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Bastos‐Oreiro M, Abrisqueta P, Gutierrez A, Jiménez Ubieto A, Poza M, Fernanez‐Caldas P, LLacer MJ, Gonzalez de Villambrosia S, Córdoba R, López A, Ceballos E, Navarro B, Muntañola A, Donato E, Diez‐Baeza E, Escoda L, Luzardo H, Peñarrubia MJ, García Belmonte D, Pardal E, Lozada C, Martín García‐Sancho A. New therapies for relapsed or refractory aggressive B-cell lymphoma increase survival: Analysis from the RELINF registry of the GELTAMO group. Hemasphere 2024; 8:e70. [PMID: 38650598 PMCID: PMC11033920 DOI: 10.1002/hem3.70] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 03/17/2024] [Accepted: 04/02/2024] [Indexed: 04/25/2024] Open
Affiliation(s)
- Mariana Bastos‐Oreiro
- Hospital Universitario Gregorio Marañon. Instituto de investigación Sanitaria Gregorio Marañon (IiSGM)MadridSpain
| | | | | | | | - Maria Poza
- Hospital Universitario 12 de OctubreMadridSpain
| | - Paula Fernanez‐Caldas
- Hospital Universitario Gregorio Marañon. Instituto de investigación Sanitaria Gregorio Marañon (IiSGM)MadridSpain
| | - María José LLacer
- Hospital Universitario Gregorio Marañon. Instituto de investigación Sanitaria Gregorio Marañon (IiSGM)MadridSpain
| | | | | | | | | | | | | | | | - Eva Diez‐Baeza
- Hospital Universitario de Salamanca, IBSAL, CIBERONCUniversidad de SalamancaSalamancaSpain
| | | | - Hugo Luzardo
- Hospital Universitario Dr NegrinGran CanariaSpain
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2
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Ribera JM, Morgades M, Garcia-Calduch O, Sirvent M, Buendia B, Cervera M, Luzardo H, Hernandez-Rivas JM, Sitges M, Garcia-Cadenas I, Abrisqueta P, Montesinos P, Bastos-Oreiro M, De Llano MPQ, Bravo P, Torrent A, Herrera P, Garcia-Guinon A, Vall-Llovera F, Serrano J, Terol MJ, Bergua JM, Garcia-Noblejas A, Barrenetxea C, Llorente L, Garcia-Belmonte D, Gimeno E, Cladera A, Mercadal S, Sancho JM. Feasibility and outcomes after dose reduction of immunochemotherapy in young adults with Burkitt lymphoma and leukemia: results of the BURKIMAB14 trial. Haematologica 2024; 109:543-552. [PMID: 37560813 PMCID: PMC10828757 DOI: 10.3324/haematol.2023.283342] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 07/31/2023] [Indexed: 08/11/2023] Open
Abstract
High dose-intensive or infusional intermediate-dose immunochemotherapy is highly effective treatment for Burkitt lymphoma irrespective of human immunodeficiency virus (HIV) infection. However, toxicities of these regimens are relevant, especially in older adults and elderly patients. The prospective multicenter BURKIMAB14 trial included four to six blocks of immunochemotherapy according to stage (localized: 1 and 2 non-bulky; advanced: 2 bulky, 3, 4) and age, with dose reduction in patients >55 years old. Dose-intensity of chemotherapy was reduced in patients ≤55 years old after achieving complete metabolic response (CMR). Their outcomes were compared with those of similar patients included in the former BURKIMAB08 trial, in which there was no dose reduction. CMR was attained in 86 of 107 (80%) patients (17/19 in localized stages and 69/88 in advanced stages). Patients from the BURKIMAB14 trial ≤55 years old showed similar overall survival (OS), fewer infections and cytopenias than patients from the BURKIMAB08 trial. Patients >55 years old had a significantly higher treatment- related mortality despite dose reduction of chemotherapy. With a median follow-up of 3.61 years the 4-year OS probability was 73% (range, 63-81%). Age (≤55 vs. >55 years) and stage (localized vs. advanced) had prognostic significance. No significant differences in OS were observed in HIV-positive versus HIV-negative patients. The results of BURKIMAB14 are similar to those of other dose-intensive immunochemotherapy trials. Age >55 years and advanced stage, but not HIV infection, were associated with poor survival. Dose reduction of chemotherapy in young adults in CMR is safe and does not impact outcomes (clinicaltrials gov. Identifier: NCT05049473).
