prague Czech Republic
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Fayette D, Gahérová Ľ, Móciková H, Marková J, Kozák T, Horáček J. [Chemotherapy-related Cognitive Impairment in Patients with Hodgkin Lymphoma - Pathophysiology and Risk Factors]. Klin Onkol 2017; 30:93-99. [PMID: 28397504 DOI: 10.14735/amko201793] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Cognitive impairment (impairment of memory, attention, or concentration) is documented in 17-75% of patients with various malignancies treated with chemotherapeutic agents that worsen quality of life. CRCI affects patients of all ages. The impairment of cognitive function in connection with chemotherapy is usually mild, but an event. relationship with dementia remains to be confirmed. Chemotherapy in combination with radiotherapy in Hodgkin lymphoma can cure 80-90% of patients. AIM This review summarizes the most frequently observed changes in cognitive function in patients suffering from CRCI. The article further describes the possible pathophysiological mechanisms behind these changes and the risk factors that can increase the likelihood of cognitive functional impairment after chemotherapy of malignant tumors. Special attention is given to how this relates to Hodgkins lymphoma. We also discuss the neuroprotective factors involved in chemotherapy-related cognitive impairment and its treatment options. CONCLUSION Changes occur mainly in the ability to learn and remember, in the speed of reactions, and in attention and executive functions. Although CRCI pathophysiological mechanisms are complex and not yet fully understood, the involvement of neurotoxicity, such as that induced by treatment, anemia, higher levels of oxidative stress and inflammatory responses, genetic factors, and reduced brain connectivity is discussed. CRCI is further modified by comorbidities and patient age. Pharmacological and nonpharmacological treatment options for CRCI are outlined.Key words: Hodgkin lymphoma - chemotherapy - cognitive impairment - risk factors The project was supported by the grant of the Agency for the Czech Republic Health Research of the Ministry of Health of the Czech Republic 16-29857A and by the project Sustainability for the National Institute of Mental Health No. LO1611 with a financial support of the Ministry of Education, Youth and Sports of the Czech Republic in the frame of the National Sustainability Programme I. The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.Submitted: 29. 9. 2016Accepted: 12. 2. 2017.
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Sýkorová A, Pytlík R, Móciková H, Belada D, Benešová K, Papajík T, Janíková A, Šálek D, Procházka V, Vokurka S, Campr V, Klener P, Kubáčková K, Trněný M. [Staging and Treatment Response Evaluation in Malignant Lymphomas - Czech Lymphoma Study Group Recommendations According to Criteria Revised in 2014 (Lugano Classification)]. Klin Onkol 2017; 29:295-302. [PMID: 27534788 DOI: 10.14735/amko2016295] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Recent advances in the use of the imaging modalities, especially PET/CT, and their utilization for determining clinical stage (CS) and assessment treatment response (TR) in malignant lymphomas, along with development of prognostic tools and new treatment modalities, formed the basis for the revised criteria for evaluating CS and TR (published as the Lugano classification, 2014). MATERIALS AND METHODS The authors summarize the new Lugano recommendations (published in 2014) and the changes from the criteria published in 2007. Moreover, discussion of the changes places emphasis on practical use. The practicality of the Lugano classification, 2014 was the subject of consensus meeting at the annual meeting of the Cooperative Lymphoma Study Group (CLSG) in March 2015. This study reports the final consensus. The CLSG recommends use of the Lugano classification, 2014, but recommends some modifications. CONCLUSIONS Standardization of the criteria used to determine CS and TR in malignant lymphomas has led to improvements in initial staging and assessment of TR. The criteria are helpful for unifying response assessment in clinical trials and simplify the work of regulatory agencies (e.g., the EMA and the Czech State Institute for Drug Control) when registering new drugs. It also allows evaluation of treatment outcomes outside clinical trials, for example within the CLSG prospective registry of patients with newly diagnosed lymphoma. KEY WORDS malignant lymphoma - computed tomography - positron emission tomography - staging - treatment responseThis work was supported by the grant Prvouk P27/2012 of the Third Faculty of Medicine, Charles University in Prague and by the grant of the Czech Lymphoma Study Group No. NT12193-5/2011.The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.Submitted: 24. 1. 2016Accepted: 16. 2. 2016.
