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Hoster E, Unterhalt M, Hänel M, Prange-Krex G, Forstpointner R, Florschütz A, Graeven U, Frickhofen N, Wulf G, Lengfelder E, Lerchenmüller C, Schlag R, Dierlamm J, Fischer Von Weikersthal L, Ahmed A, Harich H, Rosenwald A, Klapper W, Dreyling M, Hiddemann W, Herold M. RITUXIMAB MAINTENANCE VERSUS OBSERVATION AFTER IMMUNOCHEMOTHERAPY (R-CHOP, R-MCP, R-FCM) IN PREVIOUSLY UNTREATED FOLLICULAR LYMPHOMA: A RANDOMISED TRIAL OF GLSG AND OSHO. Hematol Oncol 2017. [DOI: 10.1002/hon.2437_12] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- E. Hoster
- Medizinische Klinik III; Klinikum der Ludwig-Maximilians-Universität München; Munich Germany
| | - M. Unterhalt
- Medizinische Klinik III; Klinikum der Ludwig-Maximilians-Universität München; Munich Germany
| | - M. Hänel
- Klinik für Innere Medizin III; Klinikum Chemnitz; Chemnitz Germany
| | - G. Prange-Krex
- Innere Medizin, Hämatologie, Onkologie, Gemeinschaftspraxis; Dresden Germany
| | - R. Forstpointner
- Medizinische Klinik III; Klinikum der Ludwig-Maximilians-Universität München; Munich Germany
| | - A. Florschütz
- Klinik für Innere Medizin; Städtisches Klinikum Dessau; Dessau Germany
| | - U. Graeven
- Klinik für Hämatologie, Onkologie und Gastroenterologie; Kliniken Maria Hilf; Mönchengladbach Germany
| | - N. Frickhofen
- Klinik Innere Medizin III; HELIOS Dr. Horst Schmidt Kliniken Wiesbaden; Wiesbaden Germany
| | - G. Wulf
- Hämatologie und Medizinische Onkologie; Universitätsmedizin Göttingen; Göttingen Germany
| | - E. Lengfelder
- III. Medizinische Klinik; Klinikum Mannheim; Mannheim Germany
| | | | - R. Schlag
- Innere Medizin, Hämatologie u. Internistische Onkologie; Gemeinschaftspraxis; Würzburg Germany
| | - J. Dierlamm
- II. Medizinischen Klinik und Poliklinik; Universitätsklinikum Eppendorf; Hamburg Germany
| | | | - A. Ahmed
- Medizinische Klinik III; Städtisches Klinikum Braunschweig; Braunschweig Germany
| | - H. Harich
- Onkologie Hof, Medizinisches Versorgungszentrum; Hof Germany
| | - A. Rosenwald
- Institut für Pathologie; Universität Würzburg; Würzburg Germany
| | - W. Klapper
- Sektion Hämatopathologie und Lymphknotenregister; Universitätsklinikum Schleswig-Holstein; Kiel Germany
| | - M. Dreyling
- Medizinische Klinik III; Klinikum der Ludwig-Maximilians-Universität München; Munich Germany
| | - W. Hiddemann
- Medizinische Klinik III; Klinikum der Ludwig-Maximilians-Universität München; Munich Germany
| | - M. Herold
- Onkologisches Zentrum; HELIOS Klinikum Erfurt; Erfurt Germany
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Hiddemann W, Barbui A, Canales Albendea M, Cannell P, Collins G, Dürig J, Forstpointner R, Herold M, Hertzberg M, Klanova M, Radford J, Tobinai K, Burciu A, Fingerle-Rowson G, Nielsen T, Wolbers M, Marcus R. IMMUNOCHEMOTHERAPY WITH OBINUTUZUMAB OR RITUXIMAB IN PREVIOUSLY UNTREATED FOLLICULAR LYMPHOMA IN THE RANDOMISED PHASE III GALLIUM STUDY: ANALYSIS BY CHEMOTHERAPY REGIMEN. Hematol Oncol 2017. [DOI: 10.1002/hon.2437_106] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- W. Hiddemann
- Department of Medicine III; Ludwig-Maximilians-University Hospital Munich; Munich Germany
| | - A.M. Barbui
- Department of Hematology; Azienda Ospedaliera Papa Giovanni XXIII; Bergamo Italy
| | | | - P.K. Cannell
- Haematology Department; Fiona Stanley Hospital; Murdoch Australia
| | - G.P. Collins
- Department of Clinical Haematology; Oxford Cancer and Haematology Centre, Churchill Hospital; Oxford UK
| | - J. Dürig
- Medical Faculty (Haematology), Universitaetsklinikum Essen; Essen Germany
| | - R. Forstpointner
- Department of Medicine III; Ludwig-Maximilians-University Hospital Munich; Munich Germany
| | - M. Herold
- Oncology Center; HELIOS-Klinikum Erfurt; Erfurt Germany
| | - M. Hertzberg
- Department of Haematology; Prince of Wales Hospital; Sydney Australia
| | - M. Klanova
- 1st Department of Medicine; Charles University General Hospital, Prague, Czech Republic and Pharma Development Clinical Oncology, F. Hoffmann-La Roche Ltd; Basel Switzerland
| | - J.A. Radford