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Affiliation(s)
- Josep-Maria Ribera
- Institut Catala d'Oncologia-Hospital Germans Trias i Pujol. Josep Carreras Research Institute-Badalona. Universitat Autonoma de Barcelona.
| | - Mireia Morgades
- Institut Catala d'Oncologia-Hospital Germans Trias i Pujol. Josep Carreras Research Institute-Badalona. Universitat Autonoma de Barcelona
| | - Olga Garcia-Calduch
- Institut Catala d'Oncologia-Hospital Germans Trias i Pujol. Josep Carreras Research Institute-Badalona. Universitat Autonoma de Barcelona
| | | | | | - Marta Cervera
- Institut Catala d'Oncologia-Hospital Joan XXIII. Tarragona
| | - Hugo Luzardo
- Hospital Universitario de Gran Canaria Dr. Negrin. Las Palmas de Gran Canaria
| | - Jesus-Maria Hernandez-Rivas
- IBSAL, IBMCC, Centro de Investigacion del Cancer, CIBERONC, Universidad de Salamanca-CSIC, Hospital Universitario de Salamanca. Salamanca
| | - Marta Sitges
- Institut Catala d'Oncologia-Hospital Josep Trueta. Girona
| | | | | | | | | | | | - Pilar Bravo
- Hospital Universitario de Fuenlabrada. Madrid
| | - Anna Torrent
- Institut Catala d'Oncologia-Hospital Germans Trias i Pujol. Josep Carreras Research Institute-Badalona. Universitat Autonoma de Barcelona
| | | | | | | | | | | | | | | | | | | | | | | | | | - Santiago Mercadal
- Institut Catala d'Oncologia-Hospital Duran i Reynals. L'Hospitalet de Llobregat
| | - Juan-Manuel Sancho
- Institut Catala d'Oncologia-Hospital Germans Trias i Pujol. Josep Carreras Research Institute-Badalona. Universitat Autonoma de Barcelona
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3
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Bastos-Oreiro M, Gutierrez A, Iacoboni G, López Corral L, Reguera JL, Abrisqueta P, Delgado J, Terol MJ, Hernani R, Martínez N, Ortíz V, Bailen R, Gomez-Centurión I, Caballero A, Sanz J, Guerra Domínguez L, Luzardo H, Mussetti A, Jiménez-Ubieto A, Sancho JM, Sureda A, Pérez A, Barba P, Kwon M, Martín García-Sancho A. Impact of SCHOLAR-1 Criteria on Chimeric Antigen Receptor T Cell Therapy Efficacy in Aggressive B Lymphoma: A Real-World GELTAMO/GETH Study. Transplant Cell Ther 2023; 29:747.e1-747.e10. [PMID: 37659694 DOI: 10.1016/j.jtct.2023.08.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 07/17/2023] [Accepted: 08/27/2023] [Indexed: 09/04/2023]
Abstract
In the pre-chimeric antigen receptor T cell (CAR-T) therapy era, the SCHOLAR-1 study identified a group of patients with refractory aggressive B cell lymphoma (ABCL) with particularly poor prognoses. We recently published our real-world data from Spain, focused on this SCHOLAR-1 refractory group, and compared patients who underwent CAR-T therapy with the previous standard of care. In this study, we found that the efficacy of CAR-T therapy in refractory patients, in terms of progression-free survival (PFS) and overall survival (OS), was superior to that of the treatments available in the pre-CAR-T era. The main objective of these new analyses was to analyze treatment efficacy in terms of response rates and survival for patients with ABCL with or without the SCHOLAR-1 criteria. In addition, we analyzed the prognostic impact of each SCHOLAR-1 criterion independently. Our study aimed to assess the prognostic impact of SCHOLAR-1 criteria on ABCL patients treated with CAR-T therapy in Spain. This multicenter, retrospective, observational study. We included all adult patients treated with commercially available CAR-T cell products and diagnosed with ABCL different from primary mediastinal large B cell lymphoma between February 2019 and July 2022. Patients meeting any SCHOLAR-1 criteria (progressive disease as the best response to any line of therapy, stable disease as the best response to ≥4 cycles of first-line therapy or ≥2 cycles of later-line therapy, or relapse at <12 months after autologous stem cell transplantation [auto-SCT]) in the line of treatment before CAR-T therapy (SCHOLAR-1 group) were compared with those not meeting any of these criteria (non-SCHOLAR-1 group). To analyze the prognostic impact of individual SCHOLAR-1 criteria, all the patients who met any of the SCHOLAR-1 criteria at any time were included to assess whether these criteria have the same prognostic impact in the CAR-T era. In addition, patients were grouped according to whether they were refractory to the first line of treatment, refractory to the last line of treatment, or relapsed early after auto-SCT. The PFS and OS were calculated from the time of appearance of the SCHOLAR-1 refractoriness criteria. Of 329 patients treated with CAR-T (169 with axi-cel and 160 with tisa-cel), 52 were in the non-SCHOLAR-1 group and 277 were in the SCHOLAR-1 group. We found significantly better outcomes in the non-SCHOLAR-1 patients compared with the SCHOLAR-1 patients (median PFS of 12.2 and 3.3 months, respectively; P = .009). In addition, axi-cel showed better results in terms of efficacy than tisa-cel for both the non-SCHOLAR-1 group (hazard ratio [HR] for PFS, 2.7 [95% confidence interval (CI), 1.1 to 6.7; P = .028]; HR for OS, 7.1 [95% CI, 1.5 to 34.6; P = .015]) and SCHOLAR-1 group (HR for PFS, 1.8 [95% CI, 1.3 to 2.5; P < .001]; HR for OS, 1.8 [95% CI, 1.2 to 2.6; P = .002]), but also significantly more toxicity. Finally, separately analyzing the prognostic impact of each SCHOLAR-1 criterion revealed that refractoriness to the last line of treatment was the variable with the most significant impact on survival. In conclusion, SCHOLAR-1 refractoriness criteria notably influence the efficacy of CAR-T therapy. In our experience, axi-cel showed better efficacy than tisa-cel for both SCHOLAR-1 and non-SCHOLAR-1 patients. Refractoriness to the last line of treatment was the variable with the most significant impact on survival in the CAR-T therapy era.