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Musilová K, Deván J, Zlámalíková L, Křen L, Móciková H, Procházka V, Mayer J, Trněný M, Janíková A, Mráz M. [The Importance of MicroRNA Deregulation in the Molecular Pathogenesis and Histological Transformation of Follicular Lymphoma]. Klin Onkol 2017; 30:163-165. [PMID: 28471196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND Molecular pathogenesis of follicular lymphoma (FL) is characterized by substantial dysregulation of epigenetic regulators. Many cases of FL are associated with the aberrant expression of non-coding regulatory RNAs, namely microRNAs (miRNA). Here we studied changes in miRNA expression and their association with histological transformation of FL to diffuse large B-cell lymphoma (DLBCL). MATERIAL AND METHODS To identify changes in miRNA levels during FL transformation we performed a global expression analysis of 377 miRNAs in 16 samples (8 pairs) from FL patients vs. transformed FL (tFL) (TLDA miRNA cards; Thermo Fisher Scientific). The association of miRNA expression with clinical-biological characteristics and target proteins were further analyzed in a cohort of 89 FL patients. RESULTS The miRNA expression profiling of paired FL-tFL samples revealed statistically significant changes in the expression of five miRNAs (p < 0.05). Four of them were down-regulated and one was up-regulated in tFL compared to FL. Lower levels of one of these miRNA were also associated with higher proliferation rate of FL cells (Ki-67 > 20%), higher FLIPI score ( 3) and shorter overall survival of FL patients. Furthermore, we found that this miRNA regulates the levels of FOXP1 protein in FL. The patients with high-level FOXP1 expression (> 70% positive cells) had significantly shorter overall survival in comparison to those with low-level FOXP1 expression (< 30% positive cells). Moreover, FOXP1 protein levels were higher in most tFL samples compared to FL before transformation. CONCLUSION We found miRNAs associated with the transformation of FL to a more aggressive DLBCL, and described that one of them could serve as a prognostic marker. We found that reduced expression of this tFL-associated miRNA results in increased levels of FOXP1 protein and we assume that the increased activity of FOXP1 proto-oncogene contributes to the histological transformation of FL.Key words: follicular lymphoma - microRNA - histological transformation This work was supported by Czech Ministry of Health registration No. 16-29622A. All rights reserved. The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.Submitted: 5. 3. 2017Accepted: 26. 3. 2017.
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Procházka V, Papajík T, Janíková A, Belada D, Kozák T, Šálek D, Sýkorová A, Móciková H, Campr V, Dlouhá J, Langová K, Fürst T, Trněný M. Frontline intensive chemotherapy improves outcome in young, high-risk patients with follicular lymphoma: pair-matched analysis from the Czech Lymphoma Study Group Database. Leuk Lymphoma 2016; 58:601-613. [DOI: 10.1080/10428194.2016.1213834] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Vít Procházka
- Department of Hemato-Oncology, Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic
| | - Tomáš Papajík
- Department of Hemato-Oncology, Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic
| | - Andrea Janíková
- Department of Hematology and Oncology, University Hospital, Brno, Czech Republic
| | - David Belada
- 4th Department of Internal Medicine – Hematology, University Hospital and Faculty of Medicine, Hradec Kralove, Czech Republic
| | - Tomáš Kozák
- Department of Clinical Hematology, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - David Šálek
- Department of Hematology and Oncology, University Hospital, Brno, Czech Republic
| | - Alice Sýkorová
- 4th Department of Internal Medicine – Hematology, University Hospital and Faculty of Medicine, Hradec Kralove, Czech Republic
| | - Heidi Móciková
- Department of Clinical Hematology, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Vít Campr
- Institute of Pathology, University Hospital Motol, Prague, Czech Republic
| | - Jitka Dlouhá
- Data Management Office, 1st Department of Internal Medicine – Department of Hematology, First Faculty of Medicine and General Teaching Hospital, Prague, Czech Republic
| | - Kateřina Langová
- Department of Medical Biophysics, Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic
| | - Tomáš Fürst
- Department of Mathematical Analysis and Applications of Mathematics, Faculty of Science, Palacký University, Olomouc, Czech Republic
| | - Marek Trněný
- 1st Department of Internal Medicine – Department of Hematology, First Faculty of Medicine and General Teaching Hospital, Prague, Czech Republic
