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Ringeleviciute U, Cernauskiene S, Zucenka A, Pileckyte R, Griskevicius L. TEMOZOLOMIDE, ETOPOSIDE, DOXIL, DEXAMETHASONE, IBRUTINIB AND RITUXIMAB FOR THE TREATMENT OF RELAPSED OR REFRACTORY CENTRAL NERVOUS SYSTEM LYMPHOMA IN CLINICAL PRACTICE. Hematol Oncol 2021. [DOI: 10.1002/hon.34_2881] [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] [Indexed: 11/11/2022]
Affiliation(s)
- U Ringeleviciute
- Vilnius University Hospital Santaros Klinikos, Hematology, Oncology and Trasfusion Medicine Center Vilnius Lithuania
| | - S Cernauskiene
- Vilnius University Hospital Santaros Klinikos, Hematology, Oncology and Trasfusion Medicine Center Vilnius Lithuania
| | - A Zucenka
- Vilnius University Hospital Santaros Klinikos, Hematology, Oncology and Trasfusion Medicine Center Vilnius Lithuania
| | - R Pileckyte
- Vilnius University Hospital Santaros Klinikos, Hematology, Oncology and Trasfusion Medicine Center Vilnius Lithuania
| | - L Griskevicius
- Vilnius University Hospital Santaros Klinikos, Hematology, Oncology and Trasfusion Medicine Center Vilnius Lithuania
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Zucenka A, Maneikis K, Pugaciute B, Ringeleviciute U, Dapkeviciute A, Davainis L, Daukelaite G, Burzdikaite P, Staras V, Griskevicius L. Glasdegib in combination with low-dose Cytarabine for the outpatient treatment of relapsed or refractory acute myeloid leukemia in unfit patients. Ann Hematol 2021; 100:1195-1202. [PMID: 33661333 PMCID: PMC7930524 DOI: 10.1007/s00277-021-04471-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 02/18/2021] [Indexed: 12/19/2022]
Abstract
We retrospectively collected clinical data on 31 relapsed or refractory acute myeloid leukemia (R/R AML) patients who were treated with outpatient glasdegib and low-dose Cytarabine (LDAraC) at our institution. The median age was 67 years (45–86). The median Eastern Cooperative Oncology Group performance status was 2 (1–3). The patients had previously received a median number of 2 (1–4) treatment lines, 61% (19/31) had been treated with intensive chemotherapy, 29% (9/31) had relapsed after allogeneic stem cell transplantation, and 45% (14/31) had had venetoclax exposure. Adverse cytogenetics were identified in 45% (14/31) of the cases. The CR + CRp rate was 21% (6/29) among evaluable patients. The median overall survival was 3.9 months for all patients. Different median overall survival times were observed in responders, patients achieving stable disease and those diagnosed with progressive disease: not reached vs 3.9 months vs 0.8 months, respectively (p < 0.001). The most common adverse events were pneumonia (29%, 9/31), sepsis (23%, 7/31), and febrile neutropenia (16%, 5/31). Glasdegib + LDAraC is a fairly safe, non-intensive, outpatient regimen inducing complete remission and resulting in prolonged survival in some R/R AML patients.
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Affiliation(s)
- Andrius Zucenka
- Faculty of Medicine, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania.
- Bone Marrow Transplantation Department, Hematology, Oncology and Transfusion Medicine Center, Vilnius University Hospital Santaros Klinikos, 08661, Vilnius, Lithuania.