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Affiliation(s)
- Mariana Bastos-Oreiro
- Hospital Universitario Gregorio Maran, Instituto de investigación sanitaria Gregorio Marañon (IisGM), Madrid, Spain.
| | - Antonio Gutierrez
- Hospital Universitario Son Espases, IdISBa, Palma de Mallorca, Spain
| | | | - Lucía López Corral
- Hospital Clínico Universitario de Salamanca, IBSAL, CIBERONC, Salamanca, Spain
| | | | | | | | | | - Rafael Hernani
- Hospital Clínico Universitario de Valencia, Valencia, Spain
| | | | | | - Rebeca Bailen
- Hospital Universitario Gregorio Maran, Instituto de investigación sanitaria Gregorio Marañon (IisGM), Madrid, Spain
| | - Ignacio Gomez-Centurión
- Hospital Universitario Gregorio Maran, Instituto de investigación sanitaria Gregorio Marañon (IisGM), Madrid, Spain
| | - Ana Caballero
- Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Jaime Sanz
- Hospital Universitario La Fé de Valencia, Balencia, Spain
| | | | - Hugo Luzardo
- Hospital Universitario Dr. Negrin, Las Palmas de Gran Canaria, Spain
| | - Alberto Mussetti
- Institut Català d'Oncologia-Hospitalet, IDIBELL, Universitat de Barcelona, Barcelona, Spain
| | | | | | - Anna Sureda
- Institut Català d'Oncologia-Hospitalet, IDIBELL, Universitat de Barcelona, Barcelona, Spain
| | | | - Pere Barba
- Hospital Universitario Vall d´Hebron, Barcelona, Spain
| | - Mi Kwon
- Hospital Universitario Gregorio Maran, Instituto de investigación sanitaria Gregorio Marañon (IisGM), Madrid, Spain
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Bastos-Oreiro M, Gutierrez A, Reguera JL, Iacoboni G, López-Corral L, Terol MJ, Ortíz-Maldonado V, Sanz J, Guerra-Dominguez L, Bailen R, Mussetti A, Abrisqueta P, Hernani R, Luzardo H, Sancho JM, Delgado-Serrano J, Salar A, Grande C, Bento L, González de Villambrosía S, García-Belmonte D, Sureda A, Pérez-Martínez A, Barba P, Kwon M, Martín García-Sancho A. Best Treatment Option for Patients With Refractory Aggressive B-Cell Lymphoma in the CAR-T Cell Era: Real-World Evidence From GELTAMO/GETH Spanish Groups. Front Immunol 2022; 13:855730. [PMID: 35911769 PMCID: PMC9336530 DOI: 10.3389/fimmu.2022.855730] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 05/27/2022] [Indexed: 01/12/2023] Open
Abstract
Real-world evidence comparing the efficacy of chimeric antigen receptor (CAR) T-cell therapy against that of the previous standard of care (SOC) for refractory large B-cell lymphoma (LBCL) is scarce. We retrospectively collected data from patients with LBCL according to SCHOLAR-1 criteria treated with commercial CAR T-cell therapy in Spain (204 patients included and 192 treated, 101 with axicabtagene ciloleucel [axi-cel], and 91 with tisagenlecleucel [tisa-cel]) and compared the results with a historical refractory population of patients (n = 81) obtained from the GELTAMO-IPI study. We observed superior efficacy for CAR-T therapy (for both axi-cel and tisa-cel) over pSOC, with longer progression-free survival (PFS) (median of 5.6 vs. 4–6 months, p ≤ 0.001) and overall survival (OS) (median of 15 vs. 8 months, p < 0.001), independently of other prognostic factors (HR: 0.59 (95% CI: 0.44–0.80); p < 0.001] for PFS, and 0.45 [(95% CI: 0.31–0.64)] for OS). Within the CAR-T cohort, axi-cel showed longer PFS (median of 7.3 versus 2.8 months, respectively, p = 0.027) and OS (58% versus 42% at 12 months, respectively, p = 0.048) than tisa-cel. These differences were maintained in the multivariable analysis. On the other hand, axi-cel was independently associated with a higher risk of severe cytokine release syndrome and neurotoxicity. Our results suggest that the efficacy of CAR-T cell therapy is superior to pSOC in the real-world setting. Furthermore, axi-cel could be superior in efficacy to tisa-cel, although more toxic, in this group of refractory patients according to SCHOLAR-1 criteria.
