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Onida F, Gras L, Ge J, Koster L, Hamladji RM, Byrne J, Avenoso D, Aljurf M, Robin M, Halaburda K, Passweg J, Salmenniemi U, Sengeloev H, Apperley J, Clark A, Reményi P, Morozova E, Kinsella F, Lenhoff S, Ganser A, Wu KL, Perez-Martinez A, Hayden PJ, Raj K, Drozd-Sokolowska J, OrtÍ G, de Lavallade H, Yakoub-Agha I, McLornan DP, Chalandon Y. Mismatched related donor allogeneic haematopoietic cell transplantation compared to other donor types for Ph+ chronic myeloid leukaemia: A retrospective analysis from the Chronic Malignancies Working Party of the EBMT. Br J Haematol 2024. [PMID: 38577874 DOI: 10.1111/bjh.19448] [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: 01/13/2024] [Revised: 03/21/2024] [Accepted: 03/25/2024] [Indexed: 04/06/2024]
Abstract
Allogeneic haematopoietic cell transplantation (allo-HCT) remains an option for tyrosine kinase inhibitor-resistant chronic myeloid leukaemia (CML) in first chronic phase (CP1) and high-risk patients with advanced disease phases. In this European Society for Blood and Marrow Transplantation (EBMT) registry-based study of 1686 CML patients undergoing first allo-HCT between 2012 and 2019, outcomes were evaluated according to donor type, particularly focusing on mismatched related donors (MMRDs). Median age at allo-HCT was 46 years (IQR 36-55). Disease status was CP1 in 43%, second CP (CP2) or later in 27%, accelerated phase in 12% and blast crisis in 18%. Donor type was matched related (MRD) in 39.2%, MMRD in 8.1%, matched unrelated (MUD) in 40.2%, and mismatched unrelated (MMUD) in 12.6%. In 4 years, overall survival (OS) for MRD, MMRD, MUD and MMUD was 61%, 56%, 63% and 59% (p = 0.21); relapse-free survival (RFS) was 48%, 42%, 52% and 46% (p = 0.03); cumulative incidence of relapse (CIR) was 33%, 37%, 27% and 30% (p = 0.07); non-relapse mortality (NRM) was 19%, 21%, 21% and 24% (p = 0.21); and graft-versus-host disease (GvHD)-free/relapse-free survival (GRFS) was 16%, 18%, 22% and 15% (p = 0.05) respectively. On multivariate analysis, MMRD use associated with longer engraftment times and higher risk of graft failure compared to MRD or MUD. There was no statistical evidence that MMRD use associated with different OS, RFS and incidence of GvHD compared to other donor types.
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Affiliation(s)
- Francesco Onida
- Hematology-BMT Centre, ASST Fatebenefratelli-Sacco, University of Milan, Milan, Italy
| | - Luuk Gras
- EBMT Statistical Unit, Leiden, The Netherlands
| | - Junran Ge
- EBMT Statistical Unit, Leiden, The Netherlands
| | | | | | - Jenny Byrne
- Nottingham University Hospital, Nottingham, UK
| | | | - Mahmoud Aljurf
- King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia
| | | | | | | | | | | | | | - Andrew Clark
- Beatson, West of Scotland Cancer Centre-Gartnaval General Hospital, Glasgow, UK
| | | | - Elena Morozova
- RM Gorbacheva Research Institute, Pavlov University, St. Petersburg, Russia
| | | | | | | | | | | | - Patrick J Hayden
- Department of Haematology, Trinity College Dublin, St. James's Hospital, Dublin, Ireland
| | - Kavita Raj
- Department of Haematology, University College London Hospitals, London, UK
| | | | - Guillermo OrtÍ
- Department of Hematology, Vall d'Hebron Institute of Oncology (VHIO), Vall d'Hebron University Hospital, Barcelona, Spain
| | | | | | - Donal P McLornan
- Department of Haematology, University College London Hospitals, London, UK
| | - Yves Chalandon
- Hematology Division and Faculty of Medicine, Hôpitaux Universitaires de Genève (HUG), University of Geneva, Geneva, Switzerland
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Chamuleau MED, Stenner F, Chitu DA, Novak U, Minnema MC, Geerts P, Stevens WBC, Zenz T, van Imhoff GW, Wu KL, Demandt AMP, Kersten MJ, Terpstra WE, Tick LW, Deeren D, Van Den Neste E, Gregor M, Veelken H, Böhmer LH, Caspar CB, Mutsaers P, Refos JM, Sewsaran R, Fu L, Seefat RL, Uyl-de Groot CA, Dirnhofer S, Van Den Brand M, de Jong D, Nijland M, Lugtenburg P. R-CODOX-M/R-IVAC versus DA-EPOCH-R in patients with newly diagnosed Burkitt lymphoma (HOVON/SAKK): final results of a multicentre, phase 3, open-label, randomised trial. Lancet Haematol 2023; 10:e966-e975. [PMID: 37922925 DOI: 10.1016/s2352-3026(23)00279-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 09/07/2023] [Accepted: 09/07/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND Patients with newly diagnosed high-risk Burkitt lymphoma are treated with high-intensity immune-chemotherapy regimens such as R-CODOX-M/R-IVAC or with lower-intensity regimens such as DA-EPOCH-R. The aim of this study was to make a formal comparison between these regimens. METHODS This multicentre, phase 3, open-label, randomised study was done in 26 clinical centres in the Netherlands, Belgium, and Switzerland. Eligible patients were aged 18-75 years with newly diagnosed high-risk Burkitt lymphoma without CNS involvement. Patients were randomly assigned to two cycles of R-CODOX-M/R-IVAC (R-CODOX-M: rituximab 375 mg/m2 on day 1 and 9, cyclophosphamide 800 mg/m2 on day 1, cyclophosphamide 200 mg/m2 on days 2-5, vincristine 1·5 mg/m2 on days 1 and 8, doxorubicin 40 mg/m2 on day 1, and methotrexate 3000 mg/m2 on day 10; R-IVAC: rituximab 375 mg/m2 on days 3 and 7, iphosphamide 1500 mg/m2 on days 1-5, etoposide 60 mg/m2 on days 1-5, and cytarabin 2000 mg/m2 on day 1 and 2) or six cycles of DA-EPOCH-R (dose-adjusted etoposide 50-124 mg/m2 on days 1-4, prednisolone 120 mg/m2 on days 1-5, vincristine 0·4 mg/m2 on days 1-4, dose-adjusted cyclophosphamide 480-1866 mg/m2 on day 5, dose-adjusted doxorubicin 10-24·8 mg/m2 on days 1-4, rituximab 375 mg/m2 on days 1 and 5). Patients older than 65 years received a dose modified R-CODOX-M/R-IVAC. All drugs were intravenous except for prednisolone, which was oral. Patients also received four intrathecal CNS administrations with cytarabin (70 mg) and four with methotrexate (15 mg). Patients were stratified by centre, leukemic disease, and HIV-positivity. The primary endpoint was progression-fee survival. All analyses were done by modified intention-to-treat, excluding randomly assigned patients who were subsequently found to have CNS involvement or diagnosis other than Burkitt lymphoma at study entry. This study is registered with the European Clinical Trial Register, EudraCT2013-004394-27. FINDINGS Due to a slow accrual, the study was closed prematurely on Nov 15, 2021. Between Aug 4, 2014, and Sept 17, 2021, 89 patients were enrolled and randomly assigned to receive R-CODOX-M/R-IVAC (n=46) or DA-EPOCH-R (n=43). Five patients were excluded after random assignment (three in the R-CODOX-M/R-IVAC group [one diagnosis other than Burkitt lymphoma at study entry according to local pathology and two CNS involvement] and two in the DA-EPOCH-R group [one diagnosis other than Burkitt lymphoma at study entry according to local pathology and one CNS involvement]. 84 remaining patients were included in the modified intention-to-treat analysis. 73 (87%) of 84 patients were male, 76 (90%) presented with stage III or IV disease, and nine (11%) had HIV-positive Burkitt lymphoma. Median patient age was 52 years (IQR 37-64). With a median follow-up of 28·5 months (IQR 13·2-43·7), 2-year progression-free survival was 76% (95% CI 60-86%) in the R-CODOX-M/R-IVAC group and 70% (54-82%) in the DA-EPOCH-R group (hazard ratio 1·42, 95% CI 0·63-3·18; p=0·40). There were two deaths in the R-CODOX-M/R-IVAC group (one infection [treatment related] and one due to disease progression [not treatment related]) and one death in the DA-EPOCH-R group (COVID-19 infection [treatment related]). In the R-CODOX-M/R-IVAC group, four patients went off-protocol because of toxic effects, versus none in the DA-EPOCH-R group. Patients treated with R-CODOX-M/R-IVAC had more infectious adverse events (24 [56%] of 43 patients had at least one grade 3-5 infection vs 14 [34%] of 41 patients in the DA-EPOCH-R group). INTERPRETATION The trial stopped early, but the available data suggest that while DA-EPOCH-R did not result in superior progression-free survival compared with R-CODOX-M/R-IVAC, it was associated with fewer toxic effects and need for supportive care. DA-EPOCH-R appears to be an additional valid therapeutic option for patients with high-risk Burkitt lymphoma without CNS involvement. FUNDING The Dutch Cancer Society and the Schumacher-Kramer Foundation.
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Affiliation(s)
- Martine E D Chamuleau
- Department of Hematology, Amsterdam University Medical Center, Location VU, Amsterdam, Netherlands; Cancer Centre Amsterdam, Amsterdam, Netherlands; Stichting Hemato-Oncologie voor Volwassenen Nederland (HOVON), Amsterdam, Netherlands.
| | - Frank Stenner
- Department of Oncology, University Hospital Basel, University of Basel, Basel, Switzerland; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland
| | - Dana A Chitu
- Department of Hematology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, Netherlands; Stichting Hemato-Oncologie voor Volwassenen Nederland (HOVON), Amsterdam, Netherlands
| | - Urban Novak
- Department of Medical Oncology, Inselspital /Bern University Hospital, Bern, Switzerland; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland
| | - Monique C Minnema
- Department of Hematology, University Medical Center Utrecht, Utrecht, Netherlands; Stichting Hemato-Oncologie voor Volwassenen Nederland (HOVON), Amsterdam, Netherlands
| | - Paul Geerts
- Department of Hematology, Isala Clinics, Zwolle, Netherlands; Stichting Hemato-Oncologie voor Volwassenen Nederland (HOVON), Amsterdam, Netherlands
| | - Wendy B C Stevens
- Department of Hematology, Radboud University Medical Center, Nijmegen, Netherlands; Stichting Hemato-Oncologie voor Volwassenen Nederland (HOVON), Amsterdam, Netherlands
| | - Thorsten Zenz
- Department of Medical Oncology and Hematology, University Hospital Zurich, University of Zurich, Zurich, Switzerland; University of Zurich, Zurich, Switzerland; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland
| | - Gustaaf W van Imhoff
- Department of Hematology, University Medical Center Groningen, Groningen, Netherlands; Stichting Hemato-Oncologie voor Volwassenen Nederland (HOVON), Amsterdam, Netherlands
| | - Ka Lung Wu
- Department of Hematology, Ziekenhuis Netwerk Antwerpen, Stuivenberg, Antwerp, Belgium; Stichting Hemato-Oncologie voor Volwassenen Nederland (HOVON), Amsterdam, Netherlands
| | - Astrid M P Demandt
- Division of Hematology, Department of Internal Medicine, School for Oncology and Reproduction, Maastricht University Medical Center, Maastricht, Netherlands; Stichting Hemato-Oncologie voor Volwassenen Nederland (HOVON), Amsterdam, Netherlands
| | - Marie Jose Kersten
- Department of Hematology, Amsterdam University Medical Center, location University of Amsterdam, Amsterdam, Netherlands; Stichting Hemato-Oncologie voor Volwassenen Nederland (HOVON), Amsterdam, Netherlands
| | - Wim E Terpstra
- Department of Hematology, Amsterdam-Onze Lieve Vrouwe Gasthuis, Amsterdam, Netherlands; Stichting Hemato-Oncologie voor Volwassenen Nederland (HOVON), Amsterdam, Netherlands
| | - Lidwine W Tick
- Department of Internal Medicine, Máxima Medical Center, Eindhoven, Netherlands; Stichting Hemato-Oncologie voor Volwassenen Nederland (HOVON), Amsterdam, Netherlands
| | - Dries Deeren
- Department of Hematology, Algemeen Ziekenhuis Delta, Roeselare, Belgium; Stichting Hemato-Oncologie voor Volwassenen Nederland (HOVON), Amsterdam, Netherlands
| | - Eric Van Den Neste
- Department of Hematology, Cliniques universitaires Université catholique de Louvain Saint-Luc, Belgium
| | - Michael Gregor
- Department of Hematology, Luzerner Kantonsspital, Luzern, Switzerland; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland
| | - Hendrik Veelken
- Department of Hematology, Leiden University Medical Center, Leiden, Netherlands; Stichting Hemato-Oncologie voor Volwassenen Nederland (HOVON), Amsterdam, Netherlands
| | - Lara H Böhmer
- Department of Hematology Haga Teaching Hospital, The Hague, Netherlands; Stichting Hemato-Oncologie voor Volwassenen Nederland (HOVON), Amsterdam, Netherlands
| | - Clemens B Caspar
- Department of Internal Medicine, Division of Medical Oncology and Hematology, Kantonsspital Baden, Baden, Switzerland; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland
| | - Pim Mutsaers
- Department of Hematology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, Netherlands; Stichting Hemato-Oncologie voor Volwassenen Nederland (HOVON), Amsterdam, Netherlands
| | - Jeannine M Refos
- Stichting Hemato-Oncologie voor Volwassenen Nederland (HOVON), Amsterdam, Netherlands
| | - Robby Sewsaran
- Stichting Hemato-Oncologie voor Volwassenen Nederland (HOVON), Amsterdam, Netherlands
| | - Liping Fu
- Pathology Facility, Amsterdam University Medical Center, Location VU, Amsterdam, Netherlands; Cancer Centre Amsterdam, Amsterdam, Netherlands; Stichting Hemato-Oncologie voor Volwassenen Nederland (HOVON), Amsterdam, Netherlands
| | - Rianne L Seefat
- Department of Molecular Pathology, Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Carin A Uyl-de Groot
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Netherlands
| | - Stefan Dirnhofer
- Institute of Medical Genetics and Pathology, University Hospital Basel, University of Basel, Basel, Switzerland; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland
| | - Michiel Van Den Brand
- Department of Pathology, Radboud University Medical Center, Nijmegen, Netherlands; Stichting Hemato-Oncologie voor Volwassenen Nederland (HOVON), Amsterdam, Netherlands
| | - Daphne de Jong
- Department of Pathology, Amsterdam University Medical Center, Location VU, Amsterdam, Netherlands; Cancer Centre Amsterdam, Amsterdam, Netherlands; Stichting Hemato-Oncologie voor Volwassenen Nederland (HOVON), Amsterdam, Netherlands
| | - Marcel Nijland
- Department of Hematology, University Medical Center Groningen, Groningen, Netherlands; Stichting Hemato-Oncologie voor Volwassenen Nederland (HOVON), Amsterdam, Netherlands
| | - Pieternella Lugtenburg
- Department of Hematology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, Netherlands
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van de Donk NWCJ, Minnema MC, van der Holt B, Schjesvold F, Wu KL, Broijl A, Roeloffzen WWH, Gadisseur A, Pietrantuono G, Pour L, van der Velden VHJ, Lund T, Offidani M, Grasso M, Giaccone L, Razawy W, Tacchetti P, Mancuso K, Silkjaer T, Caers J, Zweegman S, Hájek R, Benjamin R, Vangsted AJ, Boccadoro M, Gay F, Sonneveld P, Musto P. Treatment of primary plasma cell leukaemia with carfilzomib and lenalidomide-based therapy (EMN12/HOVON-129): final analysis of a non-randomised, multicentre, phase 2 study. Lancet Oncol 2023; 24:1119-1133. [PMID: 37717583 DOI: 10.1016/s1470-2045(23)00405-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 08/01/2023] [Accepted: 08/10/2023] [Indexed: 09/19/2023]
Abstract
BACKGROUND Primary plasma cell leukaemia is a rare and aggressive plasma cell disorder with a poor prognosis. The aim of the EMN12/HOVON-129 study was to improve the outcomes of patients with primary plasma cell leukaemia by incorporating carfilzomib and lenalidomide in induction, consolidation, and maintenance therapy. METHODS The EMN12/HOVON-129 study is a non-randomised, phase 2, multicentre study conducted at 19 academic centres and hospitals in seven European countries (Belgium, Czech Republic, Denmark, Italy, Norway, The Netherlands, and the UK) for previously untreated patients with primary plasma cell leukaemia aged 18 years or older. Inclusion criteria were newly diagnosed primary plasma cell leukaemia (defined as >2 ×109 cells per L circulating monoclonal plasma cells or plasmacytosis >20% of the differential white cell count) and WHO performance status 0-3. Patients aged 18-65 years (younger patients) and 66 years or older (older patients) were treated in age-specific cohorts and were analysed separately. Younger patients were treated with four 28-day cycles of carfilzomib (36 mg/m2 intravenously on days 1, 2, 8, 9, 15, and 16), lenalidomide (25 mg orally on days 1-21), and dexamethasone (20 mg orally on days 1, 2, 8, 9, 15, 16, 22, and 23). Carfilzomib-lenalidomide-dexamethasone (KRd) induction was followed by double autologous haematopoietic stem-cell transplantation (HSCT), four cycles of KRd consolidation, and then maintenance with carfilzomib (27 mg/m2 intravenously on days 1, 2, 15, and 16 for the first 12 28-day cycles, and then 56 mg/m2 on days 1 and 15 in all subsequent cycles) and lenalidomide (10 mg orally on days 1-21) until progression. Patients who were eligible for allogeneic HSCT, could also receive a single autologous HSCT followed by reduced-intensity conditioning allogeneic HSCT and then carfilzomib-lenalidomide maintenance. Older patients received eight cycles of KRd induction followed by maintenance therapy with carfilzomib and lenalidomide until progression. The primary endpoint was progression-free survival. The primary analysis population was the intention-to-treat population, irrespective of the actual treatment received. Data from all participants who received any study drug were included in the safety analyses. The trial was registered at www.trialregister.nl (until June 2022) and https://trialsearch.who.int/ as NTR5350; recruitment is complete and this is the final analysis. FINDINGS Between Oct 23, 2015, and Aug 5, 2021, 61 patients were enrolled and received KRd induction treatment (36 patients aged 18-65 years [20 (56%) were male and 16 (44%) female], and 25 aged ≥66 years [12 (48%) were male and 13 (52%) female]). With a median follow-up of 43·5 months (IQR 27·7-67·8), the median progression-free survival was 15·5 months (95% CI 9·4-38·4) for younger patients. For older patients, median follow-up was 32·0 months (IQR 24·7-34·6), and median progression-free survival was 13·8 months (95% CI 9·2-35·5). Adverse events were most frequently observed directly after treatment initiation, with infections (two of 36 (6%) younger patients and eight of 25 (32%) older patients) and respiratory events (two of 36 [6%] younger patients and four of 25 [16%] older patients) being the most common grade 3 or greater events during the first four KRd cycles. Treatment-related serious adverse events were reported in 26 (72%) of 36 younger patients and in 19 (76%) of 25 older patients, with infections being the most common. Treatment-related deaths were reported in none of the younger patients and three (12%) of the older patients (two infections and one unknown cause of death). INTERPRETATION Carfilzomib and lenalidomide-based therapy provides improved progression-free survival compared with previously published data. However, results remain inferior in primary plasma cell leukaemia compared with multiple myeloma, highlighting the need for new studies incorporating novel immunotherapies. FUNDING Dutch Cancer Society, Celgene (a BMS company), and AMGEN.
