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Cuenca I, Alameda D, Sanchez-Vega B, Gomez-Sanchez D, Alignani D, Lasa M, Onecha E, Lecumberri R, Prosper F, Ocio EM, González ME, García de Coca A, De La Rubia J, Gironella M, Palomera L, Oriol A, Casanova M, Cabañas V, Taboada F, Pérez-Montaña A, De Arriba F, Puig N, Carreño-Tarragona G, Barrio S, Enrique de la Puerta J, Ramirez-Payer A, Krsnik I, Bargay JJ, Lahuerta JJ, Mateos MV, San-Miguel JF, Paiva B, Martinez-Lopez J. Immunogenetic characterization of clonal plasma cells in systemic light-chain amyloidosis. Leukemia 2020; 35:245-249. [PMID: 32203144 PMCID: PMC7787969 DOI: 10.1038/s41375-020-0800-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 11/19/2019] [Revised: 03/04/2020] [Accepted: 03/09/2020] [Indexed: 11/09/2022]
Affiliation(s)
- Isabel Cuenca
- Hospital 12 de Octubre, Madrid, CNIO, Universidad Complutese, Madrid, Spain
| | - Daniel Alameda
- Clinica Universidad de Navarra, Centro de Investigacion Medica Aplicada (CIMA), IDISNA, CIBERONC Pamplona, Pamplona, Spain
| | | | - David Gomez-Sanchez
- Clinical and Traslational Lung Cancer Research Unit, i+12 Research Institute and Biomedical Research Networking Center in Oncology (CIBERONC), Madrid, Spain
| | - Diego Alignani
- Clinica Universidad de Navarra, Centro de Investigacion Medica Aplicada (CIMA), IDISNA, CIBERONC Pamplona, Pamplona, Spain
| | - Marta Lasa
- Clinica Universidad de Navarra, Centro de Investigacion Medica Aplicada (CIMA), IDISNA, CIBERONC Pamplona, Pamplona, Spain
| | - Esther Onecha
- Hospital 12 de Octubre, Madrid, CNIO, Universidad Complutese, Madrid, Spain
| | - Ramon Lecumberri
- Clinica Universidad de Navarra, Centro de Investigacion Medica Aplicada (CIMA), IDISNA, CIBERONC Pamplona, Pamplona, Spain
| | - Felipe Prosper
- Clinica Universidad de Navarra, Centro de Investigacion Medica Aplicada (CIMA), IDISNA, CIBERONC Pamplona, Pamplona, Spain
| | - Enrique M Ocio
- Universidad de Cantabria, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | | | | | | | | | - Luis Palomera
- Hospital Clinico Universitario Lozano Blesa, Zaragoza, Spain
| | | | | | - Valentin Cabañas
- Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
| | | | | | - Felipe De Arriba
- Hospital Universitario Morales Meseguer. IMIB-Arrixaca, Murcia, Spain
| | - Noemi Puig
- Hospital Universitario de Salamanca, Instituto de Investigacion Biomedica de Salamanca (IBSAL), Centro de Investigación del Cancer (IBMCC-USAL, CSIC), Salamanca, Spain
| | | | - Santiago Barrio
- Hospital 12 de Octubre, Madrid, CNIO, Universidad Complutese, Madrid, Spain
| | | | | | | | | | - Juan Jose Lahuerta
- Hospital 12 de Octubre, Madrid, CNIO, Universidad Complutese, Madrid, Spain
| | - Maria-Victoria Mateos
- Hospital Universitario de Salamanca, Instituto de Investigacion Biomedica de Salamanca (IBSAL), Centro de Investigación del Cancer (IBMCC-USAL, CSIC), Salamanca, Spain
| | - Jesus F San-Miguel
- Clinica Universidad de Navarra, Centro de Investigacion Medica Aplicada (CIMA), IDISNA, CIBERONC Pamplona, Pamplona, Spain
| | - Bruno Paiva
- Clinica Universidad de Navarra, Centro de Investigacion Medica Aplicada (CIMA), IDISNA, CIBERONC Pamplona, Pamplona, Spain
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Abstract
INTRODUCTION Most patients with Hodgkin lymphoma (HL) enjoy durable remissions following front-line treatment but 30% of patients are refractory or relapse after first line therapy. Salvage chemotherapy followed by autologous stem cell transplantation (ASCT) can cure an additional 50-55% of relapsing patients but new treatments are needed for patients with HL who are refractory or relapse after ASCT. Immunotherapy has emerged as a promising treatment for the management of these patients. The availability of the anti-CD30 antibody brentuximab vedotin and new targeted drugs such as immune checkpoint inhibitors, show promising clinical activity in patients with HL and are important milestones for the management of patients with HL particularly for those who have progressed after standard initial therapy and ASCT. Areas covered: Overview of the results