- Manchester Academic Health Science Centre; The University of Manchester and The Christie NHS Foundation Trust; Manchester UK
| | - K. Tobinai
- Department of Hematology; National Cancer Center Hospital; Tokyo Japan
| | - A. Burciu
- Pharma Development Safety and Risk Management; F. Hoffmann-La Roche Ltd; Basel Switzerland
| | - G.R. Fingerle-Rowson
- Pharma Development Clinical Oncology; F. Hoffmann-La Roche Ltd; Basel Switzerland
| | - T. Nielsen
- Pharma Development Clinical Oncology; F. Hoffmann-La Roche Ltd; Basel Switzerland
| | - M. Wolbers
- Pharma Development Biometrics Biostatistics; F. Hoffmann-La Roche Ltd; Basel Switzerland
| | - R. Marcus
- Department of Haematology; Kings College Hospital; London UK
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Ferrero S, Pastore A, Scholz CW, Forstpointner R, Pezzutto A, Bergmann L, Trümper L, Finke J, Keller U, Ghione P, Passera R, Hiddemann W, Weigert O, Unterhalt M, Dreyling M. Radioimmunotherapy in relapsed/refractory mantle cell lymphoma patients: final results of a European MCL Network Phase II Trial. Leukemia 2015; 30:984-7. [DOI: 10.1038/leu.2015.215] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Kluin-Nelemans HC, Hoster E, Hermine O, Walewski J, Trneny M, Geisler CH, Stilgenbauer S, Thieblemont C, Vehling-Kaiser U, Doorduijn JK, Coiffier B, Forstpointner R, Tilly H, Kanz L, Feugier P, Szymczyk M, Hallek M, Kremers S, Lepeu G, Sanhes L, Zijlstra JM, Bouabdallah R, Lugtenburg PJ, Macro M, Pfreundschuh M, Procházka V, Di Raimondo F, Ribrag V, Uppenkamp M, André M, Klapper W, Hiddemann W, Unterhalt M, Dreyling MH. Treatment of older patients with mantle-cell lymphoma. N Engl J Med 2012; 367:520-31. [PMID: 22873532 DOI: 10.1056/nejmoa1200920] [Citation(s) in RCA: 361] [Impact Index Per Article: 30.1] [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: 12/28/2022]
Abstract
BACKGROUND The long-term prognosis for older patients with mantle-cell lymphoma is poor. Chemoimmunotherapy results in low rates of complete remission, and most patients have a relapse. We investigated whether a fludarabine-containing induction regimen improved the complete-remission rate and whether maintenance therapy with rituximab prolonged remission. METHODS We randomly assigned patients 60 years of age or older with mantle-cell lymphoma, stage II to IV, who were not eligible for high-dose therapy to six cycles of rituximab, fludarabine, and cyclophosphamide (R-FC) every 28 days or to eight cycles of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) every 21 days. Patients who had a response underwent a second randomization to maintenance therapy with rituximab or interferon alfa, each given until progression. RESULTS Of the 560 patients enrolled, 532 were included in the intention-to-treat analysis for response, and 485 in the primary analysis for response. The median age was 70 years. Although complete-remission rates were similar with R-FC and R-CHOP (40% and 34%, respectively; P=0.10), progressive disease was more frequent with R-FC (14%, vs. 5% with R-CHOP). Overall survival was significantly shorter with R-FC than with R-CHOP (4-year survival rate, 47% vs. 62%; P=0.005), and more patients in the R-FC group died during the first remission (10% vs. 4%). Hematologic toxic effects occurred more frequently in the R-FC group than in the R-CHOP group, but the frequency of grade 3 or 4 infections was balanced (17% and 14%, respectively). In 274 of the 316 patients who were randomly assigned to maintenance therapy, rituximab reduced the risk of progression or death by 45% (in remission after 4 years, 58%, vs. 29% with interferon alfa; hazard ratio for progression or death, 0.55; 95% confidence interval, 0.36 to 0.87; P=0.01). Among patients who had a response to R-CHOP, maintenance therapy with rituximab significantly improved overall survival (4-year survival rate, 87%, vs. 63% with interferon alfa; P=0.005). CONCLUSIONS R-CHOP induction followed by maintenance therapy with rituximab is effective for older patients with mantle-cell lymphoma. (Funded by the European Commission and others; ClinicalTrials.gov number, NCT00209209.).
