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Frenzel L, Decaux O, Macro M, Belhadj-Merzoug K, Manier S, Touzeau C, Leleu X, Frère C, Lecompte T, Perrot A, Avet-Loiseau H, Moreau P, Chalayer E. Venous thromboembolism prophylaxis and multiple myeloma patients in real-life: Results of a large survey and clinical guidance recommendations from the IFM group. Thromb Res 2024; 233:153-164. [PMID: 38064842 DOI: 10.1016/j.thromres.2023.11.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 10/30/2023] [Accepted: 11/20/2023] [Indexed: 01/01/2024]
Abstract
Venous thromboembolism (VTE) remains a critical issue in the management of patients with multiple myeloma (MM), particularly when immunomodulatory drugs (IMiDs) combined with dexamethasone therapy are being prescribed as first-line and relapse therapy. One possible explanation for the persistent high rates of VTE, is the use of inappropriate thromboprophylaxis strategies for patients starting antimyeloma treatment. To tackle the issue, the Intergroupe francophone du myélome (IFM) offered convenient guidance for VTE thromboprophylaxis in MM patients initiating systemic therapy. This guidance is mainly supported by the results of a large survey on the clinical habits regarding VTE of physicians who are substantially involved in daily care of MM patients. VTE prophylaxis should be considered for all patients treated with IMiDs in combination with dexamethasone, in the absence of significant comorbidities, such as renal failure or bleeding risk. Anticoagulant should be preferred to antiplatelet agents for thromboprophylaxis. Despite the absence of large randomized controlled trials comparing those attitudes/options, available data on direct oral anticoagulants, which are already used in daily management of MM patients, are consistent with their potential usefulness for VTE prophylaxis in such patients. However, in order to implement a personalized continuous improvement strategy, clinicians must to be organized to collect all the data regarding this management. In other situations, thromboprophylaxis should be evaluated by using risk models and after careful evaluation of the risk/benefit ratio.
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Affiliation(s)
- Laurent Frenzel
- Service d'Hématologie Adulte et unité d'hémostase clinique, Hôpital Necker, Institut IMAGINE - INSERM U 1163/CNRS ERL 8254, Paris, France.
| | | | - Margaret Macro
- Institut d'Hématologie de Basse Normandie (IHBN), CHU Côte de Nacre, Caen, France
| | | | - Salomon Manier
- Hematology department, CHU Lille, Lille University, INSERM UMR-S1277, Lille, France
| | - Cyrille Touzeau
- Department of Hematology, University Hospital Hôtel-Dieu, 44093 Nantes, France; Centre de Recherche en Cancérologie et Immunologie Intégrée Nantes Angers, INSERM UMR 1307, CNRS UMR 6075, Nantes, France
| | - Xavier Leleu
- Hématologie Biologique, Hôpital Pontchaillou University Hospital of Rennes, Rennes, France
| | - Corinne Frère
- Service d'Hématologie Biologique, Hôpital Pitié-Salpêtrière, Sorbonne Université, Paris, France
| | | | - Aurore Perrot
- Institut Universitaire du Cancer de Toulouse-Oncopole and Centre de Recherches en Cancerologie de Toulouse Institut National de la Sante et de la Recherche Medicale, Toulouse, France
| | - Hervé Avet-Loiseau
- Institut Universitaire du Cancer de Toulouse-Oncopole and Centre de Recherches en Cancerologie de Toulouse Institut National de la Sante et de la Recherche Medicale, Toulouse, France
| | - Philippe Moreau
- Department of Hematology, University Hospital Hôtel-Dieu, 44093 Nantes, France; Centre de Recherche en Cancérologie et Immunologie Intégrée Nantes Angers, INSERM UMR 1307, CNRS UMR 6075, Nantes, France
| | - Emilie Chalayer
- Hématologie clinique, Institut de Cancérologie Hématologie Universitaire, CHU St Etienne Unité INSERM SAINBIOSE, U1059, Université Jean Monnet, St-Etienne, France
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2
