1
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Martín García-Sancho A, Baile M, Rodríguez G, Dlouhy I, Sancho JM, Jarque I, González-Barca E, Salar A, Espeso M, Grande C, Bergua J, Montes-Moreno S, Redondo A, Enjuanes A, Campo E, López-Guillermo A, Caballero D. Lenalidomide in combination with R-ESHAP in patients with relapsed or refractory diffuse large B-cell lymphoma: A phase 2 study from GELTAMO. Br J Haematol 2023; 203:202-211. [PMID: 37485564 DOI: 10.1111/bjh.18989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 06/18/2023] [Accepted: 07/10/2023] [Indexed: 07/25/2023]
Abstract
Diffuse large B-cell lymphoma (DLBCL) patients with relapsed or refractory (RR) disease have poor outcomes with current salvage regimens. We conducted a phase 2 trial to analyse the safety and efficacy of adding lenalidomide to R-ESHAP (LR-ESHAP) in patients with RR DLBCL. Subjects received 3 cycles of lenalidomide 10 mg/day on days 1-14 of every 21-day cycle, in combination with R-ESHAP at standard doses. Responding patients underwent autologous stem-cell transplantation (ASCT). The primary endpoint was the overall response rate (ORR) after 3 cycles. Centralized cell-of-origin (COO) classification was performed. Forty-six patients were included. The ORR after LR-ESHAP was 67% (35% of patients achieved complete remission). Patients with primary refractory disease (n = 26) had significantly worse ORR than patients with non-refractory disease (54% vs. 85%, p = 0.031). No differences in response rates according to the COO were observed. Twenty-eight patients (61%) underwent ASCT. At a median follow-up of 41 months, the estimated 3-year PFS and OS were 42% and 48%, respectively. The most common grade ≥3 adverse events were thrombocytopenia (70% of patients), neutropenia (67%) and anaemia (35%). There were no treatment-related deaths during LR-ESHAP cycles. In conclusion, LR-ESHAP is a feasible salvage regimen with promising efficacy results for patients with RR DLBCL.
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Affiliation(s)
- A Martín García-Sancho
- Hematology Department, Hospital Universitario de Salamanca-IBSAL, CIBERONC, Universidad de Salamanca, Salamanca, Spain
| | - M Baile
- Hematology Department, Hospital Universitario de Salamanca-IBSAL, CIBERONC, Universidad de Salamanca, Salamanca, Spain
| | - G Rodríguez
- Hematology Department, Hospital Universitario Virgen del Rocío/Virgen Macarena, Sevilla, Spain
| | - I Dlouhy
- Hematology Department, Hospital Clinic, Barcelona, Spain
| | - J M Sancho
- Hematology Department, Hospital Germans Trias i Pujol/ICO-IJC, Badalona, Spain
| | - I Jarque
- Hematology Department, Hospital Universitari i Plotècnic La Fe, CIBERONC, Valencia, Spain
| | - E González-Barca
- Institut Català d'Oncologia-Hospitalet, IDIBELL, Universitat de-Barcelona, Barcelona, Spain
| | - A Salar
- Hematology Department, Hospital del Mar, Barcelona, Spain
| | - M Espeso
- Hematology Department, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - C Grande
- Hematology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - J Bergua
- Hematology Department, Hospital San Pedro de Alcántara, Cáceres, Spain
| | - S Montes-Moreno
- Pathology Department, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - A Redondo
- Hematology Department, Hospital Virgen del Puerto, Plasencia, Spain
| | - A Enjuanes
- Unidad de Genómica del IDIBAPS, Barcelona, Spain
| | - E Campo
- Pathology Department, Hospital Clinic, Barcelona, Spain
| | | | - D Caballero
- Hematology Department, Hospital Universitario de Salamanca-IBSAL, CIBERONC, Universidad de Salamanca, Salamanca, Spain
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2
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Hapgood G, Civallero M, Stepanishyna Y, Vose J, Cabrera ME, Advani RH, Pileri SA, Manni M, Horwitz SM, Foss FM, Hitz F, Radford J, Dlouhy I, Chiattone C, Kim WS, Skrypets T, Nagler A, Trotman J, Luminari S, Federico M. The SALENTO prognostic model for limited-stage peripheral T-cell lymphoma from the International T-Cell Project Network. Blood Adv 2023; 7:5047-5054. [PMID: 37163360 PMCID: PMC10471929 DOI: 10.1182/bloodadvances.2023010037] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 04/25/2023] [Accepted: 04/26/2023] [Indexed: 05/12/2023] Open
Abstract
The natural history of limited-stage peripheral T-cell lymphomas (PTCLs) remains poorly defined. We investigated outcomes and prognostic variables in patients registered in the T-Cell Project (TCP) (#NCT01142674) to develop a model to predict overall survival (OS) for the common nodal PTCL subtypes (PTCL-NOS, AITL, ALCL). The model was validated in an independent data set from Australian and Brazilian registries. 211 patients registered in the TCP between 2006-2018 were studied. The median age was 59 years (range 18-88) and median follow-up was 49 months. One hundred twenty-seven patients (78%) received anthracycline-based regimens, 5 patients (3%) radiotherapy alone (RT), 24 patients (15%) chemotherapy+RT. 5-year OS and PFS were 47% and 37%, respectively. Age >60 years, elevated LDH and low serum albumin were independent prognostic factors. The model identified 3 groups with low- (26%, score 0), intermediate- (41%, score 1), and high-risk (33%, score 2-3) with 5-year OS of 78% (95% confidence interval [95% CI], 29-127), 46% (95% CI, 24-68), and 25% (95% CI, 20-30), respectively (P < 0.001) and 5-year PFS of 66% (95% CI, 33-99), 37% (95% CI, 9-65), and 17% (95% CI, 9-25), respectively (P < 0.001). The model demonstrated greater discriminatory power than established prognostic indices and an analogous distribution and outcomes in the 3 groups in the validation cohort of 103 patients. The SALENTO Model (Limited Stage Peripheral T-Cell Lymphoma Prognostic Model) is an objective, simple and robust prognostic tool. The high-risk group has poor outcomes, comparable to advanced stage disease, and should be considered for innovative first-line approaches.
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Affiliation(s)
- Greg Hapgood
- Department of Haematology, Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - Monica Civallero
- CHIMOMO Department, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Julie Vose
- University of Nebraska Medical Center, Omaha, NE
| | - Monica Elena Cabrera
- Hematology Section, Hospital del Salvador, University of Chile, Santiago de Chile, Chile
| | - Ranjana H. Advani
- Division of Oncology, Department of Medicine, Stanford University, Stanford, CA
| | - Stefano A. Pileri
- Division of Diagnostic Haematopathology, European Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - Martina Manni
- CHIMOMO Department, University of Modena and Reggio Emilia, Modena, Italy
| | - Steven M. Horwitz
- Department Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | | | - Felicitas Hitz
- The Swiss Group for Clinical Cancer Research, Department of Oncology/Haematology, Cantonal Hospital, St. Gallen, Switzerland
| | - John Radford
- Medical Oncology, University of Manchester, Manchester, England
| | - Ivan Dlouhy
- Clinic Barcelona, Hospital Universitari, Barcelona, Spain
| | - Carlos Chiattone
- Santa Casa Medical School of Sao Paulo and Samaritan Hospital, Sao Paulo, Brazil
| | - Won Seog Kim
- Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea
| | - Tetiana Skrypets
- Hematology, IRCCS Istituto Tumori Giovanni Paolo II, Bari, Italy
| | - Arnon Nagler
- Hematology Division BMT and Cord Blood Bank Chaim Sheba Medical Center Tel-Hashomer, Ramat-Gan, Israel
| | - Judith Trotman
- Department of Haematology, Concord Hospital, University of Sydney, Sydney, Australia
| | - Stefano Luminari
- CHIMOMO Department, University of Modena and Reggio Emilia, Modena, Italy
- Hematology, AUSL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Massimo Federico
- CHIMOMO Department, University of Modena and Reggio Emilia, Modena, Italy
| | - International T-Cell Project
- Department of Haematology, Princess Alexandra Hospital, Brisbane, QLD, Australia
- CHIMOMO Department, University of Modena and Reggio Emilia, Modena, Italy
- Kiev National Cancer Institute, Kiev, Ukraine
- University of Nebraska Medical Center, Omaha, NE
- Hematology Section, Hospital del Salvador, University of Chile, Santiago de Chile, Chile
- Division of Oncology, Department of Medicine, Stanford University, Stanford, CA
- Division of Diagnostic Haematopathology, European Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy
- Department Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
- Yale University School of Medicine, New Haven, CT
- The Swiss Group for Clinical Cancer Research, Department of Oncology/Haematology, Cantonal Hospital, St. Gallen, Switzerland
- Medical Oncology, University of Manchester, Manchester, England
- Clinic Barcelona, Hospital Universitari, Barcelona, Spain
- Santa Casa Medical School of Sao Paulo and Samaritan Hospital, Sao Paulo, Brazil
- Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea
- Hematology, IRCCS Istituto Tumori Giovanni Paolo II, Bari, Italy
- Hematology Division BMT and Cord Blood Bank Chaim Sheba Medical Center Tel-Hashomer, Ramat-Gan, Israel
- Department of Haematology, Concord Hospital, University of Sydney, Sydney, Australia
- Hematology, AUSL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
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3
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Dlouhy I, Armengol M, Recasens-Zorzo C, Ribeiro ML, Pérez-Galán P, Bosch F, López-Guillermo A, Roué G. Interleukin-1 receptor associated kinase 1/4 and bromodomain and extra-terminal inhibitions converge on NF-κB blockade and display synergistic antitumoral activity in activated B-cell subset of diffuse large B-cell lymphoma with MYD88 L265P mutation. Haematologica 2022; 107:2990. [PMID: 36453521 PMCID: PMC9713549 DOI: 10.3324/haematol.2022.281988] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Indexed: 12/02/2022] Open
Affiliation(s)
- Ivan Dlouhy
- Department of Hematology, Hospital Clínic, BarceIona, Spain; Division of Hematology and Oncology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERONC, Barcelona
| | - Marc Armengol
- Lymphoma Translational Group, Josep Carreras Leukaemia Research Institute (IJC), Badalona, Spain; Department of Biochemistry and Molecular Biology, Autonomous University of Barcelona, Barcelona
| | - Clara Recasens-Zorzo
- Division of Hematology and Oncology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERONC, Barcelona
| | - Marcelo L Ribeiro
- Lymphoma Translational Group, Josep Carreras Leukaemia Research Institute (IJC), Badalona, Spain; Post Graduate Program in Health Science, Universidade São Francisco (USF), Bragança Paulista, Brazil
| | - Patricia Pérez-Galán
- Division of Hematology and Oncology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERONC, Barcelona
| | - Francesc Bosch
- Laboratory of Experimental Hematology, Department of Hematology, Vall d'Hebron Institute of Oncology (VHIO), Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona
| | - Armando López-Guillermo
- Department of Hematology, Hospital Clínic, BarceIona, Spain; Division of Hematology and Oncology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERONC, Barcelona
| | - Gaël Roué
- Lymphoma Translational Group, Josep Carreras Leukaemia Research Institute (IJC), Badalona.
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4
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García-Sancho AM, Bellei M, López-Parra M, Gritti G, Cortés M, Novelli S, Panizo C, Petrucci L, Gutiérrez A, Dlouhy I, Bastos-Oreiro M, Sancho JM, Ramírez MJ, Moraleda JM, Carrillo E, Jiménez-Ubieto AI, Jarque I, Orsucci L, García-Torres E, Montalbán C, Dodero A, Arranz R, De Las Heras N, Pascual MJ, López-Jiménez J, Spina M, Re A, De Villambrosia SG, Bobillo S, Federico M, Caballero D. Autologous stem cell transplantation as consolidation of first-line chemotherapy in patients with peripheral T-cell lymphoma: a multicenter GELTAMO/FIL study. Haematologica 2022; 107:2675-2684. [PMID: 35320921 DOI: 10.3324/haematol.2021.279426] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Indexed: 11/09/2022] Open
Abstract
Peripheral T-cell lymphomas (PTCLs) are a heterogeneous group of rare lymphoid malignancies that mostly have poor prognoses with currently available treatments. Upfront consolidation with autologous stem cell transplantation (ASCT) is frequently carried out, but its efficacy has never been investigated in randomized trials. We designed a multicenter, international, retrospective study with the main objective of comparing progression-free survival (PFS) and overall survival (OS) of patients with PTCL who underwent ASCT in complete remission (CR) after first-line chemotherapy with a control group who did not undergo ASCT. From the initial population of 286 registered patients, 174 patients with PTCL other than anaplastic large cell lymphoma, ALK-positive, deemed fit for ASCT at the time of diagnosis, and who were in CR or uncertain CR after induction therapy (CR1) were included in our analysis. 103 patients underwent ASCT, whereas 71 did not, in most cases (n=53) because the physician decided against it. With a median follow-up of 65.5 months, PFS was significantly better in the transplanted patients than in the non-transplanted group: 63% vs. 48% at 5 years (p=0.042). OS was significantly longer for ASCT patients in the subgroup with advanced stage at diagnosis (5-year OS: 70% vs. 50%, p=0.028). In the multivariate analysis, first-line ASCT was associated with significantly prolonged PFS (HR 0.57, 95% CI 0.35-0.93) and OS (HR 0.57, 95% CI 0.33-0.99). In conclusion, our study supports the use of ASCT as a consolidation strategy for patients with PTCL in CR1. These results should be confirmed in a prospective randomized study.