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Affiliation(s)
- Mariana Bastos-Oreiro
- Hospita Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
- *Correspondence: Mariana Bastos-Oreiro,
| | - Antonio Gutierrez
- Hospital Universitario Son Espases, Fundació Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma de Mallorca, Spain
| | - Juan Luís Reguera
- Hematology Department, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Gloria Iacoboni
- Hematology Department, Hospital Vall d’ Hebron, Barcelona, Spain
| | - Lucía López-Corral
- Hospital Universitario de Salamanca, Instituto de investigación biomédica de Salamanca (IDBAL), CIBERONC, Salamanca, Spain
| | - María José Terol
- Hematology Department, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | | | - Jaime Sanz
- Hematology Department, Hospital Universitario La Fé de Valencia, Valencia, Spain
| | | | - Rebeca Bailen
- Hospita Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Alberto Mussetti
- Institut Català d’Oncologia-Hospitalet, Instituto de Investigación Biomédica de Bellvitge (IDIBELL), Universitat de Barcelona, Barcelona, Spain
| | - Pau Abrisqueta
- Hematology Department, Hospital Vall d’ Hebron, Barcelona, Spain
| | - Rafael Hernani
- Hematology Department, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Hugo Luzardo
- Hospital Negrin, Las Palmas de Gran Canari, Las Palmas de Gran Canarias, Spain
| | - Juan-Manuel Sancho
- Hematology Department, Campus ICO-Germans Trias i Pujol (ICO-IJC)-Hospital Germans Trias i Pujol, Badalona, Spain
| | | | - Antonio Salar
- Hematology Department, Hospital del Mar, Barcelona, Spain
| | - Carlos Grande
- Hematology Department, Hospital 12 de Octubre, Madrid, Spain
| | - Leyre Bento
- Hospital Universitario Son Espases, Fundació Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma de Mallorca, Spain
| | | | | | - Anna Sureda
- Institut Català d’Oncologia-Hospitalet, Instituto de Investigación Biomédica de Bellvitge (IDIBELL), Universitat de Barcelona, Barcelona, Spain
| | | | - Pere Barba
- Hematology Department, Hospital Vall d’ Hebron, Barcelona, Spain
| | - Mi Kwon
- Hospita Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Alejandro Martín García-Sancho
- Hospital Universitario de Salamanca, Instituto de investigación biomédica de Salamanca (IDBAL), CIBERONC, Salamanca, Spain
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5
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García‐Sancho AM, Izuzquiza M, Bastos‐Oreiro M, Baile M, Nistal S, Cortés M, Jiménez‐Ubieto A, Búa BR, Guillén‐García H, Cannata‐Ortiz J, Novelli S, Gómez‐Roncero MI, Peñalver FJ, Barca EMG, Infante M, Peñarrubia MJ, Franch M, Alonso‐Prieto C, Zeberio I, Sánchez‐González B, Muntañola A, Hernández‐Mohedo F, Martín‐Martitegui X, Arguiñano JM, Campo RD, Escoda L, Roldán‐Pérez A, Ramírez‐Payer Á, Luzardo H, Lorente S, Solé‐Rodríguez M, Abrisqueta P, Sancho JM. OUTCOMES OF PATIENTS WITH LYMPHOMA AND COVID‐19: AN OBSERVATIONAL COHORT STUDY FROM GELTAMO SPANISH GROUP. Hematol Oncol 2021. [PMCID: PMC8426711 DOI: 10.1002/hon.200_2880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - M. Izuzquiza
- Hospital Vall d’Hebron Hematology Department Barcelona Spain
| | | | - M. Baile
- Hospital Universitario de Salamanca and IBSAL Hematology Department Salamanca Spain
| | - S. Nistal
- Hospital Universitario HLA Moncloa Hematology Department Madrid Spain
| | - M. Cortés
- Hospital Universitario de Salamanca and IBSAL Hematology Department Salamanca Spain
| | | | - B. Rey Búa
- Hospital Universitario de Salamanca and IBSAL Hematology Department Salamanca Spain
| | - H. Guillén‐García
- Hospital Universitario de Guadalajara Hematology Department Guadalajara Spain
| | - J. Cannata‐Ortiz