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Affiliation(s)
- H C Kluin-Nelemans
- Department of Hematology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
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Nickenig C, Dreyling M, Hoster E, Ludwig WD, Dörken B, Freund M, Huber C, Ganser A, Trümper L, Forstpointner R, Unterhalt M, Hiddemann W. Initial chemotherapy with mitoxantrone, chlorambucil, prednisone impairs the collection of stem cells in patients with indolent lymphomas—results of a randomized comparison by the German Low-Grade Lymphoma Study Group. Ann Oncol 2007; 18:136-142. [PMID: 17071931 DOI: 10.1093/annonc/mdl348] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [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: 11/12/2022] Open
Abstract
Myeloablative radio-chemotherapy with subsequent autologous stem cell transplantation (ASCT) significantly prolongs progression free and probably overall survival in follicular lymphoma (FL) in first remission. The current trial explored prospectively the rate of successful stem cell mobilization in patients with advanced stage FL after initial therapy with either Mitoxantrone, Chlorambucil, Prednisone (MCP) or Cyclophosphamide, Doxorubicin, Vincristine, Prednisone (CHOP) as part of a prospective randomized comparison of both regimens. ASCT patients received Dexa-BEAM (Dexamethasone, BCNU, Melphalan, Etoposide, Cytarabine) for mobilization of stem cells. Stem cells were collected and a minimum of 2x2.0x106/kg bw CD34+ was required for ASCT. Of 79 evaluable patients, 58 (73%) had follicular lymphoma, 13 (16%) mantle cell lymphoma and 8 (10%) lymphoplasmacytic lymphoma. In the 45 patients assigned to CHOP, stem cell collection was successful in 42 cases (93%, 95% CI 82% to 99%). This high mobilization rate after CHOP could be confirmed in 61 subsequent patients (87%). In contrast, after MCP therapy stem cell collection was successful in only 15 of 34 patients (44%, 95% CI 27% to 62%; P=0.0003). In conclusion, initial therapy with MCP significantly impairs the ability to collect stem cells and should be avoided for first line therapy of younger patients potentially qualifying for high dose consolidation and ASCT in first remission.
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Affiliation(s)
- C Nickenig
- Department of Internal Medicine III, Ludwig-Maximilians University, Munich Grosshadern
| | - M Dreyling
- Department of Internal Medicine III, Ludwig-Maximilians University, Munich Grosshadern
| | - E Hoster
- Department of Internal Medicine III, Ludwig-Maximilians University, Munich Grosshadern; Institute of Medical Informatics, Biometry and Epidemiology, University of Munich
| | - W-D Ludwig
- Department of Hematology and Oncology, Charité Campus Berlin-Buch
| | - B Dörken
- Department of Hematology and Oncology, Charité Berlin Campus Virchow-Klinikum
| | - M Freund
- Division of Hematology and Oncology, University Rostock
| | - C Huber
- Department of Internal Medicine III, University of Mainz
| | - A Ganser
- Department of Hematology, Hemostasis and Oncology, Hannover Medical School
| | - L Trümper
- Department of Hematology and Oncology, Georg-August University, Göttingen, Germany
| | - R Forstpointner
- Department of Internal Medicine III, Ludwig-Maximilians University, Munich Grosshadern
| | - M Unterhalt
- Department of Internal Medicine III, Ludwig-Maximilians University, Munich Grosshadern
| | - W Hiddemann
- Department of Internal Medicine III, Ludwig-Maximilians University, Munich Grosshadern.