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Affiliation(s)
| | | | - Miriam López-Parra
- Department of Hematology, Hospital Universitario de Salamanca, IBSAL, CIBERONC, Salamanca
| | - Giuseppe Gritti
- Hematology and Bone Marrow Transplant Unit, ASST Papa Giovanni XXIII, Bergamo
| | - María Cortés
- Department of Statistics, Hospital Universitario de Salamanca / IBSAL, Salamanca
| | - Silvana Novelli
- Hematology Department, Hospital de la Santa Creu i Sant Pau, José Carreras Leukemia Research Institute and IIB Sant Pau, Barcelona
| | - Carlos Panizo
- Department of Hematology, Clínica Universidad de Navarra, IdiSNA, Pamplona
| | - Luigi Petrucci
- Department of Translational and Precision Medicine, Sapienza University, Rome
| | - Antonio Gutiérrez
- Department of Hematology, Son Espases University Hospital, IdISBa, Palma de Mallorca
| | - Ivan Dlouhy
- Department of Hematology, Hospital Clínic de Barcelona, Barcelona
| | | | - Juan M Sancho
- Hematology Department, ICO-IJC-Hospital Germans Trias i Pujol, Badalona
| | - María J Ramírez
- Hematology Department, Hospital de Especialidades de Jerez de la Frontera, Cádiz
| | - José M Moraleda
- Hematology Department, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia
| | - Estrella Carrillo
- Hematology Department, Hospital Universitario Virgen del Rocío, Seville
| | | | - Isidro Jarque
- Hematology Department, CIBERONC, Instituto Carlos III, Hospital Universitario y Politécnico La Fe, Valencia
| | - Lorella Orsucci
- Hematology, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza, Multidisciplinary Outpatient Oncology Clinic, Candiolo Cancer Institute, FPO-IRCCS, Candiolo (Torino)
| | | | - Carlos Montalbán
- Department of Translational Research, MD Anderson Cancer Center, Madrid
| | - Anna Dodero
- Division of Hematology and Bone Marrow Transplantation, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano
| | - Reyes Arranz
- Hematology Department, Hospital La Princesa, Madrid
| | | | | | | | - Michelle Spina
- Division of Medical Oncology and Immune-related Tumors, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano (PN)
| | - Alessandro Re
- Division of Hematology, ASST Spedali Civili di Brescia, Brescia
| | | | - Sabela Bobillo
- Department of Hematology, University Hospital Vall d'Hebron and Universitat Autònoma de Barcelona, Barcelona
| | - Massimo Federico
- Medical Oncology, CHIMOMO Department, University of Modena and Reggio Emilia, Modena
| | - Dolores Caballero
- Department of Hematology, Hospital Universitario de Salamanca, IBSAL, CIBERONC, Salamanca
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5
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Mercadal S, Alañá M, Barceló MI, Bruixola G, López-Pereira P, Bobillo S, Dlouhy I, Agud RC, Molina EG, Martínez P, Cacabelos P, Muntañola A, García-Catalán G, Sancho JM, Campos I, Lado T, Salar A, Caballero AC, Solé-Rodríguez M, Velasco R. Ocular involvement in patients with primary central-nervous-system lymphoma: Analysis of a multicentre study in Spain. Br J Haematol 2022; 197:792-795. [PMID: 35307813 DOI: 10.1111/bjh.18148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 03/03/2022] [Accepted: 03/04/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Santiago Mercadal
- Department of Hematology, Catalan Institute of Oncology-Hospital Duran i Reynals, IDIBELL, Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.,Bone marrow Transplant and Cellular Therapy, University of Utah Health, Hunstman Cancer Institute, Salt Lake City, Utah, USA
| | - Mónica Alañá
- Department of Neurology, Complejo Asistencial Universitario, Salamanca, Spain
| | - María Ines Barceló
- Department of Neurology, Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | - Gema Bruixola
- Department of Neurology, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Patricia López-Pereira
- Department of Hematology, Catalan Institute of Oncology-Hospital Duran i Reynals, IDIBELL, Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Sabela Bobillo
- Department of Hematology, Hospital Vall d'Hebron, Barcelona, Spain
| | - Ivan Dlouhy
- Department of Hematology, Hospital Clinic, Barcelona, Spain
| | - Rocío Caldú Agud
- Department of Neurology, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | | | - Pilar Martínez
- Department of Hematology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Purificación Cacabelos
- Department of Neurology, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - Ana Muntañola
- Department of Hematology, Hospital Universitari Mútua Terrassa, Terrassa, Spain
| | | | - Juan Manuel Sancho
- Department of Hematology, ICO-IJC-Hospital Germans Trias i Pujol, Badalona, Spain
| | - Iria Campos
- Department of Neurology, Hospital Universitario Cruces, Barakaldo, Spain
| | - Tamara Lado
- Department of Hematology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Antonio Salar
- Department of Hematology, Hospital del Mar, Barcelona, Spain
| | | | - María Solé-Rodríguez
- Department of Hematology, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Roser Velasco
- Neuro-Oncology Unit, Hospital Universitari de Bellvitge-ICO L'Hospitalet, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
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6
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Dlouhy I, Karube K, Enjuanes A, Salaverria I, Nadeu F, Ramis-Zaldivar JE, Valero JG, Rivas-Delgado A, Magnano L, Martin-García D, Pérez-Galán P, Clot G, Rovira J, Jares P, Balagué O, Giné E, Mozas P, Briones J, Sancho JM, Salar A, Mercadal S, Alcoceba M, Valera A, Campo E, López-Guillermo A. Revised International Prognostic Index and genetic alterations are associated with early failure to R-CHOP in patients with diffuse large B-cell lymphoma. Br J Haematol 2021; 196:589-598. [PMID: 34632572 DOI: 10.1111/bjh.17858] [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] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 08/26/2021] [Accepted: 09/12/2021] [Indexed: 11/28/2022]
Abstract
Relapsed or refractory diffuse large B-cell lymphoma (DLBCL) cases have a poor outcome. Here we analysed clinico-biological features in 373 DLBCL patients homogeneously treated with rituximab, cyclophosphamide, doxorubicin, vincristine and prednisolone (R-CHOP), in order to identify variables associated with early failure to treatment (EF), defined as primary refractoriness or relapse within 12 months from diagnosis. In addition to clinical features, mutational status of 106 genes was studied by targeted next-generation sequencing in 111 cases, copy number alterations in 87, and gene expression profile (GEP) in 39. Ninety-seven cases (26%) were identified as EF and showed significantly shorter overall survival (OS). Patients with B symptoms, advanced stage, high levels of serum lactate dehydrogenase (LDH) or β2-microglobulin, low lymphocyte/monocyte ratio and higher Revised International Prognostic Index (R-IPI) scores, as well as those with BCL2 rearrangements more frequently showed EF, with R-IPI being the most important in logistic regression. Mutations in NOTCH2, gains in 5p15·33 (TERT), 12q13 (CDK2), 12q14·1 (CDK4) and 12q15 (MDM2) showed predictive importance for EF independently from R-IPI. GEP studies showed that EF cases were significantly enriched in sets related to cell cycle regulation and inflammatory response, while cases in response showed over-representation of gene sets related to extra-cellular matrix and tumour microenvironment.
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Affiliation(s)
- Ivan Dlouhy
- Department of Hematology, Hospital Clínic, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Tumores Hematológicos, Madrid, Spain
| | - Kennosuke Karube
- Institut d`Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Cell Biology & Pathology Department, University of the Ryukyus Graduate School of Medicine, Okinawa, Japan
| | - Anna Enjuanes
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Tumores Hematológicos, Madrid, Spain.,Institut d`Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Itziar Salaverria
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Tumores Hematológicos, Madrid, Spain.,Institut d`Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Ferran Nadeu
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Tumores Hematológicos, Madrid, Spain.,Institut d`Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Juan Enric Ramis-Zaldivar
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Tumores Hematológicos, Madrid, Spain.,Institut d`Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Juan G Valero
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Tumores Hematológicos, Madrid, Spain.,Institut d`Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Alfredo Rivas-Delgado
- Department of Hematology, Hospital Clínic, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Tumores Hematológicos, Madrid, Spain
| | - Laura Magnano
- Department of Hematology, Hospital Clínic, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Tumores Hematológicos, Madrid, Spain
| | - David Martin-García
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Tumores Hematológicos, Madrid, Spain.,Institut d`Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Patricia Pérez-Galán
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Tumores Hematológicos, Madrid, Spain.,Institut d`Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Guillem Clot
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Tumores Hematológicos, Madrid, Spain.,Institut d`Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Jordina Rovira
- Department of Hematology, Hospital Clínic, Barcelona, Spain
| | - Pedro Jares
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Tumores Hematológicos, Madrid, Spain.,Institut d`Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Olga Balagué
- Institut d`Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Eva Giné
- Department of Hematology, Hospital Clínic, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Tumores Hematológicos, Madrid, Spain
| | - Pablo Mozas
- Department of Hematology, Hospital Clínic, Barcelona, Spain
| | | | | | | | | | - Miguel Alcoceba
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Tumores Hematológicos, Madrid, Spain.,Hospital Clínico Universitario, Salamanca, Spain
| | - Alexandra Valera
- Institut d`Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Elías Campo
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Tumores Hematológicos, Madrid, Spain.,Institut d`Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,University of Barcelona, Barcelona, Spain
| | - Armando López-Guillermo
- Department of Hematology, Hospital Clínic, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Tumores Hematológicos, Madrid, Spain.,University of Barcelona, Barcelona, Spain
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7
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López-Guillermo A, Canales MÁ, Dlouhy I, Mercadal S, Briones J, Martín García-Sancho A, Sancho JM, Moraleda JM, Terol MJ, Salar A, Palomera L, Gardella S, Jarque I, Ferrer S, Bargay J, López A, Panizo C, Muntañola A, Montalbán C, Conde E, Hernández MT, Soler A, García Marco JA, Deben G, Marín J, Tomás JF. A randomized phase II study comparing consolidation with a single dose of 90Y ibritumomab tiuxetan vs. maintenance with rituximab for two years in patients with newly diagnosed follicular lymphoma responding to R-CHOP. Long-term follow-up results. Leuk Lymphoma 2021; 63:93-100. [PMID: 34459702 DOI: 10.1080/10428194.2021.1971216] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
This is a randomized phase-2 trial aimed to compare consolidation vs. maintenance in untreated patients with follicular lymphoma (FL) responding to induction. 146 patients were enrolled from 25 Spanish institutions (ZAR2007; ClinicalTrials.gov #NCT00662948). Patients in PR or CR/CR[u] after R-CHOP were randomized 1:1 to 90Y-ibritumomab-tiuxetan 0.4 mCi/kg (arm A) vs. rituximab 375 mg/m2 every 8 weeks for 2 years (arm B). After a median follow-up of 10.55 years, 53 patients eventually progressed with a 10-year PFS of 50% vs. 56% for patients in arm A and B, respectively (HR = 1.42; p > 0.1). No significant differences were seen in OS (10-year OS 78% vs. 84.5%; HR = 1.39, p > .1). Patients receiving 90Y-ibritumomab-tiuxetan showed higher incidence of second neoplasms than those in arm B (10-year cumulative incidence 18.5 vs. 2%, respectively; p = .038). In conclusion, in FL patients responding to R-CHOP, no significant differences were found between consolidation and maintenance, although with higher late toxicity for consolidation.
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Affiliation(s)
| | | | - Ivan Dlouhy
- Hematopathology Department, Hospital Clinic de Barcelona, Barcelona, Spain
| | | | | | | | - Juan Manuel Sancho
- Hematology Department, ICO-IJC-Hospital Germans Trias i Pujol, Badalona, Spain
| | | | - María José Terol
- Department of Haematology and Medical Oncology, Hospital Clinico, Valencia, Spain
| | - Antonio Salar
- Hematology Department, Hospital del Mar, Barcelona, Spain
| | - Luis Palomera
- Hematology Department, Hospital Clínico Lozano Blesa, Zaragoza, Spain
| | | | - Isidro Jarque
- Hematology Department, Hospital La Fe, CIBERONC - Instituto Carlos III, Valencia, Spain
| | | | | | - Andrés López
- Hematology Department, Hospital Vall d'Hebron, Barcelona, Spain
| | - Carlos Panizo
- Hematology Department, Clínica Universidad de Navarra, Pamplona, Spain
| | - Anna Muntañola
- Hematology Department, Hospital Universitari Mutua de Terrassa, Terrassa, Spain
| | | | - Eulogio Conde
- Department of Hematology, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Miguel T Hernández
- Hematology Department, Hospital Universitario de Canarias, Tenerife, Spain
| | - Alfons Soler
- Hematology Department, Hospital Parc Taulí, Sabadell, Spain
| | | | - Guillermo Deben
- Hematology Department, Hospital Juan Canalejo, La Coruña, Spain
| | - Julián Marín
- Hematology Department, Hospital Nuestra Señora de Aránzazu, San Sebastián, Spain
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8
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Advani RH, Skrypets T, Civallero M, Spinner MA, Manni M, Kim WS, Shustov AR, Horwitz SM, Hitz F, Cabrera ME, Dlouhy I, Vassallo J, Pileri SA, Inghirami G, Montoto S, Vitolo U, Radford J, Vose JM, Federico M. Outcomes and prognostic factors in angioimmunoblastic T-cell lymphoma: final report from the international T-cell Project. Blood 2021; 138:213-220. [PMID: 34292324 PMCID: PMC8493974 DOI: 10.1182/blood.2020010387] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 03/12/2021] [Indexed: 11/20/2022] Open
Abstract
Angioimmunoblastic T-cell lymphoma (AITL) is a unique subtype of peripheral T-cell lymphoma (PTCL) with distinct clinicopathologic features and poor prognosis. We performed a subset analysis of 282 patients with AITL enrolled between 2006 and 2018 in the international prospective T-cell Project (NCT01142674). The primary and secondary end points were 5-year overall survival (OS) and progression-free survival (PFS), respectively. We analyzed the prognostic impact of clinical covariates and progression of disease within 24 months (POD24) and developed a novel prognostic score. The median age was 64 years, and 90% of patients had advanced-stage disease. Eighty-one percent received anthracycline-based regimens, and 13% underwent consolidative autologous stem cell transplant (ASCT) in first complete remission (CR1). Five-year OS and PFS estimates were 44% and 32%, respectively, with improved outcomes for patients who underwent ASCT in CR1. In multivariate analysis, age ≥60 years, Eastern Cooperative Oncology Group performance status >2, elevated C-reactive protein, and elevated β2 microglobulin were associated with inferior outcomes. A novel prognostic score (AITL score) combining these factors defined low-, intermediate-, and high-risk subgroups with 5-year OS estimates of 63%, 54%, and 21%, respectively, with greater discriminant power than established prognostic indices. Finally, POD24 was a powerful prognostic factor with 5-year OS of 63% for patients without POD24 compared with only 6% for patients with POD24 (P < .0001). These data will require validation in a prospective cohort of homogeneously treated patients. Optimal treatment of AITL continues to be an unmet need, and novel therapeutic approaches are required.