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Affiliation(s)
- Niels W C J van de Donk
- Department of Hematology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands; Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
| | - Monique C Minnema
- University Medical Center Utrecht, Department of Hematology, Utrecht University, Utrecht, Netherlands
| | - Bronno van der Holt
- HOVON Foundation, Rotterdam, Netherlands; Department of Hematology, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - Fredrik Schjesvold
- Oslo Myeloma Center, Department of Hematology, Oslo University Hospital and KG Jebsen Center for B cell malignancies, University of Oslo, Oslo, Norway
| | - Ka Lung Wu
- Department of Hematology, ZNA Stuivenberg, Antwerp, Belgium
| | - Annemiek Broijl
- Department of Hematology, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - Wilfried W H Roeloffzen
- Department of Hematology, University Medical Center Groningen, University Groningen, Groningen, Netherlands
| | - Alain Gadisseur
- Department of Haematology, Antwerp University Hospital, Edegem, Belgium
| | - Giuseppe Pietrantuono
- Unit of Hematology, Centro di Riferimento Oncologico della Basilicata, Rionero in Vulture, Italy
| | - Ludek Pour
- Department of Internal Medicine, Hematology and Oncology, University Hospital Brno, Brno, Czech Republic
| | | | | | | | | | - Luisa Giaccone
- Department of Oncology and Hematology, SSD Stem Cell Transplant Center, AOU Citta della Salute e della Scienza di Torino, Torino, Italy
| | | | - Paola Tacchetti
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematolgia Seràgnoli, Bologna, Italy
| | - Katia Mancuso
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematolgia Seràgnoli, Bologna, Italy; Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
| | | | - Jo Caers
- Department of Hematology, CHU Liege, Liege, Belgium
| | - Sonja Zweegman
- Department of Hematology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands; Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Roman Hájek
- Department of Hematooncology, University Hospital Ostrava, Ostrava, Czech Republic; Department of Hematooncology, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | | | - Annette Juul Vangsted
- Department of Hematology, Rigshospitalet, Copenhagen University, Copenhagen, Denmark
| | | | - Francesca Gay
- Division of Hematology, Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Pieter Sonneveld
- Department of Hematology, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - Pellegrino Musto
- Department of Precision and Regenerative Medicine and Ionian Area, Aldo Moro University School of Medicine, and Hematology and Stem Cell Transplantation Unit, AOU Consorziale Policlinico, Bari, Italy
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Liu MS, Han XY, Qu ZG, Luo QL, Wu KL, Chen J, Wu YJ, Xu WL, Yang XX, Zhu YY. [Rapid promyelocytic blast crisis of chronic myeloid leukemia with PML-RARα fusion gene: a case report and literature review]. Zhonghua Xue Ye Xue Za Zhi 2023; 44:512-515. [PMID: 37550211 PMCID: PMC10450556 DOI: 10.3760/cma.j.issn.0253-2727.2023.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Indexed: 08/09/2023]
Affiliation(s)
- M S Liu
- Yiwu Central Hospital, Yiwu 322099, China
| | - X Y Han
- The First Affiliated Hospital, Zhejiang University, Hangzhou 310003, China
| | - Z G Qu
- Yiwu Central Hospital, Yiwu 322099, China
| | - Q L Luo
- Yiwu Central Hospital, Yiwu 322099, China
| | - K L Wu
- Yiwu Central Hospital, Yiwu 322099, China
| | - J Chen
- Yiwu Central Hospital, Yiwu 322099, China
| | - Y J Wu
- Yiwu Central Hospital, Yiwu 322099, China
| | - W L Xu
- Yiwu Central Hospital, Yiwu 322099, China
| | - X X Yang
- Yiwu Central Hospital, Yiwu 322099, China
| | - Y Y Zhu
- The First Affiliated Hospital, Zhejiang University, Hangzhou 310003, China
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Wang M, Ramchandren R, Chen R, Karlin L, Chong G, Jurczak W, Wu KL, Bishton M, Collins GP, Eliadis P, Peyrade F, Lee Y, Eckert K, Neuenburg JK, Tam CS. Concurrent ibrutinib plus venetoclax in relapsed/refractory mantle cell lymphoma: the safety run-in of the phase 3 SYMPATICO study. J Hematol Oncol 2021; 14:179. [PMID: 34717692 PMCID: PMC8556975 DOI: 10.1186/s13045-021-01188-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 10/12/2021] [Indexed: 12/26/2022] Open
Abstract
Ibrutinib plus venetoclax, given with an ibrutinib lead-in, has shown encouraging clinical activity in early phase studies in mantle cell lymphoma (MCL). The ongoing phase 3 SYMPATICO study evaluates the safety and efficacy of concurrently administered, once-daily, all-oral ibrutinib plus venetoclax in patients with relapsed/refractory MCL. A safety run-in (SRI) cohort was conducted to inform whether an ibrutinib lead-in should be implemented for the randomized portion. Patients received concurrent ibrutinib 560 mg continuously plus venetoclax in a 5-week ramp-up to venetoclax 400 mg for up to 2 years. The primary endpoint was occurrence of tumor lysis syndrome (TLS) and dose-limiting toxicities (DLTs). The SRI cohort enrolled 21 patients; six and 15 were in low- or increased-risk categories for TLS, respectively. During the 5-week venetoclax ramp-up, three patients had DLTs, and one patient at increased risk for TLS had a laboratory TLS; no additional TLS events occurred during follow-up. With a median follow-up of 31 months, the overall response rate was 81% (17/21); 62% (13/21) of patients had a complete response. SRI data informed that the randomized portion should proceed with concurrent ibrutinib plus venetoclax, with no ibrutinib lead-in. Ibrutinib plus venetoclax demonstrated promising efficacy; no new safety signals were observed.Trial registration: ClinicalTrials.gov, NCT03112174. Registered 13 April 2017, https://clinicaltrials.gov/ct2/show/NCT03112174 .
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Affiliation(s)
- Michael Wang
- Department of Lymphoma and Myeloma, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd #368, Houston, TX, 77030, USA.
| | | | - Robert Chen
- City of Hope National Medical Center, Duarte, CA, USA
| | | | - Geoffrey Chong
- Olivia Newton-John Cancer Centre, Heidelberg, VIC, Australia
| | - Wojciech Jurczak
- Sklodowska Curie National Research Institute of Oncology, Kraków, Poland
| | - Ka Lung Wu
- Ziekenhuis Netwerk Antwerpen, Antwerp, Belgium
| | - Mark Bishton
- Nottinghamshire University Hospitals, Nottingham, UK
| | - Graham P Collins
- NIHR Oxford Biomedical Research Centre, Churchill Hospital, Oxford, UK
| | - Paul Eliadis
- Icon Cancer Centre, South Brisbane, QLD, Australia
| | | | - Yihua Lee
- Pharmacyclics LLC, an AbbVie Company, Sunnyvale, CA, USA
| | - Karl Eckert
- Pharmacyclics LLC, an AbbVie Company, Sunnyvale, CA, USA
| | | | - Constantine S Tam
- Peter MacCallum Cancer Centre, Royal Melbourne Hospital, St Vincent's Hospital, University of Melbourne, Melbourne, VIC, Australia
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Cohen YC, Oriol A, Wu KL, Lavi N, Vlummens P, Jackson C, Garvin W, Carson R, Crist W, Fu J, Feng H, Xie H, Schecter J, San-Miguel J, Lonial S. Daratumumab With Cetrelimab, an Anti-PD-1 Monoclonal Antibody, in Relapsed/Refractory Multiple Myeloma. Clin Lymphoma Myeloma Leuk 2021; 21:46-54.e4. [PMID: 33485428 DOI: 10.1016/j.clml.2020.08.008] [Citation(s) in RCA: 7] [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] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 05/15/2020] [Accepted: 08/11/2020] [Indexed: 01/24/2023]
Abstract
BACKGROUND Daratumumab is approved for relapsed or refractory multiple myeloma (RRMM) as monotherapy or in combination regimens. We evaluated daratumumab plus cetrelimab, a programmed death receptor-1 inhibitor, in RRMM. PATIENTS AND METHODS This open-label, multiphase study enrolled adults with RRMM with ≥ 3 prior lines of therapy. Part 1 was a safety run-in phase examining dose-limiting toxicities of daratumumab (16 mg/kg intravenously weekly for cycles 1-2, biweekly for cycles 3-6, and monthly thereafter) plus cetrelimab (240 mg intravenously biweekly, all cycles). In Parts 2 and 3, patients were to be randomized to daratumumab with or without cetrelimab (same schedule as Part 1). Endpoints included safety, overall response rate, pharmacokinetics, and biomarker analyses. RESULTS Nine patients received daratumumab plus cetrelimab in the safety run-in, and 1 received daratumumab in Part 2 before administrative study termination following a data monitoring committee's global recommendation to stop any trial including daratumumab combined with inhibitors of programmed death receptor-1 or its ligand (programmed death-ligand 1). The median follow-up times were 6.7 months (safety run-in) and 0.3 months (Part 2). No dose-limiting toxicities occurred. All 10 patients had ≥ 1 treatment-emergent adverse event; 7 patients had grade 3 to 4 treatment-emergent adverse events, and none led to treatment discontinuation or death. In the safety run-in, 7 (77.7%) patients had ≥ 1 infusion-related reaction (most grade 1-2), and 1 had a grade 2 immune-mediated reaction. Among safety run-in patients, the overall response rate was 44.4%. CONCLUSIONS No new safety concerns were identified for daratumumab plus cetrelimab in RRMM. The short study duration and small population limit complete analysis of this combination.
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Affiliation(s)
- Yael C Cohen
- Tel-Aviv Sourasky (Ichilov) Medical Center, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Albert Oriol
- Institut Català d'Oncologia i Institut Josep Carreras, Hospital Germans Trias I Pujol, Badalona, Barcelona, Spain
| | - Ka Lung Wu
- Department of Hematology, ZNA Stuivenberg Lange Beeldekensstraat, Antwerpen, Belgium
| | - Noa Lavi
- Department of Hematology and Bone Marrow Transplantation, Rambam Medical Center, Haifa, Israel
| | - Philip Vlummens
- Department of Clinical Hematology, UZ Gent - Department of Clinical Hematology, Gent, Belgium
| | | | - Wendy Garvin
- Janssen Research & Development, LLC, Raritan, NJ
| | - Robin Carson
- Janssen Research & Development, LLC, Spring House, PA
| | - Wendy Crist
- Janssen Research & Development, LLC, Spring House, PA
| | - Jiayu Fu
- Janssen Research & Development, LLC, Spring House, PA
| | - Huaibao Feng
- Janssen Research & Development, LLC, Spring House, PA
| | - Hong Xie
- Janssen Research & Development, LLC, Spring House, PA
| | | | - Jesús San-Miguel
- Clínica Universidad de Navarra-CIMA, IDISNA, CIBERONC, Pamplona, Navarra, Spain
| | - Sagar Lonial
- Winship Cancer Institute, Emory University, Atlanta, GA
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Yuan JJ, Li DP, Liu YH, Wu KL, Zhao Y, Wu J, Yao CY, Wang Y. [Application strategy and effect of cuffed tracheostomy tube with inner cannula in the treatment of postoperative complications of laryngeal or hypopharyngeal cancer]. Zhonghua Zhong Liu Za Zhi 2020; 42:976-979. [PMID: 33256313 DOI: 10.3760/cma.j.cn112152-20200418-00354] [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] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To Investigate the application strategy and effect of cuffed tracheostomy tube with inner cannula in the treatment of postoperative complications of laryngeal and hypopharyngeal cancer. Methods: A total of 60 patients with laryngeal and hypopharyngeal cancer occurred serious postoperative complications, including 31 cases of severe postoperative neck infection, 8 cases of dyspnea, 5 cases of massive hemorrhage and 16 cases of seriously intractable aspiration. The tracheal cannula with inner cannula and outer cuff was immediately worn on these patients and the cuff was inflated. Different treatments were carried out according to different complications. The outer cuffs were inflated for patients with severe neck infections to prevent a large amount of neck secretions inhaled to the trachea. Patients with dyspnea immediately received ventilator-assisted ventilation. For those with massive hemorrhage on the wound, doctors should prevent bleeding and stop bleeding under general anesthesia. Patients with severely coughing should perform eating training to prevent food aspiration. The inner cannula was regularly replaced once a month for all of these patients. Results: Through targeted treatment, the complications of 60 patients with cuffed tracheostomy tube with inner cannula were effectively controlled. After dressing change, the neck wounds of 31 patients with neck infection were shrunk or healed. Finally, all of the patients were replaced with metal tracheal tubes. Eight cases with dyspnea were rescued with the symptomatic and related special treatment, and finally replace by metal tracheal tube. Five cases with massive bleeding in the neck wound were successfully rescued and replaced with metal tracheal cannula. Thirteen patients among 16 cases with intractable aspiration were removed the tracheal cannula and other 3 cases of old and severely ill were replaced with metal tracheal cannula. Conclusions: The cuffed tracheostomy tube with inner cannula is of great value in the treatment of severe postoperative complications of laryngeal or hypopharyngeal cancer. It is strongly recommended that the operators should fully understand and use it reasonably after the operation of laryngeal or hypopharyngeal cancer.