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Dreyling M, Forstpointner R, Gramatzki M, Böck H, Hänel M, Seymour J, Planker M, Dührsen U, Wilms K, Unterhalt M, Hiddemann W. Rituximab maintenance improves progression-free and overall survival rates after combined immuno-chemotherapy (R-FCM) in patients with relapsed follicular and mantle cell lymphoma: Final results of a prospective randomized trial of the German Low Grade Lymphoma Study Group (GLSG). J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.7502] [Citation(s) in RCA: 16] [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] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
7502 Background: Rituximab (R) prolongs the progression-free survival (PFS) in patients with follicular lymphoma (FL) when given either simultaneously with or as maintenance after chemotherapy only. Methods: In the current study the impact of R maintenance after remission induction with an R-containing combined immuno-chemotherapy (R-FCM) was evaluated. Patients with advanced stage relapsed or refractory FL and mantle cell lymphoma (MCL) were eligible. The study design comprized 4 courses of chemotherapy with Fludarabine (25 mg/m2/d days 1–3), Cyclophosphamide (200 mg/m2/d days 1–3) and Mitoxantrone (8 mg/m2/d day 1) (FCM) ± Rituximab (375 mg/m2/d day 0). Patients entering a complete (CR) or partial remission (PR) underwent a second randomization for R maintenance (4 weekly doses (375 mg/m2/d) at three and nine months after end of induction) or observation only. Randomization was stratified for histology, prior therapies (up to 2 lines vs. >2), induction (±R), and response (CR vs. PR). After improved outcome of the R-FCM arm had been observed in the initial 147 randomized patients, all subsequent patients received a combined immuno-chemotherapy induction. Results: 176 of 195 randomized cases are evaluable, 138 of whom had received an R-containing induction. In these patients (as well as the total group) the median PFS after end of induction has not been reached in the R-maintenance arm in contrast to 17 months in patients with no further treatment (p = 0.001). This improvement was seen both in FL (n = 81; p = 0,035) and MCL (n = 47; p = 0,049). More importantly, overall survival rate was also improved after R maintenance with borderline significance (3 y rate 82% vs. 55%; p = 0,056). No major sided effects of R maintenance have been observed and the rate of serious infections was similar in both study arms (p = 0.72). Conclusions: The final analysis of this study confirms that R maintenance after combined immuno-chemotherapy (R-FCM) is highly effective and improves the progression-free survival—with a strong trend towards improved overall survival—of patients with relapsed FL and MCL. [Table: see text]
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Affiliation(s)
- M. Dreyling
- University Hospital Grosshadern, Munich, Germany; University Hospital, Kiel, Germany; Practice, Offenbach, Germany; Hospital Küchwald, Chemnitz, Germany; Peter MacCallum Cancer Institute, East Melbourne, Australia; Hospital, Krefeld, Germany; University Hospital, Essen, Germany; University Hospital, Würzburg, Germany
| | - R. Forstpointner
- University Hospital Grosshadern, Munich, Germany; University Hospital, Kiel, Germany; Practice, Offenbach, Germany; Hospital Küchwald, Chemnitz, Germany; Peter MacCallum Cancer Institute, East Melbourne, Australia; Hospital, Krefeld, Germany; University Hospital, Essen, Germany; University Hospital, Würzburg, Germany
| | - M. Gramatzki
- University Hospital Grosshadern, Munich, Germany; University Hospital, Kiel, Germany; Practice, Offenbach, Germany; Hospital Küchwald, Chemnitz, Germany; Peter MacCallum Cancer Institute, East Melbourne, Australia; Hospital, Krefeld, Germany; University Hospital, Essen, Germany; University Hospital, Würzburg, Germany
| | - H. Böck
- University Hospital Grosshadern, Munich, Germany; University Hospital, Kiel, Germany; Practice, Offenbach, Germany; Hospital Küchwald, Chemnitz, Germany; Peter MacCallum Cancer Institute, East Melbourne, Australia; Hospital, Krefeld, Germany; University Hospital, Essen, Germany; University Hospital, Würzburg, Germany