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Facon T, Cook G, Usmani SZ, Hulin C, Kumar S, Plesner T, Touzeau C, Bahlis NJ, Basu S, Nahi H, Goldschmidt H, Quach H, Mohty M, Venner CP, Weisel K, Raje N, Hebraud B, Belhadj-Merzoug K, Benboubker L, Decaux O, Manier S, Caillot D, Ukropec J, Pei H, Van Rampelbergh R, Uhlar CM, Kobos R, Zweegman S. Daratumumab plus lenalidomide and dexamethasone in transplant-ineligible newly diagnosed multiple myeloma: frailty subgroup analysis of MAIA. Leukemia 2022; 36:1066-1077. [PMID: 34974527 PMCID: PMC8979809 DOI: 10.1038/s41375-021-01488-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [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: 07/01/2021] [Revised: 11/19/2021] [Accepted: 11/25/2021] [Indexed: 12/14/2022]
Abstract
In the phase 3 MAIA study of patients with transplant-ineligible newly diagnosed multiple myeloma (NDMM), daratumumab plus lenalidomide/dexamethasone (D-Rd) improved progression-free survival (PFS) versus lenalidomide/dexamethasone (Rd). We present a subgroup analysis of MAIA by frailty status. Frailty assessment was performed retrospectively using age, Charlson comorbidity index, and baseline Eastern Cooperative Oncology Group performance status score. Patients were classified as fit, intermediate, non-frail (fit + intermediate), or frail. Of the randomized patients (D-Rd, n = 368; Rd, n = 369), 396 patients were non-frail (D-Rd, 196 [53.3%]; Rd, 200 [54.2%]) and 341 patients were frail (172 [46.7%]; 169 [45.8%]). After a 36.4-month median follow-up, non-frail patients had longer PFS than frail patients, but the PFS benefit of D-Rd versus Rd was maintained across subgroups: non-frail (median, not reached [NR] vs 41.7 months; hazard ratio [HR], 0.48; P < 0.0001) and frail (NR vs 30.4 months; HR, 0.62; P = 0.003). Improved rates of complete response or better and minimal residual disease (10-5) negativity were observed for D-Rd across subgroups. The most common grade 3/4 treatment-emergent adverse event in non-frail and frail patients was neutropenia (non-frail, 45.4% [D-Rd] and 37.2% [Rd]; frail, 57.7% and 33.1%). These findings support the clinical benefit of D-Rd in transplant-ineligible NDMM patients enrolled in MAIA, regardless of frailty status.
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Affiliation(s)
- Thierry Facon
- grid.503422.20000 0001 2242 6780University of Lille, CHU Lille, Service des Maladies du Sang, Lille, France
| | - Gordon Cook
- grid.415967.80000 0000 9965 1030Leeds Cancer Centre, Leeds Teaching Hospitals Trust, Leeds, UK
| | - Saad Z. Usmani
- grid.468189.aLevine Cancer Institute/Atrium Health, Charlotte, NC USA
| | - Cyrille Hulin
- grid.42399.350000 0004 0593 7118Department of Hematology, Hôpital Haut Lévêque, University Hospital, Pessac, France
| | - Shaji Kumar
- grid.66875.3a0000 0004 0459 167XDepartment of Hematology, Mayo Clinic Rochester, Rochester, MN USA
| | - Torben Plesner
- grid.417271.60000 0004 0512 5814Vejle Hospital and University of Southern Denmark, Vejle, Denmark
| | - Cyrille Touzeau
- grid.277151.70000 0004 0472 0371Centre Hospitalier Universitaire, Nantes, France
| | - Nizar J. Bahlis
- grid.22072.350000 0004 1936 7697University of Calgary, Arnie Charbonneau Cancer Research Institute, Calgary, AB Canada
| | - Supratik Basu
- grid.6374.60000000106935374The Royal Wolverhampton Hospitals NHS Trust, University of Wolverhampton, Wolverhampton, UK
| | - Hareth Nahi
- grid.24381.3c0000 0000 9241 5705Karolinska Institute, Department of Medicine, Division of Hematology, Karolinska University Hospital at Huddinge, Stockholm, Sweden
| | - Hartmut Goldschmidt
- grid.5253.10000 0001 0328 4908University Clinic Heidelberg, International Medicine V and National Center of Tumor Diseases (NCT), Heidelberg, Germany
| | - Hang Quach
- grid.1008.90000 0001 2179 088XUniversity of Melbourne, St. Vincent’s Hospital, Melbourne, VIC Australia
| | - Mohamad Mohty