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Móciková H, Sýkorová A, Štěpánková P, Marková J, Michalka J, Král Z, Burešová L, Belada D. Treatment and Prognosis of Relapsed or Refractory Hodgkin Lymphoma Patients Ineligible for Stem Cell Transplantation. Klin Onkol 2014; 27:424-8. [DOI: 10.14735/amko2014424] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Dědečková K, Móciková H, Belada D, Janíková A, Dolečková M, Malinová B, Feltl D, Vošmik M, Svoboda T, Marková J, Trněný M. [The role of radiotherapy in the treatment of malignant lymphomas - recommendations of the Czech Lymphoma Study Group]. Klin Onkol 2013; 26:99-109. [PMID: 23718668 DOI: 10.14735/amko201399] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND Indication of radiotherapy in lymphoma treatment is an important strategic decision requiring comprehensive expertise. It also calls for a better definition of the position of radiotherapy in clinical practice. DESIGN This position paper represents a consensus between hematooncologists and radiation oncologists on the role of RT in treatment of different histological types and stages of malignant lymphomas. The discussion was underway within professional societies of both specializations (Czech Lymphoma Study Group for the hematooncologists and the Society of Radiation Oncology, Biology and Physics for the radiation oncologists). RESULTS The consensus presented here was reached in early 2012 and draws on evidence-based medicine and clinical practice. Besides defining the role of radiotherapy in lymphoma treatment, this paper also gives specific recommendations on total doses of radiotherapy in lymphoma treatment. CONCLUSION These recommendations will supplement 7th edition of "Diagnostic and treatment guidelines in patients with malignant lymphoma" scheduled for publication in 2013.
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Affiliation(s)
- K Dědečková
- Ustav radiacni onkologie 1. LF UK a Nemocnice Na Bulovce, Praha.
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Bittner N, Cipkova A, Móciková H, Wojciechowska-Lampka E, Balázs M, Ocvirk J. Current management of chemotherapy-induced anemia with darbepoetin alfa: The APRIORI study. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e19723] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [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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Sýkorová A, Belada D, Smolej L, Pytlík R, Benesová K, Vásová I, Papajík T, Sálek D, Procházka V, Matuska M, Brejcha M, Kubácková K, Kabícková E, Móciková H, Campr V, Trnený M. [Staging of non-Hodgkin's lymphoma--recommendations of the Czech Lymphoma Study Group]. Klin Onkol 2010; 23:146-154. [PMID: 20608324] [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: 05/29/2023]
Abstract
BACKGROUNDS The Ann Arbor system is typically used for the staging of Non-Hodgkin's lymphomas. This classification was nevertheless originally developed in the 1970s for Hodgkin's lymphoma, a disease usually confined to the lymph nodes with less frequent dissemination to extralymphatic organs/tissues and extremely rare primary extranodal involvement. Non-Hodgkin's lymphomas, however, are more often associated with extralymphatic involvement and primary extranodal lymphomas are relatively common (approximately 1/3 of cases). Therefore, the value of the Ann Arbor staging system appears to be limited in these cases. An analysis of data from centres participating within the Czech Lymphoma Study Group showed that staging of Non-Hodgkin's lymphomas with extranodal involvement is not uniform. DESIGN At the end of 2009, a draft for a Non-Hodgkin's lymphomas staging system was put forward for use by the lymphoma register of the Czech Lymphoma Study Group with special regard paid to the involvement of extralymphatic organs/tissues. This draft was further refined following comments from members of the Czech Lymphoma Study Group committee and the final form was accepted at the meeting of the Czech Lymphoma Study Group committee in January 2010. RESULTS A consensus was reached at the meeting of the Czech Lymphoma Study Group committee regarding the staging of various combinations of nodal and extranodal involvement. For the purpose of suitable staging and appropriate treatment intensity, extranodal organs were divided into "major"--liver, lungs, bones, mesothelium (pleura, peritoneum, pericardium) and soft tissues. All other organs were defined as "minor". CONCLUSION The Ann Arbor staging system is suitable for the staging of Non-Hodgkin's lymphomas with lymph node/lymphatic tissue involvement. As regards the extralymphatic spread of the disease or primary extranodal lymphomas, this classification should rather be adapted to practical needs. The validity of the updated classification system will be assessed in both prospective and retrospective Czech Lymphoma Study Group studies.