| | - M. Hänel
- University Hospital Grosshadern, Munich, Germany; University Hospital, Kiel, Germany; Practice, Offenbach, Germany; Hospital Küchwald, Chemnitz, Germany; Peter MacCallum Cancer Institute, East Melbourne, Australia; Hospital, Krefeld, Germany; University Hospital, Essen, Germany; University Hospital, Würzburg, Germany
| | - J. Seymour
- University Hospital Grosshadern, Munich, Germany; University Hospital, Kiel, Germany; Practice, Offenbach, Germany; Hospital Küchwald, Chemnitz, Germany; Peter MacCallum Cancer Institute, East Melbourne, Australia; Hospital, Krefeld, Germany; University Hospital, Essen, Germany; University Hospital, Würzburg, Germany
| | - M. Planker
- University Hospital Grosshadern, Munich, Germany; University Hospital, Kiel, Germany; Practice, Offenbach, Germany; Hospital Küchwald, Chemnitz, Germany; Peter MacCallum Cancer Institute, East Melbourne, Australia; Hospital, Krefeld, Germany; University Hospital, Essen, Germany; University Hospital, Würzburg, Germany
| | - U. Dührsen
- University Hospital Grosshadern, Munich, Germany; University Hospital, Kiel, Germany; Practice, Offenbach, Germany; Hospital Küchwald, Chemnitz, Germany; Peter MacCallum Cancer Institute, East Melbourne, Australia; Hospital, Krefeld, Germany; University Hospital, Essen, Germany; University Hospital, Würzburg, Germany
| | - K. Wilms
- University Hospital Grosshadern, Munich, Germany; University Hospital, Kiel, Germany; Practice, Offenbach, Germany; Hospital Küchwald, Chemnitz, Germany; Peter MacCallum Cancer Institute, East Melbourne, Australia; Hospital, Krefeld, Germany; University Hospital, Essen, Germany; University Hospital, Würzburg, Germany
| | - M. Unterhalt
- University Hospital Grosshadern, Munich, Germany; University Hospital, Kiel, Germany; Practice, Offenbach, Germany; Hospital Küchwald, Chemnitz, Germany; Peter MacCallum Cancer Institute, East Melbourne, Australia; Hospital, Krefeld, Germany; University Hospital, Essen, Germany; University Hospital, Würzburg, Germany
| | - W. Hiddemann
- University Hospital Grosshadern, Munich, Germany; University Hospital, Kiel, Germany; Practice, Offenbach, Germany; Hospital Küchwald, Chemnitz, Germany; Peter MacCallum Cancer Institute, East Melbourne, Australia; Hospital, Krefeld, Germany; University Hospital, Essen, Germany; University Hospital, Würzburg, Germany
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Hiddemann W, Forstpointner R, Dreyling M, Gramatzki M, Böck HP, Haenel M, Seymour JF, Unterhalt M. Rituximab maintenance following a rituximab containing chemotherapy significantly prolongs the duration of response in patients with relapsed follicular and mantle cell lymphomas: Results of a prospective randomized trial of the German Low Grade Lymphoma Study Group (GLSG). J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.6527] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [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)
- W. Hiddemann
- Ludwig-Maximilians-Universitat, Muenchen, Germany; Friedrich Alexander Universität Erlangen, Erlangen, Germany; Practice of Hematology, Offenbach, Germany; Klin Chemnitz, Chemnitz, Germany; Peter Maccallum Cancer Institute, East Melbourne, Australia
| | - R. Forstpointner
- Ludwig-Maximilians-Universitat, Muenchen, Germany; Friedrich Alexander Universität Erlangen, Erlangen, Germany; Practice of Hematology, Offenbach, Germany; Klin Chemnitz, Chemnitz, Germany; Peter Maccallum Cancer Institute, East Melbourne, Australia
| | - M. Dreyling
- Ludwig-Maximilians-Universitat, Muenchen, Germany; Friedrich Alexander Universität Erlangen, Erlangen, Germany; Practice of Hematology, Offenbach, Germany; Klin Chemnitz, Chemnitz, Germany; Peter Maccallum Cancer Institute, East Melbourne, Australia
| | - M. Gramatzki
- Ludwig-Maximilians-Universitat, Muenchen, Germany; Friedrich Alexander Universität Erlangen, Erlangen, Germany; Practice of Hematology, Offenbach, Germany; Klin Chemnitz, Chemnitz, Germany; Peter Maccallum Cancer Institute, East Melbourne, Australia