- grid.412370.30000 0004 1937 1100Sorbonne University, Department of Hematology, Saint-Antoine Hospital, Paris, France
| | - Christopher P. Venner
- grid.17089.370000 0001 2190 316XCross Cancer Institute, University of Alberta, Edmonton, AB Canada
| | - Katja Weisel
- grid.13648.380000 0001 2180 3484Department of Oncology, Hematology and Bone Marrow Transplantation With Section of Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Noopur Raje
- grid.32224.350000 0004 0386 9924Department of Hematology/Oncology, Massachusetts General Hospital, Boston, MA USA
| | - Benjamin Hebraud
- grid.411175.70000 0001 1457 2980Institut Universitaire du Cancer and University Hospital, Toulouse, France
| | - Karim Belhadj-Merzoug
- grid.412116.10000 0001 2292 1474Hémopathies Lymphoïdes, Hôpital Henri Mondor, Créteil, France
| | | | - Olivier Decaux
- grid.410368.80000 0001 2191 9284Clinical Haematology Department, University of Rennes, CHU Rennes, CIC INSERM 1414, Rennes, France
| | - Salomon Manier
- grid.503422.20000 0001 2242 6780University of Lille, CHU Lille, Service des Maladies du Sang, Lille, France
| | - Denis Caillot
- grid.31151.37CHU Dijon, Hôpital du Bocage, Dijon, France
| | - Jon Ukropec
- Janssen Global Medical Affairs, Horsham, PA USA
| | - Huiling Pei
- grid.497530.c0000 0004 0389 4927Janssen Research & Development, LLC, Titusville, NJ USA
| | | | - Clarissa M. Uhlar
- grid.497530.c0000 0004 0389 4927Janssen Research & Development, LLC, Spring House, PA USA
| | - Rachel Kobos
- grid.497530.c0000 0004 0389 4927Janssen Research & Development, LLC, Raritan, NJ USA
| | - Sonja Zweegman
- grid.12380.380000 0004 1754 9227Department of Hematology, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
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3
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Bobin A, Kyheng M, Guidez S, Gruchet-Merouze C, Richez V, Duhamel A, Karlin L, Kolb B, Tiab M, Araujo C, Meuleman N, Malfuson JV, Bourquard P, Lenain P, Perrot A, Roussel M, Jaccard A, Petillon MO, Belhadj-Merzoug K, Chretien ML, Fontan J, Rodon P, Schmitt A, Offner F, Voillat L, Cereja S, Kuhnowski F, Rigaudeau S, Decaux O, Humbrecht-Kraut C, Frayfer J, Fitoussi O, Roos-Weil D, Eisenmann JC, Dorvaux V, Voog EG, Moreau P, Avet-Loiseau H, Hulin C, Facon T, Leleu X. Carfilzomib maintenance in newly diagnosed non-transplant eligible multiple myeloma. Leukemia 2021; 36:881-884. [PMID: 34650225 DOI: 10.1038/s41375-021-01415-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 08/31/2021] [Accepted: 09/06/2021] [Indexed: 11/09/2022]
Affiliation(s)
- Arthur Bobin
- Service d'onco-hématologie, and Inserm 1402, CHU, Poitiers, France
| | - Maéva Kyheng
- Univ., ULR 2694-METRICS, CHRU, Lille, France.,Département de Biostatistiques, CHRU, Lille, France
| | - Stéphanie Guidez
- Service d'onco-hématologie, and Inserm 1402, CHU, Poitiers, France
| | | | - Valentine Richez
- Service d'Hématologie Clinique-Greffe de Moelle, CHU, Nice, France
| | - Alain Duhamel
- Univ., ULR 2694-METRICS, CHRU, Lille, France.,Département de Biostatistiques, CHRU, Lille, France
| | | | - Brigitte Kolb
- Service d'Hématologie, Hôpital Robert Debré, CHU, Reims, France
| | - Mourad Tiab
- Service d'Hématologie, CH, La Roche sur Yon, France
| | | | - Nathalie Meuleman
- Service d'Hématologie, Institut Jules Bordet, Université Libre, Bruxelles, Belgium
| | | | | | - Pascal Lenain
- Service d'Hématologie, Centre Henri Becquerel, CNLCC, Rouen, France
| | | | | | | | | | | | | | | | | | - Anna Schmitt
- Service d'Hématologie, Institut Bergonié, Bordeaux, France
| | - Fritz Offner
- Department Clinical Hematology, University Hospital, Ghent, Belgium
| | | | | | | | | | | | | | | | | | - Damien Roos-Weil
- Service d'Hématologie, Hôpital de la Pitié Salpétrière, Paris, France
| | | | | | | | | | | | - Cyrille Hulin
- Service d'Hématologie, Hôpital Haut Leveque, CHU, Bordeaux, France
| | | | | | - Xavier Leleu
- Service d'onco-hématologie, and Inserm 1402, CHU, Poitiers, France.
