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Eyre TA, Phillips EH, Linton KM, Arumainathan A, Kassam S, Gibb A, Allibone S, Radford J, Peggs K, Burton C, Stewart G, LeDieu R, Booth C, Osborne WL, Miall F, Eyre DW, Ardeshna KM, Collins GP. Results of a multicentre UK-wide retrospective study evaluating the efficacy of brentuximab vedotin in relapsed, refractory classical Hodgkin lymphoma in the transplant naive setting. Br J Haematol 2017; 179:471-479. [PMID: 28857136 DOI: 10.1111/bjh.14898] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2017] [Accepted: 07/18/2017] [Indexed: 11/29/2022]
Abstract
Relapsed or refractory classical Hodgkin lymphoma (cHL) is associated with a poor outcome when standard chemotherapy fails. Brentuximab vedotin (BV) is an anti-CD30 monoclonal antibody-drug conjugate licensed for use at relapse after autologous stem cell transplant (ASCT) or following two prior therapies in those unsuitable for ASCT. There are limited data assessing the ability of BV to enable curative SCT. We performed a UK-wide retrospective study of 99 SCT-naïve relapsed/refractory cHL. All had received 2 prior lines and were deemed fit for transplant but had an insufficient remission to proceed. The median age was 32 years. Most had nodular sclerosis subtype, Eastern Cooperative Oncology Group performance status 0-1 and advanced stage disease. The median progression-free survival (PFS) was 5·6 months and median overall survival (OS) was 37·2 months. The overall response rate was 56% (29% complete response; 27% partial response). 61% reached SCT: 34% immediately post-BV and 27% following an inadequate BV response but were salvaged and underwent deferred SCT. Patients consolidated with SCT had a superior PFS and OS to those not receiving SCT (P < 0·001). BV is an effective, non-toxic bridge to immediate SCT in 34% and deferred SCT in 27%. 39% never reached SCT with a PFS of 3·0 months, demonstrating the unmet need to improve outcomes in those unsuitable for SCT post-BV.
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Affiliation(s)
- Toby A Eyre
- Department of Haematology, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Elizabeth H Phillips
- Department of Haematology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Kim M Linton
- Department of Medical Oncology, The Christie Hospital NHS Trust, Manchester, UK
| | | | - Shireen Kassam
- Department of Haematology, Kings College London Hospitals NHS Foundation Trust Denmark Hill, London, UK
| | - Adam Gibb
- Department of Medical Oncology, The Christie Hospital NHS Trust, Manchester, UK
| | - Suzanne Allibone
- Department of Medical Oncology, The Christie Hospital NHS Trust, Manchester, UK
| | - John Radford
- Department of Medical Oncology, The Christie Hospital NHS Trust, Manchester, UK
| | - Karl Peggs
- Department of Haematology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Cathy Burton
- Department of Haematology, Leeds Teaching Hospital NHS Trust, Leeds, UK
| | - Gillian Stewart
- Department of Haematology, Leeds Teaching Hospital NHS Trust, Leeds, UK
| | - Rifca LeDieu
- Department of Haematology, St Bartholomew's Hospital, London, UK
| | - Catherine Booth
- Department of Haematology, St Bartholomew's Hospital, London, UK
| | - Wendy L Osborne
- Department of Haematology, Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Fiona Miall
- Department of Haematology University Hospitals of Leicester NHS Trust, Leicester, UK
| | - David W Eyre
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Kirit M Ardeshna
- Department of Haematology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Graham P Collins
- Department of Haematology, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
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Sekhar M, Narat S, LeDieu R, Luqmani A, Hollamby S, Alobaidi M, Hughes G. MAJOR OBSTETRIC HAEMORRHAGE IN LATE TERMINATION OF PREGNANCY. J Thromb Haemost 2007. [DOI: 10.1111/j.1538-7836.2007.tb02765.x] [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: 11/28/2022]
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Sekhar M, Narat S, LeDieu R, Luqmani A, Hollamby S, Alobaidi M, Hughes G. MAJOR OBSTETRIC HAEMORRGHAGE IN LATE TERMINATION OF PREGNANCY. J Thromb Haemost 2007. [DOI: 10.1111/j.1538-7836.2007.tb02952.x] [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: 11/29/2022]
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Smith J, Goldsmith C, Ward A, LeDieu R. IGF-II ameliorates the dystrophic phenotype and coordinately down-regulates programmed cell death. Cell Death Differ 2000; 7:1109-18. [PMID: 11139285 DOI: 10.1038/sj.cdd.4400738] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Duchenne muscular dystrophy (DMD) is a fatal and crippling disease of skeletal muscle which displays increased fibre turnover and elevated levels of programmed cell death (PCD) in muscle stem cells. Previously we showed that this cell death is inhibited by the growth factor IGF-II. To determine the functional significance of PCD to the dystrophic phenotype, we used a transgene to over-express IGF-II in the mdx mouse. We found that ectopic expression of IGF-II inhibited the elevated PCD observed in skeletal muscles in the absence of functional dystrophin and significantly ameliorates the early gross histopathological changes in skeletal muscles characteristic of the dystrophic phenotype. Replacement of the dystrophin gene abolished abnormal skeletal muscle cell PCD levels in vivo in a dose-dependent manner and in dystrophic SMS cell lines cultured in vitro. Thus elevation of stem cell PCD in dystrophic skeletal muscle is a direct consequence of the loss of functional dystrophin. Together these data demonstrate that elevated skeletal muscle cell PCD is a critical component of dystrophic pathology and is inversely correlated with both dystrophin gene dosage and with muscle fibre pathology. Targeting PCD in dystrophic muscles reduces both PCD and the classical features of dystrophic pathology in the mdx mouse suggesting that IGF-II is a strong candidate for therapeutic intervention in the dystrophinopathies.
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MESH Headings
- Animals
- Apoptosis
- Cell Line
- Disease Models, Animal
- Dystrophin/genetics
- Dystrophin/metabolism
- Female
- Gene Dosage
- Humans
- In Situ Hybridization
- Insulin-Like Growth Factor II/genetics
- Insulin-Like Growth Factor II/metabolism
- Male
- Mice
- Mice, Inbred mdx
- Muscle, Skeletal/pathology
- Muscle, Skeletal/physiology
- Muscular Dystrophy, Animal/genetics
- Muscular Dystrophy, Animal/pathology
- Muscular Dystrophy, Animal/physiopathology
- Muscular Dystrophy, Duchenne/genetics
- Muscular Dystrophy, Duchenne/pathology
- Muscular Dystrophy, Duchenne/physiopathology
- Phenotype
- Stem Cells/pathology
- Transfection
- Transgenes
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Affiliation(s)
- J Smith
- School of Biosciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
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