| | - H.-P. Böck
- Ludwig-Maximilians-Universitat, Muenchen, Germany; Friedrich Alexander Universität Erlangen, Erlangen, Germany; Practice of Hematology, Offenbach, Germany; Klin Chemnitz, Chemnitz, Germany; Peter Maccallum Cancer Institute, East Melbourne, Australia
| | - M. Haenel
- Ludwig-Maximilians-Universitat, Muenchen, Germany; Friedrich Alexander Universität Erlangen, Erlangen, Germany; Practice of Hematology, Offenbach, Germany; Klin Chemnitz, Chemnitz, Germany; Peter Maccallum Cancer Institute, East Melbourne, Australia
| | - J. F. Seymour
- Ludwig-Maximilians-Universitat, Muenchen, Germany; Friedrich Alexander Universität Erlangen, Erlangen, Germany; Practice of Hematology, Offenbach, Germany; Klin Chemnitz, Chemnitz, Germany; Peter Maccallum Cancer Institute, East Melbourne, Australia
| | - M. Unterhalt
- Ludwig-Maximilians-Universitat, Muenchen, Germany; Friedrich Alexander Universität Erlangen, Erlangen, Germany; Practice of Hematology, Offenbach, Germany; Klin Chemnitz, Chemnitz, Germany; Peter Maccallum Cancer Institute, East Melbourne, Australia
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8
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Dreyling MH, Forstpointner R, Ludwig WD, Gramatzki M, Boeck HP, Haenel M, Wandt H, Parwaresch R, Unterhalt M, Hiddemann W. Combined immuno-chemotherapy (R-FCM) results in superior remission rates and overall survival in recurrent follicular and mantle cell lymphoma: Follow-up of a prospective randomized trial of the German Low Grade Lymphoma Study Group (GLSG). J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.6528] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- M. H. Dreyling
- Univ Hosp Grosshadern/LMU, Munich, Germany; Robert Rössle Hospital/Charite, Berlin, Germany; Univ Hosp, Erlangen, Germany; Practice of Hematology-Oncology, Offenbach, Germany; Hosp Kuechwald, Chemnitz, Germany; Klin Nord, Nuernberg, Germany; Univ of Schleswig-Holstein, Kiel, Germany
| | - R. Forstpointner
- Univ Hosp Grosshadern/LMU, Munich, Germany; Robert Rössle Hospital/Charite, Berlin, Germany; Univ Hosp, Erlangen, Germany; Practice of Hematology-Oncology, Offenbach, Germany; Hosp Kuechwald, Chemnitz, Germany; Klin Nord, Nuernberg, Germany; Univ of Schleswig-Holstein, Kiel, Germany
| | - W.-D. Ludwig
- Univ Hosp Grosshadern/LMU, Munich, Germany; Robert Rössle Hospital/Charite, Berlin, Germany; Univ Hosp, Erlangen, Germany; Practice of Hematology-Oncology, Offenbach, Germany; Hosp Kuechwald, Chemnitz, Germany; Klin Nord, Nuernberg, Germany; Univ of Schleswig-Holstein, Kiel, Germany
| | - M. Gramatzki
- Univ Hosp Grosshadern/LMU, Munich, Germany; Robert Rössle Hospital/Charite, Berlin, Germany; Univ Hosp, Erlangen, Germany; Practice of Hematology-Oncology, Offenbach, Germany; Hosp Kuechwald, Chemnitz, Germany; Klin Nord, Nuernberg, Germany; Univ of Schleswig-Holstein, Kiel, Germany
| | - H.-P. Boeck
- Univ Hosp Grosshadern/LMU, Munich, Germany; Robert Rössle Hospital/Charite, Berlin, Germany; Univ Hosp, Erlangen, Germany; Practice of Hematology-Oncology, Offenbach, Germany; Hosp Kuechwald, Chemnitz, Germany; Klin Nord, Nuernberg, Germany; Univ of Schleswig-Holstein, Kiel, Germany
| | - M. Haenel
- Univ Hosp Grosshadern/LMU, Munich, Germany; Robert Rössle Hospital/Charite, Berlin, Germany; Univ Hosp, Erlangen, Germany; Practice of Hematology-Oncology, Offenbach, Germany; Hosp Kuechwald, Chemnitz, Germany; Klin Nord, Nuernberg, Germany; Univ of Schleswig-Holstein, Kiel, Germany
| | - H. Wandt
- Univ Hosp Grosshadern/LMU, Munich, Germany; Robert Rössle Hospital/Charite, Berlin, Germany; Univ Hosp, Erlangen, Germany; Practice of Hematology-Oncology, Offenbach, Germany; Hosp Kuechwald, Chemnitz, Germany; Klin Nord, Nuernberg, Germany; Univ of Schleswig-Holstein, Kiel, Germany
| | - R. Parwaresch
- Univ Hosp Grosshadern/LMU, Munich, Germany; Robert Rössle Hospital/Charite, Berlin, Germany; Univ Hosp, Erlangen, Germany; Practice of Hematology-Oncology, Offenbach, Germany; Hosp Kuechwald, Chemnitz, Germany; Klin Nord, Nuernberg, Germany; Univ of Schleswig-Holstein, Kiel, Germany