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Mikhael J, Belhadj-Merzoug K, Hulin C, Vincent L, Moreau P, Gasparetto C, Pour L, Spicka I, Vij R, Zonder J, Atanackovic D, Gabrail N, Martin TG, Perrot A, Bensfia S, Weng Q, Brillac C, Semiond D, Macé S, Corzo KP, Leleu X. A phase 2 study of isatuximab monotherapy in patients with multiple myeloma who are refractory to daratumumab. Blood Cancer J 2021; 11:89. [PMID: 33980831 PMCID: PMC8116334 DOI: 10.1038/s41408-021-00478-4] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 03/11/2021] [Accepted: 04/15/2021] [Indexed: 11/09/2022] Open
Affiliation(s)
- Joseph Mikhael
- Translational Genomics Research Institute, City of Hope Cancer Center, Phoenix, AZ, USA
| | | | - Cyrille Hulin
- Service d'hématologie, CHRU Hôpitaux de Brabois, Nancy, France
| | - Laure Vincent
- Département d'hématologie Clinique, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Philippe Moreau
- Hematology Department, Nantes University Hospital, Nantes, France
| | | | - Ludek Pour
- Department of Internal Medicine, Hematology and Oncology, University Hospital Brno, Brno, Czech Republic
| | - Ivan Spicka
- 1st Department of Medicine-Department of Hematology First Faculty of Medicine Charles University and General Hospital in Prague, Prague, Czech Republic
| | - Ravi Vij
- Division of Medical Oncology, Washington University, St Louis, MO, USA
| | - Jeffrey Zonder
- Department of Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, MI, USA
| | - Djordje Atanackovic
- Department of Medicine, Bone Marrow Transplant, University of Maryland Greenebaum Cancer Center, Baltimore, MD, USA
| | | | - Thomas G Martin
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA
| | - Aurore Perrot
- CHU de Toulouse, IUCT-O, Université de Toulouse, UPS, Service d'hématologie, Toulouse, France
| | | | - Qilong Weng
- Sanofi Clinical Sciences and Operations, Beijing, China
| | - Claire Brillac
- Sanofi Translational Medicine and Early Development, Paris, France
| | - Dorothée Semiond
- Sanofi Translational Medicine and Early Development, Paris, France
| | - Sandrine Macé
- Sanofi Translational Medicine and Early Development, Paris, France
| | - Kathryn P Corzo
- Sanofi Global Oncology, Cambridge, MA, USA.,CHU and CIC Inserm1402, Poitiers, France
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5
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Jaccard A, Karlin L, Hebraud B, Frenzel L, Choquet S, Mohty M, Dib M, Vincent L, Slama B, Galicier L, Tournilhac O, Belhadj-Merzoug K, Moreau P, Decaux O, Benboubker L, Caillot D, Fontan J, Maisonneuve H, Bender S, Musset L, Fermand JP. A Prospective Phase II Trial of Lenalidomide and Dexamethasone in POEMS Syndrome. Clinical Lymphoma Myeloma and Leukemia 2019. [DOI: 10.1016/j.clml.2019.09.062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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6