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Affiliation(s)
- J J Yuan
- Department of Otorhinolaryngology Head and Neck Surgery of the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - D P Li
- Department of Otorhinolaryngology Head and Neck Surgery of the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - Y H Liu
- Department of Otorhinolaryngology Head and Neck Surgery of the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - K L Wu
- Department of Otorhinolaryngology Head and Neck Surgery of the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - Y Zhao
- Department of Otorhinolaryngology Head and Neck Surgery of the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - J Wu
- Department of Otorhinolaryngology Head and Neck Surgery of the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - C Y Yao
- Department of Otorhinolaryngology Head and Neck Surgery of the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - Y Wang
- Department of Otorhinolaryngology Head and Neck Surgery of the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
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Dimopoulos MA, Lonial S, White D, Moreau P, Weisel K, San-Miguel J, Shpilberg O, Grosicki S, Špička I, Walter-Croneck A, Magen H, Mateos MV, Belch A, Reece D, Beksac M, Spencer A, Oakervee H, Orlowski RZ, Taniwaki M, Röllig C, Einsele H, Matsumoto M, Wu KL, Anderson KC, Jou YM, Ganetsky A, Singhal AK, Richardson PG. Elotuzumab, lenalidomide, and dexamethasone in RRMM: final overall survival results from the phase 3 randomized ELOQUENT-2 study. Blood Cancer J 2020; 10:91. [PMID: 32887873 PMCID: PMC7474076 DOI: 10.1038/s41408-020-00357-4] [Citation(s) in RCA: 78] [Impact Index Per Article: 19.5] [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: 04/09/2020] [Revised: 08/07/2020] [Accepted: 08/17/2020] [Indexed: 12/17/2022] Open
Abstract
Prolonging overall survival (OS) remains an unmet need in relapsed or refractory multiple myeloma (RRMM). In ELOQUENT-2 (NCT01239797), elotuzumab plus lenalidomide/dexamethasone (ERd) significantly improved progression-free survival (PFS) versus lenalidomide/dexamethasone (Rd) in patients with RRMM and 1–3 prior lines of therapy (LoTs). We report results from the pre-planned final OS analysis after a minimum follow-up of 70.6 months, the longest reported for an antibody-based triplet in RRMM. Overall, 646 patients with RRMM and 1–3 prior LoTs were randomized 1:1 to ERd or Rd. PFS and overall response rate were co-primary endpoints. OS was a key secondary endpoint, with the final analysis planned after 427 deaths. ERd demonstrated a statistically significant 8.7-month improvement in OS versus Rd (median, 48.3 vs 39.6 months; hazard ratio, 0.82 [95.4% Cl, 0.68–1.00]; P = 0.0408 [less than allotted α of 0.046]), which was consistently observed across key predefined subgroups. No additional safety signals with ERd at extended follow-up were reported. ERd is the first antibody-based triplet regimen shown to significantly prolong OS in patients with RRMM and 1–3 prior LoTs. The magnitude of OS benefit was greatest among patients with adverse prognostic factors, including older age, ISS stage III, IMWG high-risk disease, and 2–3 prior LoTs.
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Affiliation(s)
| | - Sagar Lonial
- Winship Cancer Institute, Emory University, Atlanta, GA, USA
| | - Darrell White
- Queen Elizabeth II Health Sciences Centre and Dalhousie University, Halifax, NS, Canada
| | | | - Katja Weisel
- University Medical Center of Hamburg-Eppendorf, Hamburg, Germany
| | - Jesus San-Miguel
- Clínica Universidad de Navarra, Centro de Investigación Médica Aplicada, IDISNA, CIBERONC, Pamplona, Spain
| | - Ofer Shpilberg
- Institute of Haematology, Assuta Medical Centers, Tel Aviv, Israel
| | | | - Ivan Špička
- Charles University in Prague and General Teaching Hospital, Prague, Czech Republic
| | | | - Hila Magen
- Department of Hematology Chaim Sheba Medical Center, Ramat-Gan, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Maria-Victoria Mateos
- University Hospital of Salamanca-Instituto de Investigación Biomédica de Salamanca, Centro de Investigación del Cáncer-IBMCC (USAL-CSIC), Salamanca, Spain
| | - Andrew Belch
- Cross Cancer Institute and University of Alberta, Edmonton, AB, Canada
| | - Donna Reece
- Princess Margaret Hospital, Toronto, ON, Canada
| | | | - Andrew Spencer
- Alfred Health-Monash University, Melbourne, VIC, Australia
| | | | | | | | - Christoph Röllig
- Universitätsklinikum der Technischen Universität, Dresden, Germany
| | | | - Morio Matsumoto
- National Hospital Organization Shibukawa Medical Center, Shibukawa, Japan
| | - Ka Lung Wu
- Ziekenhuis Netwerk Antwerpen Stuivenberg, Antwerp, Belgium
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Cavo M, Gay F, Beksac M, Pantani L, Petrucci MT, Dimopoulos MA, Dozza L, van der Holt B, Zweegman S, Oliva S, van der Velden VHJ, Zamagni E, Palumbo GA, Patriarca F, Montefusco V, Galli M, Maisnar V, Gamberi B, Hansson M, Belotti A, Pour L, Ypma P, Grasso M, Croockewit A, Ballanti S, Offidani M, Vincelli ID, Zambello R, Liberati AM, Andersen NF, Broijl A, Troia R, Pascarella A, Benevolo G, Levin MD, Bos G, Ludwig H, Aquino S, Morelli AM, Wu KL, Boersma R, Hajek R, Durian M, von dem Borne PA, Caravita di Toritto T, Zander T, Driessen C, Specchia G, Waage A, Gimsing P, Mellqvist UH, van Marwijk Kooy M, Minnema M, Mandigers C, Cafro AM, Palmas A, Carvalho S, Spencer A, Boccadoro M, Sonneveld P. Autologous haematopoietic stem-cell transplantation versus bortezomib-melphalan-prednisone, with or without bortezomib-lenalidomide-dexamethasone consolidation therapy, and lenalidomide maintenance for newly diagnosed multiple myeloma (EMN02/HO95): a multicentre, randomised, open-label, phase 3 study. Lancet Haematol 2020; 7:e456-e468. [PMID: 32359506 DOI: 10.1016/s2352-3026(20)30099-5] [Citation(s) in RCA: 212] [Impact Index Per Article: 53.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 03/12/2020] [Accepted: 03/12/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND The emergence of highly active novel agents has led some to question the role of autologous haematopoietic stem-cell transplantation (HSCT) and subsequent consolidation therapy in newly diagnosed multiple myeloma. We therefore compared autologous HSCT with bortezomib-melphalan-prednisone (VMP) as intensification therapy, and bortezomib-lenalidomide-dexamethasone (VRD) consolidation therapy with no consolidation. METHODS In this randomised, open-label, phase 3 study we recruited previously untreated patients with multiple myeloma at 172 academic and community practice centres of the European Myeloma Network. Eligible patients were aged 18-65 years, had symptomatic multiple myeloma stage 1-3 according to the International Staging System (ISS), measurable disease (serum M protein >10 g/L or urine M protein >200 mg in 24 h or abnormal free light chain [FLC] ratio with involved FLC >100 mg/L, or proven plasmacytoma by biopsy), and WHO performance status grade 0-2 (grade 3 was allowed if secondary to myeloma). Patients were first randomly assigned (1:1) to receive either four 42-day cycles of bortezomib (1·3 mg/m2 administered intravenously or subcutaneously on days 1, 4, 8, 11, 22, 25, 29, and 32) combined with melphalan (9 mg/m2 administered orally on days 1-4) and prednisone (60 mg/m2 administered orally on days 1-4) or autologous HSCT after high-dose melphalan (200 mg/m2), stratified by site and ISS disease stage. In centres with a double HSCT policy, the first randomisation (1:1:1) was to VMP or single or double HSCT. Afterwards, a second randomisation assigned patients to receive two 28-day cycles of consolidation therapy with bortezomib (1·3 mg/m2 either intravenously or subcutaneously on days 1, 4, 8, and 11), lenalidomide (25 mg orally on days 1-21), and dexamethasone (20 mg orally on days 1, 2, 4, 5, 8, 9, 11, and 12) or no consolidation; both groups received lenalidomide maintenance therapy (10 mg orally on days 1-21 of a 28-day cycle). The primary outcomes were progression-free survival from the first and second randomisations, analysed in the intention-to-treat population, which included all patients who underwent each randomisation. All patients who received at least one dose of study drugs were included in the safety analyses. This study is registered with the EU Clinical Trials Register (EudraCT 2009-017903-28) and ClinicalTrials.gov (NCT01208766), and has completed recruitment. FINDINGS Between Feb 25, 2011, and April 3, 2014, 1503 patients were enrolled. 1197 patients were eligible for the first randomisation, of whom 702 were assigned to autologous HSCT and 495 to VMP; 877 patients who were eligible for the first randomisation underwent the second randomisation to VRD consolidation (n=449) or no consolidation (n=428). The data cutoff date for the current analysis was Nov 26, 2018. At a median follow-up of 60·3 months (IQR 52·2-67·6), median progression-free survival was significantly improved with autologous HSCT compared with VMP (56·7 months [95% CI 49·3-64·5] vs 41·9 months [37·5-46·9]; hazard ratio [HR] 0·73, 0·62-0·85; p=0·0001). For the second randomisation, the number of events of progression or death at data cutoff was lower than that preplanned for the final analysis; therefore, the results from the second protocol-specified interim analysis, when 66% of events were reached, are reported (data cutoff Jan 18, 2018). At a median follow-up of 42·1 months (IQR 32·3-49·2), consolidation therapy with VRD significantly improved median progression-free survival compared with no consolidation (58·9 months [54·0-not estimable] vs 45·5 months [39·5-58·4]; HR 0·77, 0·63-0·95; p=0·014). The most common grade ≥3 adverse events in the autologous HSCT group compared to the VMP group included neutropenia (513 [79%] of 652 patients vs 137 [29%] of 472 patients), thrombocytopenia (541 [83%] vs 74 [16%]), gastrointestinal disorders (80 [12%] vs 25 [5%]), and infections (192 [30%] vs 18 [4%]). 239 (34%) of 702 patients in the autologous HSCT group and 135 (27%) of 495 in the VMP group had at least one serious adverse event. Infection was the most common serious adverse event in each of the treatment groups (206 [56%] of 368 and 70 [37%] of 189). 38 (12%) of 311 deaths from first randomisation were likely to be treatment related: 26 (68%) in the autologous HSCT group and 12 (32%) in the VMP group, most frequently due to infections (eight [21%]), cardiac events (six [16%]), and second primary malignancies (20 [53%]). INTERPRETATION This study supports the use of autologous HSCT as intensification therapy and the use of consolidation therapy in patients with newly diagnosed multiple myeloma, even in the era of novel agents. The role of high-dose chemotherapy needs to be reassessed in future studies, in particular in patients with undetectable minimal residual disease after four-drug induction regimens including a monoclonal antiboby combined with an immunomodulatory agent and a proteasome inhibitor plus dexamethasone. FUNDING Janssen and Celgene.
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Affiliation(s)
- Michele Cavo
- Seràgnoli Institute of Hematology, Department of Experimental, Diagnostic and Specialty Medicine, Bologna University School of Medicine, S Orsola Malpighi Hospital, Bologna, Italy.