| | - M. Unterhalt
- Univ Hosp Grosshadern/LMU, Munich, Germany; Robert Rössle Hospital/Charite, Berlin, Germany; Univ Hosp, Erlangen, Germany; Practice of Hematology-Oncology, Offenbach, Germany; Hosp Kuechwald, Chemnitz, Germany; Klin Nord, Nuernberg, Germany; Univ of Schleswig-Holstein, Kiel, Germany
| | - W. Hiddemann
- Univ Hosp Grosshadern/LMU, Munich, Germany; Robert Rössle Hospital/Charite, Berlin, Germany; Univ Hosp, Erlangen, Germany; Practice of Hematology-Oncology, Offenbach, Germany; Hosp Kuechwald, Chemnitz, Germany; Klin Nord, Nuernberg, Germany; Univ of Schleswig-Holstein, Kiel, Germany
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Forstpointner R, Hänel A, Repp R, Hermann S, Metzner B, Pott C, Hartmann F, Rothmann F, Böck HP, Wandt H, Unterhalt M, Hiddemann W. [Increased response rate with rituximab in relapsed and refractory follicular and mantle cell lymphomas -- results of a prospective randomized study of the German Low-Grade Lymphoma Study Group]. Dtsch Med Wochenschr 2002; 127:2253-8. [PMID: 12397539 DOI: 10.1055/s-2002-35017] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [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: 10/27/2022]
Abstract
BACKGROUND AND OBJECTIVE Rituximab has shown a high activity in relapsed follicular lymphomas when given alone. Further on, phase-II-studies indicate that its addition to chemotherapy may improve the response rate substantially. However, so far, prospective randomized studies have not been available. PATIENTS AND METHODS In 1998 the GLSG started a multicenter trial in patients with relapsed or refractory indolent lymphoma or mantle cell lymphoma. A fludarabine-containing regimen (FCM) was chosen for salvage therapy, with fludarabine 25 mg/m(2)/d 1-3, cyclophosphamide 200 mg/m(2) d 1-3 and mitoxantrone 8 mg/m(2) d 1. A total of four courses, every 4 weeks were given. Patients were prospectively randomized for FCM alone or the immunochemotherapy with R-FCM (375 mg/m(2) one day before FCM) RESULTS: About 147 randomized patients 93 had follicular, 40 mantle cell and 14 lymphoplasmocytic/-cytoid lymphoma. Statistical analysis was performed by sequential testing and indicated for 94 fully evaluable patients a significant advantage for the R-FCM-arm, with an overall response rate of 83 % as compared to 58%, when treated with FCM alone (CR: 35 % vs. 13 %). Similar improvements of remission rate were detected in the different lymphoma subgroups, especially in MCL (OR: 65 % vs. 33 %). Both treatment options were associated with hematological toxicities of grade III and IV, but well tolerated; infectious complications were rare, with no difference between the two treatment groups. CONCLUSION This prospectively randomized trial demonstrates for the first time a significant improvement of the combined immunochemotherapy related to the remission rate in patients with relapsed or refractory indolent lymphoma.
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MESH Headings
- Adult
- Aged
- Antibodies, Monoclonal/administration & dosage
- Antibodies, Monoclonal/therapeutic use
- Antibodies, Monoclonal, Murine-Derived
- Antimetabolites/administration & dosage
- Antineoplastic Agents/administration & dosage
- Antineoplastic Agents/therapeutic use
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Combined Modality Therapy
- Female
- Humans
- Immunosuppressive Agents/administration & dosage
- Immunotherapy
- Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy
- Lymphoma, Follicular/drug therapy
- Lymphoma, Mantle-Cell/drug therapy
- Lymphoma, Non-Hodgkin/drug therapy
- Male
- Middle Aged
- Mitoxantrone/administration & dosage
- Recurrence
- Remission Induction
- Retrospective Studies
- Rituximab
- Time Factors
- Vidarabine/administration & dosage
- Vidarabine/analogs & derivatives
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Affiliation(s)
- R Forstpointner
- Medizinische Klinik und Poliklinik III, Grosshadern, Klinikum der Universität München, Germany.