- Hospital Universitario La Princesa Hematology Department Madrid Spain
| | - S. Novelli
- Hospital de la Santa Creu i Sant Pau Hematology Department Barcelona Spain
| | | | - F. J. Peñalver
- Hospital Universitario Fundación Alcorcón Hematology Department Alcorcón Madrid Spain
| | - E. M. González Barca
- Institut Català d’Oncologia Hospital Duran i Reynals IDIBELL Univertitat de Barcelona Hematology Department Barcelona Spain
| | - M. Infante
- Hospital Infanta Leonor Hematology Department Madrid Spain
| | - M. Jesús Peñarrubia
- Hospital Clínico Universitario de Valladolid Hematology Department Valladolid Spain
| | - M. Franch
- Hospital Germans Trias i Pujol Hematology Department Barcelona Spain
| | | | - I. Zeberio
- Hospital Universitario de Donostia Hematology Department Donostia‐San Sebastian Spain
| | | | - A. Muntañola
- Hospital Universitario Mutua Terrassa Hematology Department Terrassa, Barcelona Spain
| | | | | | | | - R. del Campo
- Hospital Son Llàtzer Hematology Department Palma de Mallorca Spain
| | - L. Escoda
- Institut Català d’Oncologia Hospital Joan XXIII Hematology Department Tarragona Spain
| | - A. Roldán‐Pérez
- Hospital Infanta Sofía San Sebastián de los Reyes Hematology Department Madrid Spain
| | | | - H. Luzardo
- Hospital Doctor Negrín Hematology Department Las Palmas de Gran Canaria Spain
| | - S. Lorente
- Hospital Vithas Xanit Internacional Benalmádena Hematology Department Málaga Spain
| | | | - P. Abrisqueta
- Hospital Vall d’Hebron Hematology Department Barcelona Spain
| | - J. M. Sancho
- Hospital Germans Trias i Pujol Hematology Department Barcelona Spain
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6
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Gutierrez A, Bento L, Diaz‐Lopez A, Barranco G, Garcia‐Recio M, Lopez‐Guillermo A, Dlouhy I, Rovira J, Rodriguez M, Sanchez Pina JM, Baile M, Martín A, Novelli S, Sancho J, García O, Salar A, Bastos‐Oreiro M, Rodriguez‐Salazar MJ, Fernandez R, de la Cruz F, Queizan JA, González de Villambrosia S, Cordoba R, López A, Luzardo H, García D, Sastre‐Serra J, Garcia JF, Montalban C, Cabanillas F, Rodríguez J. Evaluation of the MD Anderson tumor score for diffuse large B-cell lymphoma in the rituximab era. Eur J Haematol 2020; 104:400-408. [PMID: 31804029 PMCID: PMC7217048 DOI: 10.1111/ejh.13364] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 11/30/2019] [Accepted: 12/03/2019] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Diffuse large B-cell lymphoma (DLBCL) is an aggressive heterogeneous lymphoma with standard treatment. However, 30%-40% of patients still fail, so we should know which patients are candidates for alternative therapies. IPI is the main prognostic score but, in the rituximab era, it cannot identify a very high-risk (HR) subset. The MD Anderson Cancer Center reported a score in the prerituximab era exclusively considering tumor-related variables: Tumor Score (TS). We aim to validate TS in the rituximab era and to analyze its current potential role. METHODS From GELTAMO DLBCL registry, we selected those patients homogeneously treated with R-CHOP (n = 1327). RESULTS Five-years PFS and OS were 62% and 74%. All variables retained an independent prognostic role in the revised TS (R-TS), identifying four different risk groups, with 5-years PFS of 86%, 71%, 50%, and very HR (28%). With a further categorization of three variables of the original TS (Ann Arbor Stage, LDH and B2M), we generated a new index that allowed an improvement in HR assessment. CONCLUSIONS (a) All variables of the original TS retain an independent prognostic role, and R-TS remains predictive in the rituximab era; (b) R-TS and additional categorization of LDH, B2M, and AA stage (enhanced TS) increased the ability to identify HR subsets.