| | - Francesca Gay
- Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | - Meral Beksac
- Department of Hematology, Ankara University School of Medicine, Ankara, Turkey
| | - Lucia Pantani
- Seràgnoli Institute of Hematology, Department of Experimental, Diagnostic and Specialty Medicine, Bologna University School of Medicine, S Orsola Malpighi Hospital, Bologna, Italy
| | - Maria Teresa Petrucci
- Hematology, Department of Translational and Precision Medicine, Azienda Ospedaliera Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Meletios A Dimopoulos
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Luca Dozza
- Seràgnoli Institute of Hematology, Department of Experimental, Diagnostic and Specialty Medicine, Bologna University School of Medicine, S Orsola Malpighi Hospital, Bologna, Italy
| | - Bronno van der Holt
- Department of Trials and Statistics-HOVON Data Centre, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - Sonja Zweegman
- Department of Hematology, VU University Medical Center, Cancer Center Amsterdam, Amsterdam, Netherlands
| | - Stefania Oliva
- Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | | | - Elena Zamagni
- Seràgnoli Institute of Hematology, Department of Experimental, Diagnostic and Specialty Medicine, Bologna University School of Medicine, S Orsola Malpighi Hospital, Bologna, Italy
| | - Giuseppe A Palumbo
- Dipartimento di Science Mediche Chirurgiche e Tecnologie Avanzate "GF Ingrassia", Università degli Studi di Catania, Catania, Italy
| | - Francesca Patriarca
- Clinical Hematology and Bone Marrow Transplant Centre, S Maria della Misericordia University Hospital, DAME, University of Udine, Udine, Italy
| | - Vittorio Montefusco
- Hematology Department, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Monica Galli
- Hematology and Bone Marrow Transplant Unit, ASST-Papa Giovanni XXIII, Bergamo, Italy
| | - Vladimir Maisnar
- 4th Department of Internal Medicine-Hematology, Charles University Hospital and Faculty of Medicine, Hradec Kralove, Czech Republic
| | | | | | - Angelo Belotti
- SC Ematologia e Dipartimento di Oncologia Clinica, AO Spedali Civili, Brescia, Italy
| | - Ludek Pour
- University Hospital Brno, Brno, Czech Republic
| | - Paula Ypma
- Department of Hematology, Haga Hospital, The Hague, Netherlands
| | - Mariella Grasso
- SC Ematologia, Azienda Ospedaliera S Croce-Carle, Cuneo, Italy
| | | | - Stelvio Ballanti
- Reparto di Ematologia con TMO, Ospedale Santa Maria della Misericordia, Perugia, Italy
| | - Massimo Offidani
- Clinica di Ematologia, AOU Ospedali Riuniti di Ancona, Ancona, Italy
| | - Iolanda D Vincelli
- Division of Haematology, Grande Ospedale Metropolitano Bianchi-Melacrino-Morelli, Reggio Calabria, Italy
| | | | | | | | - Annemiek Broijl
- Department of Hematology, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - Rossella Troia
- Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | - Anna Pascarella
- Hematology Unit, Ospedale dell'Angelo, Mestre, Venice, Italy
| | - Giulia Benevolo
- Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | - Mark-David Levin
- Department of Internal Medicine, Albert Schweitzer Hospital, Dordrecht, Netherlands
| | - Gerard Bos
- Department of Haematology, Maastricht University Medical Center, Maastricht, Netherlands
| | - Heinz Ludwig
- Wilhelminen Cancer Research Institute, Wilhelminenspital, Vienna, Austria
| | - Sara Aquino
- Ematologia e Centro Trapianti, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Anna Maria Morelli
- Clinical Hematology, Department of Hematology, Transfusion Medicine and Biotechnology, "Spirito Santo" Civic Hospital, Pescara, Italy
| | - Ka Lung Wu
- Department of Hematology, ZNA Stuivenberg, Antwerp, Belgium
| | - Rinske Boersma
- Department of Internal Medicine, Amphia Hospital Breda, Breda, Netherlands
| | - Roman Hajek
- Department of Hematooncology, University Hospital Ostrava and University of Ostrava, Ostrava, Czech Republic
| | - Marc Durian
- University Hospital and Faculty of Medicine, Hradec Kralove, Czech Republic
| | | | | | - Thilo Zander
- Department Oncology/Hematology, Kantonsspital, Lucerne, Switzerland
| | | | | | - Anders Waage
- Department of Hematology, St Olavs Hospital and Norwegian University of Science and Technology, Trondheim, Norway
| | - Peter Gimsing
- Department of Haematology, University of Copenhagen, Copenhagen, Denmark
| | - Ulf-Henrik Mellqvist
- Department of Medicine, Section of Hematology and Coagulation, South Elvsborg Hospital, Gothenburg, Sweden
| | | | - Monique Minnema
- Department of Hematology, UMC Utrecht, University Utrecht, Utrecht, Netherlands
| | - Caroline Mandigers
- Department of Hematology, Canisius-Wilhelmina Hospital, Nijmegen, Netherlands
| | - Anna Maria Cafro
- Department of Hematology, ASST Grande Ospedale Metropolitano, Niguarda, Milan, Italy
| | | | - Susanna Carvalho
- Instituto Português de Oncologia de Lisboa Francisco Gentil, IPOLFG, Lisbon, Portugal
| | - Andrew Spencer
- Department of Haematology, Alfred Hospital-Monash University, Melbourne, VIC, Australia
| | - Mario Boccadoro
- Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | - Pieter Sonneveld
- Department of Hematology, Erasmus MC Cancer Institute, Rotterdam, Netherlands
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Cheng Y, Lu W, Wu KL. [Severe facial malformation caused by secondary hyperparathyroidism in uremia: report of 4 cases]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2019; 54:924-927. [PMID: 31887819 DOI: 10.3760/cma.j.issn.1673-0860.2019.12.008] [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] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the etiology, characteristics and prevention of severe facial deformity in patients with uremia entering the dialysis stage. Methods: Four cases with uremia in the dialysis stage who presented with severe facial deformity between October 2011 and November 2018 were reviewed, including 3 males and 1 female. The ages were 31, 15, 51 and 61, respectively. The general information, clinical symptoms, biochemical indicators, relevant imaging indicators, diagnoses, treatments and efficacies of the 4 patients admitted to the First Affiliated Hospital of Anhui Medical University were collected. Results: All the 4 patients appeared obviously shorter, accompanied by a certain degree of decline in self-care ability, multiple bone and joint pain and severe facial deformity. They presented with significantly increased serum levels of alkaline phosphatase, calcium, phosphorus and parathyroid hormone, and parathyroid hormone level>2 500 pg/ml.Ultrasonography and (99)Tc(m) radionuclide scan showed in situ or ectopic hyperplasia of parathyroid tissue. Bone radiography showed local decrease of bone mineral density and cystic changes.After parathyroidectomy, the serum levels of alkaline phosphatase, parathyroid hormone, calciumand phosphorus decreased significantly, while bone pain symptoms and facial deformities gradually improved. Conclusion: Secondary hyperparathyroidism is a serious complication in patients with dialysis and few of patients may have severe facial deformity (Sagliker syndrome) affecting their normal life and social activities. Parathyroidectomy can improve the facial deformity and the quality of life of patients.
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Affiliation(s)
- Y Cheng
- Department of Nephrology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022
| | - W Lu
- Department of Nephrology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022
| | - K L Wu
- Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei 230022
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11
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Wu J, Wu KL, Liu YH, Zhao Y, Wang Y, Wang D. [Surgical treatment of stomal recurrence after tracheotomy]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2019; 33:752-756. [PMID: 31446733 DOI: 10.13201/j.issn.1001-1781.2019.08.017] [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] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Indexed: 11/12/2022]
Abstract
Objective:The aim of this study is to investigate the perioperative management of stomal recurrence after tracheostomy including the method of surgical resection and repairment of postoperative defect. Method:Fifteen cases of stomal recurrence after tracheostomy, all cases received preoperative neck to chest enhanced CT scan or PET-CT examination to determine the scope of the lesion, electronic gastroscope or esophageal radiography to understand whether the esophageal mucosa is invased. All cases received extended resection and low tracheostomy. Result:Seven cases were repaired with pedicle pectoralis major myocutaneous flap. Five cases were repaired with internal thoracic artery perforator flap. Two cases were chosed approaching the skin and subcutaneous tissue, such as pedicled rotator flap or Z-shaped flap or V-Y advance flap to repaire. 1 case was chosed Stomach lifting instead of esophageal surgery and near skin flap for repairment. In all cases, the operations were completed successfully and none patient died during the perioperative period. All patients received postoperative radiotherapy after surgery. Conclusion:After proper examination, the selected stomal recurrence after tracheostomy can be surgically treated. The key to judgment before surgery is whether the surrounding large vessels can be safely dissected or reconstructed, and whether or not tracheostomy can be performed after resection. The appropriate method of repairing the defect during the operation can successfully complete the operation and extend the lives of some patients. Patients with tracheostomy maintenance should pay special attention to regular follow-up after surgery.
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Affiliation(s)
- J Wu
- Department of Otorhinolaryngology Head and Neck Surgery,the First Affiliated Hospital of Anhui Medical University,Hefei,230022,China
| | - K L Wu
- Department of Otorhinolaryngology Head and Neck Surgery,the First Affiliated Hospital of Anhui Medical University,Hefei,230022,China
| | - Y H Liu
- Department of Otorhinolaryngology Head and Neck Surgery,the First Affiliated Hospital of Anhui Medical University,Hefei,230022,China
| | - Y Zhao
- Department of Otorhinolaryngology Head and Neck Surgery,the First Affiliated Hospital of Anhui Medical University,Hefei,230022,China
| | - Y Wang
- Department of Otorhinolaryngology Head and Neck Surgery,the First Affiliated Hospital of Anhui Medical University,Hefei,230022,China
| | - D Wang
- Department of Otorhinolaryngology Head and Neck Surgery,the First Affiliated Hospital of Anhui Medical University,Hefei,230022,China
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Morschhauser F, Le Gouill S, Feugier P, Bailly S, Nicolas-Virelizier E, Bijou F, Salles GA, Tilly H, Fruchart C, Van Eygen K, Snauwaert S, Bonnet C, Haioun C, Thieblemont C, Bouabdallah R, Wu KL, Canioni D, Meignin V, Cartron G, Houot R. Obinutuzumab combined with lenalidomide for relapsed or refractory follicular B-cell lymphoma (GALEN): a multicentre, single-arm, phase 2 study. Lancet Haematol 2019; 6:e429-e437. [PMID: 31296423 DOI: 10.1016/s2352-3026(19)30089-4] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 05/02/2019] [Accepted: 05/03/2019] [Indexed: 01/18/2023]
Abstract
BACKGROUND Lenalidomide plus rituximab is approved to treat patients with relapsed or refractory follicular lymphoma. Obinutuzumab has been shown to enhance antibody-dependent cellular cytotoxicity, phagocytosis, and direct B-cell killing better than rituximab. Our aim was to determine the activity and safety of lenalidomide plus obinutuzumab in previously treated patients with relapsed or refractory follicular lymphoma. METHODS In this multicentre, single-arm, phase 2 study, patients were enrolled from 24 Lymphoma Academic Research Organisation centres in France. Eligible patients (age ≥18 years) had histologically confirmed CD20-positive relapsed or refractory follicular lymphoma of WHO grade 1, 2, or 3a; an ECOG performance status of 0-2; and received at least one previous rituximab-containing therapy. Patients received oral lenalidomide (20 mg) plus intravenously infused obinutuzumab as induction therapy (1000 mg; six 28-day cycles), 1-year maintenance with lenalidomide (10 mg; 12 28-day cycles; days 2-22) plus obinutuzumab (1000 mg; alternate cycles), and 1-year maintenance with obinutuzumab (1000 mg; six 56-day cycles; day 1). The primary endpoint was the proportion of patients who achieved an overall response at induction end as per investigator assessment using the 1999 international working group criteria. The secondary endpoints were event-free survival, progression-free survival, overall survival, and safety. Analyses were per-protocol; the efficacy population included all patients who received at least one dose of both obinutuzumab and lenalidomide, and the safety population included all patients who received one dose of either investigational drug. The study is registered with ClinicalTrials.gov, number NCT01582776, and is ongoing but closed to accrual. FINDINGS Between June 11, 2014, and Dec 18, 2015, 89 patients were recruited and 86 patients were evaluable for efficacy and 88 for safety. Median follow-up was 2·6 years (IQR 2·2-2·8). 68 (79%) of 86 evaluable patients (95% CI 69-87) achieved an overall response at induction end, meeting the prespecified primary endpoint. At 2 years, event-free survival was 62% (95% CI 51-72), progression-free survival 65% (95% CI 54-74), duration of response 70% (95% CI 57-79), and overall survival 87% (95% CI 78-93). Complete response was achieved by 33 (38%, 95% CI 28-50) of 86 patients at induction end, and the proportion of patients achieving a best overall response was 70 (81%, 95% CI 72-89) and 72 (84%, 74-91) of 86 patients during induction and treatment, respectively. The most common adverse events were asthenia (n=54, 61%), neutropenia (n=38, 43%), bronchitis (n=36, 41%), diarrhoea (n=35, 40%), and muscle spasms (n=34, 39%). Neutropenia was the most common toxicity of grade 3 or more; four (5%) patients had febrile neutropenia. 57 serious adverse events were reported in 30 (34%) of 88 patients. The most common serious adverse events were basal cell carcinoma (n=5, 6%), febrile neutropenia (n=4, 5%), and infusion-related reaction (n=3, 3%). One patient died due to treatment-related febrile neutropenia. INTERPRETATION Our data shows that lenalidomide plus obinutuzumab is active in previously treated patients with relapsed or refractory follicular lymphoma, including those with early relapse, and has a manageable safety profile. Randomised trials of new immunomodulatory regimens, such as GALEN or using GALEN as a backbone, versus lenalidomide plus rituximab, are warranted. FUNDING Lymphoma Academic Research Organisation, and Celgene and Roche.
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Affiliation(s)
- Franck Morschhauser
- Université Lille, Centre Hospitalier Régional Universitaire de Lille, EA 7365, Groupe de Recherche sur les formes Injectables et les Technologies Associées, Lille, France.
| | - Steven Le Gouill
- Department of Haematology, Centre Hospitalier Universitaire Nantes, Nantes, France
| | - Pierre Feugier
- Centre Hospitalier Régional Universitaire de Nancy, Vandœuvre-lès-Nancy, France
| | - Sarah Bailly
- Cliniques Universitaires Saint-Luc, Bruxelles, Belgique
| | | | | | - Gilles A Salles
- Department of Haematology, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Université de Lyon, Lyon, France
| | - Hervé Tilly
- Department of Haematology and INSERM 1245, Centre Henri Becquerel, University of Rouen, Rouen, France
| | - Christophe Fruchart
- Institut d'Hématologie de Basse Normandie, Centre Hospitalier Universitaire de Caen, France
| | | | | | - Christophe Bonnet
- Clinical Hematology, Centre Hospitalier Universitaire, University of Liège, Liège, Belgium
| | - Corinne Haioun
- Lymphoid Malignancies Unit, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Mondor, Créteil, France
| | - Catherine Thieblemont
- Hemato-Oncology, Hospital Saint-Louis, Assistance Publique-Hôpitaux de Paris, INSERM U 728, Institut Universitaire d'Hematologie, Paris, France
| | - Reda Bouabdallah
- Department of Hematology, Institut Paoli-Calmettes, Marseille, France
| | - Ka Lung Wu
- Ziekenhuis Netwerk Antwerpen Stuivenberg, Antwerpen, Belgium
| | - Danielle Canioni
- Pathology Department, Hôpital Necker, Assistance Publique-Hôpitaux de Paris, Paris, France et Paris V Descartes University, Sorbonne-Paris-Cité, Paris, France
| | - Véronique Meignin
- Pathology Department, Saint Louis Hospital, Assistance Publique-Hôpitaux de Paris et Paris Cité Sorbonne Diderot 7 University, Paris, France
| | - Guillaume Cartron
- Centre Hospitalier Universitaire, UMR 5235, University of Montpellier, Montpellier, France
| | - Roch Houot
- Haematology Department, Centre Hospitalier Universitaire de Rennes, Rennes, France
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Yang XG, Wu KL, Xu GH, Zhou S. [Differential analysis of protein profiles of bile from patients with hepatocellular carcinoma and gallstone]. Zhonghua Gan Zang Bing Za Zhi 2019; 27:316-318. [PMID: 31082345 DOI: 10.3760/cma.j.issn.1007-3418.2019.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- X G Yang
- Department of Interventional, Sichuan Caner Hospital, Chengdu 610041, China
| | - K L Wu
- Zhongshan University Ophthalmology Center Laboratory, Guangzhou 510000, China
| | - G H Xu
- Department of Interventional, Sichuan Caner Hospital, Chengdu 610041, China
| | - S Zhou
- Department of Interventional, Affiliated Hospital of Guizhou Medical University, Guiyang 550000, China
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Minnema MC, Nasserinejad K, Hazenberg B, Hegenbart U, Vlummens P, Ypma PF, Kröger N, Wu KL, Kersten MJ, Schaafsma MR, Croockewit S, de Waal E, Zweegman S, Tick L, Broijl A, Koene H, Bos G, Sonneveld P, Schönland S. Bortezomib-based induction followed by stem cell transplantation in light chain amyloidosis: results of the multicenter HOVON 104 trial. Haematologica 2019; 104:2274-2282. [PMID: 30923094 PMCID: PMC6821610 DOI: 10.3324/haematol.2018.213900] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [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: 12/06/2018] [Accepted: 03/18/2019] [Indexed: 01/23/2023] Open
Abstract
This prospective, multicenter, phase II study investigated the use of four cycles of bortezomib-dexamethasone induction treatment, followed by high-dose melphalan and autologous stem cell transplantation (SCT) in patients with newly diagnosed light chain amyloidosis. The aim of the study was to improve the hematologic complete remission (CR) rate 6 months after SCT from 30% to 50%. Fifty patients were enrolled and 72% had two or more organs involved. The overall hematologic response rate after induction treatment was 80% including 20% CR and 38% very good partial remissions (VGPR). Fifteen patients did not proceed to SCT for various reasons but mostly treatment-related toxicity and disease-related organ damage and death (2 patients). Thirty-one patients received melphalan 200 mg/m2 and four patients a reduced dose because of renal function impairment. There were no deaths related to the transplantation procedure. Hematologic responses improved at 6 months after SCT to 86% with 46% CR and 26% VGPR. However, due to the high treatment discontinuation rate before transplantation the primary endpoint of the study was not met and the CR rate in the intention-to-treat analysis was 32%. Organ responses continued to improve after SCT. We confirm the high efficacy of bortezomib-dexamethasone treatment in patients with AL amyloidosis. However, because of both treatment-related toxicity and disease characteristics, 30% of the patients could not proceed to SCT after induction treatment. (Trial registered at Dutch Trial Register identifier NTR3220).