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Affiliation(s)
- Ranjana H Advani
- Division of Oncology, Department of Medicine, Stanford University, Stanford, CA
| | - Tetiana Skrypets
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance (CHIMOMO), University of Modena and Reggio Emilia, Modena, Italy
| | - Monica Civallero
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance (CHIMOMO), University of Modena and Reggio Emilia, Modena, Italy
| | - Michael A Spinner
- Division of Oncology, Department of Medicine, Stanford University, Stanford, CA
| | - Martina Manni
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance (CHIMOMO), University of Modena and Reggio Emilia, Modena, Italy
| | - Won Seog Kim
- Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea
| | - Andrei R Shustov
- Division of Hematology, Fred Hutchinson Cancer Research Center, University of Washington Medical Center, Seattle, WA
| | - Steven M Horwitz
- Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Felicitas Hitz
- The Swiss Group for Clinical Cancer Research, Department of Oncology/Haematology, Cantonal Hospital, St Gallen, Switzerland
| | - Maria Elena Cabrera
- Sección Hematología, Hospital del Salvador, Universidad de Chile, Santiago, Chile
| | - Ivan Dlouhy
- Hematology Department, Hospital Clinic de Barcelona, Barcelona, Spain
| | - José Vassallo
- A.C. Camargo Cancer Center, Universidade Estadual de Campinas (Unicamp), Campinas, São Paulo, Brazil
| | - Stefano A Pileri
- Division of Haematopathology, Istituto Europeo di Oncologia Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milano, Italy
| | - Giorgio Inghirami
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY
| | - Silvia Montoto
- Department of Haemato-oncology, Barts Health NHS Trust, London, United Kingdom
| | - Umberto Vitolo
- Hematology, Città della Salute e della Scienza Hospital and University, Turin, Italy
| | - John Radford
- Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom; and
| | - Julie M Vose
- University of Nebraska Medical Center, Omaha, NE
| | - Massimo Federico
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance (CHIMOMO), University of Modena and Reggio Emilia, Modena, Italy
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9
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Dlouhy I, Armengol M, Recasens-Zorzo C, Ribeiro ML, Pérez-Galán P, Bosch F, López-Guillermo A, Roué G. Interleukin-1 receptor associated kinase 1/4 and bromodomain and extraterminal inhibitions converge on NF-κB blockade and display synergistic antitumoral activity in activated B-cell subset of diffuse large B-cell lymphoma with MYD88L265P mutation. Haematologica 2021; 106:2749-2753. [PMID: 33979991 PMCID: PMC8485659 DOI: 10.3324/haematol.2020.278258] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 12/25/2020] [Indexed: 11/23/2022] Open
Affiliation(s)
- Ivan Dlouhy
- Department of Hematology, Hospital Clínic, BarceIona, Spain; Division of Hematology and Oncology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERONC, Barcelona
| | - Marc Armengol
- Lymphoma Translational Group, Josep Carreras Leukaemia Research Institute (IJC), Badalona
| | - Clara Recasens-Zorzo
- Division of Hematology and Oncology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERONC, Barcelona
| | - Marcelo L Ribeiro
- Lymphoma Translational Group, Josep Carreras Leukaemia Research Institute (IJC), Badalona, Spain; Post Graduate Program in Health Science, Universidade São Francisco (USF), Bragança Paulista
| | - Patricia Pérez-Galán
- Division of Hematology and Oncology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERONC, Barcelona
| | - Francesc Bosch
- Laboratory of Experimental Hematology, Department of Hematology, Vall d'Hebron Institute of Oncology (VHIO), Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona
| | - Armando López-Guillermo
- Department of Hematology, Hospital Clínic, BarceIona, Spain; Division of Hematology and Oncology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERONC, Barcelona
| | - Gaël Roué
- Lymphoma Translational Group, Josep Carreras Leukaemia Research Institute (IJC), Badalona.
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10
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Rivas-Delgado A, Nadeu F, Enjuanes A, Casanueva-Eliceiry S, Mozas P, Magnano L, Castrejón de Anta N, Rovira J, Dlouhy I, Martín S, Osuna M, Rodríguez S, Simó M, Pinyol M, Baumann T, Beà S, Balagué O, Delgado J, Villamor N, Setoain X, Campo E, Giné E, López-Guillermo A. Mutational Landscape and Tumor Burden Assessed by Cell-free DNA in Diffuse Large B-Cell Lymphoma in a Population-Based Study. Clin Cancer Res 2020; 27:513-521. [PMID: 33122345 DOI: 10.1158/1078-0432.ccr-20-2558] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 08/29/2020] [Accepted: 10/26/2020] [Indexed: 11/16/2022]
Abstract
PURPOSE We analyzed the utility of cell-free DNA (cfDNA) in a prospective population-based cohort to determine the mutational profile, assess tumor burden, and estimate its impact in response rate and outcome in patients with diffuse large B-cell lymphoma (DLBCL). EXPERIMENTAL DESIGN A total of 100 patients were diagnosed with DLBCL during the study period. Mutational status of 112 genes was studied in cfDNA by targeted next-generation sequencing. Paired formalin-fixed, paraffin-embedded samples and volumetric PET/CT were assessed when available. RESULTS Appropriate cfDNA to perform the analyses was obtained in 79 of 100 cases. At least one mutation could be detected in 69 of 79 cases (87%). The sensitivity of cfDNA to detect the mutations was 68% (95% confidence interval, 56.2-78.7). The mutational landscape found in cfDNA samples was highly consistent with that shown in the tissue and allowed genetic classification in 43% of the cases. A higher amount of circulating tumor DNA (ctDNA) significantly correlated with clinical parameters related to tumor burden (elevated lactate dehydrogenase and β2-microglobulin serum levels, advanced stage, and high-risk International Prognostic Index) and total metabolic tumor volume assessed by PET/CT. In patients treated with curative intent, high ctDNA levels (>2.5 log hGE/mL) were associated with lower complete response (65% vs. 96%; P < 0.004), shorter progression-free survival (65% vs. 85%; P = 0.038), and overall survival (73% vs. 100%; P = 0.007) at 2 years, although it did not maintain prognostic value in multivariate analyses. CONCLUSIONS In a population-based prospective DLBCL series, cfDNA resulted as an alternative source to estimate tumor burden and to determine the tumor mutational profile and genetic classification, which have prognostic implications and may contribute to a future tailored treatment.
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Affiliation(s)
- Alfredo Rivas-Delgado
- Department of Hematology, Hospital Clínic de Barcelona, Barcelona, Spain. .,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Universitat de Barcelona, Barcelona, Spain
| | - Ferran Nadeu
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Barcelona, Spain
| | - Anna Enjuanes
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Barcelona, Spain
| | | | - Pablo Mozas
- Department of Hematology, Hospital Clínic de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Laura Magnano
- Department of Hematology, Hospital Clínic de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | | | - Jordina Rovira
- Department of Hematology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Ivan Dlouhy
- Department of Hematology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Silvia Martín
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Universitat de Barcelona, Barcelona, Spain
| | - Miguel Osuna
- Hematopathology Unit, Department of Pathology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Sonia Rodríguez
- Department of Radiology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Marc Simó
- Department of Nuclear Medicine, Instituto Universitario Dexeus, Grupo Quiron Salud, Barcelona, Spain
| | - Magda Pinyol
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Barcelona, Spain
| | - Tycho Baumann
- Department of Hematology, Hospital Clínic de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Barcelona, Spain
| | - Silvia Beà
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Universitat de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Barcelona, Spain
| | - Olga Balagué
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Universitat de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Barcelona, Spain.,Hematopathology Unit, Department of Pathology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Julio Delgado
- Department of Hematology, Hospital Clínic de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Universitat de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Barcelona, Spain
| | - Neus Villamor
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Barcelona, Spain.,Hematopathology Unit, Department of Pathology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Xavier Setoain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Department of Nuclear Medicine, Hospital Clínic de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBERBBN), Madrid, Spain
| | - Elías Campo
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Universitat de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Barcelona, Spain.,Hematopathology Unit, Department of Pathology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Eva Giné
- Department of Hematology, Hospital Clínic de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Barcelona, Spain
| | - Armando López-Guillermo
- Department of Hematology, Hospital Clínic de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Universitat de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Barcelona, Spain
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11
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Velasco R, Mercadal S, Vidal N, Alañá M, Barceló MI, Ibáñez-Juliá MJ, Bobillo S, Caldú Agud R, García Molina E, Martínez P, Cacabelos P, Muntañola A, García-Catalán G, Sancho JM, Camro I, Lado T, Erro ME, Gómez-Vicente L, Salar A, Caballero AC, Solé-Rodríguez M, Gállego Pérez-Larraya J, Huertas N, Estela J, Barón M, Barbero-Bordallo N, Encuentra M, Dlouhy I, Bruna J, Graus F. Diagnostic delay and outcome in immunocompetent patients with primary central nervous system lymphoma in Spain: a multicentric study. J Neurooncol 2020; 148:545-554. [PMID: 32524392 DOI: 10.1007/s11060-020-03547-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 05/26/2020] [Indexed: 12/12/2022]
Abstract
INTRODUCTION To assess the management of immunocompetent patients with primary central nervous system lymphomas (PCNSL) in Spain. METHODS Retrospective analysis of 327 immunocompetent patients with histologically confirmed PCNSL diagnosed between 2005 and 2014 in 27 Spanish hospitals. RESULTS Median age was 64 years (range: 19-84; 33% ≥ 70 years), 54% were men, and 59% had a performance status (PS) ≥ 2 at diagnosis. Median delay to diagnosis was 47 days (IQR 24-81). Diagnostic delay > 47 days was associated with PS ≥ 2 (OR 1.99; 95% CI 1.13-3.50; p = 0.016) and treatment with corticosteroids (OR 2.47; 95% CI 1.14-5.40; p = 0.023), and it did not improve over the years. Patients treated with corticosteroids (62%) had a higher risk of additional biopsies (11.7% vs 4.0%, p = 0.04) but corticosteroids withdrawal before surgery did not reduce this risk and increased the diagnostic delay (64 vs 40 days, p = 0.04). Median overall survival (OS) was 8.9 months [95% CI 5.9-11.7] for the whole series, including 52 (16%) patients that were not treated, and 14.1 months (95%CI 7.7-20.5) for the 240 (73.4%) patients that received high-dose methotrexate (HD-MTX)-based chemotherapy. Median OS was shorter in patients ≥ 70 years (4.1 vs. 13.4 months; p < 0.0001). Multivariate analysis identified age ≥ 65 years, PS ≥ 2, no treatment, and cognitive/psychiatric symptoms at diagnosis as independent predictors of short survival. CONCLUSIONS Corticosteroids withdrawal before surgery does not decrease the risk of a negative biopsy but delays diagnosis. In this community-based study, only 73.4% of patients could receive HD-MTX-based chemotherapy and OS remains poor, particularly in elderly patients ≥ 70 years.
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Affiliation(s)
- R Velasco
- Neuro-Oncology Unit, Hospital Universitari de Bellvitge-ICO Duran i Reynals, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain. .,Department of Cell Biology, Physiology and Immunology, Institute of Neurosciences, Universitat Autònoma de Barcelona, and Centro de Investigación Biomédica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED), Bellaterra, Spain. .,Department of Neurology, Neuro-Oncology Unit, Hospital Universitari de Bellvitge and ICO L'Hospitalet, C/Feixa Llarga S/N, L'Hospitalet de Llobregat, 08907, Barcelona, Spain.
| | - S Mercadal
- Department of Hematology, Catalan Institute of Oncology-Hospital Duran i Reynals, IDIBELL, Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - N Vidal
- Neuro-Oncology Unit, Hospital Universitari de Bellvitge-ICO Duran i Reynals, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.,Department of Pathology, Unit of Neuro-Oncology. Hospital Universitari de Bellvitge-ICO Duran i Reynals, IDIBELL, L'Hospitalet del Llobregat, Barcelona, Spain
| | - M Alañá
- Department of Neurology, Complejo Asistencial Universitario, Salamanca, Spain
| | - M I Barceló
- Department of Neurology, Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | - M J Ibáñez-Juliá
- Department of Neurology, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - S Bobillo
- Department of Hematology, Vall d'Hebron Institute of Oncology (VHIO), University Hospital Vall d'Hebron, Barcelona, Spain
| | - R Caldú Agud
- Department of Neurology, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - E García Molina
- Department of Neurology, Virgen de la Arrixaca University Hospital, Murcia, Spain
| | - P Martínez
- Department of Hematology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - P Cacabelos
- Department of Neurology, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, La Coruña, Spain
| | - A Muntañola
- Department of Hematology, Hospital Universitario Mutua de Terrassa, Terrassa, Spain
| | - G García-Catalán
- Department of Neurosurgery, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - J M Sancho
- Department of Hematology, ICO-IJC-Hospital Germans Trias i Pujol, Badalona, Spain
| | - I Camro
- Department of Neurology, Hospital Universitario Cruces, Barakaldo, Vizcaya, Spain
| | - T Lado
- Department of Hematology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - M E Erro
- Neurology Department, Complejo Hospitalario de Navarra, Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - L Gómez-Vicente
- Department of Neurology, Hospital Universitario Quirónsalud Madrid, Pozuelo de Alarcón, Madrid, Spain
| | - A Salar
- Department of Hematology, Hospital del Mar, Barcelona, Spain
| | - A C Caballero
- Department of Hematology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - M Solé-Rodríguez
- Department of Hematology, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - J Gállego Pérez-Larraya
- Departament of Neurology, Clínica Universidad de Navarra, IdiSNA, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain
| | - N Huertas
- Department of Neurology, Hospital Universitario Severo Ochoa, Leganés, Madrid, Spain
| | - J Estela
- Department of Neurology, Hospital Parc Taulí, Sabadell, Spain
| | - M Barón
- Unit of Neurology, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - N Barbero-Bordallo
- Department of Neurology, Hospital Universitario Rey Juan Carlos, HURJC-HUIE-HCV, Madrid, Spain
| | - M Encuentra
- Department of Hematology, Catalan Institute of Oncology-Hospital Duran i Reynals, IDIBELL, Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - I Dlouhy
- Department of Hematology and Neurology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - J Bruna
- Neuro-Oncology Unit, Hospital Universitari de Bellvitge-ICO Duran i Reynals, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.,Department of Cell Biology, Physiology and Immunology, Institute of Neurosciences, Universitat Autònoma de Barcelona, and Centro de Investigación Biomédica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED), Bellaterra, Spain
| | - F Graus
- Department of Hematology and Neurology, Hospital Clínic de Barcelona, Barcelona, Spain
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12
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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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13
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Fox CP, Civallero M, Ko YH, Manni M, Skrypets T, Pileri S, Kim SJ, Cabrera ME, Shustov AR, Chiattone CS, Horwitz SM, Dlouhy I, Spina M, Hitz F, Montoto S, Nagler A, Martinez V, De Souza CA, Fernandez-Alvarez R, Ballova V, Gabús R, Inghirami G, Federico M, Kim WS. Survival outcomes of patients with extranodal natural-killer T-cell lymphoma: a prospective cohort study from the international T-cell Project. Lancet Haematol 2020; 7:e284-e294. [PMID: 32105608 DOI: 10.1016/s2352-3026(19)30283-2] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 12/10/2019] [Accepted: 12/17/2019] [Indexed: 11/15/2022]
Abstract
BACKGROUND Extranodal natural killer (NK) T-cell lymphoma (ENKTL) is a unique clinicopathological entity, typically associated with poor survival outcomes. Most published data have come from east Asian study groups, with little information available from international cohorts. The effects of treatment advances on routine clinical practice across continental territories has not been clear. We aimed to improve understanding of the clinical characteristics and outcomes of patients with ENKTL. METHODS We did a substudy of patients with ENKTL from the T-cell Project, a global prospective cohort study. The T-cell Project registered consecutively diagnosed adults (>18 years) with newly diagnosed, untreated mature T-cell or NK lymphomas (WHO 2001 or 2008 classifications) from 74 centres in 13 countries (in Asia, Europe, North America, and South America). In total, 1695 patients with mature T-cell or NK lymphomas were enrolled between Oct 12, 2006 and Feb 28, 2018 in the T-cell Project. The first patient with ENKTL was enrolled on Feb 15, 2007, and the last on May 26, 2017. Data on baseline characteristics, first-line treatment, treatment response, and survival outcomes were recorded in a central database (locked March 30, 2019). The primary outcome was 5-year overall survival. The T-cell Project is registered on ClinicalTrials.gov, NCT01142674. FINDINGS 166 patients were diagnosed with ENKTL, comprising 11% of 1553 eligible registered cases and distributed across 40 participating centres in four continents. At a median follow-up of 44 months (IQR 20-61), overall survival at 5 years was 54% (95% CI 44-63) in patients with nasal disease (n=98) and 34% (27-46) in patients with extranasal disease (n=68). INTERPRETATION To our knowledge, this study presents the largest international cohort of patients with ENKTL. We describe a clinically significant improvement in the survival of patients with ENKTL treated in routine clinical practice over the past decade, likely to be attributable to the increasing use of treatment protocols specific for ENKTL. FUNDING The Fondazione Cassa di Risparmio di Modena, the Associazione Angela Serra per la Ricerca sul Cancro, the Fondazione Italiana Linfomi, Allos Therapeutics, Spectrum Pharmaceuticals, Associazione Italiana per la Ricerca sul Cancro, and the National Cancer Institute at the National Institutes of Health.