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Affiliation(s)
- Antonio Gutierrez
- Lymphoma UnitDepartment of HematologyHospital Universitari Son Espases/IdISBaPalmaSpain
| | - Leyre Bento
- Lymphoma UnitDepartment of HematologyHospital Universitari Son Espases/IdISBaPalmaSpain
| | - Antonio Diaz‐Lopez
- Department of Translational ResearchMD Anderson Cancer CenterMadridSpain
| | - Gilberto Barranco
- Department of Translational ResearchMD Anderson Cancer CenterMadridSpain
| | - Marta Garcia‐Recio
- Lymphoma UnitDepartment of HematologyHospital Universitari Son Espases/IdISBaPalmaSpain
| | | | | | | | | | | | - Monica Baile
- Hospital Clinico Universitario de Salamanca (CAUSA/IBSAL)SalamancaSpain
| | - Alejandro Martín
- Hospital Clinico Universitario de Salamanca (CAUSA/IBSAL)SalamancaSpain
| | - Silvana Novelli
- Department of HematologyHospital de la Santa Creu I Sant PauBarcelonaSpain
| | | | - Olga García
- Hospital Universitari Germans Trias i PujolBarcelonaSpain
| | - Antonio Salar
- Department of HematologyHospital del MarBarcelonaSpain
| | - Mariana Bastos‐Oreiro
- Department of HematologyGregorio Marañón General University Hospital (HGUGM)MadridSpain
| | | | | | | | | | | | - Raul Cordoba
- Department of HematologyFundación Jimenez DíazMadridSpain
| | | | - Hugo Luzardo
- Hospital Dr. NegrinLas Palmas de Gran CanariaMadridSpain
| | | | | | - Juan Fernando Garcia
- Department of Translational ResearchMD Anderson Cancer CenterMadridSpain
- Department of PathologyMD Anderson Cancer CenterMadridSpain
| | - Carlos Montalban
- Department of Translational ResearchMD Anderson Cancer CenterMadridSpain
| | | | - Jose Rodríguez
- Department of Translational ResearchMD Anderson Cancer CenterMadridSpain
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7
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Bastos-Oreiro M, Muntañola A, Panizo C, Gonzalez-Barca E, de Villambrosia SG, Córdoba R, López JLB, González-Sierra P, Terol MJ, Gutierrez A, Grande C, Ramirez MJ, Iserte L, Perez E, Navarro B, Gomez P, Salar A, Luzardo H, López A, Del Campo R, García-Belmonte D, Vida MJ, Infante M, Queizan-Hernandez JA, Novelli S, Moreno M, Penarrubia M, Gómez J, Domingo A, Donato E, Viguria MC, López F, Rodriguez MJ, Pardal E, Noriega V, Andreu R, Peñalver J, Martín A, Caballero D, López-Guillermo A. RELINF: prospective epidemiological registry of lymphoid neoplasms in Spain. A project from the GELTAMO group. Ann Hematol 2020; 99:799-808. [PMID: 32076827 DOI: 10.1007/s00277-020-03918-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Accepted: 01/13/2020] [Indexed: 12/17/2022]
Abstract
Lymphomas are a large, heterogeneous group of neoplasms with well-defined characteristics, and this heterogeneity highlights the importance of epidemiological data. Knowledge of local epidemiology is essential to optimise resources, design clinical trials, and identify minority entities. Given there are few published epidemiological data on lymphoma in Spain, the Spanish Lymphoma and Autologous Bone Marrow Transplant Group created the RELINF project. The aim of this project is to determine the frequencies and distribution of lymphoid neoplasms in Spain and to analyse survival. We developed an online platform for the prospective collection of data on newly diagnosed cases of lymphoma in Spain between January 2014 and July 2018; 11,400 patients were registered. Diffuse large B cell lymphoma (DLBCL) and follicular lymphoma (FL) were the most frequent lymphomas in our series. Marginal B cell lymphoma frequency was higher than that reported in other studies, representing more than 11% of mature B cell lymphomas. Peripheral T cell lymphoma not otherwise specified (PTCL-NOS) was the most common subtype of T cell lymphoma, and NK/T cell lymphomas were more frequent than expected (5.4% of total). Hodgkin's lymphoma accounted for 12% of lymphoproliferative syndromes. Overall survival was greater than 90% at 2 years for indolent B cell lymphomas, and approximately 60% for DLBCL, somewhat lower than that previously reported. Survival was poor for PTCL-NOS and angioimmunoblastic T cell lymphoma, as expected; however, it was somewhat better than that in other studies for anaplastic large cell anaplastic lymphoma kinase lymphomas. This is the first prospective registry to report the frequencies, distribution, and survival of lymphomas in Spain. The frequencies and survival data we report here are globally consistent with that reported in other Western countries. These updated frequencies and survival statistics are necessary for developing appropriate management strategies for neoplasias in the Spanish population.