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Affiliation(s)
- Monique C Minnema
- Department of Hematology, UMC Utrecht Cancer Center, Utrecht, the Netherlands
| | - Kazem Nasserinejad
- HOVON Data Center, Department of Hematology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - Bouke Hazenberg
- Department of Rheumatology & Clinical Immunology, University of Groningen Medical Center, Groningen, the Netherlands
| | - Ute Hegenbart
- Department of Hematology, Oncology and Rheumatology, Heidelberg University, Amyloidosis Center, Heidelberg, Germany
| | | | - Paula F Ypma
- Department of Hematology, HagaZiekenhuis, Den Haag, the Netherlands
| | - Nicolaus Kröger
- Department of Stem Cell Transplantation, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ka Lung Wu
- Department of Hematology, ZNA Stuivenberg, Antwerp, Belgium
| | - Marie Jose Kersten
- Department of Hematology, Academic Medical Center, Lymphoma and Myeloma Center, Amsterdam, the Netherlands
| | - M Ron Schaafsma
- Department of Hematology, Medisch Spectrum Twente, Enschede, the Netherlands
| | - Sandra Croockewit
- Department of Hematology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Esther de Waal
- Department of Hematology, University of Groningen, Medical Center, Groningen, the Netherlands
| | - Sonja Zweegman
- Department of Hematology, VU University Medical Center, Amsterdam Cancer Center, Amsterdam, the Netherlands
| | - Lidwien Tick
- Department of Internal Medicine, Maxima Medisch Centrum, Eindhoven, the Netherlands
| | - Annemieke Broijl
- Department of Hematology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - Harry Koene
- Department of Hematology, St. Antonius Hospital, Nieuwegein, the Netherlands
| | - Gerard Bos
- Department of Hematology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Pieter Sonneveld
- Department of Hematology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - Stefan Schönland
- Department of Hematology, Oncology and Rheumatology, Heidelberg University, Amyloidosis Center, Heidelberg, Germany
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15
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Ma SY, Li C, Zhao HB, Zhang JY, Zhang HZ, Wu KL, Li M. [Comparison of clinical outcomes of frozen-thawed blastocysts derived from non-pronucleus or two pronucleus zygotes]. Zhonghua Fu Chan Ke Za Zhi 2018; 53:749-754. [PMID: 30453421 DOI: 10.3760/cma.j.issn.0529-567x.2018.11.004] [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] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To evaluate the application value of the blastocysts derived from non-pronucleus (0PN) zygotes by the good quality blastocyst formation rate and the clinical outcomes of frozen-thawed blastocyst transfers. Methods: The good quality blastocyst formation rate derived from 0PN zygotes was compared with that derived from2 pronucleus (2PN) zygotes in in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) cycles from January 2015 to December 2016. In addition, the clinical pregnancy, embryo implantation and live birth rates of frozen-thawed blastocyst transfers with blastocysts derived from 0PN and 2PN zygotes were analyzed on corresponding dates. Results: (1) In IVF cycles, the high quality blastocysts formation rate of 2PN embryos was significantly higher than that of 0PN (46.64% versus 42.42%, P<0.01) . In ICSI cycles, the high quality blastocysts formation rate of 2PN embryos was markedly higher than that of 0PN (41.96% versus 21.73%, P<0.01) . (2) In frozen-thawed embryo transfer cycles for IVF, the clinical pregnancy, implantation and live birth rates of D5 0PN blastocysts were significantly higher than those of D6 2PN (52.64% versus 46.78%, 49.91% versus 41.20%, 46.54% versus 39.56%, all P<0.05) , however, the abortion and newborn abnormal rates of D5 0PN blastocysts were lower than those of D6 2PN blastocysts (17.37% versus 23.36%, 1.31% versus 4.21%, both P<0.05) ; the clinical pregnancy, implantation and livebirth rates of D5 2PN blastocysts were significantly higher than those of D5 0PN (59.73% versus 52.64%, 55.95% versus 49.91%, 53.03% versus 46.54%, all P<0.05) , but newborn abnormal rate was a little higher than that of D5 0PN (3.90% versus 1.31%, P<0.05) ; the clinical pregnancy, implantation and live birth rates of D5 2PN blastocysts were significantly higher than those of D6 2PN (59.73% versus 46.78%, 55.95% versus 41.20%, 53.03% versus 39.56%, all P<0.05) , and the abortion rate of D5 2PN blastocysts was lower than that of D6 2PN blastocysts (18.23% versus 23.36%, P<0.05) . Conclusions: Although the blastocysts derived from 0PN could be transffered, the blastocysts derived from 2PN zygotes are preferred in all cycles. In IVF cycles, the good quality blastocysts derived from 2PN or 0PN zygotes will be transferred.
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Affiliation(s)
- S Y Ma
- IVF Laboratory, Hospital for Reproductive Medicine Affiliated to Shandong University, Jinan 250021, China
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16
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Li GY, Liu YY, Wu KL, Tang ZH. A novel HLA-A*24 allele, A*24:231, was identified by sequence-based typing. HLA 2018; 92:96-97. [PMID: 29790284 DOI: 10.1111/tan.13253] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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: 03/05/2018] [Accepted: 03/06/2018] [Indexed: 11/29/2022]
Abstract
HLA-A*24:231 has one nucleotide change from HLA-A*24:02:01:01 at position 784 G>C.
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Affiliation(s)
- G Y Li
- HLA Laboratory, Gansu Red Cross Blood Center, Lanzhou, China
| | - Y Y Liu
- HLA Laboratory, Gansu Red Cross Blood Center, Lanzhou, China
| | - K L Wu
- HLA Laboratory, Gansu Red Cross Blood Center, Lanzhou, China
| | - Z H Tang
- HLA Laboratory, Gansu Red Cross Blood Center, Lanzhou, China
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Van Droogenbroeck J, Vlummens P, Lavi N, Wu KL, Fu J, Feng H, Carson RL, Crist W, Schecter J, Cohen Y. Randomized, open-label, phase 2/3 study of daratumumab (DARA) with or without JNJ-63723283, an anti-PD-1 monoclonal antibody, in relapsed/refractory multiple myeloma (RRMM). J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.tps8057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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)
| | | | - Noa Lavi
- Department of Hematology and Bone Marrow Transplantation, Rambam Health Care Campus and The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Ka Lung Wu
- Department of Hematology, ZNA Stuivenberg, Antwerp, Belgium
| | - Jiayu Fu
- Janssen Research & Development, LLC, Spring House, PA
| | - Huaibao Feng
- Janssen Research & Development, LLC, Spring House, PA
| | | | - Wendy Crist
- Janssen Research & Development, LLC, Spring House, PA
| | | | - Yael Cohen
- Department of Hematology, Tel-Aviv Sourasky (Ichilov) Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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18
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Zhang YY, Liu YH, Wu KL, Wu J, Zhao Y, Yao CY, Yang Q, Wang Y, Zhang L. [The clinical anatomy of the inferior thyroid arteries and veins and the safety of the modified tracheotomy]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2017; 31:1815-1818. [PMID: 29798394 DOI: 10.13201/j.issn.1001-1781.2017.23.009] [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] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Indexed: 11/12/2022]
Abstract
Objective:To evaluated the clinical anatomy of the inferior thyroid arteries and veins and the safety of clinical application of the modified tracheotomy. Method:Sixty patients who need partial resection or full resection of thyroid cancer and 50 patients with laryngeal or hypopharyngeal cancer required tracheotomy were enrolled in this study. The distribution of the inferior thyroid arteries and veins closely related to tracheotomy is further dissected. The inverted "U" type of tracheal flap tracheotomy was further improved based on anatomical findings. Finally, the further modified tracheotomy was used for clinical practice and compared with the conventional tracheotomy and the inverted "U" type of tracheal flap tracheotomy. Result:Of the 110 cases, the lowest thyroid artery was found in 11 cases, with a rate of 10%. The inferior thyroid vein has 2-4 branches, which originates from the lower lobe or isthmus of the thyroid lateral lobe, descending in the anterior tracheal space. According to the characteristics of the static reflux of the thyroid gland, the lower thyroid vessels are classified into four types: intravenous dry type (28 cases); intravenous double dry without traffic type (43 cases); intravenous double trunk with traffic (28 cases); mixed type (11 cases). At present, the further modified tracheotomy can effectively avoid the rebleeding of the lower thyroid arteries and veins. There were no bleeding and other complications in all cases. Conclusion:It provides a basis for the further modified of tracheotomy based on the clinical anatomy of the inferior thyroid artery and vein, which is closely related to tracheotomy. The further modified tracheotomy has certain advantages than the conventional tracheotomy and the inverted "U" type of tracheal flap tracheotomy.
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Affiliation(s)
- Y Y Zhang
- Department of Otolaryngology Head and Neck Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China
| | - Y H Liu
- Department of Otolaryngology Head and Neck Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China
| | - K L Wu
- Department of Otolaryngology Head and Neck Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China
| | - J Wu
- Department of Otolaryngology Head and Neck Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China
| | - Y Zhao
- Department of Otolaryngology Head and Neck Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China
| | - C Y Yao
- Department of Otolaryngology Head and Neck Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China
| | - Q Yang
- Department of Otolaryngology Head and Neck Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China
| | - Y Wang
- Department of Otolaryngology Head and Neck Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China
| | - L Zhang
- Department of Otolaryngology Head and Neck Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China
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Cai Q, Liu YH, Wu KL, Wu J, Zhao Y, Yao CY. [Preoperative airway management and perioperative period asphyxia prevention in patients with tumors invasion in the cervical tracheal]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2017; 31:1806-1809. [PMID: 29798392 DOI: 10.13201/j.issn.1001-1781.2017.23.007] [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] [Subscribe] [Scholar Register] [Received: 09/10/2017] [Indexed: 11/12/2022]
Abstract
Objective:To investigate the effect of preoperative airway treatment and postoperative asphyxiation preventive measures in patients with tumors invasion in the cervical tracheal. Method:The clinical date of 35 patients with different degree of tumors invasion in the cervical tracheal were analyzed retrospectively. Anesthesia including normal endotracheal intubation anesthesia, awake intubation anesthesia with visual laryngoscope assisted after topical anesthesia, intubation anesthesia with preoperative tracheotomy, intubation anesthesia after transection of trachea and anesthesia with extracoporeal circulation was selected according to the patient's situation such as whether exist forced position, or the extent of dyspnea, or the range of recurrent tumor. Preventive tracheotomy or fistulization was performed according to the patients' tracheal involvement and the choice of operation and general condition during the operation. Result:All 35 patients were successfully anesthetized, 17 of whom had no dyspnea or forced position, this kind patients were all anesthesia successfully, and 3 of them underwent prophylactic tracheotomy. Sixteen cases of nonrecurrent tumor with forced position, 15 patients were accepted awake anesthesia successfully with visual laryngoscope assisted after topical anesthesia, 1 patient who cannot be intubated or done tracheotomy is completed with extracorporeal circulation; prophylactic tracheotomy or tracheostomy was performed in this group. Of 2 cases of recurrent tumor with forced posture, preoperative tracheal intubation failed, 1 case was intubated after emergency transection of trachea, 1 case was successfully intubated by emergency tracheotomy before operation and 2 cases received postoperative tracheostomy. In this study, no serious complications such as massive bleeding, asphyxia and cardiovascular accident occurred after the operation. Conclusion:The preoperative airway management of patients whose tumors involves the cervical tracheal and whether tracheotomy or ostomy need to prevent asphyxia or not should be based on the nature of the tumor such as whether is recurrent, the extent of trachea involvement and whether to merge the OSAHS. Only by considering the various factors that affect the airway synthetically, an effective method can be adopted to ensure the safety of the operation.
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Affiliation(s)
- Q Cai
- Department of Otolaryngology Head and Neck Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China
| | - Y H Liu
- Department of Otolaryngology Head and Neck Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China
| | - K L Wu
- Department of Otolaryngology Head and Neck Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China
| | - J Wu
- Department of Otolaryngology Head and Neck Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China
| | - Y Zhao
- Department of Otolaryngology Head and Neck Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China
| | - C Y Yao
- Department of Otolaryngology Head and Neck Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China
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Zhang L, Liu YH, Wu KL, Wu J, Zhao Y, Yao CY, Yang Q, Zhang L, Wang Y. [A study of 16 cases on the island pectoralis major muscle flap in repair for the defects after the laryngeal function reserved operation of hypopharyngeal carcinoma]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2017; 31:1575-1578. [PMID: 29797953 DOI: 10.13201/j.issn.1001-1781.2017.20.008] [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] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Indexed: 11/12/2022]
Abstract
Objective:To explore the application about island pectoralis major muscle flap in repair for the defects after the laryngeal function reserved operation of hypopharyngeal carcinoma.Method:A retrospective analysis about 16 patients who underwent hypopharyngeal carcinoma surgery using pedicle island pectoralis major myocutaneous flap to repair, including 14 cases whose primary tumors located in the piriform fossa, and 2 cases in pharynx posterior wall.Result:All 16 cases' pectoralis major muscle flap survived, 2 of patient appeared to have a pharyngeal fistula, but recovered after transition. Of the 16 cases, 14 cases were removed the trachea tube in 1-3 months, 2 cases survive with tube, and all patients were satisfied with their appearance and the function. In 16 cases, 2 of them survived 3 and a half years, died of lung metastasis; 2 cases survived for four years, 1 died of local recurrence of tumor and another died of heart disease; 1 survived for four and a half years and died of lung metastasis; the remaining 11 cases were still in follow-up.Conclusion:The application in the surgical defect repair of pharyngeal carcinoma with pedicle island pectoralis major myocutaneous flap is safe and effective.
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Affiliation(s)
- L Zhang
- Department of Otolaryngology Head and Neck Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China
| | - Y H Liu
- Department of Otolaryngology Head and Neck Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China
| | - K L Wu
- Department of Otolaryngology Head and Neck Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China
| | - J Wu
- Department of Otolaryngology Head and Neck Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China
| | - Y Zhao
- Department of Otolaryngology Head and Neck Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China
| | - C Y Yao
- Department of Otolaryngology Head and Neck Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China
| | - Q Yang
- Department of Otolaryngology Head and Neck Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China
| | - L Zhang
- Department of Otolaryngology Head and Neck Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China
| | - Y Wang
- Department of Otolaryngology Head and Neck Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China
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Vojdeman FJ, Herman SEM, Kirkby N, Wiestner A, van T' Veer MB, Tjønnfjord GE, Itälä-Remes MA, Kimby E, Farooqui MZ, Polliack A, Wu KL, Doorduijn JK, Alemayehu WG, Wittebol S, Kozak T, Walewski J, Abrahamse-Testroote MCJ, van Oers MHJ, Geisler CH, Niemann CU. Soluble CD52 is an indicator of disease activity in chronic lymphocytic leukemia. Leuk Lymphoma 2017; 58:2356-2362. [PMID: 28278728 DOI: 10.1080/10428194.2017.1285027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [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: 10/20/2022]
Abstract
CD52 is a glycoprotein expressed on normal as well as leukemic immune cells and shed as soluble CD52 (sCD52). We studied sCD52 levels in three CLL cohorts: the 'early', the 'high-risk', and the 'ibrutinib-treated'. The 'high-risk' patients had significantly higher sCD52 levels than the 'early' patients. For the 'early' patients, high sCD52 levels were associated with a significantly shorter time to first treatment. Regarding prognostic factors, no clear correlations with stage, IGHV, or beta-2-microglobulin were found; in a cox multivariate analysis of the 'early' patients, sCD52 and IGHV both had independent prognostic value. Following chemo-immunotherapy, sCD52 decreased in parallel with leukocytes while during ibrutinib treatment and ibrutinib-induced ymphocytosis, sCD52 decreased along with lymph node reductions. In vitro IgM stimulation of CLL cells led to increased sCD52 levels in the medium. Our findings indicate that sCD52 reflects disease activity and potentially treatment efficacy in CLL.