from the most relevant clinical trials including monoclonal antibody-based therapy in HL. Phase 2 and phase 3 trials including brentuximab vedotin and immune checkpoints inhibitors in patients with Hodgkin lymphoma have been reviewed. In addition, the potential impact of these new therapies in the management of patients with newly diagnosed HL has also been addressed. Expert commentary: Anti-CD30 antibody brentuximab vedotin and immune checkpoint inhibitors have shown promising results in patients with relapsed and refractory HL. Administration of these therapies earlier in the course of the disease might reduce the proportion of relapsed or refractory patients and, subsequently, minimize the number of patients undergoing high-dose therapy and autologous stem cell transplantation. We have little doubt that this will have substantial effects on the outcome for future generations of HL patients.
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Affiliation(s)
- Eva M Donato
- a Hematology Service , University Hospital Doctor Peset , Valencia , Spain
| | | | - Javier De La Rubia
- a Hematology Service , University Hospital Doctor Peset , Valencia , Spain.,b Department of Internal Medicine , Universidad Católica de Valencia "San Vicente Mártir" , Valencia , Spain
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Jakubowiak AJ, Offidani M, Pegourie B, De La Rubia J, Garderet L, Laribi K, Bosi A, Marasca R, Laubach J, Mohrbacher A, Carella AM, Singhal AK, Tsao C, Lynch MJ, Bleickardt EW, Jou YM, Palumbo A. A randomized phase II study of bortezomib (Btz)/dexamethasone (dex) with or without elotuzumab (Elo) in patients (pts) with relapsed/refractory multiple myeloma (RRMM). J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.8573] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [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 Offidani
- Azienda Ospedaliero Universitaria Ospedali Riuniti di Ancona, Ancona, Italy
| | | | | | | | | | - Alberto Bosi
- Azienda Ospedaliero Universitaria Careggi, Florence, Italy
| | - Roberto Marasca
- Azienda Ospedaliera Universitaria - Policlinico di Modena, Modena, Italy
| | | | - Ann Mohrbacher
- University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA
| | | | | | - Claire Tsao
- AbbVie Biotherapeutics Inc. (ABR), Redwood City, CA
| | | | | | | | - Antonio Palumbo
- A. O. U. San Giovanni Battista di Torino - Ospedale Molinette, Torino, Italy
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Pessoa de Magalhães RJ, Vidriales MB, Paiva B, Fernandez-Gimenez C, García-Sanz R, Mateos MV, Gutierrez NC, Lecrevisse Q, Blanco JF, Hernández J, de las Heras N, Martinez-Lopez J, Roig M, Costa ES, Ocio EM, Perez-Andres M, Maiolino A, Nucci M, De La Rubia J, Lahuerta JJ, San-Miguel JF, Orfao A. Analysis of the immune system of multiple myeloma patients achieving long-term disease control by multidimensional flow cytometry. Haematologica 2012; 98:79-86. [PMID: 22773604 DOI: 10.3324/haematol.2012.067272] [Citation(s) in RCA: 117] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Multiple myeloma remains largely incurable. However, a few patients experience more than 10 years of relapse-free survival and can be considered as operationally cured. Interestingly, long-term disease control in multiple myeloma is not restricted to patients with a complete response, since some patients revert to having a profile of monoclonal gammopathy of undetermined significance. We compared the distribution of multiple compartments of lymphocytes and dendritic cells in the bone marrow and peripheral blood of multiple myeloma patients with long-term disease control (n=28), patients with newly diagnosed monoclonal gammopathy of undetermined significance (n=23), patients with symptomatic multiple myeloma (n=23), and age-matched healthy adults (n=10). Similarly to the patients with monoclonal gammopathy of undetermined significance and symptomatic multiple myeloma, patients with long-term disease control showed an expansion of cytotoxic CD8(+) T cells and natural killer cells. However, the numbers of bone marrow T-regulatory cells were