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Affiliation(s)
- Christopher P Fox
- Department of Clinical Haematology, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Monica Civallero
- CHIMOMO Department, University of Modena and Reggio Emilia, Modena, Italy
| | - Young-Hyeh Ko
- Department of Pathology, Sungkyunkwan University, Seoul, South Korea
| | - Martina Manni
- CHIMOMO Department, University of Modena and Reggio Emilia, Modena, Italy
| | - Tetiana Skrypets
- CHIMOMO Department, University of Modena and Reggio Emilia, Modena, Italy
| | - Stefano Pileri
- Division of Haematopathology, Istituto Europeo di Oncologia, Milano, Italy
| | - Seok Jin Kim
- Division of Hematology-Oncology, Samsung Medical Center, Seoul, South Korea
| | - Maria Elena Cabrera
- Sección Hematología, Hospital del Salvador, Universidad de Chile, Santiago, Chile
| | - Andrei R Shustov
- Division of Hematology, Fred Hutchinson Cancer Research Center, University of Washington Medical Center, Seattle, WA, USA
| | - Carlos S Chiattone
- Departamento de Clínica Médica, Faculdade de Ciências Médicas Santa Casa de São Paulo, São Paulo, Brazil; Centro de Linfomas Núcleo de Oncologia Hospital Samaritano, São Paulo, Brazil
| | - Steven M Horwitz
- Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Ivan Dlouhy
- Hematology Department, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Michele Spina
- Division of Medical Oncology A, Aviano National Cancer Institute, Aviano, Italy
| | - Felicitas Hitz
- The Swiss Group for Clinical Cancer Research, Department of Oncology/Haematology, Cantonal Hospital, St Gallen, Switzerland
| | - Silvia Montoto
- Department of Haematology, Barts Health NHS Trust, London, UK
| | - Arnon Nagler
- Department of Bone Marrow Transplantation, Tel Aviv University, Tel Aviv, Israel
| | | | - Carmino A De Souza
- Departamento de Clínica Médica, Universidade Estadual de Campinas, Campinas, Brazil
| | | | - Veronika Ballova
- Department of Internal Medicine, National Oncology and Hematology Institute, Bratislava, Slovakia
| | - Raul Gabús
- Hematology and Bone Marrow Transplantation Service, Hospital Maciel, Montevideo, Uruguay
| | - Giorgio Inghirami
- Department of Pathology, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Massimo Federico
- CHIMOMO Department, University of Modena and Reggio Emilia, Modena, Italy
| | - Won Seog Kim
- Division of Hematology-Oncology, Samsung Medical Center, Seoul, South Korea.
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14
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Foss FM, Horwitz SM, Civallero M, Bellei M, Marcheselli L, Kim WS, Cabrera ME, Dlouhy I, Nagler A, Advani RH, Pesce EA, Ko YH, Montoto S, Chiattone C, Moskowitz A, Spina M, Cesaretti M, Biasoli I, Federico M. Incidence and outcomes of rare T cell lymphomas from the T Cell Project: hepatosplenic, enteropathy associated and peripheral gamma delta T cell lymphomas. Am J Hematol 2020; 95:151-155. [PMID: 31709579 DOI: 10.1002/ajh.25674] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 10/18/2019] [Accepted: 11/01/2019] [Indexed: 12/20/2022]
Abstract
The T Cell Project was the largest prospective trial to explore the incidence, treatment patterns, and outcomes for T cell lymphomas. The rare subtypes of T cell lymphomas, including hepatosplenic T cell lymphoma (HSTCL), enteropathy associated T cell lymphoma (EATL), and peripheral gamma delta T cell lymphomas (PGDTCLs) are poorly represented in most studies and there is little data regarding treatment patterns. We report results from 115 patients with hepatosplenic (n = 31), enteropathy associated (n = 65), and PGDTCLs (n = 19). While anthracycline regimens were most commonly used as first line therapy, response rates ranged from 20%-40% and were suboptimal for all groups. Autologous stem cell transplantation was performed as a consolidation in first remission in a small number of patients (33% of HSTCL, 7% of EATL, and 12% of PGDTCL), and four patients with HSTCL underwent allogeneic stem cell transplantation in first remission. The progression free survival at 3 years ranged from 28%-40% for these rare subtypes, and the overall survival at 3 years was most favorable for PGDTCL (70%). These data highlight the need for novel treatment approaches for rare subtypes of T cell lymphomas and for their inclusion in clinical trials.
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MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Disease-Free Survival
- Enteropathy-Associated T-Cell Lymphoma/blood
- Enteropathy-Associated T-Cell Lymphoma/mortality
- Enteropathy-Associated T-Cell Lymphoma/therapy
- Female
- Hematopoietic Stem Cell Transplantation
- Humans
- Incidence
- Lymphoma, T-Cell, Peripheral/blood
- Lymphoma, T-Cell, Peripheral/mortality
- Lymphoma, T-Cell, Peripheral/therapy
- Male
- Middle Aged
- Neoplasm Proteins/blood
- Receptors, Antigen, T-Cell, gamma-delta/blood
- Survival Rate
- Transplantation, Autologous
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Affiliation(s)
| | - Steven M Horwitz
- Department Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Monica Civallero
- CHIMOMO Department, University of Modena and Reggio Emilia, Modena, Italy
| | - Monica Bellei
- Fondazione Italiana Linfomi (FIL) onlus, University of Modena and Reggio Emilia, Modena, Italy
| | - Luigi Marcheselli
- Fondazione Italiana Linfomi (FIL) onlus, University of Modena and Reggio Emilia, Modena, Italy
| | - Won Seog Kim
- Division of Hematology-Oncology, Samsung Medical Center, Seoul, South Korea
| | - Maria E Cabrera
- Sección Hematología, Hospital del Salvador, Universidad de Chile, Santiago, Chile
| | - Ivan Dlouhy
- Hematology Department, Hematologia, Hospital Clinic, Villarroel, Spain
| | - Arnon Nagler
- Department of Bone Marrow Transplantation, Tel-Aviv University, Tel-Aviv, Israel
| | | | - Emanuela A Pesce
- Fondazione Italiana Linfomi (FIL) onlus, University of Modena and Reggio Emilia, Modena, Italy
| | - Young-Hyeh Ko
- Department of Pathology, Sungkyunkwan University, Seoul, Korea
| | - Silvia Montoto
- Department of Haematology, Barts Health NHS Trust, London, UK
| | - Carlos Chiattone
- Departamento de Clínica Médica, FCM da Santa Casa de São Paulo, and Centro de Linfomas Núcleo de Oncologia Hospital Samaritano, São Paulo, Brazil
| | - Alison Moskowitz
- Department Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Michele Spina
- Medical Oncology A, Aviano National Cancer Institute, Aviano, Italy
| | - Marina Cesaretti
- Fondazione Italiana Linfomi (FIL) onlus, University of Modena and Reggio Emilia, Modena, Italy
| | - Irene Biasoli
- Department of Medicine, University Hospital and School of Medicine, Universida de Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Massimo Federico
- CHIMOMO Department University of Modena and Reggio Emilia, Modena, Italy
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15
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Rivas-Delgado A, Magnano L, Moreno-Velázquez M, García O, Nadeu F, Mozas P, Dlouhy I, Baumann T, Rovira J, González-Farre B, Martínez A, Balague O, Delgado J, Villamor N, Giné E, Campo E, Sancho-Cia JM, López-Guillermo A. Response duration and survival shorten after each relapse in patients with follicular lymphoma treated in the rituximab era. Br J Haematol 2018; 184:753-759. [PMID: 30515755 DOI: 10.1111/bjh.15708] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [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: 08/17/2018] [Accepted: 11/05/2018] [Indexed: 11/26/2022]
Abstract
Follicular lymphoma (FL) is an indolent disease characterized by long survival but frequent relapses. Before the introduction of rituximab, the clinical course of these patients showed a shorter response duration (RD) after each relapse. In this study, we analysed if this pattern of shortened responses remains in patients treated in the rituximab era. We selected 348 patients newly diagnosed with FL in two institutions between 2001 and 2014 that received chemoimmunotherapy. After a median follow-up of 6·3 years, 10-year progression-free and overall survivals were 53% and 72%, respectively. All patients received first-line, 111 second-line and 41 third-line treatments, with a 5-year RD of 62%, 39% and 24%, respectively (P < 0·0001). Variables predicting longer RD after first-line treatment were normal β2microglobulin, complete remission achievement and maintenance with rituximab. Patients with longer RD after first-line showed significantly longer RD after second-line therapy. Autologous stem-cell transplantation after second-line therapy did not significantly impact RD. Median survival after first, second and third therapies was not reached, 7·6 and 4·8 years, respectively, whereas relative survival with respect to a sex- and age-matched Spanish population, the decrease in the life expectancy at 10 years was 17%, 45% and 79%, respectively. Thus, RD still shortens after each relapse in patients with FL treated in first line with rituximab combinations.
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Affiliation(s)
- Alfredo Rivas-Delgado
- Department of Haematology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Laura Magnano
- Haematopathology Unit, Department of Pathology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,CIBERONC, Barcelona, Spain
| | - Miriam Moreno-Velázquez
- Haematology Department, ICO-IJC-Hospital Germans Trias i Pujol, Universitat Autonoma de Barcelona, Badalona, Spain
| | - Olga García
- Haematology Department, ICO-IJC-Hospital Germans Trias i Pujol, Universitat Autonoma de Barcelona, Badalona, Spain
| | - Ferran Nadeu
- Lymphoid Neoplasm Program, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,CIBERONC, Barcelona, Spain
| | - Pablo Mozas
- Department of Haematology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Ivan Dlouhy
- Department of Haematology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Tycho Baumann
- Department of Haematology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,CIBERONC, Barcelona, Spain
| | - Jordina Rovira
- Department of Haematology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Blanca González-Farre
- Department of Pathology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Spain.,CIBERONC, Barcelona, Spain
| | - Antonio Martínez
- Department of Pathology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Spain.,CIBERONC, Barcelona, Spain
| | - Olga Balague
- Department of Pathology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Spain.,CIBERONC, Barcelona, Spain
| | - Julio Delgado
- Department of Haematology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,CIBERONC, Barcelona, Spain
| | - Neus Villamor
- Haematopathology Unit, Department of Pathology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,CIBERONC, Barcelona, Spain
| | - Eva Giné
- Department of Haematology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,CIBERONC, Barcelona, Spain
| | - Elías Campo
- Haematopathology Unit, Department of Pathology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Lymphoid Neoplasm Program, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,CIBERONC, Barcelona, Spain
| | - Juan M Sancho-Cia
- Haematology Department, ICO-IJC-Hospital Germans Trias i Pujol, Universitat Autonoma de Barcelona, Badalona, Spain
| | - Armando López-Guillermo
- Department of Haematology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,CIBERONC, Barcelona, Spain
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16
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Baptista MJ, Tapia G, Morgades M, Muncunill J, Muñoz-Marmol AM, Montoto S, Gribben JG, Calaminici M, Martinez A, Gonzalez-Farre B, Dlouhy I, González-Barca E, Terol MJ, Miralles P, Alcoceba M, Vall-Llovera F, Briones J, Abrisqueta P, Abella E, Provencio M, García-Ballesteros C, Moraleda JM, Sancho JM, Ribera JM, Mate JL, Navarro JT. Using the Lymph2Cx assay for assessing cell-of-origin subtypes of HIV-related diffuse large B-cell lymphoma. Leuk Lymphoma 2018; 60:1087-1091. [DOI: 10.1080/10428194.2018.1512711] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Maria Joao Baptista
- Department of Hematology, ICO-Hospital Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute (IJC), Institut Germans Trias i Pujol (IGTP), Universitat Autònoma de Barcelona, Badalona, Spain
| | - Gustavo Tapia
- Department of Pathology, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Mireia Morgades
- Department of Hematology, ICO-Hospital Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute (IJC), Institut Germans Trias i Pujol (IGTP), Universitat Autònoma de Barcelona, Badalona, Spain
| | - Josep Muncunill
- Department of Hematology, ICO-Hospital Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute (IJC), Institut Germans Trias i Pujol (IGTP), Universitat Autònoma de Barcelona, Badalona, Spain
| | - Ana-María Muñoz-Marmol
- Department of Pathology, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Silvia Montoto
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London, London, United Kingdom
| | - John G. Gribben
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London, London, United Kingdom
| | - Maria Calaminici
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London, London, United Kingdom
| | - Antonio Martinez
- Department of Pathology, Hospital Clinic, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Blanca Gonzalez-Farre
- Department of Pathology, Hospital Clinic, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Ivan Dlouhy
- Department of Hematology, Hospital Clinic, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Eva González-Barca
- Department of Hematology, ICO-Hospital Duran i Reynals, L’Hospitalet de Llobregat, Spain
| | - María-José Terol
- Department of Hematology and Oncology, Hospital Clínic Universitari de València, Valencia, Spain
| | - Pilar Miralles
- Department of Infectious Diseases, Hospital Gregorio Marañón, Madrid, Spain
| | - Miguel Alcoceba
- Department of Hematology, Hospital Universitario de Salamanca, Salamanca, Spain
| | - Ferran Vall-Llovera
- Department of Clinical Hematology, Hospital Universitari Mutúa de Terrassa, Terrassa, Spain
| | - Javier Briones
- Department of Hematology, Hospital de la Santa Creu i Sant Pau, Josep Carreras Leukaemia Research Institute (IJC), Barcelona, Spain
| | - Pau Abrisqueta
- Department of Hematology, Hospital Vall d’Hebrón, Barcelona, Spain
| | - Eugenia Abella
- Department of Hematology, Hospital del Mar, Barcelona, Spain
| | - Mariano Provencio
- Department of Medical Oncology, Hospital Universitario Puerta De Hierro, Majadahonda, Spain
| | | | - José-María Moraleda
- Department of Hematology, Hospital Clinico Universitario Virgen de la Arrixaca, Murcia, Spain
| | - Juan-Manuel Sancho
- Department of Hematology, ICO-Hospital Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute (IJC), Institut Germans Trias i Pujol (IGTP), Universitat Autònoma de Barcelona, Badalona, Spain
| | - Josep-Maria Ribera
- Department of Hematology, ICO-Hospital Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute (IJC), Institut Germans Trias i Pujol (IGTP), Universitat Autònoma de Barcelona, Badalona, Spain
| | - José-Luis Mate
- Department of Pathology, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | - José-Tomas Navarro
- Department of Hematology, ICO-Hospital Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute (IJC), Institut Germans Trias i Pujol (IGTP), Universitat Autònoma de Barcelona, Badalona, Spain
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17
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Bellei M, Foss FM, Shustov AR, Horwitz SM, Marcheselli L, Kim WS, Cabrera ME, Dlouhy I, Nagler A, Advani RH, Pesce EA, Ko YH, Martinez V, Montoto S, Chiattone C, Moskowitz A, Spina M, Biasoli I, Manni M, Federico M. The outcome of peripheral T-cell lymphoma patients failing first-line therapy: a report from the prospective, International T-Cell Project. Haematologica 2018; 103:1191-1197. [PMID: 29599200 PMCID: PMC6029527 DOI: 10.3324/haematol.2017.186577] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 03/26/2018] [Indexed: 12/22/2022] Open
Abstract
This analysis explored factors influencing survival of patients with primary refractory and relapsed peripheral T-cell lymphomas enrolled in the prospective International T-cell Project. We analyzed data from 1020 patients with newly diagnosed disease, enrolled between September 2006 and December 2015. Out of 937 patients who received first-line treatment, 436 (47%) were identified as refractory and 197 (21%) as relapsed. Median time from the end of treatment to relapse was 8 months (range 2-73). Overall, 75 patients (8%) were consolidated with bone marrow transplantation, including 12 refractory and 22 relapsed patients. After a median follow up of 38 months (range 1-96 months) from documentation of refractory/relapsed disease, 440 patients had died. The median overall survival (OS) was 5.8 months; 3-year overall survival rates were 21% and 28% for refractory and relapsed patients, respectively (P<0.001). Patients receiving or not salvage bone marrow transplantation had a 3-year survival of 48% and 18%, respectively (P<0.001). In a univariate Cox regression analysis, refractory disease was associated with a higher risk of death (HR=1.43, P=0.001), whereas late relapse (>12 months, HR 0.57, P=0.001) and salvage therapy with transplantation (HR=0.36, P<0.001) were associated with a better OS. No difference was found in OS with respect to histology. This study accurately reflects outcomes for patients treated according to standards of care worldwide. Results confirm that peripheral T-cell lymphomas patients had dismal outcome after relapse or progression. Patients with chemotherapy sensitive disease who relapsed after more than 12 months might benefit from consolidation bone marrow transplantation.