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Affiliation(s)
- Fie J Vojdeman
- a Department of Hematology , Rigshospitalet , Copenhagen , Denmark.,b Department of Clinical Biochemistry , Bispebjerg-Frederiksberg Hospital , Copenhagen , Denmark
| | - Sarah E M Herman
- c Hematology Branch, National Heart, Lung, and Blood Institute , National Institutes of Health , Bethesda , MD , USA
| | - Nikolai Kirkby
- d Department of Microbiology , Rigshospitalet , Copenhagen , Denmark
| | - Adrian Wiestner
- c Hematology Branch, National Heart, Lung, and Blood Institute , National Institutes of Health , Bethesda , MD , USA
| | - Mars B van T' Veer
- e Department of Hematology , Leiden University Medical Centre , Leiden , The Netherlands
| | - Geir E Tjønnfjord
- f Department of Hematology , Oslo University Hospital and Institute of Clinical Medicine, University of Oslo , Oslo , Norway
| | - Maija A Itälä-Remes
- g Department of Hematology , Turku Central University Hospital , Turku , Finland
| | - Eva Kimby
- h Division of Hematology, Department of Medicine at Huddinge , Karolinska Institute , Stockholm , Sweden
| | - Mohammed Z Farooqui
- c Hematology Branch, National Heart, Lung, and Blood Institute , National Institutes of Health , Bethesda , MD , USA
| | - Aaron Polliack
- i Department of Hematology , Hadassah University Hospital, Hebrew University Medical School , Jerusalem , Israel
| | - Ka Lung Wu
- j Department of Hematology , Stuivenberg Hospital , Antwerpen , Belgium
| | - Jeanette K Doorduijn
- k Department of Hematology , Erasmus MC Cancer Center , Rotterdam , The Netherlands
| | | | - Shulamiet Wittebol
- m Department of Internal Medicine , Gelderse Vallei Hospital , Amersfoort , The Netherlands
| | - Tomas Kozak
- n Department of Clinical Hematology, Third Faculty of Medicine , Charles University Hospital Kralovske Vinohrady , Prague , Czech Republic
| | - Jan Walewski
- o Lymphoid Malignancies , Maria Sklodowska - Curie Memorial Institute and Oncology Centre , Warszawa , Poland
| | | | - Marinus H J van Oers
- p Department of Hematology , Academisch Medisch Centrum , Amsterdam , The Netherlands
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Vogl DT, Martin TG, Vij R, Hari P, Mikhael JR, Siegel D, Wu KL, Delforge M, Gasparetto C. Phase I/II study of the novel proteasome inhibitor delanzomib (CEP-18770) for relapsed and refractory multiple myeloma. Leuk Lymphoma 2017; 58:1872-1879. [DOI: 10.1080/10428194.2016.1263842] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Dan T. Vogl
- Abramson Cancer Center, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA
| | - Thomas G. Martin
- Adult Leukemia and Bone Marrow Transplantation Program, University of California San Francisco, San Francisco, CA, USA
| | - Ravi Vij
- Bone Marrow Transplantation and Leukemia Section, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Parameswaran Hari
- Adult Blood and Marrow Transplant Program, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Joseph R. Mikhael
- Division of Hematology and Medical Oncology, Mayo Clinic, Scottsdale, AZ, USA
| | - David Siegel
- John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ, USA
| | - Ka Lung Wu
- Department of Hematology, ZNA Stuivenberg, Antwerp, Belgium
| | - Michel Delforge
- Department of Hematology, University Hospital Leuven, Leuven, Belgium
| | - Cristina Gasparetto
- Division of Medicine–Cell Therapy and Hematologica, Duke University Medical Center, Durham, NC, USA
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Wu J, Liu YH, Wu KL, Li XH, Gao CB, Zhao Y. [Lymphadenectomy using dissection and protection of carotid sheath and main nerves in surgery for benign diseases in the neck]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2017; 52:53-56. [PMID: 28104017 DOI: 10.3760/cma.j.issn.1673-0860.2017.01.010] [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] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the significance of lymphadenectomy using dissection and protection of carotid sheath and main nerves in treating complex benign disease of neck. Methods: A total of 54 cases with benign diseases in neck who received the protective surgical treatments were reviewed. There were 25 cases of recurrent branchial fistula, 15 cases of lymphoid tuberculosis, 5 cases of cystic hygroma, 5 cases of racemose angioma, and 4 cases of Madelung's disease. According to the location and extent of disease, all cases received operation with dissection and protection of carotid sheath and main nerves to removal lesions with lymphoid tissue and fat-connective tissue. Results: All cases recovered well, and no recurrence occurred with follow-up of 3 to 65 months. There was no other complication except for occurring of Horner syndrome in 1 patient. Conclusion: The protective surgical method has certain application value in the treatment of benign neck diseases that have no indefinite boundary and widely distribute.
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Affiliation(s)
- J Wu
- Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - Y H Liu
- Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - K L Wu
- Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - X H Li
- Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - C B Gao
- Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - Y Zhao
- Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
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Wang Q, Liu YH, Wu KL, Gao CB, Zhao Y, Wu J, Zhang L, Yao CY, Yang Q. [The application of high tracheotomy in forced posture]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2017; 31:74-76. [PMID: 29774692 DOI: 10.13201/j.issn.1001-1781.2017.01.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Subscribe] [Scholar Register] [Received: 08/28/2016] [Indexed: 11/12/2022]
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Xuan XJ, Xu C, Zhao YR, Wu KL, Chen T, Zhang HB, Li X, Su SZ, Ma G, Tang R, Sheng Y, Ma JL. [Application of spontaneous acrosome reaction of sperm in prediction of outcome of in-vitro fertilization and embryo transfer]. Zhonghua Yi Xue Za Zhi 2016; 96:1285-8. [PMID: 27122463 DOI: 10.3760/cma.j.issn.0376-2491.2016.16.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To investigate the clinical application of spontaneous acrosome reaction (AR) rate of sperm in predicting the outcome of in-vitro fertilization and embryo transfer (IVF-ET). METHODS The spontaneous AR rate of the sperm of patients who underwent IVF-ET treatment in our center during the period from November to December 2014 were studied. The cut-off value from 6% to 12% were set and analyzed its association between the IVF-ET outcomes (including fertility rates, normal fertilization rates and high-quality embryo rates). For those who underwent fresh embryo transplantation, the rates of chemical pregnancy and clinical pregnancy were calculated, and compared the spontaneous AR rates and quantity of acrosomal enzyme according to the pregnancy outcome. RESULTS There were 202 patients in this study and the mean spontaneous AR rate was 5.99%±5.18%. For patients with the spontaneous AR rate ≥9% versus <9%, the fertility rate, normal fertilization rate and high-quality embryo rate were 81.33% vs 83.85%, 60.53% vs 60.99%, and 51.10% vs 59.67%, respectively, with statistically significant difference in the high-quality embryo rate (P=0.02). For patients who underwent fresh embryo transplantation, when comparison was made between those with spontaneous AR rate ≥8% and those <8%, the rate of chemical pregnancy and clinical pregnancy were 48.57% (17/35) vs 69.64% (78/112) and 37.14% (13/35) vs 63.39% (71/112), respectively, both with statistically significant difference (P=0.02 and P<0.01). The patients with clinical pregnancy had lower spontaneous AR rate than those without clinical pregnancy (5.41%±3.87% vs 7.40%±6.79%, P=0.04), while the quantity of acrosomal enzyme showed no significant difference [(131.79±68.50) vs (153.62±59.59) μU/10(6,) P=0.06]. Logistic regression analysis demonstrated association between spontaneous AR rates and clinical pregnancy (OR=0.93, 95%CI: 0.87-0.99, P=0.03). CONCLUSIONS The spontaneous AR rate of sperm may have clinical significance in predicting the outcome of IVF-ET, as it is reversely correlated with IVF high-quality embryo rate and pregnancy rate. The quantity of acrosomal enzyme may not have significant predictive value for the outcome of IVF.
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Affiliation(s)
- X J Xuan
- Department of Urology and Andrology, Reproductive Hospital Affiliated to Shandong University, Jinan 250021, China
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Wu J, Wu KL, Liu YH. [Repeated carotid blowout's rescue experience of a postoperative patient with hypopharyngeal carcinoma]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2016; 51:846-849. [PMID: 27938612 DOI: 10.3760/cma.j.issn.1673-0860.2016.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- J Wu
- Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - K L Wu
- Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - Y H Liu
- Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
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Jiang MY, Liu YH, Gao CB, Wu KL, Zhao Y, Wu J, Tong BS, Li YF, Wang Y. [Safety analysis of head and neck surgery for short-necked obese patients accompanied by sleep-disordered breathing]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2016; 30:1246-1248. [PMID: 29798341 DOI: 10.13201/j.issn.1001-1781.2016.15.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Indexed: 11/12/2022]
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28
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Wu J, Liu YH, Wu KL, Zhao Y, Tong BS, Gao CB, Li YF, Wang Y. [Different treatments of maxillary and mandible in management of para-pharynx and cranial base surgery]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2016; 30:911-914. [PMID: 29797941 DOI: 10.13201/j.issn.1001-1781.2016.11.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Indexed: 11/12/2022]
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Cavo M, Palumbo A, Zweegman S, Dimopoulos MA, Hajek R, Pantani L, Beksac M, Wester R, Johnsen HE, Mellqvist UH, Petrucci MT, Driessen C, Di Raimondo F, Troia R, Pezzi A, van der Holt B, Wu KL, Ludwig H, Gay F, Sonneveld P. Upfront autologous stem cell transplantation (ASCT) versus novel agent-based therapy for multiple myeloma (MM): A randomized phase 3 study of the European Myeloma Network (EMN02/HO95 MM trial). J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.8000] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [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)
- Michele Cavo
- Seràgnoli Institute of Hematology, Bologna University School of Medicine, Bologna, Italy
| | - Antonio Palumbo
- Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliera Citta' della Salute e della Scienza di Torino, Torino, Italy
| | - Sonja Zweegman
- Department of Hematology, VU University Medical Center, Amsterdam, Netherlands
| | | | - Roman Hajek
- Masaryk University Hospital, Brno, Czech Republic
| | - Lucia Pantani
- Seràgnoli Institute of Hematology, Bologna University School of Medicine, Bologna, Italy
| | - Meral Beksac
- Ankara Universitesi Tip Fakultesi, Ankara, Turkey
| | - Ruth Wester
- Erasmus Medical Center, Department of Hematology, Rotterdam, Netherlands
| | - Hans E. Johnsen
- Department of Hematology, Clinical Cancer Research Center, Aalborg University Hospital, Aalborg, Denmark
| | | | | | | | | | - Rossella Troia
- Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliera Citta' della Salute e della Scienza di Torino, Torino, Italy
| | - Annalisa Pezzi
- Seràgnoli Institute of Hematology, Bologna University School of Medicine, Bologna, Italy
| | - Bronno van der Holt
- HOVON Data Center, Erasmus MC Cancer Institute-Clinical Trial Center, Rotterdam, Netherlands
| | - Ka Lung Wu
- ZNA Stuivenberg, Department of Hematology, Antwerp, Belgium
| | - Heinz Ludwig
- Wilhelminen Cancer Research Institute, Wilhelminenspital, Department of Medicine, Center of Oncology, Hematology and Palliative Care, Vienna, Austria
| | - Francesca Gay
- Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliera Citta' della Salute e della Scienza di Torino, Torino, Italy
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Lonial S, Dimopoulos M, Palumbo A, White D, Grosicki S, Spicka I, Walter-Croneck A, Moreau P, Mateos MV, Magen H, Belch A, Reece D, Beksac M, Spencer A, Oakervee H, Orlowski RZ, Taniwaki M, Röllig C, Einsele H, Wu KL, Singhal A, San-Miguel J, Matsumoto M, Katz J, Bleickardt E, Poulart V, Anderson KC, Richardson P. Elotuzumab Therapy for Relapsed or Refractory Multiple Myeloma. N Engl J Med 2015; 373:621-31. [PMID: 26035255 DOI: 10.1056/nejmoa1505654] [Citation(s) in RCA: 988] [Impact Index Per Article: 109.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Elotuzumab, an immunostimulatory monoclonal antibody targeting signaling lymphocytic activation molecule F7 (SLAMF7), showed activity in combination with lenalidomide and dexamethasone in a phase 1b-2 study in patients with relapsed or refractory multiple myeloma. METHODS In this phase 3 study, we randomly assigned patients to receive either elotuzumab plus lenalidomide and dexamethasone (elotuzumab group) or lenalidomide and dexamethasone alone (control group). Coprimary end points were progression-free survival and the overall response rate. Final results for the coprimary end points are reported on the basis of a planned interim analysis of progression-free survival. RESULTS Overall, 321 patients were assigned to the elotuzumab group and 325 to the control group. After a median follow-up of 24.5 months, the rate of progression-free survival at 1 year in the elotuzumab group was 68%, as compared with 57% in the control group; at 2 years, the rates were 41% and 27%, respectively. Median progression-free survival in the elotuzumab group was 19.4 months, versus 14.9 months in the control group (hazard ratio for progression or death in the elotuzumab group, 0.70; 95% confidence interval, 0.57 to 0.85; P<0.001). The overall response rate in the elotuzumab group was 79%, versus 66% in the control group (P<0.001). Common grade 3 or 4 adverse events in the two groups were lymphocytopenia, neutropenia, fatigue, and pneumonia. Infusion reactions occurred in 33 patients (10%) in the elotuzumab group and were grade 1 or 2 in 29 patients. CONCLUSIONS Patients with relapsed or refractory multiple myeloma who received a combination of elotuzumab, lenalidomide, and dexamethasone had a significant relative reduction of 30% in the risk of disease progression or death. (Funded by Bristol-Myers Squibb and AbbVie Biotherapeutics; ELOQUENT-2 ClinicalTrials.gov number, NCT01239797.).
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Affiliation(s)
- Sagar Lonial
- From Winship Cancer Institute, Emory University School of Medicine, Atlanta (S.L.); National and Kapodistrian University of Athens, Athens (M.D.); A.O.U. San Giovanni Battista di Torino-Ospedale Molinette, Turin, Italy (A.P.); QEII Health Science Center and Dalhousie University, Halifax, NS (D.W.), Cross Cancer Institute and University of Alberta, Edmonton (A.B.), and Princess Margaret Cancer Centre, Toronto (D.R.) - all in Canada; Silesian Medical University, Katowice (S.G.), and Medical University of Lublin, Lublin (A.W.-C.) - both in Poland; Charles University Hospital, Prague, Czech Republic (I.S.); University Hospital, Nantes, France (P.M.); Complejo Asistencial Universitario de Salamanca-Instituto de Investigación Biomédica de Salamanca, Salamanca (M.-V.M.), and Clinica Universidad de Navarra-Centro de Investigación Médica Aplicada, Instituto de Investigación Sanitaria de Navarra, Pamplona (J.S.-M.) - both in Spain; Davidoff Cancer Center, Rabin Medical Center, Petah Tikva, and Tel Aviv University, Ramat Aviv - both in Israel (H.M.); Ankara University, Ankara, Turkey (M.B.); Alfred Health-Monash University, Melbourne, VIC, Australia (A. Spencer); Barts and the London NHS Trust, London (H.O.); University of Texas M.D. Anderson Cancer Center, Houston (R.Z.O.); Kyoto Prefectural University of Medicine, Kyoto (M.T.), and Nishigunma National Hospital, Shibukawa (M.M.) - both in Japan; Universitätsklinikum der Technische Universität, Dresden (C.R.), and Universitätsklinikum Würzburg, Würzburg (H.E.) - both in Germany; Zeikenhuis Netwerk Antwerpen (ZNA) Stuivenberg, Antwerp, Belgium (K.L.W.); AbbVie Biotherapeutics, Redwood City, CA (A. Singhal); Bristol-Myers Squibb, Princeton, NJ (J.K.), Wallingford, CT (E.B.), and Braine-l'Alleud, Belgium (V.P.); and Dana-Farber Cancer Institute, Boston (K.C.A., P.R.)