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Affiliation(s)
- A Sýkorová
- Oddelení klinické hematologie, II. interní klinika FN HK a LF UK, Hradec Králové.
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Móciková H, Konífrová E, Stríteský J. [Serious cutaneous toxicity following ifosfamide, gemcitabine and vinorelbine therapy in a patient with relapsed Hodgkin lymphoma and ichthyosis]. Cas Lek Cesk 2009; 148:434-437. [PMID: 19899733] [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: 05/28/2023]
Abstract
Nodular sclerosis classical Hodgkin lymphoma, clinical stage IIB with cervical and axillar lymph node involvement was histologically proven in a 47-year-old male patient with a long-lasting history of ichthyosis. Skin histology revealed only nonspecific lichenoid inflammatory changes. Patient was treated with six cycles of combined chemotherapy: doxorubicin, bleomycin, vinblastine and dacarbazine. 15 months after initial treatment the first relapse of Hodgkin lymphoma was histologically confirmed and involvement of lymph nodes was identical with initial staging. Patient was successfully treated with six cycles of chemotherapy: ifosfamide, carboplatinum and etoposide followed by radiotherapy. The above mentioned chemotherapies did not cause serious cutaneous toxicity. 4 years after previous therapy the second relapse of Hodgkin lymphoma occurred with axillar and inguinal lymph node involvement. Skin histology confirmed nonspecific lichenoid inflammatory changes. Patient was treated with three cycles of combined chemotherapy: ifosfamide, gemcitabine, vinorelbine and prednisone. This chemotherapy caused neutropenia WHO grade 4 after each cycle and a serious diffuse toxoallergic cutaneous reaction with bullous erythema developed. Several skin lesions fulfilled criteria for cutaneous WHO grade 3 and 4 toxicity. We assumed that combined toxic effect of gemcitabine and vinorelbine resulted in serious cutaneous toxicity under pre-existing condition of diffuse ichthyosis. The cutaneous toxicity subsequently resolved and residual lymph nodes were irradiated.
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Affiliation(s)
- H Móciková
- Univerzita Karlova v Praze, lékarská fakulta, I. interní klinika--klinika hematologie VFN.
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Osmancik PP, Bednar F, Móciková H, Stros P, Jirasek K, Straka Z, Widimsky P. The comparison of platelet activity between patients with patent vs. occluded coronary artery bypass grafts. Thromb Res 2007; 120:523-9. [PMID: 17303221 DOI: 10.1016/j.thromres.2006.12.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2006] [Revised: 11/17/2006] [Accepted: 12/15/2006] [Indexed: 10/23/2022]
Affiliation(s)
- Pavel P Osmancik
- Cardiocenter, Department of Cardiology, 3rd Medical School, Charles University and University Hospital Kralovske Vinohrady Prague, Czech Republic.