| | - Kazimieras Maneikis
- Bone Marrow Transplantation Department, Hematology, Oncology and Transfusion Medicine Center, Vilnius University Hospital Santaros Klinikos, 08661, Vilnius, Lithuania
| | - Birute Pugaciute
- Bone Marrow Transplantation Department, Hematology, Oncology and Transfusion Medicine Center, Vilnius University Hospital Santaros Klinikos, 08661, Vilnius, Lithuania
| | - Ugne Ringeleviciute
- Bone Marrow Transplantation Department, Hematology, Oncology and Transfusion Medicine Center, Vilnius University Hospital Santaros Klinikos, 08661, Vilnius, Lithuania
| | - Austeja Dapkeviciute
- Bone Marrow Transplantation Department, Hematology, Oncology and Transfusion Medicine Center, Vilnius University Hospital Santaros Klinikos, 08661, Vilnius, Lithuania
| | - Linas Davainis
- Bone Marrow Transplantation Department, Hematology, Oncology and Transfusion Medicine Center, Vilnius University Hospital Santaros Klinikos, 08661, Vilnius, Lithuania
| | - Guoda Daukelaite
- Faculty of Medicine, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania
| | - Paulina Burzdikaite
- Faculty of Medicine, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania
| | - Vytautas Staras
- Bone Marrow Transplantation Department, Hematology, Oncology and Transfusion Medicine Center, Vilnius University Hospital Santaros Klinikos, 08661, Vilnius, Lithuania
| | - Laimonas Griskevicius
- Faculty of Medicine, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania
- Bone Marrow Transplantation Department, Hematology, Oncology and Transfusion Medicine Center, Vilnius University Hospital Santaros Klinikos, 08661, Vilnius, Lithuania
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Maneikis K, Ringeleviciute U, Bacevicius J, Dieninyte-Misiune E, Burokaite E, Kazbaraite G, Monika Janusaite M, Dapkeviciute A, Zucenka A, Peceliunas V, Kryzauskaite L, Kasiulevicius V, Ringaitiene D, Zablockiene B, Zvirblis T, Marinskis G, Jancoriene L, Griskevicius L. Mitigating arrhythmia risk in Hydroxychloroquine and Azithromycin treated COVID-19 patients using arrhythmia risk management plan. Int J Cardiol Heart Vasc 2020; 32:100685. [PMID: 33335973 PMCID: PMC7734220 DOI: 10.1016/j.ijcha.2020.100685] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 08/09/2020] [Revised: 11/03/2020] [Accepted: 11/23/2020] [Indexed: 12/27/2022]
Abstract
Aims To assess cardiac safety in COVID-19 patients treated with the combination of Hydroxychloroquine and Azithromycin using arrhythmia risk management plan. Methods and results We retrospectively examined arrhythmia safety of treatment with Hydroxychloroquine and Azithromycin in the setting of pre-defined arrhythmia risk management plan. The data was analyzed using R statistical package version 4.0.0. A two-tailed p-value<0.05 was considered significant. 81 patients were included from March 23rd to May 10th 2020. The median age was 59 years, 58.0% were female. The majority of the study population (82.7%) had comorbidities, 98.8% had radiological signs of pneumonia. Fourteen patients (17.3%) experienced QTc ≥ 480 ms and 16 patients (19.8%) had an increase of QTc ≥ 60 ms. Seven patients (8.6%) had QTc prolongation of ≥ 500 ms. The treatment was discontinued in 4 patients (4.9%). None of the patients developed ventricular tachycardia. The risk factors significantly associated with QTc ≥ 500 ms were hypokalemia (p = 0.032) and use of diuretics during the treatment (p = 0.020). Three patients (3.7%) died, the cause of death was bacterial superinfection with septic shock in two patients, and disseminated intravascular coagulation with multiple organ failure in one patient. None of these deaths were associated with cardiac arrhythmias. Conclusion We recorded a low incidence of QTc prolongation ≥ 500 ms and no ventricular tachycardia events in COVID-19 patients treated with Hydroxychloroquine and Azithromycin using cardiac arrhythmia risk management plan.