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Chiang WY, Wu MH, Wu KL, Lin MH, Teng HH, Tsai YF, Ko CC, Yang EC, Jiang JA, Barnett LR, Chu KR. A microwave applicator for uniform irradiation by circularly polarized waves in an anechoic chamber. Rev Sci Instrum 2014; 85:084703. [PMID: 25173291 DOI: 10.1063/1.4891616] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Microwave applicators are widely employed for materials heating in scientific research and industrial applications, such as food processing, wood drying, ceramic sintering, chemical synthesis, waste treatment, and insect control. For the majority of microwave applicators, materials are heated in the standing waves of a resonant cavity, which can be highly efficient in energy consumption, but often lacks the field uniformity and controllability required for a scientific study. Here, we report a microwave applicator for rapid heating of small samples by highly uniform irradiation. It features an anechoic chamber, a 24-GHz microwave source, and a linear-to-circular polarization converter. With a rather low energy efficiency, such an applicator functions mainly as a research tool. This paper discusses the significance of its special features and describes the structure, in situ diagnostic tools, calculated and measured field patterns, and a preliminary heating test of the overall system.
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Affiliation(s)
- W Y Chiang
- Department of Physics, National Taiwan University, Taipei, Taiwan
| | - M H Wu
- Department of Physics, National Taiwan University, Taipei, Taiwan
| | - K L Wu
- Department of Physics, National Taiwan University, Taipei, Taiwan
| | - M H Lin
- Department of Physics, National Taiwan University, Taipei, Taiwan
| | - H H Teng
- Department of Physics, National Taiwan University, Taipei, Taiwan
| | - Y F Tsai
- Department of Entomology, National Taiwan University, Taipei, Taiwan
| | - C C Ko
- Department of Entomology, National Taiwan University, Taipei, Taiwan
| | - E C Yang
- Department of Entomology, National Taiwan University, Taipei, Taiwan
| | - J A Jiang
- Department of Bio-Industrial Mechatronics Engineering, National Taiwan University, Taipei, Taiwan
| | - L R Barnett
- Department of Physics, National Taiwan University, Taipei, Taiwan
| | - K R Chu
- Department of Physics, National Taiwan University, Taipei, Taiwan
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Thomas SK, Suvorov A, Noens L, Rukavitsin O, Fay J, Wu KL, Zimmerman TM, van de Velde H, Bandekar R, Puchalski TA, Qi M, Uhlar C, Samoylova OS. Evaluation of the QTc prolongation potential of a monoclonal antibody, siltuximab, in patients with monoclonal gammopathy of undetermined significance, smoldering multiple myeloma, or low-volume multiple myeloma. Cancer Chemother Pharmacol 2014; 73:35-42. [PMID: 24149943 DOI: 10.1007/s00280-013-2314-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Accepted: 10/03/2013] [Indexed: 02/03/2023]
Abstract
PURPOSE A phase 1 study evaluated the QTc prolongation potential of siltuximab, a chimeric, anti-interleukin-6 mAb, in patients with monoclonal gammopathy of undetermined significance (MGUS), smoldering multiple myeloma (SMM), or low-volume MM. METHODS Patients with baseline QTcF and QTcB ≤ 500 ms, QRS < 100 ms, PR < 200 ms and no significant cardiac disease received siltuximab 15 mg/kg q3w, the highest dosage used in clinical studies, for 4 cycles. Twelve-lead ECGs obtained at multiple time points pre- and post-infusion at cycles 1 and 4 were evaluated by central cardiology laboratory. No effect on QTc interval was concluded if the upper limit of least square (LS) mean 90 % CI for QTc change from baseline at each time point was <20 ms. RESULTS An effect on QTc prolongation was ruled out, as the upper bound of 90 % CI was <10 ms at each time point in 27 evaluable patients (13 MGUS, 13 SMM, 1 low-volume MM) with no differences between disease types. Maximum mean QTc increase from baseline occurred 3 h after cycle 1 infusion (QTcF = 3.2 [LS mean 90 % CI -0.01, 6.45] ms; QTcB = 2.7 [-0.69, 6.14] ms). At all other time points, mean QTcF and QTcB increase from baseline was ≤1.5 ms and upper bound 90 % CI was ≤5.1 ms. Twenty patients had mostly low-grade AEs, including nausea, fatigue (20 % each); thrombocytopenia, headache (each 13 %); dyspnea, leukopenia, neutropenia, paresthesia, abnormal hepatic function, URTI (each 10 %). Three MGUS patients achieved 50 % M-protein reduction. There was no association between siltuximab pharmacokinetics and QTc interval. CONCLUSIONS Siltuximab did not affect the QTc interval. Overall safety was similar to other single-agent siltuximab studies.
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Affiliation(s)
- Sheeba K Thomas
- Division of Cancer Medicine, Department of Lymphoma/Myeloma, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd., Unit 0429, Houston, TX, 77030, USA,
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Caers J, Vekemans MC, Bries G, Beel K, Delrieu V, Deweweire A, Demuynck H, De Prijck B, De Samblanx H, Kentos A, Meuleman N, Mineur P, Offner F, Vande Broek I, Van Droogenbroeck J, Vande Velde A, Wu KL, Delforge M, Schots R, Doyen C. Diagnosis and follow-up of monoclonal gammopathies of undetermined significance; information for referring physicians. Ann Med 2013; 45:413-22. [PMID: 23767978 DOI: 10.3109/07853890.2013.801562] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The prevalence of monoclonal gammopathy of undetermined significance (MGUS) is generally estimated at 3.4% in the general population over 50 years, and its incidence increases with age. MGUS represents a preneoplastic entity that can transform into multiple myeloma or other lymphoproliferative disorders. The risk of malignant transformation is estimated at 1% per year and persists over time. Predictors of malignant transformation have been identified such as the heavy chain isotype, The level of monoclonal proteins, increasing levels of the monoclonal component during the first years off follow-up, the percentage of bone marrow plasmocytosis, the dosage of serum free light chains, the presence of immunophenotypically abnormal plasma cells, aneuploidy, and the presence of circulating plasma cells. Prognostic scores that combine certain of these factors have been proposed and allow the identification of high-risk patients. Their use could assist in tailoring the care for each patient, based on his/her risk profile.
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Coiffier B, Radford J, Bosly A, Martinelli G, Barca G, Davies A, Decaudin D, Gallop-Evans E, Padmanabhan-Iyer S, Van Eygen K, Wu KL, Gupta IV, Lin TS, Goldstein N, Jewell RC, Winter P, Lisby S. A multicentre, phase II trial of ofatumumab monotherapy in relapsed/progressive diffuse large B-cell lymphoma. Br J Haematol 2013; 163:334-42. [DOI: 10.1111/bjh.12537] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Accepted: 07/05/2013] [Indexed: 01/13/2023]
Affiliation(s)
| | - John Radford
- The Christie NHS Foundation Trust and The University of Manchester; Manchester; UK
| | - André Bosly
- Service d'Hématologie; Clinique Universitaires UCL de Mont-Godinne; Yvoir; Belgium
| | | | - Gabriela Barca
- Department of Hematology; Coltea Clinical Hospital; Bucharest; Romania
| | - Andrew Davies
- Cancer Research UK Centre; University of Southampton; Southampton; UK
| | - Didier Decaudin
- Departments of Medical Oncology and Translational Research; Institut Curie; Paris; France
| | - Eve Gallop-Evans
- Department of Clinical Oncology; Velindre Cancer Centre; Cardiff; UK
| | | | | | - Ka Lung Wu
- Department of Hematology; Ziekenhuis Stuivenberg; Antwerpen; Belgium
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Lee JKT, Tsui KL, Cheung CY, Chau CH, Chan HL, Wu KL, Cheung GSH, Choi MC, Chan KK, Li SK. Aspirin desensitisation for Chinese patients with coronary artery disease. Hong Kong Med J 2013; 19:207-13. [PMID: 23650199 DOI: 10.12809/hkmj133914] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE. To assess the efficacy and safety of aspirin desensitisation in Chinese patients with coronary artery disease. DESIGN. Case series. SETTING. A regional hospital in Hong Kong. PATIENTS. Chinese patients with coronary artery disease and a history of a hypersensitivity reaction to aspirin or non-steroidal anti-inflammatory drug, who underwent aspirin desensitisation between February 2008 and July 2012. RESULTS. There were 24 Chinese patients with coronary artery disease who were admitted to our unit for aspirin desensitisation during this period. The majority (79%) were clinical admissions for desensitisation; eight (33%) of them developed a hypersensitivity reaction during desensitisation. Half of the latter had only limited cutaneous reactions and were able to complete the desensitisation protocol and developed aspirin tolerance. Overall, 20 (83%) of the patients were successfully desensitised at the initial attempt. No serious adverse reactions occurred in the cohort. Twelve of the patients had significant coronary artery disease revealed by coronary angiography and received a percutaneous coronary intervention, nine of whom received drug-eluting stents while three received bare metal stents due to financial constraints. All 11 successfully desensitised patients received aspirin and clopidogrel as double antiplatelet therapy after percutaneous coronary intervention. The remaining patient had a bare metal stent implant due to failed aspirin desensitisation. CONCLUSION. Given the potentially different genetic basis of aspirin hypersensitivity in different ethnicities, recourse to desensitisation in the Chinese population has not previously been addressed. This study demonstrated that aspirin desensitisation using a rapid protocol can be performed effectively and safely in Chinese patients. Our results were comparable to those in other reported studies involving other ethnicities. Successful aspirin desensitisation permits patients to pursue long-term double antiplatelet therapy that includes aspirin after percutaneous coronary intervention, and thus allows the use of drug-eluting stents as a feasible option.
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Affiliation(s)
- Joe K T Lee
- Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong
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Wu KL, Tsui KL, Lee KT, Chau CH, Chan HL, Cheung SH, Cheung CY, Choi MC, Chan KK, Li SK. Reperfusion strategy for ST-segment elevation myocardial infarction: trend over a 10-year period. Hong Kong Med J 2012; 18:276-283. [PMID: 22865170] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
OBJECTIVES. To review the 10-year trend of reperfusion strategies in patients with ST-segment elevation myocardial infarction, and the adoption rate of percutaneous coronary interventions as opposed to thrombolytic therapy. Also to explore why some patients did not receive reperfusion therapy, and document changes in reperfusion strategies after the introduction of primary percutaneous coronary intervention programmes. DESIGN. Case series. SETTING. A regional hospital, Hong Kong. PATIENTS. All patients with ST-segment elevation myocardial infarction from January 2000 to December 2009. RESULTS. There were 1835 patients with ST-segment elevation myocardial infarction in that period, of which 1179 (64.3%) received reperfusion therapy (thrombolytic therapy, 46.0%; primary percutaneous coronary intervention, 17.5%; emergency coronary artery bypass graft, 0.7%). After introduction of the primary percutaneous coronary intervention programme, significantly more ST-segment elevation myocardial infarction cases underwent that particular intervention (1.6% in 2000 increasing to 30.6% in 2009), while the proportion receiving thrombolytic therapy declined (57.4% in 2000 decreasing to 35.0% in 2009). Seven reasons for no reperfusion therapy were identified. The commonest ones were delayed presentation (45.1%), succumbed before reperfusion (16.0%), multiple medical co-morbidities (15.2%), and contra-indication to thrombolytic therapy (14.8%). The proportion without reperfusion therapy due to a contra-indication to thrombolytic therapy declined (22.7% in 2000 decreasing to 4.9% to 2009), whilst an increasing proportion received primary percutaneous coronary interventions. CONCLUSIONS. Primary percutaneous coronary intervention is increasingly used as the reperfusion therapy in ST-segment elevation myocardial infarction and is replacing thrombolytic therapy, though the latter still remains a mainstay of therapy. A significant proportion of ST-segment elevation myocardial infarction cases received no reperfusion due to various reasons.
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Affiliation(s)
- K L Wu
- Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong.
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37
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Delforge M, Michiels A, Doyen C, Kentos A, Van Droogenbroeck J, Offner F, Bries G, Demuynck H, Vekemans MC, Meuleman N, Mineur PO, Ravoet C, Depryck B, Van de Velde A, Pierre P, Wu KL, Schots R. Lenalidomide in relapsed refractory myeloma patients: impact of previous response to bortezomib and thalidomide on treatment efficacy. Results of a medical need program in Belgium. Acta Clin Belg 2011; 66:371-375. [PMID: 22145272 DOI: 10.2143/acb.66.5.2062589] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The prognosis of multiple myeloma patients has significantly improved since the introduction of the novel agents thalidomide, bortezomib and lenalidomide. We report the data of a medical need programme with lenalidomide plus dexamethasone, conducted in Belgium between August 2007 and March 2008, and including 98 relapsed refractory multiple myeloma patients. In addition to chemotherapy and steroids, all patients had received prior treatment with bortezomib, and 84% of them had been exposed to thalidomide. In 52 patients response data could be retrieved by post-hoc analysis. A partial remission or better was achieved in 52% (49% partial and 3% complete response) of patients, despite a median of 5 previous anti-myeloma treatment lines. Responses were rapid while the majority of patients received lenalidomide with once weekly (also called low-dose) dexamethasone. Treatment with lenalidomide plus dexamethasone did prolong overall survival by nearly half a year in this population with end-stage myeloma. Overall response and quality of response were independent of previous response to thalidomide and bortezomib, although the time to progression tended to be shorter in thalidomide- and bortezomib-refractory patients. It can be concluded that lenalidomide plus dexamethasone is an effective and safe treatment regimen in highly refractory multiple myeloma patients, and that these responses are irrespective of previous exposure or sensitivity to thalidomide and bortezomib.
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Affiliation(s)
- M Delforge
- Afdeling Hematologie, UZ Gasthuisberg, Leuven.
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Dimopoulos MA, Mateos MV, Richardson PG, Schlag R, Khuageva NK, Shpilberg O, Kropff M, Spicka I, Palumbo A, Wu KL, Esseltine DL, Liu K, Deraedt W, Cakana A, Van De Velde H, San Miguel JF. Risk factors for, and reversibility of, peripheral neuropathy associated with bortezomib-melphalan-prednisone in newly diagnosed patients with multiple myeloma: subanalysis of the phase 3 VISTA study. Eur J Haematol 2010; 86:23-31. [DOI: 10.1111/j.1600-0609.2010.01533.x] [Citation(s) in RCA: 105] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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39
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Cheung GSH, Tsui KL, Lau CC, Chan HL, Chau CH, Wu KL, Cheung CY, Choi MC, Tse TS, Chan KK, Li SK. Primary percutaneous coronary intervention for ST elevation myocardial infarction: performance with focus on timeliness of treatment. Hong Kong Med J 2010; 16:347-353. [PMID: 20889998] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
OBJECTIVE To review primary percutaneous coronary interventions performed for patients with ST elevation myocardial infarction with a focus on door-to-treatment time, especially after introduction of a new management programme in November 2003. DESIGN Retrospective study. SETTING Regional hospital, Hong Kong. PATIENTS All patients with ST elevation myocardial infarction who underwent primary percutaneous coronary intervention in our hospital from January 2002 to December 2007. RESULTS In all, 209 patients with ST elevation myocardial infarction had primary percutaneous coronary interventions between January 2002 and December 2007; 140 of them were admitted within office hours, 125 of whom came directly from Accident and Emergency Department. The mean door-to-balloon time of these patients was 115 minutes, and in 41% the time was less than 90 minutes (as recommended by the American College of Cardiology/American Heart Association guidelines). Since introduction of the new programme, the mean door-to-balloon time has diminished significantly, from 146 to 116 minutes (P=0.047). Delay in diagnosis (28%) and Cardiac Catheterization Laboratory being occupied (20%) were the two most common reasons for prolonged door-to-balloon times. CONCLUSION We achieved satisfactory performance in our primary percutaneous coronary intervention programme, providing timely reperfusion therapy for patients with ST elevation myocardial infarction. A well-organised and systematic clinical pathway is a prerequisite for a centre that provides a timely and effective primary percutaneous coronary intervention service for patients with ST elevation myocardial infarction. Better public education and greater awareness on the part of medical service providers are needed, so as to facilitate urgent revascularisation and improve outcomes in patients with ST elevation myocardial infarction.