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Osmancik PP, Bednar F, Móciková H. Glycemia, triglycerides and disease severity are best associated with higher platelet activity in patients with stable coronary artery disease. J Thromb Thrombolysis 2007; 24:105-7. [PMID: 17308964 DOI: 10.1007/s11239-006-9038-z] [Citation(s) in RCA: 6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2006] [Accepted: 10/19/2006] [Indexed: 10/23/2022]
Abstract
BACKGROUND Inconsistent findings are reported about the relation of platelet activity to disease severity in stable patients with chronic coronary artery disease (CAD). Nevertheless, most reports studied only very small groups of patients. The purpose aim of our study was to assess the relation of platelet activity to disease severity in sufficient number of patients with chronic CAD. METHODS One hundred and sixty stable patients with chronic CAD were studied (25 with single-, 63 with double- and 72 with triple-vessel disease). 91% of them were on aspirin, 1.6% on clopidogrel medication. Platelet activity was determined as membrane expression of antigens CD62P (P-selectin, as % of positive cells) and CD41 (part of GpIIb/IIIa integrin, as mean fluorescence intensity) by flow cytometry. Platelet aggregability was measured by ADP-optical aggregometry. Data sets were compared by Kruskal-Wallis test, correlation by Spearman test. Data are shown as median with 25-75 percentiles. RESULTS Membrane CD62P expression correlated with vessel severity (P < 0.001, Kruskal-Wallis test). Patients with triple-vessel disease had the highest CD62P expression (1.6; 1.1-2.0) followed by patients with double-vessel (1.2; 0.63-1.95) and single-vessel (0.7; 0.30-0.84) disease. Positive correlation was found between CD62P expression with triglycerides (r = 0.49, P < 0.05) and CD41 with fasting glucose (r = 0.48, P < 0.05). No differences in CD41 expression or ADP aggregability were found between groups. CONCLUSION Higher platelet activity is present in patients with more severe CAD. More aggressive anti-platelet treatment in these patients should be considered, especially when metabolic syndrome is simultaneously present.
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Affiliation(s)
- Pavel P Osmancik
- Cardiocenter, Department of Cardiology, 3rd Medical School, Charles University and FNKV, Srobarova 50, 100 34 Prague, Czech Republic.
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Móciková H, Marková J, Bĕlohlávek O, Cáp F, Cermák F, Feltl D, Kozák T. [Comparison between conventional imaging methods and positron emission tomography in the treatment of Hodgkin's lymphoma]. Cas Lek Cesk 2004; 143:476-9; discussion 479-80. [PMID: 15373291] [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: 04/30/2023]
Abstract
BACKGROUND Positron emission tomography with fluorodeoxyglucose offers the possibility to differentiate between lymphoma and nonmalignant tissue. The aim of this retrospective study was a comparison between PET and conventional imaging methods before and after therapy--during the follow-up of Hodgkin's lymphoma. METHODS AND RESULTS The group of 94 patients with HL underwent 180 PET examinations. PET was performed in 53 patients during initial staging of lymphoma. 119 PET studies were undertaken after therapy during the follow-up. Eight patients underwent PET examination for suspected relapse or progression of HL. Findings were verified by a follow-up in all patients and by histology in selected cases. PET and conventional imaging methods were positive in 42 of 53 (79%) patients in initial stages. The stage of the disease was changed in 7 patients (13.2%) according to PET. False negative findings were recorded in three cases and false positive in one case. Sensitivity of PET was higher compared to conventional imaging methods (92% vs 87%) in initial staging. PET and conventional imaging methods were identical in 94.9% of cases during the follow-up (77.3% negative and 17.6% positive findings). Sensitivity of PET during the follow-up after therapy was higher compared to conventional imaging methods (99.1% vs 95.7%). PET was positive in all eight cases in relapse/progression of HL and conventional imaging methods were positive in only seven of eight cases. CONCLUSIONS PET is a more sensitive method in initial staging, during follow-up and in suspected progression/relapse of HL than conventional imaging methods and it should be included into routine examination methods of HL.
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Affiliation(s)
- H Móciková
- Oddĕlení klinické hematologie 3.LF UK a FNKV, Praha.
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