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Affiliation(s)
- Monica Bellei
- Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | | | | | | | - Luigi Marcheselli
- Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Won Seog Kim
- Hematology-Oncology Samsung Medical Center, Seoul, South Korea
| | - Maria E Cabrera
- Hospital del Salvador, Universidad de Chile, Santiago, Chile
| | - Ivan Dlouhy
- Department of Hematology, Hospital Clinic, Barcelona, Spain
| | | | | | - Emanuela A Pesce
- Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Young-Hyeh Ko
- Department of Pathology, Samsung Medical Center, Seoul, South Korea
| | | | - Silvia Montoto
- Department of Haemato-Oncology, St. Bartholomew's Hospital, Barts Health NHS Trust, London, UK
| | - Carlos Chiattone
- Departamento de Clínica Médica, FCM da Santa Casa de São Paulo, Brazil
| | | | - Michele Spina
- Medical Oncology A, National Cancer Institute, Aviano, Italy
| | - Irene Biasoli
- Department of Medicine, University Hospital and School of Medicine, Universidade Federal do Rio de Janeiro, Brazil
| | - Martina Manni
- Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Massimo Federico
- Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy
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18
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Esteve-Arenys A, Valero JG, Chamorro-Jorganes A, Gonzalez D, Rodriguez V, Dlouhy I, Salaverria I, Campo E, Colomer D, Martinez A, Rymkiewicz G, Pérez-Galán P, Lopez-Guillermo A, Roué G. The BET bromodomain inhibitor CPI203 overcomes resistance to ABT-199 (venetoclax) by downregulation of BFL-1/A1 in in vitro and in vivo models of MYC+/BCL2+ double hit lymphoma. Oncogene 2018; 37:1830-1844. [PMID: 29353886 DOI: 10.1038/s41388-017-0111-1] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 09/16/2017] [Accepted: 10/19/2017] [Indexed: 12/28/2022]
Abstract
High-grade B-cell lymphoma with MYC and BCL2 and/or BCL6 rearrangements, mostly known as double-hit lymphoma (DHL), is a rare entity characterized by morphologic and molecular features between Burkitt lymphoma and the clinically manageable diffuse large B-cell lymphoma (DLBCL). DHL patients usually undergo a rapidly progressing clinical course associated with resistance to standard chemo-immunotherapy. As a consequence, the prognosis of this entity is particularly poor with a median overall survival inferior to 1 year. ABT-199 (venetoclax) is a potent and selective small-molecule antagonist of BCL-2 recently approved for the treatment of a specific subtype of lymphoid neoplasm. In this study, we demonstrate that single-agent ABT-199 efficiently displaces BAX from BCL-2 complexes but fails to maintain a significant antitumor activity over time in most MYC+/BCL2+DHL cell lines and primary cultures, as well as in a xenograft mouse model of the disease. We further identify the accumulation of the BCL2-like protein BFL-1 to be a major mechanism involved in acquired resistance to ABT-199. Noteworthy, this phenomenon can be counteracted by the BET bromodomain inhibitor CPI203, since gene expression profiling identifies BCL2A1, the BFL-1 coding gene, as one of the top apoptosis-related gene modulated by this compound. Upon CPI203 treatment, simultaneous downregulation of MYC and BFL-1 further overcomes resistance to ABT-199 both in vitro and in vivo, engaging synergistic caspase-mediated apoptosis in DHL cultures and tumor xenografts. Together, these findings highlight the relevance of BFL-1 in DH lymphoma-associated drug resistance and support the combined use of a BCL-2 antagonist and a BET inhibitor as a promising therapeutic strategy for patients with aggressive DHL.
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Affiliation(s)
- A Esteve-Arenys
- Aggressive B-cell Lymphoma Study Group, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), CIBERONC, Barcelona, Spain.,Division of Hematology and Oncology, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), CIBERONC, Barcelona, Spain
| | - J G Valero
- Aggressive B-cell Lymphoma Study Group, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), CIBERONC, Barcelona, Spain.,Division of Hematology and Oncology, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), CIBERONC, Barcelona, Spain
| | - A Chamorro-Jorganes
- Aggressive B-cell Lymphoma Study Group, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), CIBERONC, Barcelona, Spain.,Division of Hematology and Oncology, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), CIBERONC, Barcelona, Spain
| | - D Gonzalez
- Aggressive B-cell Lymphoma Study Group, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), CIBERONC, Barcelona, Spain.,Division of Hematology and Oncology, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), CIBERONC, Barcelona, Spain
| | - V Rodriguez
- Division of Hematology and Oncology, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), CIBERONC, Barcelona, Spain
| | - I Dlouhy
- Department of Hematology, Hospital Clinic, Barcelona, Spain
| | - I Salaverria
- Division of Hematology and Oncology, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), CIBERONC, Barcelona, Spain
| | - E Campo
- Division of Hematology and Oncology, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), CIBERONC, Barcelona, Spain.,Hematopathology Unit, Department of Pathology, Hospital Clinic, Barcelona, Spain
| | - D Colomer
- Division of Hematology and Oncology, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), CIBERONC, Barcelona, Spain.,Hematopathology Unit, Department of Pathology, Hospital Clinic, Barcelona, Spain
| | - A Martinez
- Hematopathology Unit, Department of Pathology, Hospital Clinic, Barcelona, Spain
| | - G Rymkiewicz
- Department of Pathology, The Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland
| | - P Pérez-Galán
- Division of Hematology and Oncology, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), CIBERONC, Barcelona, Spain
| | - A Lopez-Guillermo
- Division of Hematology and Oncology, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), CIBERONC, Barcelona, Spain.,Department of Hematology, Hospital Clinic, Barcelona, Spain
| | - G Roué
- Aggressive B-cell Lymphoma Study Group, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), CIBERONC, Barcelona, Spain. .,Division of Hematology and Oncology, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), CIBERONC, Barcelona, Spain. .,Laboratory of Experimental Hematology, Department of Hematology, Vall d'Hebron Institute of Oncology, Vall d'Hebron University Hospital, Barcelona, Spain.
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19
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Magnano L, Balagué O, Dlouhy I, Rovira J, Karube K, Pinyol M, Rivas-Delgado A, Costa D, Martínez-Trillos A, González-Farre B, Martínez-Pozo A, Giné E, Colomer D, Delgado J, Villamor N, Campo E, López-Guillermo A. Clinicobiological features and prognostic impact of diffuse large B-cell lymphoma component in the outcome of patients with previously untreated follicular lymphoma. Ann Oncol 2017; 28:2799-2805. [PMID: 29045517 DOI: 10.1093/annonc/mdx407] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [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] [Indexed: 08/08/2023] Open
Abstract
BACKGROUND The co-existence at diagnosis of follicular lymphoma (FL) and diffuse large B-cell lymphoma (DLBCL) components (FL/DLBCL) has been considered a transformed lymphoma and accordingly treated although clinicobiological information on these patients is scarce. The aim of this study was to analyze the initial features and outcome of FL/DLBCL patients in the rituximab era. PATIENTS AND METHODS All patients consecutively diagnosed at a single institution with FL/DLBCL (n = 40), as well as those with pure FL (n = 328) or de novo DLBCL (n = 510) as controls. RESULTS The proportion of the DLBCL component was highly variable (median 50%). In 29 FL/DLBCL cases analyzed, the cell of origin was GCB in 86%, ABC in 10% and unclassifiable in 4%. NOTCH1-2 was mutated in 10% of these cases. The proportion of DLBCL component did not impact on overall survival (OS). Regarding initial characteristics, patients with FL/DLBCL were closer to FL in terms of primary nodal origin, good performance status and advanced stage, whereas the other features were intermediate between FL and DLBCL. FL/DLBCL patients were treated as DLBCL with no further intensification. Complete response and primary refractory rates were 65% and 20%, respectively, with these figures being similar to DLBCL and worse than FL. Progression-free survival and OS were intermediate between FL and DLBCL (5-year OS: 85%, 73% and 63% for FL, FL/DLBCL and DLBCL, respectively). FL/DLBCL histology did not reach independent prognostic value for OS in the multivariate analyses. CONCLUSIONS The outcome of FL/DLBCL patients is not worse than that of de novo DLBCL. These cases should be treated with immunochemotherapy as DLBCL, but intensification with ASCT may not be necessary. The biological insights of FL/DLBCL warrants further genetic and molecular studies.
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MESH Headings
- Aged
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Case-Control Studies
- Female
- Follow-Up Studies
- Humans
- Lymphoma, Follicular/complications
- Lymphoma, Follicular/drug therapy
- Lymphoma, Follicular/mortality
- Lymphoma, Follicular/pathology
- Lymphoma, Large B-Cell, Diffuse/complications
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large B-Cell, Diffuse/mortality
- Lymphoma, Large B-Cell, Diffuse/pathology
- Male
- Neoplasm Recurrence, Local/complications
- Neoplasm Recurrence, Local/drug therapy
- Neoplasm Recurrence, Local/mortality
- Neoplasm Recurrence, Local/pathology
- Prognosis
- Survival Rate
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Affiliation(s)
- L Magnano
- Department of Hematology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona;; Hematopathology Unit, Department of Pathology, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona;; CIBERONC, Barcelona
| | - O Balagué
- CIBERONC, Barcelona;; Department of Pathology, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - I Dlouhy
- Department of Hematology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona;; CIBERONC, Barcelona
| | - J Rovira
- Department of Hematology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona;; CIBERONC, Barcelona
| | - K Karube
- Department of Pathology and Cell Biology, Graduate School of Medicine, University of the Ryukyus;; Faculty of Medicine, University of the Ryukyus, Japan
| | - M Pinyol
- CIBERONC, Barcelona;; Genomics Unit, IDIBAPS, Barcelona, Spain
| | - A Rivas-Delgado
- Department of Hematology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona;; CIBERONC, Barcelona
| | - D Costa
- Hematopathology Unit, Department of Pathology, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona;; CIBERONC, Barcelona
| | - A Martínez-Trillos
- Department of Hematology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona;; CIBERONC, Barcelona
| | - B González-Farre
- CIBERONC, Barcelona;; Department of Pathology, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - A Martínez-Pozo
- CIBERONC, Barcelona;; Department of Pathology, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - E Giné
- Department of Hematology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona;; CIBERONC, Barcelona
| | - D Colomer
- Hematopathology Unit, Department of Pathology, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona;; CIBERONC, Barcelona
| | - J Delgado
- Department of Hematology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona;; CIBERONC, Barcelona
| | - N Villamor
- Hematopathology Unit, Department of Pathology, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona;; CIBERONC, Barcelona
| | - E Campo
- Hematopathology Unit, Department of Pathology, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona;; CIBERONC, Barcelona
| | - A López-Guillermo
- Department of Hematology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona;; CIBERONC, Barcelona;.