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Affiliation(s)
- Mariana Bastos-Oreiro
- Haematology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain. .,Health Research Institute, Gregorio Marañon, Madrid, Spain.
| | - Ana Muntañola
- Haematology Department, Hospital Universitario Mutua Tarrasa, Tarrasa, Cataluña, Spain
| | - Carlos Panizo
- Haematology Department, Clínica Universitaria de Navarra, Navarra, Spain
| | - Eva Gonzalez-Barca
- Haematology Department, ICO Duran y Reinalds, Bellvitlle, Cataluña, Spain
| | | | - Raúl Córdoba
- Haematology Department, Fundación Jimenez Díaz, Madrid, Madrid, Spain
| | - Jose Luís Bello López
- Haematology Department, University of Santiago Hospital Clinic, Santiago de Compostela, Galicia, Spain
| | | | - María José Terol
- Haematology Department, Valencia Hospital Clinic, Valencia, Spain
| | - Antonio Gutierrez
- Haematology Department, Hospital Son Espases, Palma de Mallorca, Spain
| | - Carlos Grande
- Haematology Department, Hospital 12 de Octubre, Madrid, Spain
| | | | - Laura Iserte
- Haematology Department, Hospital Arnau de Vilanova, Lleida, Cataluña, Spain
| | - Elena Perez
- Haematology department, Hospital Morales Meseguer, Murcia, Murcia, Spain
| | - Belén Navarro
- Haematology Department, University Hospital Puerta de Hierro, Mahadahonda, Madrid, Spain
| | - Pilar Gomez
- Haematology Department, La Paz University Hospital, Madrid, Spain
| | - Antonio Salar
- Haematology Department, Hospital del Mar, Barcelona, Cataluña, Spain
| | - Hugo Luzardo
- Hospital Negrin, Las Palmas de Gran Canaria, Canary Islands, Spain
| | - Andrés López
- Haematology Department, Hospital Vall d' Hebron, Barcelona, Cataluña, Spain
| | - Raquel Del Campo
- Haematology Department, Hospital Son Llátzer, Palma de Mallorca, Spain
| | | | - María Jesús Vida
- Haematology Department, Hospital of León, León, Castilla y León, Spain
| | - María Infante
- Haematology Department, Hospital Infanta Leonor, Madrid, Spain
| | | | - Silvana Novelli
- Haematology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Cataluña, Spain
| | - Miriam Moreno
- Haematology Department, Hospital Germans Trials y Pujol, Badalona, Cataluña, Spain
| | - Miriam Penarrubia
- Haematology Department, Hospital Clinic of Valladolid, Castilla y León, Spain
| | - Joaquín Gómez
- Haematology Department, Hospital Virgen de la Arrixaca, El Palmar, Murcia, Spain
| | - Abel Domingo
- Haematology Department, Hospital de Granollers, Barcelona, Cataluña, Spain
| | - Eva Donato
- Haematology Department, Hospital Dr. Peset, Valencia, Spain
| | | | | | - María José Rodriguez
- Haematology Department, Hospital Universitario de Canarias SCT, Tenerife, Canary Islands, Spain
| | - Emilia Pardal
- Haematology Department, Hospital Virgen del Puerto, Cáceres, Extremadura, Spain
| | - Victor Noriega
- Haematology Department, University Hospital A Coruña, A Coruña, Galicia, Spain
| | - Rafael Andreu
- Haematology Department, Hospital La Fe, Valencia, Spain
| | - Javier Peñalver
- Haematology Department, Hospital of Alcorcón, Alcorcón, Madrid, Spain
| | - Alejandro Martín
- Haematology Department, Hospital Clinic of Salamanca, Salamanca, Castilla y León, Spain
| | - Dolores Caballero
- Haematology Department, Hospital Clinic of Salamanca, Salamanca, Castilla y León, Spain
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8
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Bento L, Díaz-López A, Barranco G, Martín-Moreno AM, Baile M, Martín A, Sancho JM, García O, Rodríguez M, Sánchez-Pina JM, Novelli S, Salar A, Bastos M, Rodríguez-Salazar MJ, González de Villambrosia S, Córdoba R, García-Recio M, Martínez-Serra J, Del Campo R, Luzardo H, García D, Hong A, Abrisqueta P, Sastre-Serra J, Roca P, Rodríguez J, Gutiérrez A. New prognosis score including absolute lymphocyte/monocyte ratio, red blood cell distribution width and beta-2 microglobulin in patients with diffuse large B-cell lymphoma treated with R-CHOP: Spanish Lymphoma Group Experience (GELTAMO). Br J Haematol 2019; 188:888-897. [PMID: 31782146 DOI: 10.1111/bjh.16263] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [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: 09/02/2019] [Accepted: 09/30/2019] [Indexed: 12/12/2022]
Abstract
The International Prognostic Index (IPI) is the most widely used score for non-Hodgkin lymphoma but lacks the ability to identify a high-risk population in diffuse large B-cell lymphoma (DLBCL). Low absolute lymphocyte count and high monocytes have proved to be unfavourable factors. Red-cell distribution width (RDW) has been associated with inflammation and beta-2 microglobulin (B2M) with tumour load. The retrospective study included 992 patients with DLBCL treated with R-CHOP. In the multivariate analysis, age, Eastern Cooperative Oncology Group performance status (ECOG-PS), stage, bulky mass, B2M, RDW, and lymphocyte/monocyte ratio (LMR) were independently related to progression-free survival (PFS). A new prognosis score was generated with these variables including age categorized into three groups (0, 1, 2 points); ECOG ≥ 3-4 with two; stage III/IV, bulky mass, high B2M, LMR < 2·25 and RDW > 0·96 with one each; for a maximum of 9. This score could improve the discrimination of a very high-risk subgroup with five-year PFS and overall survival (OS) of 19% and 24% versus 45% and 59% of R (revised)-IPI respectively. This score also showed greater predictive ability than IPI. A new score is presented including complete blood cell count variables and B2M, which are readily available in real-life practice without additional tests. Compared to R-IPI, it shows a more precise high-risk assessment and risk discrimination for both PFS and OS.