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Affiliation(s)
- Kazimieras Maneikis
- Hematology, Oncology and Transfusion Medicine Centre, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania.,Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Ugne Ringeleviciute
- Hematology, Oncology and Transfusion Medicine Centre, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania.,Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Justinas Bacevicius
- Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.,Centre of Cardiology and Angiology, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Egle Dieninyte-Misiune
- Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.,Center of Infectious Diseases, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Emilija Burokaite
- Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.,Center of Infectious Diseases, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Gintare Kazbaraite
- Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.,Center of Infectious Diseases, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Marta Monika Janusaite
- Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.,Center of Infectious Diseases, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Austeja Dapkeviciute
- Hematology, Oncology and Transfusion Medicine Centre, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania.,Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Andrius Zucenka
- Hematology, Oncology and Transfusion Medicine Centre, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania.,Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Valdas Peceliunas
- Hematology, Oncology and Transfusion Medicine Centre, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania.,Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Lina Kryzauskaite
- Hematology, Oncology and Transfusion Medicine Centre, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania.,Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Vytautas Kasiulevicius
- Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Donata Ringaitiene
- Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.,Anesthesiology, Intensive Care and Pain Management Centre, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Birute Zablockiene
- Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.,Center of Infectious Diseases, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Tadas Zvirblis
- Hematology, Oncology and Transfusion Medicine Centre, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Germanas Marinskis
- Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.,Centre of Cardiology and Angiology, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Ligita Jancoriene
- Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.,Center of Infectious Diseases, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Laimonas Griskevicius
- Hematology, Oncology and Transfusion Medicine Centre, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania.,Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
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Samuolis N, Samalavicius NE, Dulskas A, Markelis R, Lunevicius R, Mickys U, Ringeleviciute U. Surgical or endoscopic management of malignant colon polyps. ANZ J Surg 2018; 88:E824-E828. [PMID: 30347496 DOI: 10.1111/ans.14846] [Citation(s) in RCA: 2] [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] [Received: 02/19/2018] [Revised: 06/16/2018] [Accepted: 08/05/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND To evaluate indications for colectomy in T1 polyps and possible risk factors for lymph node metastasis. METHODS Between 2004 and 2017, 40 patients underwent colectomy after endoscopic removal of malignant polyps with T1 carcinoma. Resection was done based on at least one of the unfavourable histopathological criteria. We collected and prospectively studied histopathologic features, short-term results and the benefit-risk balance. Complications were assessed by Clavien-Dindo classification. RESULTS Twenty-five patients (62.5%) underwent laparoscopic bowel resection. Twenty-nine patients (63.0%) had more than two unfavourable criteria in the polyp that justified colorectal resection. Thirty-five patients (76%) had G2 (moderately differentiated) cancer, 11 (24%) had G1 (well-differentiated). Five patients (12.5%) had lymph node metastases and one (2.5%) had residual adenocarcinoma. All five patients with lymph node metastasis had G2 cancer. Nine patients (22.5%) had residual adenoma. Overall complications were identified in six (15.0%) patients. Oncologic benefit (or risk factors for lymph node metastasis) was significantly associated with polyp size ≥18 mm (P = 0.006), lymphovascular invasion (P = 0.05) and budding (P = 0.02). CONCLUSIONS Female gender, lymphovascular invasion, desmoplastic reaction, criteria for surgery ≥2 and polyp size ≥18 mm were all in complex significant risk factors for lymph node metastasis in T1 colorectal cancer. Acting as a single factor, these variables had no effect to increased risk of metastasis.
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Affiliation(s)
- Nikas Samuolis
- Department of Surgery, Ukmerge Hospital, Ukmerge, Lithuania
| | - Narimantas E Samalavicius
- Department of Surgery, Klaipeda University Hospital, Klaipeda, Lithuania.,Department of General and Abdominal Surgery and Oncology, Faculty of Medicine, Clinic of Internal, Family Medicine and Oncology, National Cancer Institute, Vilnius, Lithuania
| | - Audrius Dulskas
- Department of General and Abdominal Surgery and Oncology, Faculty of Medicine, Clinic of Internal, Family Medicine and Oncology, National Cancer Institute, Vilnius, Lithuania.,Department of General and Abdominal Surgery and Oncology, National Cancer Institute, Vilnius, Lithuania.,Faculty of Health Care, University of Applied Sciences, Vilnius, Lithuania
| | - Rytis Markelis
- Department of Surgery, Hospital of Oncology, Hospital of Lithuanian University of Health Sciences Kaunas Clinics, Kaunas, Lithuania
| | - Raimundas Lunevicius
- General Surgery Department, Aintree University Hospital NHS Foundation Trust, University of Liverpool, Liverpool, UK
| | - Ugnius Mickys
- National Center of Pathology, Affiliate of Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
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