lower in patients with long-term disease control than in those with symptomatic multiple myeloma. It is noteworthy that B cells were depleted in patients with monoclonal gammopathy of undetermined significance and in those with symptomatic multiple myeloma, but recovered in both the bone marrow and peripheral blood of patients with long-term disease control, due to an increase in normal bone marrow B-cell precursors and plasma cells, as well as pre-germinal center peripheral blood B cells. The number of bone marrow dendritic cells and tissue macrophages differed significantly between patients with long-term disease control and those with symptomatic multiple myeloma, with a trend to cell count recovering in the former group of patients towards levels similar to those found in healthy adults. In summary, our results indicate that multiple myeloma patients with long-term disease control have a constellation of unique immune changes favoring both immune cytotoxicity and recovery of B-cell production and homing, suggesting improved immune surveillance.
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Abstract
Until recently, combination chemotherapy with melphalan and prednisone (MP) has remained the most widely accepted treatment option for elderly patients with multiple myeloma (MM). However, since the availability of new and more active drugs, several groups have compared in several phase III trials the efficacy and safety of MP versus MP-based therapies including new agents such as thalidomide (MPT) or bortezomib (MPV). In all these studies response rate and progression-free survival were superior in patients receiving MPT or MPV. However, these new combinations are not without side effects, and the incidence of grade 3 and 4 toxicities is higher than that reported with MP. Besides, the median duration of the complete remissions obtained with these new combinations is still insufficient, ranging from 15 to 27 months, and new therapeutic alternatives are still needed in this subset of patients. The purpose of this review article is to summarize the currently available data in the front-line treatment of elderly patients with MM and to discuss which questions are still unsolved in the management of this subset of patients.
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Affiliation(s)
- Javier De La Rubia
- University Hospital La Fe, Universidad Catolica de Valencia San Vicente Martir, Valencia, Spain.
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Puig N, De La Rubia J, Jarque I, Salavert M, Moscardó F, Sanz J, Lorenzo I, Montesinos P, Martín G, Martínez J, Sanz G, Blanes M, Sanz M. Characteristics of and risk factors for pneumonia in patients with hematological malignancies developing fever after autologous blood stem cell transplantation. Leuk Lymphoma 2008; 48:2367-74. [PMID: 18067012 DOI: 10.1080/10428190701694178] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
We analyzed the incidence, etiology, risk factors and outcomes of 49 episodes of pneumonia that developed in 326 adult patients undergoing autologous stem-cell transplantation (ASCT) from January 1990 to December 2005. The median time for the onset of pneumonia after transplantation was 11 days (range 0-148). Empirical antibiotic therapy in patients with pneumonia consisted of piperacillin-tazobactam (20 cases, 49%), third-generation cephalosporin (11 cases, 27%) and carbapenem (8 cases, 19%). Multivariate analysis showed that a higher risk of pneumonia could be predicted for patients with myeloma (P = 0.006) and for patients with an absolute neutrophil count <0.5 x 10(9)/L >7 days (P = 0.008). Cumulative incidence of transplant-related mortality at 6 months was 51% versus 8% for patients with or without pneumonia, respectively (P = 0.001). Pneumonia after ASCT is a severe complication more commonly observed in patients with myeloma and with prolonged duration of neutropenia.
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Affiliation(s)
- Noemí Puig
- Hematology Service, University Hospital La Fe, Valencia, Spain
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