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20
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Karube K, Enjuanes A, Dlouhy I, Jares P, Martin-Garcia D, Nadeu F, Ordóñez GR, Rovira J, Clot G, Royo C, Navarro A, Gonzalez-Farre B, Vaghefi A, Castellano G, Rubio-Perez C, Tamborero D, Briones J, Salar A, Sancho JM, Mercadal S, Gonzalez-Barca E, Escoda L, Miyoshi H, Ohshima K, Miyawaki K, Kato K, Akashi K, Mozos A, Colomo L, Alcoceba M, Valera A, Carrió A, Costa D, Lopez-Bigas N, Schmitz R, Staudt LM, Salaverria I, López-Guillermo A, Campo E. Integrating genomic alterations in diffuse large B-cell lymphoma identifies new relevant pathways and potential therapeutic targets. Leukemia 2017; 32:675-684. [PMID: 28804123 PMCID: PMC5843901 DOI: 10.1038/leu.2017.251] [Citation(s) in RCA: 119] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 07/24/2017] [Accepted: 07/27/2017] [Indexed: 02/08/2023]
Abstract
Genome studies of diffuse large B-cell lymphoma (DLBCL) have revealed a large number of somatic mutations and structural alterations. However, the clinical significance of these alterations is still not well defined. In this study, we have integrated the analysis of targeted next-generation sequencing of 106 genes and genomic copy number alterations (CNA) in 150 DLBCL. The clinically significant findings were validated in an independent cohort of 111 patients. Germinal center B-cell and activated B-cell DLBCL had a differential profile of mutations, altered pathogenic pathways and CNA. Mutations in genes of the NOTCH pathway and tumor suppressor genes (TP53/CDKN2A), but not individual genes, conferred an unfavorable prognosis, confirmed in the independent validation cohort. A gene expression profiling analysis showed that tumors with NOTCH pathway mutations had a significant modulation of downstream target genes, emphasizing the relevance of this pathway in DLBCL. An in silico drug discovery analysis recognized 69 (46%) cases carrying at least one genomic alteration considered a potential target of drug response according to early clinical trials or preclinical assays in DLBCL or other lymphomas. In conclusion, this study identifies relevant pathways and mutated genes in DLBCL and recognizes potential targets for new intervention strategies.
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Affiliation(s)
- K Karube
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.,Department of Pathology and Cell Biology, Graduate School of Medicine and Faculty of Medicine, University of the Ryukyus, Nishihara, Japan
| | - A Enjuanes
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.,CIBERONC, Madrid, Spain
| | - I Dlouhy
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - P Jares
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.,CIBERONC, Madrid, Spain
| | - D Martin-Garcia
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.,CIBERONC, Madrid, Spain
| | - F Nadeu
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.,CIBERONC, Madrid, Spain
| | | | - J Rovira
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - G Clot
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.,CIBERONC, Madrid, Spain
| | - C Royo
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - A Navarro
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.,CIBERONC, Madrid, Spain
| | - B Gonzalez-Farre
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.,CIBERONC, Madrid, Spain
| | - A Vaghefi
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - G Castellano
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - C Rubio-Perez
- Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Research Unit on Biomedical Informatics, Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - D Tamborero
- Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Research Unit on Biomedical Informatics, Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - J Briones
- Servei de Patologia, Hospital de Sant Pau, Barcelona, Spain
| | - A Salar
- Department of Pathology, Hospital del Mar, Universitat Pompeu Fabra, Barcelona, Spain
| | - J M Sancho
- ICO-Hospital Germans Trias i Pujol, Barcelona, Spain
| | - S Mercadal
- ICO-Hospital Duran i Reynals, L'Hospitalet, Barcelona, Spain
| | | | - L Escoda
- Department of Hematology, Hospital Universitari Joan XXIII, Tarragona, Spain
| | - H Miyoshi
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - K Ohshima
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - K Miyawaki
- Department of Medicine and Biosystemic Science, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - K Kato
- Department of Medicine and Biosystemic Science, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - K Akashi
- Department of Medicine and Biosystemic Science, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - A Mozos
- Servei de Patologia, Hospital de Sant Pau, Barcelona, Spain
| | - L Colomo
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.,Department of Pathology, Hospital del Mar, Universitat Pompeu Fabra, Barcelona, Spain
| | - M Alcoceba
- CIBERONC, Madrid, Spain.,Unidad de Biología Molecular/Histocompatibilidad, Servicio de Hematología, Hospital Universitario de Salamanca, Salamanca, Spain
| | - A Valera
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - A Carrió
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.,CIBERONC, Madrid, Spain
| | - D Costa
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.,CIBERONC, Madrid, Spain
| | - N Lopez-Bigas
- Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Research Unit on Biomedical Informatics, Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain.,Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
| | - R Schmitz
- Lymphoid Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - L M Staudt
- Lymphoid Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - I Salaverria
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.,CIBERONC, Madrid, Spain
| | - A López-Guillermo
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.,CIBERONC, Madrid, Spain
| | - E Campo
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.,CIBERONC, Madrid, Spain
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21
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Rivas-Delgado A, Magnano L, Moreno-Velazquez M, Garcia O, Mozas P, Dlouhy I, Baumann T, Rovira J, Gonzalez B, Martinez A, Balague O, Delgado J, Villamor N, Campo E, Gine E, Sancho J, Lopez-Guillermo A. Progression-free survival shortens after each relapse in patients with follicular lymphoma treated in the rituximab era. Hematol Oncol 2017. [DOI: 10.1002/hon.2439_115] [Citation(s) in RCA: 4] [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: 11/09/2022]
Affiliation(s)
- A. Rivas-Delgado
- Hematology Department, Hospital Clinic, IDIBAPS; Universitat de Barcelona; Barcelona Spain
| | - L. Magnano
- Hematology Department, Hospital Clinic, IDIBAPS; Universitat de Barcelona; Barcelona Spain
| | - M. Moreno-Velazquez
- Hematology Department, ICO-IJC-Hospital Germans Trias i Pujol; Universitat Autonoma de Barcelona; Badalona Spain
| | - O. Garcia
- Hematology Department, ICO-IJC-Hospital Germans Trias i Pujol; Universitat Autonoma de Barcelona; Badalona Spain
| | - P. Mozas
- Hematology Department, Hospital Clinic, IDIBAPS; Universitat de Barcelona; Barcelona Spain
| | - I. Dlouhy
- Hematology Department, Hospital Clinic, IDIBAPS; Universitat de Barcelona; Barcelona Spain
| | - T. Baumann
- Hematology Department, Hospital Clinic, IDIBAPS; Universitat de Barcelona; Barcelona Spain
| | - J. Rovira
- Hematology Department, Hospital Clinic, IDIBAPS; Universitat de Barcelona; Barcelona Spain
| | - B. Gonzalez
- Hematopathology Unit, Pathology Department, Hospital Clinic, IDIBAPS; Universitat de Barcelona; Barcelona Spain
| | - A. Martinez
- Hematopathology Unit, Pathology Department, Hospital Clinic, IDIBAPS; Universitat de Barcelona; Barcelona Spain
| | - O. Balague
- Hematopathology Unit, Pathology Department, Hospital Clinic, IDIBAPS; Universitat de Barcelona; Barcelona Spain
| | - J. Delgado
- Hematology Department, Hospital Clinic, IDIBAPS; Universitat de Barcelona; Barcelona Spain
| | - N. Villamor
- Hematopathology Unit, Pathology Department, Hospital Clinic, IDIBAPS; Universitat de Barcelona; Barcelona Spain
| | - E. Campo
- Hematopathology Unit, Pathology Department, Hospital Clinic, IDIBAPS; Universitat de Barcelona; Barcelona Spain
| | - E. Gine
- Hematology Department, Hospital Clinic, IDIBAPS; Universitat de Barcelona; Barcelona Spain
| | - J.M. Sancho
- Hematology Department, ICO-IJC-Hospital Germans Trias i Pujol; Universitat Autonoma de Barcelona; Badalona Spain
| | - A. Lopez-Guillermo
- Hematology Department, Hospital Clinic, IDIBAPS; Universitat de Barcelona; Barcelona Spain
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22
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Fox C, Bellei M, Manni M, Kim S, Ko Y, Shustov A, Cabrera M, Chiattone C, Horwitz S, Spina M, Advani R, Angrilli F, De Souza C, Dlouhy I, Fernandez-Alvarez R, Gabús R, Hitz F, Laszlo D, Montoto S, Nagler A, Pavlovsky A, Vitolo U, Zoppegno L, Federico M, Kim W. IMPROVED SURVIVAL OUTCOMES FOR PATIENTS WITH EXTRA-NODAL NK/T LYMPHOMA: DATA FROM 140 PATIENTS PROSPECTIVELY REGISTERED IN THE INTERNATIONAL T-CELL PROJECT. Hematol Oncol 2017. [DOI: 10.1002/hon.2437_66] [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: 11/08/2022]
Affiliation(s)
- C.P. Fox
- Nottingham University Hospitals NHS Trust, and Institute of Cancer Sciences, University of Birmingham; Nottingham UK
| | - M. Bellei
- Dept. Diagnostic, Clinical and Public Health Medicine; University of Modena and Reggio Emilia; Modena Italy
| | - M. Manni
- Dept. Diagnostic, Clinical and Public Health Medicine; University of Modena and Reggio Emilia; Modena Italy
| | - S.J. Kim
- Division of Hematology-Oncology; Samsung Medical Center; Seoul Republic of Korea
| | - Y.H. Ko
- Department of Pathology; Sungkyunkwan University; Seoul Republic of Korea
| | - A.R. Shustov
- Division of Hematology, FHCRC; University of Washington Medical Center; Seattle USA
| | - M.E. Cabrera
- Sección Hematología, Hospital del Salvador; Universidad de Chile; Santiago de Chile Chile
| | - C.S. Chiattone
- Departamento de Clínica Médica, FCM da Santa Casa de São Paulo; Centro de Linfomas Núcleo de Oncologia Hospital Samaritano; São Paulo Brazil
| | - S.M. Horwitz
- Dept. Medicine; Memorial Sloan-Kettering Cancer Center; New York USA
| | - M. Spina
- Medical Oncology A; Aviano National Cancer Institute; Aviano Italy
| | - R.H. Advani
- Division of Oncology; Stanford University School of Medicine; Stanford USA
| | - F. Angrilli
- Dip. Ematologia, Medicina Trasfusionale e Biotecnologie; UOSD Centro Diagnosi e Terapia Linfomi; PO Pescara, Pescara Italy
| | - C.A. De Souza
- Departamento de Clínica Médica; Universidade Estadual de Campinas; Campinas Brazil
| | - I. Dlouhy
- Hematology Department; Hospital Clinic; Barcelona Italy
| | | | - R. Gabús
- Service of Hematology and Bone Marrow Transplantation; Hospital Maciel; Montevideo Uruguay
| | - F. Hitz
- Department of Oncology/Haematology; Cantonal Hospital; St Gallen Switzerland
| | - D. Laszlo
- Division of Haemato-Oncology; IEO - Istituto Europeo di Oncologia; Milan Italy
| | - S. Montoto
- Department of Haematology; Barts Health NHS Trust; London Italy
| | - A. Nagler
- Department of Bone Marrow Transplantation; Tel-Aviv University; Tel-Aviv Israel
| | | | - U. Vitolo
- S.C. Ematologia, Dipartimento di Oncologia ed Ematologia, S.C. Ematologia, Dipartimento di Oncologia ed Ematologia; Torino Italy
| | - L. Zoppegno
- Hematologia, Hospital provincial San Martín de La Plata; Buenos Aires Argentina
| | - M. Federico
- Dept. Diagnostic, Clinical and Public Health Medicine; University of Modena and Reggio Emilia; Modena Italy
| | - W.S. Kim
- Division of Hematology-Oncology; Samsung Medical Center; Seoul Republic of Korea
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23
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Mercadal S, Vidal N, López-Parra M, Ibañez M, Caldú R, Bobillo S, Barceló I, García E, Martinez P, Cacabelos P, Dlouhy I, Sancho J, Muntañola A, Gómez L, Erro E, Gállego J, Salar A, Caballero A, Solé M, Huertas N, Estela J, Baron M, Barbero N, González-Barca E, Graus F, Velasco R. Initial management of primary central nervous system lymphoma in Spain in the last decade. The experience of the GELTAMO and Spanish neuro-oncology groups. Hematol Oncol 2017. [DOI: 10.1002/hon.2439_107] [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)
- S. Mercadal
- Hematology; Catalan Institute of Oncology. Hospital Duran i Reynals., L'Hospitalet de Llobregat; Barcelona Spain
| | - N. Vidal
- Pathology; Hospital de Bellvitge, L'Hospitalet de Llobregat; Barcelona Spain
| | - M. López-Parra
- Hematology; Hospital Universitario de Salamanca; Salamanca Spain
| | - M. Ibañez
- Neurology; Hospital Universitario i Politècnic La Fe; Valencia Spain
| | - R. Caldú
- Neurology; Hospital Universitario Miguel Servet; Zaragoza Spain
| | - S. Bobillo
- Hematology; Hospital Vall d'Hebrón; Barcelona Spain
| | - I. Barceló
- Neurology; Hospital Universitario Son Espases; Palma de Mallorca Spain
| | - E. García
- Neurology; Hospital Universitario Virgen de la Arrixaca; Murcia Spain
| | - P. Martinez
- Hematology; Hospital Universitario Doce de Octubre; Madrid Spain
| | - P. Cacabelos
- Neurology; Complejo hospitalario Santiago Compostela; Santiago Compostela Spain
| | - I. Dlouhy
- Hematology; Hospital Clínic; Barcelona Spain
| | - J. Sancho
- Hematology; ICO. Hospital Germans Trias i Pujol; Badalona Spain
| | - A. Muntañola
- Hematology; Hospital Mutua de Terrassa; Terrassa Spain
| | - L. Gómez
- Neurology; Hospital Quirón; Madrid Spain
| | - E. Erro
- Neurology; Hospital de Navarra; Pamplona Spain
| | - J. Gállego
- Neurology; Clínica Universitaria de Navarra; Pamplona Spain
| | - A. Salar
- Hematology; Hospital del Mar; Barcelona Spain
| | - A. Caballero
- Hematology; Hospital de Sant Pau; Barcelona Spain
| | - M. Solé
- Hematology; Hospital Virgen del Rocío; Sevilla Spain
| | - N. Huertas
- Neurology; Hospiatl Severo Ochoa; Leganés Spain
| | - J. Estela
- Neurology; Hospital Parc Taulí; Sabadell Spain
| | - M. Baron
- Neurology; Hospital Fundación Alcorcón; Alcorcón Spain
| | - N. Barbero
- Neurology; Hospital Rey Juan Carlos; Móstoles Spain
| | - E. González-Barca
- Hematology; Catalan Institute of Oncology. Hospital Duran i Reynals., L'Hospitalet de Llobregat; Barcelona Spain
| | - F. Graus
- Hematology; Hospital Clínic; Barcelona Spain
| | - R. Velasco
- Neurology; Hospital de Bellvitge, L'Hospitalet de Llobregat; Barcelona Spain
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24
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Martín A, Baile M, Rodríguez G, Dlouhy I, Sancho J, Jarque I, González-Barca E, Salar A, Espeso M, Grande C, Bergua J, Montes-Moreno S, López-Guillermo A, Campo E, Caballero D. Lenalidomide in combination with R-ESHAP in patients with relapsed or refractory diffuse large B-cell lymphoma: A phase 2 study from the Spanish group GELTAMO. Hematol Oncol 2017. [DOI: 10.1002/hon.2439_93] [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: 11/08/2022]
Affiliation(s)
- A. Martín
- Hematology; Hospital Universitario de Salamanca and IBSAL; Salamanca Spain
| | - M. Baile
- Hematology; Hospital Universitario de Salamanca and IBSAL; Salamanca Spain
| | - G. Rodríguez