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Affiliation(s)
- Leyre Bento
- Hospital Universitario Son Espases, IdISBa, Palma de Mallorca, Spain
| | | | | | | | - Mónica Baile
- Hospital Clínico Universitario Salamanca, IBSAL, CIBERONC, Salamanca, Spain
| | - Alejandro Martín
- Hospital Clínico Universitario Salamanca, IBSAL, CIBERONC, Salamanca, Spain
| | - Juan M Sancho
- ICO-IJC-Hospital Germans Trias i Pujol, Badalona, Spain
| | - Olga García
- ICO-IJC-Hospital Germans Trias i Pujol, Badalona, Spain
| | | | | | | | | | - Mariana Bastos
- Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | | | | | - M García-Recio
- Hospital Universitario Son Espases, IdISBa, Palma de Mallorca, Spain
| | - J Martínez-Serra
- Hospital Universitario Son Espases, IdISBa, Palma de Mallorca, Spain
| | | | - Hugo Luzardo
- Hospital Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | | | - Azueg Hong
- Hospital General Lanzarote, Lanzarote, Spain
| | | | - Jorge Sastre-Serra
- Grupo Multidisciplinar de Oncología Traslacional, IUNICS, Palma de Mallorca, Spain
| | - Pilar Roca
- Grupo Multidisciplinar de Oncología Traslacional, IUNICS, Palma de Mallorca, Spain
| | | | - Antonio Gutiérrez
- Hospital Universitario Son Espases, IdISBa, Palma de Mallorca, Spain
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9
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De-la-Iglesia S, Luzardo H, Lemes A, Torres M, Gómez-Casares MT, Cruz N, Molero T. Positive Impact of Eculizumab Therapy on Surgery for Budd-Chiari Syndrome in a Patient with Paroxysmal Nocturnal Hemoglobinuria and a Long-Term History of Thrombosis. Hematol Rep 2016; 8:6562. [PMID: 27757214 PMCID: PMC5062621 DOI: 10.4081/hr.2016.6562] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 06/28/2016] [Accepted: 08/30/2016] [Indexed: 01/12/2023] Open
Abstract
Paroxysmal nocturnal hemoglobinuria (PNH) is associated with severe end-organ damage and a high risk of thrombosis. Budd-Chiari syndrome, which develops after thrombotic occlusion of major hepatic blood vessels, is relatively common in PNH and has been associated with increased mortality. We report the case of a 46-year-old male with PNH who presented with Budd-Chiari syndrome associated with portal cavernoma, portal hypertension and hypersplenism. In September 2010, the patient suffered gastrointestinal bleeding, hematuria, and elevated plasma lactate dehydrogenase; he started eculizumab therapy with a good response. In October 2012, he developed upper gastrointestinal variceal bleeding and a splenorenal shunt was placed. At the time of writing, the patient remains stable and eculizumab continues to be effective. There is limited data on the use of eculizumab for prevention of hemolysis and its consequences in PNH patients undergoing surgery. Our findings provide evidence for the efficacy and safety of eculizumab in this setting.
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Affiliation(s)
- Silvia De-la-Iglesia
- Hematology Department, University Hospital of Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria , Spain
| | - Hugo Luzardo
- Hematology Department, University Hospital of Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria , Spain
| | - Angelina Lemes
- Hematology Department, University Hospital of Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria , Spain
| | - Melissa Torres
- Hematology Department, University Hospital of Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria , Spain
| | - Maria Teresa Gómez-Casares
- Hematology Department, University Hospital of Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria , Spain
| | - Naylen Cruz
- Hematology Department, University Hospital of Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria , Spain
| | - Teresa Molero
- Hematology Department, University Hospital of Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria , Spain
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10
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Perera M, Suarez A, Luzardo H, Lopez J, Molero T. Spontaneous remission after a year of romiplostim in an adult patient with refractory primary immune thrombocytopenia. Ann Hematol 2012; 91:1497-8. [DOI: 10.1007/s00277-012-1437-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2012] [Accepted: 02/19/2012] [Indexed: 11/28/2022]
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