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10
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Stemmler HJ, Gutschow K, Sommer H, Malekmohammadi M, Kentenich CH, Forstpointner R, Geuenich S, Bischoff J, Hiddemann W, Heinemann V. Weekly docetaxel (Taxotere) in patients with metastatic breast cancer. Ann Oncol 2001; 12:1393-8. [PMID: 11762809 DOI: 10.1023/a:1012557528952] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.0] [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: 11/12/2022] Open
Abstract
BACKGROUND Docetaxel (Taxotere) has demonstrated high antitumour activity in first- and second-line treatment of metastatic breast cancer. This study analysed the efficacy and toxicity of docetaxel given weekly. PATIENTS AND METHODS Thirty-five patients with metastatic breast cancer received docetaxel, 35 mg/m2 weekly for six weeks, followed by two weeks without treatment. Additional cycles (three weeks' treatment, two weeks' rest) were given until disease progression. All patients had received prior chemotherapy: 32 and 5 patients had received prior anthracycline-containing and taxane-containing regimens, respectively. Docetaxel was administered for a total of 359 doses (median 9. range 6-22). RESULTS There was one complete response (3%), 11 partial responses (31%), 17 patients with stable disease (49%) and six with disease progression (17%). Overall response rate was 34% (95% confidential interval (95% CI): 18%-51). Median survival was 307 days; median progression-free survival was 2.6 months (range 1.5 to > or = 5.5 months). Three patients showed grade 3 neutropenia. 14 showed grade 3 alopecia, and various grade 1-2 non-haematological toxicities were observed. Treatment was delayed in two patients due to haematotoxicity. and stopped in one patient due to painful nail toxicity. CONCLUSION Weekly administration of docetaxel at a dose of 35 mg/m2 is effective and of low toxicity in patients with metastatic breast cancer.
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Affiliation(s)
- H J Stemmler
- Department of Internal Medicine III Klinikum Grosshadern, University of Munich Germany
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11
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Forstpointner R, Braunschweig R, Meißner H, Lang N, Kühl M, Schalhorn A. Embolization in an Adrenocortical Carcinoma as Palliative Therapy. Oncol Res Treat 2000. [DOI: 10.1159/000027030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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12
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Tischer J, Forstpointner R, Lohse P, Hiller E. [47-year-old patient with resistant pulmonary embolism in congenital hemodynamic disorder]. Internist (Berl) 2000; 41:61-5. [PMID: 10663080 DOI: 10.1007/s001080050009] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- J Tischer
- Medizinische Klinik III, Klinikum Grosshadern der Ludwig-Maximilians-Universität, München
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13
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Abstract
The authors report a case of blood-borne bilateral metastatic breast disease of alveolar rhabdomyosarcoma (RMS) in a 21-year-old patient. The possibilities of mammography, ultrasound, and MRI in the early detection of breast metastases and their appearance on these modalities are discussed. Whereas mammography rendered no additional information due to dense breast parenchyma and ultrasound showed only a solitary tumor without definite criteria of malignancy, multifocal bilateral spread was verified with MRI and early ring-like enhancement suggested malignancy. Therefore, we conclude that MRI may provide useful information in evaluating patients with sarcomas, even when there is no clinical evidence for metastatic disease of the breast.
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Affiliation(s)
- C Perlet
- Institute of Diagnostic Radiology, Klinikum Grosshadern, LMU-Munich, Marchioninistrasse 15, D-81377 Munich, Germany
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14
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Gerl A, Forstpointner R, Schalhorn A, Munker R, Prenninger S, Wilmanns W. [Septic temperatures and throat pain in a patient with hyperthyroidism]. Internist (Berl) 1990; 31:599-601. [PMID: 2242985] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- A Gerl
- Medizinsche Klinik III, Klinikum Grosshadern, Universität München
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15
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Gutensohn W, Kummer U, Forstpointner R. Production and properties of monoclonal antibodies against human ecto-5'-nucleotidase. Adv Exp Med Biol 1986; 195 Pt B:385-9. [PMID: 3020912 DOI: 10.1007/978-1-4684-1248-2_61] [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] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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