- Hematology; UGC HH.UU. Virgen del Rocío / Virgen Macarena; Sevilla Spain
| | - I. Dlouhy
- Hematology; Hospital Clinic; Barcelona Spain
| | - J.M. Sancho
- Hematology; Hospital Germans Trias i Pujol / ICO-IJC, Barcelona; Badalona Spain
| | - I. Jarque
- Hematology; Hospital Universitario La Fe; Valencia Spain
| | - E. González-Barca
- Hematology; Hospital Duran i Reynals / ICO-IDIBELL, Hospitalet de Llobregat; Barcelona Spain
| | - A. Salar
- Hematology; Hospital del Mar; Barcelona Spain
| | - M. Espeso
- Hematology; Hospital Regional Universitario de Málaga; Málaga Spain
| | - C. Grande
- Hematology; Hospital Universitario 12 de Octubre; Madrid Spain
| | - J. Bergua
- Hematology; Hospital San Pedro de Alcántara; Cáceres Spain
| | - S. Montes-Moreno
- Pathology; Hospital Universitario Marqués de Valdecilla; Santander Spain
| | | | - E. Campo
- Pathology; Hospital Clinic; Barcelona Spain
| | - D. Caballero
- Hematology; Hospital Universitario de Salamanca and IBSAL; Salamanca Spain
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25
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Dlouhy I, Karube K, Enjuanes A, Salaverría I, Pérez-Galán P, Jares P, Martín-García D, Nadeu F, Rivas-Delgado A, Rovira J, Gonzalez B, Mozos A, Clot G, Sancho J, Salar A, Mercadal S, Escola L, Briones J, Colomo L, Alcoceba M, Valera A, Campo E, López-Guillermo A. GENE MUTATIONS AND COPY NUMBER ALTERATIONS (CNA) PREDICT FOR EARLY FAILURE IN PATIENTS WITH DIFFUSE LARGE B-CELL LYMPHOMA (DLBCL) TREATED WITH R-CHOP. Hematol Oncol 2017. [DOI: 10.1002/hon.2437_82] [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)
- I. Dlouhy
- Hematology; Hospital Clinic Barcelona; Barcelona Spain
| | - K. Karube
- Department of Pathology and Cell Biology, Graduate School of Medicine and Faculty of Medicine; University of the Ryukyus; Nishihara Japan
| | - A. Enjuanes
- Hematology; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Barcelona Spain
| | - I. Salaverría
- Hematology; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Barcelona Spain
| | - P. Pérez-Galán
- Hematology; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Barcelona Spain
| | - P. Jares
- Hematology; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Barcelona Spain
| | - D. Martín-García
- Hematology; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Barcelona Spain
| | - F. Nadeu
- Hematology; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Barcelona Spain
| | | | - J. Rovira
- Hematology; Hospital Clinic Barcelona; Barcelona Spain
| | - B. Gonzalez
- Pathology; Hospital Clinic Barcelona; Barcelona Spain
| | - A. Mozos
- Pathology; Hospital Clinic Barcelona; Barcelona Spain
| | - G. Clot
- Hematology; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Barcelona Spain
| | - J.M. Sancho
- Hematology; ICO-Hospital Germans Trias i Pujol; Barcelona Spain
| | - A. Salar
- Hematology; Hospital del Mar; Barcelona Spain
| | - S. Mercadal
- Hematology; ICO-Hospital Duran i Reynals; Barcelona Spain
| | - L. Escola
- Hematology; Hospital Universitari Joan XXIII; Tarragona Spain
| | - J. Briones
- Hematology; Hospital de Sant Pau; Barcelona Spain
| | - L. Colomo
- Pathology; Hospital del Mar; Barcelona Spain
| | - M. Alcoceba
- Hematology; Hospital Universitario de Salamanca; Salamanca Spain
| | - A. Valera
- Hematology; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Barcelona Spain
| | - E. Campo
- Hematology; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Barcelona Spain
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26
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Dlouhy I, Filella X, Rovira J, Magnano L, Rivas-Delgado A, Baumann T, Martínez-Trillos A, Balagué O, Martínez A, González-Farre B, Karube K, Gine E, Delgado J, Campo E, López-Guillermo A. High serum levels of soluble interleukin-2 receptor (sIL2-R), interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF) are associated with adverse clinical features and predict poor outcome in diffuse large B-cell lymphoma. Leuk Res 2017; 59:20-25. [PMID: 28544905 DOI: 10.1016/j.leukres.2017.05.014] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [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: 03/20/2017] [Revised: 05/11/2017] [Accepted: 05/12/2017] [Indexed: 10/19/2022]
Abstract
Diffuse large B-cell lymphoma (DLBCL) is an aggressive lymphoma with heterogeneous outcomes. To improve accuracy of the international prognostic index score, new biological variables are being investigated. The aim of this study was to determine the prognostic significance of serum levels of different cytokines, namely soluble interleukin-2 receptor (sIL2-R), interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF). We analyzed 197 de novo DLBCL patients (91 M/106 F; median age 66 years) treated with immunochemotherapy in a single institution. Serum cytokine determination was performed with ELISA, using the upper normal values as cut-offs. sIL-2R, IL-6 and TNF were elevated in 133, 130 and 144 cases, respectively. Elevation of each of these cytokines correlated with worse performance status, presence of B symptoms, advanced stage, elevated LDH and β2-microglobulin (P<0.03) and lower complete remission rate (P<0.001). Elevated levels of serum sIL-2R and TNF were significantly associated with shorter progression-free (PFS) and overall survival (OS), while elevated IL-6 only with shorter PFS. Early death (<4months from diagnosis) strongly correlated with elevated cytokines. Determination of serum cytokines levels is simple and adds information regarding risk of early death, response to therapy, and outcome.
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Affiliation(s)
- Ivan Dlouhy
- Department of Hematology, Hospital Clinic, Villarroel St. 170, 08036 Barcelona, Spain.
| | - Xavier Filella
- Department of Biochemistry and Molecular Genetics, Hospital Clinic, Villarroel St. 170, 08036 Barcelona, Spain
| | - Jordina Rovira
- Department of Hematology, Hospital Clinic, Villarroel St. 170, 08036 Barcelona, Spain
| | - Laura Magnano
- Department of Hematology, Hospital Clinic, Villarroel St. 170, 08036 Barcelona, Spain
| | - Alfredo Rivas-Delgado
- Department of Hematology, Hospital Clinic, Villarroel St. 170, 08036 Barcelona, Spain
| | - Tycho Baumann
- Department of Hematology, Hospital Clinic, Villarroel St. 170, 08036 Barcelona, Spain
| | | | - Olga Balagué
- Hematopathology Unit, Hospital Clínic, August Pi and Sunyer Biomedical Investigation Center (IDIBAPS), Villarroel St. 170, 08036 Barcelona, Spain
| | - Antonio Martínez
- Hematopathology Unit, Hospital Clínic, August Pi and Sunyer Biomedical Investigation Center (IDIBAPS), Villarroel St. 170, 08036 Barcelona, Spain
| | - Blanca González-Farre
- Hematopathology Unit, Hospital Clínic, August Pi and Sunyer Biomedical Investigation Center (IDIBAPS), Villarroel St. 170, 08036 Barcelona, Spain
| | - Kennosuke Karube
- Cell Biology & Pathology Department, University of the Ryukyus Graduate School of Medicine, 207 Uehara, Nishihara, Okinawa, Japan
| | - Eva Gine
- Department of Hematology, Hospital Clinic, Villarroel St. 170, 08036 Barcelona, Spain
| | - Julio Delgado
- Department of Hematology, Hospital Clinic, Villarroel St. 170, 08036 Barcelona, Spain
| | - Elías Campo
- Hematopathology Unit, Hospital Clínic, August Pi and Sunyer Biomedical Investigation Center (IDIBAPS), Villarroel St. 170, 08036 Barcelona, Spain
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27
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Montalbán C, Díaz-López A, Dlouhy I, Rovira J, Lopez-Guillermo A, Alonso S, Martín A, Sancho JM, García O, Sánchez JM, Rodríguez M, Novelli S, Salar A, Gutiérrez A, Rodríguez-Salazar MJ, Bastos M, Domínguez JF, Fernández R, Gonzalez de Villambrosia S, Queizan JA, Córdoba R, de Oña R, López-Hernandez A, Freue JM, Garrote H, López L, Martin-Moreno AM, Rodriguez J, Abraira V, García JF. Validation of the NCCN-IPI for diffuse large B-cell lymphoma (DLBCL): the addition of β 2 -microglobulin yields a more accurate GELTAMO-IPI. Br J Haematol 2017; 176:918-928. [PMID: 28106247 DOI: 10.1111/bjh.14489] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [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: 07/20/2016] [Accepted: 10/10/2016] [Indexed: 12/18/2022]
Abstract
The study included 1848 diffuse large B-cell lymphoma (DLBCL)patients treated with chemotherapy/rituximab. The aims were to validate the National Comprehensive Cancer Network International Prognostic Index (NCCN-IPI) and explore the effect of adding high Beta-2 microglobulin (β2M), primary extranodal presentation and intense treatment to the NCCN-IPI variables in order to develop an improved index. Comparing survival curves, NCCN-IPI discriminated better than IPI, separating four risk groups with 5-year overall survival rates of 93%, 83%, 67% and 49%, but failing to identify a true high-risk population. For the second aim the series was split into training and validation cohorts: in the former the multivariate model identified age, lactate dehydrogenase, Eastern Cooperative Oncology Group performance status, Stage III-IV, and β2M as independently significant, whereas the NCCN-IPI-selected extranodal sites, primary extranodal presentation and intense treatments were not. These results were confirmed in the validation cohort. The Grupo Español de Linfomas/Trasplante de Médula ósea (GELTAMO)-IPI developed here, with 7 points, significantly separated four risk groups (0, 1-3, 4 or ≥5 points) with 11%, 58%, 17% and 14% of patients, and 5-year overall survival rates of 93%, 79%, 66% and 39%, respectively. In the comparison GELTAMO IPI discriminated better than the NCCN-IPI. In conclusion, GELTAMO-IPI is more accurate than the NCCN-IPI and has statistical and practical advantages in that the better discrimination identifies an authentic high-risk group and is not influenced by primary extranodal presentation or treatments of different intensity.
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Affiliation(s)
- Carlos Montalbán
- Department of Haematology, MD Anderson Cancer Centre, Madrid, Spain
| | - Antonio Díaz-López
- Department of Translational Research, MD Anderson Cancer Centre, Madrid, Spain
| | - Ivan Dlouhy
- Department of Haematology, Hospital Clinic, Barcelona, Spain
| | - Jordina Rovira
- Department of Haematology, Hospital Clinic, Barcelona, Spain
| | | | - Sara Alonso
- Department of Haematology, Hospital Universitario and IBSAL, Salamanca, Spain
| | - Alejandro Martín
- Department of Haematology, Hospital Universitario and IBSAL, Salamanca, Spain
| | - Juan M Sancho
- Department of Haematology, Hospital Germans Trias i Pujol, ICO-IJC, Badalona, Spain
| | - Olga García
- Department of Haematology, Hospital Germans Trias i Pujol, ICO-IJC, Badalona, Spain
| | - Jose M Sánchez
- Department of Haematology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Mario Rodríguez
- Department of Haematology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Silvana Novelli
- Department of Haematology, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain
| | - Antonio Salar
- Department of Haematology, Hospital del Mar, Barcelona, Spain
| | - Antonio Gutiérrez
- Department of Haematology, Hospital Universitari Son Espases, Palma de Mallorca (IdISPa), Spain
| | | | - Mariana Bastos
- Department of Haematology, Hospital Gregorio Marañón, Madrid, Spain
| | - Juan F Domínguez
- Department of Haematology, Hospital Virgen del Rocío, Sevilla, Spain
| | - Rubén Fernández
- Department of Haematology, Hospital de Cabueñes, Gijón, Spain
| | | | - José A Queizan
- Department of Haematology, Hospital General de Segovia, Segovia, Spain
| | - Raul Córdoba
- Department of Haematology, Fundación Jimenez Díaz, Madrid, Spain
| | - Raquel de Oña
- Department of Haematology, MD Anderson Cancer Centre, Madrid, Spain
| | | | - Julian M Freue
- Department of Translational Research, MD Anderson Cancer Centre, Madrid, Spain
| | - Heidys Garrote
- Department of Translational Research, MD Anderson Cancer Centre, Madrid, Spain
| | - Lourdes López
- Department of Translational Research, MD Anderson Cancer Centre, Madrid, Spain
| | | | - Jose Rodriguez
- Department of Haematology, MD Anderson Cancer Centre, Madrid, Spain
| | - Víctor Abraira
- Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | - Juan F García
- Department of Translational Research, MD Anderson Cancer Centre, Madrid, Spain.,Department of Pathology, MD Anderson Cancer Centre, Madrid, Spain
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- Department of Translational Research, MD Anderson Cancer Centre, Madrid, Spain.,Department of Pathology, MD Anderson Cancer Centre, Madrid, Spain
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28
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Magnano L, Martínez A, Carreras J, Martínez-Trillos A, Giné E, Rovira J, Dlouhy I, Baumann T, Balagué O, Campo E, López-Guillermo A, Villamor N. T-cell subsets in lymph nodes identify a subgroup of follicular lymphoma patients with favorable outcome. Leuk Lymphoma 2016; 58:842-850. [DOI: 10.1080/10428194.2016.1217525] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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29
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Bellei M, Sabattini E, Pesce EA, Ko YH, Kim WS, Cabrera ME, Martinez V, Dlouhy I, Paes RP, Barrese T, Vassallo J, Tarantino V, Vose J, Weisenburger D, Rüdiger T, Federico M, Pileri S. Pitfalls and major issues in the histologic diagnosis of peripheral T-cell lymphomas: results of the central review of 573 cases from the T-Cell Project, an international, cooperative study. Hematol Oncol 2016; 35:630-636. [PMID: 27255982 DOI: 10.1002/hon.2316] [Citation(s) in RCA: 18] [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: 02/22/2016] [Revised: 04/11/2016] [Accepted: 05/10/2016] [Indexed: 01/23/2023]
Abstract
Peripheral T-cell lymphomas (PTCLs) comprise a heterogeneous group of neoplasms that are derived from post-thymic lymphoid cells at different stages of differentiation with different morphological patterns, phenotypes and clinical presentations. PTCLs are highly diverse, reflecting the diverse cells from which they can originate and are currently sub-classified using World Health Organization (WHO) 2008 criteria. In 2006 the International T-Cell Lymphoma Project launched the T-Cell Project, building on the retrospective study previously carried on by the network, with the aim to prospectively collect accurate data to improve knowledge on this group of lymphomas. Based on previously published reports from International Study Groups it emerged that rendering a correct classification of PTCLs is quite difficult because the relatively low prevalence of these diseases results in a lack of confidence by most pathologists. This is the reason why the T-Cell Project requested the availability of diagnostic material from the initial biopsy of each patient registered in the study in order to have the initial diagnosis centrally reviewed by expert hematopathologists. In the present report the results of the review process performed on 573 cases are presented. Overall, an incorrect diagnosis was centrally recorded in 13.1% cases, including 8.5% cases centrally reclassified with a subtype eligible for the project and 4.6% cases misclassified and found to be disorders other than T-cell lymphomas; 2.1% cases were centrally classified as T-Cell disorders not included in the study population. Thus, the T-Cell Project confirmed the difficulties in providing an accurate classification when a diagnosis of PTCLs is suspected, singled out the major pitfalls that can bias a correct histologic categorization and confirmed that a centralized expert review with the application of adequate diagnostic algorithms is mandatory when dealing with these tumours. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Monica Bellei