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Leleu X, Fouquet G, Richez V, Guidez S, Duhamel A, Machuron F, Karlin L, Kolb B, Tiab M, Araujo C, Meuleman N, Malfuson JV, Bourquard P, Lenain P, Roussel M, Jaccard A, Pétillon MO, Belhadj-Merzoug K, Lepeu G, Chrétien ML, Fontan J, Rodon P, Schmitt A, Offner F, Voillat L, Cereja S, Kuhnowski F, Rigaudeau S, Decaux O, Humbrecht-Kraut C, Frayfer J, Fitoussi O, Roos-Weil D, Eisenmann JC, Dorvaux V, Voog EG, Attal M, Moreau P, Avet-Loiseau H, Hulin C, Facon T. Carfilzomib Weekly plus Melphalan and Prednisone in Newly Diagnosed Transplant-Ineligible Multiple Myeloma (IFM 2012-03): A Phase I Trial. Clin Cancer Res 2019; 25:4224-4230. [PMID: 31053600 DOI: 10.1158/1078-0432.ccr-18-3642] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 01/18/2019] [Accepted: 04/29/2019] [Indexed: 11/16/2022]
Abstract
PURPOSE Carfilzomib is a novel generation proteasome inhibitor. The Carmysap trial demonstrated that twice-weekly KMP (carfilzomib, melphalan, prednisone) might challenge the MPV (melphalan, prednisone, bortezomib) standard. We sought to study KMP weekly, allowing to increase carfilzomib's dose with maintained efficacy and improved safety profile. PATIENTS AND METHODS IFM2012-03, a phase I multicenter study of KMP weekly in elderly patients with newly diagnosed multiple myeloma (eNDMM), aimed to determine the MTD of carfilzomib. Carfilzomib was given intravenously at 36, 45, 56, and 70 mg/m2/day on days 1, 8, 15, and 22 with melphalan and prednisone, for nine 35-day induction cycles, followed by carfilzomib maintenance for 1 year. Three dose-limiting toxicities (DLT) determined MTD at the lower dose. RESULTS Thirty eNDMMs were treated, 6 per cohort at 36, 45, and 56 mg/m2 and 12 at 70 mg/m². There was one DLT at 36 mg/m2 (lymphopenia), one at 45 mg/m2 (lysis syndrome), two at 56 mg/m2 (cardiac insufficiency and febrile neutropenia), and two at 70 mg/m2 (vomiting and elevated liver enzymes). The safety profile was acceptable; however, specific attention must be paid to the risk of cardiovascular events, especially for elderly patients. The overall response rate was 93.3%, with 46.6% complete response. CONCLUSIONS The MTD dose of carfilzomib was 70 mg/m2 in this KMP weekly study in eNDMM. Response rates, and especially CR rate, were remarkable in this population, and would benefit from being assessed in a larger-scale study. The IFM2012-03 study demonstrated that the MTD of carfilzomib weekly is 70 mg/m2 in eNDMM, and 56 mg/m2 for patients older than 75 years. Carfilzomib used weekly in combination has a good efficacy and safety profile in eNDMM.
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Affiliation(s)
- Xavier Leleu
- Hematology and Inserm CIC 1402, CHU Poitiers, France.