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Affiliation(s)
- Gary S H Cheung
- Department of Medicine, Pamela Youde Nethersole Eastern Hospital, 3 Lok Man Road, Chai Wan, Hong Kong.
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40
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Li X, Cai JF, Guo YD, Wu KL, Wang JF, Liu QL, Wang XH, Chang YF, Yang L, Lan LM, Zhong M, Wang X, Song C, Liu Y, Li JB, Dai ZH. The availability of 16S rRNA for the identification of forensically important flies (Diptera: Muscidae) in China. Trop Biomed 2010; 27:155-166. [PMID: 20962711] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Many species of Muscidae are cosmopolitan synanthropic insects. It is frequently found on dead bodies after death, so an accurate identification of each species is necessary for the correct estimation of the postmortem interval (PMI). Identification species of Muscidae is traditionally performed through their morphological features. However, the morphological similarity of Muscidae in the level of species usually poses a challenge for forensic entomologists. Therefore a molecular method used 16S rRNA sequence on mitochondrial DNA was established for species identification. In this study, a 289 base pair region of mitochondrial DNA (mtDNA) coding for 16S rRNA was investigated for identification of the following forensically important species of Muscidae. The specimens were from four genera, including 18 Musca domestica (Linnaeus, 1758), 2 Ophyra spinigera (Stein, 1910), 2 Ophyra chalcogaster (Wiedemann, 1824), 1 Morellia hortorum (Fallén, 1817), and 1 Fannia canicularis (Linnaeus, 1761). 16S rDNA region allowed the identification of these species of Muscidae, indicating the possibility of separation congeneric species with molecular method.
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Affiliation(s)
- X Li
- Department of Forensic Science, School of Basic Medical Sciences, Central South University, and Medical Psychological Research Center, Second Xiang-Ya Hospital of Central South University, Changsha 410013, Hunan, China
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41
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Schots R, Delforge M, André M, Bries G, Caers J, Demuynck H, De Prijck B, De Samblanx H, Kentos A, Meuleman N, Offner F, Vekemans MC, Vande Broek I, Van Droogenbroeck J, Van de Vanelde A, Wu KL, Doyen C. The Belgian 2010 consensus recommendations for the treatment of multiple myeloma. Acta Clin Belg 2010; 65:252-64. [PMID: 20954465 DOI: 10.1179/acb.2010.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Since the introduction of novel therapeutic agents including thalidomide, lenalidomide and bortezomib, the prognosis of multiple myeloma (MM) has significantly improved. These agents have been incorporated into numerous treatment schedules for newly diagnosed as well as more advanced MM patients. Hence, the therapeutic options for MM have become more complex and subject to rapid changes. The multiple myeloma study group (MMSG) of the Belgian Hematological Society has established recommendations for the treatment of MM as based on an extensive review of the literature which is also summarized in this paper. The recommendations are the result of a consensus opinion between haematologists with experience in the field and representing most haematology centres in Belgium. Where applicable, reimbursement criteria are also taken into account. The consensus recommendations should be a reference for use by clinical haematologists in daily practice.
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Lv H, Wang JC, Wu KL, Gao X, Wang LC, You L, Chen ZJ. Numb regulates meiotic spindle organisation in mouse oocytes. Reprod Fertil Dev 2010; 22:664-72. [PMID: 20353726 DOI: 10.1071/rd09236] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2009] [Accepted: 10/12/2009] [Indexed: 11/23/2022] Open
Abstract
Numb is an adaptor protein that controls the fate of cells in different species through asymmetrical inheritance by sibling cells during division. It has been investigated extensively in mitosis, mostly in neural progenitor cells, but its function in meiosis remains unknown. The present study was designed to investigate the expression, subcellular localisation and functional roles of Numb during mouse oocyte meiotic maturation. Using real-time polymerase chain reaction and western blotting, we found that the expression of Numb increased from the germinal vesicle (GV) to MII stages. Immunofluorescent staining revealed that Numb was mainly concentrated in the GV before meiosis resumption, aggregated in the vicinity of the chromosomes after GV breakdown and then localised to the spindle poles from prometaphase I to MII. Nocodazole treatment resulted in spindle destruction and Numb diffusion into the cytoplasm. However, Numb appeared at the spindle poles again once the spindles had formed when nocodazole-treated oocytes were washed and cultured for spindle recovery. Depletion of Numb by RNA interference resulted in chromosome misalignment, spindle deformation and even doubled spindle formation. Our results suggest that Numb is critical for spindle organisation during mouse oocytes meiosis. The present study provides evidence of a new function for Numb in addition to its action as a cell fate-determining factor.
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Affiliation(s)
- H Lv
- Center for Reproductive Medicine, Provincial Hospital Affiliated to Shandong University, Key Laboratory of Reproductive Medicine, Shandong Province, Jinan 250021, China
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Abstract
The present work is devoted to extracting the energy or enthalpy distribution function of a physical system from the moments of the distribution using the maximum entropy method. This distribution theory has the salient traits that it utilizes only the experimental thermodynamic data. The calculated distribution functions provide invaluable insight into the state or phase behavior of the physical systems under study. As concrete evidence, we demonstrate the elegance of the distribution theory by studying first a test case of a two-dimensional six-state Potts model for which simulation results are available for comparison, then the biphasic behavior of the binary alloy Na-K whose excess heat capacity, experimentally observed to fall in a narrow temperature range, has yet to be clarified theoretically, and finally, the thermally induced state behavior of a collection of 16 proteins.
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Affiliation(s)
- K L Wu
- Complex Liquids Laboratory, Department of Physics, National Central University, Chungli 320, Taiwan
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Wu KL, Beverloo B, Lokhorst HM, Segeren CM, van der Holt B, Steijaert MM, Westveer PH, Poddighe PJ, Verhoef GE, Sonneveld P. Abnormalities of chromosome 1p/q are highly associated with chromosome 13/13q deletions and are an adverse prognostic factor for the outcome of high-dose chemotherapy in patients with multiple myeloma. Br J Haematol 2007; 136:615-23. [PMID: 17223915 DOI: 10.1111/j.1365-2141.2006.06481.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The prognostic value of chromosomal abnormalities was studied in untreated multiple myeloma patients who were registered into a prospective randomised multicentre phase 3 study for intensified treatment (HOVON24). A total of 453 patients aged less than 66 years with stage II and III A/B disease were registered in the clinical study. Cytogenetic analysis was introduced as a standard diagnostic assay in 1998. It was performed at diagnosis in 160 patients and was successful in 137/160 patients (86%). An abnormal karyotype was observed in 53/137 (39%) of the patients. Abnormalities of chromosome 1p and 1q were found in 19 (36% of patients with an abnormal karyotype) and 21 patients (40%). There was a strong association between chromosome 1p and/or 1q abnormalities and deletion of chromosome 13 or 13q (n = 27, P < 0.001). Patients with karyotypic abnormalities had a significantly shorter overall survival (OS) than patients with normal karyotypes. Complex abnormalities, hypodiploidy, chromosome 1p abnormalities, chromosome 1q abnormalities, and chromosome 13 abnormalities were associated with inferior OS on univariate analysis, as well as after adjustment for other prognostic factors. In conclusion, chromosome 13 abnormalities and chromosome 1p and/or 1q abnormalities were highly associated, and are risk factors for poor outcome after intensive therapy in multiple myeloma.
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Affiliation(s)
- Ka Lung Wu
- Erasmus MC, Department of Haematology, Rotterdam, the Netherlands
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45
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Abstract
Recent experimental studies [Z. Wu, B. Zhou, Z.B. Hu, Phys. Rev. Lett. 90 (2003) 048304] on an uncharged aqueous poly-N-isopropylacrylamide (PNIPAM) dispersion have shown that this microgel system is sensitive to temperature. This system was also experimentally found to be modeled quite well by microgel particles interacting via a hard-sphere repulsive plus an inverse power (temperature-dependent) attractive potential. To understand theoretically this thermally responsive PNIPAM dispersion, we apply a novel approach [G.F. Wang, S.K. Lai, Phys. Rev. E 70 (2004) 051402] to calculate its thermodynamic phase diagram. Differing from the conventional method in which the boundaries of the coexisting phases are the ultimate target, the present work places emphasis on crosshatching colloidal domains which include the homogeneous phase (gas, liquid or solid), two coexisting phases and perhaps also multi-phases in coexistence. Strategically, this was done by treating the coexisting phases as one composite system whose Helmholtz free energy density is written as the sum of constituent free energy densities each of which is weighed by its respective volume proportion. We show here that by minimizing the composite system's free energy density the phase-diagram domains can all be determined in addition to the phase boundaries customarily obtained by imposing the conditions of equal pressure and equal chemical potential. Also, we present the theoretically predicted phase diagram of PNIPAM dispersion and compare it with the one observed experimentally.
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Affiliation(s)
- K L Wu
- Complex Liquids Laboratory, Department of Physics, National Central University, Chungli 320, Taiwan, ROC.
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Wu KL, Beverloo B, Velthuizen SJCM, Sonneveld P. Sequential analysis of chromosome aberrations in multiple myeloma during disease progression. ACTA ACUST UNITED AC 2007; 7:280-5. [PMID: 17324335 DOI: 10.3816/clm.2007.n.003] [Citation(s) in RCA: 5] [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] [Indexed: 01/07/2023]
Abstract
PURPOSE Several chromosomal aberrations have been associated with molecular pathogenesis and classification of multiple myeloma. It is not known whether the expression of abnormal karyotypes is consistent in patients during disease progression. Herein, we report on sequential analysis of conventional cytogenetics as well as fluorescence in situ hybridization (FISH) data of 79 bone marrow specimens from 38 patients with myeloma who were longitudinally followed. PATIENTS AND METHODS We determined and characterized the development of additional chromosomal aberrations during progressive disease. RESULTS Overall, conventional cytogenetics detected an abnormal karyotype in 42% of the samples, whereas this increased to 69% by FISH. Among the cases with an abnormal conventional karyotype, 52% had a hyperdiploid subtype of myeloma. Progressive disease was correlated with an increased complexity of genetic abnormalities, which in the majority, consisted of structural aberrations acquired in later stages of disease. Using conventional cytogenetics, rearrangements of chromosome 1 were the most common structural abnormality (15%). In the majority, these rearrangements consisted of unbalanced translocations of 1p and 1q; however, no specific locus was predominantly affected. Second in frequency were structural aberrations of chromosomes 8 and 17 (6%). The frequency of del(13q) by FISH was 40% and did not increase in later stages of the disease, suggesting that del(13q) is not a genetic event associated with disease progression. Change of ploidy category during disease progression occurred in a minority of the cases. CONCLUSION This study supports the notion that cytogenetic abnormalities in multiple myeloma are not random. Particular chromosomal alterations are associated with disease progression, whereas others show a stable pattern during the course of the disease.
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Affiliation(s)
- Ka Lung Wu
- Department of Hematology, Erasmus Medical Center, Rotterdam, The Netherlands
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Khan S, Wu KL, Sedor JR, Abu Jawdeh BG, Schelling JR. The NHE1 Na+/H+ exchanger regulates cell survival by activating and targeting ezrin to specific plasma membrane domains. Cell Mol Biol (Noisy-le-grand) 2006; 52:115-21. [PMID: 17535745] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2006] [Accepted: 10/30/2006] [Indexed: 05/15/2023]
Abstract
NHE1 is a ubiquitously expressed Na+/H+ exchanger, which is important for vital cell functions. Using in vivo models of kidney podocyte injury and renal tubular epithelial cell (RTC) culture systems, we previously demonstrated that NHE1 defends against apoptosis by a mechanism involving ezrin binding to the NHE1 cytoplasmic domain. We now extend the NHE1 role to diabetic mouse models and refine the mechanism of NHE1-dependent ezrin activation. Streptozotocin induced diabetes resulted in greater azotemia, albuminuria and tubulointerstitial pathology in NHE1-deficient swe/swe compared to wild-type control mice. Increased RTC apoptosis was noted in swe/swe mice, suggesting that loss of NHE1 function leads to tubular atrophy, which predicts kidney disease progression. In vitro, proximal RTC derived from swe/swe mice also underwent increased apoptosis in response to staurosporine or a hypertonic environment. Activated ezrin normally resides in the apical domain of the proximal RTC, while NHE1 is a basolateral protein. After NHE1 activation by intracellular acidification or extracellular hypertonicity, confocal immunofluorescence microscopy in polarized LLC-PK1 cells demonstrated transient ezrin localization to lateral membrane domains, where it is positioned to interact with NHE1. We conclude that cell stresses promote NHE1-ezrin interaction, which activate cell survival pathways to prevent apoptosis in diabetic and non-diabetic kidney diseases.
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Affiliation(s)
- S Khan
- Case School of Medicine, Department of Medicine, Rammelkamp Center for Research, Cleveland, OH 44109-1998, USA
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48
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Wu KL, Beksac M, van Droogenbroeck J, Amadori S, Zweegman S, Sonneveld P. Phase II multicenter study of arsenic trioxide, ascorbic acid and dexamethasone in patients with relapsed or refractory multiple myeloma. Haematologica 2006; 91:1722-3. [PMID: 17145617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023] Open
Abstract
Arsenic trioxide induces growth inhibition and apoptosis in multiple myeloma cell lines. Reducing glutathione by ascorbic acid may enhance the efficacy of arsenic trioxide. Here we report the results of an international multi-center study of arsenic trioxide in combination with ascorbic acid and dexamethasone as treatment for patients with advanced multiple myeloma.
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49
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Wu KL, Heule F, Lam K, Sonneveld P. Pleomorphic presentation of cutaneous lesions associated with the proteasome inhibitor bortezomib in patients with multiple myeloma. J Am Acad Dermatol 2006; 55:897-900. [PMID: 17052502 DOI: 10.1016/j.jaad.2006.06.030] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.8] [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: 03/01/2006] [Revised: 04/28/2006] [Accepted: 06/14/2006] [Indexed: 12/11/2022]
Abstract
The clinical course and histologic findings of cutaneous adverse reactions associated with bortezomib treatment are presented in this study. Bortezomib (Velcade) is a proteasome inhibitor, which is used as a novel anticancer drug in the treatment of multiple myeloma. We have conducted an observational analysis of 47 patients with myeloma who were treated with bortezomib in 3 prospective clinical trials. Cutaneous adverse reactions were observed in 6 patients (13%). Five patients presented with sharply demarcated erythematous plaques or nodules on the trunk and one patient had generalized morbilliform erythema with ulcerations and fever. The time between the first bortezomib dose and occurrence of the cutaneous eruptions was at least 30 days. The cutaneous eruptions usually resolve within a few days. One patient withdrew from further treatment because of severe cutaneous toxicity. The histologic findings ranged from perivascular dermatitis to interstitial and interface dermatitis corresponding with clinically more extensive lesions.
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Affiliation(s)
- Ka Lung Wu
- Department of Hematology, Erasmus MC, Rotterdam, The Netherlands.
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50
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Affiliation(s)
- Sonja M Rosso
- Departments of Neurology/Neuro-Oncology, Daniel den Hoed Cancer Center/Erasmus University Hospital, Rotterdam, the Netherlands
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