- Dipartimento di Medicina Diagnostica, Clinica e di Sanità Pubblica, Università di Modena e Reggio Emilia, Modena, Italy
| | - Elena Sabattini
- Policlinico Sant'Orsola - Malpighi, Unità di Emolinfopatologia, Bologna, Italy
| | - Emanuela Anna Pesce
- Dipartimento di Medicina Diagnostica, Clinica e di Sanità Pubblica, Università di Modena e Reggio Emilia, Modena, Italy
| | - Young-Hyeh Ko
- Samsung General Center, Department of Pathology, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Won Seog Kim
- Samsung General Center, Division of Hematology - Oncology, Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Maria Elena Cabrera
- Sección Hematología, Hospedal del Salvator, Universidad de Chile, Santiago de Chile, Chile
| | | | - Ivan Dlouhy
- Hematology Department, Hospital Clinic de Barcelona, Barcelona, Spain
| | | | - Tomas Barrese
- Irmandade da Santa Casa de Misericordia de São Paulo, São Paulo, Brazil
| | - Josè Vassallo
- Laboratory of Molecular and Investigative Pathology, University of Campinas, Campinas, Brazil
| | - Vittoria Tarantino
- Dipartimento di Medicina Diagnostica, Clinica e di Sanità Pubblica, Università di Modena e Reggio Emilia, Modena, Italy
| | - Julie Vose
- UNMC, Internal Medicine, Nebraska Medical Center, Omaha, NE, USA
| | | | - Thomas Rüdiger
- Stadtisches Klinikum Karlsruhe gGmbH, Institute of Pathology, Karlsruhe, Baden - Württemberg, Germany
| | - Massimo Federico
- Dipartimento di Medicina Diagnostica, Clinica e di Sanità Pubblica, Università di Modena e Reggio Emilia, Modena, Italy
| | - Stefano Pileri
- Unità di Diagnosi Emolinfopatologica, IEO - Istituto Europeo di Oncologia, Milano, Italy.,Alma mater Professor of Pathology, Università degli Studi di Bologna, Scuola di Medicina e Chirurgia, Bologna, Italy
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30
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Rovira J, Karube K, Valera A, Colomer D, Enjuanes A, Colomo L, Martínez-Trillos A, Giné E, Dlouhy I, Magnano L, Delgado J, Martínez A, Villamor N, Campo E, López-Guillermo A. MYD88 L265P Mutations, But No Other Variants, Identify a Subpopulation of DLBCL Patients of Activated B-cell Origin, Extranodal Involvement, and Poor Outcome. Clin Cancer Res 2016; 22:2755-64. [PMID: 26792260 DOI: 10.1158/1078-0432.ccr-15-1525] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2015] [Accepted: 01/05/2016] [Indexed: 11/16/2022]
Abstract
PURPOSE Mutations in MYD88 are found in different lymphoproliferative disorders associated with particular biologic characteristics and clinical impact. The aim of this study was to analyze the incidence of MYD88 mutations and its clinical impact in diffuse large B-cell lymphoma (DLBCL). EXPERIMENTAL DESIGN The incidence, clinicobiological features, and outcome of 213 patients (115 M/98 F; median age, 65 years) with DLBCL treated with immunochemotherapy in a single institution according to MYD88 mutational status as assessed by an allele-specific PCR assay were analyzed. The cell of origin (COO) was determined in 129 cases by gene expression. RESULTS MYD88 mutations were found in 47 cases (22%), including L265P in 39 and S219C and M232F in 4 cases, respectively. Patients with MYD88 L265P were older, presenting frequent extranodal involvement, and mostly corresponded to activated B-cell like (ABC) subtype, whereas no preference in COO was observed in patients with other MYD88 mutations. Five-year overall survival (OS) for MYD88 wild-type, MYD88 L265P, and other variants was 62%, 52%, and 75%, respectively (P = 0.05). International Prognostic Index (IPI) (HR, 2.71; P < 0.001) and MYD88 L265P (HR, 1.786; P = 0.023) were independent variables predicting OS in the multivariate analysis. However, MYD88 L265P lost its independent value when COO was included in the model. CONCLUSIONS Our findings indicate that MYD88 L265P mutations, but no other variants, identify a subgroup of DLBCL mainly of ABC origin, with extranodal involvement and poor outcome. Clin Cancer Res; 22(11); 2755-64. ©2016 AACR.
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Affiliation(s)
- Jordina Rovira
- Hematology Department, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - Kennosuke Karube
- Pathology Department, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - Alexandra Valera
- Pathology Department, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - Dolors Colomer
- Pathology Department, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - Anna Enjuanes
- Genomics Unit, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - Lluís Colomo
- Pathology Department, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | | | - Eva Giné
- Hematology Department, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - Ivan Dlouhy
- Hematology Department, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - Laura Magnano
- Hematology Department, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - Julio Delgado
- Hematology Department, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - Antonio Martínez
- Pathology Department, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - Neus Villamor
- Pathology Department, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - Elías Campo
- Pathology Department, Hospital Clínic, IDIBAPS, Barcelona, Spain. Universitat Barcelona, Barcelona, Spain
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31
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Federico M, Bellei M, Luminari S, Horwitz SM, Montoto S, Zucca E, Pileri SA, Ko YH, Zinzani PL, Connors JM, Foss FM, Polliack A, Cabrera ME, Kim WS, Spina M, De Souza CA, Bobillo Varela S, Dlouhy I, Advani RH, Vose J. CD30+ expression in Peripheral T-cell lymphomas (PTCLs): A subset analysis from the international, prospective T-Cell Project. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.8552] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Massimo Federico
- Dept of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Monica Bellei
- Dept of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Stefano Luminari
- Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Silvia Montoto
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London, London, United Kingdom
| | - Emanuele Zucca
- Onc Inst of Southern Switzerland, Bellinzona, Switzerland
| | - Stefano A Pileri
- Unit of Hematopathology, Institute of Hematology and Medical Oncology, Bologna, Italy
| | - Young-Hyeh Ko
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University, Seoul, South Korea
| | | | | | | | - Aaron Polliack
- Hadassah University Hospital and Hebrew University Medical School, Jerusalem, Israel
| | | | - Won Seog Kim
- Hematology-Oncology, Samsung Medical Center, Seoul, South Korea
| | | | | | | | - Ivan Dlouhy
- Hematologia, Hospital Clinic, Barcelona, Spain
| | - Ranjana H. Advani
- Division of Oncology, Stanford University School of Medicine, Stanford, CA
| | - Julie Vose
- University of Nebraska Medical Center, Omaha, NE
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Rovira J, Valera A, Colomo L, Setoain X, Rodríguez S, Martínez-Trillos A, Giné E, Dlouhy I, Magnano L, Gaya A, Martínez D, Martínez A, Campo E, López-Guillermo A. Prognosis of patients with diffuse large B cell lymphoma not reaching complete response or relapsing after frontline chemotherapy or immunochemotherapy. Ann Hematol 2014; 94:803-12. [PMID: 25501975 PMCID: PMC4374121 DOI: 10.1007/s00277-014-2271-1] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Accepted: 12/01/2014] [Indexed: 01/18/2023]
Abstract
A retrospective study was performed to assess the outcome of patients with diffuse large B cell lymphoma (DLBCL) who did not achieve complete response or who relapsed before and after the use of rituximab. Clinical features and outcome of 816 (425 M/391 F; median age 63 years) patients diagnosed from 1991 to 2001 (pre-rituximab era, N = 348) and from 2002 to 2012 (rituximab era, N = 468) in a single institution were evaluated. Five hundred fifty-three patients achieved complete remission (CR), 57 partial response (PR), and 206 were refractory with a median overall survival of 15, 1.5, and 0.4 years, respectively. Patients receiving rituximab had lower risk of refractoriness or relapse. In primarily refractory and PR patients, there was not a difference in survival depending on whether patients received or not rituximab-containing frontline treatment. Early death rate was 11%, including 3.6% due to infectious complications. Rituximab did not modify these figures. In the relapse setting, 5-year survival from relapse was 25% for patients who never received rituximab, 54% for those who received rituximab only at relapse, and 48% for those treated with immunochemotherapy both as frontline and at relapse. In conclusion, relapsed/refractory patients with DLBCL show poor prognosis despite the use of frontline immunochemotherapy. New therapeutic approaches are needed in this group of patients.
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Affiliation(s)
- Jordina Rovira
- Hematology Department, Hospital Clínic, IDIBAPS, C/. Villarroel, 170, 08036, Barcelona, Spain,
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Affiliation(s)
- Ivan Dlouhy
- Department of Haematology; Hospital Clinic Barcelona; Barcelona Spain
| | - Rodrigo Santacruz
- Department of Haematology; Hospital Clinic Barcelona; Barcelona Spain
| | - Oscar Peña
- Department of Haematology; Hospital Clinic Barcelona; Barcelona Spain
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Delgado J, Ghita G, Baumann T, Santacruz R, Dlouhy I, Aymerich M, Rozman M, Creus N, Pereira A, Montserrat E. Rituximab-based chemoimmunotherapy prolongs survival of patients with chronic lymphocytic leukemia independently of the time of administration. Clin Lymphoma Myeloma Leuk 2013; 14:73-9. [PMID: 24126217 DOI: 10.1016/j.clml.2013.08.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Revised: 08/05/2013] [Accepted: 08/28/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND The combination of purine analogues (PA) and rituximab (chemoimmunotherapy) is considered the treatment of choice for CLL. The aim of this study was to determine whether chemoimmunotherapy prolonged the overall survival in patients with CLL from a single center. PATIENTS AND METHODS From 1980 to 2010, 273 patients with CLL received: (1) PA (n = 159); and (2) PA plus rituximab (PA+R) (n = 114). All treated patients were included in the analysis, regardless of time at which treatment was administered, duration of therapy, and response. RESULTS Patients from the PA and PA+R groups were well balanced for demographic, clinical, and biologic features. At 8 years, the survival from diagnosis of the PA+R group was 88% (95% confidence interval [CI], 82-94%) compared with 68% (95% CI, 60-76%) for the PA group (P < .001). When survival of patients treated with PA+R was analyzed according to the time of treatment administration (first- [n = 55] vs. second or more lines [n = 59]), no significant differences were observed (8-year overall survival 89% vs. 87%, respectively; P = .8). CONCLUSION Chemoimmunotherapy prolonged the survival of patients with CLL and this effect was independent of the phase of the disease at which treatment was given.
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Affiliation(s)
- Julio Delgado
- Institute of Hematology and Oncology, Department of Hematology, Hospital Clinic, IDIBAPS, Barcelona, Spain
| | - Gabriela Ghita
- Institute of Hematology and Oncology, Department of Hematology, Hospital Clinic, IDIBAPS, Barcelona, Spain
| | - Tycho Baumann
- Institute of Hematology and Oncology, Department of Hematology, Hospital Clinic, IDIBAPS, Barcelona, Spain
| | - Rodrigo Santacruz
- Institute of Hematology and Oncology, Department of Hematology, Hospital Clinic, IDIBAPS, Barcelona, Spain
| | - Ivan Dlouhy
- Institute of Hematology and Oncology, Department of Hematology, Hospital Clinic, IDIBAPS, Barcelona, Spain
| | - Marta Aymerich
- Hematopathology Unit, Department of Pathology, IDIBAPS, Hospital Clinic, Barcelona, Spain
| | - Maria Rozman
- Hematopathology Unit, Department of Pathology, IDIBAPS, Hospital Clinic, Barcelona, Spain
| | - Natalia Creus
- Pharmacy Department, Hospital Clinic, Barcelona, Spain
| | - Arturo Pereira
- Department of Hemotherapy and Hemostasis, Hospital Clinic, Barcelona, Spain
| | - Emili Montserrat
- Institute of Hematology and Oncology, Department of Hematology, Hospital Clinic, IDIBAPS, Barcelona, Spain.
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Dlouhy I, Ghita G, Baumann T, Gine E, Villamor N, Rozman M, Martinez-Trillos A, Lopez-Guillermo A, Delgado J. Retreatment with purine analogs in patients with chronic lymphocytic leukemia. Leuk Res 2012; 36:1521-5. [PMID: 22938831 DOI: 10.1016/j.leukres.2012.08.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2012] [Revised: 08/09/2012] [Accepted: 08/13/2012] [Indexed: 12/21/2022]
Abstract
We evaluated the efficacy and toxicity of retreatment with purine analogs (PA) in 62 patients with relapsed chronic lymphocytic leukemia. Median OS and PFS after retreatment were 60 and 26 months, respectively. By multivariate analysis, minimal residual disease status, ZAP-70 expression and age had independent predictive power in terms of OS. Toxicity was mainly neutropenia (21%) and infections (39%). Second malignancies were observed in 10 (16%) patients. Our results outline that retreatment with PA is remarkably effective in patients with relapsed CLL, but with a significant toxicity.
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MESH Headings
- Age Factors
- Aged
- Analysis of Variance
- Antineoplastic Combined Chemotherapy Protocols/administration & dosage
- Antineoplastic Combined Chemotherapy Protocols/adverse effects
- Bacterial Infections/complications
- Bacterial Infections/pathology
- Female
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell/complications
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Leukemia, Lymphocytic, Chronic, B-Cell/therapy
- Male
- Middle Aged
- Mutation
- Neoplasm, Residual
- Neutropenia/complications
- Neutropenia/pathology
- Predictive Value of Tests
- Prognosis
- Purines/administration & dosage
- Purines/adverse effects
- Recurrence
- Retreatment
- Retrospective Studies
- Survival Analysis
- ZAP-70 Protein-Tyrosine Kinase/genetics
- ZAP-70 Protein-Tyrosine Kinase/metabolism
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Affiliation(s)
- Ivan Dlouhy
- Institute of Hematology and Oncology, Department of Hematology, Hospital Clinic, Barcelona, Spain.
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Boccaccini D, Maioli M, Cannio M, Dlouhy I, Romagnoli M, Leonelli C, Boccaccini A. A lifetime prediction method based on Cumulative Flaw Length Theory. Ann Ital Chir 2012. [DOI: 10.1016/j.jeurceramsoc.2011.11.042] [Citation(s) in RCA: 2] [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: 10/14/2022]
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