| | - Guillemette Fouquet
- Institut Imagine, Inserm U1163 - CNRS ERL8254, Hôpital Necker, Paris, France
| | | | | | - Alain Duhamel
- Université de Lille, CHRU Lille, EA 2694 - Santé publique: épidémiologie et qualité des soins, Lille, France
| | - François Machuron
- Université de Lille, CHRU Lille, EA 2694 - Santé publique: épidémiologie et qualité des soins, Lille, France
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7
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Leleu X, Fouquet G, Karlin L, Kolb B, Tiab M, Araujo C, Bourquard P, Lenain P, Roussel M, Jaccard A, Petillon MO, Belhadj-Merzoug K, Lepeu G, Chretien ML, Fontan J, Rodon P, Schmitt A, Voillat L, Cereja S, Kuhnowski F, Rigaudeau S, Decaux O, Frayfer J, Fitoussi O, Roos Weil D, Eisenmann JC, Dorvaux V, Voog E, Hulin C, Attal M. Carfilzomib Weekly Plus Melphalan and Prednisone in Newly Diagnosed Elderly Multiple Myeloma (IFM 2012-03). Clinical Lymphoma Myeloma and Leukemia 2017. [DOI: 10.1016/j.clml.2017.03.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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8
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Colonna P, Andrieu JM, Ghouadni R, Zouaoui-Benhadji Z, Afiane M, Kubisz P, Tourani JM, Belhadj-Merzoug K, Krisch C, Laugier A. Advanced Hodgkin disease (clinical stages IIIB and IV): low relapse rate after brief chemotherapy followed by high-dose total lymphoid irradiation. Am J Hematol 1989; 30:121-7. [PMID: 2916559 DOI: 10.1002/ajh.2830300303] [Citation(s) in RCA: 3] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
From January 1980 to September 1986, 50 patients with Hodgkin disease, clinical stages (CS) IIIB (26 cases) and IVB (24 cases) were treated by three cycles of mechlorethamine, vincristine, procarbazine, and prednisone (MOPP) chemotherapy, followed by high-dose (40 Gy) (sub)total lymphoid irradiation, including the spleen. Ten patients (2 CS IIIB, 8 CS IVB) were in failure, and seven (4 CS IIIB, 3 CS IVB) died during their first complete remission (2 from treatment-related complications, 1 from unknown cause, 4 from insufficient supportive care and/or a shortage of health supplies); three patients (CS IIIB) relapsed (2 alive in second complete remission, 1 deceased). After 7 years, actuarial survival and relapse-free duration were, respectively, 64% for the 50 patients and 89% for the 40 patients in complete remission. Unfavourable outcome was observed in patients with pelvic nodal involvement. The low relapse rate (none in CS IVB) was the most striking result after brief chemotherapy followed by total lymphoid irradiation.
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Affiliation(s)
- P Colonna
- Hematology Clinic, Centre P.M. Curie, Mustapha Hospital, Algeria
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9
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Colonna P, Belhadj-Merzoug K, Henni T, Andrieu JM. Changes in patterns of Hodgkin's disease in Algeria, 1966-1985: influence of health care delivery system. Acta Haematol 1988; 80:227-8. [PMID: 3146204 DOI: 10.1159/000205646] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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10
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Colonna P, Andrieu JM, Ghouadni R, Zouaoui-Benhadji Z, Afiane M, Kubisz P, Tourani JM, Belhadj-Merzoug K, Schlienger M. Hodgkin's disease, clinical stages IA to IIIB: combined modality therapy (3 MOPP followed by curative and prophylactic radiotherapy including the spleen). Six-year results. Eur J Haematol 1987; 39:356-61. [PMID: 3691758 DOI: 10.1111/j.1600-0609.1987.tb00783.x] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
From January 1980 to September 1985, 82 patients with IA to IIIB clinical stage (CS) Hodgkin's disease were treated by three MOPP chemotherapy (CT) cycles followed by extended field radiotherapy (RT) including the spleen (30-40 Gy). 2 patients died during the treatment (medullary aplasia, pulmonary edema). 6 were in failure after three MOPP cycles; they received other CT; 3 died and 3 are alive in remission (survival: 2.5 to 3.5 yr). 74 were in complete remission (CR) after completion of treatment. 4 patients relapsed (all alive after re-treatment) and 4 died in first CR (tuberculosis, hepatitis, myeloma, unknown cause). At 6 yr, actuarial survival and relapse-free survival are respectively 89.8% for the 82 patients and 93% for those in CR. These good results are due to: the administration of CT before RT, limited to three cycles; identification of failures after CT; inclusion of the spleen in RT ports in all cases; and a short lumbo-aortic port in CS I and II.
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Affiliation(s)
- P Colonna
- Hematology Clinic, Centre P. M. Curie, Mustapha Hospital, Algiers, Algeria
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